CN113082430A

CN113082430A - Novel tracheal catheter

Info

Publication number: CN113082430A
Application number: CN202110381188.9A
Authority: CN
Inventors: 罗福全; 石朝凯; 李奇彬; 漆伟; 刘奕; 王洪; 朱召熊; 曾凌竹
Original assignee: Three Gorges Hospital Affiliated To Chongqing University
Current assignee: Three Gorges Hospital Affiliated To Chongqing University
Priority date: 2021-04-09
Filing date: 2021-04-09
Publication date: 2021-07-09

Abstract

The invention relates to a novel tracheal catheter for clinically establishing an artificial airway. The head end of the existing catheter and the catheter of the balloon section are basically in the same straight line, and the head end of the existing catheter and the glottis plane form a smaller included angle or even are parallel when the catheter is inserted. After the epiglottis is exposed by using a laryngoscope in clinical intubation, the head end of the tracheal tube is positioned near the glottis and cannot enter the trachea through the glottis, so that the intubation is difficult, the intubation damage is easy to cause, and even the serious anoxia and death are caused. The catheter is connected with the catheter head end in an angle mode, the minimum included angle formed by the inner diameter central line of the catheter head end and the inner diameter central line of the catheter is an angle A, and the angle A ranges from 5 degrees to 30 degrees. The problem that the head end of the catheter is difficult to insert into the glottis and feed into the trachea is solved, the angle between the head end of the catheter and the plane of the glottis is increased during intubation, the triangular guide strip and the oblique plane of the head end of the catheter can be directly fed into the glottis, or the oblique plane of the head end of the catheter is guided to enter the glottis through the triangular guide strip; the air pipe conduit is continuously pushed, and the two positions of the head end of the conduit form an angle, so that the head end of the conduit easily enters the air pipe through the glottis. The novel tracheal catheter is simple and easy to operate, high in success rate and small in damage to the airway.

Description

Novel tracheal catheter

Technical Field

The invention relates to the field of medical instruments, in particular to a novel tracheal catheter for clinically establishing an artificial airway.

Background

After the epiglottis is exposed on the clinical tracheal intubation laryngoscope, the head end of the tracheal tube is positioned near the glottis and can not pass through the glottis, so that the intubation difficulty is caused, the intubation damage is easily caused, and even serious hypoxia and death occur. The fundamental reason is that the head end of the catheter is basically in the same straight line with the catheter of the balloon section, and the included angle formed by the head end of the catheter and the glottis plane is small or even parallel when the catheter is inserted.

Various clinical reasons may cause the catheter tip to form a smaller or even parallel angle with the glottic plane during intubation. Video laryngoscopes guide transoral tracheal intubation, transnasal tracheal intubation, anatomical malformation of the upper respiratory tract, or poor exposure of the laryngoscope to the epiglottis are common causes. The front bending degree of the laryngeal airway of the pharynx is increased when the glottis is exposed on the video laryngoscope, and in order to adapt to the appearance of the video laryngoscope and the intubation operation, the whole tracheal catheter needs to be shaped into a large C-shaped rear intubation. When the head end of the catheter is guided by the laryngoscope to be sent to the area of the glottis epiglottis, the included angle formed by the head end of the catheter and the plane of the glottis is smaller or even parallel. When the trachea is intubated through the nose, the shape of the tracheal catheter is changed under the action of tissues around the glottis on the nasal cavity and the larynx, the air bag is usually positioned at an acting point, and the included angle formed by the head end of the tracheal catheter on the surface of the glottis and the glottis plane is smaller or even parallel. When the patient has anatomical deformity of the upper respiratory tract or the epiglottis is not well exposed, the clinician remodels the tracheal tube by using the tube core, inserts the tube by increasing the anteflexion degree of the tracheal tube and tightly clinging the head end of the tube to the epiglottis deep surface, and the included angle formed by the head end of the tube and the glottic plane is smaller or even parallel.

The angle formed by the tip of the catheter near the surface of the glottis and the plane of the glottis is small or even parallel, so that the tip of the catheter can be aligned with the glottic fissure under a laryngoscope but is difficult to deliver into the glottis. The trend of the subglottic airway has a backward bending degree, and the backward bending degree and the forward bending degree of the pharynx form an S-shaped channel, so that the difficulty of the catheter entering the trachea is further increased. When intubation is difficult, clinicians often use a variety of intubation techniques to pass the tip of the tube through the glottis and into the trachea as soon as possible, such as changing the shape of the tube by the tube core multiple times, pressing the cricoid cartilage to increase the angle of the tip of the tube with the plane of the glottis, rotating and advancing the tube, or even using intubation forceps to deliver the tip of the tube into the glottis. During intubation, a patient may need to expose the glottis for multiple times and perform intubation for multiple times, and during intubation, intubation force is transmitted to the head end of the catheter to damage the mucous membrane of the laryngeal cavity, so that pain of the patient is increased, and operation difficulty of a doctor is increased.

Disclosure of Invention

Aiming at the defects, the invention provides the novel tracheal catheter, which increases the angle between the head end of the catheter and the glottic plane during intubation, solves the problems of difficult glottic insertion and difficult tracheal delivery of the head end of the catheter during difficult intubation, reduces the intubation difficulty, is convenient for intubation operation, is easy to master and accept by clinicians, improves the intubation success rate and simultaneously reduces the intubation damage. Meanwhile, the bending of the head end of the catheter and the angulation of the catheter just fit with the backward anatomical bending of the subglottic airway, so that the contact injury with the mucosa is reduced; the oblique section of the head end of the catheter faces the tracheal ring and is not easy to block. The novel tracheal catheter has the advantages of simple and feasible intubation, high success rate, small airway injury and the like.

The invention is realized by the following technical scheme:

the utility model provides a novel endotracheal tube, cavity cylindrical pipe one end meets with cavity cylindrical pipe head end, the other end sets up the joint of ventilating, set up the die in the pipe, the pipe outer wall sets up pipe glottis mark line, pipe degree of depth mark line, set up pipe mark line in the pipe wall, the gasbag sets up at the pipe outer wall and meets with the pipe head end, the pipe head end sets up the scarf, guide strip and black fei shi hole, pipe and pipe head end adopt flexible soft material, the pipe is connected for taking the angle with the pipe head end, the internal diameter central line of pipe head end is the A angle with the minimum contained angle that pipe internal diameter central line formed, A angle range 5 ~ 30.

For better effect: the minimum included angle formed by the head end of the conduit and the outer walls of the two hollow cylindrical conduits of the conduit is an angle B, the angle B ranges from 150 degrees to 175 degrees, two lines forming the angle B are a conduit head end line of the angle B and a conduit line of the angle B respectively, and the highest point of the triangular guide strip bent inwards in the oblique plane is positioned on the conduit head end line of the angle B.

The balloon inflation tube is longitudinally arranged along the wall of the catheter, and the distance between the balloon inflation tube and the B-angle catheter line on the wall of the catheter is 1/4 circumferences of the wall of the catheter.

The catheter marking lines are longitudinally and continuously arranged along the catheter and the catheter head end pipe wall, one end of the catheter marking lines is connected with the starting point of the oblique cutting plane, and the distance between the catheter marking lines and the catheter line at the angle B on the catheter wall is 1/2 catheter wall circumferences.

The operability and advantages are described below in conjunction with the structure:

the novel tracheal catheter is connected with the catheter head end at an angle, the minimum included angle formed by the inner diameter central line of the catheter head end and the inner diameter central line of the catheter is an angle A, and the angle range of the angle A is 5-30 degrees. Increase pipe head end and glottis plane angle during the intubate, reduce the intubate degree of difficulty.

The minimum included angle formed by the head end of the conduit and the outer walls of the two hollow cylindrical conduits of the conduit is an angle B, the angle B ranges from 150 degrees to 175 degrees, and the highest point of the triangular guide strip bent inwards in the chamfer plane is positioned on the head end line of the conduit at the angle B. The oblique plane position of the head end of the catheter is fixed to facilitate intubation.

The head end of the catheter and the oblique section form an obtuse angle C along the marker line of the catheter, and the angle of the C is 135-145 degrees; the catheter head end and the catheter form an angle D along the catheter marking line, the angle D is equal to the angle B, and the catheter head end carries out angle conversion twice through the angle D and the angle C along the catheter marking line. After the oblique plane of the head end of the catheter enters the glottis during intubation, the head end of the catheter can enter the trachea through the glottis more easily through two angle conversions of the head end of the catheter, and the injury of the head end of the catheter to the mucous membrane of the laryngeal cavity is reduced. When the tube is inserted, the triangular guide strip and the oblique plane of the head end of the tube directly enter the glottis, or the triangular guide strip guides the oblique plane of the head end of the tube to enter the glottis.

The novel tracheal catheter mainly increases the angle between the head end of the catheter and the glottis plane during intubation, thereby solving the problems of difficult insertion of the head end of the catheter into the glottis and difficult feeding into the trachea during intubation, ensuring that the operation of clinical tracheal intubation is simpler and easier, and simultaneously reducing the damage of intubation and tube to the mucous membrane of the laryngeal cavity. The tracheal tube can be used for oral or nasal tracheal intubation, especially for tracheal intubation with poor glottic exposure. The innovation is that the head end of the catheter and the catheter of the air bag section form a certain included angle, and the angle between the head end of the catheter and the glottis plane is increased during intubation; secondly, the head end of the catheter carries out angle conversion twice through the angle D and the angle C along the marking line of the catheter, and the head end of the catheter is favorably conveyed into the trachea.

The main clinical advantages are as follows: when the novel tracheal catheter is used for intubation through mouth and nose, the angulation between the head end of the catheter and the glottic plane is larger than that of the traditional tracheal catheter, the problems that the head end of the catheter is difficult to insert into the glottis and difficult to feed into the trachea when intubation is difficult are solved, the glottis is directly entered through the triangular guide strip and the oblique plane of the head end of the catheter, or the oblique plane of the head end of the catheter is guided by the triangular guide strip to enter the glottis, and the direct contact damage between the head end of the catheter and the mucosa; the head end of the catheter is angled twice, so that the oblique section of the head end of the catheter can enter the trachea after passing through the glottis, and the damage of the head end of the catheter to the glottis front joint and the front wall of the trachea when the catheter is pushed is reduced. The angulation of the catheter head end and the air bag section catheter, the opening direction of the oblique section of the catheter head end, the twice angulation of the catheter head end and a triangular guide strip are designed to reduce the difficulty of the operation of the catheter head end entering the glottis and the trachea during intubation, improve the intubation success rate and simultaneously reduce the injury of the mucous membrane of the laryngeal cavity caused by intubation. After the catheter is fixed, the oblique section of the head end of the catheter faces the right upper part or the right front part and is opposite to the tracheal cartilage, so that the smoothness of an airway is favorably maintained.

The design of the novel tracheal catheter is based on deep understanding of angulation between the head end of the catheter and the glottic plane during intubation, aiming at the practical problem that the glottis cannot be intubated when clinical intubation is carried out, and the tube core and bougie guiding intubation technology are fused to produce the novel tracheal catheter.

Drawings

The invention will be further elucidated with reference to the following figures and examples:

FIG. 1 is a schematic view of the structure of the present invention.

Fig. 2 is a left side view of the angled catheter 3 and catheter tip 1.

Fig. 3 is a perspective view of fig. 2.

Fig. 4 is a front view of the catheter 3 and catheter tip 1 with an angled connection.

Fig. 5 is a rear view of the catheter 3 and catheter tip 1 with an angled connection.

Fig. 6 is a cross-sectional view of a catheter.

Detailed Description

See fig. 1: the utility model provides a novel endotracheal tube, 3 one ends of hollow cylindrical pipe connect with hollow cylindrical pipe head end 1 mutually, the other end sets up the joint of ventilating 5, set up tube core 6 in the

pipe

3, 3 outer walls of pipe set up pipe glottis mark line 42, pipe degree of depth mark line 43, set up pipe mark line 41 in the pipe wall of pipe 3, gasbag 2 sets up at 3 outer walls of pipe and connects with pipe head end 1, pipe head end 1 sets up scarf 12, guide strip 13 and black fei shi hole 14, pipe 3 and pipe head end 1 adopt the soft material of flexible.

See fig. 2, 3: the catheter 3 is connected with the catheter head end 1 in an angle mode, the minimum included angle formed by the inner diameter central line of the catheter head end 1 and the inner diameter central line of the catheter 3 is an angle A, and the angle A ranges from 5 degrees to 30 degrees. The minimum included angle formed by the catheter head end 1 and the outer walls of the two hollow cylindrical catheters of the catheter 3 is an angle B, the angle B ranges from 150 degrees to 175 degrees, two lines forming the angle B are an angle B catheter head end line and an angle B catheter line respectively, and the highest point of the triangular guide strip 13 bent inwards in the oblique plane 12 is positioned on the angle B catheter head end line. The catheter head end 1 and the chamfer 12 form an obtuse angle C along the catheter mark line 41, and the angle C ranges from 135 degrees to 145 degrees; the catheter tip 1 and the catheter 3 form an angle D along the catheter mark line 41, the angle D is equal to the angle B, and the catheter tip 1 performs two angle conversions along the catheter mark line 41 through the angle D and the angle C. After the oblique plane 12 of the catheter head end 1 enters the glottis during intubation, the catheter head end 1 can more easily enter the trachea through the glottis through two angle conversions of the catheter head end 1, and the damage to the mucous membrane of the laryngeal cavity caused by the catheter head end 1 is reduced. During intubation, the triangular guide strip 13 and the oblique cut 12 of the catheter head 1 directly enter the glottis, or the triangular guide strip 13 guides the oblique cut 12 of the catheter head 1 into the glottis.

Referring to fig. 1, 2, 3 and 6, the balloon inflation tube 23 is longitudinally arranged along the inner wall of the catheter 3, and the distance between the tube wall of the catheter 3 and the B-angle catheter line is 1/4.

See fig. 1, 2, 3, 5, 6: the catheter mark line 41 is longitudinally and continuously arranged along the catheter 3 and the catheter head end 1, one end of the catheter mark line is connected with the starting point of the chamfer 12, and the distance between the catheter 3 and the catheter line at the angle B is 1/2 catheter 3 wall circumferences.

Referring to fig. 1, 2, 3, 4 and 5, the Murphy's eye 14 is oval, the distance from the oblique tangent plane 12 of the catheter head end 1 is 3.0-4.0 mm, the distance between the intersection point of the major diameter and the minor diameter and the end line of the catheter head at the angle B is 1/4 the circumference of the catheter wall of the catheter 3, and the extension line of the major diameter of the Murphy's eye 14 forms an angle of 30-60 degrees with the oblique tangent plane of the catheter head end 1. The Murphy's eye 14 has the function of replacing the opening of the oblique section 12 of the head end 1 of the catheter to ventilate and can also prevent the head end of the catheter from damaging the mucous membrane of the laryngeal cavity in the process of intubation.

Before oral tracheal intubation, the front end of the tube core 6 is placed at the joint of the catheter 3 and the catheter head end 1, the catheter 3 is molded into arcs with different radiuses according to the bending amplitude of a laryngoscope, and the side of the catheter marking line 41 is an arc concave surface. The patient epiglottis glottis is exposed by using a laryngoscope, a clinician holds the joint of the catheter 3 and the ventilation joint 5, the catheter mark line 41 is positioned right above or right in front, the triangular guide strip 13 and the oblique plane 12 of the catheter head end directly enter the glottis after the catheter head end 1 is guided by the laryngoscope to be sent above the glottis, or the triangular guide strip 13 guides the oblique plane 12 of the catheter head end to enter the glottis, then the catheter 3 is continuously pushed while the catheter core 6 is pulled out, and the catheter head end 1 smoothly enters the trachea under the action of twice angulation. Before the trachea is intubated through the nose, the lubricant is smeared on the surfaces of the head end 1 of the catheter and the balloon 2. The oblique plane 12 of the head end of the catheter faces the head end of the patient, the head end 1 of the catheter is vertical to the face of the patient, and the head end of the catheter is slightly pushed to pass through the retronasal hole; then the head end of the catheter is sent to the area of the epiglottis under the epiglottis exposed by the laryngoscope, the tracheal catheter 3 rotates clockwise or anticlockwise for 180 degrees until the marker line 41 of the catheter is positioned right above or right in front, the triangular guide strip 13 enters the glottis and guides the oblique plane 12 of the head end of the catheter to enter the glottis. After the oblique section 12 of the catheter head end enters the glottis, the air inlet pipe 3 is continuously pushed, and the catheter head end 1 smoothly enters the trachea under the action of twice angulation. The catheter marker line 41 is located directly above or just in front of the laryngoscope, and the catheter glottic marker line 42 is at the glottic port, holding the endotracheal tube 3 in place.

Claims

1. The utility model provides a novel endotracheal tube, hollow cylindrical pipe (3) one end meets with hollow cylindrical pipe head end (1), the other end sets up air connector (5), set up tube core (6) in pipe (3), pipe (3) outer wall sets up pipe glottis mark line (42), pipe degree of depth mark line (43), set up pipe mark line (41) in pipe (3) pipe wall, gasbag (2) set up and meet at pipe (3) outer wall and with pipe head end (1), pipe head end (1) sets up scarf (12), guide strip (13) and Murphy's hole (14), pipe (3) and pipe head end (1) adopt the soft material of flexible, a serial communication port: the catheter (3) is connected with the catheter head end (1) with an angle, the minimum included angle formed by the inner diameter central line of the catheter head end (1) and the inner diameter central line of the catheter (3) is an angle A, and the angle A ranges from 5 degrees to 30 degrees.

2. The novel endotracheal tube of claim 1, characterized in that: the minimum included angle formed by the catheter head end (1) and the outer walls of the two hollow cylindrical catheters of the catheter (3) is an angle B, the angle B ranges from 150 degrees to 175 degrees, two lines forming the angle B are a catheter head end line of the angle B and a catheter line of the angle B respectively, and the highest point of a triangular guide strip (13) which is bent inwards in the chamfer (12) is positioned on the catheter head end line of the angle B.

3. The novel endotracheal tube of claim 1, characterized in that: the balloon inflation tube (23) is longitudinally arranged along the tube wall of the catheter (3), and the distance between the tube wall of the catheter (3) and the catheter line at the angle B is 1/4 tube wall circumferences of the catheter (3).

4. The novel endotracheal tube of claim 1, characterized in that: the catheter marking lines (41) are longitudinally and continuously arranged along the catheter wall of the catheter (3) and the catheter head end (1), one end of each catheter marking line is connected with the starting point of the inclined cutting plane (12), and the distance between the catheter marking lines and the catheter line at the angle B on the catheter wall of the catheter (3) is 1/2 of the circumference of the catheter wall of the catheter (3).