WO2018139055A1

WO2018139055A1 - Intrathoracic pressure measuring and adjusting system and method for operating same

Info

Publication number: WO2018139055A1
Application number: PCT/JP2017/043288
Authority: WO
Inventors: 浩由紀金田; 巌木幡; 崇厳中家; 惣一輪地
Original assignee: 学校法人関西医科大学; 株式会社木幡計器製作所
Priority date: 2017-01-25
Filing date: 2017-12-01
Publication date: 2018-08-02
Also published as: JPWO2018139055A1; JP6960121B2

Abstract

The purpose of the present invention is to provide an intrathoracic pressure measuring and adjusting system which conveniently measures the intrathoracic pressure and adjusts the intrathoracic pressure. This intrathoracic pressure measuring and adjusting system, which both measures intrathoracic pressure and adjusts the intrathoracic pressure, includes: an indwelling needle part for performing an intrathoracic puncture toward the inside of the thorax; a pressure gauge part for measuring the intrathoracic pressure; a container part for collecting excess air inside the thoracic cavity; and a discharge port part for discharging the collected excess air to the atmosphere, wherein this system has a first path that connects the indwelling needle part and the pressure gauge part, a second path that connects the indwelling needle part and the container part, a third path that connects the container part and the discharge port part, and a fourth path that connects the pressure gauge part and the discharge port part, and also has a direction switching valve which can switch the first path, the second path, the third path, and the fourth path.

Description

Intrathoracic pressure measurement adjustment system and its operating method

The present invention relates to an intrathoracic pressure measuring and adjusting system capable of easily measuring an intrathoracic pressure and adjusting the intrathoracic pressure in an initial medical treatment for pneumothorax treatment, and an operation method thereof.

Pneumothorax is a symptom in which air flows into the thoracic cavity through a hole opened in the side wall pleura covering the inner surface of the chest wall or the visceral pleura covering the lungs, and the lungs collapse (smallly atrophy). Depending on the cause of the hole, there are three main categories: spontaneous pneumothorax, traumatic pneumothorax, and iatrogenic pneumothorax. The most common is spontaneous pneumothorax, where a portion of the alveoli is cystized or directly under the pleura It develops when the resulting cyst is torn and inspiration leaks into the chest cavity (air leak).

The thoracic cavity is a human or animal body space surrounded by the ribs, thoracic vertebrae, sternum and diaphragm, and the pressure in the thoracic cavity space is called intrathoracic pressure. Usually, the inside of the thoracic cavity is maintained at a negative pressure (−4 to −10 cmH ₂ O from atmospheric pressure), so that the lung is pulled in the expansion direction and balanced with the elasticity (contracting force) of the lung itself and inflated. Holding. However, when pneumothorax occurs, the pressure in the thoracic cavity increases and the negative pressure cannot be maintained. As a result, the lung cannot swell and atrophy.

In pneumothorax, chest drainage is often performed. Thoracic drainage is for discharging body fluid (blood, pus, exudate / leakage fluid, etc.) and air accumulated in the chest cavity to the outside of the body. This chest drainage has a water seal, and air discharged from the patient's chest cavity becomes a bubble that passes through the water seal and is discharged to the outside.

As a method for detecting pneumothorax, a method in which a medical worker visually observes air bubbles generated in the water seal portion of chest cavity drainage due to the occurrence of air leakage is generally performed, but it is only a qualitative method. . In order to avoid this uncertainty of visual observation, the pressure between the water seal chamber and the suction source or transmission suction pump is measured, and the occurrence of bubbles is detected based on the pressure fluctuation to detect patient air leaks. A device for diagnosis has been proposed (for example, Patent Document 1).

JP 2014-136104 A

However, thoracic drainage is a treatment that requires hospitalization, and during the treatment there is severe pain due to the drainage tube compressing the intercostal nerve, etc., and body movement is restricted, so it is painful for the patient . Thoracic drainage is less necessary when air leaks stop, but it is difficult to accurately determine whether it is necessary before treatment.

Moreover, there are chest X-rays and CT as objective evaluations that can be currently performed as a diagnosis of pneumothorax, but these are still images, and dynamic observations are made as to whether or not air leakage is in a continuous state with only one imaging. The air leak cannot be estimated by comparing the images after the lapse of time. Although it is conceivable to measure the intrathoracic pressure as a method for determining air leakage, it is possible to make a visual judgment by observing a drain bag under the practice of chest drainage, but the chest cavity can be simply measured without performing chest drainage. The internal pressure cannot be measured.

The present invention has been made in consideration of the above-described conventional problems and demands from the medical field, and in particular, the intrathoracic pressure can be easily measured even in a state where chest drainage is not performed, and the chest cavity It is an object of the present invention to provide an intrathoracic pressure measurement adjustment system capable of adjusting an internal pressure and a method of operating the same.

The inventors of the present invention have intensively studied to solve the above-mentioned problems. First, when the intrathoracic pressure is a physiological state, the negative pressure (around −8 cmH ₂ O) is obtained. It was thought that it could be easily performed by using a gas pressure measuring instrument with high-speed sampling (10 msec) and high precision (0.5% FS) used for industrial and research purposes. And, if the intrathoracic pressure can be measured in real time, the presence or absence of air leakage can be immediately determined, measuring whether it is physiologically normal intrathoracic pressure, high or conversely low, and At the same time, it was thought that the treatment could be performed, and the present invention was completed.

The intrathoracic pressure measurement and adjustment system of the present invention that has solved the above-described problems is to mutually measure and adjust the intrathoracic pressure, and to measure the intrathoracic pressure, and an indwelling needle portion that punctures the chest cavity toward the thorax. A pressure gauge part, a container part for collecting excess air in the thoracic cavity, and a discharge port part for releasing the collected excess air to the outside air, and further, the indwelling needle part and the pressure gauge A first path connecting parts, a second path connecting the indwelling needle part and the container part, a third path connecting the container part and the discharge port part, the pressure gauge part and the discharge port part A first path, the second path, the third path, and the fourth path with one or two direction switching stopcocks, respectively. It is characterized in that it can be switched to a route.

In the present invention, a first direction switching stopcock is interposed in the first route, and a path branched from the first direction switching stopcock is connected to the container portion via a second direction switching stopcock. Here, the first direction switching stopcock performs switching of the excess air in the direction of the discharge port, in addition to the direction of sending the excess air to the pressure gauge unit. It is preferable that the direction switching stopcock of 2 performs switching to open the excess air to the outside air in the direction of the discharge port, in addition to the direction of collecting the excess air in the container.

The container part in the present invention is preferably a syringe.

In the present invention, it is preferable that a sterilizing filter is provided in the middle of the path from the first direction switching cock to the pressure gauge unit or at the attachment port of the first direction switching cock.

The intrathoracic pressure measurement and adjustment system of the present invention that has solved the above-described problems has an intrathoracic gas exhaust pipe, and the intrathoracic gas exhaust pipe includes a first opening for connecting to the indwelling needle portion, and a pressure gauge. A second opening for connecting to the part, a third opening for connecting to the suction device, and a stopper for blocking ventilation between the second opening and the third opening. .

In the intrathoracic pressure measurement adjustment system of the present invention, it is preferable that the intrathoracic gas discharge tube further has a fourth opening for releasing the intrathoracic gas to the outside air.

In the intrathoracic pressure measurement adjustment system of the present invention, it is preferable that the first opening is connected to an indwelling needle portion and the third opening is connected to a suction device.

In the intrathoracic pressure measurement adjustment system of the present invention, it is preferable that the second opening is connected to a pressure gauge unit.

In the intrathoracic pressure measurement adjustment system of the present invention, it is preferable that the pressure gauge unit measures pressure at intervals of 20 milliseconds or less.

In the intrathoracic pressure measurement adjustment system of the present invention, it is preferable that a tube is connected to the first opening.

An operation method of the intrathoracic pressure measurement and adjustment system of the present invention that has solved the above-described problems includes an intrathoracic gas discharge tube having first to third openings, an indwelling needle portion connected to the first opening, A pressure gauge connected to the second opening; a suction device connected to the third opening; and a stopper for blocking ventilation between the second opening and the third opening. An operation method of an intrathoracic pressure measurement adjustment system, comprising: (1) measuring the atmospheric pressure in the intrathoracic gas discharge tube with the pressure gauge unit in a state where the first opening and the second opening are in communication with each other. And (2) a second step of conveying gas from the indwelling needle portion to the suction device in a state where the first opening and the third opening are in communication with each other.

According to the intrathoracic pressure measurement adjustment system and the operation method thereof according to the present invention, since the intrathoracic pressure can be measured and the intrathoracic pressure can be adjusted based on the measurement result, the medical staff can perform It becomes possible to know the situation such as pneumothorax in almost real time.

In addition, by using the intrathoracic pressure measurement and adjustment system of the present invention, it is possible to provide a new treatment policy for pneumothorax in contrast to the diagnosis and treatment policies that depend on the conventional chest drainage, chest X-ray, CT, etc. It can be expected to contribute to the medical field.

(A) And (b) is an external view of the intrathoracic pressure measurement adjustment system which concerns on Embodiment 1 of this invention. It is the figure which showed an example of the direction switching stopcock of the intrathoracic pressure measurement adjustment system which concerns on Embodiment 1 of this invention. It is the figure which showed another example of the direction switching stopcock of the intrathoracic pressure measurement adjustment system which concerns on Embodiment 1 of this invention. It is the figure which showed another example of the direction switching stopcock of the intrathoracic pressure measurement adjustment system which concerns on Embodiment 1 of this invention. It is the figure which showed another example of the direction switching stopcock of the intrathoracic pressure measurement adjustment system which concerns on Embodiment 1 of this invention. It is the figure which showed an example of the direction of the direction switching cock and air flow in the intrathoracic pressure measurement adjustment system which concerns on Embodiment 1 of this invention. It is the figure which showed another example of the direction of the direction switching cock and the air flow in the intrathoracic pressure measurement adjustment system which concerns on Embodiment 1 of this invention. It is the figure which showed another example of the direction of the direction switching cock and the air flow in the intrathoracic pressure measurement adjustment system which concerns on Embodiment 1 of this invention. It is the figure which showed another example of the direction of the direction switching cock and the air flow in the intrathoracic pressure measurement adjustment system which concerns on Embodiment 1 of this invention. It is a drawing substitute photograph which shows the simple respiration model used for verification of the intrathoracic pressure measurement adjustment system which concerns on Embodiment 1 of this invention. It is a drawing substitute photograph which shows the whole structure of verification of the intrathoracic pressure measurement adjustment system which concerns on Embodiment 1 of this invention. It is the figure which showed an example of the data of the normal respiration model measured by verification of the intrathoracic pressure measurement adjustment system which concerns on Embodiment 1 of this invention. It is the figure which showed an example of the data of the model of the tension pneumothorax measured by verification of the intrathoracic pressure measurement adjustment system which concerns on Embodiment 1 of this invention. It is the figure which showed an example of the data of the puncture deaeration model of the tension pneumothorax measured by verification of the intrathoracic pressure measurement adjustment system which concerns on Embodiment 1 of this invention. It is a block diagram of the intrathoracic pressure measurement adjustment system in Embodiment 2 of this invention.

Hereinafter, embodiments of the present invention will be described with reference to the drawings. However, the present invention is not limited only to the following embodiments, and is implemented with modifications within a range that can meet the gist of the preceding and following descriptions. All of which are within the scope of the present invention. In the following description, the same parts are denoted by the same reference numerals.

(Embodiment 1)
FIG. 1A shows an external view of an intrathoracic pressure measurement adjustment system according to a first embodiment of the present invention. As shown in FIG. 1 (a), an intrathoracic pressure measurement adjustment system 1 according to a first embodiment of the present invention includes an indwelling needle unit 2 that punctures the chest cavity toward the thorax and a pressure gauge unit 3 that measures the intrathoracic pressure. And a container part 4 for collecting excess air in the thoracic cavity, and a discharge port part 5 for releasing the collected excess air to the outside air. In addition, the intrathoracic pressure measurement adjustment system 1 of the present invention includes a first path R1 that connects the indwelling needle part 2 and the pressure gauge part 3, a second path R2 that connects the indwelling needle part 2 and the container part 4, and a container part. 4 and the discharge port part 5, and a fourth path R 4 that connects the pressure gauge part 3 and the discharge port part 5. Here, the first route R1, the second route R2, the third route R3, and the fourth route R4 can be switched to each route by the two direction switching stopcocks 6A. .

FIG. 1 (b) shows the vicinity of the indwelling needle portion 2 in the intrathoracic pressure measurement adjustment system shown in FIG. 1 (a). A tube member 9 is connected to the proximal side of the indwelling needle portion 2 as shown in FIG. As a result, even when the intrathoracic pressure measurement adjustment system 1 moves while the doctor is performing treatment, the tube member 9 serves as a movement buffer member, so that the indwelling needle portion 2 can be prevented from moving. . Therefore, the pain of the patient during treatment can be reduced.

2 to 5 show other examples of direction switching cocks. In addition to the case of using two direction switching stopcocks 6A in combination as shown in FIG. 1, the direction switching stopcock opens a path connecting two adjacent L-shaped directions as shown in FIGS. One direction-switching stopcock 6B that can be used may be used. Specifically, the direction toward the container part 4 and the direction toward the discharge port part 5 can be closed to open the first path R1 connecting the indwelling needle part 2 and the pressure gauge part 3 (see FIG. 2). . Moreover, the direction which goes to the pressure gauge part 3 and the direction which goes to the discharge port part 5 are closed, and 2nd path | route R2 which connects the indwelling needle part 2 and the container part 4 can be opened (refer FIG. 3). Moreover, the direction which goes to the indwelling needle part 2 and the direction which goes to the pressure gauge part 3 can be closed, and the 3rd path | route R3 which connects the container part 4 and the discharge port part 5 can be opened (refer FIG. 4). Furthermore, the direction which goes to the indwelling needle part 2 and the direction which goes to the container part 4 are closed, and the 4th path | route R4 which connects the pressure gauge part 3 and the discharge port part 5 can be opened (refer FIG. 5).

In general, the direction switching stopcock can be a commercially available medical cock used for adjusting the flow path of the drug solution when performing intravenous anesthesia, infusion therapy, infusion, or the like. Specifically, for example, a structure composed of a polycarbonate main body and a polyethylene handle can be used, and the flow path direction can be changed depending on the direction of the handle.

In addition, although the above-described direction switching stopcocks have been described with respect to the one in which the path and the on-off valve have an integral configuration, it is possible to use the one in which the path and the on-off valve have a separate configuration in carrying out the present invention. For example, after a cross joint or a Y-shaped joint is provided, a configuration may be adopted in which an on-off valve is separately provided in each path.

The indwelling needle unit 2 is a medical instrument that is generally inserted and indwelled in a vein when blood is collected or infused. However, in the practice of the present invention, an indwelling needle for thoracic puncture is used. (Manufactured by Medikit Co., Ltd.).

The pressure gauge unit 3 can be a commercially available digital manometer. Specifically, when pressure is applied to the diaphragm (diaphragm), pressure corresponding to the deflection of the diaphragm is generated, and the resistivity of the gauge resistance (piezoresistance) changes in proportion to this pressure. This is converted into a digital signal and processed, and then converted into a digital pressure value and output as data. More specifically, a sensor that senses pressure is used, and a MEMS (Micro Electro Mechanical System) system can be used. For example, a digital manometer DMH-01 (manufactured by Kiso Keiki Seisakusyo Co., Ltd.) is cited. be able to.

The container part 4 is for collecting excess air in the thoracic cavity. From the viewpoint of measuring the collected amount without leaking the collected excess air to the outside, a syringe barrel (syringe) is used. preferable.

Next, the operation of the intrathoracic pressure measurement adjustment system of the present invention will be described below with reference to the drawings, taking as an example the case of using two switching cocks in three directions.

6 to 9 are schematic views showing the flow of excess air in the thoracic cavity according to the directions of the handles of the two three-way switching stopcocks for each operation of the intrathoracic pressure measuring and adjusting system of the present invention. As shown in FIGS. 6 to 9, the intrathoracic pressure measurement adjustment system 1 includes an indwelling needle unit 2 that punctures the chest cavity into the thorax, a pressure gauge unit 3 that measures the intrathoracic pressure, and excess air in the chest cavity. The container 4 is provided, and the first path R1 connecting the indwelling needle part 2 and the pressure gauge part 3 is provided with a first direction switching cock 6A1 and branches off from the first direction switching cock 6A1. The route is connected to the container part 4 via the second route R2 via the second direction switching stopcock 6A2. Here, the first direction switching stopcock 6A1 can switch the excess air in the direction of the discharge port 5 in addition to the direction of sending excess air in the thoracic cavity to the pressure gauge unit 3. Further, the second direction switching stopcock 6A2 has a direction to collect excess air discharged from the thoracic cavity in the container part 4 and a direction to open the collected excess air to the outside air from the discharge port part 5. Can be switched.

(Deaeration of excess air in the thoracic cavity and collection in a container: see FIG. 6)
By setting the direction of the handle of the first direction switching cock 6A1 as shown in FIG. 6, the path toward the pressure gauge unit 3 is closed, branching from the first direction switching cock 6A1, and the second direction switching cock. The route towards 6A2 is opened. Furthermore, by setting the direction of the handle of the second direction switching stopcock 6A2 as shown in FIG. 6, the path for releasing the air from the discharge port portion 5 is closed, and the indwelling needle portion 2 and the container portion 4 are connected. The second route R2 is opened. Thereby, excess air from the thoracic cavity is collected in the container part 4 via the second path R2.

(Exhaust of excess air collected in the container: see Fig. 7)
The direction of the handle of the first direction switching cock 6A1 is the same as in FIG. 6, and the direction of the handle of the second direction switching cock 6A2 is set as shown in FIG. The third path R3 to be connected is opened, and the air collected in the container part 4 flows to the discharge port part 5 via the third path R3, is released to the outside, and is discharged.

(Intrathoracic pressure measurement: see FIG. 8)
The direction of the handle of the second direction switching stopcock 6A2 is the same as that in FIG. 7, and the direction of the handle of the first direction switching stopcock 6A1 is set as shown in FIG. The first path R1 connecting the two is opened, and the path from the first direction switching cock 6A1 to the second direction switching cock 6A2 is closed. As a result, excess air in the thoracic cavity flows to the pressure gauge unit 3 via the first path R1, and the intrathoracic pressure is measured.

(Zero correction of pressure gauge: see Fig. 9)
By setting the direction of the handle of the first direction switching cock 6A1 and the direction of the handle of the second direction switching cock 6A2 as shown in FIG. 9, a fourth path connecting the pressure gauge unit 3 and the discharge port unit 5 is established. R4 is opened, and the direction toward the indwelling needle portion 2 and the path toward the container portion 4 are closed. Thereby, the air which exists in the pressure gauge part 3 flows into the discharge port part 5 via the 4th path | route R4, is open | released and discharged | emitted outside, and zero correction of a pressure gauge is performed.

With the above configuration, adjustment of excess air accumulated in the thoracic cavity (specifically, operations of degassing, collecting, and discharging excess air) and measurement of intrathoracic pressure can be performed mutually. That is, the medical staff can discharge excess air accumulated in the thoracic cavity and measure the intrathoracic pressure, so that the patient's pneumothorax situation can be known almost in real time.

Note that excess air accumulated in the chest cavity of the patient is directly sterilized in the middle of the path (first path R1) from the first direction switching cock 6A1 of the above configuration (see FIG. 8) to the pressure gauge unit 3. In consideration of flowing into the pressure gauge unit 3 through circulation with the air that is not in the state, it is preferable to provide a sterilizing filter 7 in the middle of the path as shown in FIG. The sterilization filter 7 may be provided at the attachment port of the first direction switching cock 6A1 in addition to the middle of the path.

Next, with respect to the intrathoracic pressure measurement adjustment system of the present invention, a simple breathing model capable of easily measuring the intrathoracic pressure is prepared, taking as an example only the chest puncture state without performing chest drainage, and the intrathoracic pressure measurement adjustment of the present invention The system was verified. In order to simplify the measurement of intrathoracic pressure, the direction switching stopcock was performed using a single three-way stopcock and without a container for collecting excess air in the chest cavity. This will be described below with reference to the drawings.

(Production of simple breathing model)
FIG. 10 is a drawing-substituting photograph of a simple breathing model used for verification of the intrathoracic pressure measurement adjustment system of the present invention. The simple breathing model 11 is produced as follows. As shown in FIG. 10, the bottom of the PET bottle 12 was cut out and a separately prepared rubber balloon 13A was attached to the cut-out trace of the PET bottle 12 to prepare a human diaphragm (simulated diaphragm 15). Next, the rubber balloon 13B is put in the plastic bottle 12, and the mouth of the plastic balloon 12 is covered while inverting the mouth of the rubber balloon 13B, thereby simulating a human airway / lung (simulated airway 16). A simulated lung 14) was prepared. In this way, the simple breathing model 11 including the simulated diaphragm 15, the simulated airway 16, and the simulated lung 14 was configured.

(Intrathoracic pressure measurement)
FIG. 11 is a drawing-substituting photograph showing the overall configuration of verification of the intrathoracic pressure measurement adjustment system 1.
As shown in FIG. 11, the intrathoracic pressure measurement adjustment system 1 is attached by puncturing the thorax portion (thoracic puncture portion 17) of the simple breathing model 11 using 18G Happy Cass (manufactured by Medikit Co., Ltd.) of the indwelling needle portion 2. did. The simulated diaphragm 15 was pressed toward the inside of the PET bottle 12, and the simulated diaphragm 15 was repeatedly pulled down or released repeatedly to simulate the breathing motion, and the intrathoracic pressure as a model of normal breathing was measured. (Measurement 1). Next, a small hole was made in the simulated lung 14, and the intrathoracic pressure as a model of tension pneumothorax was measured (measurement 2). Next, from the tension pneumothorax model, the three-way stopcock 18 of the measurement circuit was opened to the outside air, and the intrathoracic pressure as a puncture deaeration model of the tension pneumothorax was measured (measurement 3). The pressure gauge unit 3 of the intrathoracic pressure measurement adjustment system 1 used a digital manometer DMH-01 (manufactured by Kiso Keiki Seisakusho Co., Ltd.). The analysis of intrathoracic pressure data was performed by connecting an external communication unit provided in the pressure gauge unit 3 and a data analysis PC. The specifications of the pressure gauge unit 3 and the data analysis software are as follows.

Data sampling: 10msec
Accuracy: 0.5% F.V. S.
Data analysis software: HM Viewer (manufactured by Kiso Keiki Seisakusho)

(Verification of intrathoracic pressure measurement adjustment system)
FIG. 12 shows an example of data in the normal respiration model obtained in the measurement 1. From FIG. 12, it was found that the periodic change in intrathoracic pressure from the flat pressure to the negative pressure can be continuously measured.

FIG. 13 shows an example of data in the model of tension pneumothorax obtained in the above measurement 2. From FIG. 13, it was found that intrathoracic pressure can be measured continuously in a tension pneumothorax model that gradually becomes positive pressure from normal negative pressure breathing.

FIG. 14 shows an example of data in the puncture deaeration model of the tension pneumothorax obtained in the measurement 3 above. From FIG. 14, it was confirmed that in the model for treatment of tension pneumothorax, the hyperthoracic pressure can be avoided by continuously measuring the intrathoracic pressure and performing deaeration treatment.

From the above verification results, using the simple breathing model, the intrathoracic pressure measurement adjustment system in Embodiment 1 of the present invention can reproduce the treatment status of normal breathing, tension pneumothorax, and tension pneumothorax, The simulated intrathoracic pressure could be measured continuously and in real time.

In the first embodiment, the description has been given by taking as an example the state of only thoracic puncture in which chest drainage is not performed, but the intrathoracic pressure measurement adjustment system of the present invention is not limited to such an application, For example, it can be used even when chest drainage is being performed. In this case, in addition to visually determining the intrathoracic pressure by observing the drain bag, the measurement of the intrathoracic pressure by the system is quantitative. Will be done.

(Embodiment 2)
FIG. 15 is a configuration diagram of the intrathoracic pressure measurement adjustment system according to the second embodiment of the present invention. In FIG. 15, the intrathoracic gas discharge tube 19 is connected to the first opening V <b> 1 for connecting to the indwelling needle unit 2, the second opening V <b> 2 for connecting to the pressure gauge unit 3, and the suction device 4. The third opening V3 has a stopper that blocks airflow between the second opening and the third opening, for example, the stopper 20a and the stopper 20b, and the basic configuration is the first embodiment. Since this is the same as the intrathoracic pressure measurement and adjustment system, a duplicate description will not be given.

The position where the first opening V1 to the third opening V3 are provided in the intrathoracic gas exhaust pipe 19 is not particularly limited. For example, the first opening V1, the second opening V2, and the third opening V3 are arranged in this order from the upstream portion. be able to. Alternatively, the first opening V1, the third opening V3, and the second opening V2 can be arranged in order from the upstream portion. The intrathoracic gas sucked into the suction device 4 connected to the third opening V3 may be directly released from the suction device 4 to the outside air. However, the fourth opening V4 for opening the chest cavity gas to the outside air is further provided. The fourth opening V4 may be provided on the downstream side of the second opening V2 or the third opening V3.

When the intrathoracic gas exhaust pipe 19 is a disposable product, a plastic material such as polyethylene, polypropylene, or polycarbonate can be preferably used as the material of the intrathoracic gas exhaust pipe 19. When the intrathoracic gas exhaust pipe 19 is not a disposable product, glass can be used as the material of the intrathoracic gas exhaust pipe 19. The intrathoracic gas discharge tube 19 may be a member in which a portion including the first opening V1 to the third opening V3 is integrally formed. For example, the first tube including the first opening V1 and the second opening V2 ( (Not shown) and a second pipe (not shown) provided with the third opening V3 and the fourth opening V4 may be connected to each other. As the first pipe and the second pipe, the three-way cock 18 as described in the first embodiment can be used.

It is preferable that the pressure gauge unit 3 measures pressure at intervals of 20 milliseconds or less, more preferably 15 milliseconds or less, and even more preferably 10 milliseconds or less. This is because if the measurement interval is short, the output value can be obtained as a smooth output graph of the intrathoracic pressure in real time.

Also in the second embodiment, it is preferable that the tube member 9 is connected between the indwelling needle portion 2 and the first opening as in the first embodiment. This is because even when the intrathoracic gas discharge tube 19 moves during the treatment by the doctor, the tube member 9 functions as a buffer member for movement, so that the indwelling needle portion 2 can be prevented from moving. .

(Operation method of intrathoracic pressure measurement adjustment system)
The intrathoracic pressure measurement adjustment system according to the second embodiment of the present invention can be operated by at least the following two steps.
(1) Step of measuring the pressure in the intrathoracic gas discharge pipe 19 with the pressure gauge unit 3 in a state where the first opening V1 and the second opening V2 are in communication with each other (2) the first opening V1 and the third opening Step of conveying gas from the indwelling needle part 2 to the suction device 4 in a state where the V3 is in communication

The above step (1) and step (2) can be performed even if the order is changed, and step (1) and step (2) may be repeated alternately. While step (1) or step (2) is performed, the ventilation between the second opening V2 and the third opening V3 is blocked so that the pressure gauge unit 3 and the suction device 4 do not interfere with each other. The stopper to be closed (for example, the stopper 20a and / or the stopper 20b) is closed.

According to the intrathoracic pressure measurement and adjustment system and the operation method thereof according to the present invention, since the intrathoracic pressure can be measured while exhausting excess air accumulated in the thoracic cavity, the medical staff can monitor the situation of the patient's pneumothorax and the like almost in real time It becomes possible to know at. In addition, the intrathoracic pressure measurement adjustment system of the present invention makes it possible to determine the presence or absence of air leakage during puncture deaeration, and provides an index for determining a treatment policy for pneumothorax. Further contribution can be expected.

This application claims the benefit of priority based on Japanese Patent Application No. 2017-011110 filed on January 25, 2017. The entire contents of the specification of Japanese Patent Application No. 2017-011110 filed on January 25, 2017 are incorporated herein by reference.

DESCRIPTION OF SYMBOLS 1 Intrathoracic pressure measurement adjustment system 2 Indwelling needle part 3 Pressure gauge part 4 Container part 5 Outlet part 6A Direction switching cock 6B Direction switching cock 6A1 First direction switching cock 6A2 Second direction switching cock 7 Sterilization filter 8 Sterilization filter 9 Tube member 11 Simple breathing model 12 PET bottle

13A Rubber balloon

13B Rubber balloon 14 Simulated lung 15 Simulated diaphragm 16 Simulated airway 17 Thoracic puncture unit 18 Three-way stopcock R1 First route R2 Second route R3 Third route R4 Fourth Path 19 Intrathoracic gas exhaust pipe V1 1st opening V2 2nd opening V3 3rd opening V4 4th opening 20a Plug 20b Plug 20c Plug

Claims

An intrathoracic pressure measurement and adjustment system that mutually performs measurement of intrathoracic pressure and adjustment of the intrathoracic pressure,
An indwelling needle that punctures the chest cavity into the thorax,
A pressure gauge unit for measuring the intrathoracic pressure;
A container for collecting excess air in the thoracic cavity;
An exhaust port for opening the collected excess air to the outside air, and
Furthermore, the 1st path | route which connects the said indwelling needle part and the said pressure gauge part,
A second path connecting the indwelling needle part and the container part;
A third path connecting the container part and the discharge port part;
A fourth path connecting the pressure gauge part and the discharge port part,
The intrathoracic pressure, wherein the first route, the second route, the third route, and the fourth route can be switched to each route by one or two direction switching stopcocks. Measurement adjustment system.
A first direction switching stopcock is interposed in the first path,
The path branching from the first direction switching stopcock is connected to the container part via a second direction switching stopcock,
Here, the first direction switching stopcock performs switching of the excess air in the direction of the discharge port, in addition to the direction of sending the excess air to the pressure gauge unit,
The said 2nd direction switching stopcock performs switching which opens the said excess air to the external air of the direction of the said discharge port part other than the direction which collects the said excess air in the said container part. Intrathoracic pressure measurement adjustment system.
The intrathoracic pressure measurement adjustment system according to claim 1 or 2, wherein the container portion is a syringe.
The intrathoracic pressure measurement according to claim 2 or 3, wherein a sterilizing filter is provided in the middle of a path from the first direction switching cock to the pressure gauge unit or at an attachment port of the first direction switching cock. Adjustment system.
An intrathoracic pressure measurement and adjustment system having an intrathoracic gas drain,
The intrathoracic gas discharge tube includes a first opening for connecting to the indwelling needle part, a second opening for connecting to the pressure gauge part, a third opening for connecting to a suction instrument, and the second opening. And an intrathoracic pressure measuring and adjusting system, comprising a stopper that blocks ventilation between the first opening and the third opening.
6. The intrathoracic pressure measurement adjustment system according to claim 5, wherein the intrathoracic gas discharge tube further includes a fourth opening for releasing the intrathoracic gas to the outside air.
The intrathoracic pressure measurement adjustment system according to claim 5 or 6, wherein the first opening is connected to an indwelling needle portion, and the third opening is connected to a suction device.
The intrathoracic pressure measurement adjustment system according to any one of claims 5 to 7, wherein the second opening is connected to a pressure gauge unit.
The intrathoracic pressure measurement adjustment system according to any one of claims 1 to 4 and claim 8, wherein the pressure gauge unit measures pressure at intervals of 20 milliseconds or less.
The intrathoracic pressure measurement adjustment system according to any one of claims 5 to 9, wherein a tube is connected to the first opening.
An intrathoracic gas drainage tube having first to third openings, an indwelling needle portion connected to the first opening, a pressure gauge portion connected to the second opening, and a third opening. A method for operating an intrathoracic pressure measurement and adjustment system comprising: a suction device that includes: a suction device; and a stopper that blocks ventilation between the second opening and the third opening,
(1) measuring the atmospheric pressure in the intrathoracic gas discharge tube with the pressure gauge unit in a state where the first opening and the second opening are in communication with each other;
(2) a second step of conveying gas from the indwelling needle portion to the suction device in a state where the first opening and the third opening are in communication with each other;
A method of operating an intrathoracic pressure measurement adjustment system, comprising: