CN113018654B - Self-service esophageal stenosis dilator with gradually increasing and expanding functions and method - Google Patents
Self-service esophageal stenosis dilator with gradually increasing and expanding functions and method Download PDFInfo
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- CN113018654B CN113018654B CN202110210506.5A CN202110210506A CN113018654B CN 113018654 B CN113018654 B CN 113018654B CN 202110210506 A CN202110210506 A CN 202110210506A CN 113018654 B CN113018654 B CN 113018654B
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- 208000007217 Esophageal Stenosis Diseases 0.000 title claims abstract description 28
- 206010030194 Oesophageal stenosis Diseases 0.000 title claims abstract description 28
- 238000000034 method Methods 0.000 title claims abstract description 17
- 239000007924 injection Substances 0.000 claims abstract description 22
- 238000002347 injection Methods 0.000 claims abstract description 22
- 230000007246 mechanism Effects 0.000 claims abstract description 22
- 238000004891 communication Methods 0.000 claims abstract description 7
- 230000000916 dilatatory effect Effects 0.000 claims abstract description 6
- 210000003238 esophagus Anatomy 0.000 claims description 44
- FAPWRFPIFSIZLT-UHFFFAOYSA-M Sodium chloride Chemical compound [Na+].[Cl-] FAPWRFPIFSIZLT-UHFFFAOYSA-M 0.000 claims description 22
- 239000002504 physiological saline solution Substances 0.000 claims description 20
- 210000004712 air sac Anatomy 0.000 claims description 17
- 230000010339 dilation Effects 0.000 claims description 17
- 230000008569 process Effects 0.000 claims description 9
- NNJVILVZKWQKPM-UHFFFAOYSA-N Lidocaine Chemical compound CCN(CC)CC(=O)NC1=C(C)C=CC=C1C NNJVILVZKWQKPM-UHFFFAOYSA-N 0.000 claims description 6
- 229920000715 Mucilage Polymers 0.000 claims description 6
- 239000000853 adhesive Substances 0.000 claims description 6
- 229960004194 lidocaine Drugs 0.000 claims description 6
- 239000011248 coating agent Substances 0.000 claims description 3
- 238000000576 coating method Methods 0.000 claims description 3
- 238000012323 Endoscopic submucosal dissection Methods 0.000 description 8
- 239000011780 sodium chloride Substances 0.000 description 6
- 210000004283 incisor Anatomy 0.000 description 5
- 208000027418 Wounds and injury Diseases 0.000 description 4
- 241000167880 Hirundinidae Species 0.000 description 3
- 206010052428 Wound Diseases 0.000 description 3
- 231100000241 scar Toxicity 0.000 description 3
- 238000001356 surgical procedure Methods 0.000 description 3
- 206010030164 Oesophageal dilatation Diseases 0.000 description 2
- 238000010586 diagram Methods 0.000 description 2
- 208000032544 Cicatrix Diseases 0.000 description 1
- 208000019505 Deglutition disease Diseases 0.000 description 1
- 206010066054 Dysmorphism Diseases 0.000 description 1
- 208000000461 Esophageal Neoplasms Diseases 0.000 description 1
- 206010030155 Oesophageal carcinoma Diseases 0.000 description 1
- 230000004075 alteration Effects 0.000 description 1
- 230000009286 beneficial effect Effects 0.000 description 1
- 230000006378 damage Effects 0.000 description 1
- 201000004101 esophageal cancer Diseases 0.000 description 1
- 230000035876 healing Effects 0.000 description 1
- 208000014674 injury Diseases 0.000 description 1
- 230000003902 lesion Effects 0.000 description 1
- 238000002690 local anesthesia Methods 0.000 description 1
- 238000005461 lubrication Methods 0.000 description 1
- 238000012986 modification Methods 0.000 description 1
- 230000004048 modification Effects 0.000 description 1
- 210000000214 mouth Anatomy 0.000 description 1
- 210000004400 mucous membrane Anatomy 0.000 description 1
- 230000003387 muscular Effects 0.000 description 1
- 230000036407 pain Effects 0.000 description 1
- 230000002980 postoperative effect Effects 0.000 description 1
- 230000037387 scars Effects 0.000 description 1
- 238000006467 substitution reaction Methods 0.000 description 1
- 230000008093 supporting effect Effects 0.000 description 1
- 230000009747 swallowing Effects 0.000 description 1
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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
- A61M29/00—Dilators with or without means for introducing media, e.g. remedies
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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
- A61M25/00—Catheters; Hollow probes
- A61M25/10—Balloon catheters
- A61M25/1011—Multiple balloon catheters
-
- 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
- A61M25/10—Balloon catheters
- A61M25/1018—Balloon inflating or inflation-control devices
- A61M25/10181—Means for forcing inflation fluid into the balloon
- A61M25/10182—Injector syringes
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- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Heart & Thoracic Surgery (AREA)
- Engineering & Computer Science (AREA)
- Anesthesiology (AREA)
- Biomedical Technology (AREA)
- Hematology (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
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- Child & Adolescent Psychology (AREA)
- Media Introduction/Drainage Providing Device (AREA)
Abstract
The invention discloses a self-service esophageal stenosis dilator with gradually increasing and expanding functions and a method, and belongs to the technical field of medical instruments. The self-service esophageal stenosis dilator with gradually increasing diameter expansion comprises: the expansion mechanism comprises an air duct, a positioning air bag and an expansion air bag, the air duct is provided with a first through hole, a second through hole, a first air vent and a second air vent, one end of the first through hole is communicated with the positioning air bag through the first air vent, and one end of the second through hole is communicated with the expansion air bag through the second air vent; the injector is provided with scales; and the air valve mechanism is used for switching the communication between the injection port and the first through hole or the second through hole. The esophageal dilator can easily and accurately position the esophageal stenosis. The esophageal dilator can ensure that the pressure exerted by the air bag on the esophageal wall is within the maximum dilating pressure which can be borne by the esophageal wall.
Description
Technical Field
The invention relates to the technical field of medical instruments, in particular to a self-service esophageal stenosis dilator with gradually increasing and expanding functions and a method.
Background
Aiming at patients with early esophageal cancer, the current common treatment means is to perform Endoscopic Submucosal Dissection (ESD), and the Endoscopic Submucosal Dissection (ESD) is a standard minimally invasive treatment. In the healing and repairing process of the postoperative wound surface, scars are gradually formed, the esophageal stenosis is caused by scar traction, the normal esophageal diameter is about 3.0-3.5cm, after the esophageal stenosis occurs, the narrow aperture can be only several millimeters wide, and the patient has serious dysphagia; for patients with lesion areas more than or equal to 3/4 weeks, the risk of esophageal stenosis after ESD surgery is high, and the common treatment means for solving the problem of esophageal stenosis is esophageal dilation treatment through an esophageal dilator.
According to Japanese research, the patients with esophageal stenosis after ESD surgery expand for 30 times at most, and the data of the Washington hospital show that the patients with esophageal stenosis after ESD surgery expand for more than 20 times at most, and relapse after 2-3 months on average. The mechanism is still that the local wound surface is repaired after the expansion to cause the scar traction again and cause the esophageal stenosis. Patients often need to repeat multiple esophageal dilations. The esophageal dilatation operation is relatively simple, if the patients are subjected to esophageal dilatation in a hospital, not only are precious medical resources wasted, but also heavy medical burden is brought to the patients.
Traditional esophagus dilator is through letting narrow position mucous membrane or muscular layer tear to this expands narrow position, and the structure is complicated, operates inconveniently, and traditional esophagus dilator needs behind the narrow position of scope esophagus of endoscope location under the gastroscope to expand, lacks necessary narrow positioner of esophagus, and the personnel of no medical experience hardly find narrow department of esophagus and expand, are unsuitable for the patient to carry out the esophagus expansion treatment at home self-service.
Disclosure of Invention
The invention aims to overcome the problems in the prior art and provides a self-service esophageal stricture dilator with gradually increased diameter expansion and a method thereof.
The invention not only provides a self-service esophagostenosis dilator with gradually increasing and expanding diameter, comprising:
the expansion mechanism comprises an air duct, a positioning air bag and an expansion air bag, wherein a first through hole and a second through hole are axially arranged in the air duct, a first air vent and a second air vent are arranged on the side wall of the air duct, the positioning air bag and the expansion air bag are arranged at one end of the air duct, the positioning air bag is closer to the tail end of the air duct than the expansion air bag, the positioning air bag and the expansion air bag are close and not communicated with each other, one end of the first through hole is communicated with the positioning air bag through the first air vent, and one end of the second through hole is communicated with the expansion air bag through the second air vent;
the outer wall of the injector is provided with scales;
and the outlet end of the air valve mechanism is communicated with the ends, far away from the positioning air bag, of the first through hole and the second through hole, the injection port of the injector can be communicated with the inlet end of the air valve mechanism, and the air valve mechanism is used for switching the communication of the injection port and the first through hole or the second through hole.
Preferably, the air valve mechanism comprises a shell, a connector, a manual reversing valve, an overflow valve and a controllable one-way valve, wherein one end, far away from the positioning air bag, of the air guide pipe is connected to the outer wall of the shell through the connector in a threaded manner, an air outlet A of the manual reversing valve is communicated with the other end of the first through hole, an air outlet B of the manual reversing valve is communicated with the other end of the second through hole, the controllable one-way valve is provided with an air inlet and an air outlet, an air inlet P of the manual reversing valve is communicated with an air outlet of the controllable one-way valve, the manual reversing valve can switch the air inlet P to be communicated with the air outlet A or the air inlet P to be communicated with the air outlet B, and the air outlet is also communicated with the overflow valve.
Preferably, controllable check valve includes third through-hole and piston, controllable check valve one end is located to the air inlet, the air inlet with third through-hole one end intercommunication, the third through-hole is the dysmorphism hole, piston and third through-hole inner wall sliding connection, the intercommunication of air inlet and third through-hole can be blocked to the piston, is equipped with the spring in the third through-hole, and third through-hole other end inner wall connection has the interface of giving vent to anger, the gas outlet is located in the interface of giving vent to anger, the gas outlet can communicate with third through-hole and air inlet.
Preferably, the length d of the injection port of the injector is greater than the length c of the air inlet.
Preferably, the casing is provided with an observation hole, the overflow valve is a pressure-adjustable overflow valve, and a return port T of the overflow valve is communicated with the observation hole through a hose.
Preferably, a hemispherical rubber plug is arranged at the top end of the end, close to the positioning air bag, of the air duct of the expansion mechanism.
Preferably, the length L of the air duct is more than 700mm and less than 1000mm, the length H of the positioning air bag is more than 5mm and less than 20mm, and the length M of the expansion air bag is more than 20mm and less than 80mm.
The invention also provides a using method of the self-service esophageal stenosis dilator with gradually increasing and expanding diameter, which comprises the following steps:
s01: after the whole device is connected, the injector 4 is filled with air or normal saline, and the safe pressure of the overflow valve 204 is arranged in the maximum expansion pressure which can be born by the esophageal wall;
s02: injecting air or normal saline into the positioning air bag or the expansion air bag respectively by using an injector, clearly expanding the positioning air bag or the expansion air bag to the air quantity or the normal saline quantity required when the diameter is 5mm, 7mm, 9mm, 11mm, 13mm, 15mm, 18mm or 20mm in sequence, and then emptying the positioning air bag and the expansion air bag;
s03: coating lidocaine mucilage on the outer surfaces of the air duct, the positioning air bag and the expansion air bag;
s04: one end of the airway positioning air bag is inserted into the deepest part of the esophagus of the patient, and the manual reversing valve is switched to an injection port to be communicated with the first through hole;
s05: injecting air or normal saline into the positioning air bag through the injector 4, and ensuring that the diameter of the expanded positioning air bag is 15mm;
s06: slightly pulling the airway tube, pulling the positioning air bag out of the esophagus, wherein in the pulling process, a patient feels resistance for pulling the airway tube, if the airway tube is not pulled, the diameter of the positioning air bag is respectively expanded to 18mm or 20mm, and the step is repeated, if the airway tube is not pulled, the surface of the esophagus is not narrowed temporarily;
s07: if the patient feels resistance in the pulling process and the airway is difficult to pull, the positioning air bag 102 is pulled to the narrow part of the esophagus, and at the moment, the manual reversing valve is switched to the injection port to be communicated with the second through hole;
s08: injecting air or physiological saline into the dilation balloon through a syringe, sequentially dilating the dilation balloon to 5mm, 7mm, 9mm, 11mm, 13mm, or 15mm in diameter, and maintaining the dilation balloon at each dilation diameter for at least two minutes;
s9: after the expansion is finished, the air or the normal saline in the positioning air sac and the expansion air sac is discharged.
Compared with the prior art, the invention has the beneficial effects that: the self-service esophageal stenosis dilator with gradually increasing and expanding functions is provided with the positioning air bag, so that an operator can easily and accurately position the esophageal stenosis. The overflow valve is arranged to ensure that the pressure applied to the esophageal wall by the positioning air bag or the expansion air bag is within the maximum expansion pressure which can be borne by the esophageal wall, so that the esophageal wall is prevented from tearing and perforating due to overlarge bearing pressure. The air source device adopts a common injector and is easy to obtain. The narrow part of the esophagus is propped open by using the expansion air bag, so that the problem that the esophagus is torn and perforated due to overlarge pulling force when the esophagus is expanded by pulling the air bag to extrude the inner wall of the esophagus can be effectively prevented. Further, since the diameter of the inflatable balloon is determined by the volume of the injected air or physiological saline, the diameter of the inflatable balloon can be gradually changed by changing the volume of the injected air or physiological saline, and the diameter of the inflatable balloon can be gradually changed.
Drawings
FIG. 1 is a schematic view of the airway tube of the present invention in operation;
FIG. 2 is a schematic diagram of a valve train according to the present invention;
FIG. 3 is a schematic view of the structure of the airway tube of the present invention;
FIG. 4 is a cross-sectional view of an airway tube of the present invention;
FIG. 5 isbase:Sub>A cross-sectional view of the A-A side of the airway tube of the present invention;
fig. 6 is a gas path diagram of the present invention.
Description of reference numerals:
101. the air guide pipe 102, the positioning air bag 103, the expanding air bag 104, the first through hole 105, the second through hole 106, the first air vent 107, the second air vent 108, the rubber plug 201, the housing 202, the connector 203, the manual reversing valve 204, the overflow valve 204, the observation hole 205, the hose 206, the controllable one-way valve 3, the air inlet 301, the air outlet 302, the air outlet 303, the third through hole 304, the piston 305, the spring 306, the air outlet interface, the injector 4 and the injection port 401.
Detailed Description
Detailed description of the preferred embodimentsthe following detailed description of the present invention will be made with reference to the accompanying drawings 1-6, although it should be understood that the scope of the present invention is not limited to the specific embodiments. All other embodiments, which can be obtained by a person skilled in the art without any inventive step based on the embodiments of the present invention, are within the scope of the present invention.
Example 1:
as shown in fig. 1 to 6, the present invention not only provides a self-service esophageal stenosis dilator with gradually increasing diameter enlargement, comprising: the expanding mechanism, the injector 4 and the air valve mechanism comprise an air duct 101, a positioning air bag 102 and an expanding air bag 103, wherein a first through hole 104 and a second through hole 105 are axially arranged in the air duct 101, a first air vent 106 and a second air vent 107 are arranged on the side wall of the air duct 101, the positioning air bag 102 and the expanding air bag 103 are arranged at one end of the air duct 101, the positioning air bag 102 is closer to the tail end of the air duct 101 than the expanding air bag 103, the positioning air bag 102 and the expanding air bag 103 are close to each other and are not communicated with each other, one end of the first through hole 104 is communicated with the positioning air bag 102 through the first air vent 106, and one end of the second through hole 105 is communicated with the expanding air bag 103 through the second air vent 107; the outer wall of the injector 4 is provided with scales; and the outlet end of the air valve mechanism is communicated with one ends, far away from the positioning air bag 102, of the first through hole 104 and the second through hole 105, the injection port 401 of the injector 4 can be communicated with the inlet end of the air valve mechanism, and the air valve mechanism is used for switching the communication of the injection port 401 with the first through hole 104 or the second through hole 105.
As shown in fig. 1, the air valve mechanism includes a housing 201, a connector 202, a manual directional valve 203, an overflow valve 204 and a controllable one-way valve 3, one end of the air duct 101, which is far away from the positioning airbag 102, is connected to the outer wall of the housing 201 side by the connector 202 through a thread, an air outlet a of the manual directional valve 203 is communicated with the other end of the first through hole 104, an air outlet B of the manual directional valve 203 is communicated with the other end of the second through hole 105, the controllable one-way valve 3 is provided with an air inlet 301 and an air outlet 302, an air inlet P of the manual directional valve 203 is communicated with the air outlet 302 of the controllable one-way valve 3, the manual directional valve 203 can switch the air inlet P to be communicated with the air outlet a or the air inlet P to be communicated with the air outlet B, and the air outlet 302 is also communicated with the overflow valve 204.
The working principle of example 1 is now briefly described:
after the whole device is connected, the inside of the injector 4 is filled with air or normal saline, the safe pressure of the overflow valve 204 is placed within the maximum expansion pressure which can be borne by the esophageal wall, and the distance between the wound surface and the incisor teeth after the ESD operation needs to be determined before expansion. Injecting air or normal saline into the positioning air bag (102) or the expansion air bag (103) by using an injector (4), and verifying whether the positioning air bag (102) or the expansion air bag (103) is normal; because the syringe 4 is calibrated, the positioning balloon 102 is inflated after injecting a certain volume of air or physiological saline, and the diameter of the inflated positioning balloon is constant. Therefore, the air quantity or the physiological saline quantity required when the positioning balloon 102 or the expansion balloon 103 is expanded to the diameter of 5mm, 7mm, 9mm, 11mm, 13mm, 15mm, 18mm or 20mm can be determined, and then the positioning balloon 102 and the expansion balloon 103 are emptied; the patient starts to swallow the lidocaine mucilage, and the lidocaine mucilage is coated on the outer surfaces of the air duct 101, the positioning air bag 102 and the expansion air bag 103, so that the lidocaine mucilage can play a role in local anesthesia and lubrication, and pain of the patient is relieved. Then inserting the air duct 101, the positioning air bag 102 and the expansion air bag 103 into the oral cavity of a patient, and when the positioning air bag 102 reaches the throat part, the patient repeatedly swallows the air duct 101 until the positioning air bag 102 is 45-45cm away from the incisors; one end of the airway 101 positioning air bag 102 is inserted into the deepest part of the esophagus of the patient, and the manual reversing valve 203 is switched to the air inlet P to be communicated with the air outlet A. Air or physiological saline is injected into the positioning air bag 102 through the injector 4, the diameter of the expanded positioning air bag 102 is ensured to be 15mm, and a patient generally does not feel the swallowing obstruction; slightly pulling the airway tube 101, pulling the positioning airbag 102 from the far end of the esophagus to a position 15cm away from the incisor teeth (a position close to the entrance of the esophagus), wherein in the pulling process, a patient feels resistance for pulling the airway tube 101, if the patient does not have resistance, the diameter of the positioning airbag 102 can be respectively expanded to 18mm or 20mm, and the step is repeated, if the patient does not have resistance, the surface esophagus is not narrowed; if the patient experiences resistance during the stretching process, the airway 101 is difficult to pull, indicating that the positioning balloon 102 is pulled to the esophageal stricture. At this time, the specific location of the esophageal stenosis can be known. Switching the manual reversing valve 203 to enable the air inlet P to be communicated with the air outlet B, injecting air or normal saline into the expansion air bag 103 through the injector 4, sequentially expanding the diameter of the expansion air bag 103 to be 5mm, 7mm, 9mm, 11mm, 13mm or 15mm, and keeping the expansion air bag 103 at each expansion diameter for at least two minutes; because the positioning balloon 102 and the dilatation balloon 103 are close to each other, the inflated dilatation balloon 103 can accurately dilate the esophagus at the narrow part. When the esophagus is expanded, if the pressure on the inner wall of the esophagus is too high, the esophagus is torn and perforated, and therefore the traditional esophagus expander needs to be assisted by doctors and gastroscopes. The esophageal dilator of the invention ensures that the pressure born by the esophageal wall is less than the maximum dilating pressure (empirical value) which can be born by the esophageal wall by arranging the overflow valve 204. After the expansion is completed, the air or saline in the positioning balloon 102 and the expanding balloon 103 is discharged. The self-service esophagus dilator with the gradually increased diameter expansion size can very easily and accurately position the narrow part of the esophagus by arranging the positioning air bag 102, and can effectively prevent the esophagus from being torn due to overlarge pulling force when the esophagus is stretched by pulling by using the expanding air bag 103 to open the narrow part of the esophagus. Further, since the diameter of the expanding balloon 103 is determined by the volume of the injected air or physiological saline, the diameter of the expanding balloon 103 can be gradually changed by changing the volume of the injected air or physiological saline into the expanding balloon 103, and the diameter expansion of the expander can be gradually changed. The overflow valve 204 is arranged to ensure that the pressure applied to the esophagus wall by the positioning air bag 102 or the expansion air bag 103 is within the maximum expansion pressure which can be borne by the esophagus wall, and further prevent the esophagus from tearing and puncturing due to the overlarge bearing pressure of the esophagus wall.
Example 2:
on the basis of embodiment 1, the volume of the positioning balloon 102 and the expanding balloon 103 after being inflated is convenient to control, and the air or the physiological saline in the positioning balloon 102 and the expanding balloon 103 is convenient to discharge.
As shown in fig. 2, wherein the controllable check valve 3 includes a third through hole 303 and a piston 304, the air inlet 301 is disposed at one end of the controllable check valve 3, the air inlet 301 is communicated with one end of the third through hole 303, the third through hole 303 is a special-shaped hole, the piston 304 is slidably connected to an inner wall of the third through hole 303, the piston 304 can block the communication between the air inlet 301 and the third through hole 303, a spring 305 is disposed in the third through hole 303, an air outlet port 306 is connected to an inner wall of the other end of the third through hole 303, the air outlet 302 is disposed in the air outlet port 306, and the air outlet 302 can be communicated with the third through hole 303 and the air inlet 301.
As shown in fig. 2, the length d of the injection port 401 of the injector 4 is greater than the length c of the air inlet 301.
The injection port 401 of the injector 4 is inserted into the air inlet 301 of the controllable one-way valve 3, since the length d of the injection port 401 of the injector 4 is larger than the length c of said air inlet 301. Therefore, the injection port 401 of the injector 4 pushes the piston 304 of the controllable one-way valve 3 open, so that the air inlet 301 is communicated with the third through hole 303 and the air outlet 302, thereby facilitating the air or the physiological saline in the positioning air bag 102 or the expansion air bag 103 to be discharged, and facilitating the adjustment of the volume of the expanded positioning air bag 102 or the expansion air bag 103. When the air or the physiological saline in the injector 4 is not enough, the injector 4 is pulled out to suck the air or the physiological saline again, and the piston 304 blocks the communication between the air inlet 301 and the third through hole 303, so that the air or the physiological saline in the positioning air bag 102 or the expansion air bag 103 is not discharged. After a certain volume of air or physiological saline is injected into the expansion air sac 103, the injector 4 is pulled out, and in the same way, the air or physiological saline in the expansion air sac 103 is ensured not to be discharged, so that the expanded expansion air sac 103 is ensured to always support the esophagus at the narrow part. When the expansion is completed, the air or saline in the positioning balloon 102 or the expansion balloon 103 can be directly pumped out by the injector 4, so that the air or saline in the positioning balloon 102 and the expansion balloon 103 can be conveniently discharged.
Example 3:
in addition to example 1, to ensure that the pressure exerted by the positioning balloon 102 or the dilation balloon 103 on the esophageal wall is within the maximum dilation pressure that the esophageal wall can withstand.
As shown in fig. 2, the housing 201 is provided with an observation hole 205, the relief valve 204 is a pressure-adjustable relief valve 204, and a return port T of the relief valve 204 is communicated with the observation hole 205 through a hose 206.
The safety pressure of the overflow valve 204 is adjusted to be within the maximum expansion pressure which can be borne by the esophageal wall, after the injector 4 injects air or normal saline into the positioning air bag 102 or the expansion air bag 103, the positioning air bag 102 or the expansion air bag 103 is expanded and is pressed by the esophageal wall, the pressure in the positioning air bag 102 or the expansion air bag 103 is increased, and when the pressure in the positioning air bag 102 or the expansion air bag 103 is greater than the safety pressure of the overflow valve 204, the air or the normal saline overflows from the overflow valve 204 and is discharged out of the observation hole 205 through the return port T and the hose 206. At this time, the operator observes that the air or the saline is discharged from the observation hole 205, and stops the injection of the air or the saline into the positioning balloon 102 or the dilating balloon 103. By arranging the observation hole 205, when the pressure in the positioning air bag 102 or the expansion air bag 103 is greater than the safety pressure of the overflow valve 204, i.e. the maximum expansion pressure which can be borne by the esophageal wall, an operator can stop injection in time, so that the pressure applied to the esophageal wall by the positioning air bag 102 or the expansion air bag 103 can be effectively ensured to be within the maximum expansion pressure which can be borne by the esophageal wall.
As shown in fig. 3 and 4, as a preferable scheme, the top end of the airway tube 101 of the expansion mechanism near one end of the positioning balloon 102 is provided with a hemispherical rubber plug 108. Through setting up hemisphere rubber buffer 108 not only can be easier inject patient's esophagus with air duct 101 in, can also prevent the injury of air duct 101 to patient's esophagus inner wall.
As shown in fig. 3 and 4, as a preferable scheme, the length L of the airway tube 101 is greater than 700mm and less than 1000mm, the length H of the positioning balloon 102 is greater than 5mm and less than 20mm, and the length M of the expansion balloon 103 is greater than 20mm and less than 80mm. Since the normal human esophagus length is about 250mm and about 40cm-45cm from the incisors to leave enough operating length outside the body, the length L of the airway tube 101 is larger than 700mm and smaller than 1000mm. When the length H of the positioning airbag 102 is too short, the supporting effect is not good, and when the length H of the positioning airbag 102 is too long, the pressure is not well mastered and the operation is not good. The balloon 103 is expanded in the same manner.
The invention also provides a using method of the self-service esophageal stenosis dilator with gradually increasing diameter expansion in the embodiment 1, which comprises the following steps:
s01: after the whole device is connected, the injector 4 is filled with air or normal saline, and the safe pressure of the overflow valve 204 is arranged in the maximum expansion pressure which can be born by the esophageal wall;
s02: injecting air or physiological saline into the positioning air sac 102 or the expansion air sac 103 by using the injector 4, respectively, clearly expanding the positioning air sac 102 or the expansion air sac 103 to the air quantity or the physiological saline quantity required when the diameter is 5mm, 7mm, 9mm, 11mm, 13mm, 15mm, 18mm or 20mm, and then evacuating the positioning air sac 102 and the expansion air sac 103;
s03: coating lidocaine mucilage on the outer surfaces of the air duct 101, the positioning air bag 102 and the expansion air bag 103;
s04: the patient swallows the air duct 101, the positioning air bag 102 and the expansion air bag 103, when the positioning air bag 102 reaches the throat, the patient repeatedly swallows the air duct 101 until the positioning air bag 102 is 40-45cm away from the incisors;
s05: one end of the airway 101 positioning air bag 102 is inserted into the deepest part of the esophagus of the patient, and the manual reversing valve 203 is switched to the injection port 401 to be communicated with the first through hole 104;
s06: injecting air or physiological saline into the positioning air bag 102 through the injector 4 to ensure that the diameter of the expanded positioning air bag 102 is 15mm;
s07: slightly pulling the airway tube 101, pulling the positioning balloon 102 out of the esophagus tube, wherein in the pulling process, the patient feels the resistance for pulling the airway tube 101, if the resistance does not exist, the diameter of the positioning balloon 102 is respectively expanded to 18mm or 20mm, and the steps are repeated, if the resistance does not exist, the surface esophagus is not narrowed temporarily;
s08: if the patient feels resistance in the pulling process, the airway tube 101 is difficult to pull, which indicates that the positioning balloon 102 is pulled to the narrow part of the esophagus, at this time, the manual reversing valve 203 is switched to the injection port 401 to be communicated with the second through hole 105;
s09: injecting air or physiological saline into the dilation balloon 103 through the syringe 4, sequentially dilating the dilation balloon 103 to 5mm, 7mm, 9mm, 11mm, 13mm, or 15mm in diameter, and maintaining the dilation balloon 103 at each dilated diameter for at least two minutes;
s10: after the inflation is completed, the air or saline inside the positioning balloon 102 and the inflating balloon 103 is discharged.
Although embodiments of the present invention have been shown and described, it will be appreciated by those skilled in the art that changes, modifications, substitutions and alterations can be made in these embodiments without departing from the principles and spirit of the invention, the scope of which is defined in the appended claims and their equivalents.
Claims (7)
1. A self-service esophageal stricture dilator with gradually increasing diameter expansion, comprising:
the expansion mechanism comprises an air duct (101), a positioning air bag (102) and an expansion air bag (103), wherein a first through hole (104), a second through hole (105) and a first air port (106) and a second air port (107) are axially arranged in the air duct (101), the side wall of the air duct (101) is provided with the first air port (106) and the second air port (107), the positioning air bag (102) and the expansion air bag (103) are arranged at one end of the air duct (101), the positioning air bag (102) is closer to the tail end of the air duct (101) than the expansion air bag (103), the positioning air bag (102) and the expansion air bag (103) are close to each other and are not communicated with each other, one end of the first through hole (104) is communicated with the positioning air bag (102) through the first air port (106), and one end of the second through hole (105) is communicated with the expansion air bag (103) through the second air port (107);
the outer wall of the injector (4) is provided with scales;
the outlet end of the air valve mechanism is communicated with one end, far away from the positioning air bag (102), of the first through hole (104) and one end, far away from the positioning air bag (102), of the second through hole (105), the injection port (401) of the injector (4) can be communicated with the inlet end of the air valve mechanism, and the air valve mechanism is used for switching the communication between the injection port (401) and the first through hole (104) or the second through hole (105);
the air valve mechanism comprises a shell (201), a connector (202), a manual reversing valve (203), an overflow valve (204) and a controllable one-way valve (3), wherein one end, far away from a positioning air bag (102), of the air guide pipe (101) is connected to the outer wall of the side of the shell (201) through threads of the connector (202), an air outlet A of the manual reversing valve (203) is communicated with the other end of the first through hole (104), an air outlet B of the manual reversing valve (203) is communicated with the other end of the second through hole (105), the controllable one-way valve (3) is provided with an air inlet (301) and an air outlet (302), an air inlet P of the manual reversing valve (203) is communicated with the air outlet (302) of the controllable one-way valve (3), the manual reversing valve (203) can switch over the air inlet P to be communicated with the air outlet A or the air inlet P to be communicated with the air outlet B, and the air outlet (302) is further communicated with the overflow valve (204).
2. The self-service esophageal stenosis dilator with gradually increasing and expanding diameter of the esophageal stenosis dilator is characterized in that the controllable one-way valve (3) comprises a third through hole (303) and a piston (304), the air inlet (301) is arranged at one end of the controllable one-way valve (3), the air inlet (301) is communicated with one end of the third through hole (303), the third through hole (303) is a special-shaped hole, the piston (304) is slidably connected with the inner wall of the third through hole (303), the piston (304) can block the communication between the air inlet (301) and the third through hole (303), a spring (305) is arranged in the third through hole (303), an air outlet interface (306) is connected to the inner wall of the other end of the third through hole (303), the air outlet (302) is arranged in the air outlet interface (306), and the air outlet (302) can be communicated with the third through hole (303) and the air inlet (301).
3. The self-service esophageal stenosis dilator with gradually increasing diameter expansion according to claim 2, wherein the length d of the injection port (401) of the injector (4) is larger than the length c of the air inlet (301).
4. The self-service esophageal stenosis dilator with gradually increasing diameter expansion according to claim 1, wherein the housing (201) is provided with an observation hole (205), the overflow valve (204) is a pressure-adjustable overflow valve (204), and a return port T of the overflow valve (204) is communicated with the observation hole (205) through a hose (206).
5. The self-service esophageal stenosis dilator with gradually increasing diameter expansion of claim 1, wherein a hemispherical rubber plug (108) is arranged at the top end of the air duct (101) of the dilation mechanism, which is close to one end of the positioning air bag (102).
6. The self-service esophagostenosis dilator with gradually increasing diameter expansion according to claim 1, wherein the length L of the airway tube (101) is greater than 700mm and less than 1000mm, the length H of the positioning balloon (102) is greater than 5mm and less than 20mm, and the length M of the dilation balloon (103) is greater than 20mm and less than 80mm.
7. The method of using the self-service esophageal stenosis dilator with gradually increasing diameter expansion of claim 1, comprising the steps of:
s01: after the whole device is connected, the injector (4) is filled with air or normal saline, and the safe pressure of the overflow valve (204) is arranged in the maximum expansion pressure which can be born by the esophageal wall;
s02: injecting air or normal saline into the positioning air sac (102) or the expansion air sac (103) by using an injector (4), determining the air quantity or the normal saline quantity required when the positioning air sac (102) or the expansion air sac (103) is sequentially expanded to the diameter of 5mm, 7mm, 9mm, 11mm, 13mm, 15mm, 18mm or 20mm, and then emptying the positioning air sac (102) and the expansion air sac (103);
s03: coating lidocaine mucilage on the outer surfaces of the air duct (101), the positioning air bag (102) and the expansion air bag (103);
s04: one end of a positioning air bag (102) of the air duct (101) is inserted into the deepest part of the esophagus of a patient, and a manual reversing valve (203) is switched to an injection port (401) to be communicated with a first through hole (104);
s05: injecting air or normal saline into the positioning air bag (102) through the injector (4) to ensure that the diameter of the expanded positioning air bag (102) is 15mm;
s06: slightly pulling the airway tube (101), pulling the positioning balloon (102) out of the esophagus, wherein in the pulling process, a patient feels resistance for pulling the airway tube (101), if the patient has no resistance, the diameter of the positioning balloon (102) is respectively expanded to 18mm or 20mm, and the steps are repeated, if the patient has no resistance, the surface of the esophagus is temporarily not narrow;
s07: if the patient feels resistance during the pulling process, the airway tube (101) is difficult to pull, which indicates that the positioning air bag (102) is pulled to the narrow part of the esophagus, and at the moment, the manual reversing valve (203) is switched to the injection port (401) to be communicated with the second through hole (105);
s08: injecting air or physiological saline into the dilation balloon (103) through the syringe (4), sequentially dilating the dilation balloon (103) to 5mm, 7mm, 9mm, 11mm, 13mm or 15mm in diameter, and maintaining the dilation balloon (103) at each dilation diameter for at least two minutes;
s9: after the expansion is completed, the air or the normal saline in the positioning balloon (102) and the expansion balloon (103) is discharged.
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| CN202110210506.5A CN113018654B (en) | 2021-02-25 | 2021-02-25 | Self-service esophageal stenosis dilator with gradually increasing and expanding functions and method |
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| CN202110210506.5A CN113018654B (en) | 2021-02-25 | 2021-02-25 | Self-service esophageal stenosis dilator with gradually increasing and expanding functions and method |
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| CN113018654B true CN113018654B (en) | 2022-11-15 |
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