RU2122344C1 - Method of breathing function remote examination and device for its embodiment - Google Patents

Abstract

FIELD: remote examination of breathing function in electromagnetic field. SUBSTANCE: person being examined is placed in magnetic field space. Parameters of this field are measured by means of sensor matrix. Calibration procedure is performed with breathing delayed or in mode of quiet breathing. Tables of field parameter dependence from sensor matrix displacement are formed for every sensor. Volume of sensor, total volume of group of sensors and entire combination of sensors are calculated. In measuring mode, sensor matrix is installed in calibration space, and man's volume variation is recorded in process of examination in modes of vital lung capacity, forced vital lung capacity, minute volume of breathing, and maximum ventilation of lungs. EFFECT: recording of main spirometric indices of man's external breathing function, separate estimation of function of right- and left-hand lungs. 3 cl, 7 dwg

Description

 The invention relates to the field of medical technology, in particular to a remote study of respiratory function in an electromagnetic field that is harmless to humans, recording changes in volumes during breathing, pulse, peristalsis.

 The aim of this invention is the registration of the main spirometric indicators of the function of the external respiration of a person, the construction of the flow-volume curve of the FVC, estimation of the function of the right and left lung separately, analysis of the contribution of the upper, middle and lower parts to the act of breathing.

 It is known that the main method for studying the ventilation function of the lungs is spirometry, which allows you to objectively evaluate the vital capacity of the lungs (VC), minute volume of respiration (MOD), forced volumes (FVC, OFV1, MVL, RD) [1].

 Measure the speed of the air flow during forced inspiration, the values of PIC, MOS25, MOS50, MOS75, to build a flow curve - the volume allows the pneumotachometric method.

 A decrease in the functional activity of the respiratory muscles, discoordination of thoraco-abdominal movements can be recorded by the method of magnetometry (flat electrodes adhere to the skin) [2].

 The founder of the non-contact method of rheoplethysmography is M. Cremer (1907), who studied the mechanical activity of the heart by placing it in the capacitor field [3].

 The closest in technical essence is the method of E. Atzler and C. Lehmann (1932), which remotely (non-contact) recorded fluctuations in the volume of the heart when changing its blood supply [4].

 The authors of the prototype method managed to quantify the magnitude of the dielectrogram in units of liquid volume [4].

 The known method does not allow you to remotely measure the volume of the body in the process of breathing, to register the main spirometric parameters of the function of external respiration of a person, as well as to fully register biomechanics in a limited area, in the region of the human heart.

 The hypothesis about the possibility of representing the formulas of the parameters of the space of the electromagnetic field in which the body is located is not confirmed by practice, since all field parameters are random variables and depend on a number of random factors. The data obtained using the prototype method are presented only in relative units of the projection of the body on the plane.

 The technical result of the invention is the ability to register and measure the pulsation of the volume during breathing-pulse. The result is ensured due to the fact that a preliminary calibration procedure is carried out for each patient, which provides measurement, analysis of the parameters of the measured space in parallel layers (in three dimensions X, Y, Z) and serves to build a table for converting the measurement mode data into digital volume units.

The proposed method for studying the function of respiration-pulse is as follows. The subject is located in the electromagnetic field of the meter range in a medical chair in a sitting position, using the screen with a matrix of sensors (MD), field parameters are measured. The number of sensors located in the MD screen is n, where n is 64, 128, 256. When the upper and lower extremities are stationary, respectively located on the armrests and footrest of the chair, changes in the volume of the chest and abdomen cause modulation of the electromagnetic field parameters. The screen is installed in the space (X, Y, Z) so that the i-th sensor of the screen records the maximum contribution of the respiration-pulse biomechanics of the corresponding i-th surface area of the studied body (X _i , Y _i , Z _i ), where i - 1. ... n, in the measured space. Measurements are performed by the screen of MD sensors from a distance of at least L (cm) to the most protruding zone of the front wall of the body. The signal F (i, t) (the signal of the i-th sensor after demodulation, filtering and processing) is a function of time, displays the biomechanics of the i-th zone and depends on the hardware setting for measuring breathing, heart rate or peristalsis. For a given moment in time, t - F (i) = f _i (z) = k _i • C _i (z), where f _i (z) is the function of moving the ith zone along the Z coordinate (mm) and corresponds to the front-back chest movement, k _{i is the} hardware constant of the i-th sensor. Having checked the assumption that in the general case C _i (z) = A _i exp (B _i (z)), it is easy to verify that the parameters C _i (z), A _i , B _i (z) are random variables, depending on the form biological bodies and can only be obtained experimentally for a specific individual.

см, полагаем, что площади измерения, перекрываемые каждым датчиком, равны между собой, s_i = x_iy_i-const, вычисляем

Vp - введенная поправка, z_i(t) - текущая величина перемещения в см [6]. С помощью величины Vp учитываются показатели окружности грудной клетки и ее движение в боковых направлениях, Vp = k•V(t), k - коэффициент пропорциональности.For each subject, a calibration procedure is preliminarily performed, which provides measurement in parallel layers of X, Y, Z _i - X, Y, Z _k - X, Y, Z _m , space and filling in table P, with a step Δz equal to 2.4. .. 10 mm, where k = 1, ..., m. The procedure is carried out with holding the breath, or in the mode of calm breathing, and is carried out by the method of stepwise parallel movement of the screen along the Z coordinate in the measured space. For each zone, we obtain the dependence of the measured field parameter P (i, k) on Z _k , build a table P, where Z _m = Δz • m = 100 mm. Using the data of table P and mathematical interpolation methods, it is not difficult to convert the quantity F (i) into a value of length Z _k [5]. In the measurement mode, the discrete values F (i, t) are translated into digital values Z _k , the conversion can be carried out in real time. The design and dimensions of the MD screen are selected from the condition of complete overlap of the front wall of the chest and abdomen using n-sensors EMD for the examined population. Volume V (t) of the measured body

see, we assume that the measurement areas covered by each sensor are equal to each other, s _i = x _i y _i -const, we calculate

Vp is the introduced correction, z _i (t) is the current displacement in cm [6]. Using the value of Vp, the circumference of the chest and its movement in the lateral directions are taken into account, Vp = k • V (t), k is the proportionality coefficient.

The extrapolation of digital values v _i (t) to the values of regional pulmonary volumes made it possible to use the proposed method for registering MOD, VC, FVC, MVL, etc., comparing the obtained data with the proper values and determining the degree of insufficiency of pulmonary ventilation.

 A survey of a group of patients of both sexes aged 15 to 75 years with a diagnosis of norm - pathology was conducted, the measurement data were compared with the values of traditional spirometry. The analysis confirmed the comparability, repeatability and reproducibility of the survey results. The error of fluctuations in the values of MOD, VC, FVC, FEV1, MVL from the average statistical and the deviation of the received digital data from the values taken as a standard corresponded to the standards adopted in spirometry and tachometry.

Examination files for each patient are stored in a database and can be represented as:
1) spirometric curves, tables of values of MOD, VC, VF, VFV, OFV1, MVL, corresponding due values and gradation of the degree of deviation from the norm; indicators VC, FVC for the right and left lung separately, histograms of the upper, middle and lower sections of each lung;
2) a dynamic map of the correlation of regional respiration zones;
3) a sequence of static maps of the propagation of the respiratory wave for the selected interval inspiration - exit;
4) breathing schedules in selected regional zones.

 The subject examined with remote spirometry breathes in a natural atmosphere, the nose clip and mouthpiece are not used. The data displayed on the screen of the monitor enables the operator to control the procedure for recording a breath sample in more detail during the study of the respiratory function, which makes it possible to select the most informative cycle for processing.

 The analysis of the data of radiography, spirometry, radioisotope methods, the clinic of the disease, and the data of the remote method for examining the respiratory function allowed us to obtain an algorithm for converting the data of the pathological lag of the “sick” half of the chest during breathing into a corresponding decrease in the indices of the right or left lung of the patient, which makes it possible to supplement the spirometric data with volumes of the right and the left lung separately, evaluate the contribution of the upper, middle and lower parts of both lungs using histograms and dyne cardiac respiration, register the degree of deviation from the norm and the location of the pathological process.

 In FIG. 1 norm-pathology is presented by tables, spirometric curves and histograms of the upper, middle and lower sections.

 In FIG. 2 - graphs in selected zones, pathology-type of Cheyne-Stokes breathing after inhalation.

 In FIG. 3 - tabular survey data normal, correlation map of the sample VC, interval inspiration-expiration.

 In FIG. 4 - table of the test of VC of four patients, norm-pathology.

 In FIG. 5 - graphs of the gel-norm in the selected areas and the flow-volume curve of the patient with impaired bronchial conduction.

 In FIG. 6 - map of wave propagation test ZHEL-norm.

 In FIG. 7 is a map of the propagation of a wave of VC-sharp pathology.

 The device with which the proposed method is implemented consists of an RF generator 1, a medical chair 2a, an MD 3 screen, an ADC / DAC converter 10, an IBM 11 computer with a set of software and a guidance system 12. The design of a medical chair 2a provides maximum relaxation of the front muscles walls of the chest and abdomen of the subject 2b, fixation of the position of the upper and lower extremities. The MD 3 screen contains a matrix of respiratory sensors 4, a communication channel with a computer, which includes a block of detectors 5, a multiplexer 6, an amplifier for channel 7, a phase-locked loop 8, a communication cable 9.

 The guidance system 12 consists of a control unit 13, coordinating the operation of the system 12 and receiving signals from the output of the DAC 10, a lift 14, moving the screen in the vertical plane Y, corrector 15, ensuring the symmetry of the position of the screen relative to the right and left halves of the chest 2b in X coordinate, the anchor node as part of the screw 16 and stepper motors 17, moving the screen MD 3 along the Z coordinate, a group of sensors 18 that control the position of the motors.

 The device operates as follows. The subject 2b is located in the space of the electromagnetic field, the source of which is a high-frequency generator with a radiating plate 1, in a medical chair 2a in a sitting position. The patient relaxes, relieves stress, gets used to the pose. The MD 3 screen is installed using the elevator 14, the corrector 15, the screw motor 16 and the stepper motor 17 during the installation procedure and is carried out in manual or automatic mode under the control of signals from the output of the DAC of the converter 10 to the input of the control unit 13 of the guidance system. Measurements are performed by the MD 3 sensors screen from a distance of at least 3 - 10 cm to the most protruding zone of the front wall 2b. On the surface of the matrix of sensors 4, a relief is formed that has selective and filtering properties, the parameters of which depend on the height, sex, weight and constitution of the subject 2b. The signal from the i-th sensor 4 after demodulation and filtering using the block of detectors 5 is fed to the multiplexer type n-1 6, from the output of the multiplexer to the input of the amplifier 7 of the channel. The sampling frequency supplied to the control input of the multiplexer is set by the generator of the known phase-locked loop PLL 8, the reference PLL is the network frequency - 50 Hz. Using the PLL, network interference and interference are compensated for the communication channel 9. Analog signals from the channel output are fed to the input of the ADC of the converter 10 with a conversion frequency of at least 100 kHz, from the output of which they are fed to the input of the IBM-PC [7].

 The measurement of VC, FVC, MOD, MVL is carried out by analogy with the known methods of traditional spirometry in the S1p position. The calibration procedure is carried out, as a rule, in a time interval of T seconds and is performed by discrete movement of the stepper motor 17 of the position S11 to S1k, where S11 - S1k is the range of discrete values of the stepper motor (70 - 100 mm), T = 10 - 30 s.

 The software consists of software modules that implement the relevant steps of collecting, processing, displaying and documenting patient examination data.

The use of the proposed device for a functional assessment of the operability and inoperability of patients with lung diseases:
assessment of the optimal type of breathing for a given clinical form of the disease;
assessment of drug sensitivity and selection of the optimal drug for the patient;
for breathing exercises and for scientific research;
in functional diagnostics rooms, in the departments of thoracic surgery and pulmonology of multidisciplinary hospitals, in rehabilitation centers, in sanatoriums, and in other specialized medical institutions.

Sources of information
1. Handbook of functional diagnostics. Ed. I.A. Kassirsky M., Medicine, 1980.

 2. Current problems of the clinical physiology of respiration, Leningrad, Institute of Pulmonology, 1989.

 3. Impedance reoplethysmography, M.I. Gurevich, A.I. Soloviev, Kiev: Naukova Dumka, 1982, p. 7, 172.

 4. Arbeitsphysiologie, 1932, 5, N 6, S. 636-681, Atzler F., Lehmann C. Uber eine neues Verfahren zur Darstellung der Herztatigkeit (Dielectrographie).

 5. V.P. Dyakonov, Reference to algorithms and computer programs, M., Science, 1989, p. 78-83.

 6. M. Ya. Vygodsky, Handbook of Higher Mathematics M., Science, 1969, p. 489.

 7. Reference design of discrete devices on IS G.I. Pukhalsky, M., Radio and Communications, 1990, p. 270.

Claims (3)

1. A method for remote study of the respiratory function, namely, that the subject is placed in the space of an electromagnetic field and the parameters of this field are measured using sensors, characterized in that the measurements are carried out using a sensor matrix, the dimensions and number of sensors of which (n = 64, 128, 256) are selected from the condition of complete overlap of the studied surface of the body, chest and abdomen, in the coordinate system X, Y, Z in the X, Y plane, the sensor matrix is installed along the Z axis at a distance of at least L = 3 - 10 cm to the anterior of the body wall, when the patient is holding his breath or in the mode of calm breathing, the procedure is performed to calibrate the field under study by measuring the parameters P (i, k) during the n-fold stepwise parallel movement of the sensor matrix along the Z axis in increments of ΔZ; P (i, k) from the displacement Z to for each sensor of the matrix to determine the magnitude of the displacement of the body surface Z _k , using the interpolation methods, the sensor volume V _i = S _i • Z ₁ = S ₁ • Z _k , total volume groups sensors

or the whole set of sensors V _n = ΣV _l (l = 1, ... n), taking into account the fact that the projection area of the i-th sensor is constant S _i = X _i • Y _i - const, in the measurement mode the sensor matrix is set to Z _p + Z _{S of the} calibration space and using a device for remote research of respiratory function, a change in the human volume V _n (t) is recorded during the examination of the patient in the modes of vital capacity (VC), formed vital capacity (FVC), minute volume respiration (MOD), maximum lung ventilation (MVL). 2. The method according to claim 1, characterized in that spirometric indicators of the human respiration function are recorded as a result of extrapolation of the value of measuring the volume of the surface of the body V _n (t), the value of pulmonary volumes V _l (t), the parameters of lung capacity VC, minute respiratory volume (MOD), forced volumes of FVC, OFVI, MVL, as well as additional spirometric data on the volumes of the upper, middle and lower parts of both lungs, using the histograms and breathing cards, record the degree of deviation neniya from the norm, and the place of localization of the pathological process.  3. A device for remote study of the respiratory function, containing a high-frequency generator with a radiating plate, and a registration unit, characterized in that it contains a matrix of sensors in the amount of 64, 128 and 256 sensors, a detector unit, a multiplexer, a channel amplifier, a phase-locked loop the PLL frequency, which minimizes external interference, the ADC / DAC converter, the guidance system for performing the calibration procedure and setting the sensor matrix to the operating position, the sensor matrix through the demodulator and bl the detectors are connected to the multiplexer, the control input of which is connected to the PLL output, the multiplexer outputs are connected to the input of the channel amplifier, the outputs of which are connected to the ADC / DAC inputs of the converter, and the guidance system consists of a control unit (BU), a lift, an corrector, a binding unit, and sensors monitoring the state, and the output of the ADC / DAC of the converter is connected to the inputs of the control unit.

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