WO2008001724A1 - Masque laryngé doté d'un guide d'introduction de tube gastrique - Google Patents

Masque laryngé doté d'un guide d'introduction de tube gastrique Download PDF

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Publication number
WO2008001724A1
WO2008001724A1 PCT/JP2007/062703 JP2007062703W WO2008001724A1 WO 2008001724 A1 WO2008001724 A1 WO 2008001724A1 JP 2007062703 W JP2007062703 W JP 2007062703W WO 2008001724 A1 WO2008001724 A1 WO 2008001724A1
Authority
WO
WIPO (PCT)
Prior art keywords
cuff
tube
gastric tube
laryngeal mask
inflation cuff
Prior art date
Application number
PCT/JP2007/062703
Other languages
English (en)
Japanese (ja)
Inventor
Tomohiko Asahara
Original Assignee
Tomohiko Asahara
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Tomohiko Asahara filed Critical Tomohiko Asahara
Priority to JP2008522567A priority Critical patent/JP4588789B2/ja
Publication of WO2008001724A1 publication Critical patent/WO2008001724A1/fr

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Classifications

    • 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
    • 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
    • A61M16/0402—Special features for tracheal tubes not otherwise provided for
    • A61M16/0409—Special features for tracheal tubes not otherwise provided for with mean for closing the oesophagus
    • 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
    • A61M16/0402—Special features for tracheal tubes not otherwise provided for
    • A61M16/0415—Special features for tracheal tubes not otherwise provided for with access means to the stomach

Definitions

  • the present invention relates to a laryngeal mask airway (LMA) to be worn on the larynx to ensure lung ventilation and breathing.
  • LMA laryngeal mask airway
  • This laryngeal mask has a flexible airway tube and an inflatable inflation cuff attached to the distal end of the airway tube.
  • the inflation cuff in a contracted state is also inserted into the patient's loca in the larynx, and then the gas is supplied into the inflation cuff to inflate it, so that the outer periphery of the inflation cuff passes through the trachea of the larynx Close contact with the periphery of the entrance.
  • the trachea and the inside of the inflation cuff communicate with each other and are sealed from the surrounding throat and esophagus.
  • An airway tube communicating with the interior of the inflation cuff secures the airway between the lungs and the trachea and the external space. This secured airway allows the patient to breathe naturally or connect the airway tube to an artificial respirator for artificial respiration.
  • Patent Document 1 JP-A-2-283378
  • a discharge tube for discharging the contents present in the stomach and esophagus to the outside of the body is joined to the inflation cuff separately from the airway tube. That is, one end force of the drain tube is joined to the S inflation cuff and inserted into the patient together with the inflation cuff, and the other end of the drain tube remains outside the patient, e.g. to the suction device. Connected to aspirate contents present in stomach and esophagus.
  • one end of the discharge tube inserted into the patient's body together with the inflation cuff is positioned at the distal end of the inflation cuff and more than the distal end of the inflation cuff. Some have extended so that one end can be inserted into the esophagus when the inflation cuff is attached to the larynx.
  • the viewpoint power to prevent the contents existing in the stomach and esophagus from entering the inside of the infiltration cuff is more effective when one end of the latter discharge tube is inserted into the esophagus.
  • the most important thing is, for example, to quickly and surely attach a laryngeal mask to a patient who is in a self-sustained breathing state and to get out of the breathing state. .
  • the object of the present invention is to solve the above-mentioned problems, and to quickly attach an inflation cuff requiring urgency to the larynx, and to exist in the stomach and esophagus while using the mask.
  • An object of the present invention is to provide a laryngeal mask that can effectively prevent the contents to enter the inside of an inflation cuff attached to the larynx.
  • a laryngeal mask used to ensure lung ventilation and breathing A laryngeal mask used to ensure lung ventilation and breathing
  • a back plate hermetically joined to the hollow annular portion so as to cover one end of the inner diameter side space of the hollow annular portion;
  • a cuff internal space surrounded by an inner diameter-side curved surface of the hollow annular portion and an inner surface of the back plate, and open on the opposite side of the back plate;
  • An inflation cuff that allows the opening-side curved surface of the hollow annular portion that has been inserted into the larynx and inflated to be in close contact with the peripheral portion of the tracheal inlet on the entire circumference;
  • One end opens into the cuff interior space
  • an airway tube arranged so that the other end opens to a space outside the oral cavity
  • a guide surface for inserting the stomach tube from the mouth until the tip reaches the stomach or esophagus region is provided on the larynx.
  • a gastric tube insertion guide disposed continuously or intermittently from the inflation cuff located to the outside of the oral cavity;
  • FIG. 1 is a perspective view and a cross-sectional view showing the overall structure of one embodiment of a laryngeal mask provided with a gastric tube insertion guide of the present invention.
  • FIG. 2 is a side cross-sectional view as seen from arrow A in FIG.
  • FIG. 3 is a plan view (bottom) as seen from arrow C in FIG. 2.
  • FIG. 4 is a perspective view showing the overall structure of another embodiment of a laryngeal mask provided with a gastric tube insertion guide of the present invention.
  • FIG. 5 is a perspective view showing another embodiment of the cutout region provided in the tubular member of the gastric tube insertion guide according to the present invention.
  • FIG. 6 is a cross-sectional view showing another embodiment of the guide surface of the gastric tube insertion guide according to the present invention.
  • FIG. 7 is a perspective view and a sectional view showing one embodiment of a gastric tube insertion guide having no tubular member.
  • FIG. 8 is a cross-sectional view showing another embodiment of the gastric tube insertion guide having no tubular member.
  • One embodiment of the laryngeal mask of the present invention is a laryngeal mask used to ensure ventilation and respiration of the lung, and (1) a hollow annular portion that is inflatable by filling a gas therein, and A back plate hermetically joined to the hollow annular portion so as to cover one end of the inner diameter side space of the hollow annular portion, an inner diameter curved surface of the hollow annular portion, and an inner surface of the back plate A cuff interior space that is surrounded and opened on the opposite side of the back plate, and the open-side curved surface of the hollow annular portion that is inserted into the throat from the mouth and inflated, An inflation cuff capable of closely contacting, (2) connected to the inflation cuff, one end opening into the interior space of the cuff, and the inflation force An airway tube that is arranged so that the other end opens into a space outside the oral cavity, with the balloon inserted into the larynx, and (3) with the inflation cuff inserted into the larynx, Gastric tube insertion in which the
  • the highest priority should be placed on the larynx to ensure patient breathing.
  • the contents of the stomach and esophagus including gastric juice
  • the most effective way to prevent the contents of the stomach and esophagus from entering the trachea is to insert a gastric tube and suck the contents of the stomach and esophagus out of the body. It is believed that there is. In this case, however, it is not permissible for the rapid insertion of the inflation cuff to be prevented by inserting the gastric tube.
  • the gastric tube is smoothly inserted and guided to the esophageal entrance, and further inserted into the stomach and the desired region of the esophagus. It is equipped with a dedicated guide for gastric tube insertion. If there is no special gastric tube insertion guide, the inflation cuff must be inserted into the larynx and then the gastric tube alone must be inserted into the loca stomach and esophagus. Since the structure is curved anatomically, the tip of the gastric tube buckles in contact with the inner wall of the throat during insertion and insertion is extremely difficult. Also, if a gastric tube with a strength that can be inserted without buckling even if it is pulled against the inner wall of the throat, there is a high risk of damaging the inner wall of the throat, which is difficult to realize. is there.
  • the laryngeal mask of the present embodiment mainly includes an inflation cuff, an airway tube, and a gastric tube insertion guide, and further supplies gas to the hollow annular portion of the inflation cuff. Connect the inflation tube for this purpose.
  • the “inflation cuff” also has a flexible material force, and is formed with a hollow annular portion.
  • a back plate hermetically joined so as to cover one end of the inner diameter side space of the hollow annular portion, and is surrounded by the inner diameter side curved surface of the hollow annular portion and the inner surface of the back plate, A cuff interior space with the opposite side opened.
  • the hollow annular portion is filled with a gas from the supply / exhaust end of the inflating tube to be expanded, and is filled from the supply / exhaust end of the inflation tube.
  • the hollow annular portion can be contracted by exhausting the gas.
  • the inflation cuff has a substantially oval shape so that it can be in close contact with the periphery of the trachea inlet to form a sealed state, and the tip side is slightly narrowed for easy insertion. Can be.
  • the optimum shape and size can be determined according to the sex, age, etc. of the patient.
  • the "airway tube” also has a flexible material force, with one end opened to the inner space of the force hood and the inflation cuff inserted into the larynx. One end is long enough to be placed outside the oral cavity.
  • the "gastric tube insertion guide” also has a flexible material force, and a guide surface force fin for inserting the gastric tube in the state where the inflation cuff is inserted into the larynx. It has a structure that extends continuously or intermittently from the position of the france cuff to the outside of the oral cavity.
  • the guide surface is provided continuously or intermittently from the tip of the inflation cuff close to the entrance of the esophagus to the end of the airway tube exiting the oral cavity.
  • Invite to the outer surface of the cuff backboard and the outer surface of the airway tube A structure in which a conductive surface is provided is conceivable.
  • the guide surface has an arc shape that matches the outer diameter of the stomach tube so that the stomach tube does not come off the guide during insertion.
  • the two guide surfaces can be combined to have an integrated arc shape with a predetermined center angle.
  • a guide surface can be provided so that a convex portion is formed on the outer surface of the back plate of the inflation cuff and the outer surface of the airway tube, or on the outer surface of the back plate of the inflation cuff and the outer surface of the airway tube.
  • a guide surface can also be formed by providing a recess.
  • the guiding surface is continuously arranged means that the above-described guiding surface is continuously present in the longitudinal direction from the inflation cuff positioned at the larynx to the outside of the oral cavity
  • the guide surface is intermittently arranged means that there are a portion where the guide surface exists in the longitudinal direction and a portion where the guide surface does not exist.
  • the stomach tube In the region where the insertion path is close to a straight line, even if there is a portion where the guide surface does not exist, there is no problem with the insertion of the stomach tube, but in the region where the insertion path is curved, the stomach tube is A guide surface for guiding is required.
  • gastric tube insertion guide can be provided as an independent member separately from the inflation cuff and the airway tube.
  • a tubular member as shown below.
  • any material can be used as long as it is flexible and does not cause a problem when it enters the body.
  • a resin material especially when high pressure steam sterilization with autoclave is required. If the resin is preferred and sterilization thereof is not necessary, other thermoplastic flexible resins such as vinyl chloride and polyurethane can be used.
  • the same material can be used for the inflation cuff, the airway tube, and the stomach tube insertion guide, or different materials can be used. Concerning the hardness of the material, for example, it is conceivable to use a flexible coagulant for the inflation cuff and a slightly hard coagulant for the airway tube. Can have. It is also conceivable to form the gastric tube insertion guide integrally with the inflation cuff or airway tube.
  • the inflation cuff is inserted from the mouth through the throat to a predetermined position on the larynx while the hollow annular portion is contracted.
  • air is supplied from the air supply / exhaust end of the inflation tube that has come out of the oral cavity, and the hollow annular part is inflated and brought into close contact with the periphery of the trachea inlet.
  • the trachea and the cuff interior space communicate with each other. Forms a sealed state from the esophagus.
  • an urgent airway is secured.
  • artificial respiration can be started by connecting an artificial respirator to the end of the airway tube that has come out of the oral cavity.
  • the stomach tube is inserted from the end of the stomach tube insertion guide outside the oral cavity.
  • the gastric tube passes through the curved throat while being supported by the guide surface of the gastric tube insertion guide, passes through the position of the inflation cuff, and further advances from the distal end of the inflation cuff to the esophagus.
  • the stomach tube can be inserted until the distal end of the stomach tube reaches a predetermined position in the esophagus or the stomach.
  • the contents present in the stomach or esophagus can be sucked from the open end of the inserted gastric tube and discharged out of the body.
  • the tip of the gastric tube can be inserted into the stomach and the esophagus where it is sufficiently away from the larynx where the inflation cuff is attached. And can more reliably prevent entry into the trachea.
  • the inflation cuff can be quickly attached to the larynx to ensure respiration, and thereafter, the stomach tube insertion guide 'can be used.
  • the gastric tube can be easily and reliably inserted into the stomach and esophagus Therefore, it is possible to prevent the liquid and contents existing in the stomach or esophagus from being discharged and entering the trachea, and it is also suitable when the laryngeal mask is used for a long time.
  • the stomach tube insertion guide in the region passing through the inflation cuff, extends substantially linearly, or the inflection is uniform or the inflection point is less than one force. Since the above-mentioned problem does not occur, it can be smoothly inserted into the stomach tube.
  • the guide surface is provided at a distal end portion of the inflation cuff close to the entrance of the esophagus when the inflation cuff is attached to the larynx. It is characterized by.
  • the gastric tube insertion guide is provided with the guide surface. If the gastric tube is inserted along, the tip of the gastric tube can be smoothly inserted to the desired position of the stomach or esophagus by reliably reaching the entrance of the esophagus and continuing the insertion. .
  • the gastric tube insertion guide is not provided after the entrance of the esophagus, but when the esophageal force is applied to the stomach, there is no curved part like the larynx and the oral force, so even if there is no special guide, the gastric tube is inserted. Can be inserted relatively smoothly.
  • the gastric tube insertion guide is more than the tip of the inflation cuff. If the extended part is long, there is a high risk that it will become an obstacle when inserting the inflation cuff into the larynx. Therefore, even if the gastric tube insertion guide extends to the tip of the inflation cuff, even if it extends beyond the tip of the inflation force cuff, it will reach the upper esophageal sphincter when the inflation cuff is positioned at the larynx. It is desirable to keep it to a length that does not.
  • the guide surface in order to reduce a contact area between the guide surface and the outer surface of the stomach tube, is provided with irregularities.
  • the insertion resistance of the gastric tube When a gastric tube is inserted using the gastric tube insertion guide, it is important to reduce the insertion resistance of the gastric tube so that it can be inserted smoothly.
  • the contact area between the guide surface and the outer surface of the gastric tube can be greatly reduced.
  • the insertion resistance can be greatly reduced.
  • the cross-sectional shape of the projections and depressions any shape including a substantially triangular shape, a substantially trapezoidal shape, a corrugated shape, and a sawtooth shape can be used.
  • the guide surface is roughened in order to reduce a contact area between the guide surface and the outer surface of the stomach tube.
  • roughening the guide surface means to give the guide surface a fine unevenness, and in this embodiment, by roughening the guide surface of the tube insertion guide, The contact area between the guide surface and the outer surface of the gastric tube can be reduced, thereby reducing the insertion resistance of the gastric tube.
  • the guide surface can be roughened and the surface can be further roughened.
  • a method of roughening the guide surface for example, a method of mixing external particles different from the base material and extruding with the external particles is conceivable.
  • a method of precipitating fine particles Various methods can be used, including the method of forming irregularities by chemical treatment!
  • the hardness of the guide surface is a plastic hardness of 60 degrees or more.
  • plastic hardness means the durometer hardness of plastic (see JIS K7215).
  • the material surface force is more advantageous as the plastic hardness is higher.
  • the hardness of the guide surface is made to have a plastic hardness of 60 degrees or more, the slipperiness of the guide surface can be greatly improved, so that the insertion resistance of the stomach tube is greatly reduced. Can be made.
  • the gastric tube insertion guide has a tubular member having an inner surface serving as the guide surface, and at least a part of the tubular member is inside or outside the tube.
  • a notch region capable of ventilating air is provided continuously or intermittently along the longitudinal direction.
  • the stomach tube insertion guide has a tubular member whose inner surface serves as a guide surface, when the stomach tube is externally inserted with the inflation cuff attached to the larynx.
  • the gastric tube can be reliably inserted without losing the guiding surface force.
  • the tubular member of the gastric tube insertion guide It is desirable to apply a liquid lubricant to the entire stomach tube and insert it into the tubular member in order to reduce the frictional resistance between the guide surface and the outer surface of the stomach tube, which is curved.
  • the tube diameter of the stomach tube is desired to be as large as possible
  • the tube diameter of the tubular member is It is desirable to make it as small as possible and to increase the outer diameter of the airway tube accordingly.
  • the stomach tube insertion guide includes the stomach tube and the inner surface of the tubular member.
  • it has a ventilation structure with a notch area that allows ventilation inside and outside the tubular member of the insertion guide for the gastric tube .
  • the stomach tube can be advanced while the air inside the tubular member escapes to the outside of the notch region force, so that the insertion resistance can be greatly reduced.
  • This notch region is provided continuously or intermittently along the longitudinal direction of the insertion guide. That the notch area is provided continuously means that a continuous slit is cut in the longitudinal direction.
  • the slit can be of any width depending on the application, but the cross-sectional shape of the tubular member should exceed a semicircle to prevent the gastric tube from coming off.
  • the cutout regions are provided intermittently, for example, a plurality of long holes may be formed in the longitudinal direction, or a plurality of round holes may be formed in the longitudinal direction. It is possible to be. Each hole can be made at a uniform pitch or at a non-uniform pitch. It is desirable that the size and pitch of the cut-out holes are determined optimally in consideration of the strength of the tubular member and the amount of air to be discharged to the outside when inserting the gastric tube.
  • Another embodiment of the laryngeal mask of the present invention is characterized in that the space inside the tubular member and the cuff internal space are in an airtight seal.
  • the tubular member force of the gastric tube insertion guide Inflation force When fixed to the outside (for example, on the outer surface of the back plate), the tubular member is provided with a notch region. Even if it is drowned, the hermetic seal is maintained.
  • Another embodiment of the laryngeal mask of the present invention is characterized in that an inner diameter of the tubular member is within 1.2 times an outer diameter of the gastric tube.
  • the tubular shape of the guide for gastric tube insertion It is desirable that the diameter of the member is as small as possible and that the diameter of the airway tube is increased.
  • the inner diameter force of the tubular member of the gastric tube insertion guide is 1% of the outer diameter of the gastric tube. The stomach tube can be inserted smoothly even within 2 times.
  • the inflation cuff can be quickly attached to the larynx to ensure breathing as in the case of the conventional laryngeal mask.
  • the gastric tube can then be easily and reliably inserted into the stomach or esophagus by the gastric tube insertion guide ', so that the liquid or contents present in the stomach or esophagus can be drained and moved toward the trachea. It can prevent intrusion and is suitable for long-term use of the laryngeal mask.
  • the guide surface is provided with irregularities, the guide surface is roughened, the guide surface is hardened, and the bending at the position of the Z or inflation cuff is uniform. Therefore, the insertion resistance of the gastric tube can be reduced.
  • the gastric tube insertion guide has a tubular member
  • the gastric tube can be reliably inserted without losing the guide surface force, and the notch region provided in the tubular member The insertion resistance when inserting the gastric tube can be reduced.
  • FIGS. Fig. 1 is a perspective view (see Fig. 1 (a)) showing the entire structure of the linear mask of this embodiment, and a cross-sectional view taken from arrow B in Fig. 1 (a) (see Fig. 1 (b)).
  • It is. 2 is a side cross-sectional view as seen from the arrow A in FIG. 1
  • FIG. 3 is a flat (bottom) view as seen from the arrow C in FIG.
  • the insertion direction of the laryngeal mask is referred to as the front end, and the opposite side is referred to as the rear end.
  • the laryngeal mask 2 of the present embodiment is made of a flexible material, specifically a resin material cover, and as shown in Fig. 1 (a), an inflatable inflation cuff 4 and one of them Airway tube 6 with end joined to inflation cuff 4, gastric tube insertion guide 8 joined to one end force inflation cuff 4, connected in a communicable manner inside inflation cuff 4 An inflating tube 12.
  • the inflation cuff 4 has an oval shape as a whole, and can form an airtight space in close contact with the vicinity of the trachea entrance of the larynx.
  • the inflation cuff 4 includes a hollow annular portion 4a that expands and comes into close contact with the tracheal peripheral portion of the larynx, and an end portion 20a, 20b of both inner diameter side spaces 20 (shaded portions) formed by the hollow annular portion 4a.
  • the back plate 4b is airtightly joined to the hollow annular portion 4a so as to cover one end portion 20a of the first plate 20b.
  • a cuff inner space 4c is formed which is surrounded by the inner diameter-side curved surface 22 of the hollow annular portion 4a and the inner wall of the back plate 4b and is open on the opposite side (the end 20b side) of the back plate 4b.
  • the hollow annular portion 4a has an oval annular shape, and the inflation tube 12 is connected to the inside 4d of the hollow annular portion 4a so as to be able to communicate with the end of the inflation tube 12
  • the hollow annular portion 4a is expanded, and the opening-side curved surface 24 of the hollow annular portion 4a can be brought into close contact with the peripheral portion of the tracheal inlet at the entire circumference.
  • the gas filled in the hollow annular portion 4a can be discharged from the air supply / exhaust end portion 12a of the inflating tube 12, and the expanded hollow annular portion 4a can be contracted.
  • the airway tube 6 has an opening 6a that penetrates the back plate 4b and opens into the cuff internal space 4c at one end. Airway tube 6 outer diameter and back plate The airway tube 6 is fixed to the inflation cuff 4 and the airtightness of the cuff inner space 4c is also maintained. The other end 10 of the airway tube 6 is provided with a connection connector 10a so that it can be connected to the artificial respirator.
  • the airway tube 6 has a sufficient length so that the other end 10 including the connector 10a can be placed outside the oral cavity with the inflation cuff 4 inserted into the larynx. have.
  • the gastric tube insertion guide 8 has a tubular member 8 a and a part thereof is arranged to pass through the inflation cuff 4.
  • it is a guide surface that guides the gastric tube when the internal force of the tubular member 8a is inserted.
  • the specific structure of the gastric tube insertion guide 8 is that the tubular member 8a passes from the right side of the paper through the back plate 4b, passes through the cuff inner space 4c, and is in the space on the tip side of the inflation cuff 4.
  • An opening 8b is provided outside the tip of the inflation cuff 4 through the annular portion 4a. In this penetrating portion, the outer diameter of the tubular member 8a and the back plate 4b, and the outer diameter of the tubular member 8a and the shell of the hollow annular portion 4a are sealed together.
  • the stomach tube insertion guide 8 is fixed to the inflation cuff 4, and the airtightness of the cuff inner space 4c is also maintained. Further, since this gastric tube insertion guide 8 has an opening 8b outside the distal end portion of the inflation cuff 4, the gastric tube insertion guide 8 is used with the inflation cuff 4 mounted on the larynx. When the stomach tube is inserted, the entrance to the esophagus can be easily reached from this opening 8b.
  • the gastric tube insertion guide 8 extends from the inflation cuff 4 by substantially the same length as the airway tube 6. With the inflation cuff 4 inserted into the larynx, the other end 8c is located outside the oral cavity. It is long enough to allow for the arrangement of The tubular member 8a of the gastric tube insertion guide 8 is provided with a plurality of rectangular cutout regions 14 with rounded corners at regular intervals, so that the inside and outside of the tubular member 8a can communicate with each other. It has become. With this structure, when a stomach tube (not shown) is inserted into the tubular member 8a, the air inside the tubular member 8a pushed out by the stomach tube. Since this notch area 14 force can also be released to the outside, the insertion resistance of the gastric tube can be greatly reduced.
  • the cutout region 14 is not provided at all in the region where the tubular member 8 a passes through the inside of the inflation cuff 4.
  • the gastric tube insertion guide 8 in the region where the gastric tube insertion guide 8 passes through the inflation cuff 4, the gastric tube insertion guide 8 extends from the rear end portion to the distal end portion of the inflation cuff 4.
  • the curvature extends in a very large curve, and this curve is bent only in one direction. In other words, the inflection of the gastric tube insertion guide 8 is uniform (the inflection point is only one place).
  • the tip of the gastric tube passes through the first bend and enters the second bend, and the distal end of the stomach tube is in contact with the inner surface (guide surface) of the tubular member 8a.
  • the structure as in this embodiment it is possible to ensure the smooth insertion of the gastric tube even in the region passing through the inflation cuff 4. Can do.
  • the curve has a very large curvature.
  • the insertion resistance of the stomach tube can be further reduced.
  • various friction reducing means are employed in order to reduce the frictional resistance between the inner surface (guide surface) of the tubular member 8a and the outer surface of the stomach tube when the stomach tube is inserted.
  • the inner surface (guide surface) of the tubular member 8a is roughened, thereby reducing the contact area between the inner surface (guide surface) of the tubular member 8a and the outer surface of the stomach tube. This reduces the insertion resistance of the gastric tube.
  • the guide surface is roughened by mixing external particles (for example, inorganic particles) different from the base resin material and extruding them together with the external particles.
  • the guide surface can be roughened by using any other method such as a method of depositing fine particles or a method of forming irregularities by chemical treatment, which is not limited to this method.
  • the hardness of the guide surface is increased in order to reduce the frictional resistance between the inner surface (guide surface) of the tubular member 8a and the outer surface of the stomach tube.
  • the hardness of the guide surface is 50 degrees or more in terms of plastic hardness, more preferably 60 degrees or more, and more preferably 75 degrees or more. Most preferred.
  • the plastic hardness here means the durometer hardness of plastic (see JIS K7215).
  • the laryngeal mask 2 of the present embodiment for example, when high-pressure steam sterilization using an autoclave is required, it is desirable to use silicone resin. If sterilization is not required, other thermoplastic flexible resins such as vinyl chloride, polyurethane, etc. can be used, for example, the inflation cuff 4 uses a thin flexible resin.
  • the gastric tube insertion guide 8, which is preferably used with a slightly hard fat, can be used for the airway tube 6. The gastric tube can be inserted as described above. By increasing the hardness of the guide 8 guide surface, the frictional resistance when the stomach tube is inserted can be reduced.
  • a material having an optimum specification for example, flexibility, hardness, heat resistance, acid resistance, chemical resistance, etc.
  • the same type of grease material can be used for each member of the laryngeal mask 2 (inflation cuff 4, airway tube 6, gastric tube insertion guide 8, and inflation tube 12). Different types of materials can be used accordingly.
  • an adhesive can be used, welding (welding) can be used, and any other joining means can be used. Can be used.
  • the outer diameter has a smaller difference (that is, less gap) than the inner diameter of the tubular member 8a of the gastric tube insertion guide 8.
  • a gastric tube with can be inserted.
  • the inner diameter of the tubular member 8a can be made within 1.2 times the outer diameter of the gastric tube, and it should be made within 1.1 times by determining the optimum specifications. Is also possible.
  • the stomach tube having a size capable of effectively discharging the contents present in the stomach and the esophagus is used, and at the same time, the diameter of the tubular member 8a of the stomach tube insertion guide 8 is reduced to a small value.
  • the diameter of the airway tube 6 can be increased.
  • the inflation cuff 4 is inserted from the mouth through the throat to a predetermined position on the larynx while the hollow annular portion 4a is contracted.
  • gas is supplied from the air supply / exhaust end portion 12a of the inflation tube 12 that has come out of the oral cavity, and the hollow annular portion 4a is expanded, so that the opening-side curved surface 24 of the hollow annular portion 4a is formed on the entire circumference thereof. Adhere closely to the periphery of the trachea inlet.
  • the trachea and the cuff inner space 4c communicate with each other, and a sealed state can be formed from the surrounding throat and esophagus.
  • an airway requiring urgentness is secured.
  • artificial respiration can be started by connecting an artificial respirator to the connector 10a that goes out of the oral cavity of the airway tube.
  • the stomach tube is inserted from the end 8c of the stomach tube insertion guide that has come out of the oral cavity.
  • the stomach tube passes through the throat while being supported by the inner surface (guide surface) of the tubular member 8a of the stomach tube insertion guide 8, passes through the position of the inflation cuff 4, and the distal end of the stomach tube insertion guide 8 From the opening 8b of the part, it is possible to proceed further to the esophagus.
  • the stomach tube can be inserted until the distal end of the stomach tube reaches a predetermined position in the esophagus or the stomach.
  • the gastric tube insertion guide 8 has an opening 8b outside the tip of the inflation cuff 4, so that it is easy to insert the gastric tube along the gastric tube insertion guide 8. Can reach the entrance to the esophagus.
  • the tubular member 8a of the gastric tube insertion guide 8 has the cutout region 14 for allowing the air pushed out by the inserted gastric tube to escape out of the tube, and the hardness of the guide surface Since the surface that is high is roughened, the insertion resistance of the gastric tube is reduced ing.
  • the region passing through the inflation cuff 4 has a large curvature and a uniform inflection curve, which prevents the insertion resistance of the stomach tube from increasing.
  • the contents including both solid and liquid
  • the contents existing in the stomach or esophagus including gastric juice
  • the contents can be sucked from the end of the inserted gastric tube and discharged out of the body. This prevents the contents from entering the cuff inner space 4c and the trachea from the contact portion between the hollow annular portion 4a and the peripheral portion of the trachea inlet during use of the laryngeal mask. it can.
  • the tip of the gastric tube can be inserted to a position where the laryngeal force to which the inflation cuff is attached is also sufficiently separated, so that the contents can be more effectively prevented from entering the trachea.
  • the gastric tube insertion guide 8 is not provided after the entrance of the esophagus, there is no curved portion like the larynx in the oral cavity when the esophageal force is applied to the stomach. It can be inserted relatively smoothly.
  • the gastric tube insertion guide 8 can be provided so as to extend beyond the tip of the inflation cuff 4.
  • the gastric tube insertion guide 8 can be moved upward when the inflation cuff 4 is attached to the larynx, even if the distal end is extended, even if the distal end is extended, as in the above-described embodiment. It is desirable to keep the length short enough to reach the esophageal sphincter.
  • the present embodiment is greatly different in that the tubular member 8 a of the gastric tube insertion guide 8 is arranged outside the inflation cuff 4. Further, the shape of the cutout region 14 provided in the tubular member 8a is also different. However, the other points are basically the same as those of the embodiment shown in FIGS.
  • the tubular member 8 a is disposed and fixed in a recess provided in the back plate 4 b of the inflation cuff 4.
  • the inflation cuff 4 has an opening 8b at the tip, and when the inflation cuff 4 is attached to the larynx, the opening 8b is disposed adjacent to the entrance of the esophagus.
  • the tubular member 8a does not jump out of the external force of the inflation cuff 4! /, So there is no risk of preventing the inflation cuff 4 from being inserted!
  • the tubular member 8a is provided with a plurality of cutout regions 14 having a circular hole shape, and the inside and the outside of the tubular member 8a are communicated with each other.
  • the tubular member 8a is arranged outside the inflation cuff 4, it is possible to provide the notch region 14 even at the position of the inflation cuff 4, and when inserting the stomach tube The air inside the tubular member 8a can be released to the outside more effectively.
  • the tubular member 8a is disposed on the outside of the inflation cuff 4. In part of the inflation cuff 4, for example, near the distal end of the inflation cuff 4, the tubular member 8a You can place it so that it passes through the inside of the inflation cuff 4.
  • FIG. 5 (a) and 5 (b) are perspective views showing the outer shape of the tubular member 8a of the stomach tube insertion guide 8.
  • FIG. 5 (a) shows an embodiment in which a plurality of long hole-like cutout regions 14 are provided, and the cutout region 14 is not provided in a region entering the inflation force.
  • Fig. 5 (b) shows an embodiment in which a cutout region 14 having a shape in which slits are continuously cut is provided. Similarly, a cutout region 14 is cut into a region entering the inside of the inflation cuff. Missing area 14 is not provided. In the present embodiment, the continuously cut slits allow the tubular member 8a to easily expand in the radial direction. Reduction of resistance can be realized.
  • the tubular member 8a having a shape in which the slits are continuously cut can be easily manufactured by providing a protrusion on the core in the extrusion process.
  • FIGS. 6 (a) to 6 (d) are cross-sectional views showing the cross-sectional shape of the tubular member 8a of the gastric tube insertion guide 8.
  • FIG. 6 (a) to 6 (d) are cross-sectional views showing the cross-sectional shape of the tubular member 8a of the gastric tube insertion guide 8.
  • a tubular member 8a shown in FIG. 6 (a) has an irregular cross section provided with triangular or serrated irregularities. This shape can greatly reduce the friction area between the guide surface 8d (the inner surface of the tubular member 8a) and the gastric tube passing therethrough, so that when the stomach tube is inserted. The insertion resistance can be greatly reduced.
  • the uneven shape may be any uneven shape including a rounded shape, a shape similar to a trapezoid, and a corrugated shape, as well as the above-mentioned shape alone.
  • FIG. 6 (b) shows a cross section having the same uneven shape as FIG. 6 (a) and a continuous or intermittent cutout region 14 is provided.
  • the tubular member 8a has a two-layer structure in the radial direction.
  • materials having different materials, elasticity, hardness, surface properties, and the like can be used on the outer diameter side and the inner diameter side, so that an optimum material can be combined depending on the function of each location. For example, by using a material with relatively high hardness as the member on the inner diameter side, reducing the frictional resistance with the stomach tube, and by using a material with higher elasticity as the member on the outer diameter side It is conceivable to reduce the resistance when the inflation cuff is inserted.
  • FIG. 6 (d) shows a cross-section having a concavo-convex shape with a two-layer structure similar to FIG. 6 (c), and further provided with a continuous or intermittent cutout region.
  • FIG. 7 (a) is a perspective view showing the entire laryngeal mask
  • Fig. 7 (b) is a cross-sectional view of the arrow D force of Fig. 7 (a)
  • Fig. 7 (c) is FIG. 5 is a cross-sectional view taken from arrow E in FIG.
  • the stomach tube insertion guide 8 does not have a tubular member. Instead, the stomach tube insertion guide 8 has stomachs on the outer surface of the inflation cuff 4 and the outer surface of the airway tube 6. A recess is provided for inserting the tube. The concave portion is continuously provided along the insertion direction of the gastric tube, and the guide surface 8d is continuously formed up to the end portion of the inflation cuff 4 to the end of the airway tube.
  • the shape of the guide surface 8d in the inflation cuff 4 is shown in FIG. 7 (b), and the shape force of the guide surface 8d in the airway tube 6 is shown in FIG. 7 (c). Is shown in In any place, when the stomach tube is inserted, the stomach tube force does not protrude outside the outer shape of the inflation cuff 4 or the airway tube 6, so that smooth insertion can be performed with little insertion resistance.
  • FIG. 8 is a cross-sectional view schematically showing the arrangement of the guide surface 8d on the inflation cuff (see FIG. 8 (a)) and on the airway tube (see FIG. 8 (b)).
  • two independent guide surfaces 8 d are provided on the back plate 4 b of the inflation cuff 4 and on the outer surface of the airway tube 6.
  • the inflation cuff when the gastric tube is inserted, the inflation cuff is determined by appropriately determining the attachment position of the force guide surface 8d to be out of the outer shape of the gastric tube force inflation force 4 and the airway tube 6. 4 and smooth insertion of the gastric tube. 7 and 8, the guide surface 8d can be provided continuously or intermittently in the direction of insertion of the stomach tube.
  • the laryngeal mask provided with the gastric tube insertion guide of the present invention includes various other embodiments in addition to the above-described embodiment.

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  • Health & Medical Sciences (AREA)
  • Pulmonology (AREA)
  • Emergency Medicine (AREA)
  • Engineering & Computer Science (AREA)
  • Anesthesiology (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Hematology (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Media Introduction/Drainage Providing Device (AREA)

Abstract

L'invention concerne un masque laryngé comportant un ballonnet gonflable doté d'une partie tubulaire creuse gonflable, d'une plaque de support reliée par un raccord étanche à l'air à la partie tubulaire creuse gonflable de façon à recouvrir une partie de l'espace latéral du diamètre interne et d'un espace interne de ballonnet entouré par la face incurvée de diamètre interne et la face interne de la plaque de support et présentant une ouverture sur le côté opposé à la plaque de support ; un tubage endotrachéal dont une extrémité s'ouvre vers l'espace interne de ballonnet et l'autre vers l'extérieur de la cavité buccale ; et un guide d'introduction de tube gastrique dans lequel une face de guidage, permettant d'introduire un tube gastrique dans la bouche du patient jusqu'à ce que le bout dudit tube gastrique atteigne la région de l'estomac ou de l'œsophage permettant l'introduction du ballonnet gonflable dans la région pharyngée, est fournie en continu ou par intermittence à partir du ballonnet gonflable vers l'extérieur de la cavité buccale.
PCT/JP2007/062703 2006-06-26 2007-06-25 Masque laryngé doté d'un guide d'introduction de tube gastrique WO2008001724A1 (fr)

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WO2010100419A1 (fr) * 2009-03-03 2010-09-10 The Laryngeal Mask Company Limited Dispositif de voie respiratoire artificielle
JP2012531978A (ja) * 2009-07-06 2012-12-13 ウメダス、リミテッド 人工気道
WO2012127434A3 (fr) * 2011-03-22 2012-12-27 Donald Munro Miller Dispositif formant voies respiratoires
WO2013079902A1 (fr) * 2011-11-30 2013-06-06 The Laryngeal Mask Company Limited Dispositif d'endoscopie
JP2013538641A (ja) * 2010-10-01 2013-10-17 ザ ラリンジアル マスク カンパニー リミテッド 人工気道装置
JP2013543408A (ja) * 2010-10-15 2013-12-05 ザ ラリンジアル マスク カンパニー リミテッド 人工気道装置
WO2014202078A1 (fr) * 2013-06-20 2014-12-24 Ambu A/S Masque laryngé
US9326670B2 (en) 2008-06-06 2016-05-03 The Laryngeal Mask Company Limited Glottiscope
WO2016117462A1 (fr) * 2015-01-22 2016-07-28 テルモ株式会社 Tube trachéal
US9528897B2 (en) 2009-08-13 2016-12-27 Chimden Medical Pty Ltd Pressure indicator
KR101858596B1 (ko) * 2016-09-22 2018-05-17 한양대학교 산학협력단 삽관 가이드 기능을 하는 기도 유지 장치
KR101901142B1 (ko) * 2017-02-13 2018-09-21 연세대학교 산학협력단 레빈튜브 삽입 가이더가 구비된 기관 삽관 튜브
US10149955B2 (en) 2013-06-20 2018-12-11 Ambu A/S Laryngeal mask
JP2019010354A (ja) * 2017-06-30 2019-01-24 美智義 讃岐 エアウェイ
US10549054B2 (en) 2011-02-02 2020-02-04 Teleflex Life Sciences Unlimited Company Artificial airway
CN111587134A (zh) * 2018-01-12 2020-08-25 纳林尼·瓦迪维鲁 具有喉咽抽吸能力的医疗设备
CN112354057A (zh) * 2020-11-27 2021-02-12 郴州市第一人民医院 一种便于气管插管退管的喉罩及监测装置
US11077271B2 (en) 2005-03-25 2021-08-03 Airguard, Llc Medical apparatus with hypopharyngeal suctioning capability
EP3804795A4 (fr) * 2018-05-24 2022-03-02 Wuxi Holy Noah Technology Co., Ltd Masque laryngé d'aspiration d'expectorations de positionnement
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CA2817482C (fr) 2010-11-12 2018-10-30 Wolfe Tory Medical, Inc. Atomiseur pour therapie nasale
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AU201714823S (en) 2017-02-27 2017-10-12 Teleflex Life Sciences Unlimited Co Laryngeal mask airway device
CN108434569B (zh) * 2018-05-24 2024-07-05 无锡圣诺亚科技有限公司 免充气吸痰型插管喉罩

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US9326670B2 (en) 2008-06-06 2016-05-03 The Laryngeal Mask Company Limited Glottiscope
WO2010100419A1 (fr) * 2009-03-03 2010-09-10 The Laryngeal Mask Company Limited Dispositif de voie respiratoire artificielle
JP2017164548A (ja) * 2009-03-03 2017-09-21 ザ ラリンジアル マスク カンパニー リミテッド 人工気道装置
JP2012519520A (ja) * 2009-03-03 2012-08-30 ザ ラリンジアル マスク カンパニー リミテッド 人工気道装置
CN106943655A (zh) * 2009-03-03 2017-07-14 喉罩有限公司 人造导气管装置及形成该装置的方法
US10576229B2 (en) 2009-03-03 2020-03-03 The Laryngeal Mask Company Limited Artificial airway device
JP2015163235A (ja) * 2009-03-03 2015-09-10 ザ ラリンジアル マスク カンパニー リミテッド 人工気道装置
CN102387829A (zh) * 2009-03-03 2012-03-21 喉罩有限公司 人造导气管装置
JP2012531978A (ja) * 2009-07-06 2012-12-13 ウメダス、リミテッド 人工気道
US10126197B2 (en) 2009-08-13 2018-11-13 Teleflex Life Sciences Pressure indicator
US9528897B2 (en) 2009-08-13 2016-12-27 Chimden Medical Pty Ltd Pressure indicator
JP2013538641A (ja) * 2010-10-01 2013-10-17 ザ ラリンジアル マスク カンパニー リミテッド 人工気道装置
US9974912B2 (en) 2010-10-01 2018-05-22 Teleflex Life Sciences Unlimited Company Artificial airway device
JP2016105906A (ja) * 2010-10-01 2016-06-16 ザ ラリンジアル マスク カンパニー リミテッド 人工気道装置
JP2013543408A (ja) * 2010-10-15 2013-12-05 ザ ラリンジアル マスク カンパニー リミテッド 人工気道装置
JP2016147106A (ja) * 2010-10-15 2016-08-18 ザ ラリンジアル マスク カンパニー リミテッド 人工気道装置
US9675772B2 (en) 2010-10-15 2017-06-13 The Laryngeal Mask Company Limited Artificial airway device
US10842962B2 (en) 2010-10-15 2020-11-24 Teleflex Life Sciences Pte. Ltd. Artificial airway device
US10549054B2 (en) 2011-02-02 2020-02-04 Teleflex Life Sciences Unlimited Company Artificial airway
WO2012127434A3 (fr) * 2011-03-22 2012-12-27 Donald Munro Miller Dispositif formant voies respiratoires
JP2015502211A (ja) * 2011-11-30 2015-01-22 ザ ラリンジアル マスク カンパニー リミテッド 内視鏡検査装置
JP2019193858A (ja) * 2011-11-30 2019-11-07 テレフレックス、ライフ、サイエンシーズ、アンリミテッド、カンパニーＴｅｌｅｆｌｅｘ Ｌｉｆｅ Ｓｃｉｅｎｃｅｓ Ｕｎｌｉｍｉｔｅｄ Ｃｏｍｐａｎｙ 内視鏡検査装置
WO2013079902A1 (fr) * 2011-11-30 2013-06-06 The Laryngeal Mask Company Limited Dispositif d'endoscopie
US20140323806A1 (en) * 2011-11-30 2014-10-30 The Laryngeal Mask Company Limited Endoscopy device
US10806327B2 (en) 2011-11-30 2020-10-20 Teleflex Life Sciences Pte, Ltd. Laryngeal mask for use with an endoscope
JP2017221685A (ja) * 2011-11-30 2017-12-21 ザ ラリンジアル マスク カンパニー リミテッド 内視鏡検査装置
AU2012343628B2 (en) * 2011-11-30 2016-11-17 Teleflex Life Sciences Llc Endoscopy device
EP3549513A1 (fr) * 2011-11-30 2019-10-09 Teleflex Life Sciences Unlimited Company Dispositif d'endoscopie
US9889264B2 (en) 2013-06-20 2018-02-13 Ambu A/S Laryngeal mask
US10314993B2 (en) 2013-06-20 2019-06-11 Ambu A/S Laryngeal mask
US10149955B2 (en) 2013-06-20 2018-12-11 Ambu A/S Laryngeal mask
WO2014202078A1 (fr) * 2013-06-20 2014-12-24 Ambu A/S Masque laryngé
WO2016117462A1 (fr) * 2015-01-22 2016-07-28 テルモ株式会社 Tube trachéal
JPWO2016117462A1 (ja) * 2015-01-22 2017-11-02 テルモ株式会社 気管用チューブ
KR101858596B1 (ko) * 2016-09-22 2018-05-17 한양대학교 산학협력단 삽관 가이드 기능을 하는 기도 유지 장치
KR101901142B1 (ko) * 2017-02-13 2018-09-21 연세대학교 산학협력단 레빈튜브 삽입 가이더가 구비된 기관 삽관 튜브
JP2019010354A (ja) * 2017-06-30 2019-01-24 美智義 讃岐 エアウェイ
CN111587134A (zh) * 2018-01-12 2020-08-25 纳林尼·瓦迪维鲁 具有喉咽抽吸能力的医疗设备
EP3737447A4 (fr) * 2018-01-12 2021-03-17 Nalini Vadivelu Appareil médical ayant une capacité d'aspiration hypopharyngée
EP3804795A4 (fr) * 2018-05-24 2022-03-02 Wuxi Holy Noah Technology Co., Ltd Masque laryngé d'aspiration d'expectorations de positionnement
CN112354057A (zh) * 2020-11-27 2021-02-12 郴州市第一人民医院 一种便于气管插管退管的喉罩及监测装置
WO2022133525A1 (fr) * 2020-12-23 2022-06-30 Genesis Airway Innovations Pty Ltd Dispositif de voies aériennes artificielles, système et procédé d'utilisation de ceux-ci

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JP4588789B2 (ja) 2010-12-01
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CN101057994A (zh) 2007-10-24

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