CN101678185B - 与插管配合使用的内窥镜牙垫 - Google Patents
与插管配合使用的内窥镜牙垫 Download PDFInfo
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Abstract
一种在内窥镜诊断或外科手术过程中插入患者口腔的牙垫,所述牙垫具有用于接纳进入所述患者口腔的内窥镜或其他外科器械的沟道,以及向所述患者传送气体并传送来自所述患者的呼气的附加沟道。
Description
相关专利申请的交叉引用
本专利申请要求提交于2007年6月4日的美国临时专利申请No.60/941,707的优先权,该临时专利申请的内容全文以引用方式并入本文。
技术领域
本发明通常涉及内窥镜外科手术过程中使用的牙垫,具体地讲涉及与镇静镇痛系统有关的手术中使用的内窥镜牙垫。
背景技术
在一些医疗手术过程中,特别是在内窥镜手术过程中,需要将医疗器械(诸如内窥镜)插入患者口腔并向下穿入气管或食道。这类手术经常使用牙垫或口腔护套来保护患者口腔不受内窥镜伤害,同时防止内窥镜被患者口腔损坏。牙垫或口腔护套主要使患者口腔保持张开位置,为内窥镜通过提供了开口,并且可以防止患者咬到往往很昂贵的内窥器械。具备上述功能的牙垫通常是本领域所已知的,但设计与镇静镇痛输送和患者监视系统结合使用的牙垫却并不为本领域所知。
为了提高患者舒适度并减少患者对内窥镜进入的抵触作用,内窥镜手术过程中往往让患者服用镇定药物。当某些镇定药物为呼吸抑制剂时,存在某些已知的与患者呼吸有关的风险,包括肺换气不足、血氧不饱和呼吸暂停。为了降低这类风险,往往采取补充氧气和呼吸监视措施。补充氧气和呼吸气体监视取样都需要进入患者的呼吸孔,通常是通过口鼻腔插管来进入。然而当同时通过口腔控制内窥镜、输送补充氧气和进行呼吸气体采样时,有时会遇到困难。如果让口腔专门用于内窥镜,同时通过鼻腔输氧和进行呼吸取样,就会大大降低这种困难。不幸的是,该方法要求患者在手术过程中仅通过鼻腔呼吸,而在现实情况下却并非如此。
因此人们期望需要实施镇静的内窥镜手术允许通过操纵使内窥镜进入口腔,同时又用口腔和鼻腔输送氧气和对呼气进行取样。显而易见的是,使用非专门设计用于联合使用的器械在口腔内同时进行三项操作会带来麻烦。由此可见,由于内窥镜检查是手术的主要部分,其理应比其他两项功能优先使用口腔。虽然以内窥镜为主,但口鼻腔插管在操纵内窥镜过程中很容易被挤开并移动位置,使得其口腔口离口腔太远,并且有时会擦伤鼻腔内部。结果会降低补充氧气和呼吸气体取样的效果,进而危及患者的安全。
此外,在目前的实际操作中,一些医生使用手指帮助把内窥镜插入口腔并向下穿入患者的气管或食道。为此,医生可能会把一根手指插入患者口腔内部牙垫以外的地方,以便控制气管或食道口附近的内窥镜。这要求手指至少伸入到牙垫末端的深度,从而会导致牙垫四处移动。这样做会增大以下风险:在由于操纵内窥镜和插入手指而推撞牙垫的过程中,插管的口腔口会意外离开口腔。
因此本发明的目的是提供具有用于定位和保护口鼻腔插管的口腔口的装置的牙垫,并且能够更加容易地同时使用口腔进行内窥镜诊断或外科手术、输送氧气以及呼吸取样。
附图说明
本发明的新颖特征在随附的权利要求书中进行详细说明。然而,结合以下描述和附图才能最好地理解本发明(包括手术组织和方法)以及其他目的和优点,在这些附图当中:
图1为根据本发明的牙垫的前透视图;
图2为根据本发明的牙垫的后透视图;
图3为根据本发明的牙垫的侧视图,图中显示了患者口腔的截面图;
图4为根据本发明的牙垫和典型口鼻腔插管一起显示的透视图,其中牙垫和口鼻腔插管按照手术过程中常用的方式互相配合;
图5为根据本发明的牙垫的前视图;
图6为根据本发明的牙垫和典型口鼻腔插管一起显示的侧剖图,其中牙垫和口鼻腔插管按照手术过程中常用的方式互相配合;以及
图7为本发明的替代实施例的后部透视图。
具体实施方式
参见图1和图2,本发明的牙垫8由大致椭圆的圆柱形主体20组成,主体具有位于患者口腔外的近端和位于患者口腔内的远端。主体20围绕在口腔主通道7周围,口腔主通道的尺寸,能通过内窥镜并允许患者呼吸。主体20的近端包括凸缘14,其位于患者嘴唇外侧,并且同时用来固定牙垫8与患者口腔的相对位置以及保护患者嘴唇和牙齿不受内窥镜伤害。主体20的远端表面22包括凸缘14。凸缘14每侧都附接了带子19的带附接翼6,带子绕过患者头部,用来帮助固定牙垫8。
参见图3,从主体20的近端延伸到远端的是凸起的顶部表面17和底部表面18,分别用来放置患者的上齿和下齿。顶部表面17的远端有向上凸起的固位结构9,该结构朝大致垂直于顶部表面17的方向向上凸起。向上凸起的固位结构9起挡块作用,使得口腔(或者更具体地讲使得牙齿)张得足够大,可以绕过固位结构9,从而防止牙垫8被挤出患者口腔。同样地,在底部表面18上也有相同作用的向下凸起的固位结构11。
现在参见图4和图6,本发明的一些结构旨在与本领域普遍已知的具有氧气出口2和CO2取样入口3的口鼻腔插管1互相配合。代表性的口鼻腔插管在待审的专利申请US-2006-0042636中有所描述,该专利申请的内容全文以引用方式并入本文。氧气出口2是向患者口腔内输送氧气的输氧流体管的末端,而CO2取样入口3则是二氧化碳测量系统的流体管的末端,呼出的CO2从患者口腔经该入口进入测量系统中。氧气出口2和CO2取样入口3带有延长管,延长管从插管1的主体出来,以大致垂直的方式向下弯曲并进入患者口腔中。在没有牙垫的情况下,氧气出口2和CO2取样入口3的开口将靠放在口腔的开口处。
现在参见图5,主体20内部有内部气体槽10,该通道从主体20的近端延伸到远端,并且与口腔主通道7相邻。内部气体槽10由两个平行的相互连通的子槽组成,每个子槽都具有半圆形横截面。内部气体槽10占据了凸起的顶部表面17下方的区域。内部气体槽10允许从牙垫8的近端(患者口腔外部)向远端(患者口腔内部)交换气体(或从远端向近端),而不必占用口腔主通道7的大部分横截面积,这部分区域可供内窥镜使用。如图4所示,内部气体槽10提供了通道,其中一个子槽供氧气从口鼻腔插管1的氧气出口2流入患者口腔,另一个子槽供CO2从患者口腔流入插管1的CO2取样入口3。内部气体槽10的子槽能够可互换地用于氧气或CO2,具体取决于各自的口在插管1上的位置。
氧气口支承体4和CO2口支承体5从凸缘14的近端表面21伸出,并且紧邻内部气体槽10。氧气口支承体4和CO2口支承体5各自都有基本平坦的延伸部分,该延伸部分伸出近端表面21,并且相对于沿主体20纵向对齐的垂直平面大致对称。从其位于远离主体20中轴线的侧面上的附连点,氧气口支承体4和CO2口支承体5略微朝口腔主通道7的中心向下倾斜。氧气口支承体4和CO2口支承体5还在远端方向延伸至大约为凸缘14厚度的位置(图1和图6中看得最清楚),部分地将口腔主通道7和内部气体槽10隔开。这种结构是为了使插管1的氧气出口2和CO2取样入口3的末端靠放在内部气体槽10的内部,如图6所示。氧气口支承体4和CO2口支承体5各自以向上弯曲的四分之一圆构造终止于其近端处,这种构造有利于更牢固地定位于靠近输氧系统的口腔氧气出口2和二氧化碳测量系统的CO2取样入口3的位置处。氧气口支承体4和CO2口支承体5旨在提供一种方式,以防止氧气出口2和CO2取样入口3因内窥镜移动而改变位置。本具体实施方式中的术语“氧气口支承体”和“CO2口支承体”仅用来举例说明,由于支承体是大致对称的,因此可以互换使用,具体取决于每个口位于插管1的哪一侧。
图7所示的本发明的替代实施例中增加了附加的功能,允许医生将手指伸入患者口腔内较短距离,以帮助引导内窥镜向下进入气管或食道,同时还能防止牙垫8和插管1过度推撞。在替代实施例中,主体20的远端两侧具有弯曲切口23。此外,凸缘14上包括向其两侧伸出的带附接翼状延伸件24,每个延伸件都具有薄的“c”形圆弧凸起。切口23和带附接翼状延伸件24具有合适的尺寸和位置,使得手指可以穿过“c”形带附接翼状延伸件24的开口侧并经切口23进入患者口腔。带附接翼状延伸件24还可以固定带附接翼6的位置,使得带子不会阻挡手指。这样,医生就能够很容易地用手指引导内窥镜,而不必占用口腔主通道7的任何横截面积,并且不会使牙垫8和插管1过分推撞。
虽然本文已经示出并描述了本发明的优选实施例,但对于本领域的技术人员来说,显然这些实施例只是用来举例说明。此外,应当理解,上述每种结构都具有功能,并且这种结构可以称之为用来实现该功能的装置。在不脱离本发明的情况下,本领域的技术人员可以设想出各种变型、更改和替代形式。因此,本发明旨在仅受随附权利要求书的精神和范围的限制。
Claims (7)
1.一种内窥镜牙垫,所述内窥镜牙垫限定盖在患者嘴部上的前凸缘和与患者口腔连通的开口,所述开口包括伸入所述患者口腔并且具有近端和远端的第一沟道构件,其中所述第一沟道构件包括具有下表面和上表面的大致为圆形的沟道,所述上表面限定用于第二沟道构件的开口,所述第二沟道构件和所述近端以及所述远端重合,
其中,所述第二沟道构件包括尺寸能够容纳插管的第一弓形子沟道和第二弓形子沟道,以及
所述内窥镜牙垫还包括第一支承构件和第二支承构件,所述第一支承构件从所述前凸缘向近侧延伸,所述第二支承构件从所述前凸缘向近侧延伸,用于支承容纳在所述第一沟道构件和所述第二沟道构件中的插管。
2.根据权利要求1所述的牙垫,其中所述第一沟道构件为椭圆形。
3.根据权利要求1所述的牙垫,还包括与所述第一沟道构件相邻的口,所述口的尺寸能够容纳手指或外科器械。
4.根据权利要求3所述的牙垫,其中所述第一沟道构件包括从所述远端伸向所述近端的侧向切口。
5.根据权利要求1所述的牙垫,其中所述第一弓形子沟道和所述第二弓形子沟道的尺寸能够容纳用于向所述患者输送气体或监视所述患者呼气的管子。
6.根据权利要求1所述的牙垫,其中所述第一弓形子沟道和所述第二弓形子沟道的尺寸能够分别容纳用于向所述患者输送气体的管子和用于监视所述患者呼气的管子。
7.一种用于进行内窥镜手术的套件,包括:
a.牙垫,所述牙垫限定盖在患者嘴部上的前凸缘和与患者口腔连通的开口,所述开口包括伸入所述患者口腔并且具有近端和远端的第一沟道构件,其中所述第一沟道构件包括具有下表面和上表面的大致为圆形的沟道,所述上表面限定用于第二沟道构件的开口,所述第二沟道构件和所述近端以及所述远端重合;以及
b.插管,所述插管具有用于接纳气体的第一口、用于传送气体的第二口、用于向所述患者输送气体的第三口以及用于接纳来自所述患者的气体的第四口,
其中,所述第二沟道构件包括尺寸能够分别容纳所述第三口和所述第四口的第一弓形子沟道和第二弓形子沟道,以及
所述牙垫还包括第一支承构件和第二支承构件,所述第一支承构件从所述前凸缘向近侧延伸,所述第二支承构件从所述前凸缘向近侧延伸,分别用于支承所述第三口和所述第四口。
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PCT/US2008/065630 WO2008151180A1 (en) | 2007-06-04 | 2008-06-03 | Endoscopic bite block for use with cannula |
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CN101678185A CN101678185A (zh) | 2010-03-24 |
CN101678185B true CN101678185B (zh) | 2012-06-27 |
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CN2008800188808A Expired - Fee Related CN101678185B (zh) | 2007-06-04 | 2008-06-03 | 与插管配合使用的内窥镜牙垫 |
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EP (1) | EP2164549A4 (zh) |
JP (1) | JP5518700B2 (zh) |
CN (1) | CN101678185B (zh) |
AU (1) | AU2008259772B8 (zh) |
CA (1) | CA2690065C (zh) |
WO (1) | WO2008151180A1 (zh) |
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CN113768504B (zh) * | 2021-09-15 | 2023-09-19 | 首都儿科研究所 | 一种多功能惊厥护齿咬合力测试装置和测试方法 |
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- 2008-06-03 EP EP08756647.7A patent/EP2164549A4/en not_active Withdrawn
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Also Published As
Publication number | Publication date |
---|---|
US8028704B2 (en) | 2011-10-04 |
EP2164549A1 (en) | 2010-03-24 |
CN101678185A (zh) | 2010-03-24 |
CA2690065A1 (en) | 2008-12-11 |
AU2008259772A1 (en) | 2008-12-11 |
AU2008259772B2 (en) | 2014-02-06 |
EP2164549A4 (en) | 2016-03-23 |
CA2690065C (en) | 2016-01-19 |
AU2008259772A8 (en) | 2014-02-20 |
JP2010528772A (ja) | 2010-08-26 |
WO2008151180A1 (en) | 2008-12-11 |
JP5518700B2 (ja) | 2014-06-11 |
AU2008259772B8 (en) | 2014-02-20 |
US20080295849A1 (en) | 2008-12-04 |
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