CN103142400A - Method for generating diaphragm rehabilitation stimulation signal and diaphragm functional rehabilitative apparatus - Google Patents
Method for generating diaphragm rehabilitation stimulation signal and diaphragm functional rehabilitative apparatus Download PDFInfo
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Abstract
The invention discloses a method for generating a diaphragm rehabilitation stimulation signal, and the stimulation signal is generated by modulating a signal source which is generated by a computer-based controller through a stimulation signal modulation circuit, and the method comprises the following steps of a, generating two circuits of pulse sequences with adjustable width and period through the computer-based controller, and outputting one circuit of control pulse to an analog/digital conversion circuit module in the stimulation signal modulation circuit; b, modulating the two circuits of pulse sequences with the adjustable width and period into one circuit of digital pulse after the AND operation, and controlling the digital/analog conversion circuit module to output one circuit of analog signal with variable amplitude through the control pulse; c, modulating the analog signal to one circuit of envelop signal for simulating a respiration process by adopting the digital pulse through the control circuit; and d, amplifying the envelop signal for simulating the respiration process to generate a diaphragm rehabilitation stimulation signal. The invention also discloses a diaphragm functional rehabilitative apparatus based on the method. The method and the apparatus have the characteristics that the stimulation signal for simulating the natural discharge of the diaphragm nerves is generated by setting the pulse parameters, so that the damage of the stimulation signal on the diaphragm can be avoided, safety and convenience in use can be realized, and the circuit structure is simple.
Description
Technical field
The present invention relates to a kind of diaphragmatic function and recover instrument, is a kind of production method of diaphragm nerve stimulation instrument stimulus signal and based on the diaphragmatic function device for rehabilitation of the method specifically.
Background technology
Clinically, the high-level spinal cord injury of C1 or C2 level, metabolism or diseases associated with inflammation, the tumor of vertical diaphragm, myopathy, neuropathy can cause that all diaphragmatic function is incomplete after wound or operation.In intensive care unit(ICU), short-term is carried out mechanical ventilation and is used the patient of muscle relaxant usually the disuse atrophy of diaphram can occur, and relevant polyneuropathy or the myopathy of critical illness also can cause diaphram unable, and this is the main reason of removing the machine difficulty.Not plenary session of diaphragmatic function causes dyspnea, and motor capacity descends, sleep disordered breathing, pulmonary atelectasis, even respiratory failure.The electricity irritation phrenic nerves is the method for a very useful and important auxiliary diaphragmatic function rehabilitation.Recover at present the existing certain development of rehabilitation instrument of diaphragmatic function by the electricity irritation phrenic nerves, some correlation technique documents are also disclosed at home, be mainly to be divided into two kinds of body internal stimulus and stimulated in vitro generally speaking: stimulated in vitro is because positioning of electrode is accurate not, secondly often required stimulation voltage is excessive causes the Principle of Pain endurable for somatic stimulation, so external diaphragm pacemaker is difficult to be widely applied clinically; The body internal stimulus is by in the Minimally Invasive Surgery implant into body with the body electrode, this technology rarely has report at home at present, external research focuses mostly in the exploitation of permanent diaphragm pacing system, but this only is used in the patient of high paraplegia, somewhat expensive, also only have at present 3,000 routine patients to install in the whole world, and its operation process is complicated, misoperation or electrode can cause neural damage with neural direct the contact.Carry out through the internal jugular vein approach a kind of method that diaphragm nerve stimulation is Wicresoft, electrode catheter is easily inserted and is easily pulled out, and operation process has no side effect safely.This patent is used and is carried out diaphragm nerve stimulation through the internal jugular vein approach, in order to help the diaphragmatic function under the various pathological conditions for the treatment of incomplete.Helping the prerequisite of diaphram restore funcitons by electricity irritation is the functional lesion that does not cause corresponding diaphragmatic fatigue or respective muscle, so how to modulate the large difficult point that stimulus signal is this technology.
Summary of the invention
The objective of the invention is for above-mentioned technical problem, a kind of production method of diaphram rehabilitation stimulus signal is provided, the characteristics of the method are to produce by setting pulse parameter the stimulus signal that the simulation phrenic nerves discharges naturally, to avoid stimulus signal to the diaphram injury;
Another task of the present invention is to provide a kind of diaphragmatic function device for rehabilitation that produces stimulus signal based on this method, is characterized in that circuit is simple, and is safe and reliable.
Technological means: the invention discloses a kind of production method of diaphram rehabilitation stimulus signal, stimulus signal is generated after the stimulus signal modulating circuit modulates by the signal source that the computer based controller produces, and comprises step:
Step a, produce two-way width and adjustable pulse train of cycle by the computer based controller, this two-way pulse train is wherein one the tunnel for controlling the pulse train of respiratory frequency and inspiratory duration, the pulse train of discharging naturally for the simulation phrenic nerves in another road; Export one tunnel control impuls by the computer based controller to the D/A switch circuit module in the stimulus signal modulation circuit simultaneously;
Step b, the pulse train that will control respiratory frequency and inspiratory duration and the simulation phrenic nerves pulse train of naturally discharging pass through with computing or twice NAND operation after be modulated to a railway digital pulse; Simultaneously, control impuls is controlled the analogue signal of D/A switch circuit module output one tunnel variable-magnitude;
Step c, digit pulse are modulated to analogue signal by control circuit the envelope signal of one road simulated respiration process;
The envelope signal of steps d, simulated respiration process is through generating diaphram rehabilitation stimulus signal after amplifying.
The two-way pulse that generates at step a obtains output parameter by following formula:
In formula,
For the enumerator of described controller is completed the once duration of counting, i.e. machine time; OCR0 adjusts parameter the time,
Be the timing length of program,
For inspiratory cycle is adjusted parameter,
For the pulse period is adjusted parameter,
For pulse width is adjusted parameter,
Be the number of times of breathing per minute, i.e. respiratory frequency,
Be pulse frequency,
Be the ratio of inspiratory duration and expiratory duration, unit of time is ms, and process has following three steps:
(1) set inspiratory cycle and adjust parameter
, inspiratory duration and expiratory duration ratio
, respiratory frequency
And pulse frequency
(2) the computer based controller calculates time adjustment parameter OCR0, pulse period adjustment parameter
, the breathing cycle
Adjust parameter with pulse width
(3) the computer based controller generates described two-way pulse train according to each parameter values.
The amplitude of the output signal of D/A switch circuit is variable between 0-5V, and the constant current that is enlarged into to the envelope signal of simulated respiration process in steps d is amplified
the invention also discloses a kind of diaphragmatic function device for rehabilitation, this device for rehabilitation utilizes above-mentioned stimulus signal production method to produce stimulus signal, this device for rehabilitation comprises housing, power supply, key circuit, display screen, the computer based controller, stimulus signal modulation circuit and physiological electrode, power supply wherein, key circuit, computer based controller and stimulus signal modulation circuit all are arranged in housing, key circuit is connected with the computer based controller, the computer based controller is connected with the stimulus signal modulation circuit, display screen is arranged on housing, physiological electrode is connected on the stimulus signal modulation circuit by the jack that is arranged on housing,
The stimulus signal modulation circuit comprises composite pulse generative circuit, D/A switch circuit, D/A switch control circuit, signal amplification circuit and stimulation power supply circuits; The composite pulse generative circuit is by consisting of with door or two NAND gate; The impulse modulation control circuit includes two inputs and an outfan, and two inputs connect respectively the outfan of composite pulse generative circuit and the outfan of D/A switch circuit, and its outfan is connected with signal amplification circuit; The composite pulse generative circuit is provided with two signal input parts, and these two signal input parts are connected with the computer based controller respectively; The computer based controller also is connected to control the amplitude size of its outputting analog signal with the D/A switch circuit; Signal amplification circuit is connected with stimulating power supply circuits;
The computer based controller produces two-way pulse width and adjustable pulse train of cycle, and wherein one tunnel pulse train is used for controlling respiratory frequency and inspiratory duration, and another road pulse train is used for the simulation phrenic nerves and naturally discharges; Two signal input parts of this two-way pulse train input composite pulse generative circuit, through with computing or twice NAND operation after generate a railway digital pulse, digit pulse is transfused to the impulse modulation control circuit, the D/A switch circuit is to the analogue signal of impulse modulation control circuit input one tunnel variable-magnitude simultaneously, the envelope signal of impulse modulation control circuit output simulated respiration process, after amplifying through constant current, flow to physiological electrode.
This diaphragmatic function device for rehabilitation also comprises a memorizer, and this memory package is connected in described housing and with described controller.
The impulse modulation control circuit is bidirectional analog switch CD4066, perhaps photoelectrical coupler TLP521.
The body electrode is the cardiac pacemaker electrode.
The computer based controller is embedded scm.
Embedded scm is ATmega16, and described power supply is aneroid battery or built-in rechargeable battery.
Beneficial effect: the process that the stimulus signal simulation people diaphram that 1, produces discharges naturally, can avoid the damage to diaphram, use safety; 2, parameter scalable for different sufferers, only needs to regulate less parameter, just can use, and is easy to use; 3, in modulated process by CD4066 Digital Signals analog signal transmission, can avoid the interference between signal; 4, adopt signal amplification circuit, accurately control electric current, guarantee that stimulus intensity stablizes controlledly, and can guarantee the instrument trouble free service; 5, adopt the strong processor A Tmega16 of control ability as control core, reduce peripheral circuit, make the instrument overall volume little, be easy to carry, and energy consumption is little, adopt built-in rechargeable battery or aneroid battery to get final product as power supply.
Description of drawings
Fig. 1 is method flow diagram of the present invention;
Fig. 2 is the structural representation of diaphram device for rehabilitation;
Fig. 3 is the circuit diagram of realizing the inventive method.
The specific embodiment
Embodiment 1
The invention discloses a kind of production method of diaphram rehabilitation stimulus signal, stimulus signal is generated after the stimulus signal modulating circuit modulates by the signal source that the computer based controller produces, and as shown in Figure 1, the method comprises:
Step a, produce two-way width and adjustable pulse train of cycle by the computer based controller, this two-way pulse train is wherein one the tunnel for controlling the pulse train of respiratory frequency and inspiratory duration, the pulse train of discharging naturally for the simulation phrenic nerves in another road; Export one tunnel control impuls by the computer based controller to the D/A switch circuit module in the stimulus signal modulation circuit simultaneously;
The control respiratory frequency that this step generates and the pulse train of inspiratory duration, and the pulse train that the simulation phrenic nerves discharges naturally obtains output parameter by following formula:
In formula,
For the enumerator of described controller is completed the once duration of counting, i.e. machine time; OCR0 adjusts parameter the time,
Be the timing length of program,
For inspiratory cycle is adjusted parameter,
For the pulse period is adjusted parameter,
For pulse width is adjusted parameter,
Be the number of times of breathing per minute, i.e. respiratory frequency,
Be pulse frequency,
Be the ratio of inspiratory duration and expiratory duration, unit of time is ms, and process has following three steps:
(1) set inspiratory cycle and adjust parameter
, inspiratory duration and expiratory duration ratio
, respiratory frequency
And pulse frequency
(2) the computer based controller calculates time adjustment parameter OCR0, pulse period adjustment parameter
, the breathing cycle
Adjust parameter with pulse width
(3) the computer based controller generates described two-way pulse train according to each parameter values.
The pulse train that step b, the pulse train that will control respiratory frequency and inspiratory duration and simulation phrenic nerves discharge naturally is through being modulated to a railway digital pulse with computing; Simultaneously, control impuls is controlled D/A switch circuit module output one tunnel amplitude variable analogue signal between 0-5V.
Step c, digit pulse are modulated to analogue signal by control circuit the envelope signal of one road simulated respiration process.
The envelope signal of steps d, simulated respiration process generates stimulus signal after amplifying, the amplification mode adopts constant current to amplify.
Embodiment 2
based on above-mentioned stimulus signal production method, the invention also discloses a kind of diaphragmatic function device for rehabilitation, as shown in Figure 2, this diaphragmatic function device for rehabilitation comprises housing, power supply 2, computer based controller 1, key circuit 3, display screen 4, stimulus signal produces circuit 5 and physiological electrode 6, computer based controller 1 is embedded scm (under referred to as " controller "), power supply 2, controller 1, key circuit 3 and stimulus signal produce circuit 5 and all are encapsulated in housing, wherein key circuit 3 is connected with controller 1, and be provided with corresponding button on housing, controller 1 produces circuit 5 with stimulus signal and is connected, display screen 4 is arranged on housing, physiological electrode 6 is connected with impulse stimulation generation circuit 5 by the interface that is arranged on shell, the other end of physiological electrode 6 stretches into indirect stimulation phrenic nerves in human body by jugular vein, this body electrode 6 is the cardiac pacemaker physiological electrode.The stimulus signal modulation circuit comprises composite pulse generative circuit, D/A switch circuit (calling the D/A output circuit in the following text), impulse modulation control, signal amplification circuit and stimulation power supply circuits.
as shown in Figure 3, the impulse modulation control circuit is bidirectional analog switch CD4066, controller produces the two-way pulsewidth, the pulse that cycle is adjustable, wherein one tunnel pulse S1 is used for controlling respiratory frequency and inspiratory duration, another road pulse S2 simulation phrenic nerves discharges naturally, the two-way pulse is transfused to the complex stimulus signal generating circuit, the complex stimulus signal generating circuit is with door U1(or is two NAND gate, can strengthen this moment to signal), the two-way pulse through with computing after export, make signal obtain strengthening and be modulated at forming together one tunnel pulse, this pulse is transported to the control input end S3 of CD4066 through the first current-limiting resistance R101, the D/A output circuit is selected chip TLC5615, and controller output one tunnel pulse is connected with the D/A output circuit, and controls the variable analogue signal of its output amplitude, and the outfan of D/A output circuit is connected to the S4 end of CD4066 through the second current-limiting resistance R102, after modulation, the envelope signal of simulation eupnea is exported to signal amplification circuit by the emitter-base bandgap grading S5 of CD4066.Usually be by the width of stimulus signal with the intensity of electric stimulus in the electricity irritation phrenic nerves and current intensity is common determines, out of control and the current intensity of the width of stimulus signal out of control, all might damage the life entity tissue, and under different voltages, the electric current by muscle changes, only have mode that adopt to control electric current can guarantee that just intensity of electric stimulus stablizes controlledly, so signal amplification circuit adopts crossing current to amplify.Stimulate power supply circuits to be connected with signal amplification circuit, signal flows to physiological electrode after amplifying.
Controller is selected the ATmega16 digital signal processor, and the characteristics of this processor are that power consumption is little, and processing and control ability are stronger.Power acquisition is with built-in rechargeable battery or aneroid battery.The purpose that the bidirectional analog switch is set between complex stimulus signal generating circuit, D/A output circuit and signal amplification circuit is to utilize this switch to pass to outfan the pulse of input and analogue signal, CD4066 is a kind of gate-controlled switch, is suitable for the processing amplitude and is no more than the less analog or digital signal transmission of its running voltage, electric current.Each analog switch of bidirectional analog switch CD4066 has input, output, three terminals of control, when control end adds high level, and switch conduction; Switch cut-off when control end adds low level, advantage be to have the input signal peak voltage ranges to equal supply voltage, and the advantage such as conduction impedance is more stable in input reference signal; This switch also can replace with photoelectrical coupler TLP521, and its effect is that the pulse signal that will input utilizes light to pass to outfan for medium, and advantage is to have good electrical isolation capabilities and capacity of resisting disturbance.
Claims (10)
1. the production method of a diaphram rehabilitation stimulus signal is characterized in that: described stimulus signal is generated after the stimulus signal modulating circuit modulates by the signal source that the computer based controller produces, and comprises the following steps:
Step a, produce two-way width and adjustable pulse train of cycle by the computer based controller, this two-way pulse train is one tunnel pulse train for control respiratory frequency and inspiratory duration wherein, the pulse train of discharging naturally for the simulation phrenic nerves in another road is exported one tunnel control impuls by the computer based controller to the D/A switch circuit module in the stimulus signal modulation circuit simultaneously;
Step b, the pulse train that will control respiratory frequency and inspiratory duration and the simulation phrenic nerves pulse train of naturally discharging pass through with computing or twice NAND operation after be modulated to a railway digital pulse; Simultaneously, control impuls is controlled the analogue signal of D/A switch circuit module output one tunnel variable-magnitude;
Step c, digit pulse are modulated to analogue signal by a control circuit envelope signal of one road simulated respiration process;
The envelope signal of steps d, simulated respiration process is through generating diaphram rehabilitation stimulus signal after amplifying.
2. the production method of diaphram rehabilitation stimulus signal according to claim 1 is characterized in that: the two-way pulse that step a generates obtains output parameter by following formula:
（3）
In formula,
For the enumerator of described controller is completed the once duration of counting, i.e. machine time;
OCR0 is time adjustment parameter,
Be the timing length of program, namely program is carried out the time span of once-through operation,
For inspiratory cycle is adjusted parameter,
For the pulse period is adjusted parameter,
For pulse width is adjusted parameter,
Be the number of times of breathing per minute, i.e. respiratory frequency,
Be pulse frequency,
Be the ratio of inspiratory duration and expiratory duration, unit of time is ms, and process has following three steps:
(1) set inspiratory cycle and adjust parameter
, inspiratory duration and expiratory duration ratio
, respiratory frequency
And pulse frequency
(2) the computer based controller calculates time adjustment parameter
OCR0, the pulse period is adjusted parameter
, the breathing cycle
Adjust parameter with pulse width
(3) the computer based controller generates described two-way pulse train according to each parameter values.
3. the production method of diaphram rehabilitation stimulus signal according to claim 1 is characterized in that: the envelope signal to the simulated respiration process in described steps d adopts constant-current circuit to amplify.
4. the production method of according to claim 1 and 2 or 3 described diaphram rehabilitation stimulus signals, it is characterized in that: the output signal amplitude of described D/A switch circuit is variable between 0-5V.
5. diaphragmatic function device for rehabilitation, it is characterized in that: this device for rehabilitation is to utilize the production method of claim 1 or 2 or 3 or 4 described diaphram rehabilitation stimulus signals to produce stimulus signal, this device for rehabilitation comprises housing, power supply, key circuit, display screen, the computer based controller, stimulus signal modulation circuit and body electrode, power supply wherein, key circuit, computer based controller and stimulus signal modulation circuit all are arranged in housing, key circuit is connected with the computer based controller, the computer based controller is connected with the stimulus signal modulation circuit, display screen is arranged on housing, physiological electrode is connected on the stimulus signal modulation circuit by the jack that is arranged on housing,
The stimulus signal modulation circuit comprises composite pulse generative circuit, D/A switch circuit, D/A switch control circuit, signal amplification circuit and stimulation power supply circuits; The composite pulse generative circuit is by consisting of with door or two NAND gate; The impulse modulation control circuit includes two inputs and an outfan, and two inputs connect respectively the outfan of composite pulse generative circuit and the outfan of D/A switch circuit, and its outfan is connected with signal amplification circuit; The composite pulse generative circuit is provided with two signal input parts, and these two signal input parts are connected with the computer based controller respectively; The computer based controller also is connected to control the amplitude size of its outputting analog signal with the D/A switch circuit; Signal amplification circuit is connected with stimulating power supply circuits;
The computer based controller produces two-way pulse width and adjustable pulse train of cycle, and wherein one tunnel pulse train is used for controlling respiratory frequency and inspiratory duration, and another road pulse train is used for the simulation phrenic nerves and naturally discharges; Two signal input parts of this two-way pulse train input composite pulse generative circuit, through with computing or twice NAND operation after generate a railway digital pulse, digit pulse is transfused to the impulse modulation control circuit, the D/A switch circuit is to the analogue signal of impulse modulation control circuit input one tunnel variable-magnitude simultaneously, the envelope signal of impulse modulation control circuit output simulated respiration process, after amplifying through constant current, flow to physiological electrode.
6. diaphragmatic function device for rehabilitation according to claim 5, it is characterized in that: comprise a memorizer, this memory package is connected in described housing and with described controller.
7. diaphragmatic function device for rehabilitation according to claim 5, it is characterized in that: described impulse modulation control circuit comprises bidirectional analog switch CD4066, is perhaps photoelectrical coupler TLP521.
8. diaphragmatic function device for rehabilitation according to claim 5, it is characterized in that: described body electrode is the cardiac pacemaker electrode.
9. according to claim 5-8 described diaphragmatic function device for rehabilitations of any one claim, it is characterized in that: described computer based controller is embedded scm.
10. diaphragmatic function device for rehabilitation according to claim 9, it is characterized in that: described embedded scm is ATmega16, described power supply is aneroid battery or built-in rechargeable battery.
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Cited By (3)
| Publication number | Priority date | Publication date | Assignee | Title |
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| CN110974298A (en) * | 2019-12-31 | 2020-04-10 | 苏州科技城医院 | Method for capturing diaphragm movement by utilizing ultrasonic AI technology to assist judgment of ventilator off-line |
| CN112221011A (en) * | 2020-10-14 | 2021-01-15 | 长治医学院附属和平医院 | Phrenic nerve stimulator with diaphragm rehabilitation and auxiliary off-line functions |
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| US20050021102A1 (en) * | 2003-07-23 | 2005-01-27 | Ignagni Anthony R. | System and method for conditioning a diaphragm of a patient |
| US20070118183A1 (en) * | 2005-11-18 | 2007-05-24 | Mark Gelfand | System and method to modulate phrenic nerve to prevent sleep apnea |
| US8160711B2 (en) * | 2003-10-15 | 2012-04-17 | Rmx, Llc | Multimode device and method for controlling breathing |
| CN202909297U (en) * | 2012-10-12 | 2013-05-01 | 郝文延 | Temporary diaphragm stimulator |
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| US20050021102A1 (en) * | 2003-07-23 | 2005-01-27 | Ignagni Anthony R. | System and method for conditioning a diaphragm of a patient |
| US8160711B2 (en) * | 2003-10-15 | 2012-04-17 | Rmx, Llc | Multimode device and method for controlling breathing |
| US8335567B2 (en) * | 2003-10-15 | 2012-12-18 | Rmx, Llc | Multimode device and method for controlling breathing |
| US20070118183A1 (en) * | 2005-11-18 | 2007-05-24 | Mark Gelfand | System and method to modulate phrenic nerve to prevent sleep apnea |
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Cited By (4)
| Publication number | Priority date | Publication date | Assignee | Title |
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| CN104383637A (en) * | 2014-12-09 | 2015-03-04 | 北京银河润泰科技有限公司 | Training assistance equipment and training assistance method |
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| CN110974298A (en) * | 2019-12-31 | 2020-04-10 | 苏州科技城医院 | Method for capturing diaphragm movement by utilizing ultrasonic AI technology to assist judgment of ventilator off-line |
| CN112221011A (en) * | 2020-10-14 | 2021-01-15 | 长治医学院附属和平医院 | Phrenic nerve stimulator with diaphragm rehabilitation and auxiliary off-line functions |
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| CN103142400B (en) | 2014-12-31 |
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