JP4933050B2 - Fluid dosing device and method - Google Patents

Description

  The present invention relates to a fluid administration device for supplying fluid such as nutrients to a digestive tract or the like via a catheter or the like, and a control method therefor.

  In order to administer nutrients to humans, when inserting a catheter into the digestive tract by constructing a gastric fistula or intestinal fistula, etc., and supplying fluid nutrients with high fluidity through this catheter There is.

In this case, doctors, nurses, etc. once transfer the nutrients in the pack to the administration device, and then administer the nutrients to the patient from this administration device. That is, the nutrients in the pack are transferred to the bag of the administration device, the bag is hung to an appropriate height, and the tip of the tube extending from the bottom of the bag is inserted into a gastric fistula or intestinal fistula constructed in the patient. Connected to the urine, the nutrients are appropriately supplied to the stomach and intestines.
There is also a beverage supply device that directly administers nutrients in Tetra Pak without being transferred to the bag of the administration device (Patent Document 1).
JP 2003-164532 A

  However, since the nutrients supplied by the above method have high fluidity, the nutrients once administered into the stomach may flow backward from the stomach to the esophagus or the like unless careful attention is paid. At this time, the pH of the nutrient that flows backward is acidified by gastric acid or the like. For this reason, acidic nutrients that have flowed back cause inflammation of organs such as the esophagus, trachea, and lungs. In particular, when the nutrients that have flowed back enter the trachea, infections such as pneumonia may occur.

  Then, an object of this invention is to provide the fluid administration apparatus which can prevent inconveniences, such as inflammation of the trachea and other organs caused by the reverse flow of nutrients having high fluidity.

  Moreover, an object of this invention is to provide the control method for controlling the above fluid administration apparatuses.

In order to solve the above problems, a fluid administration device according to the present invention includes (a) an airtight injection container main body containing an administration substance having a fluidity solidified to a viscosity of 50 mPa · s to 6500 mPa · s, (B) Pressurizing means for pressurizing the inside of the injection container body to a predetermined level or more, (c) Provided so as to avoid interference with the pressurizing means in communication with the bottom of the injection container body, A discharge section that is a path for discharging the administration substance to the outside; (d) a pressure sensor for monitoring the pressure in the injection container body; and (e) data on the viscosity of the administration substance stored in the injection container body; And a control device for controlling the supply speed of the administration substance from feedback control of the operation of the pressurizing means based on the output of the pressure sensor, and (f) the control device via a tube device connected to the discharge unit Outflow from discharge section (G) the injection container body is cylindrical and has a lid member that can be hermetically fixed to the upper part, and the pressurizing means supplies pressurized gas to the upper part of the injection container body, (h ) A leak device for releasing the pressurized gas in the injection container main body is further provided. (I) The administration substance is a nutrient, and the discharge part is connected to the catheter via a tube.

  According to the fluid administration device, the pressurizing means pressurizes the inside of the injection container body to a predetermined level or more, so even if the dose substance has a certain viscosity or more, the dose substance is discharged from the discharge portion at a desired flow rate. Can be made. That is, regardless of the viscosity of the administration substance, the administration substance can be supplied to the stomach and other digestive tracts at an arbitrary flow rate. In particular, when the administration substance has a certain viscosity or more as described above, the administration substance introduced into the stomach or other digestive tract via the catheter or the like from the discharge part is suppressed in fluidity due to its viscosity, Prevents backflow from other digestive tracts to the esophagus.

Further, in the present invention, the injection container body has a cylindrical shape such as a cylinder, and has a lid member that can be airtightly fixed to the upper part. The discharge part communicates with the bottom part in the injection container main body. In this case, the administration substance can be appropriately discharged from the discharge part communicating with the bottom of the injection container main body by a simple means of adjusting the gas pressure of the pressurized gas.

Moreover, in this invention, the leak apparatus which releases the pressurized gas in an injection container main body is further provided. In this case, the discharge of the administration substance from the discharge unit can be quickly suppressed at a necessary timing.

Moreover, in this invention, the pressure sensor for monitoring the pressure in an injection container main body is further provided. In this case, the flow rate of the administration substance to be ejected from the ejection part can be appropriately adjusted according to various characteristics such as the viscosity of the administration substance.

The present invention further includes a control device that controls the operation of the pressurizing means based on the output of the pressure sensor. In this case, it is possible to automatically control the flow rate and total flow rate of the administration substance discharged from the discharge unit.

In the present invention, the administration substance is a semi-fluid nutrient, and the discharge part is connected to the catheter via a tube. In this case, a desired amount of semi-fluid nutrient can be supplied to the stomach and other gastrointestinal tracts via a catheter, and the nutrients flow back from the gastrointestinal tract to the esophagus. Since it can be prevented by using, it is possible to prevent inflammation of organs such as the esophagus, trachea and lungs.

  In addition, the method for controlling a fluid administration device according to the present invention includes the step of (a) pressurizing the inside of an airtight injection container body containing a fluid administration substance hardened to a viscosity of 50 mPa · s to 6500 mPa · s. And (b) a step of monitoring the pressure in the injection container body using the pressure sensor, and (c) based on the monitoring result of the pressure in the injection container body, feedback control is performed through the controller to control the inside of the injection container body. And (d) from the discharge part provided in communication with the bottom part in the injection container main body to be input / held to the control device via the tube device connected to the discharge part. And (e) the injection container body is cylindrical, with a step of guiding the administration substance in the container to the outside while adjusting the outflow amount from the discharge part and the supply speed based on the viscosity data of the administration substance and feedback control. And the top A lid member that is airtightly fixable, and the pressurizing means further includes a leak device that supplies pressurized gas to the upper part of the injection container body, and (f) releases the pressurized gas in the injection container body. g) The administered substance is a nutrient, and the discharge part is connected to the catheter via a tube.

  According to the control method of the fluid administration device, the inside of the airtight injection container main body is pressurized to a predetermined level or higher, so that even if the dosage material has a certain viscosity or more, the dosage material is delivered at a desired flow rate from the discharge part. Can be discharged. That is, regardless of the viscosity of the administration substance, the administration substance can be supplied to the stomach and other digestive tracts at an arbitrary flow rate. In particular, when the administration substance has a certain viscosity or more as described above, the administration substance introduced into the stomach or other digestive tract via the catheter or the like from the discharge part is suppressed in fluidity due to its viscosity, Prevents backflow from other digestive tracts to the esophagus.

  Hereinafter, a fluid administration device according to an embodiment of the present invention will be described with reference to the drawings.

[First Embodiment]
FIG. 1 is a schematic diagram illustrating the structure of the fluid administration device of the present embodiment. The fluid administration device 10 includes an injection container body 20, a pressurizing device 30, a pressure gauge 40, a discharge unit 50, and a supply tube 60.

Here, the injection container body 20 includes a glass jar part 21 that is a cylindrical container and a steel lid part 23 for hermetic sealing. The former glass bowl part 21 is a transparent glass container similar to a beaker, and a measuring memory 21a is formed on a side surface. The bottom 21c of the glass bowl 21 is formed flat, so that the injection container body 20 can be placed on a table in a stable state. In addition, in order to avoid the photolysis of the content, the glass jar part 21 can also be colored. On the other hand, the latter steel lid portion 23 has an opening member 23a erected at the center upper portion, and pressurized air can be fed into the injection container main body 20 by the opening member 23a. Moreover, the steel lid part 23 is a detachable lid member, and by removing the steel lid part 23, it is possible to fill the glass collar part 21 with the nutrient NS in the amount and ingredients necessary for treatment and care. . As shown in FIG. 2, the steel lid portion 23 has an internal thread portion 23 t that engages with an external thread portion 21 s formed on the outer periphery of the upper portion of the glass flange portion 21, and the steel lid portion 23 is made of glass. When screwed to the collar portion 21, the seal member 23u is interposed so that the internal space formed by the glass collar portion 21 and the steel lid portion 23 can be kept airtight and pressurized. .

The nutrient NS to be introduced into the injection container body 20 is a fluid that has been hardened to an appropriate viscosity, and once this is administered to the patient's stomach or the like, it is prevented from flowing back from the stomach to the esophagus or the like. . Thereby, it is possible to prevent organs such as the esophagus, trachea, and lungs from being inflamed by the acidic nutrient NS that has flowed back from the stomach to the esophagus and the like, and thereby causing infections such as pneumonia. The viscosity of the nutrient NS can be set according to the purpose in a wide range from a liquid with a high viscosity to a semi-fluid close to a solid, for example, a viscosity range of about 50 to 6500 ( mPa · s ). However, it is determined individually while monitoring the state of the digestive tract of the subject patient.

  The pressurizing device 30 includes a squeeze valve 31 that is a manual pump. Although not shown in the drawing, a valve dedicated to air intake is formed at the rear end of the squeeze valve 31. That is, the user who is a doctor, a nurse, or the like repeats the operation of grasping or releasing the squeeze valve 31, whereby the pressurized air can be sent to the distal end side of the squeeze valve 31. A squeeze valve 31 is connected with a leak valve 32 for releasing air as a leak device, and a knob 36 is provided on a side surface of the tubular fitting 32 a of the leak valve 32. By rotating the knob 36, the inside of the leak valve 32, the inside of the squeeze valve 31, etc. can be opened to the outside air. Moreover, the front-end | tip part 32c of the tubular metal fitting 32a of the leak valve 32 can connect the end of the pressure tube 33 which is a resin pipe which has pressure resistance airtightly. The distal end portion 32c of the tubular fitting 32a has annular projections having a sawtooth cross section at the outer periphery thereof at a plurality of positions in the axial direction to prevent the pressure tube 33 from dropping off. The distal end side of the pressure tube 33 is airtightly connected to a metal L-shaped tube 34 connected to an opening member 23 a provided in the upper center of the steel lid 23, and the pressurizing device 30 is provided inside the injection container main body 20. The pressurized air from can be supplied. Note that the distal end portion 34c of the L-shaped tube 34 has annular protrusions having a sawtooth cross-section at the outer periphery thereof at a plurality of positions in the axial direction, and prevents the pressure tube 33 from dropping off. The squeeze valve 31, the pressure tube 33, the L-shaped tube 34 and the like described above function as a pressurizing unit that pressurizes the inside of the injection container body 20 to a predetermined level or more.

  The pressure gauge 40 is connected and fixed to the L-shaped tube 34 of the pressurizing device 30 as a pressure sensor, and detects the pressure in the pressure tube 33 and the L-shaped tube 34, that is, the pressure in the injection container body 20. be able to. As described above, when the user operates the squeeze valve 31, the pressurized air is guided into the injection container body 20 via the pressure tube 33 and the L-shaped tube 34. At this time, the user can monitor the pressure in the injection container main body 20 with the pressure gauge 4, so that the amount of pressurized air fed by the pressurizing device 30 can be adjusted while visually judging.

  The discharge part 50 is a comparatively thin annular member, and is erected so as to extend to the outside from an opening 21 f formed on the side surface of the bottom part 21 c of the glass bottle part 21. The distal end portion 51 of the discharge unit 50 is for liquid-tightly connecting the base side of the supply tube 60 to the glass bottle portion 21. The tip 51 has annular projections having a sawtooth cross section at the outer periphery thereof at a plurality of positions in the axial direction, and prevents the supply tube 60 from falling off.

  The supply tube 60 is a flexible resin pipe and has an appropriate inner diameter in consideration of the supply amount and viscosity of the nutrient NS. The distal end of the supply tube 60 is fluid-tightly connected to the catheter 64 via the joint 63. The catheter 64 is inserted, for example, from the patient's nostril and extends to the stomach and intestine. In addition, by changing the shape and size of the catheter 64, the nutrient NS can be administered to the patient not by the nasal route but by the transgastric route or the enteral route. A pinch clip 65 is attached to an appropriate portion of the supply tube 60. By attaching / detaching the clip 65, the passage of the nutrient NS in the supply tube 60 can be turned ON / OFF, and administration of the nutrient NS can be started at an appropriate timing in the patient's digestive tract.

  Hereinafter, the administration of the nutrient NS using the fluid administration device 10 of FIG. 1 will be described. First, the clip 65 is stopped and the flow path in the supply tube 60 is closed. Next, the steel lid part 23 of the injection container main body 20 is removed, and the nutrient NS is poured into the glass bowl part 21. At this time, the filling amount of the nutrient NS can be adjusted by using the measuring memory 21a. Thereafter, the steel lid portion 23 is fixed again to keep the inside of the injection container body 20 airtight. Next, pressurized air is supplied into the injection container body 20 by operating the squeeze valve 31 while monitoring the pressure in the injection container body 20 with the pressure gauge 40. The pressure in the injection container body 20 is such that the nutrient NS can be discharged from the distal end of the catheter 64 through the supply tube 60 at a desired supply rate or higher. Moreover, the pressure in the injection container main body 20 shall be a grade which the discharge flow rate of the nutrient NS does not become excessive. Next, the clip 65 is removed and the supply tube 60 is circulated. Thereby, the nutrient NS can be administered from the distal end of the catheter 64 into the stomach or intestine. When the pressure in the injection container main body 20 falls, the inside of the injection container main body 20 is pressurized by further operating the squeeze valve 31, and the supply speed of the nutrient NS is adjusted. When administration of the necessary amount of the nutrient NS is completed, the supply of the nutrient tube NS is stopped with the clip 65 sandwiching the supply tube 60. Note that if it is determined from the state of the patient or the like that the discharge flow rate of the nutrient NS is excessive, for example, the leak valve 32 is opened and the air in the injection container body 20 is vented. Thereby, discharge of nutrient NS can be interrupted immediately.

[Second Embodiment]
FIG. 3 is a schematic diagram illustrating the structure of the fluid administration device according to the second embodiment. The fluid administration device of this embodiment is a modification of the fluid administration device 10 of the first embodiment shown in FIG. 1, and the same parts are denoted by the same reference numerals. In addition, parts that are not particularly described are the same as those in the first embodiment.

  The fluid administration device 110 includes an injection container main body 20, a pressurizing device 130, a pressure sensor 140, a discharge unit 50, a tube device 160, and a control device 170.

  The pressurizing device 130 includes an electric compressor 131, a pressure tube 33, and an L-shaped tube 34. Here, the compressor 131 operates based on an instruction from the control device 170, and can maintain the inside of the injection container body 20 at a desired atmospheric pressure via the pressure tube 33 and the like. The compressor 131 has a safety device and can urgently leak the compressed air in the pressure tube 33 and the injection container body 20 to return the inside of the injection container body 20 to atmospheric pressure.

  The pressure sensor 140 is attached to the L-shaped tube 34 of the pressurizing device 130. The pressure sensor 140 outputs a detection result to the control device 170 and enables feedback control for maintaining the inside of the injection container body 20 at a target atmospheric pressure state.

  The tube device 160 is provided with an open / close valve 167 on the base side of the supply tube 60. The on-off valve 167 operates based on an instruction from the control device 170 and adjusts the flow state in the supply tube 60. Thereby, the nutrient NS can be discharged from the distal end of the catheter 64 at a desired supply rate regardless of the pressure in the injection container body 20.

  The control device 170 can input and hold data such as the type, viscosity, patient's medical condition, and characteristics of the nutrient NS to be introduced into the injection container body 20, and the pressurizing device can be controlled by feedback control using the pressure sensor 140. Via the valve 130 and the opening / closing valve 167, the supply speed of the nutrient NS discharged from the distal end of the catheter 64 can be set and maintained in an intended state.

[Third Embodiment]
FIG. 4 is a schematic diagram for explaining a part of the fluid administration device of the third embodiment. The fluid administration device of this embodiment is a modification of the fluid administration device 110 of the second embodiment shown in FIG. Parts that are not specifically described are the same as those in the second embodiment.

  The portion of the fluid administration device shown in the figure is a pressure injection device 290 in which an injection container main body 220 and a pressure device 230 are integrated.

  The injection container main body 220 includes a glass bowl portion 21, a steel lid portion 223, and a piston plate 225. The steel lid portion 223 has an opening 223 a and passes through a rod 237 extending from the upper surface of the piston plate 225. On the other hand, the piston plate 225 is supported by the rod 237 and smoothly slides up and down on the inner surface of the glass flange 21. At this time, the outer periphery of the piston plate 225 and the inner surface of the glass flange 21 are kept airtight, and the internal space formed by the glass flange 21 and the piston plate 225 can be kept airtight and pressurized. ing.

  The pressurizing device 230 includes a cylinder type actuator 238 and a rod 237 extending from the actuator 238. The actuator 238 operates based on an instruction from the control device 170 shown in FIG. 3, and can discharge the nutrient NS at a desired supply speed from the distal end of the catheter 64 shown in FIG. 3 by controlling the extrusion amount of the rod 237. it can. Accordingly, the pressure sensor 140 and the opening / closing valve 167 shown in FIG. 3 are not used. That is, due to the lowering of the piston plate 225, the nutrient NS in the glass bowl 21 is pushed out to the discharge unit 50 and discharged to the supply tube 60.

  The piston plate 225 can be provided with a check valve (not shown). In this case, when the piston plate 225 is moved downward in the glass flange 21, the check valve is closed and the atmospheric pressure in the injection container main body 220 is maintained. On the other hand, when the piston plate 225 is moved upward in the glass flange 21, the check valve is opened and external air can be guided to the internal space formed by the glass flange 21 and the piston plate 225. . The piston plate 225 can also be formed with ventilation means such as a leak valve. When such a leak valve is operated when the steel lid 223 is attached to the glass flange 21 together with the actuator 238, the work of attaching the steel lid 223 and the like is facilitated.

[Fourth Embodiment]
FIG. 5 is a schematic diagram for explaining a part of the fluid administration device of the fourth embodiment. The fluid administration device of this embodiment is a modification of the fluid administration device of the third embodiment shown in FIG. 4 with respect to the injection container body 220, the pressurization device 230, and the like. Parts that are not particularly described are the same as those in the third embodiment.

  The portion of the fluid administration device shown in the figure is a pressure injection device 390 and includes a storage pack 320 and a pressure device 330.

  The storage pack 320 is an infusion pack or other deformable liquid-tight pack for storing nutrients, and such a liquid-tight pack also corresponds to the concept of the injection container body. A discharge part 350 for discharging nutrients in the storage pack 320 is attached to a part of the storage pack 320. Nutrients discharged from the discharge unit 350 are discharged from a catheter tip (not shown) via the supply tube 60.

  The pressure device 330 includes a cylinder type actuator 238, a rod 237 extending from the actuator 238, a pressure plate 335 fixed to the tip of the rod 237, and a cross-sectional core that supports the actuator 238 and sets the storage pack 320. And a character-shaped holding member 336. The actuator 238 operates based on an instruction of the control device 170 in FIG. 3, and adjusts the distance between the lower surface of the pressure plate 335 and the upper surface of the bottom of the holding member 336 by controlling the amount of extrusion of the rod 237. Thereby, nutrient NS can be discharged from the front-end | tip of the catheter 64 of FIG. 3 with a desired supply rate. Although not shown, the supply tube 60 may be provided with an open / close valve 167 similar to that shown in FIG. With this open / close valve, the flow state in the supply tube 60 can be adjusted, and nutrients can be discharged from the catheter tip at a desired supply rate.

  Although the present invention has been described based on the above embodiments, the present invention is not limited to the above embodiments. For example, in the above-described embodiment, the case where the nutrient NS is administered by the fluid administration devices 10 and 110 has been described. However, the fluid administered by the fluid administration devices 10 and 110 is not limited to a nutrient or the like, and is a favorite food. , Medicines and the like.

It is the schematic explaining the structure of the fluid administration apparatus which concerns on 1st Embodiment. It is sectional drawing to which a part of fluid administration apparatus of FIG. 1 was expanded. It is the schematic explaining the structure of the fluid administration apparatus which concerns on 2nd Embodiment. It is sectional drawing explaining a part of fluid administration apparatus concerning 3rd Embodiment. It is sectional drawing explaining a part of fluid administration apparatus concerning 4th Embodiment.

Explanation of symbols

  DESCRIPTION OF SYMBOLS 10 ... Fluid administration apparatus, 20 ... Injection container main body, 21 ... Glass bottle part, 21a ... Memory, 21f ... Opening, 23 ... Steel lid part, 23a ... Opening member, 30 ... Pressurization apparatus, 31 ... Squeeze valve, 32 ... Leak valve, 33 ... Pressure tube, 40 ... Pressure gauge, 50 ... Discharge part, 60 ... Supply tube, 63 ... Joint, 64 ... Catheter, 65 ... Clip

Claims (2)

An airtight injection container main body containing an administration substance having fluidity that has been hardened to a viscosity of 50 mPa · s to 6500 mPa · s ;
Pressurizing means for pressurizing the inside of the injection container body to a predetermined level or more;
A discharge part which is provided so as to avoid interference with the pressurizing means in communication with the bottom part in the injection container body, and serves as a path for discharging the administration substance in the injection container body to the outside;
A pressure sensor for monitoring the pressure in the injection container body;
The data for viscosity housed said substance administered in infusion container body, and a feedback control of the operation of based rather said pressurizing means to the output of the pressure sensor, a control device for controlling the feed rate of the substance administered It equipped with a door,
The control device adjusts the outflow amount from the discharge unit via a tube device connected to the discharge unit,
The injection container body is cylindrical and has a lid member that can be airtightly fixed to the upper part, and the pressurizing means supplies pressurized gas to the upper part of the injection container body,
Further comprising a leak device for releasing the pressurized gas in the injection container body,
The fluid administration apparatus, wherein the administration substance is a nutrient, and the discharge part is connected to a catheter via a tube . Pressurizing the inside of an airtight injection container body containing a fluid administration substance hardened to a viscosity of 50 mPa · s to 6500 mPa · s ;
Monitoring the pressure in the injection container body using a pressure sensor;
Based on the monitoring result of the pressure in the injection container body, pressurizing the injection container body to a predetermined level or more by feedback control via a control device ;
From the discharge part provided in communication with the bottom part in the injection container main body, via the tube device connected to the discharge part, the viscosity data of the administration substance input and held in the control device and the feedback And adjusting the flow rate and supply speed from the discharge unit based on the control and guiding the administration substance in the container to the outside,
The injection container body is cylindrical and has a lid member that can be airtightly fixed to the upper part, and the pressurizing means supplies pressurized gas to the upper part of the injection container body,
Further comprising a leak device for releasing the pressurized gas in the injection container body,
The substances administered are nutrients, the discharge unit, the control method of the fluid delivery device that is connected to the catheter through a tube.

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