RU2631629C2 - Device for bronchopulmonary system diseases diagnosis - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: device for bronchopulmonary system diseases diagnosis contains a controlled high-frequency generator (3), an analog-to-digital converter (9), a control unit (4), a result recording and display unit (2), a generation and measurement unit (1), main (6), reference (7) and receiving (8) channels. In the generation and measurement unit (1), a microwave frequency synthesizer is used as the high-frequency generator (3), the first output of which is connected to the input of a power divider (5) to divide the power of the microwave signal between the main (6) and the reference (7) channel. The main channel (6) is formed by a power amplifier (12) and a transmitting antenna-applicator (13), the reference channel (7) - by an attenuator (15) and a gain meter (16), the receiving channel (8) - by the receiving antenna-applicators array (19), a multiplexing unit (18) and a power amplifier (17). The pressing sensors (14, 20) of the transmitting antenna-applicator (13) and the receiving antenna-applicators array (19) and the optical position sensor (11) of the transmitting antenna-applicator (13) are connected to the control unit (4) which is connected to a computer (21) by means of a data bus via an interface device (10).

EFFECT: determination of changes in the bronchopulmonary system and their localization in patients of all age groups, including children of early age, increased reliability, accuracy and informativeness of the survey results obtained.

4 cl, 1 dwg

Description

The present invention relates to medical equipment, and will find application in pulmonology, pediatrics, allergology and immunology and therapy.

Respiratory diseases are still an important socio-medical problem all over the world, since they occupy one of the leading positions in the total mortality rate of the population, and the economic damage caused to society due to the high morbidity and disability of patients is enormous. Over the past 25 years, the overall incidence of respiratory diseases has been steadily increasing. According to official statistics, respiratory organs account for about 40% of all cases of morbidity that exceed levels of morbidity by other classes of diseases. In the structure of the reasons for seeking medical help, their proportion in various territories ranges from 29.2 to 43.5% among adults and from 65.4 to 83.8% among children. The most common and severe forms of respiratory diseases accompanied by the development of complications are pneumonia and bronchial asthma (Disease prevention / Alekseenko S.N., Drobot E.V. // Academy of Natural Sciences Publishing House, 2015).

It should be noted that AD is the cause of a significant decrease in the quality of life of people, limits their social and physical activity, and in severe cases leads to disability (Global Strategy for the Treatment and Prevention of Asthma (GINA). Transl. From English under the editorship of A.G. Chuchalina, Revision of 2013. - M .: Atmosphere, 2013). Therefore, it is so important to diagnose these bronchopulmonary diseases at the earliest stages and predict their course in the future.

Currently, a significant number of modern diagnostic methods have been developed for pathology, both of the bronchi and interstitial tissue, and devices for their implementation (spirographs, bodyplethysmographs, radiographs, bronchoscopes, computer and magnetic resonance imaging devices). However, most of them do not allow a non-invasive diagnosis of the disease, and often their use is impossible in patients of early childhood.

In this regard, the problem of developing a non-invasive device to diagnose diseases of the bronchopulmonary system in children from an early age is especially relevant in modern medicine.

According to the Clinical Recommendations for the Diagnosis, Treatment, and Prevention of Severe Community-Acquired Pneumonia in Adults (edited by A. Chuchalin, 2014) and the Federal Clinical Recommendations for the Diagnosis and Treatment of Community-Acquired Pneumonia in Children, the most widely used diagnostic method for pneumonia In both adults and children, a panoramic x-ray of the chest organs is performed in the anterior direct and lateral projections to detect infiltrative changes in the lung parenchyma.

The disadvantage of this method is that to obtain a chest x-ray, one of the types of ionizing radiation is used - X-ray radiation, which can have a harmful effect on the patient. The average individual patient dose for film chest x-ray is 0.3 millisievert (mSv). In addition, this research method does not allow to fully assess the condition of the bronchopulmonary system, since as a result of examination of the patient we get a static image that is independent of the phases of respiration. It should also be borne in mind that in some cases, chest x-ray may not be informative (that is, demonstrate a false-negative result). Such situations can be caused by projection layering of the shadow of the pathological focus on the shadow of the normal anatomical structure (for example, the diaphragm, mediastinum), low focus of the focus (for example, initial inflammatory manifestations), inadequate projection of the study.

In addition, the frequent use of this method of examination in the treatment process to identify the dynamics of the disease is unacceptable, since the total radiation dose and the harmful effect exerted by it will exceed the beneficial effect achieved in the treatment of the main bronchopulmonary disease.

The most informative device for the diagnosis of bronchopulmonary pathology according to the Clinical Recommendations is computed and magnetic resonance imaging of the chest organs. Computed tomography (CT) of the chest organs is a detailed layered x-ray image of the organs, as well as the structures of the chest. The study makes it possible to successfully diagnose lung diseases.

The disadvantage of this method is that the principle of operation of the tomograph is also based on the use of x-ray radiation and yet there is a small probability of complications due to the excessively high dose of radiation received by the patient. Since the child’s constantly growing body is more sensitive to the effects of radiation, CT studies can be carried out for children only if absolutely necessary for a diagnosis and should not be repeated without strict indications.

Magnetic resonance imaging (MRI) is a method of obtaining diagnostic images based on the use of the phenomenon of nuclear magnetic resonance. MRI allows you to get a detailed image of organs and soft tissues.

However, the disadvantage of this method is that this examination is not possible in patients with implants and implanted devices, since implanted medical devices that contain metal may not work correctly or deteriorate during the study. This study is possible for young children only after applying sedation (which has a negative effect on the developing central nervous system of the child), since the patient should lie still during the study. And the use of this examination method is not possible in acute situations, when quick diagnosis and timely assistance is needed, since MRI takes a lot of time.

In addition, the use of CT and MRI involves the use of rather expensive equipment, which is not available in all medical institutions.

According to the "Global Strategy for the Treatment and Prevention of Bronchial Asthma" (GINA. Transl. From English under the editorship of AG Chuchalin. Revision 2013. - M .: Atmosphere, 2013) one of the main methods for diagnosing bronchial asthma is the spirography method, based on measuring volumetric in time and calculating speed indicators of lung and respiratory tract function (Smirnov I.V. Functional diagnostics. ECG, rheography, spirography / I.V. Smirnov, AM Starshov. - M .: Eksmo, 2008. - P. 83-130). Spirography is performed by recording the rate of respirable and expiratory air and estimating the time of the respiratory phase. The method is based on the use of a turbine as a recording device, the rotation of which is detected by the electromagnetic method, as well as the duct in which the turbine is located, and a personal computer equipped with appropriate software.

The disadvantage of this method is the low information content: this diagnostic method is designed to study the speed and volume indicators of the function of external respiration, which requires three breathing maneuvers: maximum inspiration and expiration for recording vital capacity (VC), forced expiration test after maximum inspiration for recording a curve flow-volume and definitions of forced vital capacity (FVC), as well as a minute ventilation test. The performance of these tests makes increased demands on the reserve capabilities of the respiratory system of a sick person, which is difficult or sometimes impossible in severe patients, the elderly and children, which limits the scope of the method.

The scientific and medical literature also describes a method for diagnosing the function of external respiration using impedance spirography and the Bia Lab Spiro software and hardware complex (V. Mishlanov. Study of the function of external respiration by measuring the electrical impedance of the lungs and respiratory tract at various frequencies of the probing variable current / V.Yu. Mishlanov // Bulletin of modern clinical medicine. - 2011, Volume 4, issue 4 - P. 24-28; RF Patent No. 2487662 from 07.20.2013). For its implementation using the bipolar method of multifrequency impedancemetry. Determine the modular value of the impedance (Z) and phase angle (ϕ) at frequencies of 20, 98, 1000, 5000, 10000, and 20,000 Hz of an alternating electric current of low power during inhalation with a 0.9% sodium chloride solution. During the measurement, the first electrode is installed in the mouthpiece of an ultrasonic nebulizer, the second is located on the skin of the chest either in the study area or by combining the electrodes installed on symmetrical sections of the chest. If the values of Z and / or ϕ deviate less than 5 or more than 95 percentiles from normal values, a violation of the function of external respiration is diagnosed. The hardware-software complex includes a measuring unit, a mouthpiece, a nebulizer inhaler, electrodes.

The disadvantage of this method is the inability to determine the localization of changes in the lung parenchyma, which is necessary, for example, in pneumonia in patients, that is, the ability to measure only integral indicators characterizing the general condition of the bronchopulmonary system.

In the patent of the Russian Federation No. 21232344 (11/27/1998) described "A method for remote study of respiratory function and a device for its implementation." The method consists in placing the examined person in the space of an electromagnetic field and measuring the parameters of this field using a matrix of sensors. When holding the breath or in the mode of calm breathing, the calibration procedure is performed using a special calibration tool, which is a package with the possibility of injection of a blood substitute into it with a syringe. At the same time, the time of coming into operation is from 5 to 15 minutes. The tables of the dependence of the field parameters on the displacement of the sensor matrix for each sensor are obtained, the sensor volume, the total volume of the sensor group and the entire set of sensors are performed. In the measurement mode, the sensor matrix is installed in the calibration space and the change in the person’s volume is recorded during the examination procedure in the modes of vital capacity, forced vital capacity, minute respiratory volume, maximum ventilation.

The disadvantage of this method is that the performance of this examination is impossible in young children, since they cannot perform a full breathing maneuver during calibration, and, therefore, the measurement results will be unreliable. In addition, the resolution of the device is determined by the number of sensors, which cannot be increased above a certain value due to the final minimum size of the sensors, determined by the operating frequency range of the device.

In the utility model “Device for a comprehensive assessment of the mouths of the lobar and segmental bronchi” described in RF patent No. 79026 (12/20/2008), the device contains a series-connected device that receives video information (bronchoscope), a video recording unit, a video conversion adapter, a fixing unit, a registration unit data, an analysis data unit and a data output device. This device relates to devices for converting codes and is intended to determine the data (cross-sectional area of the mouths of the bronchi) of the results and compare these indicators with the average, with the subsequent conclusion based on the results. The need to determine and compare these data for the mouths of the lobar and segmental bronchi arises due to an increase in lung pathology.

The disadvantage of this device is that the method of its use is invasive, as it involves preliminary sedation, which makes it difficult to use in children, especially young children.

The utility model for RF patent No. 150778 (02.27.2015) describes an "Automated device for the diagnosis of bronchopulmonary diseases infected with bacteria containing the ndm-1 gene." The automated device contains a module for fixing the studied samples of two types with the possibility of alternating them, the first type of samples made in the form of standard glass plates with blood smears that are not significantly infected with bacteria containing the NDM-1 gene, the second type of samples made in the form of standard glass plates with blood smears of the examined patient with bronchopulmonary diseases; two groups of optical fibers, a group of controlled sources of optical effects, a spectrometer, a personal computer. An automated device allows you to detect infection with bacteria containing the ndm-1 gene in real time.

The disadvantage of this device is the narrow focus and specificity of application exclusively to the diagnosis of diseases of the bronchopulmonary system caused by bacteria containing the NDM-1 gene, while it is difficult to verify the diagnosis in each individual patient (it is impossible to conduct differential diagnosis between different types of pneumonia or bronchitis, to localize changes in the bronchopulmonary system , and also to establish a diagnosis of a non-communicable disease, such as bronchial asthma).

Closest to the claimed technical solution is the "Device for the study of regional blood supply and ventilation" described in the patent of the Russian Federation No. 2185093 (07.20.2002)

The device contains a controlled high-frequency generator, an emitter, a sensor matrix, which is installed opposite the rear surface of the chest, a detector, an analog-to-digital converter, a unit for recording measured data, two multiplexers and two feedback channels. Each channel consists of a register, a digital-to-analog converter, and an amplifier. The outputs of the amplifiers are connected to the inputs for controlling the frequency and amplitude of the generator signal. The unit for recording the measured data is made on elements that represent data in the form of respiration curves over time and evaluate blood supply and ventilation for each of the six regions of the lungs.

The disadvantage of this device is the inability to assess changes directly in the bronchopulmonary system, and, therefore, the diagnosis of diseases. As well as its lack of information, due to the small number of sensors.

These disadvantages are eliminated in the claimed invention.

The problem to which the invention is directed is the development of a device that allows non-invasively diagnose diseases of the bronchopulmonary system in patients of various age groups, including in young children.

The problem is solved due to the fact that the claimed device contains a high-frequency generator, emitter, analog-to-digital converter, control unit, a unit for recording and displaying measurement results, an amplifier, while the high-frequency generator is made controllable, the generation and measurement unit, the main one, reference and receiving channels, a microwave synthesizer is used as a high-frequency generator in the generation and measurement unit, generating a harmonic signal in the microwave range , the first output of which is connected to the input of a power divider that separates the power of the microwave signal between the main and reference channels, the main channel is formed by a power amplifier, the input of which is connected to the first output of the power divider, and a transmitting applicator antenna, the input of which is connected to the output of the power amplifier, transmitting an applicator antenna transmitting microwave energy from the main channel to the open space, the reference channel is formed by an attenuator, the input of which is connected nen with the second output of the power divider, and a gain meter, the first input of which is connected to the output of the attenuator, the receiving channel contains a receiving matrix of antenna applicators, the output of which is connected to the first input of the multiplexing unit, the second input of which is connected to the third output of the control unit, the output of the unit multiplexing is connected to the input of the power amplifier, the output of which is connected to the second input of the gain meter, the output of which is connected to the input of an analog-to-digital converter, the output of which is connected to the second input of the control unit, the second output of the microwave frequency synthesizer is connected to the first input of the control unit, the pressure sensors of the transmitting antenna applicator and the receiving matrix of antenna applicators are connected to the fourth and fifth inputs of the control unit, respectively, the input of the optical position sensor transmitting antenna-applicator connected to the second output of the control unit, the third input of which is connected to the input of the optical position sensor of the transmitting antenna-applicator, the sixth output of the block control is connected to the third input of the electronic computer using the data bus through the interface device.

In addition, the unit for recording and displaying measurement results is based on a personal computer.

In addition, the transfer of the transmitting antenna-applicator on the surface of the chest of the examined patient can be carried out both by an automated system of movement and positioning, or manually by the operator.

In addition, the receiving antenna applicator can be made in the form of a single antenna applicator, or in the form of a matrix of antenna applicators.

In addition, the unit for recording and displaying measurement results can be performed on operational and read-only memory devices, the inputs and outputs of each of which are connected via the data bus to the inputs and outputs of the processor and the input-output interface, the input and output of which are connected respectively to the keyboard and to a device for displaying measurement results, and additional inputs and outputs are a bus for communication with an external drive.

The technical result provided by the given set of signs is to determine the presence of changes in the bronchopulmonary system and their localization in patients of all age groups, including young children, to increase the reliability, accuracy and information content of the obtained examination results.

The possibility of implementing the device in the form of a portable device allows its use by ambulance doctors for a more accurate preliminary diagnosis, as well as at home to assess the condition of a patient with chronic diseases of the bronchopulmonary system. At the same time, the use of higher-frequency probing radiation makes it possible to reduce the overall dimensions of the transmitting antenna applicator and the elements of the receiving matrix of antenna applicators.

The smaller dimensions of the transmitting antenna applicator and the elements of the receiving matrix of the antenna applicators can significantly increase the resolution of the device.

The transfer of the transmitting antenna-applicator on the surface of the chest carried out both by an automated system of movement and positioning, and manually by a doctor-operator, can also significantly increase the resolution of the device compared to the prototype.

Measuring the coefficient of transmission of the microwave signal through the patient’s chest at two frequencies can significantly increase the accuracy of the examination results.

As a reference calibration value, the results of measuring the coefficient of transmission of the microwave signal through the chest of the patient himself are used, thus eliminating the need for a special calibration kit. The choice of measurement results with coordinates corresponding to the central parts of the lungs of the patient being examined, which act as a reference calibration value corresponding to a healthy state, since the central parts of the lung, due to the fact that the bronchi are mainly located here, are less likely to change due to or other respiratory disease. This fact allows us to conduct studies of changes in the bronchopulmonary system without the use of additional calibration tools while maintaining high accuracy and information content of the study.

The absence of the need to use a special calibration kit significantly reduces the examination time, which can be important in case of an acute attack of the disease.

The absence of the need to use a special calibration kit simplifies the use of the device, thus, the device can be used by medical personnel, including junior medical personnel, after a brief review of the user manual.

The ease of use of the device allows you to use the device for the diagnosis of diseases of the bronchopulmonary system in a remote area in the absence of qualified personnel.

The absence of harmful ionizing effects allows frequent use of the device for monitoring the patient's condition and analyzing the dynamics of the disease.

The possibility of frequent use of the device for analyzing the dynamics of the course of the disease allows for a more flexible and accurate selection of treatment strategies and drugs.

The ability to save the results of the examination and the accumulation of patient examination data during the course of the disease allows the analysis of the dynamics of the disease and timely response to changes in state.

The ability to work offline and perform a correlation analysis of the examination results for a certain period of time allows the attending physician to fully control the course of the disease and take timely measures in the event of a crisis or lack of positive dynamics.

The ability to output the results of the current examination and previously saved data to print and save it to an external medium allows the attending physician to view and analyze the results of the examination and the dynamics of the disease at any time and in the most convenient way.

The correctness of the examination procedure is fully controlled by software, which minimizes the error resulting from the presence of the human factor.

The course of the examination procedure is fully controlled by the software, the key points of the procedure are accompanied by textual and graphic prompts that facilitate the work with the device.

Monitoring the position of the antenna applicator on the screen of the display device allows the doctor-operator of the device to control the correctness of the procedure.

The high clock frequency of the control unit and the high speed of operation of the component parts of the device allows for a large number of measurements per unit time, which can significantly increase the accuracy of the survey results and the resolution of the device while maintaining the same amount of time required to complete the examination procedure.

The ability to maintain a patient card, which contains passport and anthropometric information about the patient, the results of all examinations, the results of other analyzes and tests, the comments of the attending physician during the course of the disease and other information facilitate the monitoring of the dynamics of the disease and the course of treatment.

The invention is illustrated in FIG. 1 - which shows a structural diagram of a device for diagnosing diseases of the bronchopulmonary system.

Detailed description of the device.

The device comprises a unit for generating and measuring 1, a unit for recording and displaying measurement results 2.

The generation and measurement unit 1 consists of a microwave frequency synthesizer 3, a control unit 4, a power divider 5, a main channel 6, a reference channel 7, a receiving channel 8, an analog-to-digital converter 9, an interface device 10, an optical position sensor of the transmitting antenna-applicator eleven.

The main channel 6 consists of a power amplifier 12, a transmitting antenna applicator 13, a pressure sensor of the transmitting antenna applicator 14.

The reference channel 7 consists of an attenuator 15, a gain meter 16.

The receiving channel 8 consists of a power amplifier 17, a multiplexing unit 18, a receiving matrix of antenna applicators 19, a pressure sensor of the receiving matrix of antenna applicators 20.

The unit for recording and displaying the results of measurements 2 includes an electronic computer 21, a display device 22, a keyboard 23. Additional inputs and outputs 2 of the unit for recording and displaying the results of measurements 2 are a communication bus with an external storage device.

The input of the microwave frequency synthesizer 3 is connected to the output 1 of the control unit 4, the output 2 of the microwave frequency synthesizer 3 is connected to the input 1 of the control unit 4. Output 1 of the microwave frequency synthesizer 3 is connected to the input of the power divider 5. Output 1 of the power divider 5 is connected to the input of the main channel 6, which is the input of the power amplifier 12. The output 2 of the power divider 5 is connected to the input 1 of the reference channel 7. The output of the power amplifier 12 is connected to the input of the transmitting antenna applicator 13. The output of the transmitting antenna applicator 13 is output ode 1 of the main channel 6. The output of the pressure sensor of the transmitting antenna applicator 14 is the output 2 of the main channel 6, which is connected to the input 4 of the control unit 4. The input 1 of the receiving channel 8 is the input of the receiving matrix of the antenna applicators 19. The output of the receiving matrix of the antenna applicators 19 is connected to the input 1 of the multiplexing unit 18. The input 2 of the multiplexing unit 18, which is the input 2 of the receiving channel 8, is connected to the output 3 of the control unit 4. The output of the multiplexing unit 18 is connected to the input of the power amplifier 17. The power output power amplifier 17 is the output 1 of the receiving channel 8, which is connected to the input 2 of the reference channel 7. The output of the pressure sensor of the receiving matrix of the antenna applicators 20 is the output 2 of the receiving channel 8, which is connected to the input 5 of the control unit 4. Input 1 of the reference channel 7 is the attenuator input 15. The attenuator 15 output is connected to the input 1 of the gain meter 16. The input 2 of the gain meter 16 is the input 2 of the reference channel 7. The output of the gain meter 16 is the output of the reference channel 7, which is connected with the input of the analog-to-digital converter 9. The output of the analog-to-digital converter 9 is connected to the input 2 of the control unit 4. The output 2 of the control unit 4 is connected to the input of the optical position sensor of the transmitting antenna-applicator 11. The output of the optical position sensor of the transmitting antenna-applicator 11 is connected to input 3 of the control unit 4. The input-output 6 of the control unit 4 is connected by a data bus to the input-output 1 of the interface device 10. The input-output 2 of the interface device 10 is the input-output 1 of the generation and measurement unit 1, which data bus with input-output 1 of the unit for recording and displaying measurement results 2. Input-output 1 of the unit for registering and displaying measurement results 2 is input-output 1 of electronic computer 21. Output 1 of electronic computer 21 is connected to the input of the display device 22. The input 2 of the electronic computer 21 is connected to the output of the keyboard 23. The additional input-output 3 of the electronic computer 21 is the input-output 2 of the unit for recording and displaying the measurement results 2 and is other communication with an external drive.

A device for diagnosing diseases of the bronchopulmonary system works as follows.

When connecting the device to the USB port of the computer, the control unit 4 initializes the optical position sensor of the transmitting antenna applicator 11, the microwave frequency synthesizer 3 and puts the device into standby mode, characterized by the absence of the microwave signal at the output of the microwave frequency synthesizer 3. After starting the computer 21 and control software, the device is polled for readiness for work by sending a special request command. After receiving a positive response from the device and setting the doctor-operator to begin the examination, the computer 21 sends a start command. After that, the control unit 4 puts the device into standby mode the beginning of the measurement mode. After applying the transmitting antenna applicator 13 and the receiving matrix of the antenna applicators 19 to the chest and back of the patient being examined, respectively, the pressure sensor of the transmitting antenna applicator 14 and the pressure sensor of the receiving matrix of the antenna applicators 20 inform the control unit 4 about the possibility of starting the measurement mode. After that, from the output 1 of the control unit 4 to the input of the frequency synthesizer microwave range 3 receives a start command containing information about the required values of the frequency and power of the microwave signal. From the output 2 of the control unit 4, the trigger command is also received at the input of the optical position sensor of the transmitting antenna-applicator 11, which resets the relative coordinates contained in the memory registers of the optical position sensor of the transmitting antenna-applicator 11.

In the case of successful establishment of the required frequency and power of the generated microwave signal at the output 1 of the microwave frequency synthesizer 3 from the output 2 of the microwave frequency synthesizer 3 to the input 1 of the control unit 4, a successful start message is received. If there is no message about the successful start, the command to start the microwave frequency synthesizer is sent again. 3. If there is no message about the successful start after the third sending the start command of the microwave frequency synthesizer 3, the control unit 4 sends a message about the device malfunction to the computer 21 through the interface device 10, which is output to the display device 22.

Next, the microwave signal from the output 1 of the frequency synthesizer of the microwave range 3 is fed to the input of the power divider 5, which performs a uniform division of the power of the microwave signal between the main channel 6 and the reference channel 7. From the output 1 of the power divider 5, the microwave signal is fed to the input of the main channel 6, which is the input of a power amplifier 12, which amplifies the power of the microwave signal to the desired level. From the output of the power amplifier, the microwave signal is fed to the input of the transmitting antenna-applicator 13, which emits the microwave signal into the open space.

From the output 2 of the power divider 5, the microwave signal is fed to the input 1 of the reference channel 7, which is the input of the attenuator 15, which attenuates the power of the microwave signal to the required power level of the reference signal. From the output of the attenuator 15, the microwave signal is fed to input 1 of the gain meter 16.

The microwave signal passed through the lungs of the examined patient is received by the receiving matrix of antenna applicators 19. From the output of the receiving matrix of antenna applicators 19, the microwave signal is fed to input 1 of multiplexing unit 18, which selects one element from the receiving matrix of antenna applicators 19. From the output of multiplexing unit 18 The microwave signal is fed to the input of a power amplifier 17, which amplifies the power of the microwave signal to a level that falls into the dynamic range of the gain meter 16. From the output of the amplifier Article 17, which is the output 1 of the receiving channel 8, the microwave signal is fed to input 2 of the reference channel 7, which is the input 2 of the gain meter 16. The gain meter 16 compares the power of the microwave signals received at inputs 1 and 2, i.e., a comparison power levels of the received and reference microwave signals. A direct current voltage is generated at the output of the gain factor meter 16, the level of which is determined by the ratio of the microwave signal powers at inputs 1 and 2. From the output of the gain factor meter 16, the direct current voltage is supplied to the input of an analog-to-digital converter 9 that converts the direct current voltage that carries information about the coefficient of transmission of the microwave signal through the chest of the patient, in a digital code. From the output of the analog-to-digital Converter 9, the resulting digital combination is fed to input 2 of the control unit 4 and stored in the memory register.

To improve the accuracy of the survey results, it is necessary to carry out measurements not at a single frequency, but at least at two frequencies. Therefore, after receiving the digital combination, the control unit 4 sends the second frequency frequency setting command to the microwave frequency synthesizer 3.

In case of successful establishment of the required frequency and power of the generated microwave signal at the output 1 of the microwave frequency synthesizer 3 from the output 2 of the microwave frequency synthesizer 3 to the input 1 of the control unit 4, a message is received about the successful installation of the second frequency. If there is no message about the successful tuning, the second frequency setting command is sent again to the input of the microwave frequency synthesizer 3. In the absence of a message about the successful second frequency setting after the third sending of the tuning command of the microwave frequency synthesizer 3, the control unit 4 sends to the computer 21 through the interface device 10 message about the malfunction of the device, which is displayed on the display device 22.

The gain meter 16 evaluates the coefficient of transmission of the microwave signal through the chest of the patient at the second frequency. The DC voltage, proportional to the ratio of the microwave power, is converted into a digital code using an analog-to-digital converter 9, fed to the input of the control unit 4 and stored in its memory register.

The resulting digital combinations containing the results of measuring the coefficient of transmission of the microwave signal through the chest at two frequencies, through the interface device 10 are sent to the computer 21 via the data bus and stored in the ROM of the computer 21.

To determine the position of the transmitting antenna-applicator 13 and to control the multiplexing unit 18, an optical position sensor of the transmitting antenna-applicator 11 is used, which determines the offset of the current position of the transmitting antenna-applicator relative to the moment of the previous survey of the optical position sensor of the transmitting antenna-applicator 11. The control unit 4 initiates sending query the position of the optical position sensor of the transmitting antenna applicator 11 relative to the position at the time of the previous survey, according le this offsets the optical position sensor transmitting antenna applicator 11 in the memory registers are reset. The position of the transmitting antenna applicator 13 at the time of the start of the survey is selected for the point with zero coordinates.

After receiving digital combinations containing the results of measuring the coefficient of transmission of the microwave signal through the chest, the computer 21 sends through the device 10 to the input of the control unit 4 a message about the successful receipt of the measurement results. After that, the control unit 4 sends the frequency synthesizer microwave range 3 command to set the first frequency.

In the event of successful establishment of the required value of the first frequency of the generated microwave signal at the output 1 of the microwave frequency synthesizer 3 from the output 2 of the microwave frequency synthesizer 3 to input 1 of the control unit 4, a message is received about the successful installation of the first frequency. If there is no message about the successful tuning, the command to set the first frequency is repeated to the input of the microwave frequency synthesizer 3. In the absence of a message about the successful installation of the first frequency after the third sending the tuning command of the microwave frequency synthesizer 3, the control unit 4 sends to the computer 21 through the interface device 10 message about the malfunction of the device, which is displayed on the display device 22.

After receiving a message about the successful reconstruction of the microwave frequency synthesizer 3, the control unit 4 sends to the input of the optical position sensor of the transmitting antenna-applicator 11 a command requesting the presence of a shift in the transmitting antenna-applicator 13 relative to the position at the time of the previous survey. The optical position sensor of the transmitting antenna-applicator 11 sends to the input 3 of the control unit 4 a message containing information about the presence or absence of a shift of the transmitting antenna-applicator 13 relative to the position at the time of the previous survey of the optical position sensor of the transmitting antenna-applicator 11. If there is no shift of the transmitting antenna- applicator 13, the device goes into standby mode for continuing the examination, characterized in that in this mode of operation, the device does not perform an analog-to-digital conversion vanie measurement results and the control unit 4 conducts periodic polling of the optical position sensor transmitting antenna 11-applicator.

After receiving a message about the presence of a shift in the transmitting antenna-applicator 13 from the optical position sensor of the transmitting antenna-applicator 11, the control unit 4 requests the relative coordinates of the optical position sensor of the transmitting antenna-applicator 11 and stores them in the memory registers. Next, the procedure for measuring the coefficient of transmission of the microwave signal through the chest of the patient at two frequencies is described above.

The received digital combinations containing information on the relative coordinates of the optical position sensor of the transmitting antenna applicator 11 and the results of measuring the transmission coefficient of the microwave signal through the chest of the patient, the control unit 4 sends via the interface device 10 to the input of the computer 21, which are stored in the ROM of the computer 21.

After receiving the data, the computer 21 sends a successful reception command to the control unit 4 and the device enters the standby mode for continuing the examination (waiting for the shift of the transmitting antenna applicator 13). After receiving a message from the optical sensor of the position of the transmitting antenna-applicator 11, the procedure for measuring the transmission coefficient of the microwave signal through the chest of the patient at two frequencies is repeated. The control unit 4 transmits the measured data and the new coordinates of the transmitting antenna-applicator via the interface device 10 to the computer 21, which are stored in the ROM of the computer 21.

To obtain the results of the survey, the movement of the transmitting antenna-applicator 13 is carried out over the entire surface of the chest of the patient. At the same time, for the convenience of monitoring the inspection procedure, information on the entire set of positions of the transmitting antenna-applicator 13 at the moments of measuring the transmission coefficient of the microwave signal is updated in real time on the display device 22 in graphical form. In this case, the received microwave signals are received by each element of the receiving matrix of the antenna applicators 19 and are fed to the input 1 of the multiplexing unit 18, which connects the output of a certain element of the receiving matrix of the antenna applicators 19 to the input of the power amplifier 17. The element of the receiving matrix of the antenna applicators 19 is selected the control unit 4 in accordance with the current position of the transmitting antenna-applicator 13.

Thus, in the process of examination in the computer ROM 21, the measurement results are accumulated in the form of a table “Relative sensor coordinates - Microwave signal transmission coefficient” for the two frequencies at which measurements were made. The procedure for processing the obtained data and displaying the results of the examination occurs after the end of the examination procedure, for which the operator removes the transmitting antenna applicator 13 from the patient’s chest and enters the appropriate command in the control computer software 21. After the examination procedure, the computer 21 converts the relative coordinates of the optical the position sensor of the transmitting antenna-applicator 11 in absolute values and generates data in the form of a table "Sensor position - Microwave transmission coefficient signal ”for the two frequencies at which measurements were made.

Computer 21 selects measurement results with coordinates corresponding to the central parts of the lungs of the patient being examined, which act as a reference calibration value corresponding to a healthy state, since the central parts of the lung, due to the fact that the bronchi are mainly located here, are least affected due to the action of a particular respiratory tract disease. This fact allows us to conduct studies of changes in the bronchopulmonary system without the use of additional calibration tools while maintaining high accuracy and information content of the study. After determining the reference value of the coefficient of transmission of the microwave signal corresponding to a healthy state, the entire set of measured data “Sensor position - coefficient of transmission of the microwave signal” is evaluated for each frequency at which the measurement was performed. As a result of data processing, each value of the table “Sensor Position - Microwave Transmittance” is assigned a certain color value, determined in accordance with the degree of discrepancy of the current microwave transmittance for a point with these coordinates with a reference value of the microwave transmittance corresponding to a healthy state.

Based on the obtained data, the control software on the computer 21 analyzes the results: it determines the presence of changes in the bronchopulmonary system, the degree of localization of changes in the bronchopulmonary system, if any, the degree of deviation of the coefficient of transmission of the microwave signal through the affected area relative to a healthy state and based on the measurement results and The analysis data determine the estimated diagnosis: bronchial asthma, pneumonia, the presence of a foreign body in the bronchopulmonary system, etc. dvaritelny diagnosis, analysis results and measurement results are displayed in graphic form via display device 22. Based on the measurement results, the advanced analysis and the preliminary diagnosis which are displayed on the display screen 22, the physician operator determines the final diagnosis.

If necessary, save the results of the examination, using the keyboard 23, passport and anthropometric data of the patient being examined are entered: age, gender, height and weight, the date of the examination is indicated. These data along with the results of the study are stored in a permanent memory of the computer 21 and, if necessary, can be stored on an external drive connected to the input-output 2 of the unit for recording and displaying the measurement results 2.

SURVEY METHODOLOGY

The survey process is as follows:

1. The doctor-operator prepares the patient for examination: the patient undresses from the top to the waist, assumes a sitting position, in this case the patient presses his back tightly on the receiving matrix of the applicator antennas 19 located in the chair, or lying on his back, in this case the patient lies down on the receiving matrix of the antenna applicators 19, which is placed on the couch;

2. The doctor-operator turns on the computer 21 and connects the device to the USB port, the device is initialized, the operator’s actions are not required at this stage;

3. Using the keyboard 23, data on the patient (passport and anthropometric data, other information) are entered into the permanent memory of the computer 21, if necessary, maintain a patient card to track the dynamics of the disease. When conducting a one-time examination, this stage can be skipped.

4. Two operating modes are available: stand-alone, in which the doctor-operator analyzes the data of past examinations, and the examination mode. At the same time, for the convenience of monitoring the course of the disease in an autonomous mode of operation, it is possible to carry out a correlation analysis of the survey results.

5. If the doctor-operator selects the examination mode, a message is displayed on the screen of the display device 22 informing that the device is ready for operation.

6. It is possible to conduct an examination of the entire chest in one procedure, or of the right and left lung separately. The choice is made by the operator physician based on the structural features of the patient’s chest.

7. The message: “Place the applicators in front and behind the patient’s chest” is displayed on the screen of the display device 22. Also on the schematic image of the patient’s chest, the point from which to begin the examination is graphically shown - the initial position of the transmitting applicator antenna 13 (the upper left point for examining the left lung, the upper right one for examining the right lung), as well as the correct location of the antenna receiving matrix applicators 19.

8. After the transmitting antenna-applicator 13 and the receiving matrix of the antenna-applicators 19 are pressed to the body, a message is displayed that the examination procedure has been started;

9. The operator operator conducts the transmitting antenna-applicator 13 along the front surface of the patient’s chest in one direction (from left to right) to the end. Then it lowers the transmitting antenna-applicator 13 lower by 1-2 cm and the procedure is repeated (the doctor-operator conducts the transmitting antenna-applicator in the opposite direction). It should be noted that tearing off the transmitting antenna-applicator 13 or the receiving matrix of the antennae-applicators 19 from the patient’s body and transferring them to another point on the surface of the chest is unacceptable.

10. In the process of examination on the screen of the display device 22 on the schematic image of the chest of the patient graphically displays the movement of the transmitting antenna applicator 13 in real time.

11. If the transmitting antenna-applicator 13 or the receiving matrix of the antenna-applicators 19 is moved away from the body, a message is displayed on the screen of the display device 22, which is accompanied by an audible command that the transmitting antenna-applicator 13 and the receiving antenna matrix must be pressed firmly applicators 19 to the patient’s body in the same place where they were located earlier. After the command is executed, a message is displayed stating that the examination can continue.

12. After completion of the examination, or its stage, the operator removes the transmitting antenna-applicator 13 from the surface of the patient’s chest and through the user interface on the computer 21 enters the command to complete the examination, or its stage.

13. In the case of examining the right and left lungs separately on the screen of the display device 22, a graphic message is displayed indicating where it is necessary to place the transmitting antenna applicator 13 for examining the second lung. Next, the procedure is repeated similarly to the previous case.

14. At the end of the examination, the operator removes the transmitting antenna-applicator 13 from the surface of the patient’s chest and through the user interface on the computer 21 enters the command to complete the examination.

15. After that, the computer 21 processes the measured data.

16. The processed examination results are displayed in graphical form on the screen of the display device 22 with a color indication of problem areas in the bronchopulmonary system of the patient being examined.

17. Based on the analysis of the results of the examination, the computer 21 formulates a preliminary diagnosis and displays it on the screen of the display device 22.

18. Based on the analysis of the results obtained and the preliminary diagnosis, the operator-operator makes a final diagnosis, which, together with the comments necessary for further monitoring of the patient, are entered through the user interface into the computer 21 read-only memory.

19. If necessary, the operator operator displays the results of the examination for printing (either only in text form, or also in the form of a graphic image of the examination results);

20. Next, the results of the examination, patient data, the results of the analysis and the conclusion of the doctor-operator are stored in a permanent memory computer 21. If necessary, the results of the examination are saved to an external drive;

21. In the case of a repeated examination of the patient in order to identify the dynamics of the course of the disease, the operator operator displays the results of previous examinations on the screen of the display device 22 to identify a correlation between the results of the examinations and analysis of the course of the disease;

22. Disconnecting the device from the USB port and turning off the power to the computer.

The device can be implemented as follows: the microwave frequency synthesizer 3 is made on an ADF4350 microchip (MS), the control unit 4 is made on an ATMega32 MS, the power divider 5 is made on an RPS-2-30 + MS, and an analog-to-digital converter 9 is ATMega32 MS, the interface device 10 is made on FT232RL MS, the optical position sensor of the transmitting applicator antenna 11 is made on the ADNS-9500 MS, the power amplifiers 12 and 17 are made on the ADL5545 MS, the transmitting antenna applicator 13 and the elements of the receiving matrix of the antenna applicators 19 are made in the form of kogshanar app waveguide type indicators, pressure sensors of the transmitting antenna applicator 14 and the receiving matrix of the antenna applicators 20 are made on a miniature button without fixing PSM1-2-0, the attenuator 15 is made in the form of a resistive T-shaped divider, gain meter 16 is made on MS AD8302, the multiplexing unit 18 is made on MS HMC252QS24, the computer 21 is made on the basis of a personal computer of domestic or foreign production.

The performance of the proposed method is confirmed by the following clinical examples:

Example 1:

A sick boy Iv., 3 years old, was admitted for examination and treatment to the Children's City Hospital No. 2 of Rostov-on-Don with complaints of coughing, shortness of breath, wheezing in the lungs. Their anamnesis established that for the first time acute bronchitis in a child developed at the age of 6 months against the background of acute respiratory disease. Subsequently, he suffered obstructive bronchitis three more times, not accompanied by an increase in body temperature. With an objective examination of the child, the condition was regarded as moderate. Rapid breathing (36 respiratory movements per minute) with mild involvement of auxiliary muscles, wheezing is noted at the end of exhalation, physical activity and speaking are preserved. A sound with a box-like shade is determined percussion over the lungs, auscultatory - against the background of hard breathing, scattered dry wheezing on exhalation. Heart sounds are distinct, the rhythm is quickened.

In order to verify the diagnosis, a device was used to diagnose diseases of the bronchopulmonary system.

The doctor-operator prepared the patient for examination: he helped the patient to undress from the top to the waist and take a sitting position, pressing his back against the receiving matrix of the antenna applicators 19 placed in the chair. The doctor-operator turned on the computer 21 and connected the device to the USB port. After that, the initial initialization of the device. Using the keyboard 23, data on the patient (last name, first name, middle name, age, height, body weight) were entered into the computer's permanent memory 21. On the computer 21 selected mode "examination". A message appears on the screen of the display device 22 informing that the device is ready for operation. The doctor decided to examine the entire chest of the patient in one procedure. A message appeared on the screen: “Place the applicators in front and behind the patient’s chest.” The computer also graphically shows the point from which the examination should be started (the upper left point for examining the left lung, the upper right one for examining the right lung), as well as the correct location of the receiving matrix of the applicator antennas 19. After that, as the transmitting antenna-applicator 13 and the receiving matrix of the antenna-applicators 19 were pressed to the body, a message appeared on the screen that the examination procedure was started. The operator operator passed the transmitting antenna-applicator along the front surface of the patient’s chest in one direction (from left to right) to the end. Then he lowered the transmitting antenna applicator lower by 1-2 cm and the procedure was repeated until the examination of the entire surface of the chest of the child was completed. During the examination, on the screen of the display device 22, in real time, the movement of the transmitting antenna-applicator 13 was graphically displayed on the schematic image of the patient’s chest.

After the examination, the operator removed the transmitting antenna applicator 13 from the surface of the chest of the patient and through the user interface on the computer 21 entered the command to complete the examination. After that, the computer 21 processed the measured data. The processed patient examination results appeared on the screen, showing the increased airiness of the pulmonary parenchyma on both sides, indicating an attack of bronchial asthma. Based on the analysis of the results of the examination, the computer 21 formulated a preliminary diagnosis of “Bronchial asthma” and displayed it on the screen of the display device 22. The obtained results of the examination were entered by the operator-operator using the user interface into the permanent memory of the computer 21 and saved and also printed out in textual and graphic forms. Next, the device was disconnected from the USB port and the computer was turned off.

Example 2:

Patient Aev, 12 years old, was admitted for examination and treatment to the Children's City Hospital No. 2 of Rostov-on-Don with complaints of coughing, shortness of breath, chest pain. From the anamnesis it was found that the child got sick a week ago, when there was a temperature increase to febrile numbers, he received antiviral, expectorant and antipyretic drugs, however, against the background of the therapy, the child's condition did not improve. An objective examination of the child: a serious condition. The skin is pale. Shortness of breath is noted, respiratory rate of 28 respiratory movements per minute. The child is scared, speech is difficult. Over the lungs, a blunting of the pulmonary sound to the right below the angle of the scapula is noted percussionly, auscultatory - against the background of weakened breathing, small-bubbly moist rales in the dull area. Heart sounds are loud, the rhythm is quickened.

In order to verify the diagnosis, a device was used to diagnose diseases of the bronchopulmonary system.

The operator-doctor prepared the patient for examination: he helped the patient undress from the top to the waist and assume a supine position, in this case the patient pressed his back tightly to the receiving matrix of the antenna applicators 19, which was placed on the couch. The doctor-operator turned on the computer 21 and connected the device to the USB port. After that, the initial initialization of the device. Using the keyboard 23, data on the patient (last name, first name, middle name, age, height, body weight) were entered into the computer's permanent memory 21. On the computer 21 selected mode "examination". A message appears on the screen of the display device 22 informing that the device is ready for operation. The doctor decided to examine the entire chest of the patient in one procedure. A message appeared on the screen: “Place the applicators in front and behind the patient’s chest.” The computer also graphically shows the point from which the examination should be started (the upper left point for examining the left lung, the upper right one for examining the right lung), as well as the correct location of the receiving matrix of the applicator antennas 19. After that, as the transmitting antenna-applicator 13 and the receiving matrix of the antenna-applicators 19 were pressed to the body, a message appeared on the screen that the examination procedure was started. The operator operator passed the transmitting antenna-applicator along the front surface of the patient’s chest in one direction (from left to right) to the end. Then he lowered the transmitting antenna applicator lower by 1-2 cm and the procedure was repeated until the examination of the entire surface of the chest of the child was completed. During the examination, on the screen of the display device 22, in real time, the movement of the transmitting antenna-applicator 13 was graphically displayed on the schematic image of the patient’s chest.

After the completion of the examination, the operator removed the transmitting antenna-applicator from the surface of the patient’s chest and through the user interface on the computer 21 entered the command to complete the examination. After that, the computer 21 processed the measured data. The processed patient examination results appeared on the screen, showing infiltration in the 8th segment (S8) of the right lung, indicating segmental pneumonia. Based on the analysis of the results of the examination, the computer 21 formulated a preliminary diagnosis of "Right-sided segmental S8 pneumonia" and displayed it on the screen of the display device 22. The obtained results of the examination were entered by the operator using the user interface into the permanent storage device of the computer 21 and stored and displayed on printing in text and graphic forms. Next, the device was disconnected from the USB port and the computer was turned off.

Statistics

Using the claimed device, 27 patients with bronchopulmonary pathology from the age of 1 to 30 years were examined, the control group consisted of 10 healthy patients of the corresponding gender and age, comparable in morphometric characteristics of the structure of the chest. All patients had previously undergone a comprehensive clinical and laboratory examination, on the basis of which diseases of the bronchopulmonary system were diagnosed.

Next, an examination was conducted using a device for diagnosing diseases of the bronchopulmonary system using a frequency range from 500 MHz to 2000 MHz. The level of output microwave power did not exceed 100 μW, which is several orders of magnitude lower than the maximum permissible power level established by the State system of sanitary and epidemiological regulation of the Russian Federation. The examination time did not exceed 10 minutes. Measurements were made of the coefficient of transmission of the microwave signal through the chest of the subjects with a subsequent analysis of the results. Only patients who gave written consent to conduct it were examined. Compliance with the requirements of the local ethics committee of the SBEI HPE Rostov State Medical University of the Ministry of Health of Russia was also checked. Statistical processing was carried out using a set of application programs "STATISTICA 6.0". The significance of differences between groups by arithmetic mean values under the normal distribution law was determined by Student's t test, t, with a difference in the distribution of indicators from normal, the non-parametric Mann-Whitney test (M-U) was used. The result was considered reliable at t> 2, at which p <0.05.

According to the results of the examination, the established diagnoses were confirmed in 100% of the examined patients.

Advantages of a device for diagnosing diseases of the bronchopulmonary system:

1. The developed device has small dimensions and is convenient to use.

2. The device allows to increase the accuracy of diagnosis of bronchopulmonary diseases without additional analyzes.

3. The device can be implemented either as a stationary device, while the role of the measured data recording unit can be played by a personal computer (laptop) of domestic or foreign production, or as a portable device equipped with an internal computer and display device.

4. The device allows directly in the process of examination to obtain information about the presence of a disease of the bronchopulmonary system of the patient, its severity and localization.

5. The device can be used for long-term monitoring of the patient’s condition during treatment to monitor the dynamics of the disease, which will allow timely response to changes in the course of the disease.

6. The device allows you to get all the information necessary for making an accurate diagnosis about the condition of the patient’s bronchopulmonary system without exposing it to harmful effects, as in the case of an X-ray examination, as well as without the use of expensive equipment and additional analyzes, or with their minimal participation.

7. The device does not require the patient to perform any action, or breathing maneuvers, for a long fixed position, which allows the device to be used to diagnose bronchopulmonary diseases in patients of various age groups, including young children.

8. The device is able to increase the visibility of educational and methodical classes in medical schools.

9. The device can be widely used for training medical personnel, indicative medicine, research work, in clinical practice by general practitioners, ambulances, as well as in remote settlements in conditions of shortage of medical personnel and / or expensive diagnostic equipment.

Claims (4)

1. A device for diagnosing diseases of the bronchopulmonary system, comprising a high-frequency generator, an analog-to-digital converter, a control unit, a unit for recording and displaying measurement results, while the high-frequency generator is made controllable, characterized in that it further comprises a generation and measurement unit, the main , reference and receiving channels, a microwave synthesizer is used as a high-frequency generator in the generation and measurement unit, the first output of which is connected to the input For the power that separates the power of the microwave signal between the main and reference channels, the main channel is formed by a power amplifier, the input of which is connected to the first output of the power divider, and a transmitting applicator antenna, the input of which is connected to the output of the power amplifier, the reference channel is formed by an attenuator, the input of which is connected with a second output of the power divider, and a gain meter, the first input of which is connected to the output of the attenuator, the receiving channel contains a receiving matrix of antennas-applicat the output of which is connected to the first input of the multiplexing unit, the output of which is connected to the input of the power amplifier, the output of which is connected to the second input of the gain factor meter, the output of which is connected to the input of the analog-to-digital converter, the output of which is connected to the second input of the control unit, the second output the microwave frequency synthesizer is connected to the first input of the control unit, the pressure sensors of the transmitting antenna applicator and the receiving matrix of the antenna applicators are connected to the fourth and fifth inputs of the control unit, respectively, the input of the optical position sensor of the transmitting antenna-applicator is connected to the second output of the control unit, the third input of which is connected to the output of the optical position sensor of the transmitting antenna-applicator, the third output of the control unit is connected to the second input of the multiplexing unit, the sixth output of the control unit is connected to the first input of the electronic computer using the data bus through the interface device. 2. The device according to p. 1, characterized in that the transfer of the transmitting antenna-applicator on the surface of the chest of the patient being examined is carried out both manually by an operator doctor and an automated system for moving and positioning. 3. The device according to p. 1, characterized in that the unit for recording and displaying the measurement results is made on operational and read-only memory devices, the inputs and outputs of each of which are connected through the data bus with the inputs and outputs of the processor and the input-output interface, input and output which are connected respectively to the keyboard and to the device for displaying the measurement results, and additional inputs and outputs are the communication bus with an external drive. 4. The device according to claim 1, characterized in that the unit for recording and displaying the measurement results is made on a personal computer.

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