JP2011078456A - Nutrition catheter - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a nutrition catheter capable of being operated relatively safely and securely without depending on the direction of the catheter in vivo in a sucking operation step when the catheter is inserted into the human body and in a nutrient feeding step. <P>SOLUTION: The nutrition catheter is characterized by a plurality of second side holes on a side wall of a tubular member in such a way as to communicate with a hollow part. The second side holes are disposed at positions on the proximal end side of a first side hole in the axial direction of the tubular member and on the same circumference at the positions. <P>COPYRIGHT: (C)2011,JPO&INPIT

Description

The present invention relates to a structure of a nutritional catheter that supplies a nutrient to the gastrointestinal tract, either orally or nasally.

Enteral nutrition therapy is known in which a nutrient catheter is inserted into the oral cavity or nasal cavity to supply a nutrient to the gastrointestinal tract. The nutrition catheter used for such enteral nutrition therapy is made of a flexible member, and is composed of a hollow and long tubular member.
In addition, the nutrition catheter supplies nutrients from the opening on the proximal end side, conducts the hollow portion and transfers it to the distal end side, and supplies the nutrient agent to the target position from the opening on the distal end side for use. .
On the other hand, a feeding catheter is inserted through the oral cavity or nasal cavity and used with its distal end reaching a target organ such as the esophagus, stomach, or duodenum. When inserting the feeding catheter and checking whether the distal end has reached the target organ, the hollow part is decompressed via the proximal end of the feeding catheter, and the target organ is opened from the opening of the feeding catheter tip. The body fluid in the vicinity is collected by performing a suction operation, and the insertion position of the tip is confirmed by confirming the properties (pH, etc.) of the body fluid. Further, during the suction operation, the hollow portion of the catheter is depressurized and the target body fluid is sucked from the opening at the distal end. At this time, the mucous membrane of the organ is sucked and the body fluid may not be sucked and collected. is there.

On the other hand, a catheter is known in which a side hole that opens to communicate with the hollow portion is provided on the side wall near the opening on the distal end side of the catheter (for example, Patent Document 1). In such a catheter, since the side hole is provided over a wide area of the middle part of the tubular member of the catheter, the above-described suction operation may hinder the operation by sucking the mucous membrane or the like during an unnecessary period. As well as the collection of body fluids in the desired organ is relatively difficult. Furthermore, it is relatively difficult to reliably supply a nutrient to a desired organ in the above-described process of supplying a nutrient or the like.

Japanese Utility Model Application Publication No. 59-177445

In view of the above circumstances, the nutritional catheter of the present invention is not dependent on the direction of the nutritional catheter in the body, in the operation of supplying / discharging various fluids (supplying and suctioning operations) when the catheter is inserted into the body. An object of the present invention is to provide a nutritional catheter capable of suction operation. It is another object of the present invention to provide a nutritional catheter capable of reliably supplying a nutrient to a desired position in a nutrient supply step when the nutritional catheter is inserted into the body.

The present invention comprises a tubular member that is flexible and has a hollow portion, and is provided such that a distal end opening portion whose distal end is open and a proximal end thereof that is open so that its lumen communicates with the hollow portion of the tubular member. A feeding catheter provided with a first side hole that opens to communicate with the hollow part on the side wall near the distal end of the tubular member,
A second side hole opened to communicate with the hollow portion on the side wall of the tubular member,
In the axial direction of the tubular member, it is provided at a position on the base end side from the first side hole,
By providing a plurality of nutrition catheters provided on the same circumference at the same position, the above-mentioned problems have been achieved.

Further, it is preferable that the second side holes are provided at equal intervals in the same circumferential direction.
Moreover, it is preferable that said 2nd side hole part was provided in the same circumferential direction in the line-symmetrical position with respect to the perpendicular divided | segmented in the direction perpendicular | vertical with respect to the axial direction of the said tubular member.
The maximum diameter of the second side hole is preferably smaller than the minimum diameter of the first side hole.
Moreover, it is preferable that the shape of said 2nd side hole part is circular shape.

In this specification, the terms “front end” or “base end” are used.
The “tip” is defined as an end side having a configuration (tip end portion inserted into the body) that mainly opens and feeds nutrients, sucks body fluid, and the like in the nutrition catheter of the present invention. On the other hand, the “proximal end” defines the opposite side of the “distal end”. In addition, when describing the positional relationship and directionality of each member, the terms “distal end (distal end)” and “proximal end (proximal end)” are used. It is used as a word indicating positional relationship and directionality.

According to the present invention, in addition to the first side hole portion opened to communicate with the hollow portion on the side wall in the vicinity of the distal end portion of the tubular member in the feeding catheter, the side wall of the tubular member is opened to communicate with the hollow portion. The second side hole portion is provided at a position closer to the base end side than the first side hole portion in the axial direction of the tubular member, and a plurality of the second side hole portions are provided on the same circumference at the position. did.
As a result, even when the distal end opening portion of the distal end is closed and the first side hole portion of the side wall is closed during the suction operation of the catheter, the second side hole portion is provided, so that the opening communicating with the hollow portion is provided. Since the portion can be secured, a suction operation can be performed.
In addition, since the second side hole is provided at a position closer to the base end side than the first side hole in the axial direction of the tubular member, the detachment operation during the suction operation can be easily performed.
Further, since the second side hole is provided in plural on the same circumference at the position in the axial direction, when the catheter is inserted into the body, a part of the side wall comes into contact with various organs. Even in this case, an opening communicating with the hollow portion can be secured by the second side hole provided separately.
In addition, since the second side holes are provided at equal intervals in the same circumferential direction, the position in the circumferential direction of the catheter when the catheter is inserted into the body is not dependent on any directionality, An opening that communicates with the hollow portion can be secured by the second side hole.
In addition, since the second side hole is provided in a line-symmetrical position with respect to a perpendicular line divided in a direction perpendicular to the axial direction of the tubular member in the same circumferential direction, the catheter described above is provided in the body. In addition to the case where one surface in the circumferential direction of the side wall of the catheter is in contact with various organs when inserted into the catheter, the two surfaces (for example, the vertical direction and the horizontal direction) facing each other in the circumferential direction are in contact with the various organs. Even in the case of contact, an opening communicating with the hollow portion can be ensured by the second side hole.
As a result, even if the catheter is inserted into a narrowed area of various organs that are sandwiched and abutted from the opposing direction, an opening communicating with the hollow portion can be secured by the second side hole. Even if the catheter is inserted into any organ, a suction operation can be performed.
In addition, since the maximum diameter of the second side hole is configured to be smaller than the minimum diameter of the first side hole, the suction operation by the tip opening or the suction operation by the first side hole is performed. The suction force is not substantially affected.
Further, during the suction operation, various fluids (air, body fluid, etc.) can be sucked from the second side hole, but the various organs are hardly sucked and a reliable suction operation is obtained.
Further, even during the operation of supplying the nutrient solution etc. of the nutrition catheter, there is almost no leakage from the second side hole, and the operation of supplying the nutrient solution or the like can be surely obtained at the desired site.

In addition, since the shape of the second side hole portion is configured in a circular shape, it is possible to further reduce the influence on the suction operation and supply operation through the tip opening portion, the first side hole portion described above, and more. Reliable suction and supply operations are possible.

As described above, the feeding catheter of the present invention can perform the suction operation in the suction operation process at the time of insertion of the catheter into the body regardless of the directionality of the feeding catheter in the body, and in the supply operation process, the desired organ It is possible to provide a nutrition catheter that can reliably supply nutrients and the like.

The front view which showed the whole in 1st Embodiment of the nutrition catheter of this invention The enlarged front view (A) and enlarged side view (B) which showed only the front-end | tip part and base end part in 1st Embodiment of the nutrition catheter of this invention The cross-sectional view by the X-X 'line | wire (location of a 2nd side hole part) in 1st Embodiment of the nutrition catheter of this invention

Hereinafter, embodiments of the nutrition catheter of the present invention will be specifically described with reference to the drawings. A first embodiment of the present invention will be described with reference to FIGS.
FIG. 1 is a front view showing the whole of a nutritional catheter according to a first embodiment of the present invention. FIG. 2 is a front view (A) and a side view (B) of the feeding catheter 1 according to the first embodiment of the present invention. FIG. 3 is a cross-sectional view taken along line XX ′ (second side hole portion) in the first embodiment of the nutrition catheter of the present invention.
In FIG. 2, the portion located between the location where the distal side hole is provided and the connecting member 5 at the proximal end is constituted by a hollow tubular member. ing.
As shown in FIG. 2, the nutritional catheter 1 according to the first embodiment of the present invention has a tubular member 10 having a hollow portion 11 that opens and communicates with a distal end thereof, and a lumen that opens at a proximal end of the tubular member 10. The connecting member 5 is provided so as to communicate with the hollow portion 11 of the tubular member 10.
A distal end opening 2 is provided at the distal end of the tubular member 10 so as to open and communicate with the hollow portion 11.
The side wall in the vicinity of the tip provided with the tip opening 2 is provided with a substantially elliptical first side hole 3 having a long axis in the axial direction, and is provided so as to communicate with the hollow portion 11. Yes.
Further, second side holes 41, 42, 43, 44 are provided at positions closer to the base end side in the axial direction than the position where the first side hole 3 is provided.
As shown in FIG. 3, the second side holes 41, 42, 43, 44 are arranged at equal intervals on the circumference in the axial direction of the tubular member 10.

As shown in FIGS. 1 and 2, the feeding catheter 1 is composed of a hollow tubular member that is long in the axial direction. The feeding catheter 1 is inserted from the oral cavity or nasal cavity and is made up of a flexible member in order to reach the tip of an organ such as the esophagus, stomach or intestine.
In addition, since the nutritional catheter 1 is inserted into the body and left for a specific period of time, the nutritional catheter 1 is preferably made of a material having high biocompatibility and low elution from the constituted material. Therefore, a specific material constituting the nutrition catheter 1 is preferably a synthetic resin such as polyvinyl chloride, polyurethane, silicon, or polybutadiene. In particular, polyvinyl chloride is preferable because it has excellent operability and is inexpensive.
Moreover, the outer diameter of the tubular member 10 of the nutrition catheter 1 is substantially the same from the distal end portion to the proximal end portion. Moreover, it is preferable that the outer diameter of the tubular member 10 is set in the range of 1.0 mm or more and 5.0 mm or less. When the outer diameter of the tubular member 10 is smaller than 1.0 mm, the inner diameter of the tubular member 10 is also reduced, and the amount of fluid flowing through the hollow portion 11 is reduced. For this reason, the transfer amount per unit time will fall, and time will be required for supply operation of nutrients, suction operation of body fluids, etc. On the other hand, when the outer diameter of the tubular member 10 is larger than 5.0 mm, not only the operability is deteriorated when inserted into the oral cavity or nasal cavity, but also a physical and psychological burden may be imposed on the treatment subject. There is.
Further, a connection member 5 is provided on the proximal end side of the feeding catheter 1. The connecting member 5 is provided such that its proximal end is open and its lumen communicates with the hollow portion 11 of the tubular member 10. When various fluids are circulated through the feeding catheter 1, for example, a syringe-like injector, such as a syringe-like injector, an extension tube having a tip shape such as a syringe-like syringe, a syringe-like injector A distal end portion of an administration set (not shown) having a distal end shape such as a container is inserted and connected for use.
When the nutrient catheter 1 is used to administer nutrients or drugs to various organs, the nutrient agent is derived from the distal end opening 2 of the nutrition catheter 1 by a pressure operation such as an injector filled with the nutrient or by natural fall. And supply. When collecting bodily fluids and the like of various organs with the feeding catheter 1, the bodily fluids and the like are sucked and collected from the distal end opening 2 of the feeding catheter 1 by a decompression operation such as an injector connected to the connection member 5.
The connecting member 5 may be connected to an injector or the like so long as it can flow a fluid. For this reason, the connection member 5 is not limited to this embodiment. For example, the connecting member 5 may be configured to be openable and closable by being provided with a lid member connected to a hinge extending from the base end peripheral edge portion that opens. The material of the connecting member 5 is preferably a soft synthetic resin having elasticity.
According to this configuration, when connecting a tip portion (not shown) such as an injector that can be connected to the connection member 5 to the connection member 5, high connection operability and connection retention are achieved due to the elastic characteristics of the connection member 5. And detachability operability can be obtained. The specific material of the connecting member 5 is preferably selected from soft polyvinyl chloride, urethane, silicon, various elastomers, and the like.

In addition, the nutritional catheter 1 includes a distal end opening 2 provided at the distal end of the tubular member 10 so as to open and communicate with the hollow portion 11.
Since the distal end opening 2 is opened in communication with the hollow portion 11 of the tubular member 10, nutrients and the like are circulated through the hollow portion 11 and led to various organs in the body through the distal end opening 2. Can be supplied. Further, when collecting the body fluid or the like of various organs when the feeding catheter 1 is introduced into the body, the distal end opening 2 can be collected by sucking the body fluid or the like through the opening. As described above, it is preferable that the tip opening 2 has a substantially circular shape that is substantially the same as the shape of the communicating hollow portion 11 in order to conduct various fluids.

On the other hand, the side wall in the vicinity of the tip provided with the tip opening 2 is provided with a first side hole 3 provided to communicate with the hollow portion 11.
In the operation of extracting and introducing various fluids of the nutritional catheter 1, various organs, for example, the mucous membrane of the stomach wall and the intestinal wall are aspirated from the distal end opening 3 during the operation of sucking and collecting body fluid or the like. May be blocked, making suction operation impossible. In such a case, since the first side hole 3 provided in the side wall in the vicinity of the tip opening 2 is configured to communicate with the hollow portion 11, the first side replaces the tip opening 2. Various fluids can be led out and in through the hole 3.
Further, the first side hole 3 has a long elliptical shape in the axial direction of the tubular member 10. This is effective for securing the size of a predetermined opening and securing the flow rate of the fluid led in and out through the first side hole 3.
Since the tubular member 10 has a relatively small diameter, if an opening having a substantially circular shape and a relatively large diameter is formed, the rigidity of the tubular member 10 may be reduced. For this reason, the first side hole 3 has a substantially elliptical shape with a long axis in the axial direction of the tubular member 10, so that the area of the opening can be secured and the flow rate of the fluid to be introduced and introduced can be sufficiently secured. it can.
The first side hole 3 is provided on the side wall in the vicinity of the base end side from the position where the distal end opening 2 is provided. This is because, when fluid is led out / in through the first side hole 3, it can be positioned relatively proximal to various target organs through which the fluid is led out / in, and the operation can be accurately performed. It is advantageous to be able to. Specifically, the first side hole 3 is preferably within about 2 cm from the position where the distal end opening 2 is provided to the base end side.

Further, second side holes 41, 42, 43, 44 are provided at positions closer to the base end than the position of the first side hole 3, respectively. The second side holes 41, 42, 43, 44 are formed in the distal end opening 2, the first side, and the like in the feeding / introducing operation of various fluids of the nutritional catheter 1 as described above (especially, aspiration / collecting operation of body fluids). When the hole 3 sucks and closes various organs, various fluids are led out through the openings of the second side holes 41, 42, 43, and 44 instead. Can do.
The second side holes 41, 42, 43, 44 are provided at positions closer to the base end than the position of the first side hole 3. When the feeding catheter 1 is introduced into the body, it is relatively easy to come into contact with the mucous membrane of the stomach wall or intestinal wall at a position located in the distal direction of the feeding catheter 1. The second side holes 41, 42, 43, and 44 are used when the distal end opening 2 and the first side hole 3 are in contact with various organs and sucked to close the opening. Since it acts as an alternative opening, it is relatively advantageous to be located more proximally.

The second side holes 41, 42, 43, and 44 are provided on the same circumference at a position closer to the base end than the position of the first side hole 3. When the feeding catheter 1 is introduced into the body, the place to be introduced is an organ having a tubular structure such as the esophagus, stomach, intestine and the like. For this reason, any location on the circumference of the feeding catheter 1 may come into contact with various organs.
On the other hand, since the feeding catheter 1 has a relatively small diameter (1.0 mm to 5.0 mm), it is relatively rare that a portion other than the contacting portion is in contact with various organs.
A plurality of the second side holes 41, 42, 43, 44 are provided on the same circumference at a position closer to the base end than the position of the first side hole 3. Even if a situation occurs in which a plurality of openings of the holes 41, 42, 43, and 44 are in contact with various organs, the openings can be secured by the other second side holes, Derivation can be performed.

The second side holes 41, 42, 43, 44 are provided at equal intervals in the same circumferential direction. The second side holes 41, 42, 43, and 44 are provided at positions symmetrical with respect to a perpendicular divided in a direction perpendicular to the axial direction of the tubular member in the same circumferential direction. Yes.
By these, there exists an effect which raises the effect which ensures the opening part of said 2nd side hole mentioned above notably. Furthermore, in terms of the physical rigidity of the tubular member of the feeding catheter due to the formation of the opening of the second side hole, it is possible to obtain a relatively stable physical rigidity without causing a decrease in strength in a specific direction. Play.

The maximum diameter of the second side holes 41, 42, 43, 44 is provided to be smaller than the minimum diameter of the first side holes. A plurality of second side holes are provided on the same circumference of the tubular member 10 of the nutrition catheter 1. For this reason, when the diameter of the second side hole is increased, the physical rigidity of the tubular member 10 is lowered and bent at the portion where the second side hole is provided during the lead-in / out operation of the feeding catheter 1. There is a possibility of hindering the entry / exit operation.
If the diameter of the second side hole is large, the distal end opening 2 and the first side hole 3 are in contact with various organs, and in the normal state where the opening is not blocked, There is a possibility that various fluids may be led out / in through the opening of the hole.
For these reasons, it is preferable that the maximum diameter of the second side hole portions 41, 42, 43, 44 be provided to be smaller than the minimum diameter of the first side hole portion.

The second side holes 41, 42, 43, 44 are provided in a circular shape. Since the second side hole portion has a circular shape, it is possible to contribute to an operation that can simultaneously solve the conflicting problems of securing the physical rigidity of the feeding catheter and the effect of introducing and introducing various fluids. In other words, by forming the second side hole portion in a circular shape, in both the axial direction of the feeding catheter at the position where the second side hole portion is provided or the direction perpendicular to the axial direction, The rigidity does not decrease.
In addition, since the opening of the various fluids is circular, the direction of the fluid is hardly affected by the amount of fluid that is introduced and obtained, and a stable fluid introduction and operation can be obtained. Can do.
Moreover, it is preferable to set the diameter of said 2nd side hole 41,42,43,44 in the range of 0.5-2 mm. If the diameter of the second side hole is less than 0.5 mm, the area of the opening cannot be ensured, and the amount of various fluids drawn in and out cannot be sufficiently ensured. In addition, if the diameter of the second side hole exceeds 2 mm, the physical strength of the tubular member of the nutritional catheter is lowered, and there is a possibility that the nutritional catheter may be bent during the lead-out operation of the nutritional catheter or hinder the operation. .
The second side hole is preferably configured such that the end of the second side hole is disposed at a distance of 10 mm from the end of the first side hole to the base end. According to this, the second side hole portion is disposed at a relatively distal end side position of the nutritional catheter, and an operation targeting a desired organ can be easily performed in the operation of leading and discharging various fluids. Furthermore, by providing a second side hole portion that is also opened in the vicinity of the first side hole portion that is opened in the tubular member of the feeding catheter, the feeding catheter can be led out without lowering the physical rigidity of the tubular member. There is an effect that a stable lead-in / out operation can be performed without causing deformation of the tubular member or the like due to a stress load during the insertion operation.

Moreover, although preferable embodiment of this invention was described, this invention is not restrict | limited only to said each embodiment, The aspect of the combination of each embodiment and the change of each structure suitably are possible. Various aspects can be adopted for the shape of the opening of the second side hole described above. For example, the shape of the opening from the tubular member toward the hollow portion may be a shape that gradually decreases or expands. Further, the shape of the opening from the tubular member toward the hollow portion may be a shape that is straight toward the center, or a shape that is inclined at a predetermined angle toward the distal end side or the proximal end side.

According to the nutrition catheter 1 in the first embodiment having the above-described configuration, the following effects can be obtained.
A second side hole that opens to communicate with the hollow part is provided at a position closer to the base end side than the first side hole in the axial direction of the tubular member of the nutrition catheter, and a plurality of holes are provided on the same circumference at the position. It was set as the structure provided individually. Accordingly, even when the various fluids are led out / in, even if the tip opening at the tip is closed and the first side hole on the side wall is closed, the second side hole is provided, so that it communicates with the hollow part. Since the opening portion to be secured can be secured, various fluids can be led out and in.

In addition, a plurality of the second side holes are provided on the same circumference at the position in the axial direction. Thereby, even if any second side hole portion of the second side hole portion is closed, an opening portion communicating with the hollow portion can be secured by the other second side hole portion.

Further, the second side hole portions are provided at equal intervals in the same circumferential direction. Thereby, the positional relationship of the 2nd side hole part in the circumferential direction of the tubular member of a nutrition catheter comes to be arrange | positioned equally, and an opening part can be ensured in any direction in the circumferential direction of a tubular member. As a result, even if any of the second side hole portions is in contact with various organs and is blocked, the opening state of the other second side hole portions can be easily ensured. This configuration has a remarkable effect when one surface in the circumferential direction of the tubular member comes into contact with various organs.

In addition, the second side hole portion is provided in a line-symmetrical position with respect to a perpendicular divided in a direction perpendicular to the axial direction of the tubular member in the same circumferential direction. Thereby, even if the two surfaces in the circumferential direction opposite to each other in the circumferential direction of the tubular member of the nutrition catheter are in contact with each other and blocked, the opening state of the other second side hole can be easily secured. Play. As a result, even if the feeding catheter is inserted into the narrowed region of various organs that are sandwiched and abutted from the opposing direction, the opening that communicates with the hollow portion can be secured by the second side hole. Therefore, the operability can be ensured regardless of any organ in the body to be inserted.

In addition, the maximum diameter of the second side hole is configured to be smaller than the minimum diameter of the first side hole. Thereby, there is substantially no influence on the suction force during the fluid lead-in / out operation, particularly the body fluid suction operation, by the tip opening or the first side hole. In addition, various fluids (air, body fluids, etc.) can be sucked through the second side hole, and since various organs are hardly sucked, safe and reliable fluid introduction and removal operations are possible. become.

Moreover, it comprised so that the shape of a 2nd side hole part might become circular shape. Thereby, it is possible to reduce the influence on the fluid inflow / outflow operation through the tip opening and the first side hole, and it is possible to perform the fluid inflow / outflow operation more reliably.

As described above, the nutrition catheter of the present invention is a nutrient catheter capable of performing a suction operation regardless of the direction of the nutrition catheter in the body in the operation of drawing and inserting the fluid, in particular, the suction operation step when the nutrition catheter is inserted into the body. It becomes possible to provide.

DESCRIPTION OF SYMBOLS 1 Nutrition catheter 10 Tubular member 11 Hollow part 2 Front-end opening part 3 First side hole part 41 Second side hole part 42 Second side hole part 43 Second side hole part 44 Second side hole part 5 Connection member

Claims (5)

A distal end opening having a flexible hollow member, the distal end of which is open, and a connecting member provided so that the proximal end of the tubular member is communicated with the hollow portion of the tubular member; ,
A nutritional catheter provided with a first side hole that opens to communicate with the hollow part on the side wall near the distal end of the tubular member,
A second side hole opened to communicate with the hollow portion on the side wall of the tubular member,
In the axial direction of the tubular member, it is provided at a position on the base end side from the first side hole,
A plurality of nutritional catheters provided on the same circumference at the position. The feeding catheter according to claim 1, wherein the second side holes are provided at equal intervals in the same circumferential direction. The said 2nd side hole part was provided in the same circumferential direction in the line-symmetrical position with respect to the perpendicular divided | segmented in the direction perpendicular | vertical with respect to the axial direction of the said tubular member. 2. The nutrition catheter according to 2. The feeding catheter according to any one of claims 1 to 3, wherein a maximum diameter of the second side hole is smaller than a minimum diameter of the first side hole. The nutritional catheter according to any one of claims 1 to 4, wherein the second side hole has a circular shape.

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