TWI569825B - Artificial airway device - Google Patents

Description

Artificial airway device

The present invention relates to an artificial airway device, and more particularly to the protection of the gastrointestinal tract when providing gastric reflux and using a gastroscope of any diameter.

In the past at least seventy years, the endotracheal tube included an elongated tube and an inflated balloon disposed adjacent the end of the tube for constructing an airway for an unconscious patient. In operation, the end of the endotracheal tube is inserted through the patient's mouth into the patient's trachea. After positioning, the balloon expands to the inner branch line to form a closure. After the closure is established, a positive pressure is applied to the front end of the tube to circulate the patient's lungs. At the same time, the closure is formed between the balloon and the inner branch tube to prevent foreign matter from entering the patient's lungs.

Although seemingly successful, there are several major drawbacks to balloon tubes. First of all, it is quite difficult to insert the balloon tube into the body properly, which requires a high degree of skill. At the same time, even experienced professionals sometimes encounter difficulties or failures. In many cases, the difficulty of intubation can unfortunately lead to the death of the patient due to the inability to quickly establish the airway. In addition, the traditional cannula must control the patient's head and neck, and further adjust the patient's chin, forcing the opening to be wide, these necessary operations The procedure leads to difficulties or is not expected to cause neck injuries caused by insertion into the patient.

The laryngeal mask airway device is a well-known device that facilitates the establishment of an airway for unconscious patients and seeks to improve the shortcomings of the balloon catheter described above.

Compared to balloon catheters, laryngeal masks are relatively easy to insert into a patient to establish an airway. At the same time, the laryngeal mask is an active device, that is, the insertion is not perfect and the airway can still be produced. Therefore, the laryngeal mask is generally regarded as a lifesaving device. At the same time, the laryngeal airway mask device can achieve the insertion action by simply adjusting the patient's head and neck chin, and the throat mask airway device provides the patient's lung circulation without touching the air tubular tissue and the inner diameter of the conventional catheter is compared. Because the device is small and the laryngeal mask airway device does not interfere with the degree of cough, based on the above advantages, the throat mask airway device has become the mainstream in recent years.

U.S. Patent No. 4,509,514 describes a laryngeal mask airway device comprising a basic component that forms an airway device, one end open to a hollow balloon-like shape adapted to the rear of the patient's throat. The periphery of the mask is formed by a cuff for forming a seal near the opening of the throat so that the air passage can be effectively established.

The laryngeal mask airway device, which provides a function of the smear of the smear, is also developed in U.S. Patent No. 4,995,388 (Fig. 7-10); U.S. Patent No. 5,241,956; and U.S. Patent No. 5,355,879. These devices use a small-diameter discharge tube to be connected to the end of the mask at one end. When the mask is positioned, it abuts the upper end of the esophageal sphincter. The length of the tube extends beyond the patient's population, so that when the active or passive is discharged from the stomach of the upper esophagus ++, get on. Alternatively, the venting tube can extend beyond the end of the mask into the esophagus itself (U.S. Patent No. 4,995,388, Figures 7 and 11).

Such a device is suitable for extracting gastric reflux, but still not sufficient to completely prevent stomach material from entering the patient's lungs, in particular, when the stomach discharge is a patient's vomit rather than just a countercurrent, in special circumstances, The vomit may fill the mask itself, as shown in Figure 62. Even when a discharge tube is provided, the airway integration is potentially affected and the vomit is introduced into the patient's lungs.

The case where the mask may be filled with vomiting may also be disclosed in U.S. Patent No. 4,509,514, but no discharge tube is provided as shown in Figs. 60 and 61.

In particular, when the mask does not provide a gastric discharge tube, and even if it is provided, it may be fatal because the vomit causes an increase in esophageal pressure and cannot be effectively vented from the esophagus, and the mask may get caught in the pharynx.

The human skeleton provides a passage in the upper esophagus and the lower pharynx, with the characteristics of a venturi that forces the fluid to rise from the stomach. The fluid flows through the tube to obtain the velocity. The fluid has pressure because the fluid energy remains the same, and the speed increase must have a corresponding pressure loss, as shown in Figure 1.

If the tube is restricted (representing the sphincter in the human bone, the upper esophageal sphincter) is connected by a second wide tube (representing the hypopharyngeal sphincter in the human bone), then when the liquid reaches the enlarged area, the speed will slow down and get pressure This description is similar to a light ball sucking up an inverted funnel. When the funnel has a downward blown air (as in Figure 2), it is equally applicable to any liquid.

Thus, an object is placed in the expanded region of a tube, and the liquid will flow from the high pressure region to the low pressure region, in other words to the restricted area of the tube. However, the object itself cannot exert pressure on the perimeter of the restricted tube neck because doing so will obstruct the outlet and shut off fluid flow. Therefore, in the ball experiment, the ball will rise upward until it reaches an equilibrium position, and the gravity of the ball will be balanced with the pressure difference between the airflow and the upper airflow. Therefore, in order to place an object in the streamline at the expansion point of the pipe, Traction to accept the wall of the restricted area, the object must have a similar shape in the enlarged area of the tube, as shown in Figure 3.

The LMA prototype is constructed according to U.S. Patent No. 4,995,388 (Fig. 7-10), No. 5,241,956, and No. 5,355,879, providing a channel for receiving a countercurrent liquid produced by the esophagus having a diameter similar to the diameter of the bone of the restricted area, i.e., upper The esophageal sphincter, as shown in Figure 4.

When the device is pressed against the sacral area (Fig. 4C area), the liquid maintains the same speed as it passes through the tubular region as it flows through the esophagus; when the device is properly positioned, it mimics the sphincter's bone, but the non-esophageal region is Low fluid but high pressure exhibits countercurrent activity. These devices are thus incapable of enjoying the actions of Bernoulli's law, except as in the Figure 2, they must maintain a closed contact with the throat region as shown in Figure 5.

However, this position is very difficult to achieve because the main object has a discharge tube to communicate with the esophageal opening to prevent the stomach liquid from coming from the esophagus and leaking from the edge of the device, which may cause serious risk to the patient.

The stomach material discharge pipe provided today does not have a pipe diameter as the size of the esophageal sphincter, and thus can only provide the speed of entering the discharge pipe, thereby causing a decrease in the pressure of entering the smaller pipe diameter as described above, and thus tends to cause The end of the device is away from the sphincter.

In view of the above, an object of the present invention is to provide an artificial airway device for promoting circulation of a patient's lungs, comprising at least one airway tube and a mask attached to the other end of the airway tube, the mask having a peripheral tissue for adapting The space behind the throat of one of the patients forms a closure around the throat into the tube, and the surrounding tissue surrounds a hollow interior or mask cavity, wherein the mask is placed to form a space in the pharynx of the patient to discharge away from the esophagus The stomach material, when the mask is present in the pharynx, the space is close to the pharyngeal space generated when no mask is present, and the effect is to re-establish the normal flow of the stomach material to leave the esophagus when refluxing and vomiting.

Preferably, the risk of masking the mask at the beginning of reflux or vomiting is substantially reduced, allowing for airway integration to be maintained, substantially reducing bloating and further allowing vomiting to be removed from the esophagus and esophageal laceration.

Preferably, the mask is configured to provide a space within the throat when the surrounding tissue forms a closure around the throat access tube.

Preferably, when the mask is not in the pharyngeal head, when the counterflow and vomiting occur, the space is close to the pharyngeal space.

Preferably, the mask includes a component that is movable in a first condition and a second condition to provide space. This space has the interior of the mask or the space defined by the mask and the pharyngeal wall.

In a preferred embodiment, the mask has a backing plate that is constrained to the surrounding tissue, and the peripheral tissue moves laterally on each side of the backing sheet to create a space and provides closure; the peripheral tissue includes a set of lateral sides that are attached to each side of the backing panel. The wings move relatively to create space and provide closure.

Preferably, the surrounding tissue is an inflated cuff or a non-expanding cuff.

The mask defines a space entry tube, wherein the access tube includes a folded loop or a U-shaped tissue.

Preferably, a device, as previously described, includes means for receiving a member that has been inserted into a portion of a device of a patient, for assisting insertion of the artificial airway device by sliding the member along a portion that has been inserted into the patient .

Preferably, the member comprises a receiving portion formed by the external space of the artificial airway device, and the receiving portion preferably includes a passage formed in the outer space of the artificial airway device.

The above described objects, features and advantages of the present invention will become more apparent from the description of the appended claims.

Figure 7-14 shows a first embodiment of the present invention. The artificial airway device is formed with a laryngeal airway device 1 for facilitating circulation of a patient's lungs. The device 1 includes at least one airway tube 2 and is connected to the other end of the airway tube 2 a mask 3 having a body 4 having a distal end 5 and a proximal end 6 and a peripheral expandable cuff 7 surrounding a hollow interior space or a mask lumen, wherein the mask 3 is disposed in the airway tube 2 and the outer tube 8. The mask of the present embodiment and the embodiments described hereinafter are shaped to conform to the periphery of the throat after the actual or potential formation of the pharynx. In this embodiment, the closure does not rely on the pharyngeal mask airway device to penetrate into the interior of the pharynx. Reference actual or potential devices will be known to point to the curved portion of the available space and surrounding tissue.

As shown in Figures 7-14, the overall appearance of the device 1 is similar to that of the previous case, as it contains the basic elements of most of the pharyngeal mask airway devices, such as an airway tube 2 and a mask 3, and includes a body member 4 and a cuff 7.

The device 1 has a dorsal side 14, a ventral surface 15, a proximal end 16 (near the user rather than the patient), a distal end 17 and a right side and a left side 18, 19.

In this embodiment, the airway tube 2 can be an elastic tube. The tube can also be a curved tube that can be a harder curve with the correct structure of the human bone.

The mask 4 includes a two-part inner mesh 20 defining an inner hollow or inner cavity and providing a slit 21 and a half hard backing plate 22, which are mouth-shaped according to the mesh 20 and attached to the rear end (back side). The back plate 22 extends into a tubular portion 23, one end of which coincides with the slit 21, and the other end receives the distal end of the airway tube 2, so that the airway tube 2 communicates with the stomach through the tubular portion 23 and the slit 21 to the inside of the body of the mask 3. The airway tube 2 is attached to a bolted state such as welded or adhesive or integrally formed by any suitable means, and in the present embodiment, the airway axial direction is substantially the same plane as the expanded cuff 7. A selection function, the slit 20 itself provides two elastic strips 24, 25 formed in the mesh 20, wherein the strips 24, 25 extend across the slit to prevent the patient's epiglottis (cartilage) from falling into the gap 20 when the device 1 is in place, Interrupt the airway.

The elliptical cuff 7 is composed of a soft and elastic crotch panel 26 and a V-shaped upper hinge portion 27. The elastic cymbal 26 is surrounded and integrally formed around the mesh 20 fixed to the back side of the mask 3, and is connected to the outer side of the V of the V-shaped upper hinge portion 27 in a tightly closed manner, and the upper hinge portion 27 The inner side is fixed to the periphery of the back plate 22. The apex of the upper hinge portion 27 extends a small amount of 2 mm from the distal end, above the apex of the distal cuff.

In the present embodiment, the nature of the upper hinge portion 27 is provided by a central hinge 28 (see Fig. 12) on the central portion of the mask as shown on the ventral line, and the two sides of the hinges 29, 30, each The arms V-shaped are respectively extended downward in the middle, and are on the ventral side of the upper hinge portion 27. Preferably, the central hinge 28 promotes lateral extension of the mask 3 and the side wings 29, 30 assist in contracting the sides of the mask.

In the present embodiment, the upper hinge portion 27 is constituted by a protruding hinge tube T, and the cross-sectional view is as shown in Fig. 15. According to this tube (the thickness of the tube wall is exaggerated in Fig. 15 to help show), two hinges H1 are provided inside the tube and two hinges H2 are supplied outside the tube. To form the upper hinge portion 27, the tube is cut along the entire axial length and most of the length is along the opposite side to form a V-shaped hinge. The upper hinge portion 27 is then sealed along the inner circumference of the mask back panel and the elastic cuff piece.

Figure 16 shows a mechanism according to the present invention for achieving expansion of one of the distal ends of the cuff, according to which the distal wall tube can be modified to be sharper than the leading edge, such that the thin elastic covering material Can adhere to thin edges to prevent glue from entering the crack.

It should be noted, however, that the present invention is not limited to the above construction method or to an expandable cuff.

The whole assembly of the invention can be disengaged when the mask is deflated, and can be inserted into the lower part of the throat of the pharyngeal space, but when it is inflated, it can reach the shape shown in the figure. Due to the tubular hinge structure, the switch is affected by the pressure of the inner cuff.

The cuffs 7 effectively provide two expansion wings on either side of the mask 3, and when fluid is running at the proximal end of the cuff 7, the edges of each of the wings 31, 32 are recessed to reduce damage to the tissue during insertion and operation of the mask 3.

The cuff 7 provides a mouth 33 (see Fig. 11) at the proximal end, wherein one of the small diameter expansion tubes 34 is in a closed state. The other end of the tube is provided with an expansion indicating bladder 35 and a valve 36 for connection to a suitable pump such as a syringe to fill the deflated cuff 7.

In use, air is drawn through the valve 36 by the side hinges 29, 30 of the upper hinge portion 27 to assist in folding the cuffs 7 wings 31, 32 inwardly. The mask 3 then facilitates insertion of the mask 3 into the patient's throat.

Preferably, when the mask 3 is initially inserted, the inner side of the mask 3 (the ventral surface 15) faces the throat rear wall to urge the mask 3 to pass through the patient's tongue when inserted; afterwards, the mask 3 is slowly rotated 180 degrees forward, and the mask 3 is further inserted until the mask 3 The distal end 5 enters into contact with the upper esophageal sphincter. This contact represents the correct positioning of the user mask 3.

The cuff 7 is then inflated and the air intake tube is then closed to the airway of the pharynx. Due to the hinge characteristics of the upper portion 27, the wings 31, 32 tend to extend toward the sides of the mask 3, i.e., the wings extend as the cuffs expand. A space is created as a discharge passage and thus is generated on the outer side (back side) of the pharyngeal inner wall and the back plate 22 and the upper hinge portion 27. This space is substantially similar to the back side when there is no mask insertion, and will be limited by the pharyngeal wall, so when the wings are stretched, the pharyngeal head space is created without the mask inserted, so when the wings are stretched, the mask is compared to the front The case captures a small pharyngeal passage space, that is, when the patient is in the body and the wings are extended, the mask substantially protects the hollow portion behind the pharynx, substantially reducing the resistance of the flow of the substance, although produced by the mask inserted into the pharyngeal head. Thus, in accordance with the present invention, most of the ventral side shields provide a catheter that approximates the shape and volume of the pharynx, which volume is large enough to affect the significant pressure rise of any fluid from the upper esophageal sphincter, while at the same time providing an expanded mask shape to maintain The closure around the throat of the throat ensures that the circulating gas will not leak through the positive pressure circulation to the lungs.

The advantage is that the low pharyngeal space is usually a closed space, but can extend when the fluid is forced to pass, or when an object such as a throat mask is inserted. Providing a contiguous space for fluid communication with the esophageal sphincter to the front of the mask while there is still sufficient space around the mask, for example, swellable such that it must be in closed contact with the tissue surrounding the throat.

In another aspect of the invention, a cuff 7 is provided that can be moved from a non-expanded state to an expanded state to facilitate insertion of the mask 3; to a second (expansion) condition to re-establish a bone that approximates the pharynx when the mask is absent space.

The invention is not limited to expansion settings, wing extension and mask movement in the first and second positions, which may be achieved by other possible means. For example, a mask can be used for a conventionally inserted shovel, wherein the mask extends as the shovel is removed to open the patient's pharyngeal bone to resemble a patient swallowing or nausea.

Preferably, unlike the previous case, the discharge passage of the present invention is not provided by the tube, but is constructed by opening the back side of the mask itself and the pharyngeal wall. The access tube to this channel is made up of a U-shaped guide, or by the distal wing end when the mask wings are stretched, as shown in Figure 14.

The present invention provides a mask that is effectively dug on the back side to define a gastric drainage channel.

When the patient vomits or reverses, the stomach material leaves the esophageal sphincter and is not obstructed by the mask 3 shown in Fig. 76, which essentially reestablishes the amount of space available for the pharyngeal discharge without the mask 3. Therefore, the mask 3 does not hinder the flow of the stomach substance, but conversely, a part of the substance is allowed to flow behind it, substantially reducing the risk of the mask being detached due to the flow pressure. In addition, the artificial airway and airway tube remain uninterrupted and the closed intake tube to the throat portion is not broken, making it extremely unlikely that a stomach substance will be mistakenly delivered to the patient's lungs.

Furthermore, in the case of vomiting, the mask 3 is close to the pharyngeal portion of the patient, so that the venturi of the discharge channel is created by the mask, in particular, the sphincter at the upper end of the esophagus of the patient's vomit will reach a high pressure of approximately 200 cm H20. The stomach material will pass through the restricted area at a higher speed than the esophagus, and according to Bernoulli's law, the increase in speed causes the pressure to drop. When leaving the upper esophageal sphincter, the stomach object enters the flow channel defined by the mask 3 and the pharynx, and the vector in the plane fluid is vertical, which has a larger cross-sectional area than the upper esophageal sphincter when vomiting. Therefore, the velocity of the stomach material is reduced through this large passage, and thus the pressure is increased more than in the esophagus. The pressure difference between the stomach material in the upper esophageal sphincter and the flow path defined by the mask 3 and the pharynx causes the mask 3 to be forced into engagement with the esophageal sphincter and thus maintains the mask 3 in a safer position than when vomiting does not occur.

A further function of the present invention is that when the mask 3 is inserted, it facilitates insertion of the gastroscope into the patient's pharynx. Unlike the former device, in which the discharge passage is provided by a pipe, the discharge passage of this embodiment is constituted by the back end when the mask is opened. The entrance to the access channel is formed by the groove 37 of the wing ends 31, 32 (see Fig. 10), which can be used to receive the line of the inserted gastroscope or to be similar to the wire that acts as a guide rail by assisting the sliding mask 3, guiding the mask 3 enter the patient's pharynx.

Conversely, when the mask 3 is in place, the gastroscope inserted thereafter can be assisted by the passage formed by the back side of the mask 3 and the pharynx, and in particular the groove 37 formed by the opposite side of the mask. Furthermore, when the present embodiment is used to rebuild the pharyngeal space for drainage, the gastroscopic insertion and similar entry into the pharynx are not hindered by the mask 3.

A further advantage of the present invention is that the upper hinge can be separated by cuff wings to clean the cuffs and the upper and back panels. The invention is reused.

The invention is not limited to construction or material application, and is directed to current or successive embodiments, for example, the airway tube 2 and the mask 3 may be constructed of a PVC material, particularly when used in a single disposable manner. Different components can be ensured in different ways or integrated.

A variation of the first embodiment, as shown in Fig. 17, is in the case of a particular architecture before the backplate and airway tube are added to the full throat mask assembly. This variation is different from the first embodiment because the upper position of the apex of the V-shape is cylindrically defined between the inlet tube 50 at the distal end of the mask and having a circular cross-sectional diameter of 10-15 cm.

Thus, most of the volume of the mask, in this embodiment, provides a catheter having a volume and shape that approximates a low pharyngeal volume that is large enough to effectively raise any fluid pressure generated by the upper esophageal sphincter, but still provides an expandable mask. The shape, which is maintained in the vicinity of the laryngeal tissue, is maintained to ensure a mechanical circulation for positive pressure use, and it is possible to repeatedly produce a gas that does not leak liquid to the lungs.

The advantage is that the low pharyngeal space is normally a closed space, but can extend when the fluid is forced to pass or when an object such as a throat mask is inserted. It is also possible to provide a suitable volume of fluid to communicate with the esophageal sphincter before the mask, yet there is sufficient space around the mask to undergo expansion to form the closed contact required for the laryngeal tissue.

As in the first embodiment, the upper hinge portion 27 is separated by a hinge tube and welded around the inside of the mask to form a single nozzle of 10 to 15 mm at one open end of the mask. The entire composition collapses when the mask is deflated, helping to insert the lower part of the throat behind the throat, but when it expands, it will reach the shape of Figure 17, because the tubular hinge mechanism causes the tube to become locked under the influence of the internal cuff pressure. . When the cuff is deflated, the mask collapses, especially for non-cut lengths of the hinged tube, defining the inlet and discharge channels, as shown in Figure 18, when the cuff is deflated.

This allows the large diameter gastric tube to be used as shown in Figure 18 when the mask is in the patient's body and the cuff is inflated, but at the same time facilitates mask insertion, when the mask is inserted into a prone to deflated condition, wherein the gastric discharge access tube is effectively closed.

The second embodiment, such as Figures 20-21, differs from the first embodiment in that the member 38 of the tubular backplate 22 is removed to aid in the insertion of the device 1 into the patient.

In accordance with a third embodiment of the present invention, as shown in Figures 22-27, the laryngeal mask airway device 1 includes a trachea 2 and a mask 39 at the distal end.

Similar to the first embodiment, the mask includes an internal mesh 40 defining the interior of the body of the mask 39 and providing a slit 41 and a half hard backing plate 42 that are mouth-shaped in accordance with the mesh 40 and attached to the rear end (back side). The back plate 42 extends into a tubular portion 43 having one end coincident with the slit 41 and the other end receiving the distal end of the airway tube 2 such that the airway tube 2 communicates with the stomach portion through the tubular portion 43 and the slit 41 to the inside of the body of the mask 39. The airway tube 2 is attached to the bolted state by any suitable means such as welding or adhesive or integrally formed. In a selective function, the slit 41 itself provides two elastic strips 44, 45 formed on the grid 40, wherein the strip 44, 45 extends across the gap to prevent the patient's epiglottis (cartilage) from falling into the gap 41 and interrupting the airway when the mask 39 is in place.

The cuff 46 is composed of an elastic cymbal 47 and a V-shaped upper hinge portion 48. The elastic cymbal 47 is surrounded and integrally formed around the mesh 40 fixed to the back side of the mask, and the inner edge V-shaped upper portion 48 surrounds the back plate 42. However, in this embodiment, the first variation of the first embodiment The V-shaped apex is provided on the cylindrical portion of the hinge, and the inlet tube 50 defining the distal end of the circular cross-sectional area of the mask 49 is preferably a change of the first embodiment to assist the entry tube to be detached to cause disease in the deflated state insertion device. Human, and when the cuff is inflated, still provides a large diameter channel (10 mm diameter).

The elastic cymbal 47 surrounds the inlet tube 50 and is connected to the outer side of the V of the V-shaped upper hinge portion 48. Further, when the upper portion 48 is hit, an elastic triangular piece 51 is attached to the opposite side 52, 53 of the cuff elastic piece. In the embodiment, the triangular piece 51 is transparent. Similar to the first embodiment, the expansion wings 54, 55 are thus produced on both sides of the device, and the edges are connected to the triangular elastic piece.

A generally cylindrical passage is formed in the mask, having a circular inlet tube 50 at the distal end and an output tube region at the proximal end, wherein the output tube region is a large cross-sectional area with a plane perpendicular to the longitudinal direction of the mask, thus, most The area inside the mask acts as a catheter with a shape volume similar to a low pharyngeal volume that is large enough to effectively raise any fluid pressure generated by the upper esophageal sphincter, but still provides an expandable mask shape that maintains the desired closure near the larynx tissue In order to ensure the mechanical circulation used in positive pressure, it can repeatedly produce gas that does not leak liquid to the lungs.

The advantage is that the low pharyngeal space is usually a closed space, but can extend when the fluid is forced to pass, or when an object such as a throat mask is inserted. Providing a contiguous space for fluid communication with the esophageal sphincter to the front of the mask while there is still sufficient space around the mask, for example, swellable such that it must be in closed contact with the tissue surrounding the throat.

Similar to the first embodiment, the third embodiment is placed in the insertion condition by the deflated cuff 46, and the hinges 57, 58 are oppositely folded on the back side indicator portion of the upper portion 48 to allow the mask wings to be folded inwardly so that the smaller the size, the better.

After insertion, the cuff 46 of the mask 39 then expands, causing the mask wings 54, 55 to separate, which is not as great as in the first embodiment, but the wings are joined to the triangular sheet 51. This avoids stress by extending the wings 54, 55 to the side wall of the throat, and in particular avoids extension to the hyoid bone and hypoglossal nerve. At the same time, when the edge of the wing is attached to the triangle to form the back of the mask, the potential damage caused by the pharyngeal tissue can be avoided when the mask is inserted. The elasticity and ductility of the triangular piece 51 allows the wings 54, 55 to open.

Preferably, the gastric tube disease of the present embodiment is not provided by a tube outside the extension nozzle as in the prior case, but is disposed at the distal end of the mask by a hole to define the inlet tube to the discharge passage. Therefore, the discharge behavior is controlled only by the patient's bones such as the pharynx.

Similar Effects and Advantages As mentioned in the first embodiment, any stomach discharge from the upper esophageal sphincter is produced by the inner passage of the mask body.

A fourth embodiment is removed from the triangular region of the backing plate by a second embodiment and is replaced by a transparent window 57 which is airtightly coupled to the backing plate for efficient gas transmission. Sex is not affected. Furthermore, the inner mesh can be ignored. Therefore, these changes, the tube into the throat can be viewed through the window, such as a gastroscope, to confirm that the mask is properly placed and the space is properly generated behind the mask.

Further to the difference between the third and fourth embodiments, the triangular piece can be ignored to allow maximum wing separation when the cuff is inflated.

Preferably, the advantages of the third embodiment are also achieved by this embodiment.

A fifth embodiment, such as shown in Figures 30-32, differs from the fourth embodiment in that the cuffs 58 are inscribed in the opposite side of the cuffs 58 to form a concave shape 59. The concave shape 59 prevents the chance of stretching the hyoid bone and the lingual nerve pressure when the mask is inflated, as in the third embodiment. By not using the sheet of the third embodiment, the embodiment is easier to clean and helps to reuse.

Preferably, the advantages of the fourth embodiment are also achieved by this embodiment.

A sixth embodiment, such as shown in Figures 33-35, is different from the fourth embodiment in that the backing plate is cut away from the region R in Figure 35 to avoid excessive pressure on the posterior surface of the annular cartilage, the muscle covering the cartilage The function will be greatly reduced, because these muscles are very important to maintain the lateral pull of the mouth to allow the throat to open.

Preferably, the advantages of the fourth embodiment are also achieved by this embodiment.

A seventh embodiment, such as shown in Figures 36-42, includes a pair of airway tubes 61, 62 that open into the interior of the mask body 63 at the distal end of the device 60 and are attached to a prong 64 to provide a similar airway connection. 65 is at the proximal end of device 60. A wedge member 66 is used between the forked portion regions of the airway tube.

The airway tubes 61, 62 form the backing plate of the mask 67 and are connected to the stomach discharge tube 68 between the airway tube and the mask 67. In order to form the back panel, when the expansion cuff 69 surrounding the mask body 63 is encountered, the upper portion (ventral side) of each airway tube 61, 62 is cut off, and one side of each tube is connected to the lower side (back side) and the other side respectively Connected to the central discharge tube 68, the stomach discharge tube 68 is further attached to the back side of the cuff proximal region to complete the mask backing plate 67.

Also attached to the back side of the cuff 69 is a curved elastic sleeve 70 in which the gastric discharge tube is empty and surrounds the airway tubes 61, 62 in a loosely fixed manner, and all open areas 71 are provided on the back side of the discharge tube to The stomach material is assisted by the discharge tube into the sleeve, and the entry end 72 of the other discharge tube 68 projects through the distal end of the cuff 69. The discharge tube inlet end is provided by a hinge tube having an inner diameter of approximately 10 mm, which is similar to the variation of the first embodiment, assisting in detachment and insertion of the device when the cuff is deflated, while at the same time allowing a large diameter discharge tube to be provided when the mask is inflated To the patient, when the mask is inserted, the mask tends to be non-expanded, and the inlet tube of the discharge tube is effectively closed. The length of the discharge pipe is about 24 mm from the inlet pipe 72 to the cut-off point, the cut-off point extends about 50 mm in the axial direction of the discharge pipe and the length of the entire discharge pipe is approximately 93 mm, although the invention is not limited to these specifications.

Similar to the previous embodiment, the cuff 69 provides a mouthpiece 33 in which one of the small diameter expansion tubes 34 is in a closed state. The other end of the tube is provided with an expansion indicating bladder 35 and a valve 36 for connection to a suitable pump such as a syringe to fill the deflated cuff 69.

In the above embodiment, the cuff 69 is first deflated to assist in the insertion of the device 60, then expanded to the distal end of the upper esophageal sphincter when the mask is in place, and the interior of the mask is closed into the tube to the pharynx.

The stomach material is delivered to the cuff 70 through the stomach tube 68 as it is discharged from the stomach. When the patient vomits, the high-speed, low-pressure stomach material quickly passes through the relatively short stomach tube from the esophageal sphincter to the plastic sleeve 70 that can be extended to the large diameter. The pressure on the vomit thus increases in the flow path of the extended sleeve 70, forcing the mask to further contact the upper esophageal sphincter.

At the same time, preferably, when the elastic sleeve 70 provides a flow passage having a large cross-sectional area, the sleeve 70 does not particularly restrict the entry by the pharynx, the simple folding and the twisted or thin-walled traits, and does not hinder the pharyngeal space.

An eighth embodiment is shown in Figures 43-50.

Similar to the seventh embodiment, the eighth embodiment provides two airway tubes 73, 74 that open into the interior of the mask portion with the mask portion surrounded by the expansion cuffs 76. The airway tubes 73, 74 are attached to the prongs 77 at the proximal end of the device 78 to provide a single airway connector 79.

The airway tubes 73, 74 form the backing plate of the mask 80 and are attached to the stomach discharge tube 81 at the center of the mask between the airway tubes. To form the panel, the upper (ventral side) of each airway tube 73, 74 is cut off in the mask, and the cut-off portion on one side of each tube is connected to the lower side (back side) of the cuff 76 and the other side is connected to the discharge tube 81, respectively. On the side, the discharge tube 81 is further connected to the lower end of the cuff 76 to complete the mask 80 back plate.

The discharge tube 81 projects through the distal end of the cuff 76 and provides a passage for passage of stomach discharge. The ventral side of the discharge tube is severed to the rear end of the cuff to form a discharge chute 82 extending from the rear end of the cuff to continuously guide the stomach material by the mask 80.

The inlet tube 83 of the gastric discharge tube is set to define a linear slit width of approximately 25 mm when the mask is deflated. The cuff expansion causes the intake pipe to open, forming a 17 mm large diameter opening with a circular cross section. The distal discharge tube that is inserted into this slot for insertion reduces the diameter of the front end to the distal end of the back cover, thus allowing easy passage through the lower 1/3 of the pharynx. This allows the large diameter gas tube to be provided when the mask 80 is in the patient's body, but at the same time helps the mask to be inserted, when the mask is inserted into the deflated state, wherein the air inlet tube of the stomach discharge tube is effectively closed. The longitudinal length of the discharge tube extends through the cuff, up until the ramp 82 becomes 90 mm, and the ramp 82 has an axial length of approximately 60 mm. The invention is not limited to the dimensions of the slits, discharge pipes and ramps described above.

A ninth embodiment, such as shown in Figures 51-58, includes a relatively rigid and curved airway tube 83 having a mask 84 attached to the distal end. The mask body 85 is formed by an inner mesh 20 that defines a hollow interior and provides a slit 87 and a half hard backing plate 22 in accordance with the mesh mouth shape and attached to the rear end. The back plate extends into a tubular portion 89, one end of which coincides with the slit 87, and the other end receives the distal end of the airway tube 83 such that the airway tube 83 communicates with the stomach portion of the mask body 85 through the tubular portion 89 and the slit 87. The airway tube 82 provides a pentagonal section of the airway and lumen and is curved on one side, as shown in Fig. 58, and is attached to a pinned condition such as welded or adhesive or integrally formed by any suitable means. The slit 87 itself provides two elastic strips 90, 91 formed in the mesh, wherein the strip extends across the slit to prevent the patient's epiglottis (cartilage) from falling into the gap and interrupting the airway.

The expansion cuff 92 is defined around the periphery of the mask body and is comprised of a soft and resilient flap 93. The elastic crotch panel 26 is wrapped around and fixed to the mesh 86 on the back side of the mask, and is fixed to the periphery of the back plate 22 at the rear side of the mask. As in the first embodiment, the cuff 92 provides a mouth 33 that enters the small diameter gas inlet tube 34 at one end and is fixed in a gas-tight manner such that the gas entering the tube from the gas supply to the cuff 92 is permeable to the pump 35 at the other end. And valve 36.

The inlet tube 94 protrudes through the distal cuff 92 in a short length of the discharge tube 95, and the output tube is provided on the back side of the device in conformity with an elastic sleeve 96. In the present embodiment, the discharge tube is formed by a short length of the hinge from the protruding tube. It is a variation of the first embodiment. When the cuff is deflated to achieve device insertion, the entry tube can be made up of a linear slit and the generally circular cross-sectional area is larger than that of the previous case when the cuff is inflated. When inflated, the inner diameter of the circular area of the inlet tube is approximately 10 mm, and the tube itself is cut at an angle to the axial end of the tube at the rear end of the tube to conform to the contour of the cuff. The shortest axis of the tube is on the back side of the tube, approximately 16 mm; the longest on the ventral side is approximately 30 mm, and the invention is not limited to these dimensions.

The sleeve 96 is attached to the airway tube plane to the distal end of the cuff, and the thin wall is designed for use with a sufficiently high side stiffness material to allow it to resemble a semi-rigid distal wall, surrounding the general bone space, available to the throat, when the device is not Time. However, the cuff will be far from the junction of the cuffs 92.

The material stiffness of the cuff is due to the high hardness tester, and the elasticity comes from the thin wall. Stiffness is interpreted as being relatively inelastic compared to the hardness material, so in a preferred embodiment, the cuff provides a curved shape to correspond to the bone shape of the upper pharyngeal head and the mouth cavity.

A high side durometer is preferably such that a portion of the cuff forms a dome to cover the back of the mask to resist disengagement as the mask expands to create space behind the mask, similar to the uninserted feel of the mask. Similar to the eighth embodiment, the large-area flow passage thus provides the cuff 96 as in the ninth embodiment, and the aforementioned similar effects and advantages are achieved.

Therefore, the above embodiment solves the problem of the previous case to update the innovative way.

The functions of the above embodiments may be combined into further application examples, and the present invention is not limited to the exemplary materials and construction methods, and the above connections indicate the embodiments and any suitable materials.

For example, although the cuff can be made of soft elastic bracts, other materials such as PVC and latex, PVC is particularly suitable for single use, but silicone is suitable for repeated use in a large number of medical procedures.

Further, for example, the cuff sheet is integrally formed on the mesh or provided on a separate member, substantially fixed by the adhesive.

Furthermore, those skilled in the art can apply the various functions of the present invention to a wide range of throat airway devices, and the invention is not limited to the embodiments described above.

For example, the present invention is applicable to a laryngeal mask airway device having a lax-up strip through a mask slit, a strip for lifting the patient's epiglottis away from the slit when inserted into the stomach tube, or other longitudinally extending elements Through the airway tube to merge through the mask gap into the hollow or mask cavity. The invention can be applied to a single or reusable device having a slit strip or not, generating an airway device to allow a gastric tube or the like to be introduced into the throat through the mask airway tube, the device and having an optical fiber observation device, etc., and is not limited to the description of the present invention The scope.

The present invention has been described above with reference to the preferred embodiments thereof, and is not intended to limit the scope of the present invention, and the invention may be modified and modified without departing from the spirit and scope of the invention. The scope of the invention is defined by the scope of the appended claims.

1‧‧‧ device

2‧‧‧airway tube

3‧‧‧ mask

4‧‧‧ Subject

5‧‧‧ distal

6‧‧‧ Near end

7‧‧‧ cuffs

8‧‧‧External tube

14‧‧‧ Back side

15‧‧‧ belly

16‧‧‧ Near end

17‧‧‧ distal

18‧‧‧right

19‧‧‧ left

20 ‧ ‧ inner grid

21‧‧‧ slit

22‧‧‧Semi-hard backplane

23‧‧‧Tube

24‧‧‧Flexible strips

25‧‧‧Flexible strips

26‧‧‧Flexible film

27‧‧‧Upper hinge

28‧‧‧Center hinge

29‧‧‧Chain

30‧‧‧Chain

31‧‧‧ wings

32‧‧‧ wings

33‧‧‧埠口

34‧‧‧Expansion tube

35‧‧‧Expansion indicator capsule

36‧‧‧ Valve

37‧‧‧ditch

39‧‧‧ mask

40‧‧‧Internal Grid

41‧‧‧ slit

42‧‧‧ Backplane

43‧‧‧Tube

44‧‧‧ strips

45‧‧‧ strips

46‧‧‧ cuffs

47‧‧‧Flexible film

48‧‧‧Chain section

49‧‧‧ mask

50‧‧‧Into the tube

51‧‧‧Triangular piece

52‧‧‧ side

53‧‧‧ side

54‧‧‧Expanding wings

55‧‧‧Expanding wings

57‧‧‧Chain

58‧‧‧Chain

59‧‧‧ concave

61‧‧‧airway tube

62‧‧‧airway tube

68‧‧‧Draining tube

69‧‧‧ cuffs

70‧‧‧ Curved elastic sleeves

71‧‧‧cut area

72‧‧‧ Entering end

73‧‧‧airway tube

74‧‧‧airway tube

76‧‧‧ cuffs

77‧‧‧Fork type department

79‧‧‧airway connector

80‧‧‧ mask

81‧‧‧Stomach discharge tube

82‧‧‧ ramp

83‧‧‧Into the tube

84‧‧‧ mask

85‧‧‧ mask body

87‧‧‧ slit

89‧‧‧Tube

90‧‧‧Flexible strips

91‧‧‧Flexible strips

92‧‧‧ cuffs

93‧‧‧ Picture

94‧‧‧Into the tube

95‧‧‧Draining tube

96‧‧‧Flexible sleeves

C‧‧‧ area

H1‧‧‧Chain

H2‧‧‧Chain

R‧‧‧ area

T‧‧‧Chain tube

Figure 1 is a diagram showing the flow of fluid in the upper esophagus and the lower pharynx; Figure 2 is a diagram showing an experiment in which a light ball is sucked up when the funnel has air blown downward. An inverted funnel; Fig. 3 shows the inverted funnel and an object in Fig. 2, wherein the object has a similar form to the enlarged position of the tube; and Figs. 4-6 show the principle of operation of the prior art device. Where the devices include a plurality of channels for receiving countercurrent fluid produced by the esophagus Figure 7-10 shows the inner, back, side, end (frontward) with respect to the deflated state of the first embodiment; the figures 11-14 show the inner, back, side, and end ( Frontward) regarding the inflated state of the first embodiment; Fig. 15 is a cross-sectional view of the tube; Fig. 16 is a view showing the joining mechanism; and Fig. 17 is a view showing another variation of the first embodiment in the expanded state; The figures are respectively shown in the embodiment of Fig. 17, the cross-sectional view of the gastric discharge shows the deflation and expansion of the inlet cuff; the 20th to 21st shows the mask of the second embodiment; the 22th to 27th respectively show the left Third embodiment before, after and after expansion; Figures 28-29 show the fourth embodiment of the front and lower sides in the expanded state; and the 30th to 32th drawings show the rear, lower and side sides in the expanded state Fifth embodiment: Figures 33-35 show a sixth embodiment of the front, rear and lower sides in an expanded state; and figures 36-37 show a seventh embodiment of the upper and the front sides in a deflated state; 38-39 shows the seventh embodiment of the front and lower sides in the expanded state; the 40th figure shows that the elastic sheath is rolled down to clear Show two embodiments of a seventh embodiment of the trachea; Figures 41-42 are lines showing the ventral and lateral sides of the mask; Figures 43-46 are the eighth embodiment of the lower, upper, side, and front sides in a deflated state; and Figures 47-50 are the lower The eighth embodiment of the upper, the side and the front side in the expanded state; the fifth embodiment shows the ninth embodiment of the lower, upper, side and front sides in the deflated state; the 55th to 58th shows the lower and upper parts. The ninth embodiment of the side, front side in the expanded state; Fig. 59 is a schematic view showing the esophagus of the vomiting process in the absence of a mask; and Fig. 60-61 shows the mask of the esophagus in the vomiting process when the mask of the U.S. Patent No. 4,509,514 is present in the pharynx. Figure 62 is a schematic view showing the esophagus of the vomiting process when the mask is present in the pharyngeal head; and Fig. 63 is a schematic view showing the esophagus of the vomiting process when the mask of the present invention is present in the pharyngeal head.

twenty two. . . Semi-hard back

twenty three. . . Tubular part

31. . . wing

32. . . wing

37. . . ditch

Claims (14)

An artificial airway device for promoting circulation of a patient's lungs, comprising at least one airway tube and a mask attached to the other end of the airway tube, the mask having an expandable peripheral tissue adapted to fit one of the patient's throat a space, thereby forming a closure around a throat access tube, and surrounding tissue surrounding a hollow interior space or the mask lumen, wherein the mask provides a space for discharging stomach material exiting the esophagus, wherein The space is an interior space of the mask, and a cylindrical channel is formed in the mask, the cylindrical channel having an inlet at a distal end of the mask and an outlet at a proximal end of the mask, wherein the outlet has a cross-sectional area that is larger than the entrance, and the cross-sectional area is located in a plane perpendicular to the longitudinal direction of the mask to effectively raise the fluid pressure generated by the esophageal sphincter, and at the same time provide for maintaining the closure to enter the throat An expandable shape of the mask around the tube. The device of claim 1, wherein the mask is configured to provide the space within the throat when the surrounding tissue forms the closure around the throat access tube. The device of claim 1, wherein the space is close to the pharyngeal space when the mask is present in the pharynx, when countercurrent and vomiting occur. The device of claim 1, wherein the space is created by the mask and the pharyngeal wall. The device of claim 1, wherein the mask comprises a component movable between a first condition and a second condition to For this space. The device of claim 5, wherein the mask has a backing plate constrained to the peripheral tissue, and the peripheral tissue moves laterally on each side of the backing panel to create the space and provide the closure. The device of claim 6, wherein the peripheral tissue comprises a set of lateral wings that are attached to each side of the backing plate for relative movement to create the space and provide the closure. The device of claim 1, wherein the space is formed by a relatively soft surrounding and folded sheath. The device of claim 1, wherein the peripheral tissue is an inflated cuff. The device of claim 1, wherein the mask defines one of the spaces into the tube, and the inlet tube includes a folded loop. The device of claim 1, wherein the inlet tube comprises a U-shaped tissue. The device of any one of claims 1 to 11, wherein the artificial airway device further comprises a member for receiving a portion of a device that has been inserted into the patient, by being inserted along the patient Partially to slide the member to aid in the insertion of the artificial airway device. The device of claim 12, wherein the member comprises a receiving portion formed by an outer space of the artificial airway device, and the receiving portion preferably includes a passage formed in an outer space of the artificial airway device. The device of claim 13, wherein the receiving portion comprises a passage formed in an outer space of the artificial airway device.