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WO2021093842A1 - Système d'aspiration sous-glottique et son procédé de commande - Google Patents

Système d'aspiration sous-glottique et son procédé de commande Download PDF

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Publication number
WO2021093842A1
WO2021093842A1 PCT/CN2020/128609 CN2020128609W WO2021093842A1 WO 2021093842 A1 WO2021093842 A1 WO 2021093842A1 CN 2020128609 W CN2020128609 W CN 2020128609W WO 2021093842 A1 WO2021093842 A1 WO 2021093842A1
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WIPO (PCT)
Prior art keywords
suction
pressure
data
valve
phase
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Ceased
Application number
PCT/CN2020/128609
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English (en)
Chinese (zh)
Inventor
李维
李小苗
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
BEIJING YAGUO TECHNOLOGY Co Ltd
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BEIJING YAGUO TECHNOLOGY Co Ltd
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Publication of WO2021093842A1 publication Critical patent/WO2021093842A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

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    • A61M1/0023—
    • 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
    • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/71—Suction drainage systems
    • A61M1/73—Suction drainage systems comprising sensors or indicators for physical values
    • 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
    • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/71—Suction drainage systems
    • A61M1/74—Suction control
    • 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
    • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/71—Suction drainage systems
    • A61M1/74—Suction control
    • A61M1/743—Suction control by changing the cross-section of the line, e.g. flow regulating valves
    • 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
    • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/71—Suction drainage systems
    • A61M1/74—Suction control
    • A61M1/75—Intermittent or pulsating suction
    • 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
    • A61M2205/00—General characteristics of the apparatus
    • A61M2205/33—Controlling, regulating or measuring
    • A61M2205/3327—Measuring
    • 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
    • A61M2205/00—General characteristics of the apparatus
    • A61M2205/33—Controlling, regulating or measuring
    • A61M2205/3331—Pressure; Flow
    • 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
    • A61M2210/00—Anatomical parts of the body
    • A61M2210/06—Head
    • A61M2210/0625—Mouth
    • A61M2210/065—Throat; Pharynx

Definitions

  • This application relates to the field of medical auxiliary equipment, and in particular to a subglottic suction system and a control method thereof.
  • VAP ventilator associated pneumonia
  • Continuous subglottic suction is to connect the sputum drainage tube to the negative pressure suction device, and use constant negative pressure to continuously suck.
  • the advantage of this method is that it can prevent the retention of secretions above the air sac.
  • the disadvantage is that it is easy to cause drying and bleeding of the respiratory mucosa. infection.
  • Intermittent subglottic suction is intermittent suction with constant negative pressure. This method can make the mucosa above the airbag fully rest, and the airway temperature and humidity will change little, alleviate the damage of negative pressure to the mucosa, and avoid the disadvantages of continuous subglottic suction. .
  • the current intermittent subglottic suction is mainly done manually by nurses, such as intermittent suction using a syringe.
  • This manual method will greatly increase the workload of medical staff and cannot guarantee sufficient frequency of attraction.
  • the amount of secretions on the capsule cannot be directly observed, it is difficult to determine the timing of suction and to monitor the quality of suction care, which may lead to insufficient suction care on the capsule.
  • the existing subglottic suction method increases the manual workload, and there is a problem that the control timing cannot be determined.
  • This application aims to solve at least one of the technical problems existing in the prior art.
  • the present application provides a subglottic suction system and a control method thereof to solve the problem that the subglottic suction method in the related art increases the manual workload and cannot determine the control timing.
  • an embodiment of the present application provides a subglottic suction system, which includes: a secretion collection device for collecting secretions sucked from the patient's subglottis through a suction tube; a pressure part, and the suction tube Connection, used to provide negative pressure for the suction pipe, and adjust the magnitude of the negative pressure provided according to the pressure adjustment signal; a sensing unit, connected to the suction pipe, for real-time control of the suction pipe The flow and/or pressure in the road are monitored to obtain monitoring data; a control unit, connected to the pressure part and connected to the sensing unit, for receiving the monitoring data and generating the pressure adjustment based on the monitoring data Signal, the pressure adjustment signal is sent to the pressure part, and the suction of the suction system is controlled according to the calculation, judgment and decision-making of the monitoring data.
  • it further includes: an on-off valve, connected between the pressure part and the suction pipe, for controlling whether the pressure part is directed to the suction pipe according to the opening or closing of the on-off valve. Negative pressure is introduced into the pipeline.
  • the on-off valve is also connected to the control unit for controlling the on-off valve to open according to an opening instruction from the control unit, and controlling the on-off valve according to a closing instruction from the control unit.
  • the on-off valve is closed.
  • the embodiment of the present application also provides a method for controlling the subglottic suction system, which includes: monitoring the flow and/or pressure in the suction pipeline in real time to obtain monitoring data; and calculating, according to the monitoring data, Judgment and decision-making, control the suction of the suction system, and generate a pressure adjustment signal according to the monitoring data, and send the pressure adjustment signal to the pressure part; and perform the magnitude of the negative pressure provided according to the pressure adjustment signal adjust.
  • the subglottic suction system includes an on-off valve, which is connected between the pressure part and the suction pipeline, and is used to control the station according to the opening or closing of the on-off valve.
  • the calculation, judgment, and decision based on the monitoring data, controlling the suction of the suction system, and generating a pressure adjustment signal according to the monitoring data includes: controlling The subglottic suction system works in manual mode, timing mode, or automatic mode and performs mode switching; in the manual mode, the suction time and the suction interval are determined according to the operator's operation of the on-off valve, and continue Suction or intermittent suction; in the timing mode, the opening and closing instructions are sent to the on-off valve according to the preset suction time and the suction interval time, and the suction is performed at a time; in the automatic mode, according to the monitoring data
  • the pressure adjustment signal is generated in combination with a preset threshold, and an opening command or a closing command is generated to
  • the monitoring data includes flow data and/or pressure data
  • the automatic mode includes a trial suction phase and a formal suction phase.
  • the method further includes: judging jointly based on the flow data and the pressure data, and controlling the start and end of the trial suction phase and the formal suction phase Or judge according to at least one of the flow data and the pressure data, and control the start and end of the trial suction phase and the formal suction phase.
  • the joint judgment based on the flow data and the pressure data, and controlling the start and end of the trial suction phase and the formal suction phase includes: sending to the on-off valve Open the command, open the on-off valve, and the trial suction phase begins.
  • the product of the pressure data and the inverse of the flow data is greater than or equal to the first preset threshold
  • the joint judgment based on the flow data and the pressure data, and controlling the start and end of the trial suction phase and the formal suction phase includes: sending to the on-off valve
  • the opening instruction is to open the on-off valve, and the suction test phase begins.
  • the formal suction is entered.
  • the suction phase otherwise the test suction phase ends.
  • the judging based on at least one of the flow data and the pressure data, and controlling the start and end of the trial suction phase and the formal suction phase includes:
  • the on-off valve sends an opening instruction to open the on-off valve and enter the suction test phase.
  • the suction test is stopped; When the pressure data is greater than the first pressure threshold and/or the flow data is less than the first flow data, enter the formal suction phase; in the formal suction phase, when the pressure data is less than the second pressure threshold And/or when the flow data is greater than the second flow threshold, a closing instruction is issued to the on-off valve, and the formal suction phase ends, wherein the first pressure threshold is greater than the second pressure threshold, and the first flow threshold Less than the second flow threshold.
  • the beneficial effects of this application are: the subglottic suction system and its control method provided by the embodiments of this application are performed by monitoring the flow and/or pressure of the suction line connecting the patient and the secretion collection device in the subglottic suction system. Monitor, and then control and adjust the working conditions of the suction system according to the monitoring results.
  • the suction operation on the capsule can be automatically completed, and the suction can be automatically activated by detecting the amount of secretions accumulated under the glottis of the patient, which not only reduces the labor intensity of the nurse, but also It can protect the patient's respiratory mucosa, and also ensure sufficient suction frequency and suction quality.
  • Figure 1 is a schematic diagram of a subglottic suction system according to an embodiment of the application.
  • FIG. 2 is a schematic diagram of the connection relationship when the subglottic suction system works in an embodiment of the application
  • Fig. 3 is a flowchart of a control method of a subglottic suction system according to another embodiment of the application.
  • FIG. 1 is a schematic diagram of a subglottic suction system provided by an embodiment of the application.
  • the system 100 (that is, the subglottic suction system) includes: a secretion collection device 110, a pressure part 120, and a sensing unit 130 and control unit 140.
  • the secretion collection device 110 is used to collect secretions sucked from the patient's subglottis through a suction pipeline; the pressure part 120 is connected to the suction pipeline and is used to provide negative pressure for the suction pipeline, and to provide negative pressure to the suction pipeline according to the pressure regulation signal.
  • the sensing unit 130 is connected to the suction pipeline to monitor the flow and/or pressure in the suction pipeline in real time to obtain monitoring data; the control unit 140 is connected to the pressure unit 120 and senses The unit 130 is connected (the control unit 140 is connected to the pressure unit 120 and the sensing unit 130 respectively), and is used to receive monitoring data and generate a pressure adjustment signal according to the monitoring data, send the pressure adjustment signal to the pressure unit 120, and calculate, Judgment and decision-making, to control the suction of the suction system.
  • the system 100 further includes: an on-off valve (not shown in the figure).
  • the on-off valve is connected between the pressure part 120 and the suction pipe for controlling the pressure part according to the opening or closing of the on-off valve. Whether to pass negative pressure to the suction pipeline.
  • the on-off valve is also connected to the control unit 140 for controlling the on-off valve to open according to the opening instruction from the control unit 140 and controlling the on-off valve to close according to the closing instruction from the control unit 140.
  • FIG 2 is a schematic diagram of the connection relationship when a subglottic suction system of this application works.
  • the secretion collection device 6 receives secretions from the patient through a suction pipe (not marked), and is set on the suction pipe
  • the sensing unit 5 is connected to the control unit 3.
  • the pressure part includes a negative pressure source 1 and a pressure regulating unit 2.
  • the negative pressure source 1 is used to provide negative pressure with suction power;
  • the pressure regulating unit 2 is connected to the negative pressure source 1 and the control unit 3, It is used to adjust the magnitude of the negative pressure provided by the negative pressure source 1 according to the pressure adjustment signal from the control unit 3.
  • an on-off valve 4 is also provided on the connecting pipeline between the pressure regulating unit 2 and the suction pipeline.
  • the negative pressure source 1 in FIG. 2 provides suction power for the entire subglottic suction system, which can be an independent vacuum pump, such as a piston, rotary vane, or water ring vacuum pump, or It is a negative pressure turbine, it can also be a central suction system configured on the treatment belt of a hospital ward, or a commercially available sputum suction device that can generate negative pressure.
  • an independent vacuum pump such as a piston, rotary vane, or water ring vacuum pump
  • It is a negative pressure turbine
  • it can also be a central suction system configured on the treatment belt of a hospital ward, or a commercially available sputum suction device that can generate negative pressure.
  • the pressure adjusting unit 2 in FIG. 2 can adjust the magnitude of the negative pressure value output by the negative pressure source, and keep the output negative pressure value dynamically stable, which can be a separate mechanical or electronic type
  • the negative pressure source 1 is independent, such as a vacuum pump or a fan, the pressure can also be adjusted directly by adjusting the speed of the drive motor in a closed loop.
  • control unit 3 in FIG. 2 is used to receive information such as external instructions or monitoring data of the sensing unit 5, and after processing, can send a signal for adjusting the pressure value to the pressure adjustment unit 2 (ie Pressure adjustment signal) to adjust the negative pressure; it is also possible to send instructions to the on-off valve 4 to control the on-off valve 4 to open or close, so as to start the attraction and stop the attraction.
  • a signal for adjusting the pressure value to the pressure adjustment unit 2 (ie Pressure adjustment signal) to adjust the negative pressure
  • pressure adjustment unit 2 ie Pressure adjustment signal
  • the on-off valve 4 in FIG. 2 may be a two-position, two-way solenoid valve, a pneumatic valve, an electric valve, or a manual on-off valve.
  • the on-off valve 4 can be controlled by the control unit 3 to realize opening and closing through command control, or it can be manually opened and closed to control when to supply and stop supplying negative pressure to the suction pipeline.
  • the sensing unit 5 in FIG. 2 monitors the pressure and/or flow rate in the suction pipeline. It can monitor the pressure through a pressure sensor, and use a flow sensor (or through measured different parts). Calculate the flow value based on the pressure value) to monitor the flow rate.
  • the secretion collection device 6 in FIG. 2 collects secretions (such as sputum) sucked from the patient's glottis through the suction tube into a container, and after the accumulation reaches a certain amount, the nursing staff will act as Medical waste treatment.
  • secretions such as sputum
  • the sensing unit 5 by adding the sensing unit 5, by monitoring the flow and/or pressure in the suction pipeline, the working condition of the suction system can be monitored according to the monitoring results. Control and adjustment, can automatically complete the suction operation on the capsule, and can automatically start the suction by detecting the amount of secretions accumulated under the glottis of the patient, which not only reduces the labor intensity of the nurse, but also protects the respiratory mucosa of the patient, and ensures sufficient suction frequency And attract quality.
  • the working modes of the subglottic suction system provided in the above embodiments include manual mode, timing mode and automatic mode.
  • the control method provided in this application can switch between different modes, and can also perform continuous and intermittent suction to achieve Automatic and appropriate suction can not only reduce manual operation but also protect the patient's respiratory mucosa.
  • FIG. 3 is a flowchart of a method for controlling a subglottic suction system according to another embodiment of the application. As shown in FIG. 3, it specifically includes the following steps:
  • step S310 the flow rate and/or pressure in the suction pipeline are monitored in real time to obtain monitoring data
  • step S320 control the suction of the suction system according to the monitoring data calculation, judgment and decision, generate a pressure adjustment signal according to the monitoring data, and send the pressure adjustment signal to the pressure part;
  • step S330 the magnitude of the negative pressure provided is adjusted according to the pressure adjustment signal.
  • the subglottic suction system in the control method, is controlled to work in manual mode, timing mode, or automatic mode, and to perform mode switching;
  • the suction time and the suction interval are determined according to the operator's operation of the on-off valve, and continuous suction or intermittent suction is performed.
  • the suction can be started by pressing the manual suction button and opening the on-off valve 4, and pressing it again will close the on-off valve 4 and the suction will stop.
  • a single subglottic suction can be realized by manual operation, and the suction time and the suction interval time are determined by the time the operator presses the manual suction button twice next to each other to achieve intermittent suction.
  • continuous attraction can also be performed, that is, after the manual attraction start button is pressed, the manual attraction button is no longer pressed within a certain period of time, so as to achieve continuous attraction.
  • the opening and closing instructions are sent to the on-off valve according to the preset suction time and the suction interval time, and the suction is carried out at a fixed time.
  • the control unit 3 is used to replace the function of manually pressing the suction button.
  • the control unit 3 sets the suction duration and suction interval time by setting instructions.
  • the instructions are applied to the on-off valve 4, and then according to the control unit 3 Send an opening command to open the on-off valve 4, and open and close the on-off valve according to the closing command to realize the timing control of the suction time and the suction interval.
  • the timing control can be intermittent suction within a period of time, or continuous suction.
  • the sensor unit 5 does not participate in the operation of the system.
  • the pressure adjustment signal is generated according to the monitoring data combined with the preset threshold, and the opening instruction or the closing instruction is generated to control the on-off valve and automatically attract.
  • the sensing unit 5 works after the test suction is started, and the obtained monitoring data includes flow data and/or pressure data.
  • the system will periodically detect whether secretions have accumulated, and if so, the suction system will be activated.
  • the automatic mode includes a test suction phase and a formal suction phase, that is, the general control flow is: open the on-off valve ⁇ enter the test suction phase ⁇ meet the condition one and stop the test suction ⁇ meet the condition two and enter Formal suction stage ⁇ Stop formal suction when condition 3 is met.
  • an opening instruction and a closing instruction are sent to the on-off valve according to the preset test suction time period, and the test suction is performed.
  • the situation (1) specifically includes:
  • the negative pressure in the normal suction phase is determined by the operator; if it is automatic mode, the operator sets the maximum pressure through the control unit, and the control unit adjusts it from 0 to the maximum pressure.
  • the principle of adjustment is The F flow rate reaches at least a certain threshold, for example, the threshold can be 2L/min.
  • the integral over a period of time may also be considered, which specifically includes:
  • the test suction phase ends.
  • the product of the above-mentioned pressure value P and the reciprocal (1/F) of the flow value F can be changed to the integral of the product of the pressure value P and the reciprocal (1/F) of the flow value F within a period of time T1, the formula is:
  • the cumulative value over a period of time is calculated, and then divided by the time to get the average value over a period of time.
  • the average value obtained by solving is different from the instantaneous value of a single moment in the above situation.
  • the sensing unit 5 may simultaneously detect pressure and flow rate for joint judgment, or may only detect pressure and/or flow rate for judgment, that is, situation (2) specifically includes:
  • (2.1) Send an opening instruction to the on-off valve, open the on-off valve, and enter the test suction stage.
  • the pressure data is less than the first pressure threshold and/or the flow data is greater than the first flow threshold, stop the test suction.
  • the control unit 3 regularly issues an opening instruction to the on-off valve 4 to open the on-off valve 4, and at the same time, the sensing unit 5 monitors the airflow data/pressure data in real time, and performs a test suction.
  • the pressure value P detected by the sensing unit 5 is lower than a pressure threshold value P1 and/or the detected flow rate is greater than a flow threshold value F1, the suction is stopped immediately.
  • the formal suction phase is entered.
  • the control unit 3 Adjust the suction pressure to a suitable value and continue to suck.
  • the maximum pressure is set by the control unit 3, and the control unit automatically adjusts to a suitable value within the range of 0 to the maximum pressure.
  • the pressure and flow thresholds P1, P2, F1, and F2 in the above method may be preset or calculated based on pressure and flow detection values over a period of time.
  • the pressure value, flow value and each threshold value are all absolute values.
  • the pressure adjustment in this application can be manual or automatic closed-loop adjustment of the vacuum pressure control valve or adjustment of the motor driving the negative pressure source. Rotation speed to achieve the desired pressure value.
  • the method for controlling the subglottic suction system provided in the embodiments of the present application, by monitoring the flow or pressure in the suction pipeline, and controlling and adjusting the working conditions of the suction system according to the monitoring results, it can be automatically
  • the suction operation on the capsule is completed, and the suction can be automatically activated by detecting the amount of secretions accumulated under the glottis of the patient, which not only reduces the labor intensity of the nurse, but also protects the respiratory mucosa of the patient, and also ensures sufficient suction frequency and suction quality.
  • modules or units of the device for action execution are mentioned in the above detailed description, this division is not mandatory.
  • the features and functions of two or more modules or units described above may be embodied in one module or unit.
  • the features and functions of a module or unit described above can be further divided into multiple modules or units to be embodied.

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  • Health & Medical Sciences (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Vascular Medicine (AREA)
  • Engineering & Computer Science (AREA)
  • Anesthesiology (AREA)
  • Biomedical Technology (AREA)
  • Hematology (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • External Artificial Organs (AREA)

Abstract

La présente invention concerne un système d'aspiration sous-glottique (100) et un procédé de commande de celui-ci, le système d'aspiration sous-glottique (100) comprenant : un appareil de collecte de sécrétions (110), utilisé pour collecter des sécrétions aspirées depuis la sous-glotte d'un patient au moyen d'un tube d'aspiration ; un composant de pression (120), utilisée pour fournir une pression négative au tube d'aspiration, et pour effectuer un ajustement d'une amplitude de la pression négative fournie en fonction d'un signal de réglage de pression ; une unité de détection (130) utilisée pour surveiller le volume d'écoulement et/ou la pression dans le tube d'aspiration en temps réel, obtenant des données de surveillance ; une unité de commande (140) connectée séparément au composant de pression (120) et à l'unité de détection (130), utilisée pour recevoir les données de surveillance et générer un signal de réglage de pression en fonction des données de surveillance, envoyer le signal de réglage de pression au composant de pression, et également pour effectuer un calcul, une détermination et une décision en fonction des données de surveillance, commandant l'aspiration du système d'aspiration.
PCT/CN2020/128609 2019-11-14 2020-11-13 Système d'aspiration sous-glottique et son procédé de commande Ceased WO2021093842A1 (fr)

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CN201911112220.2A CN110755705A (zh) 2019-11-14 2019-11-14 一种声门下吸引系统及其控制方法
CN201911112220.2 2019-11-14

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CN112675393B (zh) * 2020-12-18 2024-04-19 杭州脉兴医疗科技有限公司 一种呼吸机撤机管理系统及方法
CN113413191A (zh) * 2021-07-13 2021-09-21 上海融脉医疗科技有限公司 一种用于介入导管抽吸取栓术的智能控制装置及控制方法

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