WO2011079500A1 - Guide core and guide wire of pencil-shaped endotracheal tube for retrograde tracheal intubation - Google Patents

Guide core and guide wire of pencil-shaped endotracheal tube for retrograde tracheal intubation Download PDF

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Publication number
WO2011079500A1
WO2011079500A1 PCT/CN2010/001567 CN2010001567W WO2011079500A1 WO 2011079500 A1 WO2011079500 A1 WO 2011079500A1 CN 2010001567 W CN2010001567 W CN 2010001567W WO 2011079500 A1 WO2011079500 A1 WO 2011079500A1
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Prior art keywords
guide
pencil
guide wire
core
retrograde
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PCT/CN2010/001567
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French (fr)
Chinese (zh)
Inventor
陈志扬
陈瑞光
刘瑾
Original Assignee
Chen Zhiyang
Chen Ruiguang
Liu Jin
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Application filed by Chen Zhiyang, Chen Ruiguang, Liu Jin filed Critical Chen Zhiyang
Publication of WO2011079500A1 publication Critical patent/WO2011079500A1/en

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
    • A61M25/0102—Insertion or introduction using an inner stiffening member, e.g. stylet or push-rod
    • 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
    • A61M16/0465—Tracheostomy tubes; Devices for performing a tracheostomy; Accessories therefor, e.g. masks, filters
    • A61M16/0472—Devices for performing a tracheostomy
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M2025/0008—Catheters; Hollow probes having visible markings on its surface, i.e. visible to the naked eye, for any purpose, e.g. insertion depth markers, rotational markers or identification of type
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
    • A61M25/09—Guide wires

Definitions

  • the present invention relates to a retrograde tracheal intubation guide core having a tapered front end and an inner bore, like a sharpened pencil, especially in a retrograde intubation cannula
  • the slope of the front end of the catheter is often blocked by the epiglottis and vocal cords, which makes the feeding tube difficult, and the front end of the catheter is blocked on the glottis, so the failure rate is high.
  • the front end of the pencil-type retrograde tracheal intubation lead is designed as a pencil-type, jacketed tracheal tube, so that when the lead and the tracheal tube are inserted, the front end of the lead core "tightly hugs" the guide wire, and the glottal guide The core gradually squeezes the vocal cords from thin to thick.
  • the inner diameter of the conduit is slightly larger than the outer diameter of the guide core, "tightly hugs" the guide core, and then the air supply duct leads to the air tube wall, and the guide core and the guide wire are removed. Then, the tracheal tube can be advanced to inflate and mechanically ventilate the cuff of the tracheal tube. Book
  • the guide wire used in retrograde tracheal intubation is an epidural catheter, and the rigidity is insufficient. It is often difficult to reach the oral cavity or nasal cavity from the trachea.
  • the guide wire is designed as a semi-circular spring wire, similar to deep vein puncture. When the guide wire is used, when the trachea is inserted into the oral cavity, the semi-circular bevel is in the sagittal plane, which coincides with the glottal fissure, so that the guide wire with strong rigidity can pass through the glottis smoothly without being Damage to the airway mucosa.
  • the tracheal tube bevel is easily blocked by the epiglottis and glottis.
  • the front end of the pencil-type retrograde tracheal intubation lead of the common tracheal tube is in the shape of a sharpened pencil.
  • the operation is performed. First, the guide wire is inserted into the trachea from the outside of the trachea through the skin through the puncture needle. After coming out from the oral cavity, the two ends of the guide wire are tightened. The guide wire is relatively straight, and the front end of the guide core is tightly held. The line advances so that the lead is not blocked when it is inserted.
  • the technical solution adopted by the present invention to solve the technical problem is:
  • the inner diameter of the tracheal tube currently used clinically is generally 5. 5 mm, 6. 0 hidden, 6. 5 round, 7. 0 mm, 7. 5 mm, 8. 0 mm 8 5mm, etc.
  • the front end of the pencil-type retrograde tracheal intubation guide core of the present invention is "pencil head” shape, the outer diameter is 5-8 ⁇ , the inner diameter is 0. 5- 6mm (through the guide wire), the length is 38cm,
  • the "pencil head” is 1 - 4cm long, and the end scales are 33cm, 34cm, 35cra, 36cm, 37cm, 38cm, similar to a sharpened pencil.
  • the guide lead is a plastic spring wire with a semicircular front end, similar to the guide wire in the deep vein puncture bag, which has a certain rigidity, which can smoothly pass through the glottis, and does not cause the airway when the guide wire is inserted. Mucosal damage.
  • the lead length is 75cm
  • the diameter is 0. 5- 2mm
  • the root of the lead wire is set to 0cm after 3cm
  • the other points are 39cm, 40cm, 41cm. Since the front end of the guiding core is of pencil type, the guiding core can be started from the fine door and gradually thickened when passing through the glottis. When pushing the guiding core and the endotracheal tube, the guiding core can "tightly hug" the guiding line, and the tracheal tube can be tight Hold the "guide core” and make the push process smooth.
  • the beneficial effects of the present invention are that the guide core and the endotracheal tube can be inserted into the guide lead after the guide wire is passed out from the oral cavity or the nasal cavity, and the guide core and the endotracheal tube can be easily inserted.
  • Suitable for any difficult airway intubation Since only a puncture is made on the wall of the trachea, the damage is small. It requires less equipment and is inexpensive, and is suitable for medical units of any level. The operation is simple, the technical requirements are not high, and the experience of the anesthesiologist is not high, so it has a high promotion value.
  • FIG. 1 is a schematic view of a pencil type retrograde tracheal intubation guide core of the present invention.
  • Figure 2 is a schematic diagram of the guide line.
  • Figure 1. Pencil head, 2. Inner hole.
  • Figure 2. The guide line half ring.
  • Fig. 1 when the retrograde tracheal intubation is performed, the airway surface is anesthetized first, and the guide wire is inserted into the trachea of the patient from the tracheal wall, and the guide wire is pulled out from the oral cavity or the nostril after the glottis, and the trachea is left 3 cm.
  • Display the Ocm scale point fix the outer part of the trachea of the guide wire, straighten the guide wire as much as possible, first insert the tracheal tube into the lead core, and expose the front end of the lead core from the front end of the tracheal tube to the "pencil head", and guide the guide line from The inner end of the lead core is inserted at the inner end of the lead core.
  • the guide core When the tail end of the lead core is seen on the guide line at a distance of 39 cm , the guide core can be felt blocked by the tracheal wall. For patients with a large distance from the skin to the inner wall of the trachea, see 40 Cm . At the 41cm scale, when the feed core is blocked, the front end of the lead core can be basically determined to reach the air tube wall. Push the endotracheal tube forward to the tracheal wall, remove the lead and guide wire, and then advance the tracheal tube slightly to complete the difficult tracheal intubation.

Abstract

A guide core of retrograde endotracheal tube with a shape of pencil stub at the front end can be passed through by a guide wire. The guide wire is a moldable spring steel wire with a semi-circular front end. The guide wire has a degree of stiffness to pass glottis smoothly and not to result in airway mucosal lesions when the guide wire is inserted. The "pencil stub" of the guide core can avoid being blocked by epiglottis and glottis during intubation, and reach trachea wall smoothly, thus accomplishing retrograde tracheal intubation.

Description

铅笔型逆行气管插管导芯、 导引线 本发明涉及一种逆行气管插管导芯， 前端为锥形， 有一个内孔， 像一根削好的铅笔， 尤 其是能在逆行气管插管时， 先把气管导管套入导芯，露出导芯的 "铅笔头"， 再把导芯的 "铅 笔头"套入导引线， 插送导芯及气管导管， 这样就能避开会厌及声门的阻碍， 顺利到达气管 壁， 完成逆行气管插管。 适用于任何困难气管插管。  The present invention relates to a retrograde tracheal intubation guide core having a tapered front end and an inner bore, like a sharpened pencil, especially in a retrograde intubation cannula When the endotracheal tube is inserted into the guiding core, the "pencil head" of the guiding core is exposed, and then the "pencil head" of the guiding core is put into the guiding line, and the guiding core and the tracheal tube are inserted, so that the meeting can be avoided. Obstruction of the glottis, successfully reach the tracheal wall, complete the retrograde tracheal intubation. Suitable for any difficult endotracheal intubation.
一、 背景技术 I. Background technology
目前， 各种针对困难气管插管的方法都不能保证对所有病人都肯定能成功， 因为在困难 气管插管时气管导管最容易受阻于会厌及声门。 临床上， 对病人逆行气管插管时， 先把导引 线从气管外插入气管， 经口腔或鼻孔出说来， 再套入气管导管， 插送气管导管时由于导管的口 径很大， 导引线往往贴住导管管壁， 导管前端的斜面经常受阻于会厌及声带， 导致送管困难， 导管前端受阻于声门上， 因此失败率很高。本铅笔型逆行气管插管导芯的前端设计为铅笔型， 外套气管导管， 使得在插送导芯和气管导管时， 导芯的前端 "紧紧抱住"导引线， 过声门时 导芯由细变粗渐渐排挤声带，导芯到达气管壁时，导管的内径稍大于导芯的外径，"紧紧抱住" 导芯， 再送气管导管达气管壁， 拔除导芯和导引线， 再稍推进气管导管即可给气管导管的套 囊充气、 机械通气。 书  At present, various methods for difficult tracheal intubation are not guaranteed to be successful for all patients, because tracheal catheters are most vulnerable to epiglottis and glottis in difficult tracheal intubation. Clinically, when the patient is retrogradely intubated, the guide wire is inserted into the trachea from the outside of the trachea, and the trachea is inserted through the oral cavity or nostril. When the tracheal catheter is inserted, the diameter of the catheter is large. The line tends to stick to the wall of the catheter tube. The slope of the front end of the catheter is often blocked by the epiglottis and vocal cords, which makes the feeding tube difficult, and the front end of the catheter is blocked on the glottis, so the failure rate is high. The front end of the pencil-type retrograde tracheal intubation lead is designed as a pencil-type, jacketed tracheal tube, so that when the lead and the tracheal tube are inserted, the front end of the lead core "tightly hugs" the guide wire, and the glottal guide The core gradually squeezes the vocal cords from thin to thick. When the guide core reaches the tracheal wall, the inner diameter of the conduit is slightly larger than the outer diameter of the guide core, "tightly hugs" the guide core, and then the air supply duct leads to the air tube wall, and the guide core and the guide wire are removed. Then, the tracheal tube can be advanced to inflate and mechanically ventilate the cuff of the tracheal tube. Book
既往逆行气管插管时采用的导引线为硬膜外导管等， 刚性不足， 往往难以从气管内到达 口腔或鼻腔， 本导引线设计为前端为半圆形弹簧钢丝，类似于深静脉穿刺时使用的导引钢丝， 从气管内插向口腔时， 半圆形斜面处于矢状面， 正好与声门裂隙一致， 这样具有较强刚性的 导引线就可顺利通过声门， 又不至于损伤气道粘膜。  The guide wire used in retrograde tracheal intubation is an epidural catheter, and the rigidity is insufficient. It is often difficult to reach the oral cavity or nasal cavity from the trachea. The guide wire is designed as a semi-circular spring wire, similar to deep vein puncture. When the guide wire is used, when the trachea is inserted into the oral cavity, the semi-circular bevel is in the sagittal plane, which coincides with the glottal fissure, so that the guide wire with strong rigidity can pass through the glottis smoothly without being Damage to the airway mucosa.
二、 发明内容 Second, the content of the invention
为了克服现有的逆行气管插管时气管导管斜面易受阻于会厌及声门， 外套普通气管导管 的铅笔型逆行气管插管导芯的前端为削好的铅笔形状， 逆行气管插管时， 操作者先把导引线 从气管外经皮肤通过穿刺针插入气管内，从口腔出来后拉紧导引线的两端，导引线比较"直"， 导芯前端紧紧 "抱"住导引线前进， 使得插送导芯时不会受阻。  In order to overcome the existing retrograde tracheal intubation, the tracheal tube bevel is easily blocked by the epiglottis and glottis. The front end of the pencil-type retrograde tracheal intubation lead of the common tracheal tube is in the shape of a sharpened pencil. When the tracheal intubation is reversed, the operation is performed. First, the guide wire is inserted into the trachea from the outside of the trachea through the skin through the puncture needle. After coming out from the oral cavity, the two ends of the guide wire are tightened. The guide wire is relatively straight, and the front end of the guide core is tightly held. The line advances so that the lead is not blocked when it is inserted.
本发明解决其技术问题所采用的技术方案是： 目前临床上使用的气管导管的内径一般是 5. 5mm、 6. 0隱、 6. 5圆、 7. 0mm、 7. 5mm, 8. 0mm 8. 5mm等， 本发明设计铅笔型逆行气管插管导 芯的前端为 "铅笔头"形， 外径为 5-8瞧， 内径为 0. 5- 6mm (通过导引线）， 长度为 38cm， "铅 笔头"长 1- 4cm， 末端刻度有 33cm、 34cm, 35cra、 36cm, 37cm, 38cm, 类似一支削好的铅笔状。 导引线为前端是半圆形的可塑弹簧钢丝，类似于深静脉穿刺包中的导引钢丝， 有一定的刚性， 既可顺利通过声门， 又不至于插送导引线时造成气道粘膜损伤。 导引线长 75cm， 直径为 0. 5- 2mm, 导引线根部 3cm后设为 0cm点， 另外设有 39cm、 40cm, 41 cm等刻度点。 由于导芯的前 端为铅笔型，通过声门时导芯可由细开始， 渐渐变粗，在推送导芯和气管导管时， 导芯可 "紧 紧抱住"导引线， 气管导管可 "紧紧抱住"导芯， 使得推送过程顺畅无碍。  The technical solution adopted by the present invention to solve the technical problem is: The inner diameter of the tracheal tube currently used clinically is generally 5. 5 mm, 6. 0 hidden, 6. 5 round, 7. 0 mm, 7. 5 mm, 8. 0 mm 8 5mm, etc., the front end of the pencil-type retrograde tracheal intubation guide core of the present invention is "pencil head" shape, the outer diameter is 5-8 瞧, the inner diameter is 0. 5- 6mm (through the guide wire), the length is 38cm, The "pencil head" is 1 - 4cm long, and the end scales are 33cm, 34cm, 35cra, 36cm, 37cm, 38cm, similar to a sharpened pencil. The guide lead is a plastic spring wire with a semicircular front end, similar to the guide wire in the deep vein puncture bag, which has a certain rigidity, which can smoothly pass through the glottis, and does not cause the airway when the guide wire is inserted. Mucosal damage. The lead length is 75cm, the diameter is 0. 5- 2mm, the root of the lead wire is set to 0cm after 3cm, and the other points are 39cm, 40cm, 41cm. Since the front end of the guiding core is of pencil type, the guiding core can be started from the fine door and gradually thickened when passing through the glottis. When pushing the guiding core and the endotracheal tube, the guiding core can "tightly hug" the guiding line, and the tracheal tube can be tight Hold the "guide core" and make the push process smooth.
本发明的有益效果是， 可以在导引线从口腔或鼻腔中穿出后， 把导芯和气管导管套入导 引线， 很容易插入导芯和气管导管。 适用于任何困难气道插管时。 由于仅仅是在气管壁上作 一穿刺， 损伤小。 需要的设备少， 费用低廉， 适用于任何级别的医疗单位。 操作简单， 技术 要求不高， 对麻醉医生的经验要求不高， 因此有很高的推广价值。  The beneficial effects of the present invention are that the guide core and the endotracheal tube can be inserted into the guide lead after the guide wire is passed out from the oral cavity or the nasal cavity, and the guide core and the endotracheal tube can be easily inserted. Suitable for any difficult airway intubation. Since only a puncture is made on the wall of the trachea, the damage is small. It requires less equipment and is inexpensive, and is suitable for medical units of any level. The operation is simple, the technical requirements are not high, and the experience of the anesthesiologist is not high, so it has a high promotion value.
四、 附图说明 Fourth, the description of the drawings
下面结合附图和实施例对本发明进一步说明。  The invention will now be further described with reference to the drawings and embodiments.
图 1是本发明铅笔型逆行气管插管导芯的原理图。  BRIEF DESCRIPTION OF THE DRAWINGS Fig. 1 is a schematic view of a pencil type retrograde tracheal intubation guide core of the present invention.
图 2是导引线原理图。 图 1中 1.铅笔型头， 2.内孔。 图 2中 1.导引线半圆环。 Figure 2 is a schematic diagram of the guide line. Figure 1. Pencil head, 2. Inner hole. Figure 2. The guide line half ring.
五、 具体实施方式 V. Specific implementation methods
在图 1中， 逆行气管插管时先给气道表面麻醉， 把导引线从气管壁插入患者的气管内， 经声门后从口腔或鼻孔部分拔出导引线， 气管外留 3cm,显示 Ocm刻度点， 固定好导引线的气 管外部分， 尽量拉直导引线， 先把气管导管套入导芯， 使导芯前端从气管导管前端外露 "铅 笔头"， 把导引线从导芯的前端内口处插入， 当导芯尾端见导引线上 39cm的刻度时， 可感觉 到导芯受阻于气管壁， 特别肥胖、 皮肤到气管内壁的距离大的病人见 40Cm、 41cm刻度时、 送 导芯受阻时也可基本确定导芯前端到达气管壁。 把气管导管向前推进至气管壁， 拔除导芯和 导引线， 再向前稍稍推进气管导管即可完成困难气管插管。 In Fig. 1, when the retrograde tracheal intubation is performed, the airway surface is anesthetized first, and the guide wire is inserted into the trachea of the patient from the tracheal wall, and the guide wire is pulled out from the oral cavity or the nostril after the glottis, and the trachea is left 3 cm. Display the Ocm scale point, fix the outer part of the trachea of the guide wire, straighten the guide wire as much as possible, first insert the tracheal tube into the lead core, and expose the front end of the lead core from the front end of the tracheal tube to the "pencil head", and guide the guide line from The inner end of the lead core is inserted at the inner end of the lead core. When the tail end of the lead core is seen on the guide line at a distance of 39 cm , the guide core can be felt blocked by the tracheal wall. For patients with a large distance from the skin to the inner wall of the trachea, see 40 Cm . At the 41cm scale, when the feed core is blocked, the front end of the lead core can be basically determined to reach the air tube wall. Push the endotracheal tube forward to the tracheal wall, remove the lead and guide wire, and then advance the tracheal tube slightly to complete the difficult tracheal intubation.

Claims

1. 一种铅笔型逆行气管插管导芯， 前端为 "铅笔头"形， 导引线为前端带半圆形环的弹簧钢 丝。 1. A pencil-type retrograde tracheal intubation lead with a "pencil head" shape at the front and a spring wire with a semi-circular ring at the front end.
2. 根据权利要求 1所述的铅笔型逆行气管插管导芯， 其特征是： 前端为 "铅笔头"形， "铅 笔头"长 1- 4cm，总长为 38cm，有一内径为 0. 5- 6瞧小孔，外径为 5- 8mm，后端设有刻度 33cm、 34cm> 35cra> 36cm> 37cm、 38cm点。  2. The pencil-type retrograde endotracheal tube guide core according to claim 1, wherein: the front end is a "pencil head" shape, the "pencil head" is 1 - 4 cm long, the total length is 38 cm, and an inner diameter is 0. 5- 6 瞧 small hole, outer diameter is 5-8 mm, the back end is provided with scale 33cm, 34cm> 35cra> 36cm> 37cm, 38cm point.
3. 导引线为前端带半圆形环的弹簧钢丝， 长为 75cm， 直径为 0. 5- 2蘭， 离根部 3cm处设为 0cm点， 中间设有 39cm、 40cra, 41 cm的刻度点。  3. The guide wire is a spring wire with a semicircular ring at the front end. The length is 75cm and the diameter is 0. 5- 2 blue. It is set to 0cm from the root 3cm and the 39cm, 40cra, 41cm mark point in the middle. .
PCT/CN2010/001567 2009-12-28 2010-10-08 Guide core and guide wire of pencil-shaped endotracheal tube for retrograde tracheal intubation WO2011079500A1 (en)

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CN103386161A (en) * 2012-05-10 2013-11-13 陈志扬 Guide core applied to retrograde tracheal intubation

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