CN100431635C - Esophageal obstruction type ventilation pipe of larynx cover - Google Patents

Abstract

The invention relates to an esophageal obstructed laryngeal mask airway, comprising: a ventilation catheter, a ventilation mask, a drainage tube, and a stabilizing device, and also includes: a thin lumen placed on the inner side of the drainage tube wall; an esophagus The occluder further includes: a thin-cavity catheter with an inflation port on the side wall near the front end and an inflation valve at the rear end, the thin-cavity catheter passes through the thin lumen in the drainage tube wall, and can Move up and down; a set of cuffs, tightly set on the inflation port near the front end of the thin-cavity catheter, and the inner cavity of the cuff communicates with the inflation port; a mark, set on the outer wall of the upper middle part of the thin-cavity catheter; a restriction device , located above the mark on the thin-cavity catheter, when the present invention is used to maintain the airway, the upper end of the esophagus can be completely closed, which can not only effectively prevent gastric content reflux and aspiration, but also prevent leakage from around the airway of the laryngeal mask Gas entering the stomach causes flatulence, making the laryngeal mask airway a truly safe and effective airway maintenance device.

Description

Esophageal obstruction laryngeal mask airway

technical field

The invention relates to a medical instrument used in surgical anesthesia and rescue of critically ill patients-a laryngeal mask airway, in particular to an esophageal obstruction type laryngeal mask airway.

Background technique

The laryngeal mask airway is a new type of airway invented by Brain in 1983 and first advocated for use. Its basic structure is shown in Figure 1. It has a ventilation catheter 1 and a ventilation mask 2. The purpose of the design is: after insertion, the ventilation mask 2 at the far end is located in the hypopharynx a, and forms a seal around the larynx b. The ventilation mask 2 The wall of the long axis faces the piriform recess. The hypopharynx a or hypopharynx b is the pharyngeal space behind the arytenoid and cricoid cartilages. Therefore, when the airway of the laryngeal mask is inserted correctly, the distal end of the ventilation mask 2 is located behind the arytenoid cartilage and cricoid cartilage e, and its top is attached to the upper sphincter of the esophagus c, which is equivalent to the level of the 5th to 6th cervical vertebrae. The proximal end of the hood is at the base of the tongue and below the level of the tonsils.

Insert the ventilation mask 2 of the laryngeal mask airway into the throat a, and after inflating it can form a sealing ring around the throat b, which can not only allow the patient to breathe spontaneously, but also perform positive pressure ventilation, which is between the endotracheal intubation and the mask ventilation device between.

In the past 20 years, in order to improve the clinical use of the laryngeal mask airway, three basic types of laryngeal mask airways have been developed:

1. The standard laryngeal mask airway is currently the most commonly used laryngeal mask airway in clinical practice. It consists of a ventilation catheter and a ventilation mask, and is mainly used to maintain the airway. In order to solve the difficulty of insertion operation caused by the soft air tube of the standard laryngeal mask airway and the stenosis of the lumen during ventilation maintenance, a reinforced standard laryngeal mask airway has been produced, and its main features are the length of the air tube, The wall thickness and strength are increased, and metal spiral wires are embedded in the vent tube wall of the laryngeal mask airway produced by some manufacturers.

2. A special laryngeal mask airway for guiding endotracheal intubation. This laryngeal mask airway is an improved device specially designed for endotracheal intubation. A typical intubation-specific laryngeal mask airway consists of a standard ventilation mask, pre-shaped metal ventilation tube, and handle. The ventilation tube of the special laryngeal mask airway for tracheal intubation is quite thick, and a tracheal tube with a maximum inner diameter of 9.0mm can be inserted.

In the ventilation mask of this kind of laryngeal mask airway, there is only a triangular-like movable epiglottis lifting plate. When the front end of the endotracheal tube passes through the epiglottis lifting plate, it and the epiglottis can be pushed away quite easily, thus effectively It is beneficial for the tracheal tube to pass through the cavity of the ventilation mask and enter the glottis smoothly. The metal handle attached to the proximal end of the ventilation catheter can not only hold the laryngeal mask airway firmly, but also control the direction of the mask opening.

3. Esophageal drainage type laryngeal mask airway, as shown in Figure 2, an improved laryngeal mask airway with drainage effect on esophageal reflux has been developed. The basic structure of this improved laryngeal mask airway is similar to that of the standard laryngeal mask airway, except that it has a drainage tube 4 parallel to the ventilation catheter 1, and the drainage tube 4 passes through the inner cavity of the ventilation mask 2 and opens into the cone of the ventilation mask 2. shaped front end. When the esophageal drainage type laryngeal mask airway is correctly inserted, the front end of the drainage tube 4 is just positioned at the upper part of the esophagus, so that the gastrointestinal decompression tube can be inserted into the esophagus through the drainage tube when the laryngeal mask airway is used for lung ventilation. To attract reflux and gastric contents, if necessary, a nasal feeding tube can be inserted into the gastrointestinal tract through the drainage tube 4 for artificial gastrointestinal nutrition. Although the esophageal drainage type laryngeal mask airway has a certain preventive effect on gastric aspiration, but in patients with high risk of pulmonary aspiration (such as patients with a full stomach), this improved laryngeal mask airway still cannot achieve satisfactory results. Respiratory protection.

Contents of the invention

The purpose of the present invention is to overcome the deficiencies and defects of the prior art, and propose an esophageal obstruction type laryngeal mask airway. On the basis of the esophageal drainage type laryngeal mask airway, a special esophageal occluder is added. During airway maintenance, the upper end of the esophagus is completely sealed by inflating the cuff of the esophageal obstructor, which can not only effectively prevent gastric content reflux and aspiration, but also prevent gas leaking from around the laryngeal mask airway from entering the stomach and causing Gastric flatulence, making the laryngeal mask airway indeed a safe and effective airway maintenance device.

In order to achieve the above purpose, the present invention proposes an esophageal obstruction type laryngeal mask airway, comprising:

A ventilation catheter, made of silicone rubber, with a helical wire prefabricated inside the tube wall to enhance the strength of the tube wall and maintain the lumen in a smooth state. The proximal end of the ventilation catheter has a standard ventilation loop connector, which is compatible with the ventilation The conduit is detachable;

A ventilation hood, which is similar to an elliptical oblique cone, is made of soft and thin rubber. The periphery of the oblique cone bottom is a hollow cylindrical elliptical ring bulge, and the oblique cone surface is made of soft rubber sheet. The oblique cone surface and the oblique cone bottom It is glued tightly connected, and a ventilation duct is connected above the oblique cone face of the ventilation hood. There is a self-sealing inflation valve at the end of the inflation tube;

A drainage tube, the drainage tube is made of semi-rigid transparent medical plastic, located on one side of the ventilation catheter, parallel to the ventilation catheter, the length above the proximal end is slightly longer than the ventilation catheter, and it passes through the top of the inclined cone face of the ventilation mask into the cavity in the center of the ventilation hood, and after passing through the cavity in the center of the ventilation hood, it passes through the midpoint below the beveled cone face of the ventilator, where its distal end terminates, where the drainage tube enters and exits the beveled cone face of the ventilator The parts are all glued and tightly connected;

A stabilizing device, placed on the middle and upper part of the ventilation catheter and the drainage tube, to connect the ventilation catheter and the drainage tube into one;

In addition, the esophageal obstruction type laryngeal mask airway also includes:

A thin lumen is placed on the inner side of the drainage tube wall. When the cavity of the ventilation hood faces forward, the starting point of the thin lumen is located at 12 o’clock in the middle of the lumen at the proximal end of the drainage tube, and the ending point of the thin lumen is at 8-15 mm from the distal end of the drainage tube;

An esophageal occluder that can be inserted into the drainage tube, the esophageal occluder further comprising:

A thin-cavity catheter has an inflation port on the side wall near the front end, and its rear end is connected with a self-sealing inflation valve. The thin-cavity catheter passes through the thin lumen in the wall of the drainage tube, and can go up, move down;

A set of cuffs, which are tightly covered at the inflation port near the front end of the thin-cavity catheter, and the inner cavity of the cuff communicates with the inflation port and the lumen of the thin-cavity catheter;

A mark, set on the outer wall of the upper middle part of the thin lumen catheter, when the thin lumen catheter moves up in the lumen of the thin lumen and the front end of the thin lumen catheter is completely retracted into the drainage tube, the mark is just at the proximal end of the drainage tube ;

A restricting device is arranged above the mark of the thin-cavity catheter, and the length from the mark to the position of the restricting device is 35-50 mm.

The drainage tube and the narrow lumen can also be integrally formed.

The material of the cuff of the esophageal occluder is selected from elastic rubber or plastic.

The mark of the esophageal occluder is a circular mark, which can be identified by various colors.

The restricting device of the esophageal occluder is a circular tube-shaped restricting ring made of semi-hard rubber, which can be fixedly sheathed on the thin-cavity catheter.

A scale can be marked between the mark on the thin-cavity catheter of the esophageal occluder and the limit position of the restriction device.

The present invention has the advantages that: on the basis of having an esophageal drainage type laryngeal mask airway, a special esophageal occluder is added, and when the airway is used to maintain the airway, the cuff of the esophageal occluder can be inflated. Completely sealing the upper end of the esophagus can not only effectively prevent gastric content reflux and aspiration, but also prevent gas leaking from around the laryngeal mask airway from entering the stomach and causing flatulence, making the laryngeal mask airway a safe and effective method. airway maintenance device.

Description of drawings

Figure 1 is a schematic diagram of the normal anatomical position of the existing laryngeal mask airway;

Fig. 2 is a structural schematic diagram of an existing esophageal drainage type laryngeal mask airway;

Fig. 3 is a schematic structural view of the esophageal obstruction type laryngeal mask airway of the present invention;

Fig. 4 is a rear view of the airway structure of the esophageal obstruction type laryngeal mask shown in Fig. 3;

Fig. 5 is a schematic structural view of an esophageal occluder;

Fig. 6 is a schematic diagram of the application method of the esophageal occluder;

Fig. 7 is a schematic diagram of the normal anatomical position of the airway of the esophageal obstruction type laryngeal mask of the present invention;

Fig. 8 is a schematic diagram of the present invention when it is used for gastric suction and gastrointestinal perfusion with artificial nutrient solution.

Detailed ways

The specific implementation manner of the present invention will be described in detail below in conjunction with the accompanying drawings and examples.

As shown in Figure 3, Figure 4 and Figure 5, it is an embodiment of an esophageal obstruction type laryngeal mask airway, including:

A ventilation catheter 1 is made of silicone rubber, and the tube wall is prefabricated with a helical wire to enhance the strength of the tube wall and maintain the lumen in a smooth state. The proximal end of the ventilation catheter 1 has a standard ventilation loop connector 11. The joint 11 is detachably connected to the ventilation conduit 1;

A ventilation cover 2 is similar to an elliptical oblique cone, made of soft and thin rubber, and the bottom periphery of the oblique cone is a hollow cylindrical elliptical ring bulge 21, and its oblique cone surface 22 is made of soft rubber sheet, and the oblique cone surface 22 It is glued tightly connected with the bottom 21 of the oblique cone, and a ventilation duct 1 is connected above the oblique cone surface 22 of the ventilation hood. There is also an inflatable tube 3 sealedly connected to the top of the ventilator 2 inclined cone surface 22, and the end of the inflatable tube 3 has a self-sealing inflation valve 31;

A drainage tube 4, the drainage tube 4 is made of semi-rigid transparent medical plastics, is positioned at one side of the ventilation duct 1, is parallel with the ventilation duct 1, and the length above its proximal end 41 is slightly longer than the ventilation duct 1, and it is drawn from the ventilation hood The top of the oblique cone surface 22 penetrates into the cavity at the center of the ventilator 2, and passes through the cavity at the center of the ventilator 2 to pass through the midpoint below the oblique cone portion 22 of the ventilator, where the distal end 42 terminates. The parts where the pipe 4 penetrates and passes through the inclined cone surface 22 of the ventilation hood are all glued tightly connected;

A stabilizing device 5 is placed on the middle and upper part of the ventilation tube 1 and the drainage tube 4, and connects the ventilation tube 1 and the drainage tube 4 into one;

In addition, this esophageal obstruction laryngeal mask airway includes:

A thin lumen 6 is placed on the inner side of the tube wall of the drainage tube 4. When the cavity of the ventilation cover 2 is facing forward, the starting point of the thin lumen 6 is located at 12 o'clock in the middle of the lumen at the proximal end 41 of the drainage tube 4. The termination point of the thin lumen 6 is located within 15 millimeters away from the distal end 42 of the drainage tube 4;

An esophageal occluder 7, please refer to Fig. 5 and Fig. 6 at the same time, it further includes:

A thin cavity conduit 71 has an inflation port 711 near the front end side wall, and its rear end is connected with a self-sealing inflation valve 72. The thin cavity conduit 71 passes through the thin tube cavity 6 in the drainage tube 4 wall, and can Thin lumen 6 moves up and down;

A set of cuff 73 is tightly set at the inflation port 711 near the front end of the thin-cavity catheter 71, and the inner cavity of the cuff 73 communicates with the inflation port 711 and the lumen of the thin-cavity catheter 71;

A mark 74 is arranged on the outer wall of the upper part of the thin cavity catheter 71. When the thin cavity catheter 71 moves up in the thin lumen 6 and the front end 712 of the thin cavity catheter 71 is completely retracted into the drainage tube 6, the The mark 74 is located right at the proximal end 41 of the drainage tube 4;

A restricting device 75 is arranged above the mark 74 of the thin-cavity catheter 71 , and the length from the mark 74 to the limiting position of the restricting device 75 is 50 mm.

The drainage tube 4 and the narrow lumen 6 of the present invention can also be integrally formed.

The cuff 73 of the esophageal occluder 7 is made of rubber or plastic with good elasticity.

The mark 74 of the esophageal occluder 7 is a circular mark, which can be identified by various colors.

The restricting device 75 of the esophageal occluder 7 is a circular tubular restricting ring made of semi-hard rubber, which can be fixedly placed on the thin cavity catheter 71 , and its diameter should be significantly larger than the inner diameter of the thin lumen 6 .

A scale can be marked between the mark 74 on the thin cavity catheter 71 of the esophageal occluder 7 and the limit position of the restricting device 75 .

There are many types of esophageal obstructive laryngeal mask airway designs, which are suitable for children, teenagers, ordinary adults, tall obese adults, etc., and the specific sizes are different. The scope of application of the esophageal obstructive laryngeal mask airway is mainly: 1. Emergency resuscitation in the emergency department, ICU and various departments, especially when non-anesthesia staff perform emergency airway management operations; 2. Patients with difficult tracheal intubation, especially Emergency surgery patients with full stomach; 3. Examination of trachea and larynx and removal of foreign bodies in the trachea; 4. General anesthesia patients who do not want to use tracheal intubation, such as ophthalmic surgery, actors, patients with severe hypertension, etc.

When using the airway of the esophageal obstruction type laryngeal mask, first pump out the air in the ventilation mask, insert the front end of the airway of the esophageal obstruction type laryngeal mask into the oral cavity until the upper end of the ventilation mask is below the base of the tongue, and then inflate through the ventilation mask The self-sealing inflation valve 31 at the end of the pipe 3 inflates the ventilation cover. When the ventilation mask is inflated, the ventilation catheter 1 usually withdraws slightly from the oral cavity; the thyroid and cricoid overlying tissues are slightly raised. Connect the ventilation catheter 1 to the ventilation circuit, and evaluate the satisfaction of the patient's lung ventilation. After confirming that the laryngeal mask airway is satisfactorily ventilated, the ventilation catheter 1 and drainage tube 4 are fixed on the patient's face with adhesive tape. The operator holds the restricting device 75 at the middle and upper part of the esophageal obstructor 7 with the index finger and the thumb, and pushes the esophageal obstructor 7 downward until the restricting device 75 is located at the upper end 41 of the drainage tube 4 . As shown in Figure 6, at this time, the front end 712 of the thin-cavity catheter 71 stretches forward to a position 50 mm outward from the front end 42 of the drainage tube 4, and then the cuff 73 of the esophageal obstructor 7 is inflated with a syringe through the inflation valve 72. Inject an appropriate amount of air, and the esophagus has been blocked at this time (see Figure 7). Thereby, it can effectively prevent the reflux of gastric contents to the oropharynx or prevent the gas leaking from around the laryngeal mask airway from entering the esophagus and stomach.

When gastric suction and gastrointestinal perfusion with artificial nutrient solution are required, the cuff 73 of the esophageal obstructor 7 is deflated, and the esophageal obstructor 7 is completely returned to the drainage tube 4, through the drainage of the esophageal obstructed laryngeal mask airway The tube 4 can be inserted into a stomach tube 8 of a suitable type (see FIG. 8 ). When perfusing the nutrient solution, it is better to inflate the cuff 73 of the esophageal occluder 7 after the gastric tube 8 is inserted, so as to avoid the reflux of the nutrient solution poured into the stomach to the esophagus and oropharynx and cause aspiration.

The esophageal obstruction type laryngeal mask airway provided by the present invention has the following characteristics:

1. In addition to the function and characteristics of the standard laryngeal mask airway, the esophageal obstruction type laryngeal mask airway is more suitable for the comprehensive anesthesia process and the rescue treatment of critically ill patients. Because it can effectively seal the esophagus, the airway protection effect is better, especially in surgical patients and emergency rescue patients (such as patients with a full stomach) who have a high risk of aspiration and reflux.

2. It can effectively prevent the gas leaked from the ventilation hood from entering the patient's stomach during positive pressure ventilation, especially suitable for patients who need high ventilation pressure.

3. The double tube setting can not only provide more effective airway ventilation, but also provide a channel for discharging gastric juice and supplementing nutrition.

4. The double-tube design helps to fix the position of the airway of the esophageal obstructed laryngeal mask for better positive pressure ventilation.

Claims (6)

1. esophageal obstruction formula intubating laryngeal mask airway comprises:

One airway is made with silicone rubber, is shaped on helical metal wire in the tube wall in advance, and with the intensity that strengthens tube wall with keep tube chamber and be in unobstructed state, the near-end of airway has standard ventilation ring pipeline connector, and this joint is dismountable type with airway and is connected;

One vent hood, be oval oblique cone shape, make by soft thin rubber, the elliptical ring protuberance that its oblique cone bottom periphery is a hollow cylindrical, its oblique cone face is made by the soft rubber sheet, and the oblique cone face is adhesive type with the oblique cone bottom and closely is connected, above vent hood oblique cone face, be connected with airway, the far-end of airway enters vent hood and is adhesive type with vent hood and closely is connected, and also is sealedly connected with gas tube above vent hood oblique cone face, and the end of gas tube has the self-sealing charge valve;

One drainage tube, drainage tube is made by the semi-rigid transparent medical grade plastic, be positioned at a side of airway, parallel with airway, the length of its near-end top is longer than airway slightly, it is from vent hood oblique cone face top, penetrate the cavity at vent hood center, and pass the mid-point of vent hood scalene cone subordinate side behind the cavity through the vent hood center, its far-end stops herein, penetrate and pass the position of vent hood oblique cone face at drainage tube, all be adhesive type and closely connect;

One stabilising arrangement places the middle and upper part of airway and drainage tube, and airway and drainage tube are connected as a single entity;

It is characterized in that described esophageal obstruction formula intubating laryngeal mask airway also comprises:

One tubule chamber places the inboard of drainage tube tube wall, when the cavity of vent hood to forwards the time, tubule chamber starting point is positioned at the position of 12 of drainage tube near-end tube chamber centers, the terminating point in tubule chamber is positioned at 8～15 millimeters places apart from the drainage tube far-end;

One esophageal obstruction device can penetrate described drainage tube, and this esophageal obstruction device further comprises;

One thin cavity conduit, its front end sidewall has an inflation inlet, and its rear end is connected with a self-sealing charge valve, and thin cavity conduit passes the tubule chamber in the drainage wall, and can be upper and lower mobile along the tubule chamber;

One overlaps capsule, closely is enclosed within the inflation inlet place of thin cavity conduit front end, and cover capsule inner chamber communicates with the tube chamber of inflation inlet and thin cavity conduit;

One labelling is located on the outer wall of thin cavity conduit middle and upper part, and when thin cavity conduit moves on the tubule intracavity, when the front end of thin cavity conduit was retracted in the drainage tube fully, this labelling just in time was positioned at the near-end of drainage tube;

One restraint device is located at above the labelling of thin cavity conduit, and the spacing length from labelling to restraint device is 35～60 millimeters.

2. esophageal obstruction formula intubating laryngeal mask airway according to claim 1 is characterized in that described drainage tube and tubule chamber are one-body molded.

3. esophageal obstruction formula intubating laryngeal mask airway according to claim 1 is characterized in that the material of the cover capsule of described esophageal obstruction device is selected from rubber or the plastics with elastic performance.

4. esophageal obstruction formula intubating laryngeal mask airway according to claim 1 is characterized in that, described esophageal obstruction device be labeled as annulet, use various colour code.

5. esophageal obstruction formula intubating laryngeal mask airway according to claim 1 is characterized in that, the restraint device of described esophageal obstruction device is the pipe shape limit collar that a semi-ebonite is made, and fixed cover is on thin cavity conduit.

6. esophageal obstruction formula intubating laryngeal mask airway according to claim 1 is characterized in that, the supravasal labelling of thin cavity of described esophageal obstruction device is to calibrate between the spacing place of restraint device.

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