NO821215L - Medisinsk instrument. - Google Patents
Medisinsk instrument.Info
- Publication number
- NO821215L NO821215L NO821215A NO821215A NO821215L NO 821215 L NO821215 L NO 821215L NO 821215 A NO821215 A NO 821215A NO 821215 A NO821215 A NO 821215A NO 821215 L NO821215 L NO 821215L
- Authority
- NO
- Norway
- Prior art keywords
- tube
- opening
- instrument according
- pipe
- distal end
- Prior art date
Links
- 239000000523 sample Substances 0.000 claims description 29
- 230000028327 secretion Effects 0.000 claims description 20
- 210000003437 trachea Anatomy 0.000 claims description 12
- 239000003814 drug Substances 0.000 claims description 11
- 210000000867 larynx Anatomy 0.000 claims description 10
- 229940079593 drug Drugs 0.000 claims description 9
- 210000002345 respiratory system Anatomy 0.000 claims description 9
- 210000003238 esophagus Anatomy 0.000 claims description 6
- 235000015097 nutrients Nutrition 0.000 claims description 5
- 241000894006 Bacteria Species 0.000 claims description 3
- 239000000463 material Substances 0.000 claims description 3
- 230000007704 transition Effects 0.000 claims description 2
- 210000000621 bronchi Anatomy 0.000 description 5
- 238000013461 design Methods 0.000 description 5
- 210000000214 mouth Anatomy 0.000 description 5
- 210000003296 saliva Anatomy 0.000 description 4
- 238000003780 insertion Methods 0.000 description 3
- 230000037431 insertion Effects 0.000 description 3
- 238000000034 method Methods 0.000 description 3
- 210000003800 pharynx Anatomy 0.000 description 3
- 230000009747 swallowing Effects 0.000 description 3
- 206010011224 Cough Diseases 0.000 description 2
- 206010002091 Anaesthesia Diseases 0.000 description 1
- 230000006978 adaptation Effects 0.000 description 1
- 230000037005 anaesthesia Effects 0.000 description 1
- 230000000721 bacterilogical effect Effects 0.000 description 1
- 230000000903 blocking effect Effects 0.000 description 1
- 230000002380 cytological effect Effects 0.000 description 1
- 238000003745 diagnosis Methods 0.000 description 1
- 201000010099 disease Diseases 0.000 description 1
- 208000037265 diseases, disorders, signs and symptoms Diseases 0.000 description 1
- 230000002452 interceptive effect Effects 0.000 description 1
- 238000004519 manufacturing process Methods 0.000 description 1
- 238000005259 measurement Methods 0.000 description 1
- 230000002093 peripheral effect Effects 0.000 description 1
- 238000003825 pressing Methods 0.000 description 1
- 238000004080 punching Methods 0.000 description 1
- 230000029058 respiratory gaseous exchange Effects 0.000 description 1
- 238000000926 separation method Methods 0.000 description 1
- 238000007493 shaping process Methods 0.000 description 1
- 238000002627 tracheal intubation Methods 0.000 description 1
- -1 tubes Substances 0.000 description 1
- 238000012795 verification Methods 0.000 description 1
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B10/00—Other methods or instruments for diagnosis, e.g. instruments for taking a cell sample, for biopsy, for vaccination diagnosis; Sex determination; Ovulation-period determination; Throat striking implements
- A61B10/02—Instruments for taking cell samples or for biopsy
- A61B10/04—Endoscopic instruments
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/00064—Constructional details of the endoscope body
- A61B1/00071—Insertion part of the endoscope body
- A61B1/0008—Insertion part of the endoscope body characterised by distal tip features
- A61B1/00098—Deflecting means for inserted tools
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/00147—Holding or positioning arrangements
- A61B1/00154—Holding or positioning arrangements using guiding arrangements for insertion
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/267—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor for the respiratory tract, e.g. laryngoscopes, bronchoscopes
- A61B1/2676—Bronchoscopes
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
- A61M16/04—Tracheal tubes
- A61M16/0488—Mouthpieces; Means for guiding, securing or introducing the tubes
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
Description
Oppfinnelsen gjelder et medisinsk instrument for uttak av tracheobronkialt sekret eller for innføring av medisiner, rør, føringselementer, sonder, endoskoper, katetere og lignende i respirasjonstrakten til en pasient.
Ved diagnosen av intrathorakale sykdommer kan man blant annet gå frem slik at tracheo-bronkialt sekret fra pasienten undersøkes bakteriologisk. Når sekret uttas fra munn- og svelg-rommet, kan det ikke unngås at også endel spytt tas med, slik at det kreves en separering av det tracheo-bronkiale sekretet. Dette kan vanligvis bare gjennomføres i et laboratorium av erfarne personer med tilsvarende omkost-ninger .
Det er imidlertid også umulig å oppsuge tracheo-bronkialt sekret med bronkoskoper eller gjennomføre en transtracheal aspirasjon. Begge disse metoder er dog like-ledes meget kostbare og kan bare gjennomføres av øvede leger. Endelig oppstår det ved-disse metodene også visse risker for pasientene.
Dessuten oppstår ofte problemet å innføre og målrettet å bringe til stede medisiner eller katetere, sonder og liknende i pasientenes luftveier, hvor det f.eks. er nødvendig med et uttak av sekret eller en behandling med medisiner. Forøvrig kan også disse forholdsregler med de til nå kjente teknikker bare gjennomføres av erfarne leger.
Oppfinnelsens oppgave består i å tilveiebringe et instrument som kan fremstilles billig., som er relativt enkelt å anvende og med hvilket tracheobronkialt sekret kan uttas direkte og uten spyttandeler. Videre skal instrumentet være egnet for problemløs og målrettet innføring av medisiner, sonder, katetere og lignende i respirasjonstrakten.
For løsning av denne oppgave formes det innlednings-vis nevnte instrument ifølge oppfinnelsen slik at et gjennom munn- og svelg-rommet til pasienten innførbart, fleksibelt og i tverrsnitt formstabilt rør med en distal fortsettelse, er forskyvbart inn i spiserøret og at røret ovenfor fortsettelsen har en åpning, som ved innført instrument er utrettbar i side-retning på strupehoderommet til pasienten og over hvilket sekret uttas fra, henholdsvis medisiner, rør, sonder, endoskoper, katetere og lignende innføres i pasientens respirasjonstrakt.
I røret kan et samlekar eller en næringsbærer for bakterier forskyves aksialt ved hjelp av et iverksettelses-element, for å bringe en opptaksåpning i samlekaret i overdekning med røråpningen, hvorved samlekaret er kombinert med en lukkeanordning, som avdekker røråpningen så snart samlekaret forskyves langt utenfor røråpningen. Når åpningen til samlekaret og åpningen til røret befinner seg i overdekning og begge åpninger er utrettet på strupehoderommet, kan pasienten fås til å hoste, for å bringe tracheobronkialt sekret i samlebeholderen. Deretter kan samlebeholderen trekkes ut av røret og det sekret som befinner seg i samlekaret undersøkes.
Videre kan røret være utstyrt med en rampe, som strekker seg i området av den nevnte røråpning fra røréts baksideveggområde ovenfra skrått forover og ned og skaffer en jevn overgang til den nedre distale ende av røråpningen, slik at et proksimalt i røret innført kateter, et inner-rør, et føringselement, en sonde, et fleksibelt endoskop eller lignende kan skyves over rampen inn i luftrøret. På denne måten kan eksempelvis en medisin målrettet bringes til det stedet en behandling trenges, eksempelvis ved hjelp av et kateter som er innført i luftrøret eller en på tilsvarende måte innført sonde. På den annen side kan det oppsuges sekret med kateteret henholdsvis med sonden på tilfeldige steder i respirasjonstrakten.
Ytterligere kjennetegn ved instrumentet ifølge oppfinnelsen vil fremgå av den etterfølgende beskrivelse av noen utførelseseksempler, som er vist forenklet og skjematisk i den medfølgende tegning. Det vises i: Figurene 1 til 4 et første utførelseseksempel på et instrument ifølge oppfinnelsen i lengdesnitt, Figurene 5 til 8 et andre utførelseseksempel på et instrument ifølge oppfinnelsen i lengdesnitt, Figurene 9 til 14 et tredje utførelseseksempel på et instrument ifølge oppfinnelsen i lengdesnitt, Figur 15 et instrument ifølge oppfinnelsen sett
forfra som fjerde utførelseseksempel,
Figur 16 tverrsnittet A - A gjennom instrumentet
ifølge figur 15 og
Figur 17 det delvise lengdesnittet B - B gjennom
instrumentet i figur 15.
Det instrument som er vist i figurene 1 til 4, består av et fleksibelt, men i tverrsnittet formstabilt, rør 1, som kan innføres i munnhulen og svelget til pasienten, og som på sin distale ende har ansluttet en fortsettelse 2, som eventuelt er avtrappet med minsket diameter. Når det gjelder denne fortsettelse kan det eksempelvis dreie seg om en ca. 10 cm lang slange med lukket ende av mykt, meget bøyelig materiale, som f.eks. myk gummi eller myk plast. Den distale ende av røret med fortsettelsen 2 innføres i spiserøret ved hjelp av tilsvarende svelgebevegelser av pasienten, som det er vist i sammenheng med andre utførelseseksempler i figurene 5 og 9. Forøvrig skal røret 1 hensiktsmessig være bøyd tilsvarende det anatomiske forløp av munn- og svelg-rommet.
Røret 1 med en lengde på eksempelvis 25 cm er i en avstand på ca. 5 cm fra sin distale ende på den konkave side utstyrt med en oval åpning 4, hvis største hovedakse er parallell med rørets 1 lengdeakse. Denne åpning 4 kan lukkes ved hjelp av en lukkeanordning 5 som er tilpasset til inner-diameteren i røret 1, og som er forskyvbar i røret ved hjelp av en tråd 6. Til lukkeanordningen 5 anslutter seg på den distale ende en næringsbærer eller et løsbart samlekar 7 med eller uten næring for bakterier, som er åpent på siden mot
åpningen 4. Med lukket åpning 4 innføres røret 1 med den distale delen og fortsettelsen 2 i spiserøret 3 (figur 1), hvorpå lukkeanordningen 5 med samlebeholderen 7 forskyves mot rørets 1 distale ende og røret 1 forskyves så langt at åpningen 4
befinner seg i overdekning med strupehoderommet til pasienten
(figur 2). Dette kan den behandlende lege enkelt fastslå ved at han lar pasienten puste ut med lukket munn, slik at i angjeldende tilfelle åndningsluft bare kommer inn i røret 1 gjennom åpningen 4 og vil strømme ut proksimalt, noe som kan merkes akustisk.
Da lengden til lukkeanordningen 5 og også lengden til den åpne siden til samlebeholderen 7 er kjent, kan i til-slutning disse to delene 5, 7 forskyves i proksimal retning i røret 1 i en bestemt strekning, til den åpne siden hhv. åpningen til samlebeholderen 7 dekker åpningen 4 (figur 3).
Nå kan pasienten fås til å hoste eller puste kraftig ut, for å bringe tracheobronkialt sekret inn i samlebeholderen 7. Deretter lukkes åpningen 4 igjen, slik det vises i figur 4, slik at røret 1 med lukkeanordningen 5 og samlebeholderen .7 endelig kan trekkes ut av pasienten. Det sekret som befinner seg i samlebeholderen kan så underkastes bakteriologisk eller zytologisk undersøkelse. Av betydning er det at hverken ved innføring eller ved uttrekning av instrumentetet kan spytt komme inn i samlebeholderen 7, slik at ved de beskrevne forholdsregler • viB-ibare tracheobronkialt sekret uten andre bestand-deler stilles til disposisjon.
Ved det utførelseseksempel som vises i figurene 5
til 8 anvendes det også et rør 1 av den foran beskrevne type med en fortsettelse 2 og en åpning 4. Dette rør 1 er imidlertid utstyrt med en rampe 9 i området for den langstrakt ovale åpning 4, som forløper ovenfra og på skrå forover og ned utgående fra den bakre rørveggen og jevnt over i den fjerne ende av åpningen 4, slik det best kan sees i figur 6. Rampen 9 kan eksempelvis enkelt fremstilles ved at det fra den bakre rør-veggen, utskilles en lapp, som så tilsvarende formen på rampen 9 avbøyes forover og ligger på den distale omkrets av åpningen 4.
I røret 1 innføres også her. ved hjelp av en tråd 6a en lukkeanordning 10 for avsperring av åpningen 4. Denne lukkeanordning er tilpasset til forløpet av rampen 9 med sin distale ende (figur 5). Det således forberedte rør 1 med den lukkede åpning 4 innføres igjen over munn- og svelg-rommet med den distale ende og fortsettelsen 2 i spiserøret 3, og på en slik måte at åpningen 4 ligger på den distale ende av strupehoderommet (figur 5). Etter at lukkeanordningen 10 er trukket ut av røret 1, trekkes røret 1 så langt ut at røråpningen 4 befinner seg i overdekning med strupehoderommet 8 (figur 6).. Denne stilling kan legen lett erkjenne, idet han lar pasienten puste ut. Deretter innskyves en slangesonde 11 i røret 1 fra den proksimale ende,.som av rampen 9 avledes i sideretningen og endelig kommer til luftrøret 12 (figur 7).
Gjennom denne sonden 11 kan det føres et fleksibelt kateter 13 (figur 8), som kan skyves inn til bronkiene, slik at det fra bronkieområdet kan avsuges tracheobronkialt sekret gjennom kateteret 13. På den andre siden kan det også inn-føres medisiner gjennom kateteret 13 i respirasjonstrakten. Sonden 11 utstyres hensiktsmessig med en lukkeanordning som er lett å åpne i sin fjerne ende, som kan åpnes av det gjennom-førte kateter. Denne lukkeanordning består eksempelvis av en elastisk tunge 14 (figur 8) som rager ut over hhv. avdekker den fjerne enden til sonden 11, som kan tilbakebøyes i den fjerne sondeende og som igjen kan utstøtes gjennom den fjerne ende av kateter 13 som kan skyves gjennom den. Denne lukkeanordning 14 forhindrer at spytt kan komme inn i sonden eller kateteret 13 ved innføring av sonden i luftrøret.
Ved det utførelseseksempel som er vist i figurene
9 til 14 er røret 1 formet på samme måte som tidligere beskrevet. Dog lukkes i dette tilfelle røråpningen 4 ved innføring i instrumentet av omkretsen til et innerrør 15 i røret 1. Dette innerrør har en åpning 16 som kan bringes i overdekning med åpningen 4.
Innerrøret 15 lukker ved innføring i instrumentet åpningen 4 i røret 1 med sin på den nærmeste side av åpningen 16 liggende omkretsvegg,slik det fremgår av figur 9. Tilsvarende de valgte mål bringes så ved forskyvning av inner-røret 15 i røret 1 begge åpninger-4 og 16 i overdekning. På innerrøret 15 er det anbragt en rampe 9a, som befinner seg i området for åpningen 16 (figur 10). Så beveges det.ytre røret 1 og innerrøret 15 i proksimal retning, til begge åpningene 4 og 6 er kommet i overdekning med strupehoderommet 8 (figur 11). At denne stilling er oppnådd kan legen igjen lett overprøve
ved at han lar pasienten puste ut.
Deretter bringes en med sonden 15 løsbart forbundet næringsbærer eller en samlebeholder 7a med sin åpne side i overdekning med strupehoderommet 8 ved hjelp av en adapter, slik at det nå igjen på på forhånd beskrevet måte kan bringes sekret fra respirasjonstrakten inn i samlebeholderen 7a hhv. til næringsbæreren. Uavhengig av om det arbeides med eller uten samlebeholder 7a, kan det utgående fra den i figurene 11 og 13 viste posisjon av rampen'9a også gås frem slik videre at en slangesonde 11 med et kateter 13 skyves gjennom inner-røret 15 (figur 14), som igjen ved hjelp av rampen 9a avbøyes sidelengs gjennom åpningen 4 inn i luftrøret 12, hvorved kateteret 13 kan skyves foran inn i bronkiene, for å suge sekret fra bronkiene med kateteret eller å føre en medisin inn i bronkieområdet.
Kateteret 13 ifølge figurene 8 og 14 utstyres hensiktsmessig med en tråd som går gjennom det og som etter inn-føringen kan trekkes ut i proksimal retning. Denne tråd kan være utstyrt med en avbøyning i den distale ende, som også avbøyer kateteret tilsvarende. Proksimalt er tråden og sonden 11 utstyrt med en markering som dekkes i en nullstilling. Når kateteret 13 med tråden i nullstilling innføres i bronkiene, kan det ved proksimal manipulering av tråden fra nullstillingen dreies mot venstre eller høyre, slik at den distalt avbøyde kateterende kan innføres i den venstre eller.høyre avgrening av bronkiene.
For å holde diameteren på ytterrøret 1 relativt liten, kan innerrøret 15 også erstattes av et ikke videre vist føringselement med et sigdformet tverrsnitt, som beveger seg gjennom røret 1 langs dettes indre bakvegg ved gjennomskyvning og som også kan oppvise en rampe, som ved de foran beskrevne utførelseseksempler ved tilsvarende lang innskyvning av føringselementet bringes til området for åpningen 4.
Figurene 15 til 17 viser endelig et instrument i hvilket det går to luftrør 17, 18 parallelt med røret 1, som er forbundet med.røret 1. Rørene 17, 18 er proksimalt åpne og har begge en distal åpning 20, 21 i nærheten av åpningen 4
i røret 1 som er avdekket av klaffen 19. De tre rørene 1, 17
og 18 fremstilles hensiktsmessig i ett stykke ved strengpres-sing av kunststoff. Den således fremstilte profil .tilskjæres så i passende lengde. Den ende av profilen som danner fortsettelsen 2 flatpresses ved hjelp av varme, slik at det oppstår en i det vesentlige jevn strimmel. Fortsettelsen 2 kan imidlertid også tildannes med et hvelvet eller lett krummet tverrsnitt, for å oppnå en anpasning til den anatomisk gitte tverrsnittsform av spiserøret. Klaffen 19 tilveiebringes, idet røret 1 gjennomskjæres slik at klaffkonturen tilsvares. De to hullene 20 og 21 fremstilles ved utstansing av materiale fra de to rørene 17 og 18.
Avvikende fra den form som er vist i figur 15, kan de to luftrørene 17 og 18 også gå over i fortsettelsen 2 utenfor sine distale åpninger 20, 21 og danne disses lang-sider, slik det stiplet er antydet i figur 15. Dette bringer den for-del at pasienten lettere kan svelge instrumentets distale ende, uten at eventuelle skarpe kanter på fortsettelsen 2 herved forstyrrer.
Forøvrig vil pasienten også i dette tilfelle oppta instrumentet ved svelgebevegelser så langt at klaffen som avdekker åpningen 4 og åpningene 20, 21 befinner seg i spise-røret 3. Deretter trekker legen instrumentet i proksimal retning. Så snart åpningene 20, 21 kommer i overdekning med strupehoderommet 8 kan pasienten blåse utåndet luft gjennom disse åpningene inn i rørene 17, 18. Dette fastslår legen akustisk. Han vet da at åpningen 4 i røret 1 i det minste befinner seg i tilnærmet riktig stilling. ' Ved videre uttrekking av instrumentet en viss strekning x kan endelig åpningen 4 nøyaktig og sentrert utrettes på strupehoderommet.
Når man dog vil være helt sikker på at den åpning
av røret 1 som avdekkes av klaffen 19 skal befinne seg i nøyak-tig den riktige stilling for behandlingen, kan åpningene 20,
21 som det vises stiplet i figur 15, også plasseres noe lenger enn strekningen x i distal retning. Så snart det nemlig da ved uttrekking av instrumentet kan fastslås at pasienten allerede kan puste luft via åpningene 20, 21 inn i rørene 17, 18, behøver ikke legen trekke instrumentet lenger ut. Forøvrig er det klart at strekningen x skal avmåles slik at den tilsvarer
de anatomiske forhold.
I røret 1 kan, som også tidligere beskrevet i for-bindelse med de andre utførelseseksemplene, innføres andre rør, sonder eller katetere. Disse glir over rampen 9 og av-bøyer klaffen 19 fleksibelt, slik at åpningen 4 frigjøres for den videre innskyvning av de angjeldende deler inn i luft-røret.
De spesielle fordeler med instrumentet består blant annet i at rampen 9 kan dannes ganske enkelt ved tilsvarende formgivning av røret 1. Dessuten er det ikke nødvendig å avsperre åpningen 4 i det rør 1 som skal innføres med en sær-skilt lukkeanordning. Sonder og katetere kan faktisk allerede være innskjøvet i røret 1 ved innføringen, da overprøvingen av den riktige stilling for åpningen 4 kan foregå ved utånding av pasienten via siderørene 17 og 18.
Instrumentet ifølge de fire beskrevne utførelses-eksemplene er relativt enkle å fremstille og anvende. Som allerede nevnt kan det med sikkerhet uttas sekret med et slikt instrument. Dessuten kan medisiner målrettet bringes til an-vendelse på ethvert sted i respiras jonstrakten.. Videre har instrumentet enda flere anvendelsesmuligheter, som det kort skal gås inn på nedenfor.
Således kan eksempelvis det instrument som er vist i figur 6, benyttes for å innføre andre instrumenter, fleksible endoskoper eller innåndingsrør i luftrøret. Derved kan det også gås frem slik at etter innføringen av innåndingsrøret trekkes det instrument som bare tjente som intubasjonshjelp ut, mens innåndingsrøret forblir i den innførte stilling. På samme måte kan også innføring av endoskoper, varighetskatetere, sonder og lignende foregå, hvilke hjelpemidler de naturligvis også i det proksimale område må ha en slik diameter at de går gjennom røret 1.
Når man i spesielle anvendelsestilfeller vil holde rørets hulrom lite, består også den mulighet, at det gjennom røret 1, som det eksempelvis er vist i figur 6, først bare innføres en tråd som føringselement•i luftrøret og at instrumentet så trekkes ut, mens tråden forblir i den innførte stilling. På denne tråd kan det proksimalt skyves et inn- åndingsrør, som beveges inn i luftrøret, ved føring av den tråd som løper gjennom det. Endelig trekkes føringstråden ut av innåndingsrøret som forblir i luftrøret.
Da disse forholdsregler normalt gjennomføres på pasienter som er under narkose og pasienten altså ikke kan utføre vilkårlige svelgebevegelser, bortfaller eventuelt den fleksible fortsettelsen 2 og røret 1 er tildannet distalt noe lenger enn vist. Forøvrig skal også da det distale endeområde av røret 1 forløpe rett under åpningen 4.
Claims (19)
1. Medisinsk instrument for uttak av tracheobronkialt sekret eller for innføring av medisiner, rør, føringselementer, sonder, endoskoper, katetere og lignende i respirasjonstrakten til en pasient,
karakterisert ved at et fleksibelt og i tverrsnitt formstabilt rør (1), som kan innføres gjennom munn-og svelg-rommet til pasienten, med en distal fortsettelse (2) er skyvbar inn i spiserøret (3) og at røret (1) har en åpning (4) over fortsettelsen (2), som er utrettbar til siden på strupehoderommet (8) til pasienten når instrumentet er innført, og over hvilket sekret er uttagbart henholdsvis medisinene, rørene, føringselementene, sondene, endoskopene, kateterene og lignende er innførbare i respirasjonstrakten.
2. Instrument ifølge krav 1,
karakterisert ved at den nevnte åpning (4) i røret (1) er avsperrbar ved hjelp av en aksialt i røret still-bar lukkeanordning (5, 10) eller ved hjelp av en på røret forekommende klaff (19).
3. Instrument ifølge kravene 1 og 2, karakterisert ved at fortsettelsen (2) består av mykt og bøyelig materiale, som f.eks. myk gummi eller myk plast, og fortrinnsvis er gitt form av flate strimler.
4. Instrument ifølge et av kravene 1 til 3, karakterisert ved at røret (1) er bøyet slik at det tilsvarer de anatomiske forhold i pasientens munn- og svelg-rom.
5. Instrument ifølge et av kravene 1 til 4, karakterisert ved at et samlekar (7, 7a) eller en næringsbærer for bakterier er aksialt forskyvbar i røret (1) ved hjelp av et iverksettelsesinstrument (6), en opptaksåpning for samlekaret kan bringes til overdekking med røråpningen (4) og samlekaret er kombinert med en lukkeanordning (5, 15), som avdekker røråpningen, så snart samlekaret er forskjøvet i distal retning utenfor røråpningen.
6. Instrument ifølge krav 5, karakterisert ved at iverksettelseselementet (6) er en tråd, lukkeanordningen (5) er et rør- eller sylinder-stykke og samlekaret (7) fortrinnsvis er løsbart festet til lukkeanordningen.
7. Instrument ifølge et av kravene 1 til 6, karakterisert ved at det foreligger en rampe (9), som strekker seg i området av røråpningen (4) fra rørets (1) bakside-veggområde ovenfra og på skrå nedover og danner en jevn overgang til det nedre, distale endeområde av røråpningen og et i røret (1) innført kateter (13), et innerrør (15), et føringselement, et endoskop eller lignende kan skyves over rampen (9) og inn i luftrøret (12).
8. Instrument ifølge krav 7, karakterisert ved at rampen dannes av en lapp som er utskilt fra baksideveggen. av røret, som er bøyd nedover og forover og avsluttes i den distale ende av rør-åpningen (4) med sin distale ende eller et særlig element med en rampeflate er innpasset i røret (1).
9. Instrument ifølge et av kravene 1 til 8, karakterisert ved at den distale enden til lukkeanordningen (10) for røråpningen (4) er anpasset til for-løpet av rampen (9).
10. Instrument ifølge krav 7, karakterisert ved at rampen (9a) er tildannet som en del av et i røret (1) forskyvbart innerrør (15), som er utstyrt med en åpning (16) som kan bringes i overdekning med røråpningen (4).
11. Instrument ifølge et av kravene 1 til 10, karakterisert ved at et føringselement som er forskyvbart langs den indre bakvegg i røret (1) og har sigdformet. tverrsnitt, er utstyrt med en rampe (9, 9a).
12. Instrument ifølge et av kravene 1 til 11, karakterisert ved at kateteret (13) kan inn-føres gjennom en slangeaktig sonde (11), som er skyvbar gjennom det ytre røret (1) eller innerrøret (15) og over rampen (9, 9a) inn i luftrøret, hvorved kateterets ende kan skyves gjennom en distal åpning i sonden inn i pasientens bronkie-område.
13. Instrument ifølge krav 12, karakterisert ved at sondens distale ende (11) er utstyrt med en lukkeanordning (14), som kan åpnes ved støt mot kateterets (13) distale ende.
14. Instrument ifølge krav 13, karakterisert ved at den nevnte lukkeanordning (14) i sonden (11) er dannet av en tunge i sondens ende, som er bøyet i den distale sondeåpningen.
15. Instrument ifølge et av kravene 1 til 14, karakterisert ved at samlekaret (7, 7a) er løsbart festet i innerrørets (15) distale ende henholdsvis den distale enden til det i tverrsnitt sigdformede føringselementet.
16. Instrument ifølge et av kravene 1 til 15, karakterisert ved at åpningene (4, 16) i de foran nevnte rør (1, 15), sett ovenfra, har en oval form, hvis største hovedakse forløper parallelt med rørets lengdeakse.
17. Instrument ifølge et av kravene 1 til 16, karakterisert ved at kateteret (13) er utstyrt med en indre, i proksimal retning uttrekkbar tråd, som i den distale ende har en avbøyning og som proksimalt fra en markert nullstilling er dreibar like overfor sonden (11)..
18. Instrument ifølge et av kravene 1 til 17, karakterisert ved at det parallelt med røret (1) forløper to med dette forbundne luftrør (17, 18), som <p> roksimalt er åpne og hver har en distal åpning (20, 21) i nærheten av åpningen (4) i røret (1).
19. Instrument ifølge krav 18, karakterisert ved at luftrørene (17, 18) utenfor sine distale åpninger (20, 21) går over i den nevnte fortsettelse (2) og danner dennes langsider.
Applications Claiming Priority (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
DE3115192A DE3115192C2 (de) | 1981-04-15 | 1981-04-15 | Medizinisches Instrument |
Publications (1)
Publication Number | Publication Date |
---|---|
NO821215L true NO821215L (no) | 1982-10-18 |
Family
ID=6130191
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
NO821215A NO821215L (no) | 1981-04-15 | 1982-04-14 | Medisinsk instrument. |
Country Status (22)
Country | Link |
---|---|
US (1) | US4454887A (no) |
JP (1) | JPS57177771A (no) |
AR (1) | AR228898A1 (no) |
AT (1) | ATA129782A (no) |
AU (1) | AU8265782A (no) |
BE (1) | BE892831A (no) |
BR (1) | BR8202191A (no) |
CH (1) | CH658587A5 (no) |
DD (1) | DD202244A5 (no) |
DE (1) | DE3115192C2 (no) |
DK (1) | DK169182A (no) |
ES (1) | ES272710Y (no) |
FI (1) | FI821254L (no) |
FR (1) | FR2504012A1 (no) |
GB (1) | GB2096467B (no) |
IL (1) | IL65495A (no) |
IT (1) | IT1218319B (no) |
NL (1) | NL8201545A (no) |
NO (1) | NO821215L (no) |
PT (1) | PT74738B (no) |
SE (1) | SE456481B (no) |
ZA (1) | ZA822508B (no) |
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DE7424041U (no) * | 1900-01-01 | Marusho Sangyo Co., Inc., Tokio | ||
US1747407A (en) * | 1928-07-20 | 1930-02-18 | Reinhold H Wappler | Catheterizing instrument |
US2862498A (en) * | 1957-06-14 | 1958-12-02 | Don J Weekes | Endotracheal tube |
US3799173A (en) * | 1972-03-24 | 1974-03-26 | J Kamen | Tracheal tubes |
FR2220729B1 (no) * | 1973-03-06 | 1975-10-31 | Technological Supply | |
FR2332743A1 (fr) * | 1975-11-28 | 1977-06-24 | Inst Nat Sante Rech Med | Sondes et appareils de biopsie cerebrale |
SU610529A1 (ru) * | 1977-01-05 | 1978-06-15 | Алтайский государственный медицинский институт | Эластичный зонд |
US4168703A (en) * | 1977-07-18 | 1979-09-25 | Kenneth Kenigsberg | Gastroesophageal reflux diagnostic tool |
DD140980A1 (de) * | 1979-02-28 | 1980-04-09 | Gert Mueller | Fuehrungseinrichtung fuer medizinische geraete und instrumente |
US4230108A (en) * | 1979-03-13 | 1980-10-28 | Young Sharon L | Apparatus and method for sealing esophageal entrance to trachea above and below |
FR2459051A1 (fr) * | 1979-06-20 | 1981-01-09 | Materiels Annexes Dialyse | Dispositif pour le prelevement de secretions bronchiques |
US4364394A (en) * | 1980-11-24 | 1982-12-21 | Wilkinson Lawrence H | Combined sump drainage and irrigation device |
-
1981
- 1981-04-15 DE DE3115192A patent/DE3115192C2/de not_active Expired
-
1982
- 1982-04-01 AT AT1297/82A patent/ATA129782A/de not_active Application Discontinuation
- 1982-04-05 SE SE8202173A patent/SE456481B/sv not_active IP Right Cessation
- 1982-04-07 FI FI821254A patent/FI821254L/fi not_active Application Discontinuation
- 1982-04-08 FR FR8206154A patent/FR2504012A1/fr active Pending
- 1982-04-12 US US06/367,408 patent/US4454887A/en not_active Expired - Fee Related
- 1982-04-12 PT PT74738A patent/PT74738B/pt unknown
- 1982-04-13 ES ES1982272710U patent/ES272710Y/es not_active Expired
- 1982-04-13 AR AR289094A patent/AR228898A1/es active
- 1982-04-13 IL IL65495A patent/IL65495A/xx unknown
- 1982-04-13 DD DD82238952A patent/DD202244A5/de unknown
- 1982-04-13 GB GB8210627A patent/GB2096467B/en not_active Expired
- 1982-04-13 NL NL8201545A patent/NL8201545A/nl not_active Application Discontinuation
- 1982-04-14 NO NO821215A patent/NO821215L/no unknown
- 1982-04-14 CH CH2265/82A patent/CH658587A5/de not_active IP Right Cessation
- 1982-04-14 ZA ZA822508A patent/ZA822508B/xx unknown
- 1982-04-14 BR BR8202191A patent/BR8202191A/pt unknown
- 1982-04-14 BE BE2/59664A patent/BE892831A/fr not_active IP Right Cessation
- 1982-04-14 JP JP57061197A patent/JPS57177771A/ja active Pending
- 1982-04-15 AU AU82657/82A patent/AU8265782A/en not_active Abandoned
- 1982-04-15 DK DK169182A patent/DK169182A/da not_active IP Right Cessation
- 1982-04-15 IT IT20763/82A patent/IT1218319B/it active
Also Published As
Publication number | Publication date |
---|---|
SE8202173L (sv) | 1982-10-16 |
BR8202191A (pt) | 1983-03-29 |
GB2096467B (en) | 1984-07-18 |
DE3115192A1 (de) | 1982-11-04 |
US4454887A (en) | 1984-06-19 |
DD202244A5 (de) | 1983-09-07 |
ZA822508B (en) | 1983-03-30 |
NL8201545A (nl) | 1982-11-01 |
SE456481B (sv) | 1988-10-10 |
DK169182A (da) | 1982-10-16 |
ES272710U (es) | 1983-12-16 |
PT74738A (de) | 1982-05-01 |
ATA129782A (de) | 1991-06-15 |
ES272710Y (es) | 1984-07-16 |
CH658587A5 (de) | 1986-11-28 |
IT8220763A0 (it) | 1982-04-15 |
IT1218319B (it) | 1990-04-12 |
JPS57177771A (en) | 1982-11-01 |
BE892831A (fr) | 1982-08-02 |
GB2096467A (en) | 1982-10-20 |
FI821254L (fi) | 1982-10-16 |
IL65495A (en) | 1985-04-30 |
AR228898A1 (es) | 1983-04-29 |
AU8265782A (en) | 1982-10-21 |
DE3115192C2 (de) | 1983-05-19 |
FR2504012A1 (fr) | 1982-10-22 |
PT74738B (de) | 1983-11-16 |
FI821254A0 (fi) | 1982-04-07 |
IL65495A0 (en) | 1982-07-30 |
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