JPH0422750Y2 - - Google Patents

Description

[Detailed description of the invention] "Field of industrial application" The present invention relates to a medical low-pressure suction and evacuation device, and particularly relates to a medical low-pressure suction and evacuation device used to expel liquid and gas from body cavities such as the chest of the human body. .

``Prior Art'' Conventionally, as a low-pressure medical suction and discharge device of this type, an underwater discharge device described in Japanese Patent Publication No. 13913/1983 has been proposed.

That is, as shown in FIGS. 1 to 3, this underwater discharge device
A suction pressure adjustment section 3 having a manometer chamber 2 that accommodates the human body is formed integrally with the suction pressure adjustment section 3, and is partitioned from the manometer chamber 2 at required intervals by a partition wall 4 extending from the bottom wall, and is separated from the atmosphere by a human body. A water seal section 6 having a water seal chamber 5 that can contain water W2 to prevent air from flowing into the thoracic cavity of the patient, and both the water seal chamber 5 of the water seal section and the manometer chamber 2 of the suction pressure adjustment section. A suction port 7 is provided at an appropriate location on the upper wall that forms the upper space where the chambers communicate and communicates with the suction source via a connecting tube, and a manometer is provided in case the intrathoracic cavity suddenly becomes positive pressure due to factors such as coughing. A valve device 8 is provided on the side wall of the water-sealed chamber 5 at a position close to the upper part of the water-sealed chamber 5 to prevent the water W1 in the chamber 2 from flowing out to the outside, and a valve device 8 is formed integrally with the water-sealed portion 6 and is connected to the water-sealed chamber. 5 is a drain which is partitioned by a partition wall 9 extending from the bottom wall, has an inlet 11 communicating with the chest of the human body via a connecting tube 10, and has a collection chamber 12 capable of storing fluid W3 discharged from the thoracic cavity. It was composed of a liquid amount measuring section 13.

In the above configuration, when a suction pump (not shown) serving as a suction source is activated, the air existing above the water surface in both the manometer chamber 2 and the water-sealed chamber 5 is sucked out from the suction port 7 to the suction source. The pressure in chambers 2 and 5 immediately becomes negative. Then, as shown in FIG. 1, the water level on the large volume side of the water W1 for suction pressure adjustment, which is injected to set an arbitrary suction pressure in the manometer chamber 2 of the suction pressure adjustment section 3, is on the right side in the drawing. On the other hand, the water level on the small volume side, which is on the left side in the drawing, falls due to atmospheric pressure and reaches the lower end of the hanging bulkhead 14 of the manometer chamber 2. In this way, when the water level existing on the side of the intake hole 1 of the manometer chamber 2 reaches the lower end of the hanging bulkhead 14, the water level does not drop any further, and from now on, the air flows from the intake hole 1 into the manometer chamber as shown by the arrow. The water enters the thin tube 2, passes through the water W1 in a foamed state, and is guided to the suction port 7. On the other hand, water W2 in the water seal chamber 5 of the water seal section 6 is symmetrically set to the water level on the left side in the drawing, in a thick pipe partitioned by a hanging bulkhead 15 with an opening at the lower end, symmetrically to the water W1 in the manometer chamber 2. While the water level rises in response to the pressure, the water level in the right thin tube falls to the position of the lower end of the hanging partition wall 15. If the suction pump continues to operate in the state shown in FIG.
The effluent W3 is stored in the collection chamber 12, while the gas enters the thin tube of the water-tight chamber 5 from the collection chamber 12 as shown by the arrow.
The water W2 in the water-sealed chamber 5 passes through in a foamed state and is guided to the suction port 7.

By the way, while suction is being performed at the desired set suction pressure as shown in FIG. When a squeeze operation is performed, a part of the air or gas in the connecting pipe 10 and the collection chamber 12 passes through the water or liquid 2W in the water seal section 6 and is pushed out into the thick pipe in the water seal chamber 5. Similarly, if the patient coughs, connect the connecting tube 10 to the chest cavity.
A part of the gas in the collection chamber 12 passes through the water W2 and flows into the thick pipe of the water-sealed chamber 5.
At this time, if the pressure inside the water-sealed chamber 5 and the manometer chamber 2 becomes positive, the valve of the valve device 8 momentarily opens, and the gas that has flowed into the water-sealed chamber 5 is released into the atmosphere.
As a result, the inside of the patient's thoracic cavity does not rise, and the water W1 in the manometer chamber 2 also does not flow out from the intake hole 1.

However, due to the patient's coughing or milking, a phenomenon occurs in which the patient's intrathoracic pressure immediately becomes a negative pressure stronger than the set suction pressure. That is, FIG. 2 shows a state in which the negative pressure in the thoracic cavity becomes stronger than the set suction pressure due to coughing or milking.To explain specifically based on this figure, the left and right sides of the water W2 in the water seal part 6 are As a result, the water level rising in the right side tube of the water-sealed chamber 5 no longer returns to the lower end of the hanging bulkhead 15 as shown in FIG. The desired set suction pressure and the negative pressure in the patient's thoracic cavity differ by an amount corresponding to the water level h that has risen in the tubule, and the patient continues suctioning in that state.

Therefore, the intrathoracic pressure of the patient at this time is the set suction pressure + the symbol h shown in FIG.

If we elaborate on the reason why the negative pressure in the patient's thoracic cavity is different from the set suction pressure of the submersible evacuation device
Since the volume of 0 becomes significantly smaller, the same amount of negative pressure gas as the reduced volume flows into the water W in the water-tight chamber 5.
2 and is discharged outside the vessel by the valve device 8 or the suction pump. However, after coughing or milking is finished, the volume of the thoracic cavity or the connecting tube 10 returns to its original volume, but the gas discharged outside the device cannot return to the inside of the device or the thoracic cavity, so the connection is made in proportion to the amount of gas discharged. This is because the air pressure within the tube 10 and within the thoracic cavity decreases. Therefore, the water W2 acts as a kind of partition, resulting in a difference in air pressure between the suction pump side and the thoracic cavity side, and therefore, the water in the right tubule of the water-sealed chamber 5 is sucked up. . Therefore, when the suction is stopped, the water W2 in the water seal section 6 fluctuates as shown in FIG.
Although it has the original role of a so-called anti-reflux valve, which is to prevent backflow through the narrow tubes of the body into the collection chamber 12 and the thoracic cavity, it also has the function of causing the negative pressure in the thoracic cavity to differ from the set pressure due to factors such as coughing. This results in a reflex action. Therefore, methods such as devising the structure of the water seal section 6 or reducing the amount of water in the water seal section 6 may be considered in order to reduce such reflex action as much as possible. The original function of preventing backflow will be impaired. If the suction pump stops suctioning, the atmosphere will easily flow back into the patient's thoracic cavity, making it impossible to maintain negative pressure in the thoracic cavity, and as a result, the preservation of the patient's lung function will be compromised. .

"Problems to be Solved by the Present Invention" In view of the above-mentioned conventional drawbacks, the present invention aims to solve the following problems.

Due to factors such as coughing and milking, the set suction pressure of the suction/evacuation device differs from the negative pressure in the patient's thoracic cavity, and when the negative pressure in the thoracic cavity becomes stronger than the set suction pressure, the negative pressure in the thoracic cavity is Must be able to automatically return to the set suction pressure. However, it should not respond to changes in intrathoracic pressure due to patient breathing. The reason for this is that in order to maintain the patient's lung function sufficiently, a negative pressure stronger than the set suction pressure may be required during inspiration.

In the above case, the duration of the negative pressure in the thoracic cavity that differs from the set suction pressure varies depending on the cause of its occurrence. That is, negative pressure different from the set suction pressure generated by coughing or milking continues for a long time, but negative pressure different from the set suction pressure generated by breathing occurs only during inspiration and returns to the set suction pressure during breathing.
Focusing on this difference in duration, the function of the thoracic cavity negative pressure control section is made to work automatically and slowly only when it is longer than one cycle of inspiration and expiration.

To be able to control strong negative pressure in a patient's thoracic cavity while sufficiently maintaining the original function of a backflow prevention valve of a water seal part 6 of a conventional underwater discharge device X.

It is possible to visually read directly the pressure fluctuations in the chest cavity caused by the patient's coughing, breathing, or milking.

This prevents problems such as increased bleeding at the surgical site, suture failure, difficulty breathing due to mediastinal movement, damage to the mediastinum and lung tissue, and discomfort to the patient, which occur when the thoracic cavity is exposed to strong negative pressure for a long period of time. Things that can be prevented.

``Means for Solving the Problems'' The medical low-pressure suction and discharge device of the present invention includes a suction pressure adjustment section having a manometer chamber partitioned by a first hanging partition, and a gas flow connection between the suction pressure adjustment section and the suction pressure adjustment section. A water seal section having a first water seal chamber that communicates with the water seal section and is partitioned by a second hanging partition wall, a drainage volume measurement section that has a collection chamber that communicates with the water seal section in a gas flow manner, and the drainage liquid. It consists of a thoracic cavity negative pressure control unit having a second water-tight chamber that communicates with the volume measuring unit in a gas flow manner, and the second water-tight chamber of the thoracic cavity negative pressure control unit is configured to control the negative pressure in the patient's thoracic cavity. The float stopper has a float that fits into a flow hole formed in the wall of the float stopper so that when the negative pressure becomes stronger than the set suction pressure, the negative pressure in the thoracic cavity can be automatically slowly returned to the set suction pressure. It is characterized by being partitioned into a first chamber and a second chamber having intake and exhaust holes communicating with the first chamber and communicating with the atmosphere.

``Embodiment of the present invention'' The present invention will be described in detail below with reference to an embodiment shown in the drawings.

In the embodiments shown in FIGS. 4 to 13, Y is a medical low-pressure suction and discharge device made of transparent or translucent synthetic resin material for discharging liquid and gas from body cavities such as the chest of the human body. . When compared with the conventional embodiment shown in FIGS. 1 to 3, this low-pressure suction and discharge device Y has the same basic principle except that it does not include the valve device 8.

That is, 20 is a suction pressure adjusting section which has an intake hole 21 communicating with the atmosphere and has a manometer chamber 22 in the lower part which can contain liquid or water for adjusting the suction pressure. The chamber 22 has a hanging partition wall 23 which is appropriately bent from the upper wall and has an opening at the lower end that hangs downward, thereby forming a thin tube (on the left side in the figure) or a small chamber 22a, and a suction port 24 which is connected to the opening at the lower part and a suction source at the upper part. It is partitioned into a thick pipe (on the right side in the figure) or a large chamber 22b that communicates with the main body. Reference numeral 25 denotes a water-tight chamber 26 which is integrally formed to communicate with the suction pressure adjustment unit 20 in a gas flow manner and can contain water W2 to prevent air from flowing back into the patient's chest cavity (not shown) from the atmosphere. The water-sealed chamber 26 of this water-sealed section 25 also has a suction port 2 similar to the manometer chamber.
The large room 2
2b and the suction port 24, and a small chamber 26b on the right side that communicates with the lower end opening at the lower part,
At a position near the upper end of the small chamber 26b, there is a water seal portion 2 that rises rapidly when the patient's thoracic cavity becomes strong negative pressure.
A float 28 is provided to stop the rise of the water level on the right side of 5. Reference numeral 29 denotes a drainage volume measuring device having a collection chamber 31 for storing fluid W3 discharged from the thoracic cavity through a connecting tube 30 which is integrally formed to communicate with the water seal portion 25 in a gas flow manner and is connected to the patient. In the part, the collection chamber 31 of this waste liquid amount measurement part 29 is a waste liquid W.
It is partitioned into a plurality of parts by partition walls 32, 32 having an opening at the upper end so that the storage amount of 3 can be visually measured in detail. 33 is the drainage amount measuring section 29
In this embodiment, it is integrally formed so as to be in gas flow communication with the patient, and when the negative pressure in the patient's thoracic cavity becomes stronger than the set suction pressure due to coughing by the patient or milking of the connecting tube 30, the internal pressure in the thoracic cavity is This thoracic cavity negative pressure control unit has a water-sealed chamber 34 that can return the negative pressure of the thoracic cavity to the set suction pressure. The collection chamber 3 is
1 and the first chamber 34a in gas flow communication through the guide hole 31a, and the first chamber 34a in the lower part through the lower end opening and the atmosphere in the upper part through the intake and exhaust hole 36, respectively. The first chamber is partitioned into a thick tubular second chamber 34b that communicates with the second chamber 34b.
At a position near the lower end of the partition wall 35 at the lower part of the first chamber 34a, as shown in FIGS. 8 and 9, a liquid or water W4 can pass through when the liquid or water W4 rises through the lower part of the first chamber 34a. A horizontal float stopper wall 38 is formed with a water passage hole 37 having a small notch 37a, and a water passage hole 37 is formed in the float stopper wall 38 to close the passage hole 37 during suction. A ball-shaped float 39 that fits into the ball is provided. The fitting relationship between the flow hole 37 of the float stopper wall 38 and the float 39 is such that the water W4 in the water-tight chamber 34 is connected to the first chamber 34a.
In order to be able to rise slowly, for example, in addition to this embodiment, the communication hole 37 is not provided with a notch 37a and the communication hole 37 is made into a non-perfect circular shape, or the float 39 is formed in a perfect circular communication hole. Possible configurations include an ellipsoidal shape. 40 is water W4 in the water-sealed chamber 34 provided in the thoracic cavity negative pressure control unit 33.
The pressure fluctuation display chamber 40 allows you to directly read the pressure fluctuations in the thoracic cavity caused by the patient's inhalation, coughing, and milking by visually observing the rise and fall of the water level. A valve device 41 is provided for stopping the. 42 forms a part of the guide hole, and if water W4 rises through the hole in the upper float stopper wall of the valve device 41,
Even if the water passes through, the water that has passed is returned to the first chamber 34.
This is a guide wall that guides you so that you can fall to the a side.

The operating state of the low-pressure suction and discharge device Y having the above configuration during suction and discharge is almost the same as that of the conventional underwater discharge device X, but as a result of the patient coughing or milking the connecting pipe 30, A difference occurs when the negative pressure in the patient's thoracic cavity differs from the set suction pressure and becomes a strong negative pressure.

That is, as shown in FIG. 6, when a patient coughs, some of the gas in the collection chamber 31 flows into the guide hole 31a.
as a result, the water level in the first chamber 34a of the water-sealed chamber 34 drops to the lower end of the partition wall 35, and at the same time the water level in the first chamber 34a of the water-tight chamber 34 drops to the lower end of the partition wall 35. water level rises. Then, the gas on the water surface in the first chamber 34a passes through the water W4 in the form of bubbles, and reaches the second chamber 34b communicating with the atmosphere as shown by the arrow. Therefore,
In the case of this embodiment as well, as in the valve device 8 of the conventional embodiment, when the intrathoracic pressure of the patient becomes positive,
Because of the positive pressure, the gas present in the collection chamber 31 or the first chamber 34 of the water-tight chamber 34 is transferred to the second chamber 34 of the water-tight chamber 34.
Since the gas is discharged into the chamber 34b, an increase in intrathoracic pressure can be prevented.

However, in the embodiment of the present invention, immediately after the gas is released, the negative pressure in the patient's thoracic cavity is strong by the amount of released gas, that is, the negative pressure in the patient's thoracic cavity is strong by the amount of released gas. If the water level in the small chamber 26b rises, for example, by an amount indicated by the symbol h shown in FIG. 7, and the negative pressure in the patient's thoracic cavity becomes stronger than the set suction pressure, the negative pressure in the thoracic cavity is controlled as shown in FIG. 8. The water W4 in the water-sealed chamber 34 of the section 33 is pushed by atmospheric pressure, and at the same time as the water level in the second chamber 34b falls, the water level in the first chamber 34a begins to rise. The float 39 floats up due to the rising water, and the upper outer circumference of the float 39 is connected to the flow hole 37 of the stopper wall 38.
and are tightly fitted. Float 39 is the flow hole 3
7, the rising water still gradually passes through the notch 37a and rises until the water level in the second chamber 34b reaches the lower end of the partition wall 35, as shown in FIG. In the present invention, the notch 37 is designed so that the rising speed can be increased slowly taking into account the time course of the patient's inhalation and exhalation.
In addition, the amount of water W4 in the water-tight chamber 34 (amount of water injected) is set so that even if the suction pump stops during suction, the inside of the thoracic cavity can be maintained at the same negative pressure as the set suction pressure. It is set. In other words, this invention focuses on the difference between the duration of negative pressure in the patient's thoracic cavity, which differs from the set suction pressure, and the patient's breathing time, and only when the duration is longer than at least one cycle of inspiration and expiration, a watertight chamber is created. The air above the water surface existing in the second chamber 34b of 34 passes through the water W4 as bubbles and enters the first chamber 34a communicating with the collection chamber 31 as shown by the arrow. Therefore, the strong negative pressure inside the thoracic cavity is gradually relieved, and the small chamber 26b of the water seal part 25
The water surface that had been rising inside slowly descends to its original position.

Note that even if the patient's inhalation causes the inside of the thoracic cavity to have a negative pressure stronger than the set suction pressure and the water W4 begins to rise in the first chamber 34a, the descending water level in the second chamber 34b reaches the lower end of the partition wall 35. Before expiration, the patient's thoracic cavity returns to the set suction pressure, so each water level returns to its original position. Therefore, in this case, the negative pressure control function does not work.

"Effects of the Present Invention" As is clear from the above explanation, the present invention has the following excellent effects.

(1) Even if the set suction pressure of the suction and evacuation device differs from the negative pressure in the patient's thoracic cavity due to the patient's cough or milking (squeezing) of the connecting tube, the thoracic cavity negative pressure control unit with a watertight chamber can The negative pressure in the patient's thoracic cavity can be automatically returned to the original set suction pressure.

(2) Using the float 39 that fits with the float stopper wall 38, the thoracic cavity negative pressure control unit functions only when the duration of the strong negative pressure in the thoracic cavity is longer than one cycle of the patient's breathing time. Since it works gradually, the patient's lung function can be maintained reliably and the patient will not feel discomfort.

(3) Since the thoracic cavity is not exposed to strong negative pressure for a long period of time, the following problems that are undesirable for the patient can be prevented.

Increased bleeding or suture failure at the surgical site.

Dyspnea due to mediastinal shift.

Damage to the mediasphragm or lung tissue.

Patient discomfort due to excessive negative pressure.

(4) In the case of an embodiment in which the pressure fluctuation display chamber 40 that can utilize the water W4 stored in the water-sealed chamber 34 is provided in the thoracic cavity negative pressure control section 33, as shown in FIG. By reading the water level in the pressure fluctuation display chamber 40 using the intrathoracic pressure measuring scale 43 written on the surface of the Y container body, it is possible to always directly read the intrathoracic pressure fluctuations caused by the patient's breathing, coughing, and milking.

[Brief explanation of the drawing]

Fig. 1 is a vertical cross-sectional view showing the suction and discharge state during normal suction in a conventional embodiment, and Fig. 2 shows a state in which the inside of the thoracic cavity has become a negative pressure stronger than the set suction pressure in the embodiment of Fig. 1. An explanatory diagram showing. 3 is an explanatory diagram of the embodiment shown in FIG. 1 with the suction pump of the suction source stopped; FIG. 4 is a vertical sectional view showing an embodiment of the present invention; FIG. 5 is a plan view of the present invention; FIG. 6 is an explanatory diagram showing the state at the moment the patient coughs in the embodiment of the present invention. FIG. 7 is an explanatory diagram showing a state in which the negative pressure in the patient's thoracic cavity becomes stronger by sign h than the set suction pressure immediately after coughing in the embodiment of the present invention, and FIG. 8 shows the negative pressure in the thoracic cavity of the present invention. An explanatory diagram showing the rising state of water in the control section, FIG. 9 is a sectional view taken along the line A-A in FIG. 8,
FIG. 10 is an explanatory diagram of a state in which the strong negative pressure within the patient's thoracic cavity is alleviated in the embodiment of the present invention, and FIG. FIG. 3 is an explanatory diagram showing a state in which the internal pressure has returned to the set suction pressure. FIG. 12 is an explanatory diagram showing a state in which the suction pump of the suction source is stopped in the embodiment of the present invention. FIG. 13 is a schematic front view of the present invention. 20... Suction pressure adjustment section, 22... Manometer chamber, 23, 27... Hanging bulkhead, 24... Suction port, 25... Water seal section, 26, 34... Water seal chamber,
28, 39... Float, 29... Drainage amount measuring section, 30... Connecting pipe, 31... Collection chamber, 33...
Thoracic cavity negative pressure control unit, 35... Partition wall, 36... Suction/exhaust hole, 37... Distribution hole, 38... Float stopper wall, 40... Pressure fluctuation display chamber.

Claims (1)

[Scope of utility model registration request] A suction pressure adjustment section 20 having a manometer chamber 22 partitioned by a first hanging partition 23, and a second hanging partition 2 that communicates with the suction pressure adjustment section in a gas flow manner.
A water seal section 25 having a first water seal chamber 26 partitioned by a water seal section 7, a drainage volume measurement section 29 having a collection chamber 31 communicating with the water seal section in a gas flow manner, and this drainage volume measurement section. and a thoracic cavity negative pressure control unit 33 having a second water-sealed chamber 34 communicating with the thoracic cavity in a gas flow manner. A communication hole 3 is formed in a float stopper wall 38 having a notch 37a so that when the negative pressure in the thoracic cavity becomes stronger than the suction pressure, the negative pressure in the thoracic cavity can be automatically slowly returned to the set suction pressure.
a first chamber 34 having a float 39 fitted with 7;
A medical low-pressure suction/exhaust device characterized by being partitioned into a second chamber 34b having an intake/exhaust hole 36 that communicates with the first chamber and communicates with the atmosphere.