CN1533288A - 鼻套管 - Google Patents
鼻套管 Download PDFInfo
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- CN1533288A CN1533288A CNA028144783A CN02814478A CN1533288A CN 1533288 A CN1533288 A CN 1533288A CN A028144783 A CNA028144783 A CN A028144783A CN 02814478 A CN02814478 A CN 02814478A CN 1533288 A CN1533288 A CN 1533288A
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- nasal
- exhaust port
- nasal cannula
- cannula
- intubation
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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
- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
- A61M16/06—Respiratory or anaesthetic masks
- A61M16/0666—Nasal cannulas or tubing
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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
- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
- A61M16/08—Bellows; Connecting tubes ; Water traps; Patient circuits
- A61M16/0816—Joints or connectors
- A61M16/0833—T- or Y-type connectors, e.g. Y-piece
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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
- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
- A61M16/06—Respiratory or anaesthetic masks
- A61M16/0683—Holding devices therefor
Abstract
一种鼻套管(10),用于给患者的鼻腔(14)输送空气。提供两条输送导管(20)和(21)以给一对鼻插管(12)和(13)提供空气,每一鼻插管和鼻腔(14)的形状相适应。位于适当位置的排气端口(16)和(17)可以减少噪音和系统中残留的二氧化碳。在带系统(18)的辅助下,套管(10)被置于患者的脸部。
Description
技术领域
本发明主要涉及一种鼻罩或套管,特别是涉及一种鼻套管,这种鼻套管通过一种正压通气机来辅助通气而用以治疗病人。
背景技术
正气压(PAP)辅助通气系统已用于治疗各种疾病。PAP系统广泛用于睡眠呼吸暂停。正气压系统的变体已经用于药物管理及相似领域。
在手术中,由外部的泵来辅助病人呼吸,这种泵通过轻微的正压给病人输送空气。在传统的系统中,要为每个病人选择适合当时情况的空气输送方式。在一般的手术中,病人的吸气阶段由泵辅助,这种泵以轻微的气压给放置在病人脸部的面罩或者套管输送大量的空气。能覆盖病人口和鼻部的全面式面罩系统也有所应用。分别覆盖口或鼻部的系统也很常见。
在应用中,当病人呼吸时,面罩或套管中较高的压力用于打开排气阀。因此,病人的呼吸在吸气阶段由正压辅助,而呼气阶段则在大气压下进行。
在一些实例中,患者的依从性要受面罩舒适度的影响,目前,以“只有鼻部”的套管设备作为首选已经被普遍接受。目前使用的设备的实例可以参见兰迪斯的美国专利US 5,477,852、伍德的美国专利US 5,533,506、兰迪斯的美国专利US 5,269,296、兰迪斯的的美国专利US 5,687,715、及汉德克的美国专利US 5,724,965。
发明内容
与以前的空气鼻罩相比较,本系统包括一对鼻插管,其能从一对输送导管得到双侧供给,输送导管包括左、右支管。如果患者堵塞了面罩的一支管,另一侧的支管足以供应病人所需要的空气。
空气通过一个Y字形的适配器或连接器导入系统。这种形状的连接器和其他部件一起合作将噪音减到最小。
在套管体中靠近患者鼻部的位置设置有一对排气端口。这些排气端口减少了留存在系统内的二氧化碳的量。这两个联合的端口置于套管中以减小噪音和降低系统中不断增加的二氧化碳。实例中的计算示出了这些端口的大小、形状和位置是如何相互协作来降低吸入气体中二氧化碳浓度。
另一个特征直接涉及鼻插管的形状。鼻插管足够长并具有良好的顺应性,以便可以插入鼻腔直至某一位置,在该位置鼻孔的横断面和插管的横断面基本相等。生产该设备的原料的顺应性使鼻腔内有充分的舒适感。
附图简要说明
在所有附图中,同一附图标记表示同一结构,其中:
图1为戴在使用者头部上的鼻套管的示意图。
图2为处于独立状态的鼻套管的投影图。
图3为一部分鼻套管的截面图,示意出了排气端口;
图4为一部分鼻套管的截面图,示意出了排气端口;
图5为一部分鼻套管的截面图,示意出了排气端口;
图6为一部分鼻套管的截面图,示意出了排气端口;及
图7为计算排气端口大小和位置所涉及到的容量和尺寸的图表。
详细描述
图1示出了鼻套管10,该鼻套管示出了置于病人鼻腔14内的鼻插管12。如在附图标记16处所见,每个鼻插管的正下方是一个排气端口。整个鼻套管用一个便利且为常规结构的带系统18固定于患者的面部。由输送导管20代表的左、右两条输送导管终止于连接器22中。这种Y字形连接器22连接至传统的正压通气机24上。
在手术中,正压通气机24在压力下把空气传送至鼻套管10并且向大气中释放呼出的气体。传统的机器有一个阀门,在呼气以排气时这个阀门是超压力的。在一些情况下,这些系统还可以加热或加湿所输送的空气。有些情况下,这些机器还可用于输送药物。
左边的输送导管和右边的输送导管20应该放置在靠近患者面部的地方,而连接器22应该位于颈部的附近(如图所示)。
图2示出了鼻套管10的立体图。整个套管10可以由聚合材料如硅橡胶或聚氨酯橡胶模铸而成。鼻套管某些部分可被局部加强以增加硬度。例如,这可能有利于加强某些部位的结构,如带系统18和套管设备10的连接处。
如图,部分带系统18与输送导管20相连接。如图所示在截面中的各种变化增加了设备的坚硬度。最佳形状和横截面还不为人所知,因而还需要一些试验来优化设备。然而人造橡胶的柔软度和顺应性对于患者的舒适感而言是一个重要的因素。Y字形连接器22适合用于连接到正气压系统24。
鼻插管12和鼻插管13分别连接到输送导管20、21并从输送导管20、21延伸。插管12最末端的部分是一个凸缘26。每个凸缘26最好非常柔软。这种凸缘26的设计,使其易于与患者的鼻腔相符合。在使用中患者直接将插管放入鼻中,插管12和13在鼻腔中移动直到鼻孔的横截面和凸缘的横截面相匹配。鼻部的解剖结构将使插管及其凸缘的形状变形以令人舒适的密合性。所期望的是,仅需要一种或两种尺寸就可以适应大众的需要,因为大多数的患者鼻腔的大小是相似的。
由端口16代表的排气端口是一个输送导管20延伸到插管12的管。每一管都有特定的高度或长度。这些排气端口提供几种功能。如果排气端口16和17位置、大小适宜,它们可以减少二氧化碳的积累。如果它们的结构、大小和位置都适宜,还可以用于减少“口哨声”及其他声音的影响。排气端口的一个目标是在吸气期间,把套管中的二氧化碳数量减小到0.2%到0.7%之间的目标值。而理想的值在大约0.5%以下。申请人相信系统中低的二氧化碳浓度将阻止患者体内二氧化碳的积累。
图3为表示正常吸气时鼻套管10中的空气流的合成示意图。如箭头30和32所示,吸入气体在空气源24的压力下流动。如旋涡34所示的一小股气流进入插管12和13之间的空间。在正常的手术中,系统的每一侧都承载着一半所需的气体流量。
图4为表示输送导管20中的一个阻塞23或夹断的合成示意图。应用中,当由于患者的移动或类似活动将输送导管(如输送导管20)关闭时,这时仍然可以通过另一输送导管21提供足够的空气,如图中气流31所示。在这种情况下,所有空气均通过系统的插管12和13供给患者。在图中,排气端口的长度或高度表示为“h2”,其表示排气端口16的最小高度。理想地,排气端口的最小高度是其所在位置输送导管壁厚度的两倍。
图5为表示鼻套管10中的理想气流的合成示意图。有三种不同的出气通路。通路50和51表示回到通气机24的排气阀。这股气流压倒排气阀而且其中的大多数逸出系统。通路52和53表示分别直接通过排气端口16和17的废气。如通路箭头54和55所示的通路反应出在两插管之间的区域的复杂换气。这股气流稀释了该空间中的空气以便减少二氧化碳。
图6为表示呼吸中止期间的气流的合成示意图。在这期间患者既不呼气也不吸气。在手术中的这一时期,如通路箭头60和61所示,来自PAP通气系统的空气直接从排气端口16和17排出。在该图中,排气端口被示为“高的”排气端口。高度值h1小于排气端口所在位置的管壁厚度的10倍。排气端口直径(BPD)的设置是为了减少二氧化碳的积累。排气端口高度“h1和h2”的设立是为了减少寄生声音影响的发生率。排气端口直径(BPD)和高度h1之间的最佳比值是在0.1和0.5之间。即,0.1≤(BPD/h1)≤0.5。最好在插管的附近使用两个排气端口,不过,排气端口的其他数量和位置也在本发明的范围之内。
例子
目前,已经广泛认识到,简单的通风系统会在空气入口通道上残余大量的呼出气体,这样就导致了患者血液中二氧化碳浓度的增加。可溶解二氧化碳的增加导致了血液的酸化并增加呼吸动力,通常也会增加呼吸频率。在系统中,设备中的死区使用排气端口结构的大小和位置来平衡,以阻止吸入的空气中的二氧化碳浓度的升高。当端口的大小和位置被优化以后,可显著降低二氧化碳气体的浓度。
总而言之,如果排气端口小,则它们要被设置在靠近鼻插管的位置。如果套管中死区很大,这种影响会很显著。因此,应该认识到,死区、排气端口的大小和位置之间存在着一种关系,这种关系相互协作以使鼻套管有良好的性能。虽然,看上去优化的端口由于其长度和大小是有限制的,但是,已确定的是,它们还可被成形以减小寄生声音的影响,比如发生在当前使用的鼻套管中的“哨声”。
图7,直接死区为如图所示的圆柱体40、42、44、46、48的总和。该死区用于计算以确定适合的排气端口大小(BPD)。直接死区的体积被确定为鼻插管体积和鼻插管之间的输送导管的体积。简单的几何学可以用于通过图7所示的圆柱体估计死区的体积。由于排气端口16和17沿着输送导管侧向移动,圆柱体40的体积随插管间的距离而增加。因此,排气端口要在一秒钟内向大气传递直接死区容量的气体,需要一个计算区域(BPD),这个区域与排气端口之间距离总和的平方根相关。因此,对于给定的一秒钟的排气时间和一个所想要的0.5%的二氧化碳浓度,可以计算出排气端口的大小或任何给定距离,或任何给定排气端口间的理想距离。基于这些规则排气端口直径和横截面积区域(X)的平方根、直接死区(IDS)和最大系统流率(F)相关,表示如下:
应该注意的是,如果端口之间分开过远,它们要足够大以达到降低二氧化碳的目的,但是这样大的端口会降低系统中的压力,使其不可能给系统提供有效正压力辅助作用。
典型的原形设备的直径被制作为3/8至5/8英寸之间,其他的尺寸可以依据图2大致换算出来。
在不脱离本发明的范围的情况下,可对本发明进行各种改动和添加。
Claims (8)
1、一种鼻套管,包括:
第一和第二可以插入患者鼻腔的鼻插管;
与两个所述鼻插管相连接的左、右输送导管,每一鼻插管均与左、右输送导管相通;
一位于所述鼻插管的远端的连接器,用于连接所述套管到一呼吸气体源。
2、如权利要求1所述的鼻套管,还包括:
一具有内腔的管状排气端口;
所述管状排气端口和所述鼻插管位于同一直线上,以在呼气时优先截取所呼出的气体。
3、如权利要求2所述的鼻套管,其中:
所述管状排气端口的位置和大小可使吸入气体中的二氧化碳含量值减少到大约在0.5%二氧化碳以下。
4、如权利要求2所述的鼻套管,其中:
所述管状排气端口具有一在0.1到0.5之间的BDP/L比率。
5、如权利要求1所述的鼻套管,其中:
所述鼻套管在其远端有一个适应性的凸缘以与患者的鼻腔相符。
6、如权利要求5所述的鼻套管,其中:
鼻插管有足够的长度,以使其可在鼻腔中移动,直到鼻腔的横截面积和鼻插管的横截面积相匹配。
7、如权利要求2所述的鼻套管,其中:
所述管状排气端口的直径大小(BPD)由以下公式确定
8、如权利要求2所述的鼻套管,其中:
权利要求2所述的排气端口数目为2,其间距(L)近似为(L)排气端口间距近似为
Applications Claiming Priority (2)
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US10/042,042 | 2001-10-25 | ||
US10/042,042 US6679265B2 (en) | 2001-10-25 | 2001-10-25 | Nasal cannula |
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CN1533288A true CN1533288A (zh) | 2004-09-29 |
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CNA028144783A Pending CN1533288A (zh) | 2001-10-25 | 2002-10-24 | 鼻套管 |
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US (3) | US6679265B2 (zh) |
EP (1) | EP1438086A4 (zh) |
CN (1) | CN1533288A (zh) |
AU (2) | AU2002342108B2 (zh) |
CA (1) | CA2462685A1 (zh) |
WO (1) | WO2003035141A2 (zh) |
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-
2001
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-
2002
- 2002-10-24 CN CNA028144783A patent/CN1533288A/zh active Pending
- 2002-10-24 AU AU2002342108A patent/AU2002342108B2/en not_active Ceased
- 2002-10-24 CA CA002462685A patent/CA2462685A1/en not_active Abandoned
- 2002-10-24 EP EP02776274A patent/EP1438086A4/en not_active Withdrawn
- 2002-10-24 WO PCT/US2002/034010 patent/WO2003035141A2/en not_active Application Discontinuation
-
2003
- 2003-10-20 US US10/689,174 patent/US7047974B2/en not_active Expired - Lifetime
-
2006
- 2006-01-19 US US11/334,822 patent/USRE42843E1/en not_active Expired - Lifetime
-
2009
- 2009-02-20 AU AU2009200686A patent/AU2009200686A1/en not_active Abandoned
Cited By (6)
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CN101098726B (zh) * | 2005-01-07 | 2010-08-11 | 塞利昂有限公司 | 鼻套管 |
CN101365508B (zh) * | 2005-09-30 | 2012-12-05 | 卡尔夫207有限公司 | 针对流发生器病人回路的文氏管几何结构设计 |
CN104902948A (zh) * | 2012-10-31 | 2015-09-09 | 蒸汽热能公司 | 静音鼻部插管 |
CN104902948B (zh) * | 2012-10-31 | 2017-05-03 | 蒸汽热能公司 | 静音鼻部插管 |
CN105073170A (zh) * | 2012-12-04 | 2015-11-18 | 亿诺医疗公司 | 用于在氧化氮递送期间对给药的稀释最小化的套管 |
CN105709349A (zh) * | 2016-04-24 | 2016-06-29 | 唐淑华 | 一种吸气鼻罩 |
Also Published As
Publication number | Publication date |
---|---|
WO2003035141A2 (en) | 2003-05-01 |
US20040134498A1 (en) | 2004-07-15 |
AU2002342108A1 (en) | 2003-05-06 |
WO2003035141A3 (en) | 2003-09-12 |
USRE42843E1 (en) | 2011-10-18 |
AU2009200686A1 (en) | 2009-03-26 |
CA2462685A1 (en) | 2003-05-01 |
US6679265B2 (en) | 2004-01-20 |
US7047974B2 (en) | 2006-05-23 |
EP1438086A4 (en) | 2004-11-17 |
EP1438086A2 (en) | 2004-07-21 |
AU2002342108B2 (en) | 2008-11-20 |
US20030079749A1 (en) | 2003-05-01 |
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