WO2020155652A1 - 气管插管导丝，气管导管，及其应用 - Google Patents

气管插管导丝，气管导管，及其应用 Download PDF

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Publication number
WO2020155652A1
WO2020155652A1 PCT/CN2019/107187 CN2019107187W WO2020155652A1 WO 2020155652 A1 WO2020155652 A1 WO 2020155652A1 CN 2019107187 W CN2019107187 W CN 2019107187W WO 2020155652 A1 WO2020155652 A1 WO 2020155652A1
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WIPO (PCT)
Prior art keywords
guide wire
channel
tracheal intubation
patient
tracheal
Prior art date
Application number
PCT/CN2019/107187
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English (en)
French (fr)
Inventor
鲍永新
王丽娥
鲍永岩
刘丹
陈作雷
张海青
魏建凤
李婧
Original Assignee
青岛市妇女儿童医院（青岛市妇幼保健院、青岛市残疾儿童医疗康复中心、青岛市新生儿疾病筛查中心）
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
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Priority claimed from CN201910109011.6A external-priority patent/CN109675173A/zh
Application filed by 青岛市妇女儿童医院（青岛市妇幼保健院、青岛市残疾儿童医疗康复中心、青岛市新生儿疾病筛查中心） filed Critical 青岛市妇女儿童医院（青岛市妇幼保健院、青岛市残疾儿童医疗康复中心、青岛市新生儿疾病筛查中心）
Publication of WO2020155652A1 publication Critical patent/WO2020155652A1/zh

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/04—Tracheal tubes
    • A61M16/0402—Special features for tracheal tubes not otherwise provided for
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
    • A61M25/09—Guide wires
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
    • A61M25/09—Guide wires
    • A61M2025/091—Guide wires having a lumen for drug delivery or suction
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M2202/00—Special media to be introduced, removed or treated
    • A61M2202/04—Liquids
    • A61M2202/0468—Liquids non-physiological
    • A61M2202/048—Anaesthetics

Definitions

  • This application belongs to the technical field of medical devices, and in particular relates to a tracheal intubation guide wire, a tracheal catheter, and applications thereof.
  • Tracheal intubation refers to the technique of inserting a special tracheal tube into the trachea through the glottis. It is an important technique to ensure the patient's airway patency, effective ventilation and oxygen supply and avoid aspiration in emergency and general anesthesia.
  • Figures 1 and 2 show a schematic diagram of a tracheal intubation in the prior art.
  • Figure 1 also shows some structures of the human body, including the nasal cavity 1, the oral cavity 2, the tongue 3, the epiglottis 4, the glottis 5, the trachea 6 and the esophagus 7.
  • Figure 1 also shows the trachea A catheter 8 and a laryngoscope 9 for assisting intubation;
  • Fig. 2 shows a wire guide wire 10 in the prior art.
  • the steel wire 10 can be used as a guide wire to change the advancing direction of the tracheal tube 8 by rotating the steel wire 10, especially the bending part of the front end of the wire, to find a better angle (as shown in Figure 2) during intubation.
  • a better angle as shown in Figure 2
  • Patent CN203777449U discloses a multifunctional tracheal intubation guide core.
  • a channel is provided in the guide core housing.
  • anesthetics can be sprayed on the surface through the channel, or through the tail master Orifice spontaneous breathing airflow carbon dioxide detection to identify the airway, and then guide the tracheal tube to make it smoothly inserted.
  • the multifunctional endotracheal intubation guide core has a poor drug delivery effect.
  • the application provides a tracheal intubation guide wire, a tracheal catheter, and applications thereof; it is more convenient for intubation.
  • the first aspect of the present application provides a tracheal intubation guide wire, including an elongated guide wire body and an inhalation body located at the first end of the guide wire body; when the intubation is applied, the inhalation body has a volume and can pass through Inhalation drives a part of the inhalation body and the guide wire body into the patient's body.
  • the volume of the suction body is adjustable or the suction body is a sealed body with a fixed volume.
  • the inhalation body can be filled with gas or liquid to give it volume.
  • the diameter of the inhalation body is smaller than the diameter of the cross section from the oropharynx to the smallest part of the trachea.
  • the guide wire is made of plastic material.
  • a first channel is axially provided in the guide wire body, which communicates with the inhalation body, and can fill or release substances into the inhalation body through the first channel to increase or decrease the volume.
  • the tracheal intubation guide wire includes a guide wire body, the guide wire body is axially provided with a first channel for injecting drugs, such as anesthetics, and the first channel includes a guide wire that extends out of the guide wire.
  • the drug delivery end of the silk body, the drug delivery end is sheathed with a spray head slidably connected to the first channel, and the spray head is covered with an inhalation body for storing the medicine.
  • the first through hole on the spray head communicates with the first channel, and the spray head is also provided with a second through hole for spraying the medicine when the patient inhales.
  • the inhalation body is a soft capsule located on the side of the spray head, and the second through hole is located at the front end of the spray head.
  • a groove for accommodating the spray head is provided on the guide wire body.
  • the spray head is provided with a plurality of first through holes along the circumferential direction, and the front end of the spray head is provided with a plurality of second through holes.
  • a wireless probe is provided at the first end of the guide wire body or the front end of the nozzle.
  • a buffer assembly is provided in the spray head.
  • the buffer assembly includes a fixing piece and an elastic piece, the fixing piece is connected to the drug delivery end, and the elastic piece is located between the fixing piece and the spray head away from the second through hole.
  • the buffer assembly includes a fixing member and an elastic member, the drug delivery end of the first channel is formed inside the fixing member; the fixing member is located between the elastic member and the second through hole; when the elastic member is released, the fixing member The first through hole is blocked, and the drug delivery end is communicated with the first through hole; when the elastic member is compressed, the fixing member is removed and the first through hole is exposed.
  • the elastic member is a spring.
  • a section of the first passage between the guide wire body and the fixing member may be provided with an outer wall layer, the outer wall layer has a thickness, and the nozzle slides on the surface of the outer wall layer; preferably, the outer wall layer and the guide wire body And the fixing part are arranged as an integral structure.
  • one end of the fixing member facing the elastic member, or an end of the outer wall layer close to the fixing member and facing the elastic member is provided with an engaging member; the nozzle is provided with a clamped member matching the engaging member Together.
  • the engaging member is a raised bump located on the outer edge of the fixing member or the outer wall layer; the engaged member is also a raised bump near the first channel.
  • a wrapping film is provided between the front end of the spray head and the guide wire body, and the wrapping film has redundant length or elasticity.
  • a second channel is axially provided in the guide wire body.
  • the second channel and the first channel are independent of each other.
  • a first one-way valve is provided in the first channel; a second one-way valve is provided in the second channel.
  • a scale is provided on the guide wire body.
  • a support member is provided in the first channel and/or the second channel; it is generally elongated, for example, it may be an elongated steel wire.
  • a sealing ring is provided in the circumferential direction of the fixing member.
  • the second aspect of the application provides an application of the tracheal intubation guide wire, which adopts the tracheal intubation guide wire described above.
  • the fourth aspect of the present application provides an application of a tracheal intubation guide wire.
  • the use of the aforementioned tracheal intubation guide wire includes placing a volumetric inhalation body in the oropharynx, and inhaling the inhalation body and A part of the guide wire body is sucked into the trachea; the tracheal tube is inserted into the trachea along the guide wire, and the guide wire is drawn out to complete the intubation.
  • the fifth aspect of the present application provides an application of a tracheal intubation guide wire, which adopts the aforementioned tracheal intubation guide wire.
  • the application includes the following steps:
  • the tracheal intubation guide wire fix the tracheal intubation guide wire and deliver anesthetics to the soft bladder through the first channel; when the patient inhales, the nozzle moves forward to the patient’s glottis, and at the same time
  • the soft capsule is elastically retracted and the anesthetic in the soft capsule is ejected through the second through hole to anesthetize the glottis of the patient. Can be repeated many times, such as 3 times.
  • the fixed position of the tracheal intubation guide wire is re-determined in a direction away from the nozzle, and the fixed position is determined according to the distance between the patient's glottis and the airway, and the tracheal intubation is performed by the patient's inspiratory force
  • the tube guide wire is inhaled into the patient's airway, and the tracheal intubation guide wire anaesthetizes the patient's airway through the second channel and guides the tracheal tube intubation.
  • the sixth aspect of the present application provides a tracheal catheter, including the guide wire described above.
  • the tracheal intubation guide wire described above is provided in the tracheal tube; wherein the nozzle of the guide wire exposes the front end of the catheter.
  • the length of the guide wire is greater than the length of the tracheal tube.
  • the seventh aspect of the present application provides an application of a tracheal tube, using the above-mentioned tracheal tube, including placing a bulky inhalation body in the oropharynx, and inhaling a part of the inhalation body and the guide wire body In the trachea; insert the tracheal tube into the trachea along the guide wire, withdraw the guide wire, and complete the intubation.
  • the tracheal intubation guide wire provided in this application avoids the traditional intubation method's dependence on the exposure of the glottis, and can cooperate with the patient's spontaneous breathing to enter the trachea. It can reduce the difficulty of tracheal intubation and provide a more convenient way to achieve extremely difficult tracheal intubation;
  • the tracheal intubation guide wire provided in some embodiments of the present application can also be administered, and the administration effect is good, and it is suitable for various slow-induced general anesthesia intubations that retain spontaneous breathing;
  • Some embodiments of the present application realize the protection of the nozzle by arranging a buffer component in the nozzle, and at the same time avoid the harm to the human body during the intubation process;
  • Some embodiments of the present application are provided with a second channel, on the one hand, it can be used to quickly administer the patient’s trachea to achieve rapid anesthesia to the patient’s airway, and on the other hand to monitor the exhaled CO 2 through the second channel. To achieve the purpose of identifying the airway, so as to smooth intubation.
  • Figure 1 is a schematic diagram of a tracheal intubation method in the prior art
  • Figure 2 is a wire guide wire in the prior art
  • 3A and 3B are schematic diagrams of a guide wire according to an embodiment of the application.
  • Figure 4 is a schematic diagram of a guide wire according to an embodiment of the application.
  • 5A, 5B and 5C are schematic diagrams of the intubation process
  • Fig. 6 is a schematic diagram of a guide wire according to an embodiment of the application.
  • Figure 7 is a schematic diagram of the drug delivery process of the guide wire provided in Figure 6;
  • Figure 8 is a schematic diagram of a guide wire according to an embodiment
  • Figure 9 is the first partial schematic diagram of the guide wire
  • Figure 10 is a second partial schematic diagram of the guide wire
  • first and second are only used for descriptive purposes, and cannot be understood as indicating or implying relative importance or implicitly indicating the number of indicated technical features. Thus, the features defined with “first” and “second” may explicitly or implicitly include one or more of these features.
  • connection and “connected” should be understood in a broad sense, for example, it can be a fixed connection, a detachable connection, or an integral Ground connection; it can be directly connected, or indirectly connected through an intermediate medium, and it can be the internal communication between two components.
  • connection should be understood in a broad sense, for example, it can be a fixed connection, a detachable connection, or an integral Ground connection; it can be directly connected, or indirectly connected through an intermediate medium, and it can be the internal communication between two components.
  • the "guide wire” referred to in this application is a device used to guide the tracheal tube for intubation, which can be located in the tracheal tube during use. Since the tracheal tube is generally a slender structure, the guide wire is generally also It is a slender structure, that is, the diameter is relatively small relative to the length; for example, according to different tracheal tube types, different patient types, the guide wire diameter can be 0.5-7.5mm, the length can be 20-60cm, etc. Generally; the diameter of the guide wire is smaller than the inner diameter of the tracheal tube. For example, it may be the steel wire mentioned in the background art.
  • An embodiment of the present application provides a tracheal intubation guide wire 13 (hereinafter referred to as a guide wire), as shown in FIG. 3A and FIG. 3B, including an elongated guide wire body 14 which The first end 15 is provided with an inhalation body 16 that can increase in volume; when intubation is required, the inhalation body 16 increases in volume and can enter the patient’s trachea 6 with inhalation, and can drive the guide wire body A part of 14 enters the trachea 6.
  • the volume of the suction body 16 is variable, the operation is more convenient, and it can be applied to various working conditions.
  • the inhalation body 16 may also be a sealed body with a fixed volume, which can also enter the patient's trachea during inhalation.
  • the diameter of the inhalation body 16 is smaller than the diameter of the cross section of the smallest part between the oropharynx 17 and the trachea 6 in the respiratory tract; generally, the smallest part is located at the glottis 5, which mainly refers to the degree of opening of the glottis; It may change according to the patient's condition, such as when there are abnormal structures such as tumors in the patient's respiratory tract. Therefore, the suction body 16 can be normally sucked into the trachea 6 without being stuck.
  • the inhalation body 16 may be roughly the size of a peanut grain or a glass ball.
  • the shape can also be various, such as a round sphere, an ellipsoid, a capsule, or other regular or irregular shapes. It is worth understanding that its surface is smooth and will not cause harm to the patient's respiratory tract.
  • the pharynx can be divided into nasopharynx, oropharynx, and throat; the oropharynx is roughly within the range of the dashed circle in FIG. 1.
  • the length of the guide wire 13 is greater than the length of the tracheal tube, for example, it may be 40-60 cm, such as 45 cm, 50 cm, 55 cm and so on.
  • the first end 15 of the guide wire body and the inhalation body 16 are located in the trachea 6 together, and the second end 18 of the guide wire body is located outside the oral cavity 2.
  • the inhalation body 16 can be filled with gas, or liquid, or other fillings; preferably, it is filled with gas. Because of the light weight of the gas, it is more convenient for the patient to inhale.
  • the guide wire can be made of plastic material, such as a hard plastic tube or a soft plastic tube made of polyvinyl chloride (PVC); it can also be made of rubber, silica gel, etc.; its weight should be light enough, It can be driven by the inhalation body 16 to partially enter the patient's body.
  • plastic material such as a hard plastic tube or a soft plastic tube made of polyvinyl chloride (PVC); it can also be made of rubber, silica gel, etc.; its weight should be light enough, It can be driven by the inhalation body 16 to partially enter the patient's body.
  • the guide wire body 14 may be provided with a first channel 19 in the axial direction, which communicates with the suction body 16, and the suction body 16 can be filled with substances, such as gas or liquid, through the first channel 19.
  • substances such as gas or liquid
  • the inhalation body 16 can be filled with substances, such as gas or liquid, through the first channel 19, so that the inhalation body 16 is increased in volume; if the inhalation body 16 itself is a volume-sealed body, The inflating step can be avoided; then the inhalation body 16 is placed at the patient’s oropharynx 17, the depth of placement into the oral cavity 2 can be adjusted according to the actual situation, the second end 18 of the guide wire body extends outside the oral cavity 2; The patient's inhalation draws the inhalation body 16 and a part of the guide wire body (mainly the first end 15) into the trachea 6, thereby completing the guide wire 13 introduction. At this time, the substance in the inhalation body 16 can be led out through the first channel 19 in the reverse direction, so that the volume of the inhalation body 16 is reduced, which facilitates subsequent insertion of the catheter.
  • substances such as gas or liquid
  • the tracheal tube 8 is set from the second end 18 of the guide wire body to the periphery of the guide wire 13 (as shown in Figure 5A, the arrow indicates the movement of the tracheal tube 8 Direction); the tracheal tube 8 is intubated along the guide wire 13 that has entered the patient's body; when the first end 11 of the tracheal tube enters the trachea 6, the intubation is completed (as shown in Figure 5B); the guide wire body can be used at this time
  • the second end 18 of the tracheal tube is slowly drawn out of the guide wire 13 along the inside of the tracheal tube (as shown in Figure 5C, the arrow indicates the direction of movement of the guide wire 13), leaving the first end 11 of the tracheal tube in the trachea, the first end of the tracheal tube
  • the two ends 12 are located in or outside the oral cavity 2.
  • the volume of the inhalation body 16 when the volume of the inhalation body 16 is variable, the volume of the tracheal tube 8 can be reduced before reaching the trachea, thereby facilitating the extraction of the guide wire 13; when the volume of the inhalation body 16 is not variable, its diameter should be smaller than that of the trachea The diameter of the catheter 8 facilitates the extraction of the guide wire 13 after intubation.
  • the guide wire 13 is introduced into the trachea 6 through the patient’s spontaneous breathing.
  • the assistance of the laryngoscope 9 is not required, and the glottis 5 is not required to be exposed to make the intubation
  • the difficulty is greatly reduced, the operability is good, and the intubation time is saved.
  • the tracheal intubation guide wire 13 in this embodiment can also be shown in FIG. 6, including a guide wire body 14, which is axially provided with a first channel 19 for injecting anesthetics (which can make the inhaler 16 volume
  • the first channel 19 includes a drug delivery end 20 extending from the guide wire body 14.
  • the drug delivery end 20 is sleeved with a spray head 21 that is slidably connected to the first channel 19, and the outer circumference of the spray head 21 is covered with an anesthetic
  • the inhalation body 16 may be a soft capsule 22.
  • the soft capsule 22 communicates with the first channel 19 through the first through hole 23 provided on the spray head 21.
  • the spray head 21 is also provided with a first for spraying anesthetics when the patient is inhaled. Two through holes 24.
  • the guide wire body can be regarded as the housing of the channel.
  • the guide wire 13 can cooperate with the patient's spontaneous breathing to administer anesthesia to the glottis of the patient.
  • an anesthetic is injected into the soft capsule 22 through the first channel 19.
  • the nozzle 21 is driven by the inhalation body 16 to move forward to the glottis of the patient or the place where the drug is to be administered.
  • the soft capsule 22 elastically retracts and squeezes the anesthetic in the soft capsule 22 through the first through hole 23
  • the spray head 21 then sprays through the second through hole 24 to anaesthetize the patient's glottis or the preparation site for drug delivery.
  • the guide wire is provided with a spray head 21 slidably connected to the first channel 19 and a soft capsule 22 is provided on the spray head 21.
  • a spray head 21 slidably connected to the first channel 19 and a soft capsule 22 is provided on the spray head 21.
  • it can cooperate with the patient's spontaneous breathing to realize the glottis drug delivery process. It overcomes the dependence of the traditional intubation method on the exposure of the glottis.
  • the elastic retraction force of the soft capsule 22 ejects the drug, which helps to control the dose, and this drug delivery method achieves uniform drug delivery. Improved drug delivery effect.
  • the first through hole 23 and the second through hole 24 may each include a plurality of through holes.
  • anesthetic can be added to the soft capsule 22 through the first channel 19 for multiple anesthesia, so as to achieve a complete anesthesia for the patient's glottis.
  • the soft capsule 22 is located on the side of the spray head 21 and the second through hole 24 is located at the front end of the spray head 21.
  • This setting is conducive to when the patient inhales, the soft capsule 22 uses the elastic retraction force to spray all the anesthetics in the soft capsule 22 and spray it to the glottis of the patient. On the one hand, it helps to better control the amount of medicine injected. On the other hand, it is beneficial to spray the anesthetic to the glottis of the patient better and improve the administration effect.
  • the guide wire body 14 is provided with a groove 25 for accommodating the spray head 21; before the drug is administered, the spray head 21 is located in the groove 25; when the drug is administered, the spray head 21 can be all or partly The ground leaves the groove 25; after the drug is administered, the spray head 21 returns to the groove.
  • the groove 25 can realize the guiding and positioning function of the spray head 21 and prevent the spray head 21 from falling.
  • the spray head 21 is provided with a plurality of first through holes 23 along the circumferential direction, so that the medicine can enter or squeeze out of the soft capsule 22 more conveniently and quickly.
  • One or more of the first through holes 23 can communicate with the drug delivery end 20.
  • a plurality of second through holes 24 are uniformly provided on the spray head 21, which is beneficial to disperse drugs, such as anesthetics.
  • the first end 15 of the guide wire body such as the front end of the nozzle 21, may be provided with a wireless probe 26, and the probe is preferably a mini video probe or a mini wireless video camera, For example, it can also be arranged close to the second through hole 24, so that the patient's condition can be viewed from the front end of the spray head 21 and timely feedback to the medical staff.
  • a buffer assembly 27 is provided in the spray head 21 to protect the spray head 21.
  • the buffer assembly 27 includes a fixing piece 28 and an elastic piece 29.
  • the fixing piece 28 is represented by shading; the fixing member 28 is connected to the drug delivery end 20, and the elastic member 29 is located between the fixing member 28 and the end of the nozzle 21 away from the second through hole 24, that is, the elastic member 29 is located in the nozzle 21 and away from the second through hole.
  • the buffer assembly 27 includes a fixing member 28 and an elastic member 29.
  • the drug delivery end 20 of the first channel 19 is formed inside the fixing member 28; the fixing member 28 is located between the elastic member 29 and the second through hole 24. between.
  • the fixing member 342 blocks the first through hole 23, and the drug delivery end 20 communicates with the first through hole 23, and can pass through the drug delivery end 20 of the first channel 19 at this time.
  • Inject drugs such as anesthetics
  • the medicine in the soft capsule 22 will not leak into the nozzle, at this time the volume of the soft capsule 22 increases; as shown in Figure 7, when the patient During spontaneous breathing, the spray head 21 slides on the first channel 19 and moves toward the patient's inhalation direction.
  • the elastic member 29 When the elastic member 29 is in a compressed state, the first through hole 23 is exposed, and the medicine in the soft capsule 22 enters through the first through hole 23
  • the nozzle 21 is then inhaled by the patient through the second through hole 24; it can be simply summarized as: when the elastic member 29 is released, the fixing member 28 blocks the first through hole 23, and the drug delivery end 20 communicates with the first through hole 23; When compressed, the fixing member 28 is removed, and the first through hole 23 is exposed.
  • the fixing member 28 and the elastic member 29 cooperate with each other to have a buffering effect, avoiding damage to the spray head 21 due to collisions, thereby helping to ensure that the spray head 21 better administers drugs and improving the drug delivery effect.
  • the fixing member 28 delivers anesthetics to the soft capsule 22 through the first channel 19, it can be removed from the first channel 19 (the dosing end 20 )
  • the blocking effect of the other first through holes 23 outside the connected first through hole 23 prevents the anesthetic from overflowing the soft capsule 22.
  • the elastic member 29 is preferably a spring.
  • a section of the first channel 19 between the guide wire body 1 and the fixing member 28 may be provided with an outer wall layer 30, the outer wall layer 30 has a thickness, and the spray head 21 is on the outer wall layer. 30 slides on the surface; the outer wall layer 30 can be provided with the guide wire body 1 and the fixing member 28 as an integral structure, as shown by the shadow in FIG. 8.
  • the thickness of the outer wall layer 30 is based on the principle that the guide wire is sufficiently strong and not easily broken; in addition, since the nozzle 21 slides on the surface of the outer wall layer 30, the thickness of the outer wall layer 30 is also preferably wear-resistant.
  • the present application does not make too many requirements for the thickness of the outer wall layer 30, as long as the above requirements can be met.
  • one end of the fixing member 28 facing the elastic member 29, or an end of the outer wall layer 30 close to the fixing member 28 and facing the elastic member 29 is provided with an engaging member 31; the spray head 21 There is an engaged member 32 matching the engaging member 31; the mutual restriction between the engaging member 31 and the engaged member 32 can effectively prevent medical accidents caused by the nozzle 21 falling.
  • the engaging member 31 is a raised bump located on the outer edge of the fixing member 28 or the outer wall layer 30; the engaged member 32 is also a raised bump near the first channel 19; As shown in Figure 9. Since the various parts of the guide wire are often made of medical plastics, they are often soft and have some elasticity; when the nozzle 21 moves excessively to the right, the engaged part 32 will be caught in the groove formed by the protrusion of the engaging part 31 , Thereby preventing the spray head 21 from continuing to move excessively to the right, causing it to fall off and enter the patient's body.
  • a wrapping film 33 is provided between the front end of the spray head 21 and the guide wire body 14.
  • the wrapping film 33 has redundant length or elasticity; when the patient inhales, the spray head 21 is guaranteed While it can be sucked out of the groove, the spray head 21 is further prevented from being separated from the fixing member 28 to prevent medical accidents.
  • a first one-way valve 34 is provided in the first passage 19; the one-way valve can control the direction of the medicine entering the spray head 21 without backflow.
  • the guide wire body 1 is axially provided with a second channel 35; it can be extended to be close to the first end 15 of the guide wire body.
  • the second channel 35 in this embodiment has two functions. One is that after the intubation enters the airway, the second channel 35 can quickly administer the airway to realize the anesthesia of the patient’s airway; When the second channel 35 is not for drug delivery, a monitor can be connected to the end of the second channel away from the drug delivery end to monitor the CO 2 exhaled by the patient through the second channel 35, thereby achieving the purpose of identifying the airway and helping Smooth intubation and improve the accuracy of intubation.
  • the second channel 35 and the first channel 19 are independent of each other.
  • a second one-way valve 36 is provided in the second passage 35, and the one-way valve can control the medicine to enter the patient without backflow.
  • the main guide wire body 14 is provided with a scale 37; it can be used to measure the length of the guide wire into the patient's body to assist in judging whether the guide wire has reached a designated position.
  • a support member such as a rigid guide wire with a diameter smaller than the channel, a guide wire, etc.
  • a support member such as a rigid guide wire with a diameter smaller than the channel, a guide wire, etc.
  • a support member can be inserted into the first channel 19 and/or the second channel 35 to strengthen the tube wall; Due to the slender structure, it is often relatively soft, which may not be very conducive to the circulation of drugs. After the channel wall is hardened, it is often more convenient for the circulation of drugs and the control of the stability of the guide wire and catheter cannula.
  • the fixing member 28 may be provided with a sealing ring in the circumferential direction, that is, the sealing ring is located between the fixing member 28 and the inner wall of the spray head 21, and can be waterproof and gas-proof, that is, the purpose of water sealing and air sealing is achieved.
  • the second embodiment of the present application provides a tracheal catheter, as shown in FIG. 5, the tracheal catheter has the tracheal intubation guide wire 13 described in any of the preceding embodiments; wherein the nozzle 21 of the guide wire exposes the trachea The first end of the catheter 11.
  • the third embodiment of the present application provides an application of a tracheal intubation guide wire in tracheal intubation.
  • the tracheal intubation guide wire described in any of the preceding embodiments may include the following steps:
  • the inhalation body 16 Place the inhalation body 16 with volume at the first end 15 of the guide wire body deep in the oral cavity, such as the oropharynx, and place the second end 18 of the guide wire body outside the oral cavity; by inhaling, the inhalation body 16 and the guide wire A part of the body is sucked into the trachea 6; further, the tracheal tube 6 is inserted into the trachea 6 along the guide wire 13, and then the guide wire 13 is withdrawn to complete the intubation.
  • the spray head 21 moves forward to the patient’s glottis, while the soft capsule 22 elastically retracts And spray the anesthetic in the soft capsule 22 through the second through hole 24 to anesthetize the patient's glottis, which can be repeated many times, such as 3 times;
  • the fixed position is determined according to the distance between the patient’s glottis and the airway.
  • the tracheal intubation guide wire is drawn into the patient’s airway through the patient’s inspiratory force.
  • the tube guide wire passes through the second channel 35 to anesthetize the patient's airway and guide the tracheal tube intubation.
  • the above method adjusts the patient's spontaneous breathing and inhales the guide wire into the airway to guide the intubation of the tracheal tube, avoiding the traditional intubation method relying on the exposure of the glottis, reducing the difficulty of tracheal intubation, which is extremely difficult.
  • Intubation provides security.
  • surface anesthesia can also be achieved at the same time.

Abstract

一种气管插管导丝(13)，属于医疗器械；导丝(13)包括细长形的导丝本体(14)，以及位于导丝本体(14)第一端(15)的吸入体(16)；插管应用时，吸入体(16)具有体积，可通过吸气而带动吸入体(16)和导丝本体(14)的一部分进入患者体内。

Description

气管插管导丝，气管导管，及其应用 技术领域
本申请属于医疗器械技术领域，尤其涉及一种气管插管导丝，气管导管，及其应用。
背景技术
这里的陈述仅提供与本申请有关的背景信息，而不必然地构成现有技术。
气管插管是指将一特制的气管导管经声门置入气管的技术，它是急救和全身麻醉中保障患者气道通畅、有效通气供氧和避免误吸的重要技术。
如图1和图2示出了现有技术中气管插管的一种示意图。为了便于理解技术方案，图1中还分别示出了人体的一些结构，包括鼻腔1，口腔2，舌头3，会厌4，声门5，气管6和食管7，图1中还示出了气管导管8和用于协助插管的喉镜9；图2中示出了一种现有技术中的钢丝导丝10。在进行气管插管前，在气管导管8中插入一根导向用的钢丝10，作为导丝；在进行插管时，首先使用喉镜9使得声门5露出，然后，将内置有导丝的气管导管8在喉镜9和钢丝10的引导下而插入至气管6中；当完成插管后，取出钢丝10和喉镜9；至此，气管导管的第一端11位于气管6中，气管导管的第二端12位于口腔2外，使得气管6通过气管导管8与大气相通，从而为患者提供顺畅的呼吸通道；其中图1为插管完成后取出钢丝10，尚未取出喉镜9的示意图。在该情况下，钢丝10作为导丝可以在进行插管时，通过旋转钢丝10，尤其是钢丝前端的弯折部找到更好的角度(如图2)，来改变气管导管8的前进方向，以便于插管。但在插管过程中，由于人体个体的结构存在一些差异，并不容易找到声门5，因此给气管插管造成了一些困难。
专利CN203777449U公开了一种多功能气管插管导芯，其导芯壳体内设置通道，在进行盲探插管或者声门显露不佳时，可以通过通道在表面喷洒麻醉药，也可以通过尾主孔自主呼吸气流二氧化碳检测鉴别气道，进而引导气管导管，使其顺利插入。然而，所述多功能气管插管导芯给药效果不佳。
发明内容
本申请提供了一种气管插管导丝，气管导管，及其应用；更方便插管。
本申请第一方面提供了一种气管插管导丝，包括细长形的导丝本体，以及位于导丝本体第一端的吸入体；插管应用时，所述吸入体具有体积，可通过吸气而带动吸入体和导丝本体的一部分进入患者体内。
可选地，所述吸入体的体积为可调的或所述吸入体为体积固定的密封体。
可选地，所述吸入体中可充入气体或液体，使其具有体积。
可选地，所述吸入体的直径小于由口咽部至气管之间的最小处的横截面的直径。
可选地，所述导丝采用塑料材质制成。
可选地，所述导丝本体中轴向设有第一通道，其与吸入体连通，可通过第一通道向吸入体充入或释放物质，使其体积增大或缩小。
更具体地，所述气管插管导丝包括导丝本体，所述导丝本体内轴向设置有用于注入药物，如麻醉药，的第一通道，所述第一通道包括伸出所述导丝本体的给药端，所述给药端套设有与所述第一通道滑动连接的喷头，所述喷头外周包覆有用于储存所述药物的吸入体，所述吸入体通过设置在所述喷头上的第一通孔与所述第一通道连通，所述喷头还设有用于在患者吸气状态下喷出所述药物的第二通孔。
可选地，所述吸入体为软囊，位于所述喷头侧面，所述第二通孔位于所述喷头前端。
可选地，所述导丝本体上设有用于容纳所述喷头的凹槽。
可选地，所述喷头沿着周向设置有多个第一通孔，喷头前端设置多个第二通孔。
可选地，所述导丝本体第一端或喷头前端设有无线探头。
可选地，所述喷头内设有缓冲组件。
可选地，所述缓冲组件包括固定件及弹性件，所述固定件与所述给药端相连，所述弹性件处于所述固定件与所述喷头远离所述第二通孔之间。
或者，可选地，所述缓冲组件包括固定件和弹性件，第一通道的给药端形成于固定件内部；固定件位于弹性件与第二通孔之间；弹性件释放时，固定件堵塞第一通孔，给药端与第一通孔连通；弹性件被压缩时，固定件移走，第一通孔露出。
可选地，所述弹性件为弹簧。
可选地，位于导丝本体和固定件之间的、第一通道的一段可以设置外壁层，所述外壁层具有厚度，所述喷头在外壁层表面滑动；优选所述外壁层与导丝本体和固定件设置为一体式的结构。
可选地，所述固定件面向弹性件的一端，或者所述外壁层靠近固定件且面向弹性件的一端设置有卡合件；所述喷头上设置有与所述卡合件匹配的被卡合件。
可选地，所述卡合件为凸起的凸块，位于固定件或外壁层的外缘；所述被卡合件也为凸起的凸块，靠近第一通道。
可选地，所述喷头前端和导丝本体之间设有包裹膜，所述包裹膜具有冗余长度或者具有弹性。
可选地，所述导丝本体内轴向设置有第二通道。
可选地，所述第二通道与所述第一通道相互独立。
可选地，所述第一通道内设置第一单向阀；所述第二通道内设置有第二单向阀。
可选地，所述导丝本体上设有刻度。
可选地，所述第一通道内和/或第二通道内设有支撑件；一般为细长形，例如可为细长形的钢丝。
可选地，所述固定件周向设置有密封圈。
本申请第二方面提供了一种气管插管导丝的应用，采用前文所述的气管插管导丝。
本申请第三方面提供了一种气管插管导丝的应用，采用前文所述的气管插管导丝，包括，将具有体积的吸入体放置于口咽部，通过吸气，将吸入体和导 丝本体的一部分吸入气管中。
本申请第四方面提供了一种气管插管导丝的应用，采用前文所述的气管插管导丝，包括，将具有体积的吸入体放置于口咽部，通过吸气，将吸入体和导丝本体的一部分吸入气管中；将气管导管沿着导丝插入气管中，抽出导丝，完成插管。
本申请第五方面提供了一种气管插管导丝的应用，采用前文所述的气管插管导丝。所述应用包括以下步骤：
根据患者声门的位置，固定所述气管插管导丝，通过所述第一通道向所述软囊输送麻醉药；患者吸气时，所述喷头向前移动至患者声门处，同时所述软囊弹性回缩并将所述软囊内的麻醉药通过所述第二通孔喷出对患者声门进行麻醉。可重复多次，如3次。
进一步地，向远离所述喷头的方向重新确定所述气管插管导丝的固定位置，所述固定位置根据患者声门到气道之间的距离确定，通过患者吸气力量将所述气管插管导丝吸入患者气道，所述气管插管导丝通过所述第二通道对患者气道进行麻醉，并引导气管导管插管。
本申请第六方面提供了一种气管导管，包括前文所述的导丝。具体地，所述气管导管内设有前文所述的气管插管导丝；其中，所述导丝的喷头露出导管前端。可选地，所述导丝长度大于气管导管的长度。
本申请第七方面提供了一种气管导管的应用，采用前文所述的气管导管，包括，将具有体积的吸入体放置于口咽部，通过吸气，将吸入体和导丝本体的一部分吸入气管中；将气管导管沿着导丝插入气管中，抽出导丝，完成插管。
与现有技术相比，本申请的有益效果在于：
1、本申请提供的气管插管导丝，避免了传统插管方式对声门显露的依赖，能够配合患者自主呼吸进入气管。可降低气管插管的难度，为极困难气管插管提供了更便捷的实现方式；
2、本申请的一些实施方式中提供的气管插管导丝还可以进行给药，且给药效果好，适用于各种保留自主呼吸的慢诱导全麻插管；
3、本申请的一些实施方式通过在喷头内设置缓冲组件，实现了对喷头的保护，同时避免了插管过程对人体的伤害；
4、本申请的一些实施方式通过设置第二通道，一方面可用于对患者气管进行快速给药，实现对患者气道的快速麻醉，另一方面通过第二通道对呼出气CO 2进行监测，实现了鉴别气道的目的，以便顺利插管。
附图说明
图1为现有技术中的一种气管插管方式的示意图；
图2为现有技术中的一种钢丝导丝；
图3A和图3B为本申请的一种实施方式的导丝示意图；
图4为本申请的一种实施方式的导丝示意图；
图5A，图5B和图5C为插管过程示意图；
图6为本申请的一种实施方式的导丝示意图；
图7为图6中所提供导丝的给药过程示意图；
图8为一种实施方式的导丝示意图；
图9为导丝的第一种局部示意图；
图10为导丝的第二种局部示意图；
具体实施方式
下面，通过示例性的实施方式对本申请进行具体描述。然而应当理解，在没有进一步叙述的情况下，一个实施方式中的元件、结构和特征也可以有益地结合到其他实施方式中。
在本申请的描述中，需要理解的是，文中指示的方位或位置关系的术语为基于附图1所示的方位或位置关系，仅是为了便于描述本申请和简化描述，而不是指示或暗示所指的装置或元件必须具有特定的方位、以特定的方位构造和操作，因此不能理解为对本申请的限制。
术语“第一”、“第二”仅用于描述目的，而不能理解为指示或暗示相对重要性或者隐含指明所指示的技术特征的数量。由此，限定有“第一”、“第二”的特征可以明示或者隐含地包括一个或者更多个该特征。
在本申请的描述中，需要说明的是，除非另有明确的规定和限定，术语“相连”、“连接”应做广义理解，例如，可以是固定连接，也可以是可拆卸连接，或一体地连接；可以是直接相连，也可以通过中间媒介间接相连，可以是两个元件内部的连通。对于本领域的普通技术人员而言，可以具体情况理解上述术语在本申请中的具体含义。
本申请中所指的“导丝”是一种用于引导气管导管进行插管的装置，其在使用过程中可位于气管导管内，由于气管导管一般为细长形结构，所以导丝一般也为细长形结构，即直径相对于长度较小；例如根据不同的气管导管类型，不同的患者类型，导丝直径可为0.5-7.5mm，长度可为20-60cm等等。一般地；导丝的直径小于气管导管的内径。诸如，可以是背景技术中提到的钢丝。
本申请的一种实施方式提供了一种气管插管导丝13(以下可简称为导丝)，如图3A和图3B所示，包括细长形的导丝本体14，所述导丝本体的第一端15设有体积可增大的吸入体16；当需要进行插管时，所述吸入体16体积增大，并可随吸气进入患者的气管6中，并可带动导丝本体14的一部分进入气管6中。当吸入体16体积可变时，操作更方便，可适用多种工况。
或者可选地，如图4所示，所述吸入体16也可为体积固定的密封体，在吸气时，同样可进入患者的气管中。
所述吸入体16的直径小于呼吸道中由口咽部17至气管6之间的最小处的横截面的直径；一般地，该最小处位于声门5处，主要指声门的敞开程度；也可能根据患者的情况变化，如当患者呼吸道中有肿瘤等异常结构。由此，所述吸入体16方可被正常地吸入至气管6中，而不会被卡住。在常规使用时，吸入体16可大致为花生粒大小或玻璃球大小。其形状也是可以是多样的，例如为圆球形，椭球形，囊状，或者其他规则或不规则形状。值得理解的是，其表面光滑，不会对患者呼吸道造成伤害。
常规地，咽可以分为鼻咽部，口咽部以及咽喉部；口咽部大致在如图1中的虚线圈内的范围。
可选地，所述导丝13的长度大于气管导管的长度，例如可为40-60cm， 如45cm，50cm，55cm等等。可选地，在使用中，所述导丝本体第一端15与吸入体16一并位于气管6中，所述导丝本体第二端18位于口腔2外。
所述吸入体16中可以充入气体，或者液体，或者其他填充物；优选地充入气体，由于气体的质量轻，更便于患者吸入。
所述导丝可采用塑料材质制成，如可采用聚氯乙烯(PVC)制得的硬质塑料管或软质塑料管；还可以采用橡胶，硅胶等材质制得；其质量应足够轻，可由吸入体16带动而部分地进入患者体内。
可选地，所述导丝本体14中可轴向设有第一通道19，其与吸入体16连通，可通过第一通道19向吸入体16充入物质，如气体或液体。当插管时，可通过第一通道19放气或排液，使得导丝13更便于取出。
导丝13导入步骤：首先，可通过第一通道19向吸入体16填充物质，如充入气体或液体，使得吸入体16体积增大；如果吸入体16本身即为具有体积的密封体时，则可免除充气步骤；然后将吸入体16放置于患者的口咽部17处，放置入口腔2的深浅可根据实际的情况调整，导丝本体的第二端18延伸至口腔2外；然后通过患者的吸气，将吸入体16及导丝本体的一部分(主要是第一端15)吸入气管6中，从而完成导丝13的导入。此时，可将吸入体16中的物质通过第一通道19反向导出，使得吸入体16体积减小，便于后续插入导管。
插管步骤如图5A-图5C所示：插管时，将气管导管8从导丝本体的第二端18套装在导丝13的外围(如图5A所示，箭头表示气管导管8的运动方向)；气管导管8沿着已进入患者体内的导丝13进行插管；当气管导管的第一端11进入气管6后，插管完成(如图5B所示)；此时可由导丝本体的第二端18沿着气管导管内部慢慢抽出导丝13(如图5C所示，箭头表示导丝13的运动方向)，将气管导管的第一端11留在气管中，气管导管的第二端12位于口腔2中或口腔2外。
值得理解的是，当吸入体16体积可变时，可在气管导管8到达气管前，使其体积变小，从而便于抽出导丝13；当吸入体16体积不可变时，其直径应 小于气管导管8的直径，以便于插管后导丝13的抽出。
本申请中导丝13的导入是通过患者的自主呼吸进入气管6的，顺着导丝13进行插管时，不需要喉镜9等的辅助，也不必要求必须显露声门5，使得插管的难度大大降低，可操作性好，且节约插管时间。
具体地，本实施方式中的气管插管导丝13还可以如图6所示，包括导丝本体14，其内轴向设置有用于注入麻醉药的第一通道19(可使吸入体16体积变大)，第一通道19包括伸出导丝本体14的给药端20，给药端20套设有与第一通道19滑动连接的喷头21，喷头21外周包覆有用于储存麻醉药的吸入体16，可为软囊22，软囊22通过设置在喷头21上的第一通孔23与第一通道19连通，喷头21还设有用于在患者吸气状态下喷出麻醉药的第二通孔24。所述导丝本体可看做通道的壳体。
所述导丝13可以配合患者的自主呼吸对患者声门进行给药麻醉，具体的，如图6和图7所示，通过第一通道19向软囊22内注入麻醉药，当患者吸气时，喷头21在吸入体16的带动下，向前移动至患者声门处或预备给药处，同时软囊22弹性回缩并将软囊22内的麻醉药通过第一通孔23挤回喷头21内，继而通过第二通孔24喷出对患者声门或预备给药处进行麻醉。需要说明的是，所述导丝通过设置与第一通道19滑动连接的喷头21以及在喷头21上设置软囊22，一方面实现了配合患者的自主呼吸实现对患者声门的给药过程，克服了传统插管方式对声门显露的依赖，另一方面通过软囊22的弹性回缩力喷出给药，有助于控制给药量，且该种给药方式实现了均匀给药，提高了给药效果。同时，为了使得软囊22内的麻醉药全部快速喷出，提高给药效果，第一通孔23及第二通孔24可以各包括多个通孔。另外根据患者的情况，可以通过第一通道19向软囊22内补充麻醉药，多次麻醉，以实现对患者声门的全面麻醉。
为了进一步提高给药效果，软囊22位于喷头21侧面，第二通孔24位于喷头21前端。该设置有利于在患者吸气时，软囊22通过弹性回缩力将软囊22内的麻醉药全部喷出并喷向患者声门处，一方面有助于更好的控制进药量， 另一方面有利于更好的将麻醉药喷向患者声门部位，提高给药效果。
可选地，如图7所示，所述导丝本体14上设有用于容纳喷头21的凹槽25；给药前，喷头21位于凹槽25内；给药时，喷头21可以全部或者部分地脱离凹槽25；给药后，喷头21又返回至凹槽中。在导丝伸入患者体内或者从患者体内抽出的过程中，凹槽25可以实现对喷头21的导向和定位作用，防止喷头21掉落。
可选地，所述喷头21沿着周向设置有多个第一通孔23，使得药物在软囊22中的进入或者挤出更加方便、迅速。其中的一个或多个第一通孔23可以与给药端20相通。优选地，喷头21上均匀设置多个第二通孔24，有利于分散药物，如麻醉药。
可选地，如图9所示，所述导丝本体第一端15，如所述喷头21前端，可设有无线探头26，所述探头优选为迷你的视频探头、迷你的无线视频摄像头，例如还可以设置在靠近第二通孔24处，从而可以从喷头21的最前端查看患者的状况，并及时反馈给医务人员。
可选地，所述喷头21内设有缓冲组件27，可以保护喷头21。可选地，所述缓冲组件27包括固定件28及弹性件29，在图6-9中，为了更好地示出固定件28以便与喷头21的内腔和弹性件29区别，对于固定件28采用阴影表示；固定件28与给药端20相连，弹性件29处于固定件28与喷头21远离第二通孔24的一端之间，即弹性件29位于喷头21内，且远离第二通孔24的一端。
或者，可选地，所述缓冲组件27包括固定件28和弹性件29，第一通道19的给药端20形成于固定件28内部；固定件28位于弹性件29与第二通孔24之间。如图6所示，当弹性件29处于释放状态时，固定件342堵塞第一通孔23，给药端20与第一通孔23连通，此时可以通过第一通道19的给药端20，经由第一通孔23向软囊22内注射药物，如麻醉药；软囊22中的药物不会泄露至喷头内，此时软囊22的体积增大；如图7所示，当患者进行自主呼吸时，喷头21在第一通道19上滑动，向患者吸气方向运动，弹性件29处于 压缩状态时，露出第一通孔23，软囊22内的药物通过第一通孔23进入喷头21内，进而通过第二通孔24被患者吸入；可以简单总结为：弹性件29释放时，固定件28堵塞第一通孔23，给药端20与第一通孔23连通；弹性件被压缩时，固定件28移走，第一通孔23露出。
本实施例中，一方面，所述固定件28与弹性件29相互配合起到缓冲效果，避免了因碰撞造成的喷头21损伤，进而有利于保证喷头21更好地给药，提高给药效果；另一方面，当有多个第一通孔23时，所述固定件28在通过第一通道19向软囊22输送麻醉药时，实现了对除与第一通道19(给药端20)连通的第一通孔23外的其它第一通孔23的堵塞作用，防止麻醉药溢出软囊22，同时，在患者吸气时，喷头21与缓冲组件27发生相对运动，固定件28不再堵塞第一通孔23，实现了麻醉药通过多个第一通孔23快速进入喷头21的效果，有利于实现快速给药，提高给药效果。
为了进一步提高缓冲效果，优选所述弹性件29为弹簧。
可选地，如图8所示，位于导丝本体1和固定件28之间的、第一通道19的一段可以设置外壁层30，所述外壁层30具有厚度，所述喷头21在外壁层30表面滑动；所述外壁层30可与导丝本体1和固定件28设置为一体式的结构，如图8中阴影所示。
所述外壁层30的厚度以使得导丝足够结实，不容易断裂为原则；此外，由于喷头21在外壁层30表面滑动，因此，外壁层30的厚度还优选耐磨。本申请对于外壁层30的厚度并不做过多的要求，能满足上述要求即可。
可选地，如图9所示，所述固定件28面向弹性件29的一端，或者所述外壁层30靠近固定件28且面向弹性件29的一端设置有卡合件31；所述喷头21上设置有与所述卡合件31匹配的被卡合件32；通过卡合件31和被卡合件32之间的相互限制，可以有效防止喷头21掉落而引起的医疗事故。
可选地，所述卡合件31为凸起的凸块，位于固定件28或外壁层30的外缘；所述被卡合件32也为凸起的凸块，靠近第一通道19；如图9所示。由于导丝的各个部件常采用医疗塑料制成，往往柔软且具有一些弹性；当喷头21 过度向右边运动时，被卡合件32将卡在卡合件31的凸块所形成的凹槽中，从而防止喷头21继续过度向右运动，造成脱落而进入患者体内。
可选地，如图10所示，所述喷头21前端和导丝本体14之间设有包裹膜33，所述包裹膜33具有冗余长度或者具有弹性；在患者吸气时，保证喷头21可以被吸出凹槽的同时，进一步地防止喷头21脱离固定件28，防止医疗事故。
可选地，所述第一通道19内设置第一单向阀34；所述单向阀可以控制药物进入喷头21方向，而不会倒流。
进一步的，导丝本体1内轴向设置有第二通道35；可延伸至靠近导丝本体的第一端15处。本实施例中的第二通道35有两个作用，一是在插管进入气道后，可通过第二通道35对气道进行快速给药，实现对患者气道的麻醉；二是在第二通道35不进行给药时，可以通过在第二通道远离给药端一端连接监测器的方式，实现通过第二通道35监测患者呼出的CO 2，从而实现鉴别气道的目的，有助于顺利插管，提高插管的准确性。
为了提高给药效果及监测的准确性，第二通道35与第一通道19相互独立。
可选地，所述第二通道35内设置有第二单向阀36，所述单向阀可以控制药物进入患者，而不会倒流。
可选地，所述导丝上，主要指导丝本体14上，设有刻度37；可以用于测量导丝进入患者体内的长度，以便辅助判断导丝是否到达指定的位置。
可选地，所述第一通道19内和/或第二通道35内可以插入支撑件，例如直径小于所述通道的硬质导丝，导引钢丝等等，以强化管壁；因为导丝由于细长的结构，往往较为柔软，可能不是很利于药物的流通，通过对通道壁进行硬化后，往往更加便于药物流通和对导丝、导管插管的稳定性的控制。
可选地，所述固定件28周向可以设置有密封圈，即所述密封圈位于固定件28与喷头21的内壁之间，可以防水防气，即达到水密封和气密封的目的。
本申请的第二种实施方式提供了一种气管导管，如图5所示，所述气管导管具有前文任意实施方式所述的气管插管导丝13；其中所述导丝的喷头21露 出气管导管第一端11。
本申请的第三种实施方式提供了一种气管插管导丝在气管插管中的应用，采用前文任意实施方式所述的气管插管导丝，可以包括以下步骤：
将位于导丝本体第一端15的具有体积的吸入体16放置于口腔深处，如口咽部，导丝本体第二端18置于口腔外；通过吸气，将吸入体16及导丝本体的一部分吸入气管6中；进一步地，将气管导管6沿着导丝13插入气管6中，然后抽出导丝13，完成插管。
还可以具体地包括以下步骤：
根据患者声门的位置，固定气管插管导丝，通过第一通道19向软囊22输送麻醉药，患者吸气时，喷头21向前移动至患者声门处，同时软囊22弹性回缩并将软囊22内的麻醉药通过第二通孔24喷出对患者声门进行麻醉，可重复多次，如3次；
向远离喷头21的方向重新确定气管插管导丝的固定位置，固定位置根据患者声门到气道之间的距离确定，通过患者吸气力量将气管插管导丝吸入患者气道，气管插管导丝通过第二通道35对患者气道进行麻醉，并引导气管导管插管。
上述方法通过患者自主呼吸的调节，通过吸气力量将引导丝吸入气道引导气管导管插管，避免了传统插管方式对声门显露的依赖，降低了气管插管的难度，为极困难气道插管提供了安全保障。在一些实施方式中，还可以同时实现表面麻醉。

Claims (13)

  1. 一种气管插管导丝，包括导丝本体，所述导丝本体内轴向设置有用于注入药物的第一通道，所述第一通道包括伸出所述导丝本体的给药端，所述给药端套设有与所述第一通道滑动连接的喷头，所述喷头外周包覆有用于储存所述药物的软囊，所述软囊通过设置在所述喷头上的第一通孔与所述第一通道连通，所述喷头还设有用于在患者吸气状态下喷出所述药物的第二通孔。
  2. 根据权利要求1所述的气管插管导丝，其特征在于，所述软囊位于所述喷头侧面，所述第二通孔位于所述喷头前端。
  3. 根据权利要求1或2所述的气管插管导丝，其特征在于，所述喷头内设有缓冲组件，所述缓冲组件包括固定件及弹性件，所述固定件与所述给药端相连，所述弹性件处于所述固定件与所述喷头远离所述第二通孔之间。
  4. 根据权利要求1或2所述的气管插管导丝，其特征在于，所述喷头内设有缓冲组件，所述缓冲组件包括固定件和弹性件，第一通道的给药端形成于固定件内部；固定件位于弹性件与第二通孔之间；弹性件释放时，固定件堵塞第一通孔，给药端与第一通孔连通；弹性件被压缩时，固定件移走，第一通孔露出。
  5. 根据权利要求3或4所述的气管插管导丝，其特征在于，所述弹性件为弹簧。
  6. 根据权利要求3或4所述的气管插管导丝，其特征在于，所述导丝本体上设有用于容纳所述喷头的凹槽。
  7. 根据权利要求3或4所述的气管插管导丝，所述喷头沿着周向设置有多个第一通孔，喷头前端设置多个第二通孔。
  8. 根据权利要求3或4所述的气管插管导丝，其特征在于，位于导丝本体和固定件之间的、第一通道的一段设置外壁层，所述外壁层具有厚度，所述喷头在外壁层表面滑动。
  9. 根据权利要求8所述的气管插管导丝，其特征在于，所述固定件面向弹性件的一端，或者所述外壁层靠近固定件且面向弹性件的一端设置有卡合件； 所述喷头上设置有与所述卡合件匹配的被卡合件；优选所述卡合件为凸起的凸块，位于固定件或外壁层的外缘；所述被卡合件也为凸起的凸块，靠近第一通道。
  10. 根据权利要求1所述的气管插管导丝，其特征在于，所述导丝本体内轴向设置有用于注射药物的第二通道。
  11. 根据权利要求1或2所述的气管插管导丝，其特征在于，所述第一通道中设有细长形支撑件。
  12. 一种气管导管，其特征在于，所述气管导管内设有权利要求1-11任一项所述的气管插管导丝。
  13. 根据权利要求1-11任一项所述的气管插管导丝在气管插管中的应用，其特征在于，包括以下步骤：
    根据患者声门的位置，固定所述气管插管导丝，通过所述第一通道向所述软囊输送麻醉药；患者吸气时，所述喷头向前移动至患者声门处，同时所述软囊弹性回缩并将所述软囊内的麻醉药通过所述第二通孔喷出对患者声门进行麻醉；
    向远离所述喷头的方向重新确定所述气管插管导丝的固定位置，所述固定位置根据患者声门到气道之间的距离确定，通过患者吸气力量将所述气管插管导丝吸入患者气道，所述气管插管导丝通过所述第二通道对患者气道进行麻醉，并引导气管导管插管。
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CN203777449U (zh) * 2014-04-22 2014-08-20 潍坊医学院 一种多功能气管插管导芯
CN204092779U (zh) * 2014-10-30 2015-01-14 许庆林 气管导管
CN205698842U (zh) * 2016-04-28 2016-11-23 张玉琴 无创气管插管引导丝
CN109675173A (zh) * 2019-02-03 2019-04-26 青岛市妇女儿童医院（青岛市妇幼保健院、青岛市残疾儿童医疗康复中心、青岛市新生儿疾病筛查中心） 呼吸引导式气管插管导丝及其在气管插管中的应用
CN110013593A (zh) * 2019-02-03 2019-07-16 青岛市妇女儿童医院（青岛市妇幼保健院、青岛市残疾儿童医疗康复中心、青岛市新生儿疾病筛查中心） 气管插管导丝，气管导管，以及该导丝的应用

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