JP2005270319A - Tracheostomy tube - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a tracheostomy tube that effectively prevents secretions such as saliva from sagging to the lung side and facilitates vocalization.
A cuff is provided on the distal end side of a tube body formed in a vent shape, and the tube is brought into a predetermined position in the trachea by injecting air into the cuff from the rear end side of the tube and expanding the cuff. An indwelling tracheostomy tube includes an annular body disposed adjacent to the rear end side of the tube with respect to the cuff, and the annular body has a plurality of openings on the rear end side of the tube. A tracheostomy tube which is provided and connected to a flow path for suction or air supply from the rear end side of the tube.
[Selection] Figure 1

Description

  The present invention relates to a tracheostomy tube.

  2. Description of the Related Art A tracheostomy tube in which a cuff, which is a hollow air balloon, is attached in the vicinity of a distal end is known as a medical instrument used for a patient with insufficient respiratory function. As shown in FIG. 5, this tracheostomy tube is inserted into an incision 67 opened from the patient's throat 60 to the trachea 61 after the tracheotomy is performed on the patient, and air is injected into the cuff 51 to be expanded. Then, it is attached to a predetermined position by being brought into close contact with the inner wall surface 63 of the trachea 61.

  According to such a tracheostomy tube, since breathing is performed via the tracheostomy tube 50 attached to the throat 60, air is not supplied to the vocal cord 65 on the oral cavity A side from the cuff 51, and a voice is produced. I can't. Therefore, in order to communicate, it is necessary to do so by writing or by hand, and attaching the tracheostomy tube 50 to the patient has also caused a reduction in the quality of life (QOL) of the patient.

  Therefore, Patent Document 1 discloses a tracheostomy tube having an air supply tube capable of supplying air from the rear end side on the outer peripheral surface. The air supply hole of the air supply tube is provided at the vent position of the tube body, and is formed so that the outflow air flows in the vocal cord direction. According to this tracheostomy tube, the patient can vibrate by vocalizing the vocal cords with the outflow air from the air supply tube.

  In the configuration shown in FIG. 5, since the cuff 51 is in close contact with the inner wall surface 63 of the trachea 61, most of secretions such as saliva and foreign matters such as food that have flowed into the trachea 61 from the oral cavity side A are obtained. Although clogged by the cuff 51, some of the secretions and the like staying in the vicinity of the cuff may pass between the cuff 51 and the inner wall surface 63 of the trachea 61 and sag to the lung side B. The sagging of secretions or the like to the lung side B causes a further worsening of symptoms in severe pneumonia and the like.

Therefore, in Patent Document 2, as shown in FIG. 6, a plurality of suction holes 53, 53 for removing secretions and the like are provided on the rear end 57 side of the tube body 52 with respect to the cuff 51. A tracheostomy tube is disclosed. Each of the suction holes 53, 53 is disposed on a part of the outer peripheral surface of the tube main body 52, and the suction tube 55 is interposed via the flow paths 54, 54 embedded in the thick part of the tube main body 52. Communicated with. When this tracheostomy tube is attached to a human body, a secretion device or the like accumulated on the oral cavity side of the cuff 51 can be removed from the body by connecting a suction device to the suction tube 55.
Japanese Utility Model Publication No. 60-7741 Japanese Patent Laid-Open No. 10-5340

  However, since the tracheostomy tube disclosed in Patent Document 1 is intended for easy voice production, the air supply hole of the air supply tube is provided at the vent position of the tube body away from the cuff. . Therefore, in order to remove secretions and the like accumulated on the oral cavity side of the cuff, suction cannot be performed using this air supply tube, and a suction means has to be provided separately.

  In addition, since the tracheostomy tube disclosed in Patent Document 2 is provided with a suction hole for removing secretions and the like accumulated on the oral cavity side of the cuff, a part of the secretion around the suction hole is provided. There is a problem in that only secretions can be aspirated, and the secretions cannot be removed reliably. In addition, in order to enable speech using this suction hole, even if an air supply device is connected to the suction tube and air is supplied, the air flowing out from the suction hole is In addition, there is a problem that the air distribution passing through the vocal cords is non-uniform and smooth utterance is difficult because the suction holes are displaced in the radial direction.

  The present invention has been made to solve such problems, and provides a tracheostomy tube that effectively prevents saliva and other secretions from drooping to the lung side and facilitates speech production. With the goal.

  The object of the present invention is to provide a cuff at the distal end side of a tube body formed in a vent shape, and inflate and inflate the cuff from the rear end side of the tube to make the tube in the trachea. The tracheostomy tube to be placed at a predetermined position includes an annular body arranged adjacent to the rear end side of the tube with respect to the cuff, and a plurality of the annular bodies are provided on the rear end side of the tube. This is achieved by a tracheostomy tube to which a flow path for suction or air supply is connected from the rear end side of the tube.

  Moreover, it is preferable that the plurality of openings are provided at substantially equal intervals along the outer periphery of the annular body.

  Moreover, it is preferable that the area of the plurality of openings is formed so as to increase toward the downstream side in the air supply direction.

  Moreover, it is preferable that the said flow path and the said annular body are formed of the one flexible tube, and are closely_contact | adhered to the outer peripheral surface of the said tube.

  ADVANTAGE OF THE INVENTION According to this invention, the tracheotomy tube which prevents effectively that secretions, such as saliva, sag to the lung side, and makes speech easy can be provided.

Embodiments of the present invention will be described below with reference to the accompanying drawings. FIG. 1 is a perspective view showing a schematic configuration of a tracheostomy tube according to an embodiment of the present invention. As shown in FIG. 1, the tracheostomy tube 1 includes a tube body 10, a cuff 11, and a suction air supply tube 12.

  The tube main body 10 is formed in a vent shape having a large curvature in the vicinity of the central portion in order to facilitate insertion into the trachea.

  The cuff 11 is connected to a cuff tube 23 via a cuff inflation lumen 22, and can be expanded or contracted by pressurizing or depressurizing.

  The suction / air supply tube 12 is a flexible tube intended for suction or air supply, and is formed of, for example, a synthetic resin such as polypropylene. The suction / air supply tube 12 constitutes a flow path by being attached on the outer peripheral surface along the longitudinal direction of the tube main body 10. Further, as shown in FIG. 2, the distal end portion of the suction / air supply tube 12 is wound around the outer peripheral surface of the tube body 10 so as to be adjacent to the cuff 11 on the tube rear end portion 17 side. A body 13 is formed. On the tube rear end 17 side of the annular body 13, three openings 14, 14, 14 are formed along the outer periphery of the annular body 13 as shown in FIG. It is provided to be evenly distributed. Moreover, the area of each opening 14, 14, and 14 is formed so that it may become large toward the downstream in the air feeding direction. As shown in FIG. 1, a connecting portion 15 for detachably attaching a supply device such as air or a suction device is provided on the rear end side of the suction / air supply tube 12.

  Further, the rear end portion 17 of the tube body 10 has a connector portion 20 to which an artificial respirator or the like is attached. The connector unit 20 includes a fixture 21 for attaching a string or the like and fixing it to the human body.

  A method of using the tracheostomy tube having the above configuration will be described below with reference to FIG. FIG. 4 is a schematic configuration diagram showing a state in which the tracheostomy tube 1 is attached to the trachea.

  First, a tracheotomy is performed on the patient, an incision portion 42 is formed in the throat 40, and then the tracheostomy tube 1 is inserted into the trachea 41 so that the distal end portion 16 faces the lung side B. After the insertion, a fixing string or the like (not shown) is attached to the fixing tool 21, and the string or the like is fixed to the patient's neck. Next, air is injected from a cuff tube (not shown) to inflate the cuff 11, thereby bringing the inner wall surface 43 of the trachea 41 and the surface of the cuff 11 into close contact with each other so that the distal end portion 16 of the tracheostomy tube 1 is attached. Place in the human body. At this time, since the tracheostomy tube 1 is fixed so that the cuff covering portion 46 of the tube body 10 is substantially parallel to the trachea 41, the three openings 14, 14, 14 provided in the annular body 13 are Each will face the oral cavity A.

  After the tracheostomy tube 1 is fixed, the air exhaled from the lungs is exhausted to the outside of the human body through the tracheostomy tube 1 without passing through the nose or mouth, and the air from the outside of the human body is exhausted. Through the lungs. By repeating this, breathing can be performed.

  A supply device (not shown) for supplying air or oxygen is connected to the connecting portion 15 of the suction / air supply tube 12. Air or the like supplied from the supply device passes through the inside of the suction air supply tube 12 and flows out from the three openings 14, 14, 14 provided in the annular body 13 into the trachea 41. Since the openings 14, 14, 14 face the oral cavity A, the air flowing out from the openings 14, 14, 14 smoothly passes through the vocal cords 45 and is then discharged from the nose and mouth to the outside of the human body. The flow rate of air or the like sent from the supplier is, for example, 7 L / min.

  According to the tracheostomy tube 1 of the present embodiment, since the openings 14, 14, and 14 face the oral cavity A, the outflowing air smoothly flows toward the oral cavity A along the trachea. The patient can speak clearly. Further, when secretions or the like accumulate on the oral cavity side A of the cuff 11, the supply device such as air connected to the connecting portion 15 is removed, and an aspirator (not shown) is connected to three places. Since the secretions and the like can be sucked from the openings 14, 14, and 14 of the body, a wide range of secretions can be removed, and dripping of the secretions and the like to the lung side B can be effectively prevented. .

  As shown in FIG. 3, the openings 14, 14, 14 are provided at substantially equal intervals along the outer periphery of the annular body 13, so that air to the oral cavity A is supplied when air or the like is supplied. The flow is more uniform. As a result, since the air flow close to the living body can be maintained, clearer speech and conversation are possible, and the patient's QOL can be improved. Further, when sucking secretions and the like, since secretions accumulated on the oral cavity side A of the cuff 11 can be uniformly removed over a wider range, it is possible to effectively prevent the generation of residual suction. Can do. In addition, although three openings 14, 14, 14 are provided in the annular body 13, the number of openings is not particularly limited, and three or more openings may be provided.

  Moreover, since the area of each opening 14, 14, 14 provided in the annular body 13 is formed so as to increase toward the downstream side in the air supply direction, the suction air supply tube 12 is supplied when air or the like is supplied. The variation in the amount of air outflow from the openings 14, 14, and 14 due to the pressure drop inside can be suppressed, and air having a more uniform distribution can be supplied to the oral cavity A. Further, even when a secretion or the like accumulated on the oral cavity side A of the cuff is sucked, the suction force of each opening 14, 14, 14 can be kept constant, and a secretion or the like staying on the oral cavity side A of the cuff 11. Can be more effectively removed.

  Further, when air or the like is supplied to the suction air supply tube 12, the air or the like flowing out from the openings 14, 14, 14 passes through the trachea 41 and flows from the tracheal inlet 47 toward the oral cavity side A. The inflow into the trachea 41 of the secretion etc. which flowed out from A can be suppressed. As a result, it is possible to reduce the amount of secretions and the like that accumulate on the oral cavity side A of the cuff 11, so that the secretions that sag to the lung side B through the space between the cuff 11 and the inner wall surface 43 of the trachea 41 can be reduced. The amount can also be reduced.

  As mentioned above, although one Embodiment of this invention was described, the specific aspect of this invention is not limited to the said embodiment.

  For example, in the above embodiment, the annular body 13 is configured by winding the distal end portion of one flexible tube around the outer peripheral surface of the tube body 10 so that the annular body 13 can be easily manufactured. The body 13 may be formed separately from the flow path extending along the longitudinal direction of the tube body 10. For example, the annular body 13 may be formed of a hollow ring-shaped member, and may be externally fitted to a predetermined position of the tube body 10 to be connected to a flexible tube that forms a flow path. A plurality of flexible tubes connected to the annular body 13 may be attached on the outer peripheral surface along the longitudinal direction of the tube body 10. Furthermore, instead of using a flexible tube as the flow path, a lumen formed in the thick portion of the tube body 10 can be used.

It is a perspective view showing a schematic structure of a tracheostomy tube according to an embodiment of the present invention. It is the top view to which the principal part of the tracheostomy tube shown in FIG. 1 was expanded. It is CC sectional drawing in FIG. It is a schematic block diagram at the time of attaching the tracheostomy tube shown in FIG. 1 to a human body. It is a schematic block diagram at the time of attaching the conventional tracheostomy tube to a human body. It is a schematic block diagram which shows one example of a tracheostomy tube.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 Tracheostomy tube 10 Tube 11 Cuff 12 Suction / air supply tube 13 Annular body 14 Opening 15 Connecting part 16 Front end part 17 Rear end part 20 Connector part 21 Fixing part 22 Cuff inflation lumen 23 Cuff tube 40 Throat 41 Trachea 42 Incision part 43 Inner wall 45 Vocal cord 46 Cuff covering part 47 Tracheal inlet A Oral side B Lung side

Claims (4)

A cuff is provided on the distal end side of the tube body formed in a vent shape, and tracheostomy is performed by inflating the cuff by injecting air from the rear end side of the tube to inflate the tube at a predetermined position in the trachea. In the tube
The cuff includes an annular body arranged to be adjacent to the rear end side of the tube,
The annular body includes a plurality of openings on the rear end side of the tube, and a tracheostomy tube to which a flow path for suction or air supply is connected from the rear end side of the tube. The tracheostomy tube according to claim 1, wherein the plurality of openings are provided at substantially equal intervals along the outer periphery of the annular body. The tracheostomy tube according to claim 1 or 2, wherein an area of the plurality of openings is formed so as to increase toward the downstream side in the air supply direction. The tracheostomy tube according to any one of claims 1 to 3, wherein the flow path and the annular body are formed of a single flexible tube and are in close contact with an outer peripheral surface of the tube.

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