WO2020082651A1

WO2020082651A1 - Double-lumen tube and intubation method

Info

Publication number: WO2020082651A1
Application number: PCT/CN2019/076143
Authority: WO
Inventors: 孙喜家
Original assignee: 孙喜家
Priority date: 2018-10-23
Filing date: 2019-02-26
Publication date: 2020-04-30
Also published as: CN109224235B; CN109224235A

Abstract

A double-lumen tube and an intubation method. The double-lumen tube comprises a tracheal cannula (1), a partition plate (12) provided along the longitudinal direction of the tracheal cannula (1) to partition an inner cavity of the tracheal cannula (1) into two independent ventilation chambers (11), tracheal catheters (2) inserted into the two ventilation chambers (11) from the bottom of the tracheal cannula (1), and a ventilation device (3) and an adjustment device (4) sequentially provided on the top of the tracheal cannula (1) from bottom to top; the ventilation device (3) is in communication with a gas source (100) for supplying gas into the two ventilation chambers (11); the ventilation device (3) is fixedly connected to the partition plate (12); the adjustment device (4) is fixedly connected to the tracheal catheters (2); the tracheal catheters (2) are rotatable relative to the axis of the tracheal cannula (1) by means of the ventilation device (3), and/or at least one of the two tracheal catheters (2) is rotatable relative to the axis by means of the adjustment device (4); and the tracheal catheters (2) are extendable and retractable relative to the tracheal cannula (1) by means of the adjustment device (4). The double-lumen tube is designed to have a split structure, and the tracheal catheters (2) are extendable, retractable and rotatable, improving the accuracy and success rate of intubation, having good adjustability, and reducing tissue injury.

Description

Double-lumen tube and intubation method

This application requires the priority of the Chinese patent application submitted to the State Intellectual Property Office of China on October 23, 2018, with the application number 201811236239.3 and the invention titled "a double-lumen tube and intubation method", the entire contents of which are incorporated by reference In this application.

Technical field

The invention relates to the technical field of medical sanitary materials, in particular to a telescopically rotatable double-lumen tube and intubation method.

Background technique

At present, the most commonly used double-lumen tube is divided into a left-side double-lumen tube and a right-side double-lumen tube. The left-side double-lumen tube is composed of left and right double-lumen, left-end cuff, and total line cuff. There are vents at the head end of the tube, which can be connected to the ventilator for mechanical ventilation; the left end of the double-lumen tube has left and right double-lumen openings, and the left opening of the left tube is the main path. There is an approximately 18mm balloon at the end of the main path 15mm above the balloon is the opening of the right lumen. This opening is only a fixed oblique opening with the tip close to the left lumen. During intubation ventilation, insert the left main path of the tracheal intubation tube into the left main bronchus, and the right side hole is aligned with the right bronchus for ventilation to achieve double lung isolation. When the tracheal tube is placed in an upright position, the front end of the catheter has a natural bend to the left to facilitate intubation to the left bronchus. The right double-lumen tube is similar to the left, except that there is a cuff on the right end of the right side. The right opening of the right tube is the main path, and there is one more right upper lobe opening at the right end of the main path. This opening is away from the tail of the catheter The end is about 0.5cm, close to the right upper lobe opening is the cuff, the left opening is a fixed oblique opening with the tip close to the right lumen, and the catheter has a natural bend toward the right side. After the intubation is completed, the auscultation of airway pressure changes and fiber bronchoscopy is generally used to determine whether the dual-lumen bronchial catheter is inserted into the correct position.

The applicant found that the existing technology has at least the following technical problems:

Due to the characteristics of the tracheal anatomy, the left double-lumen tube is easily inserted into the right bronchus by mistake. When the left double-lumen tube is inserted, it needs to be rotated to the left after the catheter enters the glottis, about 90 degrees. The front end of the double lumen tube is turned to the left to facilitate insertion of the left bronchus. The problem of this process is that the process of turning the tube will cause some damage to the glottis and the trachea; in addition, the rotation angle is not enough or the timing is inappropriate. For example, after the intubation is too deep, the trachea is wrapped to wrap the lower catheter. The inner catheter cannot follow the same angle, so that the catheter is inserted into the right bronchus by mistake; once the left double-lumen tube is inserted into the right main bronchus by mistake, you need to use the following methods to adjust: (1) manual adjustment: insert the trachea The tube retracts to the main airway, and then rotates by a certain angle (usually counterclockwise by 90 degrees), and then inserts the trachea to determine whether the position of the catheter is inserted into the left bronchus. From a clinical point of view, this method is difficult to adjust the tracheal catheter to the correct position, and the repeated adjustment of the depth of the catheter will increase the risk of glottis, airway injury, edema, etc .; (2) Application of fiberoptic bronchoscopy: judge the left side After the double-lumen tube was inserted into the right side by mistake, insert the fiber bronchoscope through the opening of the left end of the lumen to the opening of the tail end, visually retreat the bronchus to the main airway, and then insert the fiber bronchoscope into the left bronchus, The tracheal tube was then guided along the bronchoscope into the left bronchus. The problem with this process is that not all units have fiberoptic bronchoscopy. Even the application requires adjustment of the depth of the tracheal tube. This process will also increase the risk of glottis, airway injury, edema, etc .; Out: Intubation again; all of the above adjustment methods have poor intubation accuracy and need to be adjusted repeatedly, so that the glottis, trachea and other tissues will be damaged during the adjustment process.

The current dual-lumen endotracheal intubation is divided into a left-side double-lumen tube and a right-side double-lumen tube. The functions of the two tubes are very different and cannot be interchanged, which affects clinical use. For example, if a left total lobectomy is done, The left double-lumen tube affects the clinical operation, and the tracheal intubation needs to be re-introduced and replaced with the right double-lumen tube.

Summary of the invention

The purpose of the present invention is to provide a double-lumen tube and a method of intubation, to solve the existing double-lumen tube intubation accuracy, convenience and adjustability are poor, and easy to cause glottis in the process of intubation, Technical problems with trachea and other tissue damage.

To achieve the above objectives, the present invention provides the following technical solutions:

A double-lumen tube provided by the present invention includes an endotracheal tube and a partition plate provided along the length of the endotracheal tube to divide the inner cavity of the endotracheal tube into two independent ventilation chambers and from the trachea A tracheal tube inserted into the two ventilation chambers at the bottom of the intubation tube, and a ventilation device and an adjustment device sequentially arranged on the top of the tracheal intubation tube from bottom to top;

The ventilation device communicates with the air source for supplying gas to the two ventilation chambers;

The ventilation device is fixedly connected to the partition plate; the adjustment device is fixedly connected to the tracheal tube;

The tracheal tube can be rotated relative to the tracheal intubation axis by the ventilation device; and / or at least one of the two tracheal tubes can be rotated relative to the axis thereof by the adjustment device;

The endotracheal tube can expand and contract relative to the endotracheal tube through the adjustment device. The two ventilation chambers have the same specifications; in the initial state, the lower end of the tracheal tube is located within the lower end of the tracheal tube; and the distance between the lower end of the tracheal tube and the lower end of the tracheal tube is 0.5 cm.

As a further improvement of the present invention, the bottom ends of the tracheal tubes are all ramped structures.

As a further improvement of the present invention, the tracheal cannula has a length of 26 cm, a diameter of 13-14 mm, and a wall thickness of 0.5-1 mm.

As a further improvement of the present invention, the thickness of the partition plate is 0.5-1 mm.

As a further improvement of the present invention, the end surface of the partition plate in contact with the ventilation chamber is provided with a first rubber layer that increases the sealing effect. The first rubber layer has the same arc structure as the ventilation chamber, and the length of the first rubber layer is greater than the thickness of the partition plate. The first rubber layer has a length of 5 mm and a thickness of 0.5 mm.

As a further improvement of the present invention, the length of the tracheal tube is 80 mm and the diameter is 5 mm. An annular second rubber layer is provided on the upper end mouth of the tracheal tube for increased sealing; the length of the second rubber layer is 1 mm.

As a further improvement of the present invention, the lower parts of the two tracheal tubes are integrally provided, the upper part is provided, and the partition plate is interposed between the regions of the upper parts of the two tracheal tubes.

As a further improvement of the present invention, the lower parts of the two tracheal tubes are connected by a slide rail, and the upper part is provided in a body, and the partition plate is interposed between the regions of the upper part of the two trachea tubes.

As a further improvement of the present invention, when the endotracheal tube rotates relative to the axis of the endotracheal tube, the ventilator is rotatably connected to the top of the endotracheal tube.

As a further improvement of the present invention, an annular fixed seat is provided on the upper outer wall of the endotracheal tube, an annular chute is provided on the top of the fixed seat, the ventilation device is a cylindrical structure with a top seal, and the lower edge of the ventilation device A slider adapted to the sliding groove is provided, and the ventilation device is disposed on the fixed seat through rotation of the slider, so the partition plate extends into the ventilation device to divide the ventilation device In two parts, the side walls of the two parts are respectively provided with air inlets communicating with the ventilation chamber.

As a further improvement of the present invention, the size of the air inlet is 10 mm.

As a further improvement of the present invention, the specification of the fixing seat is 5 mm in height and 3 mm in width.

As a further improvement of the present invention, a locking member is further provided between the ventilation device and the fixing seat, and the locking or releasing of the locking member can realize the fixing of the ventilation device relative to the fixing seat Or rotate.

As a further improvement of the present invention, the locking member is a buckle. The buckle includes a clamping bar hinged on the ventilation device and a hook fixed on the fixing seat. The buckle is realized by using the products in the existing technology and can be purchased through the market.

As a further improvement of the present invention, the specification of the clip is 6 mm in length and 5 mm in width.

As a further improvement of the present invention, the number of the adjusting devices is two, the two adjusting devices are arranged side by side on the top of the ventilation device, and the two adjusting devices are respectively connected to the two tracheal tubes, when When the tracheal tube rotates with respect to its axis, at least one of the two adjusting devices is rotatably disposed on the top of the ventilation device, and the adjustment device can be raised and lowered relative to the ventilation device.

As a further improvement of the present invention, the adjustment device includes a ring-shaped adjustment valve, a hollow tubular adjustment column, and an adjustment member. The adjustment valve is sleeved on the outside of the adjustment column and can rotate and lift relative to the adjustment column; One end of the adjustment piece is connected to the top of the tracheal tube, and the other end is connected to the adjustment valve after passing through the ventilation device; the lower end of the adjustment column is fixedly connected to the top of the ventilation device, and the top of the ventilation device is provided with The opening has the same specification as the inner cavity of the adjustment column.

As a further improvement of the present invention, the adjustment device further includes a guide structure disposed between the adjustment column and the adjustment valve, the guide structure includes a first piston, a second piston, and a guide, the first piston A ring-shaped structure is sleeved on the outside of the adjustment column; the second piston is sector-shaped, and the number of the second pistons is four, and the four second pistons are along the circumferential direction of the first piston Evenly arranged, the first piston and the second piston are fixedly connected, and there is a gap between the two adjacent second pistons for the guide member to pass through, the number of the guide member is four, The shape of the four guides is the same as the shape of the second piston, the guide is surrounded on the outside of the second piston, and the heights of the guide and the adjustment column are the same, and the lower end of the guide is The top of the ventilation device is rotationally connected, the guide member is slidingly connected to the side wall of the first piston near the opening end of the first piston, and the regulating valve is fixedly connected to the first piston through a connection member, the One end of the connecting piece Regulating valve connected to the inner wall, the other end through the gap between the two guide member is fixedly connected with the first piston. The inner cavity of the adjustment column is used for ventilation or penetrating fiber bronchoscopy.

As a further improvement of the present invention, the adjustment device further includes a fixed valve, the fixed valve is disposed at a position where the gap between the outer side of the adjustment valve and the two sector-shaped second pistons intersects, and the length and height of the fixed valve are The width of the regulating valve is the same, the width of the fixed valve is the same as the width of the slit, the rotating shaft is inside the regulating valve, and it is embedded in the regulating valve when it is not in use. When the regulating valve is adjusted to a suitable position, the fixed valve is opened to make it stuck In the gap, it plays a role of temporary fixation.

As a further improvement of the present invention, the gap between two adjacent second pistons is 3 mm.

As a further improvement of the present invention, the first piston has a width of 0.3 mm and a height of 1 cm.

As a further improvement of the present invention, the bottom of the regulating valve is rotatably connected to the top of the ventilation device through a sliding groove and a slider.

As a further improvement of the present invention, the top of the adjusting valve and the top of the venting device are provided with vent holes having the same specifications as the inner cavity of the adjusting column.

As a further improvement of the present invention, the top view projections of the two regulating valves are both circular ring structures less than 3/4 of the circumference, so that the two regulating valves are arranged side by side without interference.

As a further improvement of the present invention, the guide member is made of hard plastic; the guide member has a diameter of 1 cm and a length of 8 cm; a scale layer is provided on the outer wall of the guide member, and the unit scale of the scale layer is 1 cm; The diameter of the adjusting post is 6 mm, and the length of the adjusting post is the same as the length of the guide.

As a further improvement of the present invention, the adjusting member is two adjusting rods, two ends of the adjusting rod are respectively connected to the tracheal tube and the bottom of the second piston, the adjusting rod is a segmented structure, including a front section and In the rear section, the front section, that is, the side of the adjustment rod close to the tracheal tube, is made of a bendable hard plastic material, and the rear section, that is, the side of the adjustment rod, which is far from the tracheal tube, is made of a hard, non-bendable material Made of materials. The width of the adjusting rod is 2mm.

As a further improvement of the present invention, the adjustment device further includes a rubber cap, the diameter of the rubber cap is the same as the diameter of the adjustment valve, and the bottom of the rubber cap is also provided with a downward projection and the adjustment A rubber plug with a suitable inner diameter of the column.

As a further improvement of the present invention, an adjustment tee is further provided between the ventilation device and the air source, and two pipes of the adjustment tee communicate with the two air inlets, and the adjustment tee The third pipeline communicates with the ventilator, and two pipelines communicating with the two intake ports are respectively provided with regulators, and the regulators are used to adjust the intake air volume.

As a further improvement of the present invention, the tee has a Y-shaped structure.

As a further improvement of the present invention, the adjustment device further includes a fixed valve provided outside the adjustment valve for locking or releasing the adjustment valve.

As a further improvement of the present invention, an inflatable intubation cuff is provided at the bottom of the endotracheal tube, and the intubation cuff is made of transparent material.

As a further improvement of the present invention, the distance between the intubation cuff and the tracheal intubation orifice is 0.5 cm; the length of the intubation cuff is 3 cm, and the color of the intubation cuff is transparent.

As a further improvement of the present invention, a catheter cuff is provided at the lower part of the tracheal tube; the catheter cuff specification is 1 cm long; the color of the catheter cuff on the two tracheal tubes is different, respectively blue and red The distance between the catheter cuff and the bottom end of the tracheal tube is 0.5cm.

As a further improvement of the present invention, the two tracheal tubes are divided into a left side tube and a right side tube. An elliptical opening is formed on the bottom wall of the right side of the right tube, and the long diameter of the opening is The axis of the right catheter is parallel. The distance between the opening and the bottom end of the right-side catheter is 0.3 cm; the long diameter length of the opening is 0.9 cm, and the short diameter length is 0.4 cm. The color of the catheter cuff on the left catheter is blue.

As a further improvement of the present invention, the lower end of the left catheter is curved to the left as a whole, and the lower end of the right catheter is curved to the right; and the bending angle of the left catheter is parallel to the parallel plane The angle is 30 degrees; the slope of the bottom of the left duct is toward the left; the bending angle of the right duct is 15 degrees from the parallel plane; the slope of the bottom of the right duct is toward the right.

As a further improvement of the present invention, the lumen of the tracheal cannula is oval or circular, and the cross-sectional shape of the partition plate is selected according to needs, and the ventilation chamber partitioned by the partition plate is circular , Oval or semicircular, the tracheal tube is an overall circular tube, or an elliptical tube at the top and a circular tube at the bottom. When the rotation of the tracheal tube needs to be adjusted by the adjustment device, the top cross-sectional shape of the tracheal tube is the same as the cross-sectional shape of the ventilation chamber, and both are circular; when the adjustment device cannot adjust the tracheal tube During rotation, the top section of the tracheal tube is non-circular.

The method for intubating a double-lumen tube provided by the present invention includes the following steps:

Step A: prepare for surgery, prepare the corresponding surgical tools before intubation, and adjust the bending direction of the end of the tracheal tube according to the intubation needs to facilitate intubation;

Step B: Induction of rapid anesthesia, and then start the insertion of the tracheal intubation. During the tracheal intubation process, try to ensure that the tracheal tubes on the left and right sides are in the center and in parallel positions. If the tracheal tube is angularly offset, you can pass ventilation The rotation of the device drives the partition plate to rotate, thereby adjusting the angle adjustment of the two tracheal tubes, so that the tracheal tubes on both sides are in a horizontal position; during the intubation process, the depth of the tracheal tube is adjusted, and the tracheal tube is inserted into the 24-24 cm from the front teeth depth;

Step C: There are three ways to insert the tracheal tube:

The first case is that when it is used as a double-lumen tube on the left side, it includes two operation steps. The first one is to slowly push the right regulating valve to advance the right tracheal tube by an appropriate distance (the distance is about 4 cm), Then push the left regulating valve to insert the left tracheal tube into the left bronchus, because the right side is occupied by the tracheal tube, greatly reducing the chance of inserting the left tracheal tube into the right bronchus, and obviously increasing the accuracy of intubation; the second, slow Push the left regulating valve, make the left tracheal tube out and insert into the left bronchus, stop when there is resistance, and then retreat about 0.5-1cm; push the right regulating valve to the appropriate distance (the distance is about the distance from the left Adjustment valve (about 4cm), the catheter cuff on the tracheal catheter on both sides is inflated;

The second case is that when used as a double-lumen tube on the right, slowly advance the right regulating valve until there is resistance to stop, retreat about 0.5-1cm, and then push the left regulating valve to an appropriate distance (about the distance from the left regulating valve) 4cm); then close the connecting tube for single lung ventilation, determine the position of the tracheal tube, especially pay attention to whether there is breathing sound in the upper lobe of the right lung, fine-tune the right regulating valve to find the clear breathing sound in the upper lobe of the right lung; or pass the right Insert the fiber bronchoscope into the right hole of the head of the tracheal tube. With the aid of fiber bronchoscope, aim at the opening of the right upper lobe of the lung, and at the same time, determine the position of the left opening;

The third case is to insert the fiber bronchoscope auxiliary intubation through the hole in the right end of the endotracheal tube. When visible, push or turn the left adjustment valve to achieve the best intubation position, and then push Right regulating valve, send the right tracheal tube above the carina, or send the right tracheal tube into the right bronchus, and align the opening of the right upper lobe with the right upper lobe; Symmetrical, adjust the tee and connecting catheter to connect the cannula to the ventilator; then close the left or right connecting catheter to observe whether the breathing sound disappears and whether there is breathing sound on the opposite side to determine whether the cannula is inserted in the wrong position , And whether the position is correct; if necessary, use the adjustment device to expand or contract the tracheal tube for local fine-tuning. After the adjustment is completed, it is fixed by the fixed valve on the adjustment valve.

Step D: Incorrect adjustment of the endotracheal tube, when the position of the endotracheal tube is wrong, withdraw the left or right endotracheal tube into the endotracheal tube, and determine whether the endotracheal tube is in the center. The tracheal tube is in the center position, and the bronchial intubation of the left tracheal tube is repeated; if the adjustment fails, the intubation can not be achieved in the correct position, and the fiber bronchoscope can be used for intubation.

Step E: When the dual-lumen tube is inserted and the single-tube ventilation needs to be replaced after surgery, remove the ventilation device and the adjustment device from the endotracheal tube, and pull out together with the partition plate and two endotracheal tubes in the endotracheal tube Out, make the tracheal intubation into a single-lumen tube, and connect a ventilation interface at the top interface of the tracheal intubation, single-lumen tube ventilation can be performed.

The endotracheal tube in the dual-lumen endotracheal tube provided by the present invention is telescopic and rotatable. After the main endotracheal tube is inserted, there is no need to adjust the position of the intubation tube. Only the position of the endotracheal tube at the tail end needs to be adjusted to achieve the purpose of adjusting the tube , Reducing tissue damage.

Compared with the prior art, the embodiments of the present invention have the following beneficial effects:

1. In the present invention, the tracheal tube can be adjusted in depth and angle through the adjustment valve, which increases the probability of successful intubation, and can be easily adjusted even if it is inserted in the wrong direction.

2. The telescopic tracheal tube in the present invention is located in the inner cavity of the main tracheal intubation tube, which is easier and more convenient to adjust. The tracheal tube is only 8cm long, and is connected to the upper regulating valve through the designed hard rod for easy adjustment.

3. In order to reduce the diameter of the double-lumen tube in the present invention, the method of separating the catheter cannula is adopted, while the length of the tracheal tube is reduced, and the tubular structure is adopted, which greatly reduces the diameter of the double-lumen tube and increases the inner diameter to facilitate the operation. Middle ventilation; and for easy adjustment, the middle partition plate part adopts a rotatable design.

4. In the prior art, when the patient is lying in a supine position, the left and right bronchial orifices are generally horizontal, and after tracheal intubation, the position of the two tracheal tubes is not necessarily guaranteed to be horizontal, and there may be certain The angle deviation affects the effect of intubation. The present invention uses a rotatable ventilation device fixedly connected to the middle partition plate. By rotating the ventilation device, the position of the two tracheal tubes can be adjusted to be in a horizontal position, which is convenient for intubation.

5. At present, the double-lumen tube is used, which is divided into a left-side double-lumen tube and a right-side double-lumen tube. The two have different structures and cannot be used universally. In the present invention, a double tracheal catheter is used, and both tubes are used to achieve independent ventilation. The tube type, so you can freely switch between the left and right double-lumen tubes. At the same time, both sides are inserted into the ideal position at the same time, which can significantly improve the effect of lung collapse on the surgical side and increase the process of single lung ventilation. Oxygenation; the double-lumen tube in the present invention fully achieves the purpose of current double lung isolation required by clinical practice.

6. In the prior art, according to the needs of the operation, the clinical may need to change the double-lumen tube to a single-lumen tube. The current method can only pull out the double-lumen tube, re-intubate the tube, and insert the single-lumen endotracheal tube; this The invention uses a detachable method. When it needs to be replaced, the partition plate and the tracheal tube in the tracheal cannula can be directly pulled out at the same time, and the vent plug can be easily changed into a single Lumen, reducing the process of tracheal intubation.

7. In the present invention, a regulator is added to the ventilated three-way structure, which does not require pliers to clamp the catheter and directly pushes the regulator to control whether or not ventilation is performed.

BRIEF DESCRIPTION

In order to more clearly explain the embodiments of the present invention or the technical solutions in the prior art, the following will briefly introduce the drawings required in the embodiments or the description of the prior art. Obviously, the drawings in the following description are only These are some embodiments of the present invention. For those of ordinary skill in the art, without paying any creative labor, other drawings can be obtained based on these drawings.

FIG. 1 is a schematic structural view of a double-lumen tube of the present invention;

2 is a schematic diagram of the internal structure of the adjusting device in the double-lumen tube of the present invention after removing the rubber cap and the top wall of the adjusting valve;

FIG. 3 is a three-dimensional schematic diagram of the adjusting device in the double-lumen tube of the present invention;

4 is a partial schematic view of the gas conduit in the double-lumen tube of the present invention;

5 is a partial schematic view of the partition plate in the double-lumen tube of the present invention;

6 is a schematic diagram of the structure of the adjustable tee in the double-lumen tube of the present invention;

7 is a schematic cross-sectional view of the regulator in the double-lumen tube of the present invention.

In the picture 1, tracheal intubation; 11, ventilation chamber; 12, partition plate; 121, first rubber layer; 13, fixed seat; 131, chute; 14, intubation cuff; 2, tracheal catheter; 21 , Catheter cuff; 22, oblique opening; 23, opening; 24, second rubber layer; 3, ventilation device; 31, air inlet; 32, locking member; 33, adjustment tee; 34, regulator; 341 , Hollow part; 342, solid part; 4, regulating device; 41, regulating valve; 411, connecting piece; 42, regulating column; 43, regulating piece; 44, opening; 45, guide structure; 451, first piston; 452 , Second piston; 453, guide; 46, rubber cap; 100, air source.

detailed description

To make the objectives, technical solutions, and advantages of the present invention clearer, the technical solutions of the present invention will be described in detail below. Obviously, the described embodiments are only a part of the embodiments of the present invention, but not all the embodiments. Based on the embodiments of the present invention, all other embodiments obtained by a person of ordinary skill in the art without creative efforts shall fall within the protection scope of the present invention.

Example 1:

As shown in FIG. 1, the present invention provides a dual-lumen tube, including an endotracheal tube 1, a partition plate 12 disposed along the length of the endotracheal tube 1, so as to divide the inner cavity of the endotracheal tube 1 into two independent ventilation chambers Chamber 11, tracheal tube 2 inserted into the two ventilation chambers 11 from the bottom of the endotracheal tube 1, and the ventilation device 3 and the adjustment device 4 which are sequentially arranged on the top of the endotracheal tube 1 from bottom to top; the ventilation device 3 and the air source 100 communication is used to supply oxygen to the two ventilation chambers 11; the ventilation device 3 is fixedly connected to the partition plate 12; the adjusting device 4 is fixedly connected to the tracheal tube 2;

In the first embodiment, the endotracheal tube 2 can rotate relative to the axis of the endotracheal tube 1 through the ventilator 3; the endotracheal tube 2 can telescopically move relative to the endotracheal tube 1 through the adjusting device 4. When the endotracheal tube 2 rotates relative to the axis of the endotracheal tube 1, the ventilator 3 is rotatably connected to the top of the endotracheal tube 1.

As an alternative embodiment, the upper outer wall of the endotracheal tube 1 is provided with a ring-shaped fixed seat 13, a ring-shaped chute 131 is provided on the top of the fixed seat 13, the vent device 3 is a cylindrical structure with a top seal, and the vent device 3 is provided with a lower edge The slider adapted to the sliding groove 131 is arranged on the fixed seat 13 through the rotation of the slider. The side wall of the ventilation device 3 is provided with an air inlet 31 communicating with the two ventilation chambers 11.

In order to prevent the ventilation device 3 from rotating during the intubation process to cause the tracheal tube 2 to rotate, a locking member 32 is also provided between the ventilation device 3 and the fixed seat 13, and the locking or releasing of the locking member 32 can realize the ventilation device 3 Relative to the fixation or rotation between the fixed seats 13. In the present invention, the locking member 32 is a buckle, and the buckle includes a buckle hinged on the ventilation device 3 and a buckle fixed on the fixing seat 13, and the buckle can also be realized by using products in the prior art. Available through the market. The specification of the card strip is 6mm in length and 5mm in width.

As shown in FIG. 3, as an optional embodiment, the number of the adjusting devices 4 is two, the two adjusting devices 4 are fixedly arranged side by side on the top of the ventilation device 3, and the two adjusting devices 4 are respectively connected to the two tracheal tubes 2 The adjusting device 4 can be raised and lowered relative to the ventilation device 3 to control the expansion and contraction of the tracheal tube 2.

In the present invention, the adjusting device 4 includes a ring-shaped adjusting valve 41, a hollow tubular adjusting column 42 and an adjusting member 43. The adjusting valve 41 is sleeved on the outside of the adjusting column 42 and can rotate and lift relative to the adjusting column 42; one end of the adjusting member 43 Connected to the top of the tracheal tube 2, the other end passes through the ventilation device 3 and then connected to the adjustment valve 41; the lower end of the adjustment column 42 is fixedly connected to the top of the ventilation device 3, the top of the ventilation device 3 is provided with an opening 44 of the same cavity size .

As shown in FIG. 2, in order to realize the raising and lowering of the adjusting device 4, the adjusting device 4 in the present invention includes a guide structure 45 disposed between the adjusting column 42 and the adjusting valve 41. The guide structure 45 includes a first piston 451, a second piston 452 and The guide 453, the first piston 451 is a ring-shaped structure and is sleeved on the outside of the adjustment column 42; the height of the first piston 451 is smaller than the height of the adjustment column 42, the first piston 451 can rise and fall relative to the adjustment column 42, the second piston 452 is Fan-shaped, and the number of the second piston 452 is four, the four second pistons 452 are evenly arranged along the circumferential direction of the first piston 451, the first piston 451 and the second piston 452 are fixedly connected, and two adjacent second pistons 452 There is a gap for the guide member 453 to pass through. The number of the guide member 453 is four. The shape of the four guide members 453 is the same as the shape of the second piston 452. The guide member 453 surrounds the outside of the second piston 452, and the guide member 453 At the same height as the adjustment column 42, the lower end of the guide 453 is rotatably connected to the top of the ventilator 3, the guide 453 is slidingly connected to the side wall of the first piston 451 near the opening end of the first piston 451, and the adjustment valve 41 is connected to the first One piston 451 fixed To connect, one end of the connecting member 411 is connected to the inner wall of the regulating valve 41, and the other end is fixedly connected to the first piston 451 through the interval between the two guide members 453. When holding the adjustment valve 41 and pulling upward, the first piston 451 will move upward relative to the adjustment column 42 under the driving of the connecting member 411, and the movement of the first piston 451 will cause the second piston 452 to move upward together. During the movement of the first piston 451, the limit guiding effect of the guiding member 453 has the characteristics of stable up and down movement. The lumen of the adjustment column 42 is used for ventilation or penetrating fiber bronchoscopy. The gap between two adjacent second pistons 452 is 3 mm. The first piston 451 has a width of 0.3 mm and a height of 1 cm.

The adjusting device 4 further includes a fixed valve provided outside the adjusting valve 41 for locking or releasing the adjusting valve 41; a fixed valve (not shown in the drawings) is provided outside the adjusting valve 41 and two sector-shaped second pistons 452 At the intersection between the gaps, the length and height of the fixed valve are the same as the width of the regulating valve 41. The width of the fixed valve is the same as the width of the slit. The rotation axis is inside the regulating valve 41. When it is adjusted to a suitable position, the fixed valve is actuated so that it can be caught in the gap and plays a role of temporary fixation.

Preferably, the projections of the two regulating valves 41 in a plan view are both circular and less than 3/4 of a circle, so that the two regulating valves 41 are arranged side by side without interference.

In the present invention, the guide 453 is made of hard plastic; the guide 453 has a diameter of 1 cm and a length of 8 cm; the outer wall of the guide 453 is provided with a scale layer, and the unit scale of the scale layer is 1 cm; the diameter of the adjustment column 42 is 6 mm The length of the adjusting post 42 is the same as the length of the guide 453.

In order to reduce the adjustment member 43 occupying the internal space of the endotracheal tube 1, the adjustment member 43 is two adjustment rods, the two ends of the adjustment rod are respectively connected to the tracheal tube 2 and the bottom of the second piston 452, the adjustment rod is a segmented structure, including the front and rear In the front section, the side of the adjustment rod near the tracheal tube 2 is made of a bendable hard plastic material, and the side of the adjustment rod away from the tracheal tube 2 is made of a hard material that cannot be bent; the width of the adjustment rod is 2 mm. In order to prevent the inflowing airflow from leaking out of the adjusting device 4, the adjusting device 4 further includes a rubber cap 46, which has the same diameter as the adjusting valve 41, and the bottom of the rubber cap 46 is provided with a downwardly protruding and adjusting column 42 rubber plugs with suitable inner diameter specifications.

As shown in FIG. 6, a Y-shaped adjusting tee 33 is also provided between the ventilation device 3 and the air source 100. Two of the pipes of the adjusting tee 33 communicate with the two air inlets 31 and the adjusting tee 33 The third pipe of the is connected to the ventilator, and the two pipes connected to the two air inlets 31 are respectively provided with regulators 34, which are used to adjust the amount of intake air. In the present invention, as shown in FIG. 7, the structure of the regulator 34 includes a lower hollow portion 341 and an upper solid portion 342. The regulator 34 is movably connected to the pipeline. When the hollow portion 341 is aligned with the inner cavity of the pipeline, oxygen can pass through. When it is necessary to close the gas supply line, press the regulator 34 to make the solid part 342 align with the lumen of the pipeline, thereby cutting off the oxygen supply; when air supply is needed again, just press the regulator 34 in the opposite direction to re-make the hollow part 341 Just align with the inner cavity of the pipeline. The regulator 34 is also implemented using products in the prior art and is commercially available.

As in the prior art, an inflatable cannula cuff 14 is provided at the bottom of the endotracheal tube 1, and the cannula cuff 14 is made of transparent material, and an inflatable catheter cuff 21 is provided at the lower part of the tracheal tube 2; The distance between the cuff 14 and the mouth of the tracheal intubation 1 is 0.5 cm; the length of the intubation cuff 14 is 3 cm, and the color of the intubation cuff 14 is transparent. The size of the catheter cuff 21 is 1 cm long; the color of the catheter cuff 21 on the two tracheal tubes 2 is different, respectively blue and red; the distance between the catheter cuff 21 and the bottom end of the tracheal tube 2 is 0.5 cm. The cannula cuff 14 and the catheter cuff 21 have the same or similar specifications in the prior art.

In this embodiment, two types of tracheal tube 2 can be selected. The first is that the tracheal tube 2 is two independent tubes, and the two tracheal tubes 2 are divided into a left tube and a right tube. The left tube Both the right and the right ducts have a slanted opening 22 at the bottom, and an elliptical opening 23 is also provided on the bottom wall of the right duct, and the long diameter of the opening 23 is parallel to the axis of the right duct, the opening 23 is upward Leaf opening. The distance between the opening 23 and the bottom end of the right catheter is 0.3 cm; the length of the opening 23 is 0.9 cm in length and 0.4 cm in short length. The color of the catheter cuff 21 on the left catheter is blue. The catheter cuff 21 on the right catheter is red. The double-lumen tube of this structure can be used as a left-side double-lumen tube or as a right-side double-lumen tube. During adjustment, the two tracheal tubes 2 are controlled to expand or rotate respectively; the second is that the lower parts of the two tracheal tubes 2 are integrally provided, and there is a distance of about 4 cm along the long axis between the front ends of the two tracheal tubes 2, press the left When the side tube is used, the left tracheal tube 2 is at the front and the right side is rear. When the right tube is used, the right tracheal tube 2 is at the front and the left side is rear, the upper part is provided, and the partition plate 12 is inserted in two Between the upper body regions of the tracheal tube 2. This structure differs from the first structure only in that the expansion and rotation of the two tracheal tubes 2 are performed at the same time; the third is that in order to facilitate the expansion and contraction of the tracheal tube 2, the lower part of the two tracheal tubes 2 passes through the slideway The upper part is connected, and the partition plate 12 is inserted between the upper part regions of the two tracheal tubes 2. When the tracheal tube 2 is connected by a slideway, the tracheal tube 2 can only rotate relative to the central axis of the tracheal cannula 1, and only the ventilation device 3 can adjust the rotation of the tracheal tube 2; when the tracheal tube 2 can pass the ventilation device 3 When the rotation is controlled by the adjusting device 4 separately, no slideway is provided between the two tracheal tubes 2.

In order to increase the success rate of intubation, the lower end of the left catheter is curved to the left and the lower end of the right catheter is curved to the right; and the left catheter is bent at an angle of 30 degrees from the parallel plane; left The bottom oblique port 22 of the side duct faces the left side; the right duct has a bending angle of 15 degrees from the parallel plane; the right oblique port 22 of the right duct faces the right side. The side-to-side bending structure of the tracheal tube 2 is the same as that of the double-lumen tube in the prior art.

As an optional embodiment, the inner cavity of the endotracheal tube 1 is oval or circular, and the cross-sectional shape of the partition plate 12 is selected according to needs. The partition chamber 12 makes the divided ventilation chamber 11 circular, oval or The semi-circular, tracheal tube 2 is an overall circular tube, or an elliptical tube at the top and a circular tube at the bottom. When the rotation of the tracheal tube 2 needs to be adjusted by the adjustment device 4, the top cross-sectional shape of the tracheal tube 2 is the same as the cross-sectional shape of the ventilation chamber 11, and both are circular; when the adjustment device 4 cannot adjust the rotation of the tracheal tube 2, the tracheal tube 2 The top section is non-circular.

In this embodiment, the size of the air inlet 31 is 10 mm; the size of the fixed seat 13 is 5 mm in height and 3 mm in width; preferably, the specifications of the two ventilation chambers 11 are the same; in the initial state, the lower end of the tracheal tube 2 is located in the tracheal tube 1 Within the lower end; and the distance between the lower end of the tracheal tube 2 and the lower end of the endotracheal tube 1 is 0.5cm. Among them, the bottom end of the tracheal tube 2 is a structure with an oblique opening 22. The structure of the ramp opening of the cannula at the bottom of the double-lumen tube in the prior art is the same. In the present invention, the endotracheal tube 1 has a length of 26 cm, a diameter of 13-14 mm, and a wall thickness of 0.5-1 mm. The thickness of the partition plate 12 is 0.5-1 mm. The tracheal tube 2 has a length of 80 mm and a diameter of 5 mm.

As shown in FIGS. 4 and 5, in order to increase the sealing performance, the first rubber layer 121 that increases the sealing effect is provided on the end surface of the partition plate 12 that contacts the ventilation chamber 11. The first rubber layer 121 is of the same arc structure as the ventilation chamber 11 and the length of the first rubber layer 121 is greater than the thickness of the partition plate 12. The first rubber layer 121 has a length of 5 mm and a thickness of 0.5 mm. The upper end mouth of the tracheal tube 2 is provided with an annular second rubber layer 24 for increased sealing; the length of the second rubber layer 24 is 1 mm.

Example 2:

The difference between the present embodiment 2 and the embodiment 1 is that at least one of the two tracheal tubes 2 can rotate relative to its axis through the adjusting device 4, and the tracheal tube 2 can expand and contract with respect to the endotracheal tube 1 through the adjusting device 4. In this embodiment, the ventilation device 3 and the fixed base 13 are fixedly connected. The ventilation device 3 cannot rotate with respect to the endotracheal tube 1, so that the partition plate 12 cannot rotate, and both the expansion and rotation of the tracheal tube 2 pass through the adjustment device 4 Realize. The technical solution in Embodiment 2 differs from Embodiment 1 only in that the ventilation device 3 and the fixed base 13 are fixedly connected, and the adjusting device 4 and the ventilation device 3 are rotationally connected at the top.

As an optional embodiment, the number of the adjusting devices 4 is two, the two adjusting devices 4 are arranged side by side on the top of the ventilation device 3, and the two adjusting devices 4 are respectively connected to the two tracheal tubes 2, when the tracheal tubes 2 are opposite When its axis rotates, at least one of the two adjusting devices 4 is rotatably disposed on the top of the ventilation device 3, and the adjusting device 4 can be raised and lowered relative to the ventilation device 3.

Further, the bottom of the adjustment column 42 is fixedly connected to the top of the ventilation device 3, the bottom of the guide member 453 is rotatably connected to the top of the ventilation device 3, and the adjustment valve 41 can be raised and lowered relative to the ventilation device 3 to drive the adjustment member 43 to move up and down. The bottom of the guide 453 and the top of the ventilating device 3 are connected to each other through a sliding groove and a slider.

Example 3:

The difference between Embodiment 3 and Embodiment 2 is that the tracheal tube 2 can be rotated relative to the axis of the endotracheal tube 1 through the ventilation device 3, and at least one of the two tracheal tubes 2 can be rotated relative to the axis thereof through the adjustment device 4 The endotracheal tube 2 can expand and contract with respect to the endotracheal tube 1 through the adjustment device 4.

The structure and connection relationship between the ventilation device 3 and the endotracheal tube 1 in this embodiment 3 are the same as the solution in Example 1, and the connection and structure relationship between the adjustment device 4 and the ventilation device 3 are the same as the solution in Example 2 the same.

The invention also provides a double-lumen tube intubation method, including the following steps:

Step A: Prepare for surgery, prepare the corresponding surgical tools before intubation, and adjust the bending direction of the end of the tracheal tube 2 according to the intubation needs to facilitate intubation;

Step B: Induction of rapid anesthesia, and then start the insertion of the tracheal intubation. During the insertion of the tracheal intubation 1, try to ensure that the tracheal tubes 2 on the left and right sides are in the center and in a parallel position. The partition plate 12 can be rotated by the ventilation device 3 to adjust the angle adjustment of the two tracheal tubes 2, so that the tracheal tubes 2 on both sides are in a horizontal position; during the intubation process, the depth of the tracheal tube 1 is adjusted and the tracheal tube is intubated 1 Insert to a depth of 22-24cm from the front teeth;

Step C: There are three ways to insert the tracheal tube:

The first case is that when it is used as a double-lumen tube on the left side, it includes two operation steps. The first one is to slowly push the right regulating valve 41 to advance the right tracheal tube 2 by an appropriate distance, which is about 4 cm. , Then push the left regulating valve 41 to insert the left tracheal tube 2 into the left bronchus, because the right side is occupied by the tracheal tube 2, greatly reducing the chance of the left tracheal tube 2 inserted into the right bronchus, and significantly increasing the accuracy of intubation; Second, slowly push the left regulating valve 41 to make the left tracheal tube 2 reach out and insert into the left bronchus, stop when there is resistance, and then retreat about 0.5-1cm; push the right regulating valve 41 to the appropriate distance The distance is about 4 cm from the left side regulating valve 41, and the catheter cuff 21 on the tracheal tube 2 on both sides is inflated;

The second case is that when used as a double-lumen tube on the right, slowly advance the right regulating valve 41 until it stops with resistance, retreating about 0.5-1 cm, and then push the left regulating valve 41 to an appropriate distance, which is about About 4cm away from the left regulating valve 41; then close each connecting tube for single lung ventilation, determine the position of the tracheal tube 2, pay special attention to whether there is breathing sound in the right upper lobe, fine-tune the right regulating valve 41, find the right upper lobe breathing Where the sound is clear; or insert a fiber bronchoscope through the right hole of the right end of the right tracheal tube 2 and, with the help of fiber bronchoscope, aim at the opening of the right upper lobe of the lung and at the same time determine the position of the left opening;

The third case is to insert the fiber bronchoscope auxiliary intubation through the hole on the right end of the right tracheal tube 2, and when visible, push or turn the left regulating valve 41 to achieve the best intubation position. Then push the right regulating valve 41 to send the right tracheal tube 2 above the carina, or the right tracheal tube 2 into the right bronchus, and align the opening of the right upper lobe with the right upper lobe; auscultation, through Auscultate the breathing sounds of the two lungs symmetrically, connect the cannula to the ventilator by adjusting the tee and connecting catheter; then close the left or right connecting catheter respectively, observe whether the breathing sound disappears, and whether there is breathing sound on the opposite side, judge the insertion Whether the tube is inserted in the wrong position and the position is correct; if necessary, the adjustment device 4 is used to expand or contract the tracheal tube 2 for local fine adjustment. After the adjustment is completed, it is fixed by the fixed valve on the adjustment valve 41.

Step D: Incorrect adjustment of the endotracheal tube, when the position of the endotracheal tube 2 is wrong, withdraw the left or right endotracheal tube 2 into the endotracheal tube 1, and determine whether the endotracheal tube 2 is in the center. If there is a deviation, pass ventilation The device 3 adjusts the two tracheal tubes 2 to be in the middle position, and re-introduces the bronchial intubation of the left tracheal tube 2; if the adjustment fails and the intubation cannot be achieved in the correct position, the fiber bronchoscope can be used for intubation.

Step E: When the double-lumen tube is inserted and the single-tube ventilation needs to be replaced after surgery, remove the ventilation device 3 and the adjustment device 4 from the endotracheal tube 1, together with the partition plate 12 and the two in the endotracheal tube 1. Two tracheal tubes 2 are pulled out at the same time, so that the tracheal cannula 1 becomes a single lumen tube, and a ventilation port is connected to the top interface of the tracheal cannula 1 to perform single lumen tube ventilation.

The above are only specific embodiments of the present invention, but the scope of protection of the present invention is not limited to this. Any person skilled in the art can easily think of changes or replacements within the technical scope disclosed by the present invention. It should be covered by the protection scope of the present invention. Therefore, the protection scope of the present invention shall be subject to the protection scope of the claims.

Claims

A double-lumen tube, characterized in that it includes an endotracheal tube (1) and a partition plate (12) provided along the length of the endotracheal tube (1) to separate the inner cavity of the endotracheal tube (1) Into two independent ventilation chambers (11), tracheal tubes (2) inserted into the two ventilation chambers (11) from the bottom of the tracheal cannula (1), and sequentially arranged in the Ventilation device (3) and adjustment device (4) on the top of the endotracheal tube (1);

The ventilation device (3) communicates with a gas source (100) for supplying gas into the two ventilation chambers (11);

The ventilation device (3) is fixedly connected to the partition plate (12); the adjustment device (4) is fixedly connected to the tracheal tube (2);

The tracheal tube (2) can rotate relative to the axis of the tracheal tube (1) through the ventilation device (3); and / or at least one of the two tracheal tubes (2) passes through the adjustment device (4) Can rotate relative to its axis;

The endotracheal tube (2) can be telescoped relative to the endotracheal tube (1) by the adjusting device (4).
The dual-lumen tube according to claim 1, characterized in that when the tracheal tube (2) rotates relative to the axis of the tracheal cannula (1), the ventilation device (3) is rotationally connected to the trachea Cannula (1) top.
The dual-lumen tube according to claim 2, characterized in that: an annular fixed seat (13) is provided on the upper outer wall of the tracheal cannula (1), and an annular slide groove (131) is provided on the top of the fixed seat (13) ), The ventilation device (3) is a cylindrical structure with a top seal, the lower edge of the ventilation device (3) is provided with a slider adapted to the sliding groove (131), and the ventilation device (3) The slider is set on the fixed seat (13) by rotation, and an air inlet (31) communicating with the two ventilation chambers (11) is provided on the side wall of the ventilation device (3).
The dual-lumen tube according to claim 3, characterized in that a locking member (32) is further provided between the ventilation device (3) and the fixing seat (13), and the locking of the locking member (32) Or loosening can realize the fixation or rotation of the ventilation device (3) relative to the fixing seat (13).
The dual-lumen tube according to claim 1, characterized in that the number of the adjusting devices (4) is two, and the two adjusting devices (4) are respectively connected to the two tracheal tubes (2), When the tracheal tube (2) rotates relative to its axis, at least one of the two adjusting devices (4) is rotatably disposed on the top of the ventilation device (3), and the adjusting device (4) can be opposed Lifting on the ventilation device (3).
The double-lumen tube according to claim 5, characterized in that the adjusting device (4) includes an annular adjusting valve (41), a hollow tubular adjusting column (42) and an adjusting member (43), the adjusting valve (41) sleeved on the outside of the adjustment column (42), which can rotate and lift relative to the adjustment column (42); one end of the adjustment member (43) is connected to the top of the tracheal tube (2), and the other end After passing through the ventilation device (3), it is connected to the regulating valve (41); the lower end of the regulating column (42) is fixedly connected to the top of the ventilation device (3), and the top of the ventilation device (3) is provided with The opening (44) has the same specification as the inner cavity of the adjusting column (42).
The dual-lumen tube according to claim 6, characterized in that the adjustment device (4) further includes a guide structure (45) disposed between the adjustment column (42) and the adjustment valve (41), so The guide structure (45) includes a first piston (451), a second piston (452), and a guide (453). The first piston (451) is a ring-shaped structure and is sleeved on the adjustment column (42) ) Outside; the second piston (452) is fan-shaped, and the number of the second piston (452) is four, four of the second piston (452) along the circumferential direction of the first piston (451) Evenly arranged, the first piston (451) and the second piston (452) are fixedly connected, and there is a gap between the adjacent two second pistons (452) for the guide member (453) to pass through , The number of the guides (453) is four, the cross-sectional shape of the four guides (453) is the same as the shape of the second piston (452), and the guides (453) are surrounded by the first The outside of the two pistons (452), and the height of the guide (453) and the adjustment column (42) are the same, the lower end of the guide (453) is rotatably connected to the top of the ventilation device (3), the guide Piece (453) near the first The open end of the piston (451) is slidingly connected to the side wall of the first piston (451), and the regulating valve (41) is fixedly connected to the first piston (451) through a connecting member (411), the connecting member (41) One end is connected to the inner wall of the regulating valve (41), and the other end is fixedly connected to the first piston (451) through a gap between the two guides (453).
The dual-lumen tube according to claim 7, characterized in that the adjusting member (411) is two adjusting rods, and both ends of the adjusting rod are connected to the tracheal tube (2) and the second piston ( 452) Bottom connection, the adjustment rod is a segmented structure, including a front section and a rear section, the front section is the side of the adjustment rod near the tracheal tube made of bendable hard plastic material, the rear section is The side of the adjusting rod away from the tracheal tube is made of a hard material that cannot be bent.
The dual-lumen tube according to claim 6, characterized in that the adjusting device (4) further comprises a rubber cap (46), the diameter of the rubber cap (46) is the same as the diameter of the adjusting valve (41) And, the bottom of the rubber cap (46) is also provided with a rubber plug protruding downward and adapted to the inner diameter specification of the adjusting column (42).
A double-lumen tube intubation method, characterized in that it includes the following steps:

Step A: Prepare for surgery, prepare the corresponding surgical tools before intubation, and adjust the bending direction of the end of the tracheal tube (2) according to the needs of intubation to facilitate intubation;

Step B: Induction of rapid anesthesia, and then start the insertion of the tracheal intubation. During the insertion of the tracheal intubation (1), try to ensure that the left and right tracheal tubes (2) are in the center and in a parallel position, if the tracheal tube (2) is found With an angular offset, you can rotate the ventilation device (3) to drive the partition plate (12) to rotate, thereby adjusting the angle of the two tracheal tubes (2) so that the tracheal tubes (2) on both sides are in a horizontal position; During the process, adjust the depth of the endotracheal tube (1), and insert the endotracheal tube (1) to a depth of 22-24 cm from the incisors;

Step C: There are three ways to insert the tracheal tube (2):

The first case is that when it is used as a double-lumen tube on the left side, it includes two operation steps. The first one is to slowly push the right regulating valve (41) to advance the right endotracheal tube (2) an appropriate distance, and then push The left regulating valve (41) allows the left tracheal tube (2) to be inserted into the left bronchus, because the right side is occupied by the tracheal tube (2), greatly reducing the chance of the left tracheal tube (2) being inserted into the right bronchus, and significantly increasing the insertion The accuracy of the tube; the second kind, slowly push the left regulating valve (41), so that the left tracheal tube (2) is protruded and inserted into the left bronchus, stop when there is resistance, and then retreat about 0.5-1cm; Push the right regulating valve (41) to an appropriate distance to inflate the catheter cuff (21) on both tracheal tubes (2);

The second case is that when used as a double-lumen tube on the right, slowly advance the right regulating valve (41) until there is resistance to stop, retreat about 0.5-1cm, and then push the left regulating valve (41) to an appropriate distance; Close each connecting tube for one-lung ventilation, determine the position of the tracheal tube (2), pay special attention to whether there is breathing sound in the upper lobe of the right lung, fine-tune the right regulating valve (41) to find the clear breathing sound in the upper lobe of the right lung; or pass the right Insert the fiber bronchoscope into the right side hole of the lateral end of the lateral tracheal tube (2), with the aid of fiber bronchoscope, aim at the opening of the right upper lobe of the lung, and at the same time, determine the position of the left opening;

The third situation is to insert the fiber bronchoscope auxiliary intubation through the hole at the head end of the right tracheal tube (2), and when visible, push or turn the left regulating valve (41) to achieve the best Intubation position, then push the right regulating valve (41) to send the right tracheal tube (2) above the carina, or the right tracheal tube (2) into the right bronchus, and open the right upper lobe Aim at the upper lobe of the right lung; auscultate, by auscultating the breath sounds of the two lungs are symmetrical, adjust the tee and connecting catheter to connect the cannula to the ventilator; then close the left or right connecting catheter to observe whether the breath sound disappears And whether there is breathing sound on the opposite side, determine whether the intubation is inserted in the wrong position, and whether the position is correct; if necessary, use the adjustment device (4) to expand or contract the tracheal tube (2) for local fine adjustment. After the adjustment, pass the adjustment valve ( 41) to fix the fixed valve.

Step D: Incorrect adjustment of the tracheal tube (2) intubation, when the position of the tracheal tube (2) is wrong, withdraw the left or right tracheal tube (2) into the tracheal tube (1), and judge the tracheal tube (2) ) Whether it is in the center, if there is a deviation, adjust the two tracheal tubes (2) to the center position through the ventilation device (3), and re-intubate the bronchus of the left tracheal tube (2); if the adjustment fails, the correct position cannot be achieved Intubation, fiber bronchoscope can be used for intubation.

Step E: When the double-lumen tube is inserted and the single-tube ventilation needs to be replaced after surgery, remove the ventilation device (3) and the adjustment device (4) from the endotracheal tube (1), together with the endotracheal tube (1) The inner partition plate (12) and the two tracheal tubes (2) are pulled out at the same time, so that the tracheal cannula (1) becomes a single lumen tube, and a ventilation port is connected to the top interface of the tracheal cannula (1). Perform single-lumen tube ventilation.