JP5508221B2 - Respiratory information detection tube - Google Patents

Description

  The present invention relates to a respiratory information detection method for detecting respiratory information such as presence or absence of a patient and pressure, and a respiratory information detection tube used therefor.

  As for detecting the presence / absence and pressure of the subject's breathing, the pressure change caused by the respiratory airflow is detected by a nasal cannula (see, for example, Patent Document 1), or a thermistor or thermocouple placed in the nasal cavity and mouth. A device that detects a change in temperature due to the above (for example, see Patent Document 2) is widely known.

  In addition, the nasal cannula for acquiring the respiration information of Patent Document 1 and Patent Document 2 described above detects respiration information by detecting changes in pressure and temperature in the nasal cavity. A device that obtains respiratory information by measuring carbon dioxide (see Patent Document 3) is also known.

  Patent Document 3 discloses the following as a catheter set on the pharynx for measuring the amount of carbon dioxide contained in the alveolar part.

The present invention relates to an apparatus used for measuring carbon dioxide contained in an alveolar part.
An object of the present invention is to perform an invasive procedure such as inserting a catheter directly into a blood vessel in order to measure carbon dioxide in a gas contained in blood in a patient's artery in the state of anesthesia or when performing artificial respiration. It is in providing the method of implementing without taking a general method.

An embodiment of Patent Document 3 will be described with reference to FIG.
The catheter 10 set in the pharynx according to the present invention is inserted into the nostril 1 and the nasopharynx 2 located on the soft palate 3 of the patient. The catheter 10 includes end portions 12 and 14, and a lumen 15 is formed in the entire catheter 10. Several gas intake holes 16 are arranged at the end portion 14, and the end portion 14 is set at the junction of the oropharynx 4 and the pharyngeal head 6 or as close as possible to the inserted catheter 10.
As a result, the end 14 is located on the epiglottis 7, the trachea 8 and the esophagus 9.

The diameter of the catheter 10 is about 2 to 4 mm, and the diameter of the gas intake hole 16 is about 1 to 3 mm. Since the region 18 near the end 14 is set from the patient's nose to the position of the opening of the nasopharynx 2, the gas intake hole can be set in the patient's pharynx.
Further, the portion 18 is formed by molding a hard material such as vinyl chloride so that it matches the shape of the patient's nasal cavity and the end portion 14 is located at the opening of the middle nostril away from the posterior pharynx.

  On the other hand, the end 12 on the opposite side of the catheter 10 is located near the site 22 and is flexible with a plasticizer mixed with polyvinyl chloride so that it matches the shape of the patient's face and head and can be easily attached. It is an important part. In addition, a suction trap 24 equipped with a suction port 26 is disposed at a portion 22 located away from the patient's face. The end 12 is connected to a gas measuring device 86 by a take-in line 30.

Special table 2008-543447 gazette Special table 2008-526328 US Pat. No. 5,555,890

In the above-mentioned patent document 1, when a patient breathes, a nasal cannula is attached to detect a change in pressure in the patient's nasal cavity. Therefore, measurement is performed when the patient breathes through the mouth. There was a problem that could not be done.
Moreover, in the thing of the said patent document 2, although a measurement is possible when a patient breathes into the mouth, since the opening state of the mouth changes and the airflow from the mouth is disengaged from the detection unit, the change in the airflow is ensured. However, it was not possible to accurately measure the respiratory pressure change of the patient.
Moreover, in the thing of the said patent document 3, the end part in which several holes for gas intake are arrange | positioned is inserted in the pharynx vicinity, the gas in the vicinity of the pharynx is sucked and taken in, and a carbon dioxide is measured with a measuring apparatus. Therefore, there has been a problem that the body fluid in the vicinity of the pharynx closes the hole for gas intake, and the gas cannot be reliably taken up.

  The problem (objective) of the present invention is that a change in airflow of breathing can be detected reliably in both mouth breathing and nasal breathing without burdening the patient on the physical burden and the medical staff, and the tube is formed on the tube. An object of the present invention is to provide a respiratory information detection method in which body fluid does not enter a hole and a respiratory information detection tube used therefor.

  The respiratory information detection method of the present invention for solving the above-described problem includes a first lumen provided with at least one hole in a portion to be inserted in the vicinity of the pharynx of a patient by inserting one end through the nasal cavity or the oral cavity. A detection device and / or a pump is connected to the other end of the medical tube, and respiratory information is detected based on pressure fluctuation in the vicinity of the patient's pharynx by the detection device.

  The medical tube further includes a second lumen, and the second lumen is provided with at least one hole in a portion where one end of the second lumen is placed in the stomach via the nasal cavity, the oral cavity, and the esophagus. In the state where one end of the lumen is placed in the stomach, a pressure fluctuation in the vicinity of the pharynx of the patient by the detection device is detected through the hole of the first lumen.

Further, the positive pressure is always applied to the vicinity of the hole of the first lumen at the connection portion of the detection device with the first lumen.
The positive pressure is applied at a constant flow rate.
The respiratory information is one or more of respiratory pressure, presence or absence of breathing, ventilation volume, snoring, breathing state, and breathing rate.

  The medical tube used in the respiratory information detection method of the present invention for solving the above-described problem has at least one hole in a portion where one end is inserted through the nasal cavity or the oral cavity and is placed near the pharynx of the patient. It has a first lumen and is configured so that a detection device and / or a pump can be connected to the other end. By the detection device, pressure fluctuation in the vicinity of the patient's pharynx obtained through the hole of the first lumen can be obtained. Based on this, it is possible to detect respiratory information.

  The medical tube further includes a second lumen, and the second lumen is provided with at least one hole in a portion where one end of the second lumen is placed in the stomach via the nasal cavity, the oral cavity, and the esophagus. In the state in which the lumen is left in the stomach, the pressure fluctuation in the vicinity of the pharynx of the patient by the detection device is detected through the hole of the first lumen.

According to the respiratory information detection method of the present invention, a medical tube having a first lumen having at least one hole in a portion that is inserted in the vicinity of the pharynx of a patient by inserting one end through the nasal cavity or the oral cavity. Since a detection device and / or pump is connected to the other end and respiratory information is detected based on pressure fluctuations in the vicinity of the patient's pharynx by the detection device, it is ensured whether the patient breathes through the mouth or nasally. Changes in respiratory airflow can be detected.
In addition, a body fluid enters the hole formed near the pharynx of the lumen by connecting a pump that sends out stable pressure to the vicinity of the connection between the pressure sensor and the lumen and always applying positive pressure. Can be prevented. In particular, when a positive pressure is applied at a constant flow rate, the baseline is stabilized, so that it is easy to grasp the pressure change.
Further, when a plurality of holes are provided, measurement can be continued even when any of them is clogged.
Furthermore, if the respiratory information detection tube has a double-lumen structure that is integrated with the Margen tube (gastric tube) that is widely used in the medical field, a new tube cannot be inserted into the patient. Respiratory information such as the presence or absence of breathing and pressure, which could not be done before, can be measured without burdening the body of physical health and further burdening medical staff.

It is a figure which shows the state which is performing the respiration detection of a patient with the single lumen respiration information detection tube which is the 1st Example of this invention. It is a figure which shows the state which is performing the respiration detection of a patient with the tube for double lumen respiration information detection which is the 2nd Example of this invention. It is a figure which shows the detection waveform of the pressure sensor in the respiration detection of this invention. It is a figure which shows the use condition of the apparatus used in order to measure the carbon dioxide which the conventional alveolar part contains.

A first embodiment of the respiratory information detection method of the present invention will be described with reference to FIG.
FIG. 1 is a diagram illustrating a state in which a patient's respiration detection is being performed using a single lumen respiration information detection tube.
In FIG. 1, a single lumen respiratory information detection tube 10 is inserted at one end through the nasal cavity 1 or the oral cavity 3 and is placed in the vicinity of the pharynx of the patient.

At least one hole 4 for exhausting air into the pharynx is provided at one end of the single lumen respiratory information detection tube 10.
Further, a detection device (pressure sensor) 86 is connected to the other end of the single lumen respiratory information detection tube 10, and whether or not there is pressure fluctuation due to a change in airflow based on patient breathing obtained through the hole 4. Respiratory information such as pressure is detected. It is desirable that a plurality of holes exist. This is because even if any one of the holes is blocked by a body fluid containing saliva, sputum or the like, measurement can be performed using any other hole. Respiration information is related to respiration, such as respiration pressure, presence / absence of respiration, volume of ventilation, snoring, respiration rate, and respiration status (for example, determining whether respiration is obstructive) obtained based on this pressure fluctuation. It means information and is not limited to these.

The detection output waveform of the pressure sensor is as shown in FIG.
FIG. 3 shows the relationship between time and airflow (pressure) in the vicinity of the pharynx.
In FIG. 3A, when the patient is breathing, the pressure in the vicinity of the pharynx fluctuates based on the change in the airflow due to respiration, and a continuous fluctuation waveform appears as shown in the figure.
Since the fluctuation waveform does not appear when the patient's breathing stops, it can be determined whether or not the patient is breathing.

1 through a hole provided at one end of the single lumen respiratory information detection tube through the single lumen respiratory information detection tube by a pump 100 connected in the vicinity of the detection device (pressure sensor) in FIG. The air is discharged and the vicinity of the hole is kept at a positive pressure. That is, a positive pressure is applied from the inside of the tube to the outside of the tube through the hole.
By connecting a pump that delivers a stable pressure in this way and always applying positive pressure, it is possible to prevent body fluid from entering a hole formed in the vicinity of the pharynx of the lumen.
The pump 100 is configured such that a small amount of air is discharged at a high speed to reduce the pressure fluctuation caused by the pump, and the pressure in the vicinity of the hole based on the change in the air flow due to breathing can be accurately detected. .

  In FIG. 3 (b), the pressure in the vicinity of the pharynx fluctuates based on the change in the airflow due to breathing in a state where a predetermined bias is applied by the positive pressure from the pump, and a continuous fluctuation waveform appears as shown in the figure. It is shown that. In particular, when a positive pressure is applied at a constant flow rate, the pressure baseline is stabilized (dotted line in FIG. 3B), so that the pressure can be measured stably and easily. Moreover, the magnitude | size of the pressure applied as a positive pressure should just be a grade which a bodily fluid does not penetrate | invade into a hole.

Next, a second embodiment of the respiratory information detection method of the present invention will be described with reference to FIG.
FIG. 2 is a diagram showing a state in which patient respiration detection is being executed using a double lumen respiration information detection tube.
In FIG. 2, one lumen of the double lumen respiratory information detection tube 10 is inserted through the nasal cavity 1 or the oral cavity 3 and is placed in the vicinity of the pharynx of the patient, like the single lumen in FIG. 1.

One end of one lumen of the double lumen respiratory information detection tube 10 is provided with at least one hole 4 for discharging air into the pharynx as in FIG.
In addition, a detection device (pressure sensor) 86 is connected to the other end of one lumen of the double lumen respiratory information detection tube 10 in the same manner as in FIG. The presence or absence is detected. Respiratory information is detected based on the detected pressure fluctuation.

One end of the other lumen of the double lumen respiratory information detection tube 10 is inserted into the stomach (not shown) via the esophagus and is left in place. The other lumen here has the same function and effect as the conventional Margen tube that has been frequently used in the medical field.
The other lumen 200 of the other lumen of the double-lumen respiratory information detection tube 10 is used for various treatments (suction, nutrition supply, etc.) on the patient's stomach.

The detection waveform of the inspection apparatus in FIG. 2 is the same as that in FIG.
The detection output waveform of the detection device (pressure sensor) is as shown in FIG.
In FIG. 3A, when the patient is breathing, the pressure in the vicinity of the pharynx fluctuates based on the change in the airflow due to respiration, and a continuous fluctuation waveform appears as shown in the figure.
Since the fluctuation waveform does not appear when the patient's breathing stops, it can be determined whether or not the patient is breathing.

In FIG. 2, similarly to FIG. 1, the single lumen respiration information detection tube is supplied with air through the single lumen respiration information detection tube by the pump 100 connected in the vicinity of the detection device (pressure sensor). The air is discharged from the hole provided at one end of the hole, and the vicinity of the hole is maintained at a positive pressure.
This pump 100 discharges a small amount of air at a high speed to reduce the pressure fluctuation caused by the pump, and at a constant flow rate, the pressure in the vicinity of the pharynx based on the change in the airflow due to breathing is accurately detected. The configuration is such that it can be detected.

  In FIG. 3 (b), the pressure in the vicinity of the pharynx fluctuates based on the change in the airflow due to breathing in a state where a predetermined bias is applied by the positive pressure from the pump, and a continuous fluctuation waveform appears as shown in the figure. It is shown that.

The single-lumen respiratory information detection tube and double-lumen respiratory information detection tube of FIGS. 1 and 2 are inserted into the patient's body, so a material that does not damage the nasal cavity, oral cavity, esophagus, etc. use.
Suitable materials include, for example, silicone, polyurethane, and polyvinyl chloride.

1: nasal cavity part 3: oral cavity part 4: pharynx 10: respiratory information detection tube 10-1: gastric tube 16: hole (hole)
86: Detection device (pressure sensor)
100: Pump

Claims (2)

Having a first lumen with at least one hole in a portion inserted through the nasal cavity or oral cavity and placed in the vicinity of the pharynx of the patient, and configured to connect the detection device to the other end;
The patient's pharynx obtained by the detection device through the hole of the first lumen in a state where the positive pressure is always applied to the first lumen so that the vicinity of the hole is maintained at a positive pressure A medical tube characterized in that respiration information can be detected based on pressure fluctuations in the vicinity . The medical tube further has a second lumen;
Comprising at least one hole in a portion where the end of the second lumen is placed in the stomach through the nasal cavity, oral cavity and esophagus;
2. The medical treatment according to claim 1 , wherein a pressure fluctuation in the vicinity of a pharynx of a patient by the detection device is detected through a hole of the first lumen while the second lumen is placed in the stomach. For tubes .

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