JPH055508B2 - - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION (Field of Industrial Application) The present invention relates to a ventilator that is provided with auxiliary functions for inhalation and exhalation for a patient.

(Prior Art) Conventionally, mechanical ventilation methods for patients with respiratory failure include inserting a tube into the trachea through the nostrils, etc., and forcibly applying positive air pressure intermittently through the tube. Positive internal pressure artificial respiration is commonly used. However, this method
While it is excellent for unconscious patients to open the airway and suction out endotracheal secretions, for conscious patients the presence of a tube in the airway can be extremely painful and, therefore, analgesia is sometimes required. There are problems such as the need for drugs, muscle relaxants, and the inability to ingest or talk.

In order to relieve patients from such pain and inconvenience,
Recently, an extrathoracic negative pressure artificial respiration method has been developed and is now in clinical use. In this artificial respiration method, the thorax is surrounded by a highly rigid shell, the human body including the shell is covered with an airtight jacket, and the pressure is reduced by suctioning air through the intake hole leading to the inside of the shell, and the pressure is returned to normal pressure by the inflow of air. By repeatedly applying negative pressure to the outside of the thorax, the thorax is expanded intermittently, allowing the patient to inhale in the same way as natural breathing.

(Problems to be Solved by the Invention) The above-mentioned extrathoracic negative pressure artificial respiration method has been recognized for its effectiveness and has been used clinically, but there are some cases in which the effect is not significant. Among these, an example in which hypoventilation cannot be improved is seen in patients with end-stage muscular dystrophy. This may be due to failure of chest reduction function due to exhaustion of muscle contraction force. In this example, even if negative pressure is applied outside the thorax to expand the thorax and allow air into the lungs, the pressure is returned to normal and expiration is performed by the elasticity of the respiratory muscles, but there is no muscle contraction force, so sufficient exhalation is not possible. In this case, it is not possible to obtain

Therefore, it is an object of the present invention to solve such problems.

(Means for Solving the Problems) The problem of the present invention is to solve the above problems by using a pressure band that includes a flexible tube having an air inlet/outlet and that wraps around the upper body and ties both ends together. a high-rigidity shell with open ends that surrounds the thorax at a distance from the outside of the compression band; an airtight jacket that wraps around the human body from above the shell; and a positive pressure inside the compression band. A first means comprising: an air pressure control device that alternately applies and releases negative pressure within the shell;
Or, the means described in claim 2, in which the pressure band is divided into upper and lower stages extending from the chest to the abdomen, and the pressure is applied sequentially from the lower stage is added to claim 1. This problem is solved by means 2.

(Function) According to the first means, compressed air is supplied to the pressurizing tube to apply positive pressure to the outer surface of the upper body, thereby compressing the upper body to assist exhalation, and then releasing the positive pressure. After that, negative pressure is applied inside the shell to expand the thorax and assist in breathing. Furthermore, according to the second means, the area from the abdominal cavity to the thoracic cavity is compressed in stages during exhalation, so exhalation can be easily performed. Inhalation assistance is performed in the same manner as in the first method.

(Example) Hereinafter, an example of the present invention will be described with reference to the drawings. In Fig. 1, A is a patient, 1 is a pressure band wrapped around the patient's upper body, that is, from the abdomen to the chest, 2 is a shell that surrounds patient A's thorax from the outside of the pressure band 1, and 3 is a It is an airtight jacket that airtightly surrounds the body of patient A from the neck to the knees from the outside of the shell 2, 4 is a positive pressure hose group consisting of three sets of hoses that supply positive pressure into the pressure band, and 5 is a shell A decompression hose 6 is used to apply negative pressure to the interior of 2, and 6 is an air pressure control device that alternately applies the positive pressure and negative pressure.

As shown in FIG. 2, the pressure band 1 is in the shape of a cloak, and has surface-bonded velvet fasteners (for example, Magic Tape) attached to both ends of the cloth bag 7.
8 and 9 are sewn, and the middle part is divided into three upper and lower stages, into which rubber tubes 11, 12, and 13 are inserted and held, and each tube is provided with air inlets and outlets 11a, 12a, and 13a that extend outside the cloth bag 2. ing.
As shown in FIG. 3, this pressure band 1 is attached to patient A by placing the lower rubber tube 11 on the abdomen and the upper rubber tube 13 on the chest with the air inlets and outlets 11a, 12a... in the front. The positive pressure hoses 11b, 12 constituting the positive pressure hose group 4 are wrapped around the upper body, and the fasteners 8 and 9 are connected to each other on the back side.
b, 13b are connected through the airtight hole 14 of the airtight jacket 3. The shell 2 is shaped like kendo armor, as shown in Fig. 4, and is divided into two parts, a front shell 15 and a rear shell 16 made of highly rigid hard plastic, with buckles 17 and 17 on both sides.
The inner surface is lined with a urethane sponge 18 that softens the contact with the human body, the edges are attached with soft rubber tubes 19 and 20, and the upper edge is connected and separated with a buckle 22. A pair of shoulder suspension bands 21 are attached to the rear shell 16, and a stop band 23 is attached to the inside of the rear shell 16. At the front of the front shell 15, there is a joint 24 that passes through the jacket 3 and connects to the decompression hose 5.
A nut 25 is screwed into the joint 24 to connect the airtight jacket 3 in an airtight manner at the jacket penetrating portion.

It is sufficient for the airtight jacket 3 to airtightly surround the pressure band 1 and shell 2 from the outside, but as shown in FIG. One airtight sheet is folded at the upper side 26 and cut into a shape that can wrap the entire torso and part of the four limbs as the front cloth 27 and back cloth 28, and the upper side 26 is folded with elastic cord. Connecting the neck cover 29, which has many parts, the sides and inseam can be separated and connected with fasteners 30, 31, and the arms and legs are provided with bands 32, 33, which make it easy to put on and take off and maintain and release airtightness. A band 34 on the torso provides conformance to the body, but the band 34 is not critical. Velvet fasteners for coupling are provided at both ends of each band 32-34. A hole 35 is made in the chest of the front cloth 27, through which the joint 24 of the shell 2 is inserted from the inside, and the nut 25 is screwed from the outside, and the front cloth is compressed and sealed.

The air pressure control device 6 controls the pressure in the exhalation phase and the inspiratory phase, and controls the pressure in the expiration extrathoracic positive pressure generation section 3.
1 and an extrathoracic negative pressure generator 31 during inspiration. The positive pressure generating section 30 includes a high pressure circuit 32 connected to a high pressure air source through a joint 33, a filter 34, and a requilator 3.
5. Three air supply solenoid valves SV ₁ through the throttle valve 36,
SV ₂ and SV ₃ are connected in parallel, and exhalation valves EV ₁ , EV ₂ , and EV ₃ are connected in series with each air supply solenoid valve, and each exhalation valve EV ₁ , EV ₂ , and EV ₃ is connected to the inflow port 37 , respectively. It has an outflow port 38, and both ports 37, 38 are connected to the positive pressure hoses 11b, 12b, 1 of the positive pressure hose group 4.
3b, and each outflow port 38 is connected to an air vent circuit 39 on the outflow side at the exhaust position.

The opening and closing timings of the air supply solenoid valves SV ₁ , SV ₂ , and SV ₃ are controlled by timers T ₁ , T ₂ , and T ₃ of the controller C ₁ so that the opening times are delayed little by little. Also each exhalation valve EV ₁ ,
EV ₂ ... is controlled by the pneumatic pressure of a pneumatic circuit 40 branched from the high pressure circuit 32, and the pneumatic pressure is controlled by a solenoid valve for driving an exhalation valve via a circuit 41 in the control panel _C1 .
Can be switched with SV ₄ .

Next, the extrathoracic negative pressure generating section 31 during inspiration is the shell 2
The negative pressure pipe 45 communicates with the inside of the air via the joint 25 and joins the decompression hose 5 and the air vent circuit 39. A large blower 46 as a negative pressure source is connected to the terminal of the negative pressure pipe 43, and a flow rate adjustment valve 47, an intake reverse relief valve 48, and a negative pressure release reverse relief valve 49 are connected to the intermediate portion. The reverse relief valve 49 for negative pressure release is also controlled by the control panel _C2 , and the negative pressure pipe 45 is controlled by the intake/exhalation switching solenoid valve _SV5 controlled by the control panel _C2 .
The communication part with the main body is opened and closed.

The method of using this device is as follows. Patient A wears the pressure band 1, shell 2, and airtight jacket 3 in sequence as described above, and operates the air pressure control device 6 to automatically control the exhalation phase and the inhalation phase to occur alternately. During the exhalation phase, the control panel
C ₂ opens the inhalation/exhalation switching valve SV ₅ and the pressure inside the negative pressure pipe 45 reaches the pressure set by the negative pressure release reverse relief valve 49 , and then the control panel C ₁ opens the exhalation valve driving solenoid valve.
SV ₄ opens and inflow port 37 of exhalation valves EV ₁ to _{EV 3}
Switch the air supply solenoid valve so that it is in communication state, and then
SV ₁ to SV ₃ are sequentially opened by valve opening timers T ₁ to _{T 3} , and air is first supplied to the lower rubber tube 11 to compress the abdominal cavity with positive pressure, and after t ₁ second, air is supplied to the middle rubber tube 12. and compress the midway between the abdominal cavity and the thoracic cavity,
t After ₂ seconds, blow air into the upper rubber tube 13 to open the thoracic cavity.
Compress for t ₃ seconds and exhale for t ₁ + t ₂ + t ₃ = t seconds. During this exhalation, the exhalation switching solenoid valve SV ₅ is opened by the control panel C ₂ and the negative pressure release reverse relief valve 49 is opened.
is communicated with the negative pressure pipe 45 to reduce the negative pressure inside the airtight jacket 3 and shell 2 to the set pressure of the reverse relief valve 49.

After the elapse of t seconds, when the exhalation valve driving solenoid valve SV ₄ closes to reduce the pressure in the circuit 40, the exhalation valve EV ₁
~EV ₃ returns to the state shown, and rubber tube 11~
The air inside 13 is suctioned and discharged through the outflow port 38 and the air vent circuit 39 at the set pressure of the negative pressure release reverse relief valve 49, and is brought to a pressure close to normal pressure.

In the next intake phase, when the intake/exhalation switching valve SV ₅ is closed, a negative pressure is generated in the shell 2 up to the suction flow rate set by the flow rate control valve 47 and the maximum suction pressure set by the reverse relief valve 48, and at the same time, the rubber tube 11 ，
The insides of the shells 12 and 13 are also connected to the negative pressure pipe 45 through the outflow ports 38 of the exhalation valves EV ₁ to _{EV 3} , so that the pressure is the same as the negative pressure inside the shell 2. This results in a negative pressure outside the patient's thorax and abdomen, causing the thorax and abdomen to expand and draw air into the lungs. Next, when moving to the exhalation phase, the negative pressure release reverse relief valve 49 opens as described above, and the negative pressure in the shell 2 is released via the negative pressure pipe 45 and the pressure reduction hose 5, and then the pressure is released to the pressure band 1. Positive pressure is applied.

Artificial respiration is performed by repeating the above expiratory and inspiratory phases, but during the expiratory phase, timer T ₁
~ _T3 may be set to operate simultaneously to pressurize the rubber tubes 11 to 13 at the same time. In addition, instead of the pressure band consisting of three rubber tubes, a pressure band having one or two wide rubber tubes or a large number of rubber tubes may be used, and the high pressure circuit 33 and the negative pressure tube 45 may be replaced by a booster pump with replenishment, It is also possible to make changes such as connecting via a pressure accumulator or the like to form a closed circuit.

(Effects of the Invention) The present invention can support both exhalation and inhalation for patients, so it can be used for patients with weak muscle contraction force and impaired thoracic reduction function, such as patients with end-stage muscular dystrophy. It can have the effect of assisting breathing. Furthermore, since the shell is placed away from the patient's thorax, the expansion and contraction of the chest will not be hindered by the shell, and the shell and airtight jacket can be easily attached and detached, making it easy to use during preparation and during treatment. It has the effect of causing almost no suffering or inconvenience to the patient, and also has the effect of helping to save labor because no human power is required for the treatment.

[Brief explanation of drawings]

Fig. 1 is a perspective view showing the device of the present invention in use, Fig. 2 is a front view of the pressure band, Fig. 3 is also a mounting view, and Figs. FIG. 5 is a perspective view of the airtight jacket, and FIG. 6 is a circuit diagram of the air pressure control device. 1... Pressure band, 2... Shell, 3... Airtight jacket, 6... Air pressure control device. 11,1
2,13...Rubber tube.

Claims (1)

[Scope of Claims] 1. A pressure band incorporating a flexible tube with an air inlet/outlet, which is wrapped around the upper body and tied at both ends, and which surrounds the ribcage at a distance from the outside of the pressure band. A highly rigid shell with both ends open, an airtight jacket that wraps around the human body from above the shell, and applying and releasing positive pressure within the pressure band and applying and releasing negative pressure within the shell alternately. An extrathoracic negative pressure artificial respirator with an exhalation assist function, characterized in that it is equipped with a pneumatic pressure control device. 2. The extrathoracic negative pressure artificial respirator with an expiratory assist function according to claim 1, wherein the pressure band is divided into upper and lower stages extending from the chest to the abdomen, and the pressure is applied sequentially from the lower stage.