WO2016129284A1

WO2016129284A1 - Tracheal tube

Info

Publication number: WO2016129284A1
Application number: PCT/JP2016/000706
Authority: WO
Inventors: 杏梨藤城; 康之本間
Original assignee: テルモ株式会社
Priority date: 2015-02-10
Filing date: 2016-02-10
Publication date: 2016-08-18
Also published as: JPWO2016129284A1; JP6841662B2

Abstract

A tracheal tube is provided with: a tube body (2) in which a tip (8) and a base end (11) are connected via a curved section (10); and a cuff (3) fitted on the outer peripheral surface of the tube body (2). At a position closer to the base end (11) side than the cuff (3), a suction lumen (12), which extends along the central axis (O1) of the inner peripheral surface of the tube body (2), is connected to the outside through a suction opening (12b) that penetrates from an inner-wall opening (26) formed in the inner wall of the suction lumen (12) to an outer-wall opening (27) formed in the outer peripheral surface. The suction opening (12b) is formed such that, from the viewpoint of a point on the straight line connecting two third top parts (73) at which a first notch (61) and a second notch (62) intersect, a second angle, which is formed by a cross-section orthogonal to the central axis (O1) and a straight line connecting the third top parts (73) to a top part at which the second notch (62) intersects the outer peripheral surface, is smaller than a first angle, which is formed by a cross-section orthogonal to the central axis (O1) and a straight line connecting the third top parts (73) to a top part at which the first notch (61) intersects the outer peripheral surface.

Description

Tracheal tube

The present invention relates to a tracheal tube.

Traditionally, the trachea is a tracheal tube that makes it easy to breathe and suck foreign objects such as sputum by directly connecting the outside of the body and the trachea to patients who have difficulty breathing spontaneously or patients who have difficulty discharging sputum by themselves. Incision tubes are known. Medical workers connect the ventilator to the tracheostomy tube to maintain the patient's breathing or insert a suction catheter into the tracheostomy tube to aspirate and remove foreign substances such as sputum . Patent Document 1 discloses such a tracheal tube.

Japanese Patent Laid-Open No. 09-290023

However, with the conventional tracheal tube, it may be difficult to suck and remove foreign matters.

In view of the above problems, an object of the present invention is to provide a tracheal tube capable of improving foreign substance suction performance.

A tracheal tube according to a first aspect of the present invention includes a tube body in which a distal end portion and a proximal end portion are connected via a bending portion, and a cuff that is attached to the outer peripheral surface of the tube body and can be contracted and expanded. A suction lumen extending along the central axis of the inner peripheral surface of the tube main body is defined in the wall of the tube main body, the suction lumen from the cuff Is also communicated with the outside through a suction port penetrating from an inner wall opening formed on the inner wall of the suction lumen to an outer wall opening formed on the outer peripheral surface at a position on the base end side, A straight line that is defined by the first cut portion on the cuff side and the second cut portion on the base end portion side and connects the two third top portions where the first cut portion and the second cut portion intersect. A point outside the tracheal tube An angle formed by a cross section perpendicular to the central axis at the third top portion and a straight line connecting the first top portion and the third top portion where the first cut portion and the outer peripheral surface of the tracheal tube intersect. A first angle, a cross section perpendicular to the central axis at the third top, and a straight line connecting the second top and the third top where the outer peripheral surface of the second cut portion and the tracheal tube intersects; When the second angle is defined as the second angle, the second angle is smaller than the first angle.

As one embodiment of the present invention, a plane including the central axis at the positions of the distal end portion and the proximal end portion is defined as a first virtual plane, and passes through the first virtual plane and the central axis on the cross section. When a line intersecting with the lower surface portion located on the outer curved surface side of the curved portion of the outer peripheral surface of the tube main body is set as the first intersecting line than the second virtual plane orthogonal to the first virtual plane, The center point of the inner wall opening in the circumferential direction of the tube body preferably has a central angle in the range of 0 to 60 degrees from the point on the first intersection line in the cross section.

As one embodiment of the present invention, it is preferable that the suction port has a substantially semi-elliptical shape having a straight portion on the cuff side when viewed from the outside of the outer peripheral surface.

As one embodiment of the present invention, the suction port is configured by a groove formed in an outer wall of the tube body, and the groove extends along a circumferential direction of the tube body in a direction not parallel to the central axis. It is preferable to extend linearly.

As one embodiment of the present invention, when the suction lumen is a first suction lumen, the cuff is inserted into the wall of the tube body from the base end side with respect to the cuff along the central axis. A second suction lumen that extends to the distal end side and is located at a position intersecting with the first virtual plane, and includes the first suction lumen and the second suction lumen. In a cross section orthogonal to the central axis, the first suction lumen and the second suction lumen have a substantially elliptical shape, and the second suction lumen has an extension line of a long axis of the first suction lumen. It is preferable that they are formed at positions that do not intersect.

According to the present invention, it is possible to provide a tracheal tube capable of improving the foreign substance suction performance.

It is a figure which shows the state which indwelled the tracheal tube 1 as 1st Embodiment of this invention in the trachea. It is a perspective view which shows the tube main body 2 in the tracheal tube 1 shown in FIG. 3A and 3B are side views of the tube body 2 alone shown in FIG. 4 (a) and 4 (b) are side views of the tube body 2 alone shown in FIG. FIG. 5A is a top view of the tube main body 2, and FIG. 5B is a bottom view of the tube main body 2. FIG. 4 is a cross-sectional view taken along the line II in FIG. FIG. 6 is a cross-sectional view obtained by adding a cuff 3 to the III-III cross-sectional view of FIG. It is the figure which looked at the tracheal tube 1 shown in FIG. 1 from the base end side. FIG. 6 is a view showing a modification of the position of the first suction lumen in the II cross section of FIG. FIG. 3 is a diagram schematically showing an enlarged first suction port portion 12b in a side view of the tube main body 2 shown in FIG. FIG. 4 is a sectional view taken along the line IV-IV in FIG. It is a flowchart figure which shows the procedure of the manufacturing method of the tube main body 2 among the manufacturing methods of the tracheal tube 1 which concerns on 1st Embodiment of this invention. It is sectional drawing which shows the tracheal tube set 100 as 1st Embodiment of this invention. It is a perspective view which shows the tube main body 2 in the tracheal tube 1 which concerns on 2nd Embodiment of this invention alone. FIG. 15A and FIG. 15B are side views of the tube body 2 alone shown in FIG. FIG. 16A and FIG. 16B are side views of the tube body 2 alone shown in FIG. FIG. 17A is a top view of the tube main body 2, and FIG. 17B is a bottom view of the tube main body 2. It is II sectional drawing of Fig.15 (a). It is II-II sectional drawing of Fig.15 (a). FIG. 18 is a cross-sectional view obtained by adding a cuff 3 to the III-III cross-sectional view of FIG. It is the figure which looked at the tracheal tube 1 from the base end side. It is IV-IV sectional drawing of Fig.16 (a). It is a flowchart figure which shows the procedure of the manufacturing method of the tube main body 2 among the manufacturing methods of the tracheal tube 1 which concerns on 2nd Embodiment of this invention. It is a side view which shows the modification of a 1st suction port part. It is sectional drawing which shows the modification of the 2nd suction opening part shown in FIG.

Hereinafter, embodiments of the tracheal tube according to the present invention will be described with reference to the drawings. In each figure, the same code | symbol is attached | subjected to the common member.

(First embodiment)
FIG. 1 is a view showing a state in which the tracheal tube 1 of the first embodiment is placed in the trachea, and FIG. 2 is a perspective view showing a single tube body 2 of the tracheal tube 1. 3A, 3B, 4A, and 4B are side views of the tube main body 2. FIG. FIG. 5A is a top view of the tube main body 2, and FIG. 5B is a bottom view of the tube main body 2. 6 is a cross-sectional view taken along the line II in FIG. 3A, and FIG. 7 is a cross-sectional view taken along the line III-III in FIG. FIG. 8 is a view of the tracheal tube 1 as seen from the proximal end side. FIG. 9 is a view showing a modification of the position of the first suction lumen in the II cross section of FIG. FIG. 10 is a diagram schematically showing an enlarged first suction port portion 12b in a side view of the tube main body 2 shown in FIG. FIG. 11 is a cross-sectional view taken along the line IV-IV in FIG. In addition, in FIG. 7, in addition to the tube main body 2, the cuff 3 is shown for convenience of explanation.

As shown in FIG. 1, a tracheal tube 1 is attached to a tube body 2, a contractible and expandable cuff 3 attached on the outer peripheral surface of the tube body 2, and one end of the tube body 2. And a flange member 4.

As shown in FIGS. 2 to 5 and the like, the tube main body 2 extends from the distal end 5 in the extending direction of the central axis O1 of the inner peripheral surface of the tube main body 2 (hereinafter simply referred to as “central axis direction A”). In the state where the hollow portion 7 penetrating to the proximal end 6 is partitioned and the tracheal tube 1 is inserted and indwelled from the outside into the trachea, an airway is secured by the hollow portion 7. The distal end 5 of the tube body 2 is the distal end of the tube body 2 and is one end located on the trachea branch portion side in a state where the tracheal tube 1 is placed in the trachea. The proximal end 6 is the proximal end of the tube body 2 and is the other end that is located on the jaw side when the tracheal tube 1 is placed in the trachea.

More specifically, the tube body 2 is continuous with the distal end portion 8 including the distal end 5 on the proximal end 6 side of the distal end portion 8 in the central axis direction A, and the cuff attachment portion 9 to which the cuff 3 is attached on the outer peripheral surface. A curved portion 10 that is continuous on the proximal end 6 side of the cuff mounting portion 9, and a proximal end portion 11 that is continuous on the proximal end 6 side of the curved portion 10 and includes the proximal end 6. In other words, the distal end portion 8 of the tube main body 2 is connected to the proximal end portion 11 via the cuff mounting portion 9 and the bending portion 10. The flange member 4 is attached to the base end portion 11.

Here, in the present embodiment, when the tube body 2 is viewed from the distal end 5 side of the distal end portion 8 (see FIG. 3B), the direction in which the proximal end 6 is located with respect to the distal end 5, that is, the distal end 5 On the other hand, the direction in which the bending portion 10 is curved is referred to as “upper side”, and the opposite side is referred to as “lower side”.

Further, as shown in FIG. 2 to FIG. 7 and the like, a central axis O1 is provided in the wall of the tube main body 2 between the outer peripheral surface of the tube main body 2 and the inner peripheral surface defining the hollow portion 7 of the tube main body 2. Two hollow portions extending along the line are defined. Specifically, the tube body 2 includes a first lumen 12 formed along a central axis O1 from a first base end opening 12a and a third base end opening 14a that are formed in a wall and defined on a base end surface. A third lumen 14 is provided. In addition, although the small diameter 1st lumen | rumen 12 and the 3rd lumen | rumen 14 which were divided in the wall are also a hollow part, in order to distinguish with the large diameter hollow part 7 for ensuring an airway for convenience of explanation, here " "Lumen".

The tube body 2 may include the second lumen 13 in addition to the first lumen 12 and the third lumen 14, but in the present embodiment, the case where the tube body 2 does not include the second lumen 13 will be described. To do. The configuration of the tube main body 2 including the second lumen 13 will be described in the second embodiment.

The first lumen 12 extends from the first base end opening 12a on the base end surface to a predetermined position on the base end portion 11 side with respect to the cuff 3 and the cuff mounting portion 9, and is formed at the predetermined position. The tube main body 2 communicates with the outside of the tube main body 2 through a first suction port portion 12b that penetrates to the outer peripheral surface of the tube main body 2. In addition, the 1st suction port part 12b of this embodiment is a suction port, and is formed in the curved part 10 as a position of the base end part 11 side rather than the cuff 3 and the cuff mounting part 9. FIG. More specifically, the first suction port portion 12b of the present embodiment is formed in the end portion of the bending portion 10 on the distal end portion 8 side, that is, in the vicinity of the proximal end portion 11 side of the cuff attachment portion 9. The first lumen 12 is a lumen for sucking and removing foreign substances X such as sputum, saliva, blood and the like stored in the trachea upstream side (jaw side) with respect to the cuff 3 in a state indwelled in the trachea. Hereinafter, this will be referred to as a “first suction lumen”.

The third lumen 14 extends from the third base end opening 14a of the base end surface to the position of the cuff 3 and the cuff mounting portion 9, and passes through to the outer peripheral surface of the tube body 2 formed at that position. It communicates with the outside through 14b. Therefore, for example, using a syringe or the like, air or the like into the annular space Y defined by the outer peripheral surface of the cuff mounting portion 9 and the inner surface of the cuff 3 through the flow path 14b from the third proximal end opening 14a of the third lumen 14. The cuff 3 can be expanded in the radial direction B (see FIG. 7) by the supplied fluid. For the expanded cuff 3, if the fluid is sucked from the annular space Y through the flow path 14 b and the third proximal end opening 14 a of the third lumen 14, the cuff 3 is contracted in the radial direction B. Can be made. Thus, the third lumen 14 is a lumen used for contracting and expanding the cuff 3, and is hereinafter referred to as a “cuff lumen”.

Examples of the constituent material of the tube body 2 include silicone, polyvinyl chloride, polyethylene, polypropylene, cyclic polyolefin, polystyrene, poly- (4-methylpentene-1), polycarbonate, acrylic resin, acrylonitrile-butadiene-styrene copolymer Various resins such as a polymer, polyester such as polyethylene terephthalate, butadiene-styrene copolymer, polyamide (for example, nylon 6,

nylon

6,6,

nylon

6,10, nylon 12) can be used. Among them, it is preferable to use a resin such as polyvinyl chloride, polypropylene, cyclic polyolefin, polyester, poly- (4-methylpentene-1) in terms of easy molding.

1 and 7, the cuff 3 is attached on the outer peripheral surface of the cuff mounting portion 9 of the tube main body 2, and the outer peripheral surface of the cuff mounting portion 9 through the cuff lumen 14 of the tube main body 2 described above. And the pressure of the fluid supplied to the annular space Y defined by the inner surface of the cuff 3 can be expanded. Therefore, when the tracheal tube 1 is inserted from the outside into the trachea and the tracheal tube 1 is to be placed at a predetermined position, fluid is supplied to the annular space Y through the cuff lumen of the tube body 2 to 3 is expanded in the radial direction B of the tube body 2 (see FIG. 7). As a result, the outer surface of the expanded cuff 3 is in close contact with the inner wall of the trachea, and the cuff 3 is sandwiched by the inner peripheral surface of the trachea by the frictional force between the outer surface of the cuff 3 and the inner wall of the trachea. Blocks the trachea. Therefore, the position of the cuff 3 in the trachea is fixed, and the tracheal tube 1 can be placed at the predetermined position described above.

Further, when the tracheal tube 1 is pulled out from the trachea or when the position where the tracheal tube 1 is placed is readjusted, the fluid in the annular space Y is sucked using the cuff lumen, and the cuff 3 is removed. Shrink. Thereby, the tube main body 2 of the tracheal tube 1 can be moved along the trachea in the trachea.

In such a cuff 3, the end edge 15 on the proximal end 6 side and the end edge 16 on the distal end 5 side in the central axis direction A are respectively in the circumferential direction C of the tube body 2 (see FIGS. 2 and 6). In the whole area, it is bonded to the outer peripheral surface of the cuff mounting portion 9 by welding, ultrasonic bonding or the like. Thereby, the annular space Y described above is defined by the inner surface of the cuff 3 and the outer peripheral surface of the cuff mounting portion 9. More specifically, as shown in FIG. 7, the end edge 15 on the base end 6 side is bent inside the annular space Y, and the surface of the end edge 15 extending from the outer surface of the cuff 3. Is bonded to the outer peripheral surface of the cuff mounting portion 9 in the annular space Y. Further, the end edge 16 on the tip 5 side is bent to the outside of the annular space Y, and the surface of the end edge 16 extending from the inner surface of the cuff 3 is outside the annular space Y, and the cuff mounting portion 9. It is adhered to the outer peripheral surface of.

The constituent material of the cuff 3 may be, for example, soft polyvinyl chloride, polyurethane, polyethylene, polypropylene, polyester, ethylene-vinyl acetate copolymer (EVA), silicone, or a mixture of these materials. A flexible material can be used.

As shown in FIG. 1, the flange member 4 is attached to the base end portion 11 (see FIG. 2 and the like) of the tube body 2, and when the tube body 2 is inserted into the trachea from outside the body, the tracheal tube 1 is placed. Furthermore, the tip 8 is fixed at an appropriate position in the trachea by contacting the skin. As shown in FIGS. 1 and 8, the flange member 4 is a cylindrical tube that is fitted to the tube main body 2 when the proximal end portion 11 of the tube main body 2 is inserted and fitted to the tube main body 2. And a plate-like flange portion 18 that protrudes radially outward from the outer wall of the cylindrical portion 17 and abuts against the skin in a state where the tracheal tube 1 is indwelled. In FIG. 8, for convenience of explanation, the positions of the first suction lumen 12 and the cuff lumen 14 of the tube body 2 are indicated by two-dot chain lines.

As shown in FIG. 8, communication holes 17 a and 17 c communicating with the first suction lumen 12 and the cuff lumen 14 described above are defined in the cylindrical portion 17 at positions closer to the proximal end than the flange portion 18. ing. In a state where the proximal end portion 11 of the tube body 2 is fitted into the tubular portion 17, the first suction lumen 12 and the cuff lumen 14 are respectively connected through corresponding communication holes 17 a and 17 c. The tracheal tube 1 communicates with the outside, and a medical tube is connected to each of the

communication holes

17a and 17c.

Specifically, the first suction lumen 12 communicates with the outside of the tracheal tube 1 on the proximal end side of the tracheal tube 1 through a corresponding communication hole 17 a formed in the cylindrical portion 17. Therefore, if suction is performed by connecting a syringe or a suction pump to the other end of the suction tube 19 whose one end is fitted to the communication hole 17a of the cylindrical portion 17 exposed outside the body, the first suction lumen from outside the body. The foreign matter X such as a heel can be sucked through 12.

Further, the cuff lumen 14 communicates with the outside of the tracheal tube 1 on the proximal end side of the tracheal tube 1 through a corresponding communication hole 17 c formed in the cylindrical portion 17. Accordingly, if a syringe or the like is connected to the other end of the cuff tube 21 whose one end is fitted to the communication hole 17c of the cylindrical portion 17 exposed to the outside of the body, the annular space of the cuff 3 can be operated by operating the syringe or the like outside the body. The supply and suction of fluid to Y can be performed, whereby the expansion and contraction of the cuff 3 can be manipulated.

The cylindrical portion 17 of the flange member 4 is mounted concentrically with the proximal end portion 11 of the tube main body 2, and the position of the first suction lumen 12 and the cuff lumen 14 in the circumferential direction C of the tube main body 2. The positions are in the vicinity of the positions in the circumferential direction C of the

corresponding communication holes

17a and 17c in the cylindrical portion 17, respectively. Thereby, each communicating

hole

17a and 17c can be shortened, and it is suppressed that the structure of the communicating

holes

17a and 17c of the cylinder part 17 becomes complicated. Further, as shown in FIG. 8, the suction tube 19 and the cuff tube 21 extend from the

communication holes

17a and 17c in the direction in which the flange portion 18 protrudes in the plan view of FIG. It is connected and does not extend to the tip 8 side. By connecting in this way, in the state where the tracheal tube 1 is indwelled in the trachea, the suction tube 19 and the cuff tube 21 are less likely to hit the patient's chin, and the patient's discomfort can be reduced. .

The flange member 4 can be formed of the same material as that of the tube main body 2, for example.

Hereinafter, details of the tube body 2 in the present embodiment will be further described.

[Tip 8 of tube body 2]
As shown in FIG. 6, the tube body 2 is different from the central axis O 2 of the outer peripheral surface and the central axis O 1 of the inner peripheral surface that defines the hollow portion 7. Specifically, in the cross section orthogonal to the central axis O1 of the inner peripheral surface shown in FIG. 6 (in this embodiment, excluding one cross section including the distal end surface of the tube body 2), the central axis O1 of the inner peripheral surface is: It is located above the central axis O2 of the outer peripheral surface, and the outer peripheral surface and the inner peripheral surface are not concentric in the cross section shown in FIG. More specifically, as shown in FIG. 6, the outer peripheral surface of the tube body 2 is on the outer curved surface side (lower side in FIG. 6) of the curved portion 10 in a cross section orthogonal to the central axis O 1 of the inner peripheral surface. The lower surface portion 22 positioned, the upper surface portion 23 positioned on the inner curved surface side (the upper side in FIG. 6) of the bending portion 10, and the side surface portion 24 connecting the lower surface portion 22 and the upper surface portion 23 in the circumferential direction C of the tube body 2. The thickness T of the tube body 2 is the same cross-section (in this embodiment, the same cross-section not including a portion on the upper surface portion 23 side of a tapered portion 25 described later) on the upper surface portion 23 side. The lower surface portion 22 side is larger than that. Furthermore, in this embodiment, the thickness T of the tube body 2 is configured to gradually increase from the upper surface portion 23 toward the lower surface portion 22 in the circumferential direction C in the same cross section (see FIG. 6). The “thickness T of the tube main body 2” means the thickness of the tube main body 2 on a line segment connecting the central axis O1 and one point on the outer peripheral surface.

By making the thickness T on the lower surface portion 22 side of the tube body 2 larger than the thickness T on the upper surface portion 23 side, the sectional area of the first suction lumen 12 formed in the wall on the lower surface portion 22 side is relatively It becomes possible to increase the size, and it becomes easy to prevent clogging of the foreign matter X in the first suction lumen 12, and the suction pressure necessary for suction can be reduced, and the suction efficiency can be improved.

Here, as shown in FIGS. 2 to 7 and the like, the outer peripheral surface of the distal end portion 8 of the tube body 2 is formed with a tapered portion 25 whose outer diameter gradually decreases toward the distal end 5 and extends to the distal end 5. Has been. This tapered portion 25 can reduce the insertion resistance when the tube body 2 is inserted from the outside of the body into the trachea. In particular, as described above, by providing the tapered portion 25 on the outer peripheral surface of the distal end portion 8 of the tube main body 2 having a thickness T (see FIG. 6) depending on the position in the circumferential direction C, the tube main body 2 is moved from outside the body into the trachea. An increase in insertion resistance that can occur at a portion where the thickness T is thick during insertion can be suppressed. When the tube body 2 is inserted into the trachea from outside the body, for example, the skin and trachea at the throat are incised to form an insertion port, and the tube port 2 is expanded using an obturator 50 or the like described later. 2 is inserted. The obturator 50 is removed from the proximal end 6 side of the tube body 2 after the cuff 3 is expanded and the tube body 2 is placed at a predetermined position in the trachea. Further, the obturator 50 may be removed from the proximal end 6 side of the tube body 2 before the tube body 2 is placed at a predetermined position in the trachea and the cuff 3 is expanded.

Furthermore, in this embodiment, as shown in FIG. 7, the angle θ1 of the tapered portion 25 with respect to the central axis O1 of the inner peripheral surface of the tube body 2 is substantially the same regardless of the position in the circumferential direction C. Thereby, the insertion resistance difference in the circumferential direction C that can be generated when the angle with respect to the central axis O1 varies depending on the position in the circumferential direction C when the tube body 2 is inserted into the trachea from outside the body can be reduced.

Furthermore, the tapered portion 25 of the present embodiment has a truncated cone shape in which the length in the central axis direction A at the lower surface portion 22 is longer than the length in the central axis direction A at the upper surface portion 23. Specifically, as described above, the angle θ1 of the tapered portion 25 with respect to the central axis O1 of the inner peripheral surface of the tube body 2 is substantially the same regardless of the position in the circumferential direction C (see FIG. 7). 3 (a), an ellipse formed by connecting the base end of the outer peripheral surface of the tapered portion 25 in the central axis direction A in the circumferential direction C (a solid line indicated by “M” in FIG. 3A) In the circle formed by connecting the cross section including the formed ellipse and the tip of the outer peripheral surface of the tapered portion 25 (the same as the tip of the outer peripheral surface of the tube body 2) in the circumferential direction C (in FIG. 3A) It is not parallel to a cross section including a circle formed by a solid line indicated by “N”. That is, as shown in FIG. 7, the angle θ1 of the tapered portion 25 with respect to the central axis O1 at the lower surface portion 22 and the upper surface portion 23 is the same, but the taper in the central axis direction A at the lower surface portion 22 and the upper surface portion 23. The length of the shape part 25 is different.

Then, the length in the central axis direction A at the lower surface portion 22 is longer than the length in the central axis direction A at the upper surface portion 23, so that the tube on the lower surface portion 22 side in the portion other than the tapered portion 25. Although the thickness T (see FIG. 6) of the main body 2 is thicker than the thickness T of the tube main body 2 on the upper surface portion 23 side, the thickness T on the lower surface portion 22 side and the upper surface portion 23 side are on the distal end surface of the tube main body 2. It is possible to adopt a configuration in which the thickness difference (thickness T difference) is small or the thickness T is substantially equal. That is, since the difference in thickness due to the position in the circumferential direction C can be reduced on the distal end surface of the tube body 2, nonuniform deformation of the tube body 2 due to the difference in rigidity in the circumferential direction C, and this nonuniformity. An increase in insertion resistance due to various deformations can be suppressed.

In particular, like the tube body 2 of the present embodiment, the thickness T of the tube body 2 at the distal end surface is made uniform regardless of the position in the circumferential direction C, and the central axis O1 of the inner circumferential surface is formed at the distal end surface of the tube body 2. It is preferable to adopt a concentric configuration in which the outer peripheral surface and the central axis O2 of the outer peripheral surface substantially coincide (see FIG. 7). In the case of such a configuration, it is particularly preferable to make the thickness T uniform at the distal end surface so as to reduce the insertion resistance at the distal end surface. Note that the thickness T of the distal end surface of the tube body 2 of the present embodiment is 0.6 mm regardless of the position in the circumferential direction C.

[First suction lumen 12 of the tube body 2]
Next, the first suction lumen 12 (first lumen 12) will be described in detail.

2 to 7, the first suction lumen 12 extends in the wall of the tube body 2 along the central axis O1 of the inner peripheral surface of the tube body 2. The first suction lumen 12 is positioned closer to the base end portion 11 than the cuff 3 and the cuff attachment portion 9, and passes through an inner wall opening 26 formed on the inner wall of the first suction lumen 12 to the outer peripheral surface of the tube body 2. It communicates with the outside through a suction port as the first suction port portion 12 b that penetrates to the formed outer wall opening 27.

Here, the cross section shown in FIG. 6 is a cross section that includes the first suction lumen 12 and the cuff lumen 14 and is orthogonal to the central axis O1. 6 indicates a first virtual plane P1 including the central axis O1 at the positions of the distal end portion 8 and the proximal end portion 11 of the tube main body 2, and the first virtual plane P1 of the present embodiment. The virtual plane P1 is a plane including all the central axis O1 of the tube main body 2. Further, “P2” indicated by a broken line in FIG. 6 indicates a second virtual plane P2 that passes through the central axis O1 on the cross section of FIG. 6 and is orthogonal to the first virtual plane P1. Then, an intersection line between the first virtual plane P1 and the lower surface portion 22 located on the outer curved surface side of the curved portion 10 (see FIG. 2 etc.) of the outer peripheral surface of the tube main body 2 is a first intersection line L1 (FIG. 7), a point K1 shown in FIG. 6 indicates a point on the first intersection line L1. Moreover, when the intersection line which the 1st virtual plane P1 and the upper surface part 23 located in the inner curved surface side of the curved part 10 among the outer peripheral surfaces of the tube main body 2 cross is made into the 2nd intersection line L2 (refer FIG. 7). In addition, a point K2 shown in FIG. 6 indicates a point on the second intersection line L2. Furthermore, a straight line L3 indicated by a two-dot chain line in FIG. 6 is an imaginary line passing through two points constituting the maximum diameter of the first suction lumen 12 among the inner walls that define the first suction lumen 12 in this sectional view. Is shown. For convenience of explanation, the straight line L3 is hereinafter referred to as “first straight line L3”.

As shown in FIG. 6, the first suction lumen 12 is provided on the lower surface portion 22 side of the tube body 2 and at a position intersecting the first virtual plane P1. The lower surface portion 22 of the tube main body 2 is a surface on the back side when the tracheal tube 1 is placed in the trachea, and is a surface on the lower side in the vertical direction for a patient sleeping on his back. That is, by disposing the first suction lumen 12 on the lower surface portion 22 side, foreign matter X (such as a sputum) that can easily be stored on the inner surface (back side surface) vertically below in the trachea of the sleeping patient. 1) can be easily sucked through the first suction lumen 12.

As shown in FIG. 6, in the present embodiment, since the midpoint R of the first suction lumen 12 on the first straight line L3 exists on the first virtual plane P1, the first suction port portion 12b faces upward. Since the patient opens toward the lower side in the vertical direction of the sleeping patient, the suction rate of the foreign matter X tends to be high. Here, the suction rate of the foreign matter X is the amount of the foreign matter X that can be sucked through the first suction lumen 12 with respect to the amount of the foreign matter X in the trachea of the patient.

The position of the first suction lumen 12 is not limited to the case where the midpoint R of the first suction lumen 12 on the first straight line L3 exists on the first virtual plane P1. For example, as shown in FIG. 9 as a modified example, the first suction lumen 12 has a midpoint R of the first suction lumen 12 on the first straight line L3 centered on the central axis O1. It may be arranged at a position where the central angle θ2 is in the range of 0 to 60 degrees from the point K1 on L1. When the central angle θ2 is larger than 60 degrees, the suction port of the first suction lumen 12 contacts the foreign matter X that is easily stored on the inner surface (the back side surface) vertically below in the trachea of the sleeping patient. The suction rate of the foreign matter X is likely to be greatly reduced. However, by setting the central angle θ2 in the range of 0 to 60 degrees, the suction rate of the foreign matter X through the first suction lumen 12 is easily maintained at a predetermined value or higher that can function as the tracheal tube 1.

Further, in the cross section including the first suction lumen 12 and perpendicular to the central axis O1, as shown in FIG. 6, the first suction lumen 12 has a substantially elliptical shape. Therefore, the first straight line L3 in the present embodiment is the long axis of the first suction lumen 12 and its extension line.

In addition, in the cross section including the first suction lumen 12 and the cuff lumen 14 and orthogonal to the central axis O1, as shown in FIG. 6, the cuff lumen 14 is also on the upper surface portion 23 side of the outer peripheral surface of the tube body 2. , Formed at a position intersecting the first virtual plane P1. That is, in the cross-sectional view shown in FIG. 6, the first suction lumen 12 and the cuff lumen 14 are formed at positions that are substantially opposed to each other across the central axis O1.

[First Suction Port 12b of First Suction Lumen 12]
Next, the details of the suction port as the first suction port portion 12b of the first suction lumen 12 will be described. As shown in FIGS. 3 (a), 4 (a) and 5 (b), the first suction port portion 12b is located closer to the base end portion 11 than the cuff 3 and is the inner wall of the first suction lumen 12. This is a suction port that penetrates from the inner wall opening 26 formed in the outer wall opening 27 to the outer wall opening 27 formed in the outer peripheral surface of the tube body 2.

As shown in FIG. 5B, the first suction port portion 12b has a first cut portion 61 on the cuff attachment portion 9 side and a second cut portion 62 on the base end 6 side. That is, it is formed in a semi-elliptical shape in front view of the first suction port. That is, the opening portion (outer wall opening 27) of the first suction port portion 12b is defined by the first cut portion 61 and the second cut portion 62, and has a straight portion in the first cut portion 61 in a bottom view. It is formed in a semi-elliptical shape. Such shapes of the inner wall opening 26 and the outer wall opening 27 are formed by using a suction port as the first suction port portion 12b as a groove formed in the outer wall of the tube body 2. Specifically, the groove forming the first suction port portion 12b extends in a straight line not along the circumferential direction C of the tube body 2 in a direction not parallel to the central axis O1. A midpoint of the first cut portion 61 is a first top portion 71, and a midpoint of the second cut portion 62 is a second top portion 72.

As shown in FIG. 4A, the groove forming the first suction port portion 12b has a third apex portion 73 located closest to the upper surface portion 23 in a side view. The 3rd top part 73 is a point where the 1st notch part 61 and the 2nd notch part 62 cross (contact). The first cut portion 61 and the second cut portion 62 intersect at two points. FIG. 10 is a diagram schematically showing an enlarged first suction port portion 12b in a side view of the tube main body 2 shown in FIG. FIG. 10 is a view when one point on a straight line connecting two third top portions 73 is viewed as a viewpoint, and is a view seen from the direction of the arrow shown below FIG. However, as a viewpoint, the inside of the tracheal tube 1 (on the line segment connecting the two third apexes 73) is excluded and viewed from the outside. In the present embodiment, as shown in FIG. 10, the third top portion 73 exists in the direction from the first cut portion 61 to the upper surface portion 23 (that is, the direction directly above in FIG. 4A) in a side view. That is, the cross section perpendicular to the central axis O1 at the third top portion 73 and the straight line connecting the first top portion 71 and the third top portion 73 coincide with each other in a side view of the first suction port portion 12b. In view, it is orthogonal to the first intersection line L1. Further, in the present embodiment, the first cut portion 61 is formed in a straight line shape in a side view, and the second cut portion 62 is formed in a gently curved shape that swells in the direction of the upper surface portion 23 in a side view. Yes. In other words, the groove forming the suction port is, in other words, a cylindrical member having a cross-sectional outer shape on the outer peripheral surface of the tube body 2 and having a groove shape forming the first suction port portion 12b in a side view. The receiving shape of the outer peripheral surface of the cylindrical member is similar to that formed by pressing the outer peripheral surface.

In this way, the suction port as the first suction port portion 12b is configured by a groove extending linearly in the direction not parallel to the central axis O1 and not along the circumferential direction C of the tube body 2, so that during suction. It is possible to prevent the inner surface of the trachea from coming into close contact with the inner wall opening 26. As shown in FIG. 6, when the first suction lumen 12 is provided on the lower surface 22 side of the tube body 2 and at a position intersecting the first virtual plane P1 (that is, θ2 in FIG. 9 is 0 degree). In this case, the suction port is particularly easily blocked by the inner surface of the trachea. However, as in the present embodiment, the inner surface of the trachea inner surface is formed during the suction by configuring the suction port with a groove extending linearly in a direction not parallel to the central axis O1 and not along the circumferential direction C of the tube body 2. It becomes easy to suppress contact | adhering so that the opening 26 may be plugged up. In addition, by forming the third top portion 73 so as to be positioned in the direction from the first top portion 71 toward the upper surface portion 23, the tracheal tube 1 is positioned so that the third top portion 73 is closer to the second top portion 72 than the first top portion 71. The foreign matter X (see FIG. 1) around the cuff 3 that is difficult to be sucked is easily sucked from the first suction port portion 12b.

Further, in the present embodiment, as shown in FIG. 10, the straight line connecting the first top portion 71 and the third top portion 73 is orthogonal to the first intersection line L1. Therefore, when the first suction port portion 12b is viewed from the outside of the outer peripheral surface to the front, the first cut portion 61 is formed on a cross section orthogonal to the central axis O1 on the cuff 3 side. Since the distance of the inner wall opening 26 is reduced, the suction performance can be improved.

It should be noted that a plurality of convex portions may be provided on the inner surface of the groove constituting the suction port as the first suction port portion 12b to form an uneven shape. By forming such a concavo-convex shape on the inner surface of the groove, it becomes further easier to prevent the inner surface of the trachea from adhering to the inner wall opening 26 during suction.

FIG. 11 shows a cross section perpendicular to the central axis O1 and including the inner wall opening 26. As shown in FIG. 11, the first suction lumen 12 is located at the midpoint R of the first suction lumen 12 on the first straight line L3 on the first virtual plane P1, as in FIG. Is formed. That is, in the cross section shown in FIG. 11, the position of the midpoint W in the circumferential direction of the inner wall opening 26 is the same as the midpoint R of the first suction lumen 12 on the first straight line L3 in FIG. The first suction lumen 12 has a midpoint W of the first suction lumen 12 having a central angle θ2 of 0 to 60 from the point K1 on the first intersection line L1 with the central axis O1 on the cross section as the center. You may arrange | position in the position used as the range of a degree.

As described above, the suction port as the first suction port portion 12b sucks foreign matter X (see FIG. 1) such as sputum and saliva stored near the proximal end 6 side of the cuff 3 of the tracheal tube 1. In the central axis direction A, it is particularly preferable that the cuff 3 and the cuff mounting portion 9 are in a position in the vicinity of the base end 6 side.

[Method of manufacturing tracheal tube 1]
Next, a method for manufacturing the tracheal tube 1 of the present embodiment will be described. FIG. 12 is a flowchart showing the procedure of the method for manufacturing the tube main body 2 in the method for manufacturing the tracheal tube 1. As shown in FIG. 12, the manufacturing method of the tube main body 2 of the tracheal tube 1 defines a hollow portion 7 penetrating from the distal end 5 to the proximal end 6 and extrudes a tube material having a first suction lumen 12 in the wall. Step S1 for molding, Step S2 for adhering the cuff 3 to the outer peripheral surface of the extruded tube material, and a die having an inner surface formed in a tapered shape against the tip of the tube material, Step S3 in which the outer diameter is gradually reduced toward the distal end on the outer peripheral surface of the distal end portion of the tube and a tapered shape portion 25 extending to the distal end is formed. And the step S4 of forming the first suction port portion 12b with a blade or the like having a groove shape that forms the first suction port portion 12b in the side view.

In step S3 for forming the tapered portion 25 described above, the end edge 16 on the distal end 5 side of the tube material of the cuff 3 is sandwiched between the inner surface of the mold and the outer peripheral surface of the tube material. Melt part. Thereby, the edge part 16 of the melted cuff 3 is melted, and the adhesive force between the edge part 16 of the cuff 3 and the outer peripheral surface of the cuff mounting part 9 can be further strengthened.

Moreover, in the manufacturing method mentioned above, in step S5 which forms the 1st suction port part 12b, FIG. 3 (a), FIG. 4 (a), FIG. 5 (b), etc. using the cutter which a front-end | tip has a predetermined shape etc. The groove-shaped first suction port portion 12b is formed as long as it is a notch member capable of forming a groove-shaped first suction port portion 12b by cutting out a part of the outer wall of the tube material, It is not restricted to the above-mentioned blade.

Moreover, in step S5 which forms the 1st suction port part 12b, the lower surface part 22 of the tube main body 2 is formed so that the 1st cut part 61 and the 2nd cut part 62 may be formed, for example using a flat blade. The groove-shaped first suction port portion 12b can also be formed by engraving.

In addition, each step of the method for manufacturing the tracheal tube 1 other than the method for manufacturing the tube body 2 can be realized using various known methods, and description thereof is omitted here.

[Tracheal tube set 100]
Finally, a tracheal tube set 100 including the above-described tracheal tube 1 and an obturator 50 inserted into the trachea from outside the body together with the tube main body 2 will be described.

FIG. 13 is a cross-sectional view of the tracheal tube set 100. As shown in FIG. 13, the tracheal tube set 100 is inserted into the trachea from outside the body together with the tracheal tube 1 with the tracheal tube 1 including the tube main body 2 and the distal end protruding from the distal end opening 28 of the tube main body 2. The obturator 50 is provided.

The distal end of the obturator 50 is inserted into the insertion opening formed in the skin and trachea before the distal end 5 of the tube body 2 of the tracheal tube 1. The insertion port is widened by the obturator 50, and the tube body 2 is easily inserted into the trachea.

When the obturator 50 is inserted into the tube body 2 in the tracheal tube 1, the amount of insertion of the obturator 50 into the tracheal tube 1 in the central axis direction A of the inner peripheral surface of the tube body 2 is engaged with the obturator 50. An engagement portion 29 is provided to restrict the movement.

Specifically, the engagement portion 29 of the tracheal tube 1 shown in FIG. 13 is the proximal end surface of the cylindrical portion 17 of the flange member 4, and the obturator 50 is moved from the proximal end 6 (see FIG. 2 etc.) side of the tube body 2. As the tube body 2 is inserted, the flange portion 52 provided at the proximal end portion 51 of the obturator 50 comes into contact with the proximal end surface of the cylindrical portion 17 of the flange member 4 of the tracheal tube 1, and the obturator 50 is moved further. It becomes impossible to insert. That is, the amount of insertion of the obturator 50 into the tracheal tube 1 is regulated by the proximal end surface of the cylindrical portion 17 in the flange member 4 of the tracheal tube 1. The engaging portion is not limited to that shown in FIG. 13. For example, a female screw portion is provided on the inner surface of the cylindrical portion 17 of the flange member 4, and a male screw portion is provided on the outer surface of the proximal end portion 51 of the obturator 50. The tracheal tube 1 and the obturator 50 may be engaged with each other by screwing the female screw portion and the male screw portion.

As described above, the outer peripheral surface of the distal end portion 8 of the tube body 2 is formed with the tapered portion 25 extending to the distal end 5 whose outer diameter gradually decreases toward the distal end 5 (see FIG. 2 and the like). . In addition, a tapered portion 54 whose outer diameter gradually decreases toward the tip is formed on the outer peripheral surface of the tip 53 of the obturator 50. Hereinafter, in order to distinguish the tapered portion 25 of the tube body 2 and the tapered portion 54 of the obturator 50, the tapered portion 25 of the tube body 2 is referred to as a “first tapered portion 25”, and the taper of the obturator 50 is referred to. The shape portion 54 is referred to as a “second taper shape portion 54”.

In a state where the obturator 50 is engaged with the engaging portion 29, at least a part of the second tapered portion 54 is exposed outward from the distal end opening 28 of the tube main body 2, and in the central axis direction A, the tube main body 2. The first tapered portion 25 and the second tapered portion 54 of the obturator 50 are continuously located. By setting it as such a structure, the insertion resistance in the front-end | tip 5 of the tube main body 2 at the time of inserting in a trachea from the outside body can be reduced.

Further, in FIG. 13, the angle θ1 of the first tapered portion 25 with respect to the central axis direction A is larger than the angle θ3 of the second tapered portion 54. Note that the angle θ1 of the first tapered portion 25 with respect to the central axis direction A can be smaller than or substantially equal to the angle θ3 of the second tapered portion 54, but as shown in FIG. By making the angle θ1 of the first taper-shaped portion 25 larger than the angle θ3 of the second taper-shaped portion 54, the insertion resistance at the distal end 5 of the tube body 2 can be reduced, which is more preferable. Further, by making the angle θ1 of the first taper-shaped portion 25 substantially equal to the angle θ3 of the second taper-shaped portion 54, the tip 5 of the tube body 2 and the obturator 50 have a substantially integrated structure, and The insertion resistance can also be reduced. Further, by making the angle θ1 of the first taper-shaped portion 25 smaller than the angle θ3 of the second taper-shaped portion 54, the distal end 5 of the tube body 2 and the obturator 50 are excessively inserted into the tracheal inner wall. Damage can be reduced.

Furthermore, the tube main body 2 includes a distal end surface including an edge portion 30 that defines the distal end opening 28, and in a state where the obturator 50 is engaged with the engaging portion 29, the outer peripheral surface of the second tapered portion 54 is a tube. It fits and contacts the edge 30 of the main body 2. That is, the outer peripheral surface of the second tapered portion 54 is in contact with the edge 30 over the entire area in the circumferential direction C. By adopting such a configuration, the step in the radial direction B between the first taper-shaped portion 25 and the second taper-shaped portion 54 is only the thickness T (see FIG. 6) at the distal end surface of the tube body 2. The insertion resistance at the distal end 5 of the tube main body 2 can be reduced as compared with the configuration in which the outer peripheral surface of the second tapered portion 54 is not in contact with the edge 30 of the tube main body 2 in the entire circumferential direction C. be able to.

(Second Embodiment)
In the first embodiment, the configuration in which the tube body 2 includes the first suction lumen 12 and the cuff lumen 14 has been described. In the second embodiment, a configuration in which the tube body 2 further includes a second suction lumen will be described. The description of the same points as in the first embodiment will be omitted, and different points will be described.

FIG. 14 is a perspective view showing a single tube body 2 of the tracheal tube 1 according to the second embodiment. 15 (a), 15 (b), 16 (a) and 16 (b) are side views of the tube body 2. FIG. FIG. 17A is a top view of the tube main body 2, and FIG. 17B is a bottom view of the tube main body 2. 18 is a sectional view taken along the line II in FIG. 15A, FIG. 19 is a sectional view taken along the line II-II in FIG. 15A, and FIG. 20 is a sectional view taken along the line III-III in FIG. FIG. 21 is a view of the tracheal tube 1 as seen from the proximal end side. FIG. 22 is a cross-sectional view taken along the line IV-IV in FIG. In addition, in FIG. 20, in addition to the tube main body 2, the cuff 3 is shown for convenience of explanation.

In the second embodiment, as shown in FIGS. 14 to 20 and the like, the wall of the tube main body 2 is between the outer peripheral surface of the tube main body 2 and the inner peripheral surface that defines the hollow portion 7 of the tube main body 2. Three hollow portions extending along the central axis O1 are defined. Specifically, the tube body 2 has a second lumen that is formed in the wall and extends along the central axis O1 from the second base end opening 13a that is defined in the base end face as compared with the first embodiment. 13 is further provided.

The second lumen 13 extends from the second base end opening 13a on the base end surface to a predetermined position closer to the distal end portion 8 than the cuff 3 and the cuff mounting portion 9, and is a tube formed at the predetermined position. It communicates with the hollow portion 7 of the tube main body 2 through the second suction port portion 13 b that penetrates to the inner peripheral surface of the main body 2. In addition, the 2nd suction port part 13b of this embodiment is formed in the front-end | tip part 8 as a position of the front-end | tip part 8 side rather than the cuff 3 and the cuff mounting part 9. FIG. More specifically, the second suction port portion 13b of the present embodiment is a notch-shaped suction port that continues to the position of the tip 5 on the inner peripheral surface of the tip 8 as shown in FIG. The second lumen 13 is a lumen for sucking and removing foreign substances X such as soot stored near the tip 8 on the trachea downstream side (tracheal branching portion side) with respect to the cuff 3 placed in the trachea. Hereinafter, it is referred to as “second lumen for suction”.

In this embodiment, as shown in FIG. 21, the first suction lumen 12, the second suction lumen 13, and the cuff lumen 14 described above are disposed in the tube portion 17 at a position closer to the proximal end than the flange portion 18.

Communication holes

17a, 17b, and 17c communicating with each of them are defined. In a state where the proximal end portion 11 of the tube body 2 is fitted in the cylindrical portion 17, the first suction lumen 12, the second suction lumen 13, and the cuff lumen 14 correspond to corresponding communication holes. It communicates with the outside of the tracheal tube 1 via 17a, 17b, 17c, and a medical tube is connected to each of the communication holes 17a-17c. In FIG. 21, for convenience of explanation, the positions of the first suction lumen 12, the second suction lumen 13 and the cuff lumen 14 of the tube body 2 are indicated by a two-dot chain line.

In the present embodiment, the second suction lumen 13 is similar to the first suction lumen 12 in the first embodiment, and the corresponding communication hole 17b and the second suction hole formed in the tube portion 17 are the suction tube 20. The foreign matter X can be sucked through the lumen 13.

The cylindrical portion 17 of the flange member 4 is mounted concentrically with the proximal end portion 11 of the tube main body 2, and the position of the first suction lumen 12 in the circumferential direction C of the tube main body 2 and the second suction lumen 13. The position and the position of the cuff lumen 14 are in the vicinity of the positions in the circumferential direction C of the

corresponding communication holes

17a, 17b and 17c in the cylindrical portion 17, respectively. Thereby, each communicating

hole

17a, 17b, and 17c can be shortened, and it is suppressed that the structure of the communicating

holes

17a, 17b, and 17c of the cylinder part 17 becomes complicated. Further, as shown in FIG. 21, the

suction tubes

19 and 20 and the cuff tube 21 are arranged in the direction in which the flange portion 18 protrudes from the

communication holes

17a, 17b and 17c in the plan view of FIG. It connects so that it may extend, and it does not extend to the front-end | tip part 8 side. By connecting in this way, the

suction tubes

19 and 20 and the cuff tube 21 are less likely to collide with the patient's jaw in a state where the tracheal tube 1 is indwelled in the trachea, thereby reducing patient discomfort. be able to.

[First and

second suction lumens

12 and 13 of the tube body 2]
Next, the positional relationship between the first suction lumen 12 (first lumen 12) and the second suction lumen 13 (second lumen 13) will be described in detail.

The second suction lumen 13 is formed in the wall of the tube main body 2 along the central axis O1 of the inner peripheral surface of the tube main body 2 from the base end portion 11 to the base end portion 11 side of the cuff 3 than the cuff 3. It extends to the tip 8 on the tip 8 side. As described above, the second suction lumen 13 communicates with the inner hollow portion 7 of the tube body 2 through the suction port as the second suction port portion 13b penetrating to the inner peripheral surface of the tube body 2. Yes.

18 is a cross section that includes the first suction lumen 12, the second suction lumen 13, and the cuff lumen 14, and is orthogonal to the central axis O1. A straight line L3 indicated by a two-dot chain line in FIG. 18 indicates an imaginary line passing through two points constituting the maximum diameter of the first suction lumen 12 among the inner walls defining the first suction lumen 12 in this cross-sectional view. A straight line L4 indicated by a two-dot chain line in FIG. 18 is an imaginary line passing through two points constituting the maximum diameter of the second suction lumen 13 among the inner walls defining the second suction lumen 13 in this sectional view. Show. For convenience of explanation, the straight line L3 is hereinafter referred to as “first straight line L3”, and the straight line L4 is referred to as “second straight line L4”.

As shown in FIG. 18, the second suction lumen 13 is formed at a position where the first straight line L3 does not intersect, and the first suction lumen 12 is formed at a position where the second straight line L4 does not intersect. With such a configuration, the distance in the circumferential direction C between the first suction lumen 12 and the second suction lumen 13 can be set to a predetermined distance or more, and the tube body 2 of the tracheal tube 1 is manufactured. In addition, the first suction lumen 12 and the second suction lumen 13 can be easily formed as separate lumens. Further, as shown in FIG. 11, when the outer wall opening 27 is formed on the outer peripheral surface of the tube body 2, it is possible to prevent the opening to be formed from communicating with the second suction lumen 13.

In the present embodiment, as shown in FIG. 18, the second suction lumen 13 is provided on the lower surface portion 22 side of the tube body 2 and at a position intersecting the first virtual plane P1. The lower surface portion 22 of the tube main body 2 is a surface on the back side when the tracheal tube 1 is placed in the trachea, and is a surface on the lower side in the vertical direction for a patient sleeping on his back. That is, by disposing the second suction lumen 13 on the lower surface portion 22 side, foreign substances X such as sputum that can easily be stored on the inner surface (back surface) vertically below in the trachea of the sleeping patient. Thus, it is possible to easily suck through the second suction lumen 13.

Furthermore, as shown in FIG. 18, the angle θ4 formed by the first straight line L3 and the second straight line L4 is larger than 90 degrees. By adopting such a configuration, the distance in the circumferential direction C between the first suction lumen 12 and the second suction lumen 13 can be less than a predetermined distance. As described above, in the trachea of a sleeping patient, foreign substances X such as wrinkles are easily stored on the back side surface in the trachea. Accordingly, the first suction lumen 12 is also preferably located on the side of the lower surface portion 22 of the tube body 2, similarly to the second suction lumen 13. Therefore, by arranging the first suction lumen 12 and the second suction lumen 13 so that the angle θ4 formed by the first straight line L3 and the second straight line L4 in the cross-sectional view of FIG. 18 is greater than 90 degrees, The position in the circumferential direction C of the first suction lumen 12 can be set to a position close to the second suction lumen 13 disposed at a position where the first virtual plane P1 intersects the lower surface portion 22 side.

In other words, the first suction lumen 12 is formed at a position where the central angle is less than 90 degrees from the point K1 on the first intersection line L1 around the central axis O1 in the cross-sectional view of FIG. It is formed at a position that does not intersect the first virtual plane P1 and the second virtual plane P2. That is, in the cross-sectional view of FIG. 18, the first suction lumen 12 is formed on the lower surface portion 22 side with respect to the second virtual plane P2 and at a position that does not intersect the first virtual plane P1 and the second virtual plane P2. ing.

In the cross-sectional view of FIG. 18, the center point R of the first suction lumen 12 on the first straight line L3 centering on the central axis O1 is on the first intersection line L1 as in the first embodiment. The central angle is set to be in the range of 0 to 60 degrees from the point K1. In addition, in the cross-sectional view of FIG. 18, the midpoint S of the second suction lumen 13 on the second straight line L4 is preferably at a position that intersects the first virtual plane P1. Centering on the central axis O1, the midpoint R of the first suction lumen 12 on the first straight line L3 has a central angle of 30 to 80 degrees from the midpoint S of the second suction lumen 13 on the second straight line L4. Is preferably in the range of 40 to 70 degrees, more preferably in the range of 55 to 65 degrees. However, the second suction lumen 13 only needs to be positioned on the lower surface portion 22 side, and as shown in FIG. 18, the midpoint S of the second suction lumen 13 is not positioned on the first virtual plane P1. It may be a configuration.

Further, as shown in FIG. 18, in the cross section including the first suction lumen 12 and the second suction lumen 13 and orthogonal to the central axis O1, the first suction lumen 12 and the second suction lumen 13 are substantially elliptical. have. Accordingly, the first straight line L3 in the present embodiment is the long axis of the first suction lumen 12 and its extension line, and the second straight line L4 in the present embodiment is the long axis of the second suction lumen 13 and This is an extension.

In the present embodiment, as shown in FIG. 18, the cuff lumen 14 in the cross section including the first suction lumen 12, the second suction lumen 13 and the cuff lumen 14 and orthogonal to the central axis O 1 is also provided. On the upper surface 23 side of the outer peripheral surface of the tube body 2, the tube body 2 is formed at a position that intersects the first virtual plane P 1. That is, in the cross-sectional view shown in FIG. 18, the second suction lumen 13 and the cuff lumen 14 are formed at positions substantially opposite to each other with the central axis O1 interposed therebetween.

[Method of manufacturing tracheal tube 1]
Next, a method for manufacturing the tracheal tube 1 of the present embodiment will be described. FIG. 23 is a flowchart showing the procedure of the method for manufacturing the tube body 2 in the method for manufacturing the tracheal tube 1 of the second embodiment. In FIG. 23, steps S11, S12, S13, and S15 correspond to steps S1, S2, S3, and S4 of FIG. 12 in the first embodiment, respectively. The manufacturing method of the tube main body 2 in the second embodiment further includes a cutting tool such as a feather blade from the tip opening of the tube material in addition to the manufacturing method of the tube main body in the first embodiment, and the tapered shape of the outer peripheral surface. Step S14 is included in which a groove is formed at a position where the tip of the second suction lumen 13 is located on the inner peripheral surface at the position where the portion 25 is formed.

The second suction port 13b (see FIG. 19) of the second suction lumen 13 described above is formed by the groove formed in step S14 that forms a groove on the inner peripheral surface that defines the distal end portion of the second suction lumen 13. It is formed. In the manufacturing method described above, the groove is formed by cutting off a part of the inner wall using a cutter, but any cutout member that can form a groove by cutting out a part of the inner wall may be used. It is not limited to.

The present invention is not limited to the configuration specified in the above-described embodiment, and various modifications can be made without departing from the scope of the invention described in the claims. For example, in the tube body 2 described above, the distal end portion 8, the cuff attachment portion 9, and the proximal end portion 11 are straight cylindrical portions that are not curved. However, the tube body 2 may be curved from the distal end portion to the proximal end portion. it can.

For example, the shape of the first suction port portion 12b is not limited to that described in the first embodiment. FIG. 24 is a diagram illustrating a modification of the first suction port portion 12b. The first suction port portion 12 b is defined by the first cut portion 61 and the second cut portion 62. FIG. 24 shows the first suction port portion 12b with a point on the outside of the tracheal tube 1 existing on a straight line connecting two third top portions 73 where the first cut portion 61 and the second cut portion 62 intersect. FIG. That is, for example, if the first suction port portion 12b is formed at the position shown in the first embodiment, FIG. 24 is a diagram showing the first suction port portion 12b in a side view of the tracheal tube 1. In the modification shown in FIG. 24A, unlike the first embodiment, the third top portion 73 is not in the direction from the first top portion 71 to the upper surface portion 23 (the direction directly above in FIG. 4A) but the upper surface portion. 23 side and the base end 6 side. In the example shown in FIG. 24A, the first cut portion 61 from the first top portion 71 toward the third top portion 73 and the second cut portion 62 from the second top portion 72 toward the third top portion 73 are Is also formed in a straight line in a side view.

Here, an angle formed by a cross section orthogonal to the central axis O1 in the third top portion 73 and a straight line connecting the first top portion 71 and the third top portion 73 in a side view of the first suction port portion 12b is θ5. In addition, an angle formed by a cross section orthogonal to the central axis O1 in the third top portion 73 and a straight line connecting the second top portion 72 and the third top portion 73 in the side view of the first suction port portion 12b is θ6. The first suction port portion 12b is formed so that θ5 is smaller than θ6. As a result, the tracheal tube 1 has a foreign substance X (see FIG. 1) around the cuff 3 that is difficult to suck when the third top 73 is formed at a position closer to the second top 72 than the first top 71. It becomes easy to suck from the first suction port portion 12b, and the suction performance of the foreign matter X can be improved.

In the example shown in FIG. 24B, the first notch portion 61 going from the first apex portion 71 to the third apex portion 73 and the second notch portion 62 going from the second apex portion 72 to the third apex portion 73 are Is also formed in a gently curved shape in side view. Also in the example shown in FIG. 24B, the tracheal tube 1 can improve the suction performance because θ5 is formed to be smaller than θ6. Note that FIG. 10 shown in the first embodiment shows a case where θ5 is 0 degree.

In the second embodiment, as shown in FIG. 18, the midpoint S of the second suction lumen 13 on the second straight line L4 in the tube body 2 described above is located on the first virtual plane P1. However, if the configuration is such that the midpoint S is located on the first virtual plane P1 in the cross-sectional view of FIG. 18, it is easy to store on the inner surface on the back side in the trachea. Since foreign matter X such as wrinkles is easily sucked through the second suction lumen 13, it is more preferable to use such an arrangement. In addition, as shown in FIG. 18, in the tube body 2 described above, the midpoint S of the second suction lumen 13 on the second straight line L4 is not located on the first virtual plane P1. Even if it exists, as shown in FIG. 25, if the suction port as the second suction port portion 13b is formed at a position close to the point K1 on the first intersection line L1, the foreign matter X is easily sucked. It can be configured. 25 shows a cross-section at the same position as FIG. 19, and in this cross-sectional view, the third through two points constituting the maximum diameter of the suction port among the suction ports as the second suction port portion 13b. The suction port as the second suction port portion 13b is arranged so that the midpoint U of the suction port on the straight line L5 (virtual line) is located on the first virtual plane P1.

The present invention relates to a tracheal tube.

1: Tracheal tube 2: Tube body 3: Cuff 4: Flange member 5: Tip of tube body 6: Base end of tube body 7: Hollow part 8: Tip part of tube body 9: Cuff mounting part 10 of tube body: Tube Curved portion 11 of main body: Base end portion 12 of tube main body: First suction lumen (first lumen)
12a: first base end opening 12b: first suction port (suction port)
13: Second suction lumen (second lumen)
13a: second base end opening 13b: second suction port (suction port)
14: Cuff lumen (third lumen)
14a: third base end opening 14b: flow path 15: base end side edge portion 16: tip end side edge portion 17: tube portions 17a to 17c: communication hole 18: flange portions 19, 20: suction tube ( Medical tube)
21: Tube for cuff (medical tube)
22: Lower surface portion 23: Upper surface portion 24: Side surface portion 25: First tapered shape portion (tapered shape portion)
26: inner wall opening 27: outer wall opening 28: distal end opening 29: engagement portion 30: edge portion 50: obturator 51: obturator proximal end portion 52: flange portion 53: obturator distal end portion 54: second tapered shape portion (taper) Shape part)
61: 1st cut part 62: 2nd cut part 71: 1st top part 72: 2nd top part 73: 3rd top part A: Direction of central axis of inner peripheral surface of tube main body B: Radial direction C of tube main body : Circumferential direction of tube body K1: Point on first intersection line K2: Point on second intersection line L1: First intersection line L2: Second intersection line L3: First straight line (virtual line)
L4: Second straight line (virtual line)
L5: 3rd straight line (virtual line)
M: Line connecting the proximal end of the tapered portion in the circumferential direction N: Line connecting the distal end of the tapered portion in the circumferential direction O1: Center axis line O2 of the inner peripheral surface of the tube body P2: Center axis line P1 of the outer peripheral surface of the tube body First virtual plane P2: Second virtual plane R: Midpoint S of the first suction lumen on the first straight line: Midpoint T of the second suction lumen on the second straight line: Thickness U of the tube body U: Third Middle point X of the second suction port portion on the straight line: foreign matter Y: annular space W: midpoint θ in the circumferential direction of the inner wall opening θ1: angle θ2 of the tapered portion of the tube body with respect to the central axis line: first virtual plane and center Angle θ3 formed by the straight line connecting the midpoint R of the first suction lumen on the axis and the first straight line: Angle θ4 of the tapered portion of the obturator with respect to the central axis θ5: Angle θ5 formed by the first straight line and the second straight line Cross section perpendicular to the central axis, first top and third top Is a side view of the first suction port, and a straight line connecting the cross section perpendicular to the central axis and the straight line connecting the second top and the third top is a side view of the first suction port. Angle to make

Claims

A tracheal tube comprising: a tube main body in which a distal end portion and a base end portion are connected via a bending portion; and a cuff that is attached to the outer peripheral surface of the tube main body and can be contracted and expanded,
In the wall of the tube main body, a suction lumen extending along the central axis of the inner peripheral surface of the tube main body is defined, and the suction lumen is at a position closer to the base end than the cuff, Communicating with the outside through a suction port penetrating from an inner wall opening formed in the inner wall of the suction lumen to an outer wall opening formed in the outer peripheral surface;
The suction port is
It is defined by the first cut part on the cuff side and the second cut part on the base end part side,
A cross-section orthogonal to the central axis at the third top, with a point on the outside of the tracheal tube on a straight line connecting two third tops where the first cut and the second cut intersect, The angle formed by the first notch and the straight line connecting the first apex where the outer peripheral surface of the tracheal tube intersects the third apex is defined as the first angle, and the central axis at the third apex When the angle formed by the perpendicular cross section and the straight line connecting the second top portion and the third top portion where the second cut portion and the outer peripheral surface of the tracheal tube intersect is the second angle, A tracheal tube characterized in that the second angle is smaller than an angle of 1.
A plane including the central axis at the positions of the distal end and the base is defined as a first virtual plane, and the first virtual plane passes through the central axis on the cross section and is orthogonal to the first virtual plane. The inner wall in the circumferential direction of the tube body when a line intersecting a lower surface portion located on the outer curved surface side of the curved portion of the outer circumferential surface of the tube main body is defined as a first intersecting line, rather than two virtual planes. The tracheal tube according to claim 1, wherein a position of a midpoint of the opening is within a range of a central angle of 0 to 60 degrees from a point on the first intersection line in the cross section.
The tracheal tube according to claim 1 or 2, wherein when the suction port is viewed from the outside of the outer peripheral surface to the front, the suction port has a substantially semi-elliptical shape having a straight portion on the cuff side. .
The suction port is constituted by a groove formed in the outer wall of the tube body,
4. The groove according to claim 1, wherein the groove extends linearly in a direction not parallel to the central axis, not along the circumferential direction of the tube main body. 5. Tracheal tube.
When the suction lumen is a first suction lumen, it extends from the base end side of the cuff from the base end side to the tip end side of the cuff along the central axis in the wall of the tube body. And a second suction lumen located at a position intersecting the first virtual plane is defined,
In a cross section perpendicular to the central axis including the first suction lumen and the second suction lumen, the first suction lumen and the second suction lumen have a substantially elliptical shape and the second suction lumen. The tracheal tube according to any one of claims 1 to 4, wherein the lumen is formed at a position that does not intersect with an extended line of the long axis of the first suction lumen.