CN106255523A - 使用医药技术泵控制体内压力的方法及装置 - Google Patents
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Abstract
本发明涉及一种用于使用医药技术流体泵控制例如关节压力的体内压力的方法,以及涉及一种用于实行所述方法的装置。
Description
本发明涉及一种用于使用医药技术流体泵控制例如关节压力的体内压力的方法,且涉及一种用于实行所述方法的装置。
在各种体内医药干预期间,将流体(例如,气体或液体)引入到体内,并从其中移除。实例为关节镜检查,其中,例如出于膝关节检查或治疗处理的目的,用冲洗液冲洗膝盖。另一示范性处理为腹腔镜检查,其中在治疗性干预期间,将气体(例如,CO2)供应到体内。对于此些程序来说,测量、控制及特别是限制体内压力极其重要。在治疗性干预期间,尤其有必要保证一定的流体流动,以便从体内冲洗掉(例如)烟或血液,但同时必需限制压力,以免不必要地损害身体组织。为此目的,可在现有技术中发现各种解决方案。问题的简单解决方案为立即将压力传感器引入到体内。特别地,此解决方案的缺点为需要体内的额外空间,特别是对于较小体腔来说,所述额外空间是不可获得的(例如,关节镜检查)。此外,到体内的每一额外导管将增加总是出现的感染风险。
另一解决方案为测量供应管线中的压力。然而,归因于供应管线及排出管线的流体动力学条件,此压力或多或少地不同于体内实际压力。由于所测量的压力与实际值之间的此种差异以非线性方式取决于一系列参数(例如,流速、管线长度、管线直径等),所以简单校正是不可能的。
在此背景下,目标为提供用于测量、控制及特别是用于限制压力的方法,所述方法克服上述缺点。为达成此目标,提议根据技术方案1所述的方法。有利实施例为往回参照技术方案1的附属技术方案的标的物。此外,提议一种用于实行根据技术方案5的方法的装置。有利实施例为往回参照技术方案5的附属技术方案的标的物。
根据本发明的方法大体上基于使用数学模型以用于测量及控制体内压力。为此目的,由压力控制器、泵电动机、供应管线、压力传感器、医药插入装置(例如,具有光学系统的套管针)、体腔及流体出口(例如,抽吸装置)组成的完整系统通过一组微分方程式加以描述,并以所谓的状态空间模型加以概括。倘若已充分精确地确定所述模型的参数,那么接着是在具有相同输入变量的情况下估计传感器压力及体内压力。通过实际压力与所估计的传感器压力之间的比较,可检测到偏差(所谓的观察者误差)。此些偏差可(例如)由不同初始状态(例如,在操作开始时,不存在关于体内压力的先验信息)或由压力传感器的噪声测量信号引起。如果用质量准则评估观察者误差,并且随后将结果反馈到模型的能量存储装置上,那么所述误差将衰减,并且其结果是,获得体内压力的精确估计。特别地,所提议方法的优点为体内压力的测量不需要额外的压力传感器。结果,获得体内压力的明显更佳的测量,即使是在修改影响参数的情况下(例如,当开启及关闭抽吸泵时,或其类似者)也是如此。
优选地,根据本发明的方法经配置以使得估计系统以卡尔曼(Kalman)滤波器的形式实现。例如,在控制工程的教科书中解释了此些卡尔曼滤波器。所述卡尔曼滤波器允许将表示(由参数变化、容限等引起的)系统噪声及/或测量噪声(干扰、传感器缺陷等)的加权矩阵计算在内。借此改进所述模型表示真实系统的精确度。此类卡尔曼滤波器可以连续时间或离散时间的方式配置,并且此情形适用于线性及非线性系统。
实现上述方法的装置的特定实施例为蠕动软管泵,因为所述蠕动软管泵用于(例如)关节镜检查。所述蠕动软管泵含有供应蠕动泵电力的可控制电动机。经由供应管线(例如,软管及具有光学系统的套管针),将抽汲液体引导到体内(例如,膝关节)。从膝关节经由第二管线排出,所述第二管线呈简单排泄管线的形式或呈连接到所述管线的抽吸泵的形式。通过根据本发明的方法,关节中的实际压力使用压力传感器的测量数据来估计,并由泵电动机控制。
本发明的替代实施例提供吹入器,因为所述吹入器用于腹腔镜检查。借助于吹入器,将气体引导到体内(例如,腹部)。此处也可(例如)通过提取管线实现从体内的气体排出。此处,也在供应管线中进行压力测量。体内实际压力通过根据本发明的方法估计,并用于控制吹入器。结果,获得即使在极端条件下(例如,当开启及关闭抽吸装置时)也确保压力的精确测量及控制的装置。
本发明的实施例在图式中说明,并在下文中更详细地解释。
图1示意性地展示治疗师的理想情境:通过关节中的直接无故障压力测量,控制泵,确保液体流到所述关节中。由于此直接压力测量几乎不可能,所以图1仅展示所意欲的目标。
图2展示根据本发明的解决方案的实例:基于软管中的压力传感器的数据,使用卡尔曼滤波器估计关节中的实际压力。所测量的压力与所估计的压力之间检测到的偏差经由数学模型中所谓的卡尔曼增益处理,且用于进一步估计。此外,图2展示用于此模型的状态方程式。
图中所示的数字具有以下含义:
本文所使用的变量具有以下含义:
上述方法的实际实施方案适合发生在为医药技术装置的部分的微控制器上。以常规方式,所述微控制器具备输入及输出以及存储器。以软件模块的形式执行数学运算。图3中展示软件模块的流程图。所述软件可存储在自身存储器芯片(例如,EPROM)上。
图4展示所获得的结果。在上部图中,将所测量的传感器压力与所估计的传感器压力进行比较,且在中间图,将所测量的关节压力与所估计的关节压力进行比较。图4中所示的曲线图指示控制处理,其中将通过卡尔曼滤波器重新建构的关节压力用作控制变量。使用中间图,可清晰地看出所估计的关节压力与所测量的关节压力几乎相同。在下部图中,展示由卡尔曼滤波器估计的液体排出。
图5展示比较测量的结果。在一个实验中,比较两种医药泵。也就是说,一方面,供应管线中具有压力传感器的典型蠕动泵(称为A114)及具有数学估计系统的根据本发明的泵(称为A124)接收供应管线中测量的压力传感器的压力作为输入变量。两种泵皆连接到模拟实际体腔内条件的虚设件。展示实际上通过单独传感器在虚设件内所测量的值。在两种泵处,调整70mmHg的设定点压力(称为“设定值”),其中±10mmHg的压力变化被认为是可接受的(分别称为“上限”或“下限”)。
曲线的比较展示,根据本发明设计的泵在5秒后就达到所提到的60到80mmHg的范围内的压力,并在短暂上升时间后极其精确地保持在所意欲的压力。相对比地,在现有技术泵中,在60秒后才能达成比较稳定的值,但这超出了调整的范围。即使此处将执行再校准,在前60秒内,与设定值之间存在明显偏差,且随着时间的推移,变化变大。
因此,所述两种泵的比较清楚地展示根据本发明的系统的出人意料的优点,也就是说显著更快地达到压力设定值,并可进一步随时间流逝以好很多的方式保持恒定。此改进无法从现有技术获得。
基于上述描述(特别是图2中的描述)及本申请案申请时公认的专业文献,所属领域的技术人员可实施本发明的其它实施例,而不需要任何创造性。
Claims (9)
1.一种用于以医药方法确定及控制体内压力的方法,
将流体通过抽汲装置经由供应管线抽汲到体腔中,
所述流体经第二管线流出所述体腔,
控制包括于所述抽汲装置中的泵,
至少所述供应管线含有测量所述管线中的压力的压力传感器,
其特征在于
由所述压力传感器测量的所述压力为数学估计系统的输入变量,所述数学估计系统以数学方式描述状态空间,所述状态空间估计所述体腔中的实际压力,并借助于此估计值控制所述泵的电力。
2.根据权利要求1所述的方法,其特征在于所述数学估计系统经配置为卡尔曼滤波器。
3.根据权利要求2所述的方法,其特征在于所述卡尔曼滤波器以连续时间或离散时间的方式配置。
4.根据权利要求1、2或3所述的方法,其特征在于所述流体为气体。
5.根据权利要求1、2或3所述的方法,其特征在于所述流体为液体。
6.一种用于将流体引入到体腔中的医药技术装置,其含有可控制流体泵、供应管线、所述供应管线中的压力传感器,
其特征在于
所述装置经配置以实行根据权利要求1所述的方法。
7.根据权利要求5所述的医药技术装置,其由经配置以实行根据权利要求1所述的方法的至少一个微处理器、至少一个存储器以及至少一个软件表征。
8.根据权利要求6或7所述的用于将流体引入到体腔中的医药技术装置,其特征在于所述装置为吹入器。
9.根据权利要求6或7所述的用于将流体引入到体腔中的医药技术装置,其特征在于所述装置为用于关节镜检查的液体泵。
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CN111182844A (zh) * | 2017-09-07 | 2020-05-19 | 康美公司 | 用于校准气动密封套管针的性能范围的方法 |
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JP2017518776A (ja) | 2017-07-13 |
DE102014004480A1 (de) | 2015-10-01 |
DE102014004480B4 (de) | 2017-11-09 |
JP6587069B2 (ja) | 2019-10-09 |
US20160101247A1 (en) | 2016-04-14 |
EP3122231B1 (de) | 2020-03-11 |
WO2015144120A1 (de) | 2015-10-01 |
ES2795327T3 (es) | 2020-11-23 |
EP3122231A1 (de) | 2017-02-01 |
CN106255523B (zh) | 2022-05-17 |
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