JPH0847537A - Catheter for incision of trachea - Google Patents

Abstract

PURPOSE:To obtain a catheter for incision of the trachea which is adequate for respiration control over a long period of time, is insertable into the trachea without giving pain to a patient and has double pipe structures to hardly damage the trachea. CONSTITUTION:This tracheal has the double pipe structures consisting of an outside pipe 12 and an inside pipe 13. A Murphy hole 12a is formed at this outside pipe 12 and a cuff 14 is mounted at the front end of the outside pipe 12. The front end part of this cuff 14 is integrated by fusion to the outer peripheral surface of the outside pipe 12 and the fused parts of both are superposed in a curved surface form in such a manner that edges are not formed in the fused parts of the cuff 14 and the outside pipe 12.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION The present invention relates to long-term respiratory management,
Or, regarding a tracheostomy catheter used during respiratory management or general anesthesia of a patient with consciousness disorder, in particular,
The present invention relates to an improvement of a tracheostomy catheter having a double-tube structure having an outer tube and an inner tube.

[0002]

2. Description of the Related Art Conventionally, various tubes or catheters to be inserted into the trachea have been developed to secure an airway during general anesthesia during surgery. For long-term respiratory management and respiratory management for patients with impaired consciousness, it was necessary to secure an airway by tracheostomy. Training for spontaneous breathing and vocalizations is needed for patients who are no longer needed.

Therefore, in order to meet the above requirements, a tracheostomy catheter having a double tube structure of an outer tube and an inner tube has been developed. An example of such a tracheostomy catheter will be described with reference to FIG.

FIG. 1 is a sectional view schematically showing a state in which a conventional tracheostomy catheter is left in the trachea. The trachea 1 of the patient is incised, and the tracheostomy catheter 2 is inserted from the incised portion. Tracheostomy catheter 2
Has a curved outer tube 3 and an inner tube 4 inserted into the outer tube 3. A Murphy hole 3a is formed in a portion of the outer tube 3 inserted into the trachea 1. A cuff 5 is fixed near the tip of the outer tube 3. The cuff 5 is made of a stretchable synthetic resin and forms a sealed space on the outer circumference of the outer tube 3. The sealed space in the cuff 5 is connected to the balloon 6, and the balloon 6 can be used to inflate the cuff 5. As a result, the outer peripheral surface of the cuff 5 is pressed against the inner surface of the trachea 1 to prevent air leakage.

On the other hand, the Murphy hole 3a provided in the outer tube 3
Is used for vocal training and the like. That is, the Murphy hole 3a is provided to remove the inner tube 4, block the outer end of the outer tube 3 with a finger or the like, and allow air to flow from the lungs to the vocal cords through the Murphy hole 3a. ing.

By the way, in the conventional tracheostomy catheter 2, as shown in FIG. 2, the cuff 5 is configured to be in close contact with the inner wall 1a of the trachea 1 to prevent air leakage. The cross-sectional structure of the portion where the cuff 5 is provided is shown in FIG.
Enlarged to show. That is, the cuff 5 is attached to the outer peripheral wall of the outer tube 4.
The cuff 5 is configured by adhering or fusing a stretchable synthetic resin sheet to the outer peripheral surface of the outer tube 3. Therefore, on the tip 3b side of the outer tube 3, an edge indicated by an arrow A in FIG. 3 is formed on the outer peripheral surface 3c of the outer tube 3 and the tip side portion 5a of the cuff 5.

Therefore, when the tracheostomy catheter 2 is inserted into the trachea 1, the edge A may damage the inner wall 1a of the trachea 1. Further, in a tracheostomy catheter having a double-tube structure that is actually commercially available, the outer tube was made of relatively hard, hard vinyl chloride. Therefore, since the outer tube is relatively hard, it is not possible to absorb individual differences in body size depending on the patient, and there is a problem that the patient tends to suffer.

Further, in the above tracheostomy catheter having a double-tube structure which is commercially available, the stylet cannot be used simultaneously with the inner tube. Therefore, when the tracheostomy catheter is inserted into the trachea, the tip portion is not used. The shape could not be close to streamlined.

On the other hand, various endotracheal tubes which are constructed by using only a single tube instead of the double tube structure having an outer tube and an inner tube are commercially available. In this type of single-tracheal endotracheal tube, the tube is made of a flexible material such as soft vinyl chloride or silicone resin. Therefore, it is difficult for the patient to feel pain during insertion. However, since it does not have a double structure of an outer tube and an inner tube, it is naturally impossible to provide a Murphy hole in the outer tube for spontaneous breathing and vocal training. Further, when the inner surface of the tube became dirty, it had to be removed and washed once.

[0010]

SUMMARY OF THE INVENTION An object of the present invention is to provide a double-tube structure of an outer tube having a hole formed therein and an inner tube for allowing spontaneous breathing and vocal training for long-term respiratory management. Another object of the present invention is to provide a tracheostomy catheter having a structure that does not cause pain to a patient during insertion and is unlikely to cause damage to the inner wall of the trachea.

[0011]

The invention according to claim 1 is a tracheostomy catheter inserted into the trachea,
An outer pipe made of a soft vinyl chloride resin having a through hole formed in the pipe wall, an inner pipe that is inserted into and removable from the outer pipe, and a portion of the outer pipe where the through hole is provided. A cuff fixed to the outer circumference of the outer tube at the tip side of the outer tube, and the cuff is fused to the outer tube at least at the tip side portion of the outer tube so that the tip side portion of the cuff does not have an edge. The tracheostomy catheter is characterized in that the outer surface of the outer tube and the tip side portion of the cuff are connected in a curved shape.

Further, in the tracheostomy catheter of the present invention,
Preferably, as described in claim 2, the through hole,
Between the cuff and the cuff, an open vocalization hole is formed on the outer surface of the outer pipe, and a path communicating with the vocalization hole is formed inside the outer wall of the outer pipe and along the longitudinal direction of the outer pipe. It is formed so as to reach the end opposite to the tip end side portion of the tube.

Further, preferably, as described in claim 3, a stylet disposed so as to be insertable into and removable from the inner pipe is provided.

[0014]

In the invention described in claim 1, since the outer tube is made of soft vinyl chloride resin and has flexibility, it is easy to perform the tracheotomy regardless of the size of the trachea of the patient and the variation in the size and shape of the incised portion. A catheter can be inserted.

Further, since it has a double pipe structure of an outer pipe and an inner pipe, when the inner surface is dirty, only the inner pipe can be removed for cleaning. Further, since the outer tube is provided with the through hole, it is possible to perform spontaneous breathing training and vocal training using the through hole, as will be apparent from the description of the embodiments below.

Further, in the tracheostomy catheter of the present invention, the outer peripheral surface of the outer tube and the tip side portion of the cuff are connected in a curved shape, and there is no edge at the tip side portion of the cuff. Therefore, when inserted into the trachea, there is less risk of damaging the inner wall of the trachea by the tip side portion of the cuff.

According to the second aspect of the present invention, since the above-mentioned vocalization hole and path are formed in the outer tube, it is possible to suck in secretions and contaminants accumulated in the vicinity of the cuff.

[0018]

DESCRIPTION OF THE PREFERRED EMBODIMENTS Hereinafter, the present invention will be clarified by describing non-limiting embodiments of the present invention with reference to the drawings.

FIG. 4 is a schematic diagram showing the overall structure of a tracheostomy catheter according to an embodiment of the present invention. The tracheostomy catheter 11 has an outer tube 12 and an inner tube 13. That is, the tracheostomy catheter 11 has a double tube structure.

Since the outer tube 12 is made of soft vinyl chloride resin, it can easily take a curved shape as shown in the drawing, and the curvature can be freely changed. That is, since it is easy to deform, when it is inserted into the trachea of a patient, by deforming the outer tube 12 in accordance with the size of the trachea, the shape and size of the incised portion, and the like,
It can be dealt with easily. Therefore, it is difficult to cause pain to the patient when the tracheostomy catheter 11 is inserted.

A Murphy hole 12a is formed as a through hole on the outer peripheral surface of the outer tube 12. Further, a cuff 14 is fixed to the tip 12b side of the outer tube 12. On the other hand, a connector 15 is fixed to the proximal end portion of the outer tube 12 opposite to the distal end 12b.

As shown in FIG. 5, the inner tube 13 is composed of a circular tubular member made of curved synthetic resin. The inner tube 13 is made of a synthetic resin material having excellent flexibility such as soft vinyl chloride resin, silicon resin, or polyethylene. The outer diameter of the inner pipe 13 is smaller than the inner diameter of the outer pipe 12 so that it can be inserted into and removed from the outer pipe 12.

On the other hand, an inner pipe connecting adapter 16 is fixed to the base end portion of the inner pipe 13 opposite to the tip 13a. The inner pipe connecting adapter 16 has a connecting portion 16a whose tip has a relatively small diameter, and a main body portion 16b having a relatively large diameter on the base end side of the connecting portion 16a. Connection 1
The outer diameter of 6a is selected so as to approximately match the inner diameter of the outer tube 12. That is, the inner pipe 13 is inserted into the outer pipe 12 as shown by the arrow B in FIG. 4, and the connecting portion 16a is inserted into the outer pipe 1.
The outer pipe 12 of the inner pipe 13 is brought into close contact with the inner wall of 2.
Fixed against.

On the other hand, in the body portion 16b, the inner tube 13 is the outer tube 1
The diameter of the outer tube 12 is set larger than the inner diameter of the outer tube 12 so as not to fit into the inner tube 2. In the tracheostomy catheter 11 of the present invention, the inner tube 13 is inserted into the outer tube 12 for use. Therefore, when the inner surface of the inner pipe 13 becomes dirty, only the inner pipe can be removed for cleaning.

Since the inner tube 13 and the outer tube 12 have a double tube structure, the Murphy hole 12 is formed in the outer tube 12 as described above.
It is possible to provide a. Furthermore, the inner pipe 13
Also functions to supplement the strength of the flexible outer tube 12 when inserting the tracheostomy catheter 11 into the trachea.

In the tracheostomy catheter 11 of this embodiment,
A stylet 17 is provided. Stylet 17
As shown in FIG. 6, has a guide portion 17a having a streamlined shape at its tip. A rod 17b that is curved as shown in the figure is connected to the guide portion 17a.
A grip 17c is connected to the base end side of 7b. The stylet 17 is made of a material harder than the outer tube 12 and the inner tube 13 such as polypropylene resin. This is to increase the overall strength of the tracheostomy catheter 11 by inserting the stylet 17 as shown by the arrow C in FIG.

Further, the guide portion 17a is constructed so that its tip has a substantially conical curved surface as shown in the figure. This guide portion 17a is formed by attaching the stylet 17 to the arrow C in FIG.
When it is mounted in the direction shown by, it is projected from the tip of the outer tube 12. Therefore, when the stylet 17 is set, the guide portion 17a is attached to the distal end side of the tracheostomy catheter 11.
Is located, it can be easily inserted into the trachea from the tracheotomy.

Returning to FIG. 4, the cuff 14 is provided in order to prevent air from leaking because the outer peripheral surface of the cuff 14 is in close contact with the trachea. Details of the cuff 14 will be described with reference to FIGS. 7 and 8.

In this embodiment, the cuff 14 is made of soft vinyl chloride resin, and is fused to the outer tube 12 at the tip side portion thereof. That is, as shown in FIG.
The tip end side portion 14a of the outer tube 12 and the outer peripheral surface 12c of the outer tube 12 are fused and integrated so as to be connected in a curved shape. As a result, the edge A (see FIG. 3) in the conventional tracheostomy catheter does not exist at the distal end side portion 14a of the cuff 14. Therefore, since the edge A does not exist, there is little risk of damaging the inner wall of the trachea during insertion into the trachea.

As is apparent from FIG. 8, the cuff 14
An edge D exists on the proximal end side portion 14b of the above, but since this edge D exists on the side opposite to the insertion direction of the tracheostomy catheter 11, the trachea inner wall is not damaged by the edge D. However, the base end side portion 14b of the cuff 14 may also be fused to the outer peripheral surface 12c of the outer tube 12 so that the edge D does not exist.

Next, the function of the Murphy hole 12a shown in FIG. 4 will be described with reference to FIG. Murphy hole 12a
Used for spontaneous breathing and vocalization. That is, as shown in FIG. 9, with the tracheostomy catheter 11 inserted in the trachea 1, the inner tube 13 is removed, and the proximal end side of the outer tube 12 is closed with a finger, whereby air is drawn from the lungs to the vocal cords E. Can be flowed to the side of. Therefore, it becomes possible to perform vocalization and spontaneous breathing.

Next, the vocalize hole provided in the outer tube 12 will be described. As shown by cutting a part of the outer tube 12 in FIG. 10, the outer tube 12 is provided with a vocalized hole 12d. As is apparent from FIG. 4, the vocalize hole 12d is provided near the upper portion of the cuff 14. Of course, the vocalized hole 12d does not penetrate the outer tube 12, but is communicated with the path 12e extending in the longitudinal direction within the tube wall of the outer tube 12, as is apparent from FIG. The path 12e is formed so as to extend along the longitudinal direction of the outer tube 12 and reach the base end portion. The tube 18 is connected to the path 12e. The tube 18 is connected to a vocalize hole adapter 19. As shown in FIG. 11, saliva and secretions E can be removed by suctioning from the vocalization hole adapter 19.

In FIG. 4, 20 indicates an indicator cuff, and the indicator cuff 20 is formed of a balloon. The indicator cuff 20 is connected to the cuff 14 via a tube 21. The indicator cuff 20 is provided to confirm the state where the cuff 14 is inflated.

[0034]

The tracheostomy catheter of the present invention has a double-tube structure of an inner tube and an outer tube, and since the outer tube is provided with a through hole, the inner tube is left in the trachea. It is possible to perform vocal training and spontaneous breathing by removing the above and using the through hole. Therefore, it is possible to provide a tracheostomy catheter most suitable for long-term respiratory management.

Moreover, in the tracheostomy catheter of the present invention, since the outer tube is made of flexible soft vinyl chloride resin, the size of the trachea of the patient and the size or shape of the tracheostomy portion can be easily adjusted during insertion. Can be adapted to. Therefore, it is difficult to cause pain to the patient during insertion.

Further, since the tip side portion of the cuff is integrated with the outer peripheral surface of the outer tube by fusion so as not to form an edge, there is little risk of damaging the inner wall of the trachea when inserting into the trachea. .

Further, since it has a double tube structure of an inner tube and an outer tube, when the inner surface of the catheter becomes dirty, only the inner tube can be removed and washed. Further, as described in the second aspect, when the vocalating hole and the path are provided, the secretions accumulated in the vicinity of the cuff can be sucked and removed by the vocalating function. Therefore, the occurrence of infectious disease and inflammation can be prevented.

Furthermore, when a stylet is combined as described in claim 3, the strength of the entire tracheostomy catheter can be increased, and the insertion work into the trachea can be facilitated.

[Brief description of drawings]

FIG. 1 is a schematic cross-sectional view showing a state in which a conventional tracheostomy catheter is left inside the trachea.

FIG. 2 is a cross-sectional view for explaining the role of a cuff in a conventional tracheostomy catheter.

FIG. 3 is a partially cutaway cross-sectional view for explaining a problem of a conventional cuff.

FIG. 4 is a schematic configuration diagram of a tracheostomy catheter according to an embodiment of the present invention.

FIG. 5 is a front view showing an inner pipe.

FIG. 6 is a front view for explaining a stylet.

FIG. 7 is a partially cutaway perspective view showing an enlarged portion where a cuff is provided.

FIG. 8 is a partially cutaway cross-sectional view for explaining details of a structure of a portion where a cuff is provided.

FIG. 9 is a schematic cross-sectional view for explaining the function of the Murphy hole.

FIG. 10 is a partial cross-sectional perspective view for explaining a vocabulary hole and a path.

FIG. 11 is a schematic cross-sectional view for explaining the function of the vocabulary hole.

[Explanation of symbols]

 11 ... Tracheotomy catheter 12 ... Outer tube 12a ... Through hole (Murphy hole) 12b ... Tip 12d ... Vocalate hole 12e ... Path 13 ... Inner tube 14 ... Cuff 17 ... Stylet

Claims (3)

[Claims] 1. A tracheostomy catheter to be inserted into the trachea, the outer tube being made of a soft vinyl chloride resin having a through hole formed in the tube wall, and the insertion / removal with respect to the outer tube in the outer tube. An inner pipe freely arranged, and a cuff fixed to the outer periphery of the outer pipe on the tip side of the portion where the through hole of the outer pipe is provided, so that the tip side portion of the cuff does not have an edge. The tracheostomy catheter, wherein the cuff is fused to the outer tube at least at the tip side portion of the outer tube, and the outer surface of the outer tube and the tip side portion of the cuff are connected in a curved shape. 2. A calibrated hole that is open on the outer surface of the outer tube is formed between the through hole and the cuff, and a path communicating with the calibrated hole is formed in the tube wall of the outer tube. The tracheostomy catheter according to claim 1, wherein the tracheostomy catheter is formed so as to extend along the longitudinal direction of the outer tube to reach an end portion of the outer tube opposite to the distal end side portion. 3. The tracheostomy catheter according to claim 1, further comprising a stylet that is inserted into and removed from the inner tube.