CN2865589Y - Medical device for assisting in detecting transesophageal echocardiography blind area - Google Patents

Abstract

A medical device for assisting detection of blind areas in transesophageal echocardiography, mainly composed of a water bladder, a water bladder push rod, a water injection outlet, and a pressure measurement port. The water bladder can be made of latex, silica gel or any material that is harmless to the human body , located in the front section of the water bag propulsion rod. The water bag propulsion rod is the support and push object of the water bag, which can be bent, has a length scale mark on the outside, and has a lumen inside to pass through the water bag. There are multiple openings in the front part of the water bag for water injection, drainage and pressure measurement. The water injection outlet and the pressure measuring port are valve-type medical syringe interfaces, and communicate with the inside of the water bag through the lumen of the water bag propulsion rod. The TEE transtracheal acoustic window established with the above device can examine the distal ascending aorta, proximal aortic arch, innominate artery, left subclavian artery, left common carotid artery, and left pulmonary artery that cannot be examined by TEE at present, supplementing the current TEE examination. Insufficient range.

Description

Medical device for assisting detection of blind zone in transesophageal echocardiography

technical field

The utility model belongs to the field of medical equipment, and in particular relates to a medical detection facility or device for assisting transesophageal echocardiography (TEE) examination and monitoring of trachea (including bronchi) prevascular structure and blood flow information for patients with tracheal intubation .

Background technique

TEE is currently a routine monitoring technique in cardiovascular surgery. It is often used to check the extent of arterial dissection, the development trend of large vessel trauma, and the location of atherosclerotic plaque and thrombus. However, since the trachea is located between the esophagus and the aortic arch, conventional TEE cannot examine or monitor some large blood vessels in front of the trachea and bronchi, including the distal ascending aorta, the proximal aortic arch, the innominate artery, the left pulmonary artery, and the left subclavian artery in some patients. , left common carotid artery can not be detected. These areas are known as TEE's "blind spots" and are caused by the inability of ultrasound waves to pass through the air in the trachea. Currently, methods for examining TEE blind spots can be divided into two categories: ultrasound methods and other imaging methods. Ultrasound methods mainly include transthoracic echocardiography, vessel surface ultrasound and intravascular ultrasound. Transthoracic echocardiography is generally performed through the suprasternal fossa. This method cannot obtain satisfactory images for patients with obesity, emphysema, and thick chest walls. Due to the requirement of surgical disinfection, it cannot be used for detection in cardiac surgery. Ultrasound of the vessel surface is performed by placing a small sterile probe on the surface of the structure to be examined. In this method, the thoracic cavity must be opened to expose blood vessels, and the detection process interferes with the surgical operation and consumes surgical time. Intravascular ultrasound requires a special probe to be punctured into the blood vessel. The inspection range is limited and the field of view is small, so it is not suitable for intraoperative detection.

Other imaging methods include angiography, computed tomography (CT) and magnetic resonance imaging (MRI). Such methods are not only expensive, require special technicians and equipment, but also can only obtain instantaneous static blood vessel images, cannot perform dynamic blood flow monitoring, and cannot be used in the operating room. Angiography and enhanced computed tomography (CT) also need to inject a special contrast agent into the patient's blood vessel, which may cause complications such as allergies. In addition, patients need to be transported between various departments of the hospital, which is not suitable for emergency patients with large vessel trauma.

Contents of the invention

In order to overcome the defects of high cost, interference with operation, and inconvenient application in operation of the above-mentioned prior art, and aiming at the characteristics of rapid development of large vessel lesions in emergency and critical condition, the utility model provides a device for assisting detection of blind areas in transesophageal echocardiography The medical device, on the basis of tracheal intubation, establishes a temporary TEE transtracheal acoustic window to expand the application range of TEE, so that clinicians can check and monitor blood vessels and blood flow information in the TEE blind area during operation.

The technical solution adopted by the utility model to solve the technical problem is: the medical device for auxiliary detection of the blind area of transesophageal echocardiography is mainly composed of a water bag, a water bag propulsion rod, a water injection outlet and a pressure measurement port. The water bag can be made of latex, silica gel or any material that is harmless to the human body. It is located in the front section of the water bag propulsion rod. When emptying, it can be inserted into the trachea and taken out through any type of endotracheal intubation port through the nose or through the mouth. After being filled with liquid, it is close to the tracheal wall, and the pressure in the bag does not exceed 30cmH ₂ O. Physiological saline or any fluid for intravenous infusion can be used in the water bag.

In the above scheme, the water bladder propulsion rod is the support and pusher of the water bladder, which can be bent. When in use, its bending arc coincides with the arc of the endotracheal tube in the human body, and the length is sufficient to reach from the incisors to the distal bronchus. Through the water bladder, there are multiple openings in the front part of the inner part of the water bladder for water injection, drainage and pressure measurement, as shown in Figure 3. There is a length scale mark on the outside of the push rod. The water injection outlet and the pressure measurement port are valve-type medical syringe interfaces (the syringe can be used to inject or extract liquid into the water bag in the trachea, and it will automatically close after the syringe is removed), and communicate with the inside of the water bag through the lumen of the water bag push rod. The water injection outlet and the pressure measurement port have the same function, and can be used for water injection, pumping or pressure measurement. The water bladder and the water bladder propelling rod can have different models (diameter and length), which can be selected and used by the examiner according to the patient's weight, height and examination site.

In the above scheme, the water injection outlet and the pressure measurement port at the end of the water bag propulsion rod are generally placed outside the endotracheal tube, and a pressure sensing sensor system, such as hydraulic pressure, transmits the pressure inside the water bag in the trachea, and through water injection and drainage. Connected to an external pressure gauge or pressure sensor connected to the port or pressure measuring port. Also can only have water injection outlet, do not have pressure measuring port and the pipeline that is continuous with water bag propelling rod, connect a medical three-way cock and pressure measuring device at the water injection outlet end and get final product.

Utilize tracheal intubation and TEE detection equipment, put the water bag of the medical device described in the present invention into the trachea through the trachea intubation port, fill the liquid to get rid of the air in the corresponding area in the trachea (need to measure the pressure at the same time to prevent damage to the trachea), The ultrasonic wave emitted by the TEE probe in the esophagus can pass through the water bag, and a new TEE transtracheal acoustic window can be temporarily established, so that the blind area of TEE can be eliminated, and the large blood vessel structure and blood flow information in front of the trachea and bronchi can be detected. After the inspection is completed, the water bag is emptied and taken out. (For patients using pure oxygen mechanical ventilation, the body’s oxygen reserve allows the ventilation to be stopped for 3 minutes.) A double-port endotracheal tube connector can also be used, and the water bag placed in the trachea can be partially or completely emptied during the examination without affecting ventilation. If necessary, check the filling again to prevent the patient from hypoxia. Cardiovascular surgery does not require mechanical ventilation during extracorporeal circulation, the water bag can be filled continuously, and the trachea, prebronchial blood vessels and blood flow can be observed continuously.

The beneficial effect of the utility model is that the "TEE Transtracheal Acoustic Window" established by the device described in the utility model can be used to detect the large blood vessel structure and blood flow in front of the trachea and bronchi with TEE at any time, non-invasively and dynamically. It can be used in the operating room without interfering with the operation; clear images can also be obtained for patients with obesity, emphysema, and thick chest wall; physiological saline can be used as the sound wave medium, which is cheap and will not cause allergies; For example, the inspection of Marfan syndrome intimal tear, large aneurysm or atherosclerotic plaque suspicious rupture, thrombosis, etc.) can be carried out simultaneously with surgical operation without prolonging the preoperative waiting time; the utility model is especially suitable for cardiac Patients undergoing vascular surgery can continuously observe the large blood vessels in front of the trachea and their blood flow during extracorporeal circulation, and provide timely information for surgical operations in related areas. The TEE transtracheal acoustic window established by the utility model can check the distal ascending aorta, the proximal aortic arch, the innominate artery, the left subclavian artery, the left common carotid artery and the left pulmonary artery, which cannot be checked by TEE at present, supplementing the current TEE examination. It can provide reliable imaging information for surgical operations, and provide a new perspective for intraoperative anesthesia monitoring and hemodynamic research.

Description of drawings

Fig. 1 is a schematic diagram of the basic structure of the medical device for assisting detection of blind areas in transesophageal echocardiography according to the present invention.

Fig. 2 is a schematic diagram of the cross-sectional structure of the water bag propulsion rod (at A) of the utility model.

Fig. 3 is a schematic diagram of the longitudinal section structure of the water bag propulsion rod inside the front section of the water bag of the utility model.

Fig. 4 is a schematic longitudinal sectional view of an embodiment of the utility model.

In the figure, 1. water bag, 2. water bag propulsion rod, 3. water injection outlet, 4. pressure measuring port, 5. front opening of water bag propulsion rod, 6. trachea, 7. endotracheal intubation, 8. esophagus, 9. Transesophageal echocardiography probe, 10. Innominate artery, 11. Left common carotid artery, 12. Left subclavian artery, 13. Aortic arch.

Detailed ways

Below in conjunction with accompanying drawing and embodiment the utility model is further described. The utility model is not limited to the described embodiments.

As shown in the embodiment of Figure 4, the utility model water bag 1 is placed in the trachea 6 through the tracheal intubation tube 7, and the air in the trachea in the corresponding area is removed after filling with normal saline, so that the TEE probe 9 in the esophagus 8 behind it can The proximal segment of the aortic arch, innominate artery 10, left common carotid artery 11, and left subclavian artery 12 in front of the trachea were monitored by water balloon 1 examination. When in use, the water bladder can be placed in an appropriate position through methods such as blind detection, auscultation, calculation, fiberoptic bronchoscopy or X-ray, and the position of the water bladder can be changed according to the inspection needs. The cannula is removed.

Claims (6)

1, a kind of medical apparatus that is used for assistant check of via esophagus ultrasound cardiogram blind zone, it is characterized in that mainly being made of water pocket (1), water pocket pushing ram (2), the water filling discharge outlet (3) and the pressure tap (4) that communicate with water pocket by the water pocket pushing ram, water pocket is positioned at water pocket pushing ram leading portion.

2, the medical apparatus that is used for assistant check of via esophagus ultrasound cardiogram blind zone according to claim 1 is characterized in that the intracapsular pressure behind water pocket (1) full of liquid is no more than 30cmH ₂O.

3, the medical apparatus that is used for assistant check of via esophagus ultrasound cardiogram blind zone according to claim 1 is characterized in that water pocket pushing ram (2) is flexible.

4, the medical apparatus that is used for assistant check of via esophagus ultrasound cardiogram blind zone according to claim 1 is characterized in that the length scale mark is arranged outside the water pocket pushing ram (2).

5, the medical apparatus that is used for assistant check of via esophagus ultrasound cardiogram blind zone according to claim 1 is characterized in that water pocket pushing ram (2) part leading portion in water pocket has a plurality of openings (5) for water filling, draining and pressure measurement use.

6, the medical apparatus that is used for assistant check of via esophagus ultrasound cardiogram blind zone according to claim 1 is characterized in that water filling discharge outlet (3) and pressure tap (4) are valve-type injector for medical purpose interface.

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