CN100589768C - Lithotripsy device - Google Patents
Lithotripsy device Download PDFInfo
- Publication number
- CN100589768C CN100589768C CN200680021676A CN200680021676A CN100589768C CN 100589768 C CN100589768 C CN 100589768C CN 200680021676 A CN200680021676 A CN 200680021676A CN 200680021676 A CN200680021676 A CN 200680021676A CN 100589768 C CN100589768 C CN 100589768C
- Authority
- CN
- China
- Prior art keywords
- shock wave
- patient
- wave source
- power
- focus
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Expired - Fee Related
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Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
- A61B17/225—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for for extracorporeal shock wave lithotripsy [ESWL], e.g. by using ultrasonic waves
- A61B17/2251—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for for extracorporeal shock wave lithotripsy [ESWL], e.g. by using ultrasonic waves characterised by coupling elements between the apparatus, e.g. shock wave apparatus or locating means, and the patient, e.g. details of bags, pressure control of bag on patient
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
- A61B17/225—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for for extracorporeal shock wave lithotripsy [ESWL], e.g. by using ultrasonic waves
- A61B17/2255—Means for positioning patient, shock wave apparatus or locating means, e.g. mechanical aspects, patient beds, support arms, aiming means
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
- A61B17/225—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for for extracorporeal shock wave lithotripsy [ESWL], e.g. by using ultrasonic waves
- A61B17/2256—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for for extracorporeal shock wave lithotripsy [ESWL], e.g. by using ultrasonic waves with means for locating or checking the concrement, e.g. X-ray apparatus, imaging means
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
- A61B17/225—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for for extracorporeal shock wave lithotripsy [ESWL], e.g. by using ultrasonic waves
- A61B17/2251—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for for extracorporeal shock wave lithotripsy [ESWL], e.g. by using ultrasonic waves characterised by coupling elements between the apparatus, e.g. shock wave apparatus or locating means, and the patient, e.g. details of bags, pressure control of bag on patient
- A61B2017/2253—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for for extracorporeal shock wave lithotripsy [ESWL], e.g. by using ultrasonic waves characterised by coupling elements between the apparatus, e.g. shock wave apparatus or locating means, and the patient, e.g. details of bags, pressure control of bag on patient using a coupling gel or liquid
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/06—Measuring instruments not otherwise provided for
- A61B2090/064—Measuring instruments not otherwise provided for for measuring force, pressure or mechanical tension
- A61B2090/065—Measuring instruments not otherwise provided for for measuring force, pressure or mechanical tension for measuring contact or contact pressure
Abstract
The invention relates to a method for operating a lithotripsy device, whereby a shock wave source (2) is applied to a patient (12) to be treated, said source generating a shock wave that is focused ina focus (S). The invention is characterized by detecting and evaluating at least one force (F) exerted on the shock wave source (2) when it is applied.
Description
Technical field
The present invention relates to the calculi breaking device of the described method operation of a kind of calculi breaking device operational approach and a kind of usefulness.
Background technology
Lithotrity is a kind of by operation, but the Therapeutic Method that the intravital calculus of patient is smashed by focused shock wave.Need mechanically coupled surge wave source on one's body the patient for this reason, be about to have the shock wave source that connects corrugated tube (inside is marked with fluid) and be placed on human body surface.For shock wave there not being as far as possible loss ground to import in patient's body, connect corrugated tube and must have no to be close to gap human body surface.
For guaranteeing this lossless acoustical coupling, known way is by the fluid pressure that connects in the corrugated tube power that is used for shock wave source is placed or is coupled to patient's body surface to be regulated.But, possibly can't adjust the bonding force of having an effect by pressure-regulating device (for example disclosing this pressure-regulating device among DE 197 48 071 A1) again according to patient's the concrete structoure of the human body and the required concrete depth of penetration of shock wave of treatment.In addition, be adjusted at fluid pressure under the situation of default rated value, the active force between shock wave source and the body surface is not always identical, and its reason is that the power that acts on is relevant with how much contact structures with contact surface between shock wave source and body surface.
In the case, the power that is applied to during coupling on the shock wave source can make the assembly of carrying shock wave source deform, thereby makes the focus of shock wave depart from its calibration position.This calibration position is common and the picture centre of the X-ray equipment that the calculus location is used overlaps.Fig. 3 has carried out detailed icon to this.As shown in Figure 3, shock wave source 2 is arranged on the C type arm 6 rotationally by support arm 4, and C type arm 6 is installed on the control station 8 that only shows in schematic form in the accompanying drawings.Shock wave source 2 has one and connects corrugated tube 10, and shock wave source 2 is placed on patient 12 the body surface by connecting corrugated tube 10, and with patient 12 body surface acoustical coupling.Ideally, promptly the directed force F that is subjected on the shock wave source 2 hour, the focus S of shock wave overlaps with its calibration position C, for example at the concentric point of C type arm 6).Calibration position C simultaneously also is the picture centre of the X-ray equipment that being used for of not showing among the figure calculus positioned.What the dotted line in the accompanying drawing was represented is, at shock wave source 2 during with patient's 12 couplings, and the situation that when the direction of the central shaft 14 of shock wave source 2 applies a power F on shock wave source 2, is occurred.At this moment, recoverable strain can take place in supporting mechanism usually that be made of support arm 4 and C type arm 6, and this can make the focus S of shock wave be displaced to physical location C ' from its calibration position C.
If this drift condition of focus S is unrecognized and consider, will affect the treatment, bring unnecessary burden to the patient.
For avoiding occurring this situation, known way of the prior art is: when shock wave source 2 is not subjected to active force as yet, the focus S of shock wave placed outside the calibration position C compensate the distortion that is occurred.In the case, be coupled to patient 12 body surface when shock wave source 2 after, the distortion of Chu Xianing ideally can make focus S overlap with calibration position C thereupon.Fig. 4 with dashed lines illustrates this.But look the difference of concrete application and difference owing to be used for that shock wave source 2 is coupled to patient 12 power on one's body, even thereby can not always guarantee that by this measure focus S overlaps with calibration position C.
Except that restorability position skew above by the illustrated focus S of Fig. 3 and Fig. 4, under expection or the bigger situation of unexpected active force, also expendable distortion might occur, this can cause focus S for good and all to depart from calibration position C, and brings great risk to the patient.
Summary of the invention
Therefore, the purpose of this invention is to provide a kind of calculi breaking device operational approach, can avoid the generation of the problems referred to above by means of this method.In addition, another object of the present invention provides the calculi breaking device of the described method operation of a kind of usefulness.
The present invention's purpose relevant with method reached by a kind of method with following described feature.Described calculi breaking device operational approach is to be coupled on one's body patient to be treated to be used to produce the shock wave source of focused shock wave, and at least one power that coupling is applied on the shock wave source time detects and analyzes.Produce the judgment criteria that another is available for users to use thus, user can utilize this judgment criteria to improve curative effect.For example, can be the rated value or the rated value scope of user specified force, when the size of power is a rated value or when being in the rated value scope, the skew of focus is in the boundary of allowing.Set up between in addition can the active force when curative effect, the pain sensation and treatment time and treatment and get in touch, the experience that will obtain in this process is used for the successive treatment relevant with the patient in case of necessity.By to force measurement, also can regulate the default rated value relevant with the patient.
Detected Z-TEK is not used for the mensuration of focus physical location and the accurate location of shock wave source.Because if the power that coupling the time acts on the shock wave source is known quantity, just can determine the deformation extent of supporting construction and the physical location of focus according to this force-summing device associated arguments the look-up table of verification experimental verification (for example through).
If the physical location of focus is presented in patient's the radioscopic image, just simply the focus of mode shock wave is accurately located.
The favourable embodiment of another of described method is that the application of force is compared with a upper threshold force, and the situation that this upper threshold force is exceeded is indicated.Can avoid the excessive expendable distortion that causes of the application of force by this measure, thereby avoid calculi breaking device to be subjected to unexpected permanent damage.
In addition, if trigger the automatic compensating motion that can reduce active force when upper threshold force is exceeded, just can guarantee, even under the situation of user careless manipulation, also can avoid taking place irreversible damage situations.
Another embodiment of the present invention is that the application of force is compared with a lower threshold force, and the situation (the expression coupling is not in place) that is lower than this lower threshold force is indicated.
If the application of force in the time of will being coupled and other patient data and treatment related data are stored together, just can in follow-up treatment, between the application of force and curative effect, set up and get in touch.
The present invention's purpose relevant with calculi breaking device reached by following feature, and a kind of calculi breaking device comprises: a shock wave source, and described shock wave source is used to produce the shock wave that accumulates in a focus; At least one measuring transducer, described measuring transducer are used to measure described shock wave source and are coupled to patient to be treated suffered power on one's body the time; And control and analytical equipment, it determines the physical location of described focus according to the power that measures.Advantage relevant with calculi breaking device and the advantage of those corresponding the inventive method are corresponding.
Description of drawings
The invention will be further described by embodiment shown in the drawings below, wherein:
Fig. 1 is the schematic diagram of calculi breaking device of the present invention;
Fig. 2 is the radioscopic image of schematic form, and what wherein show is the physical location of shock wave focus; And
Fig. 3 and Fig. 4 are sketch map, show that calculi breaking device is coupled to the distortion situation that patient to be treated is occurred on one's body the time with shock wave source.
The specific embodiment
Be installed on the C type arm 6 by support arm 4 as above illustrated, shown in Figure 1 shock wave source 2, and can center on calibration position C (being the concentric point of the C type arm 6 in the present embodiment) rotation of the focus of shock wave source 2 by Fig. 3 and Fig. 4.The calibration position C of the focus of shock wave source 2 is positioned at the picture centre of x-ray imaging device 18, x-ray imaging device 18 is a C type arm X-ray equipment in the present embodiment, wherein, X ray receptor 20 and X-ray tube 22 are arranged on the X ray C type arm 16, and the concentric point of X ray C type arm 16 overlaps with the calibration position C of focus.X ray receptor 20 and X-ray tube 22 can rotate around this calibration position C together.
Shown in the four-headed arrow in the accompanying drawing, central authorities' control and analytical equipment 26 are used for X-ray apparatus 18 and shock wave source 2 are controlled.Be connected with operating equipment and display device on control and the analytical equipment 26, i.e. the keyboard 28 and the monitor 30 that show in schematic form of accompanying drawing.In the shown patient's 12 of monitor 30 radioscopic image B, the calculus K that is positioned on the concentric point of X ray C type arm 16 appears at picture centre.
Be furnished with a plurality of measuring transducers 32 between shock wave source 2 and the support arm 4, these measuring transducers are coupled to patient 12 on one's body the time at shock wave source 2, respectively the power on central shaft 14 directions that are applied to shock wave source 2 are measured.When the coupling direction tilted with respect to central shaft 14, each measuring transducer 32 measured power may not necessarily be big equally.By measuring transducer 32 suitably being selected and arranged,, also can detect other component perpendicular to central shaft even be not accurately vertically under the situation of effect in power.In other words be exactly: measuring transducer is measured is not only a power or a component, but acts on the distribution situation of the power on the support arm.But only need to determine the meansigma methods that is subjected on the measuring transducer 32 generally speaking, and this meansigma methods is analyzed along the component on central shaft 14 directions, just enough.
The measuring-signal M of measuring transducer 32 is transferred on control and the analytical equipment 26, by control and analytical equipment 26 it analyzed, thus the physical location of the focus of definite shock wave source 2.This step for example can realize by including through the analysis software of the look-up table of verification experimental verification, look-up table contains the focus that the change in location by shock wave source 2 causes and departs from the data of calibration position C, and is applied to power on the shock wave source (being the measured measuring-signal M of measuring transducer 32).
The physical location of measuring by this method with corresponding symbol 34 (for example cross hairs) expression, and it is presented among the radioscopic image B that X-ray apparatus 18 produced.
In addition, control and analytical equipment 26 are also checked by measuring-signal M, whether have lower limit that is lower than power or the situation that surpasses the higher limit of power.This situation that is lower than or surpasses is by indicator elment 36 and 38 indications, and indicator elment 36 and 38 also can be arranged in the plane of delineation of monitor 30.
Control and analytical equipment 26 in addition with figure in not the driving device that is used to drive patient table 24 of demonstration link to each other, when measuring transducer 32 measured power surpassed higher limit, control and analytical equipment 26 can trigger patient table 24 and leave original position (as shown in arrow 40) automatically.
Control and analytical equipment 26 also include storage device 42, and storage device 42 is used for storing therapeutic process applied force F and other corresponding patient datas and treatment related data D.
As shown in Figure 2, calculus K is positioned at the picture centre of the radioscopic image B that is produced by X-ray apparatus.Ideally, if be not subjected to the external force effect on the shock wave source, picture centre just overlaps with the calibration position C of shock wave source focus.If apply an external force on shock wave source, the focus of shock wave source will be displaced to physical location C ' from calibration position C, i.e. the symbol 34 seen of user.User can from shown in find out that the physical location C ' of focus no longer is positioned at the inside of calculus K the legend, thereby can not release of shock wave.At this moment, the application of force that user can be when reducing to be coupled or implement coupling again by mobile patient position, thus physical location C ' shown among the radioscopic image B is navigated on the calculus K, perhaps calculus K is displaced on the described physical location C '.
Claims (6)
1. calculi breaking device comprises: a shock wave source (2), described shock wave source are used for producing the shock wave that accumulates in a focus (S); At least one measuring transducer (32), described measuring transducer are used to measure described shock wave source (2) and are coupled to patient to be treated (12) suffered power on one's body the time; And control and analytical equipment (26), it determines the physical location (C ') of described focus (S) according to the power (F) that measures.
2. calculi breaking device according to claim 1, wherein, have an X-ray apparatus (18), described X-ray apparatus is used for producing and reproducing the radioscopic image (B) of described patient (12), and the physical location of described focus (S) (C ') is presented in the described radioscopic image (B).
3. calculi breaking device according to claim 1 wherein, has an indicator elment (36), is used for indicating when the power that measures (F) is lower than a predetermined lower limit value coupling to have defective.
4. calculi breaking device according to claim 1, wherein, when the power that measures (F) surpassed a preset upper limit value, described control and analytical equipment (26) can trigger compensating motion automatically.
5. calculi breaking device according to claim 4, wherein, described compensating motion refers to the patient table (24) that is triggered by described control and analytical equipment (26) and departs from moving of its origin-location, settles described patient to be treated (12) on the described patient table.
6. according to the described calculi breaking device of each claim in the claim 1 to 5, wherein, have storage device (42), described storage device is used to store described power (F) and other corresponding patient datas and treatment related data (D).
Applications Claiming Priority (2)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| DE102005028876.6 | 2005-06-22 | ||
| DE102005028876A DE102005028876B3 (en) | 2005-06-22 | 2005-06-22 | Lithotripsy device |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| CN101198281A CN101198281A (en) | 2008-06-11 |
| CN100589768C true CN100589768C (en) | 2010-02-17 |
Family
ID=36825723
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN200680021676A Expired - Fee Related CN100589768C (en) | 2005-06-22 | 2006-06-14 | Lithotripsy device |
Country Status (4)
| Country | Link |
|---|---|
| EP (1) | EP1893106A1 (en) |
| CN (1) | CN100589768C (en) |
| DE (1) | DE102005028876B3 (en) |
| WO (1) | WO2006136517A1 (en) |
Families Citing this family (4)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| EP3407816B1 (en) | 2016-01-29 | 2023-03-22 | Boston Scientific Scimed, Inc. | Medical user interface |
| CN107198555A (en) * | 2017-07-07 | 2017-09-26 | 北京索迪医疗器械开发有限责任公司 | A kind of twin pulse ESWL system |
| CN109965943A (en) * | 2019-05-05 | 2019-07-05 | 厦门市领汇医疗科技有限公司 | A kind of the double end shock wave source and extracorporeal lithotiptor of extracorporeal lithotiptor |
| CN112315547B (en) * | 2020-11-05 | 2021-09-10 | 皖南医学院第一附属医院（皖南医学院弋矶山医院） | External shock wave bladder stone breaking device |
Citations (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US4811725A (en) * | 1986-12-22 | 1989-03-14 | Siemens Aktiengesellschaft | Extracorporeal lithotripsy apparatus |
Family Cites Families (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| DE3725129A1 (en) * | 1987-07-29 | 1989-02-09 | Dornier Medizintechnik | MEDICAL SAFETY DEVICE FOR DIAGNOSIS AND THERAPY, ESPECIALLY FOR CONTACT-FREE LITHOTRIPSY |
| EP0462295A1 (en) * | 1990-06-13 | 1991-12-27 | Siemens Aktiengesellschaft | Medical device for diagnostic and therapeutic purposes |
| DE19748071A1 (en) * | 1997-10-30 | 1998-10-29 | Siemens Ag | Therapy device using focused acoustic waves |
-
2005
- 2005-06-22 DE DE102005028876A patent/DE102005028876B3/en not_active Expired - Fee Related
-
2006
- 2006-06-14 EP EP06777320A patent/EP1893106A1/en not_active Withdrawn
- 2006-06-14 WO PCT/EP2006/063180 patent/WO2006136517A1/en not_active Application Discontinuation
- 2006-06-14 CN CN200680021676A patent/CN100589768C/en not_active Expired - Fee Related
Patent Citations (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US4811725A (en) * | 1986-12-22 | 1989-03-14 | Siemens Aktiengesellschaft | Extracorporeal lithotripsy apparatus |
Also Published As
| Publication number | Publication date |
|---|---|
| WO2006136517A1 (en) | 2006-12-28 |
| CN101198281A (en) | 2008-06-11 |
| DE102005028876B3 (en) | 2007-01-25 |
| EP1893106A1 (en) | 2008-03-05 |
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Granted publication date: 20100217 Termination date: 20200614 |