CN103170061B - Defibrillating circuit - Google Patents
Defibrillating circuit Download PDFInfo
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- CN103170061B CN103170061B CN201310065994.0A CN201310065994A CN103170061B CN 103170061 B CN103170061 B CN 103170061B CN 201310065994 A CN201310065994 A CN 201310065994A CN 103170061 B CN103170061 B CN 103170061B
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Abstract
The invention discloses a defibrillating circuit which comprises a control module, an energy storage module, a waveform generating circuit and a patient connector. The waveform generating circuit is connected between the energy storage module and the patient connector. The control module is respectively connected with the energy storage module and the waveform generating circuit. The energy storage module comprises a first energy storage device and a second energy storage device, the first energy storage device is used for providing energy for generation of a phase waveform, the second energy storage device is used for providing energy for generation of a second phase waveform, the first energy storage device and the second energy storage device share a same positive or negative public electrode, the public electrodes are coupled to the waveform generating circuit, and another electrodes of the first energy storage device and the second energy storage device are respectively coupled to the waveform generating circuit. Flexible adjustment of energy ratio, charge ratio and voltage ratio of first phase and second phase is realized so as to realize optimum conversion rate.
Description
The divisional application of the application's to be in December, 2008 No. 05 application number submitted be patent application of 200810218274.2, the denomination of invention of original application is " defibrillation circuit and method ".
Technical field
The application relates to a kind of defibrillation circuit.
Background technology
According to related statistical data, the increasing people in the world is not treated effectively and timely due to heart attack and is lost life, wherein to people's life threat maximum be exactly ventricular fibrillation, namely ventricle lose blood supply ability cannot blood volume one state again for human body pumping required for.According to the research of medical circle, exactly defibrillation is carried out to patient for the most effective Therapeutic Method of ventricular fibrillation, namely utilize a heavy current pulse to stimulate ventricle to recover normal blood-pumping function.
Early stage defibrillation generally adopts single-phase ripple defibrillation, as Fig. 1, namely applies a unidirectional current pulses to patient's heart, to reach the object of defibrillation.Unidirectional ripple defibrillation generally has very high voltage and current, and voltage often reaches more than 4000V even 5000V, and electric current also even reaches hundreds of ampere.Therefore often can cause the myocardial damage of patient while defibrillation, reduce therapeutic effect.
The research of medical circle shows, utilizes bi-phase wave to carry out defibrillation therapy, can largely improve defibrillation effectiveness, reduces Myocardial injury degree.Bi-phase wave can obtain and turn multiple rate than the defibrillation of single-phase Bo Genggao under lower energy and lower electric current, therefore bi-phase wave is more safe and effective.Defibrillator new is at present substantially all defibrillation with biphasic wave instrument.Defibrillation with biphasic wave is after the larger electric current therapy pulse of a patient chest resistance applying forward, followed by applying a reverse less current impulse again.The voltage and current more single-phase ripple defibrillation of defibrillation with biphasic wave is much little, and ceiling voltage is generally no more than 2500V.Application more a kind of bi-phase wave is that two phase exponential blocks (BTE) waveform, as shown in Figure 2.
Existing defibrillation with biphasic wave equipment adopts an energy storage module (such as electric capacity) and corresponding wave generator circuit to realize defibrillation with biphasic wave usually.First it utilize the primary power of energy storage module to carry out a phase defibrillation electric discharge; Then its dump energy is utilized to carry out the electric discharge of two-phase defibrillation.In this case, the initial discharge voltage of two phase discharges, necessarily lower than the blanking voltage after a phase discharge, not easily realizes the control of voltage ratio, energy Ratios, charge ratio flexibly according to clinical setting.
Summary of the invention
The application provides a kind of defibrillation circuit, comprise control module, energy storage module, wave generator circuit and patient interface, described wave generator circuit is connected between energy storage module and patient interface, described control module is connected with energy storage module and wave generator circuit respectively, described energy storage module comprises for providing the first energy storage device of energy for the generation of a phase waveform and for providing the second energy storage device of energy for the generation of two phase waveform, first energy storage device and the second energy storage device have common plus or minus public pole, described public pole is coupled to wave generator circuit, wave generator circuit is also coupled to respectively in another pole of described first energy storage device and the second energy storage device.
Accompanying drawing explanation
Fig. 1 is single-phase ripple defibrillation waveform;
Fig. 2 is that two-phase blocks exponential wave waveform;
Fig. 3 is defibrillation with biphasic wave schematic block circuit diagram;
Fig. 4 is the defibrillation control flow chart of a kind of embodiment of the application;
Fig. 5 is the defibrillation with biphasic wave oscillogram of a kind of embodiment of the application;
Fig. 6 is the defibrillation circuit theory diagram of a kind of embodiment of the application;
Fig. 7 is the defibrillation circuit figure of a kind of embodiment of the application;
Fig. 8 is the defibrillation control flow chart of the another kind of embodiment of the application;
Fig. 9 is the defibrillation circuit figure of the another kind of embodiment of the application.
Detailed description of the invention
The feature of the application and advantage will be described in detail by reference to the accompanying drawings by embodiment.
Bi-phase wave has a phase and two-phase two discharge regimes, and the polarity of second-phase electric current is contrary with first-phase, and amplitude is usually low than first-phase, and application more widely bi-phase wave is that two phase exponential blocks (BTE) waveform, as shown in Figure 2.
As shown in Figure 3, defibrillation circuit comprises control module, energy storage module, wave generator circuit and patient interface, the generation that energy storage module is biphasic waveform provides energy, described control module is connected with energy storage module and wave generator circuit respectively, control module exports certain sequential, control waveform circuit for generating switches between open and closed, so that the energy making energy storage module discharge is applied to it patient by patient interface.Biphasic waveform is called a phase waveform and two phase waveform in this article, and the direction that a phase waveform and two phase waveform flow through patient is contrary.Energy storage module comprises for providing the first energy storage device of energy for the generation of a phase waveform and for providing the second energy storage device of energy for the generation of two phase waveform.
First energy storage device and the second energy storage device can be electric capacity or battery respectively.Electric capacity is charged by charging circuit, to make capacitance energy storage, when needing defibrillation, makes electric capacity make electric current flow through patient by wave generator circuit electric discharge.
Patient interface comprises two electrode terminals for contacting patient, in the embodiment improved, patient interface also comprises relay, for the outfan of wave generator circuit is switched on or switched off with two electrode terminals respectively, so as defibrillation waveform to be applied to patient with it or stop defibrillation waveform being applied to it patient.
Wave generator circuit comprises double switch, and a road is used for the discharge current of the first energy storage device to flow through patient, and another road is used for the discharge current reverse flow of the second energy storage device through patient.
Defibrillation therapy normally indicates using energy as dosage, and there are relation energy and voltage, electric current and time.Energy, voltage, electric current, time, impedance just constitute the relevant several major parameters of bi-phase wave waveform.
The success rate of defibrillation is closely related with the average current flowing through patient thoracic cavity, and different patients has different thorax impedance, from 20 ohm ~ 200 ohm, becomes for each person at 70 ohms.When defibrillation voltage is identical, patient's impedance is higher, and its electric charge accepted is less, and defibrillation success rate will reduce.In order to compensation of patient impedance on change on the impact of defibrillation success rate, usually can carry out impedance-compensated to waveform, compensation method has: according to impedance change voltage and according to impedance change the persistent period.
A kind of impedance-compensated scheme is as follows: first, uniquely according to the size selecting energy, determines a charging voltage.The amplitude of this voltage is only relevant with energy settings value, has nothing to do with impedance.Then measurement impedance in discharge process, and determine the pulse duration according to this impedance, the impedance higher persistent period is longer.Such as: first receive the energy that user selects, in this step, rule of thumb can select required energy with practical situation to the selection of energy; Then according to the energy that user selects, the charging voltage of a phase electric capacity and two-phase capacitor is determined; Then start a phase capacitor discharge, a phase capacitor discharge persistent period is determined in the impedance according to the patient initially recorded that discharges.In like manner determine the two-phase capacitor discharge period.Owing to there is all parameter restrictions being used for ensureing curative effect, if the biphase overall pulse persistent period is no longer than 25mS etc., so this compensation is limited, under high impedance, the actual energy sent can lower than setting value.When the advantage of this mode is charging, electrode slice can not be connected on human body.
Another kind of impedance-compensated method is: the impedance first exporting a small current measurement patient before charging to capacitor, then according to persistent period and the charging voltage of this impedance determination pulse.Under identical energy is arranged, more high charge voltage is higher in impedance.Under high impedance, improve charging voltage by conbined usage and increase pulse duration two kinds of compensatory devices, thus the energy discharged under guaranteeing high impedance reaches the energy size of selection.The shortcoming of this scheme Electrode connection just can must be charged to human body.
Can only be different lower than the electric discharge end voltage of a phase electric capacity from the initial discharge voltage of two-phase capacitor in prior art, in the embodiment improved, for the situation with two energy storage devices, the initial discharge voltage of control module to the second energy storage device is determined, make the initial discharge voltage of the second energy storage device can higher than, be equal to or less than the electric discharge end voltage of the first energy storage device.First control module gets the initial discharge voltage of the second energy storage device, then after the first energy storage device electric discharge terminates, controls the second energy storage device and discharges from its initial discharge voltage.
The defining method of the initial discharge voltage of the second energy storage device is determined according to the situation of the first energy storage device or determines according to the setting of user.
Be defined as example with the defining method of the initial discharge voltage of the second energy storage device according to the situation of the first energy storage device to be below described.
The initial discharge voltage of the second energy storage device can be determined in the first energy storage device discharge process, namely determines based on some parameters recorded in the first energy storage device discharge process; Also can be determined by some parameters recorded before the first energy storage device electric discharge.Defibrillation circuit comprises: energy storage module, and it comprises for providing the first energy storage device of energy for the generation of a phase waveform and for providing the second energy storage device of energy for the generation of two phase waveform; For obtaining the first module of the initial discharge voltage of the second energy storage device; For after the first energy storage device electric discharge terminates, control the second energy storage device from described initial discharge voltage to the second module that patient discharges.Also comprise computing module and charging circuit, the energy that computing module is used for selecting according to user determines the first energy storage device and the second energy storage device charging voltage value separately; Charging circuit is used for the first energy storage device and the second energy storage device to be charged to respective charging voltage value.
In one embodiment, described first module obtains the initial discharge voltage of the second energy storage device in the first energy storage device discharge process.Wherein scheme is that described first module can comprise: first detecting unit, for detecting the impedance of the first energy storage device the magnitude of voltage in this detection moment, the socking out time in this detection moment and patient in the first energy storage device discharge process; First computing unit, the initial discharge voltage of the second energy storage device is determined in the impedance for the magnitude of voltage of the first energy storage device based on this detection moment, socking out time and patient.
When calculating the initial discharge voltage of the second energy storage device by this method, defibrillation circuit also comprises three module, it is in the first energy storage device discharge process, and after the initial discharge voltage of acquisition second energy storage device by the Voltage Cortrol of the second energy storage device to described initial discharge voltage.Described three module, at the first energy storage device interdischarge interval, is controlled the second energy storage device and is discharged by inner leadage circuit, thus by the Voltage Cortrol of the second energy storage device to described initial discharge voltage.
In another embodiment, described first module can obtain the initial discharge voltage of the second energy storage device before the first energy storage device electric discharge.
In one embodiment, the first module, the second module, three module and computing module accessible site are in control module.
Be illustrated in figure 4 a kind of control flow realizing defibrillation with biphasic wave, be applicable to above-mentioned defibrillation with biphasic wave circuit, be respectively a phase electric capacity and two-phase capacitor is described for the first energy storage device and the second energy storage device, described flow process comprises the following steps:
In step 101, when after charging instruction user being detected, receive or read the energy that user selects, in step 103, according to the energy that user selects, determine the charging voltage value of a phase and two-phase capacitor.A kind of method is the charging voltage value that formula can be adopted first to determine a phase electric capacity, the charging voltage value of two-phase capacitor is the fixed percentage of the charging voltage value of a phase electric capacity, and the charging voltage value of such as two-phase capacitor is 80% or 70% of the charging voltage value of a phase electric capacity.Another kind method is the form that can adopt synopsis, when determining corresponding relation, can consider the derate requirement of the effective voltage range of bi-phase wave and energy storage capacitor.When user select energy be certain value or certain scope time, a phase corresponding with this energy and the charging voltage value of two-phase capacitor can be found by synopsis.After determining the charging voltage value of a phase and two-phase capacitor, in step 105, start and complete charging.
In step 107, when receiving the instruction of defibrillation, start a phase loop electric discharge, in step 109, in a phase discharge start time, measuring voltage and current parameters, calculate the resistance value of patient, then performs step 111.
In step 111, determine the discharge period of a phase and two-phase capacitor according to patent impedance.Those skilled in the art also can adopt existing computing formula to determine the discharge period of a phase, two-phase capacitor, such as:
T1=0.0441*R+4.5802+0.00002*E
T2=2.1258*log(R)-3.1572+0.00001*E
Wherein, T1, T2 are respectively the discharge period of a phase and two-phase capacitor, and R is patent impedance, and E is the energy value that user selects.
Step 113 is performed after the discharge period calculating a phase and two-phase capacitor.
In step 113, the magnitude of voltage of the first energy storage device detected according to certain moment, the socking out time of first energy storage device in this moment and the impedance of patient, calculate the initial discharge voltage of two-phase capacitor.Such as based on the magnitude of voltage (i.e. the initial discharge voltage of a phase electric capacity) of a phase electric capacity in step 109 impedance measurement moment, the socking out time in this moment (i.e. the discharge period of a phase electric capacity) and impedance, calculate the initial discharge voltage of two-phase capacitor.Such as: utilize capacitor discharge formula can calculate the electric discharge end voltage of a phase electric capacity by the initial discharge voltage of a phase electric capacity, discharge period and patent impedance, according to the requirement of the impedance of patient, energy Ratios, charge ratio and voltage ratio, by the initial discharge voltage of the proportionate relationship determination two-phase capacitor of setting.Can also directly calculate the initial discharge voltage of two-phase capacitor by the formula of definition, computing formula such as:
U21=(-0.01*R+1.4)*U11*exp(-T1/((R+3)*195))
Wherein, U21 is the initial discharge voltage of two-phase capacitor, and U11 is the initial discharge voltage of a phase electric capacity, and T1 is the discharge period of a phase electric capacity, and R is patent impedance.
From the defining method of the initial discharge voltage of two-phase capacitor, the initial discharge voltage of the two-phase capacitor calculated in the present embodiment may higher than, be equal to or less than the electric discharge end voltage of a phase electric capacity, the requirement of the impedance of patient, energy Ratios, charge ratio and voltage ratio can be met.Step 115 is performed after determining the initial discharge voltage of two-phase capacitor.
In step 115, in a phase discharge process, by the initial discharge voltage of the Voltage Cortrol in two-phase capacitor to two-phase capacitor.Method of adjustment can take following methods: one, by hardware circuit, as comparator circuit, makes two-phase capacitor follow the discharge voltage of a phase electric capacity and discharge; Two, during a phase discharge, two-phase capacitor is discharged by inner bleed-off circuit, thus by the initial discharge voltage of Voltage Cortrol to two-phase capacitor.Step 117 is performed after adjusting to the initial discharge voltage of two-phase capacitor.
In step 117, after a phase discharge persistent period arrives, terminate a phase discharge, start the electric discharge of two-phase capacitor, also can delay the electric discharge that certain hour (such as 5ms or 8ms) starts two-phase capacitor again after end one phase discharge, then perform step 119.
In step 119, after the two-phase discharge period arrives, terminate two phase discharges.
Above according to sequencing contro one phase determined and two phase discharges, complete the transmission of bi-phase wave pulse, defibrillation with biphasic wave oscillogram as shown in Figure 5.The defibrillation current flow I of a patient and phase electric capacity C1 voltage VC1 and two-phase capacitor C2 voltage VC2 waveform is flowed through as Fig. 5 during defibrillation.In Fig. 5, T1 is a phase discharge persistent period, and T2 is the time slot of a phase discharge and two phase discharges; T3 is the two-phase discharge period; T4 is that dump energy is released the time.The adjustment process of two-phase capacitor voltage during a phase discharge as seen from Figure 5.
In the present embodiment, the initial discharge voltage of two-phase capacitor is decided by the charging voltage of a phase electric capacity all the time, is subordinated to a phase.In charging process, two-phase capacitor voltage is charged to a fixed proportion of a phase capacitor charging voltage, such as 0.75 times, in first-phase discharge process, two-phase capacitor voltage is adjusted to a magnitude of voltage consistently by the mode of interior electric discharge, can be a particular value or the value relevant with the electric discharge end voltage of a phase electric capacity, 1.2 times or 0.9 times of a such as phase capacitor discharge end voltage.The object done like this is to make two-phase discharge waveform can regulate firing voltage according to patient parameter, overcome the limitation of existing single capacitor technology, improve the ability with residual charge in myocardial cell in two-phase pulse, thus obtain a kind of follow-on BTE discharge waveform.
More than for obtaining a kind of scheme of the initial discharge voltage of the second energy storage device in the first energy storage device discharge process, the initial discharge voltage obtaining the second energy storage device in the first energy storage device discharge process can also be realized by another kind of scheme, that is: in the first energy storage device discharge process, monitor the magnitude of voltage of the first energy storage device in real time, and the voltage of dynamic conditioning second energy storage device by a certain percentage, the voltage such as controlling the second energy storage device is 1.1 times of the first energy storage device voltage, namely at the end of the first energy storage device electric discharge, the voltage of the second energy storage device is still 1.1 times of the first energy storage device electric discharge end voltage, this voltage is the initial discharge voltage of the second energy storage device.
In above-mentioned steps, the discharge period of two-phase capacitor also can calculate before two-phase capacitor electric discharge starts.
Be illustrated in figure 6 a kind of specific embodiment realizing said method, in the present embodiment, first energy storage device and the second energy storage device have a common public pole, this public pole can be both negative or positive electrode, this public pole is coupled to wave generator circuit, and wave generator circuit is coupled to respectively in another pole of the first energy storage device and the second energy storage device.If public pole is the positive pole of the first energy storage device and the second energy storage device, then the negative pole of the first energy storage device and the second energy storage device is coupled to wave generator circuit respectively.If public pole is the negative pole of the first energy storage device and the second energy storage device, then the positive pole of the first energy storage device and the second energy storage device is coupled to wave generator circuit respectively.
In the present embodiment, the energy storage module of defibrillation circuit also comprises the first voltage collection circuit, second voltage collection circuit, first energy leadage circuit and the second energy leadage circuit, described first voltage collection circuit is for gathering the voltage of the first energy storage device, its outfan is coupled to control module, described second voltage collection circuit is for gathering the voltage of the second energy storage device, its outfan is coupled to control module, between the positive pole that first energy leadage circuit is connected to the first energy storage device and ground, between the positive pole that second energy leadage circuit is connected to the second energy storage device and ground.Control module controls the first energy leadage circuit and the second energy leadage circuit conducting by drive circuit, makes the first energy storage device and the second energy storage device release energy respectively.
Between the public pole and wave generator circuit of the first energy storage device and the second energy storage device, be connected with current detection circuit, for detecting defibrillation discharge current, described current detection circuit converts the electric current of detection to voltage and outputs to control module.Also be provided with current foldback circuit, current foldback circuit judges whether the electric current detected exceeds the pre-value of setting, and if it is output overcurrent guard signal is to wave generator circuit, and control waveform circuit for generating disconnects.
As further improvement; defibrillation circuit also comprises the protection circuit with inductive and resistive feature; described protection circuit is connected between current detection circuit and wave generator circuit; described protection circuit is also connected with current foldback circuit, for the electric current of detection is outputted to current foldback circuit.
The present embodiment adopts two cover energy storage devices to carry out defibrillation with biphasic wave, the firing potential that therefore can realize two-phase discharge waveform during defibrillation electric discharge higher than, be equal to or less than the end voltage of a phase discharge waveform, the flexible setting of the energy Ratios of a phase discharge and two phase discharges, charge ratio and voltage ratio can be realized, to realize optimum turn of multiple rate effect.
In above-mentioned defibrillation with biphasic wave circuit, two energy storage devices have a public pole, conveniently can establish current detection circuit on bus, are convenient to detect defibrillation discharge current, can monitor discharge current whether overcurrent in time, to carry out overcurrent protection in time.Simultaneously because protection circuit also detects defibrillation discharge current simultaneously, can be used for carrying out overcurrent protection, therefore circuit has two-way independently current protecting function, effectively can prevent the risk continuing defibrillation electric discharge when single failure and electric discharge exception.Current detecting can adopt other modes such as Hall current sensor or current transformer to detect.
In foregoing circuit, control device can select controller, such as microprocessor or single-chip microcomputer.
Please refer to Fig. 7, Figure 7 shows that a kind of concrete defibrillation circuit, comprise control module 1, charging circuit 3, energy storage module 4, wave generator circuit 2, relay 5 and electrode terminal (treatment cable) 18,19.Energy storage module 4 comprises the first energy storage device and the second energy storage device, first energy storage device and the second energy storage device are respectively a phase electric capacity C1 and two-phase capacitor C2, wherein electric capacity C1 is for storing the pulse discharging energy of bi-phase wave first-phase, is referred to as a phase electric capacity; Electric capacity C2, for storing the pulse discharging energy of bi-phase wave second-phase, is referred to as two-phase capacitor.The negative pole of two storage capacitors C1, C2 is connected on an earth potential.In a further embodiment, also the positive pole of electric capacity C1, C2 can be linked together and become common pole.Energy storage module 4 also comprises the first energy leadage circuit 42a and the second energy leadage circuit 42b, drive singal that first energy leadage circuit 42a and the second energy leadage circuit 42b is sent by control module 1 respectively controls drive circuit 41a and 41b and controls conducting, thus carries out energy to a phase electric capacity C1 and two-phase capacitor C2 respectively and release.
Charging circuit 3 is Switching Power Supplies, and its Main Function charges to a phase electric capacity C1 and two-phase capacitor C2.
In one embodiment, wave generator circuit 2 comprises drive circuit 25a, 25b, 25c, 25d of four solid-state switch parts 21,22,23,24 and correspondence, and is controlled to drive by control module 1 drive singal 12a, 12b, 12c, 12d respectively.
Wave generator circuit 2 and energy storing device C1, C2 go between by three and are connected, and we are referred to as the first lead-in wire 13, second lead-in wire the 14, the 3rd lead-in wire 15.Wave generator circuit to be gone between 16(SternumLine by breastbone), apex lead 17 (Apex Line) is coupled with patient 6 through relay 5 and treatment cable 18,19.
Wave generator circuit 2 is coupled with a phase electric capacity C1 positive terminal by the first lead-in wire 13; Be coupled with two-phase capacitor C2 positive terminal by the second lead-in wire 14; By going between, 15 negative pole ends common with two energy storage capacitors are coupled.
Switch block 21 is coupled with two-phase capacitor C2 positive terminal through the second lead-in wire 14, and is coupled with patient 6 through relay 5 and treatment cable 18 by breastbone lead-in wire 16 (Sternum Line); Switch block 21 is driven by signal 12a by drive circuit 25a.
Switch block 22 is coupled with a phase electric capacity C1 positive terminal by the first lead-in wire 13, and is coupled with patient 6 through relay 5 and treatment cable 19 by apex lead 17 (Apex Line); Switch block 22 is driven by signal 12b by drive circuit 25b.
Switch block 23 is coupled with patient 6 by output lead 17 (Apex Line) and relay 5, treatment cable 19; And be coupled to two-phase capacitor C2 negative pole end through the 3rd lead-in wire 15 (Back Line); Switch block 23 is driven by signal 12c by drive circuit 25c.
Switch block 24 is coupled with patient 6 by output lead 16 (Sternum Line) and relay 5, treatment cable 18; And the 3rd lead-in wire 15 (Back Line) are coupled to a phase electric capacity C1 negative pole end; Switch block 24 is driven by signal 12d by drive circuit 25d.
The optional device with having one-way conduction of switch block 21 and 22, has very little conduction impedance during conducting, have very large cut-off impedance during cut-off.
The effect of the unidirectional general character of switch block 21 can be described below: when carrying out a phase waveform electric discharge because switch block 22 is in conducting state, a phase electric capacity C1 voltage is greater than two-phase capacitor C2 voltage simultaneously, if now there is the single failure condition of open circuit in switch block 24, the unidirectional general character of switch block 21 then can stop electric current from a phase electric capacity C1 positive pole through going between 13, switch block 22, lead-in wire 17, relay 5, cable 19, patient 6, cable 18, relay 5, lead-in wire 16, switch block 21 flows into the positive pole of two-phase capacitor C2, and less desirable electric current is produced in patient 6 body.
There is when switch block 23 and 24 conducting very little conduction impedance, there is during cut-off larger impedance, but impedance during its cut-off is generally not more than 50M ohm.Therefore before electric discharge starts after charging complete, breast can be kept to hinder line 16 consistent with the above earth potential of apex line 17, make that relay 5 is closed would not hinder line 16 due to breast and apex line 17 current potential is inconsistent in patient body, flow through a less desirable electric current instantaneously.
The effect of the unidirectional general character of switch block 22 can be described below: parts 21 conducting when two phase discharges, simultaneously because two-phase capacitor C2 voltage may be greater than a now phase electric capacity C1 voltage, if now there is the single failure condition of open circuit in parts 23, the unidirectional general character of switch block 22 then can stop electric current from two-phase capacitor positive pole through going between 14, parts 21, lead-in wire 16, relay 5, cable 18, patient 6, cable 19, relay 5, lead-in wire 17, parts 22 flow into a phase capacitance cathode, and produce less desirable electric current in patient 6 bodies.
The current detection circuit 8 be connected between electric capacity C1, C2 negative pole and switch block 24 is defibrillation discharge current sample units; defibrillation discharge current signal is converted to voltage signal and samples to controller 1 by it; also produce overcurrent protection signal 91 by current foldback circuit 9 simultaneously, realize overcurrent protection function.After defibrillation electric discharge overcurrent, current foldback circuit 9 produces defibrillation overcurrent OCP signal 91.OCP signal can turn off drive circuit 25a, 25b, 25c, 25d fast by hardware, and makes switch block 21,22,23,24 become cut-off state rapidly.OCP signal 91 also can inform that controller 1 there occurs defibrillation over-current state simultaneously, processes further to make controller 1.
The protection circuit 7 be connected between current detection circuit 8 and switch block 24 is the parts with inductive and resistive feature, also has the effect of current detecting simultaneously.Its inductance characteristic effectively can limit the rate of climb that electric discharge starts immediate current; Its resistance characteristic can play the effect of current limliting in defibrillation procedure, and it can limit the maximum defibrillation discharge current under worst case.Protection circuit 7 also detects defibrillation discharge current simultaneously, and realizes overcurrent protection function by overcurrent protection OCP circuit 9, produces overcurrent protection OCP signal 91.Therefore it serves double protection, the risk that effectively under prevention single failure, defibrillation discharge current is excessive for defibrillation electric discharge overcurrent protection.
The control loop switch of the second energy leadage circuit 42b can adopt solid-state switch.It can be opened fast or turn off fast, and it and control signal have the control time delay of Microsecond grade.When control signal has significant level (high or low), the rapid conducting of 42b can be made by drive circuit 41b, start energy and release; When control signal has invalid effect level (low or high), it can be able to make 42b end rapidly by drive circuit 41b, stops energy releasing.
The control loop switch of the first energy leadage circuit 42a can adopt solid-state switch, also can adopt other forms of gauge tap.Drive circuit 41a can adopt the circuit identical with 41b, also can adopt other control circuit.When control signal is significant level (high or low), make the first energy leadage circuit 42a conducting by drive circuit 41a, start energy and release; When control signal has invalid effect level (low or high), the first energy leadage circuit 42a can be made to end by drive circuit 41a, stop energy releasing.
Capacitance voltage sample circuit 43a, 43b realize the voltage sample to storage capacitor C1 and C2 respectively, and give controller 1 sampled signal, and are detected in real time by controller 1 and judge the charging voltage of process two storage capacitors.Because during charging, the charging voltage of two storage capacitors maintains a fixing ratio, and their capacitance voltage sample circuit is independently; Therefore according to two capacitance voltage sampled signal relations, controller 1 can judge whether charging circuit and sample circuit break down, effectively continues the risk of charging and defibrillation shock under prevention single failure.
The present embodiment can complete defibrillation therapy through the operation of three steps.
The first step: controller 1 sends control signal 10 to charging circuit 3, make it work and start to charge to energy storage capacitor C1 and C2, the charging voltage of storage capacitor C1 and C2 is sampled by controller 1 by capacitance voltage sample circuit 43a, 43b, after the charging voltage of storage capacitor reaches target voltage values, controller 1 stops exporting control signal 10 to stop charging operations.The energy value that charging target voltage numerical value is selected by user determines.
Second step: send defibrillation with biphasic wave pulse.After controller 1 receives defibrillation electric discharge order, send control signal 11 closing relay 5 and wait for that time delay is to make relay completely closed, then drive singal 12b is synchronously sent, 12d is high level and through drive circuit 25b, 25d driving switch parts 22 and 24 conducting simultaneously, now a phase pulse current flows through switch block 22 from a phase electric capacity C1 positive pole through the first lead-in wire 13, apex lead 17, relay 5, cable tail 19, patient 6, cable tail 18, relay 5, breastbone lead-in wire 16, switch block 24, protection circuit 7, current sample parts 8, 3rd lead-in wire 15 flow back into the negative pole end of a phase electric capacity C1.Therefore the sense of current flowing through patient flows into from treatment cable tail 19, flows out, be defined as the positive sense of current herein from cable tail 18.In the electric discharge start time in a phase loop, controller 1 measures a phase capacitance voltage and patient's current parameters simultaneously, calculates patent impedance's value, and according to the impedance determination first-phase discharge period.At the end of phase current discharge time, controller 1 makes drive singal 12b, 12d simultaneously for low level and ends through drive circuit 25b, 25d driving switch parts 22 and 24 simultaneously, and a phase discharge current loop is cut off, and a phase discharge terminates.
After less time (about 0.5ms) postpones; controller 1 makes drive singal 12a, 12c be high level and through the simultaneously conducting of drive circuit 25a, 25c driving switch parts 21 and 23 simultaneously, now two-phase pulse current from two-phase capacitor C2 positive pole through the second lead-in wire 14 flows through switch block 21, breast resistance lead-in wire 16, relay 5, cable tail 18, patient 6, cable tail 19, relay 5, apex lead 17, switch 23, protection circuit 7, current sample parts 8, the 3rd lead-in wire 15 flow back into two-phase capacitor C2 negative pole end.Therefore the sense of current flowing through patient flows into from cable tail 18, flows out, be defined as negative phase current direction herein from cable tail 19.At the end of two-phase current discharge time, controller 1 makes drive singal 12a, 12c simultaneously for low level and ends through drive circuit 25a, 25c driving switch parts 21 and 23 simultaneously, and two-phase discharge current loop is cut off, and two phase discharges terminate.
Controller 1 control signal 11 is low level, and relay 5 is disconnected.Bi-phase wave pulsing is complete.
3rd step: releasing of dump energy.After defibrillation bi-phase wave treatment injure sends and terminates, the drive singal carrying out self-controller 1 becomes significant level, makes energy leadage circuit 42a and 42b conducting by drive circuit 41a and 41b, starts energy and releases.
Due to the present embodiment employing is two energy storage components, while a phase capacitor discharge, also carry out regulable control to the voltage of two-phase capacitor.Its workflow is as follows:
During charging, charging circuit 3 charges to two storage capacitors C1, C2, according to hardware designs feature, can be the certain proportion of a phase electric capacity C1 voltage by the voltage design of two-phase capacitor C2.Ratio can be fixed, also can be variable, such as, be set as fixed proportion 75%.During charging, the charging voltage value of a phase electric capacity C1 is determined according to user-selected energy by controller 1, and the charging voltage value of two-phase capacitor C2 is determined according to the charging voltage value of a phase electric capacity C1.
When one phase discharge starts, controller 1, by measurement one phase electric capacity C1 voltage and patient's discharge current parameter, calculates patent impedance's value, and according to the impedance determination first-phase discharge period.Also adjust the voltage of C2 with this according to the firing potential of the requirement determination two-phase capacitor C2 of impedance and energy Ratios, charge ratio, voltage ratio simultaneously.Because the charging voltage of two-phase capacitor has been designed to a higher fixed proportion relative to the charging voltage (being also a phase discharge starting voltage) of a phase electric capacity C1, be a higher ratio for the electric discharge end voltage of a phase electric capacity, therefore the adjustment of two-phase capacitor generally only has downward adjustment.But the voltage of the two-phase capacitor C2 after regulating still can higher than, be equal to or less than the electric discharge end voltage of a phase electric capacity.
In the first energy leadage circuit discharge process, can regulate according to a particular value of user's setting the adjustment of the second energy leadage circuit voltage, the voltage by the second energy leadage circuit is adjusted to this particular value.Controller controls the conducting of control second energy leadage circuit, make the second energy storage device by the second energy leadage circuit electric discharge and its Voltage Cortrol is disconnected to controlling the second energy leadage circuit during this particular value, make the second energy storage device stop electric discharge, this particular value is the initial discharge voltage that next second energy storage device discharges to patient.
In the first energy leadage circuit discharge process, can also regulate according to the voltage scale of the first energy leadage circuit the adjustment of the second energy leadage circuit voltage.Controller controls the conducting of control second energy leadage circuit, second energy storage device is discharged by the second energy leadage circuit, and its voltage is adjusted by with the voltage of the first energy leadage circuit is proportional, at the end of the first energy leadage circuit electric discharge, the voltage-regulation of the second energy storage device is complete, controller controls the second energy leadage circuit and disconnects, make the second energy storage device stop electric discharge, the second energy storage device magnitude of voltage is now the initial discharge voltage that next second energy storage device discharges to patient.
Realized by leadage circuit 42b in the adjustment process of a phase discharge process middle controller 1 pair of two-phase capacitor voltage.What the control loop switch due to energy leadage circuit 42b adopted is solid-state switch, and it and control signal have the control time delay of Microsecond grade, and therefore controller 1 can start and stop energy releasing at any time.Controller 1 makes control signal effectively release to start energy, and when the voltage of electric capacity C2 is adjusted to firing potential, controller 1 makes control signal invalid to stop energy releasing.
In foregoing circuit, solid-state switch can select semiconductor switch, it can be such as full-control type semiconductor switch device, both can controlled conducting processed also can be ended by control, there is good controllable type, solid-state switch also can be half control type semiconductor switch device, such as audion, metal-oxide-semiconductor, IGBT pipe etc.
Because the solid-state switch in foregoing circuit is connected in fault offset loop, be that adopt can the switching tube of high pressure resistant and big current than more preferably scheme, the such as withstand voltage switching tube reaching more than 8V.If adopt high withstand voltage switching tube, driving force then required for it is larger, and the driving force of the control signal that the controller in equipment exports is smaller, generally can drive withstand voltage is the switching tube of 2 ~ 3V, think and adapt to high withstand voltage switching tube, add drive circuit for each solid-state switch in the present embodiment.
Drive circuit 25a, 25b, 25c, 25d can have identical circuit structure, drive circuit can make switch block 21,22,23,24 conducting time slow conducting, end fast during cut-off.Drive circuit, also by the control of overcurrent protection OCP signal 91, when OCP signal is effective, regardless of drive singal 12a, 12b, 12c, 12d level state, all can turn off drive circuit fast and export, corresponding switch block is ended fast.Drive circuit 25a, 25b, 25c, 25d power by independently isolating power supply respectively.
Be illustrated in figure 8 the control flow that another kind realizes defibrillation with biphasic wave, this embodiment can obtain the initial discharge voltage of the second energy storage device before the first energy storage device electric discharge, and described flow process comprises the following steps:
In step 201, receive or read the energy that user selects, in step 203, determine the charging voltage value of the first energy storage device according to the energy of user's selection.
In step 205, obtain the impedance of patient, first can send a small area analysis to patient, for detecting the electric current that flows through patient and being applied to patient's voltage with it, thus calculate the impedance of patient.If record the impedance of this patient in defibrillation device, the impedance of this patient also can be read out from the memorizer of defibrillation device.Then step 207 is performed.
In step 207, according to the discharge period of impedance computation first energy storage device of patient, then perform step 209.
In step 209, based on the impedance of the charging voltage value of the first energy storage device, discharge period and patient, determine the charging voltage of the second energy storage device, this voltage is also the initial discharge voltage of the second energy storage device simultaneously, and the initial discharge voltage of usual second energy storage device is lower than the charging voltage of the first energy storage device.Then step 211 is performed.
In step 211, control charging circuit to charge to the first energy storage device and the second energy storage device, detect the voltage of the first energy storage device and the second energy storage device simultaneously, when the voltage of the second energy storage device reaches its initial discharge voltage, stop the charging to the second energy storage device.When the voltage of the first energy storage device reaches its charging voltage, stop the charging to the first energy storage device.
In the present embodiment, step 201,203 and the order interchangeable of step 205.
Realize a kind of circuit of above-mentioned defibrillation method as shown in Figure 9, the difference of circuit shown in this circuit and Fig. 7 is the increase in the 5th switch block SW5, when charging beginning, 5th switch block SW5 conducting, therefore charging circuit charges to a phase electric capacity and two-phase capacitor simultaneously, in charging process, control module is detected in real time by the voltage of capacitance voltage sample circuit 43b to two-phase capacitor C2, when the voltage of two-phase capacitor C2 reaches the initial discharge voltage of calculating, control module exports control signal and drives the 5th switch block SW5 to disconnect by drive circuit, thus stop charging to two-phase capacitor C2, but charging circuit can continue a phase capacitor charging until its desired value.Control module is detected the voltage of a phase electric capacity C1 in real time by capacitance voltage sample circuit 43a, and when the voltage of a phase electric capacity C1 reaches the charging voltage of calculating, control module output control signal 10 controls charging circuit 3 and stops charging to a phase electric capacity C1.
In above-described embodiment, a phase electric capacity and two-phase capacitor can be independently electric capacity, also can be the capacitor combinations by series, parallel or series-parallel connection, also can comprise other device, such as resistive device in capacitor combination.
Defibrillation control method in above-described embodiment is also applicable to the defibrillation circuit that other has two energy storage devices, and in addition, the defibrillation circuit in above-described embodiment also can adopt other control method to realize defibrillation.
In sum, the application can realize the flexible of a phase and two-phase energy Ratios, charge ratio and voltage ratio, to realize optimum turn of multiple rate effect.
Above content is the further description done the application in conjunction with concrete preferred implementation, can not assert that the concrete enforcement of the application is confined to these explanations.For the application person of an ordinary skill in the technical field, under the prerequisite not departing from the application's design, some simple deduction or replace can also be made, all should be considered as the protection domain belonging to the application.
Claims (5)
1. a defibrillation circuit, comprise control module, energy storage module, wave generator circuit and patient interface, described wave generator circuit is connected between energy storage module and patient interface, described control module is connected with energy storage module and wave generator circuit respectively, it is characterized in that: described energy storage module comprises for providing the first energy storage device of energy for the generation of a phase waveform and for providing the second energy storage device of energy for the generation of two phase waveform, first energy storage device and the second energy storage device have common plus or minus public pole, the common plus or minus public pole that described first energy storage device and the second energy storage device have is coupled to wave generator circuit, wave generator circuit is also coupled to respectively in another pole of described first energy storage device and the second energy storage device,
Described wave generator circuit comprises the first switch block, second switch parts, 3rd switch block and the 4th switch block, between the positive pole that described first switch block is connected to described second energy storage device and the first electrode terminal of patient interface, described 3rd switch block is connected between the second electrode terminal of patient interface and described public pole, between the positive pole that described second switch parts are connected to described first energy storage device and the second electrode terminal of patient interface, described 4th switch block is connected between the first electrode terminal of patient interface and described public pole.
2. defibrillation circuit as claimed in claim 1, it is characterized in that: described first energy storage device is electric capacity or battery, described second energy storage device is electric capacity or battery.
3. defibrillation circuit as claimed in claim 2, it is characterized in that: also comprise the current detection circuit between public pole and wave generator circuit being connected to described first energy storage device and the second energy storage device, described current detection circuit is also connected with control module.
4. defibrillation circuit as claimed in claim 3; it is characterized in that: also comprise current foldback circuit; described current foldback circuit is connected with current detection circuit and wave generator circuit respectively; for the current signal that response current testing circuit exports; after current signal exceeds set point, output protection signal is to wave generator circuit, and control waveform circuit for generating is switched to off-state.
5. defibrillation circuit as claimed in claim 4; it is characterized in that: also comprise the protection circuit with inductive and resistive feature; described protection circuit is connected between current detection circuit and wave generator circuit; described protection circuit is also connected with current foldback circuit, for the electric current of detection is outputted to current foldback circuit.
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| US10625087B2 (en) * | 2014-04-24 | 2020-04-21 | Medtronic, Inc. | Therapy delivery methods and circuits for an implantable medical device |
| CN107831418A (en) * | 2017-10-27 | 2018-03-23 | 深圳迈瑞生物医疗电子股份有限公司 | Detect method, system and the defibrillator of defibrillator |
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| CN1323232A (en) * | 1998-10-13 | 2001-11-21 | 梅德特里奥尼克菲塞奥-康特尔制造公司 | Circuit for performing external pacing and biphasic defibrillation |
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| Publication number | Priority date | Publication date | Assignee | Title |
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| CN1323232A (en) * | 1998-10-13 | 2001-11-21 | 梅德特里奥尼克菲塞奥-康特尔制造公司 | Circuit for performing external pacing and biphasic defibrillation |
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| ADSP-BF531的双相波体外除颤仪控制系统的研究;叶益浩;《中国优秀硕士学位论文全文数据库工程科技Ⅱ辑2007年》;20070415(第4期);第22页第3段，第27页第9段，第38页第1段-39页第2段，第45页第2-3段；附图3-1、3-2、3-11、3-15、5-1 * |
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Effective date of registration: 20180628 Address after: 518057 the 1-4 floor of MINDRAY building, science and technology south twelve Road, Nanshan District high tech Industrial Park, Shenzhen, Guangdong. Co-patentee after: Shenzhen MINDRAY Technology Co., Ltd. Patentee after: Shenzhen Mairui Biotherapeutic Electronic Co., Ltd. Address before: 518057 MINDRAY science and technology south twelve road MINDRAY high tech Industrial Park, Shenzhen, Guangdong Patentee before: Shenzhen Mairui Biotherapeutic Electronic Co., Ltd. |