CN111298293B

CN111298293B - Diaphragm pacing expectoration auxiliary device

Info

Publication number: CN111298293B
Application number: CN202010202815.3A
Authority: CN
Inventors: 石岩; 王一轩; 蔡茂林; 许未晴; 任帅; 王娜
Original assignee: Beihang University
Current assignee: Beihang University
Priority date: 2020-03-20
Filing date: 2020-03-20
Publication date: 2022-02-11
Anticipated expiration: 2040-03-20
Also published as: CN111298293A

Abstract

The invention discloses a diaphragm pacing expectoration auxiliary device, which comprises: the device comprises a gas source, an exhaust port, a pneumatic reversing valve, a gas flowmeter, an oxygen mask, a nerve electrical stimulation system, a probe and a collection card, wherein the gas flowmeter is connected with the oxygen mask, the collection card is respectively connected with the nerve electrical stimulation system and the gas flowmeter, and the nerve electrical stimulation system is connected with the probe. The diaphragm pacing expectoration auxiliary device provided by the invention adopts a mode of electrically stimulating the diaphragm nerve from the outside to enable the diaphragm muscle to generate contraction and relaxation pacing actions, thereby achieving the effects of simulating human body cough and stimulating expectoration.

Description

Diaphragm pacing expectoration auxiliary device

Technical Field

The invention relates to the technical field of medical equipment, in particular to a diaphragm pacing expectoration auxiliary device.

Background

The cough process belongs to nerve reflex, the nerve reflex caused by stimulation of the medulla oblongata cough center is an explosive expiration action, and the whole step has the functions of diaphragm muscle and intercostal muscle, particularly the contraction and the relaxation of the diaphragm muscle and the intercostal muscle, so that high-pressure air in the chest and the lung is ejected. Caused by inflammation, foreign body, physical or chemical stimulation of trachea, bronchial mucosa or pleura, the specific appearance of the whole process is as follows: first, secretions or foreign bodies in the airways cause the central system to produce the cough reflex; then, the inspiratory muscles contract forcefully to generate deep suction action; then, the glottis is closed, and the expiratory muscles contract forcefully to enable the intrathoracic pressure to rise rapidly in a short time; finally, the glottis is suddenly opened and the instantaneous release of the teeth in the chest significantly increases the exhaled air flow, shearing, crushing and expelling the airway secretions, usually with sound. However, if the cough changes from acute to chronic, it often causes great pain to the patient, such as chest distress, throat itching, panting, etc.

At present, when sputum or foreign matter is blocked in the throat, the most common methods are as follows:

the Heimlich technique is the most practical and most common method in medicine, in which a human applies a sudden upward pressure below the diaphragm to drive the air flow of residual air in the lung into the trachea quickly and expel the object or foreign matter blocked at the mouth of the trachea.

The abdominal percussion method is to impact the abdomen to increase the abdominal pressure, the diaphragm and the chest pressure, and then to force the air in the lung to discharge, resulting in artificial cough. In addition, for the patient with neck marrow injury, because intercostal muscles and abdominal muscles are paralyzed, the respiration of the patient is maintained only by the relaxation and contraction of diaphragm muscles, when the patient coughs forcefully, the diaphragm muscles descend, and because the abdominal muscles are paralyzed, the contraction capacity is lost, the abdomen is inflated, the pressure in the lung and the pressure in the pleural cavity are reduced, and the effective cough cannot be generated.

The artificial cough intervention method is characterized in that a patient with neck marrow injury can take a breath deeply, and in the end-expiratory cough, under the condition of ensuring the stability of cervical vertebra, an abdominal impact method is added for sputum excretion nursing, and the specific operation method is as follows: the patient takes the supine position, and nurse's fixed patient's neck portion of both hands, and another nurse places the both hands in patient's two side chest walls and epigastrium (the side chest wall is placed in to the finger, and the upper abdomen is placed in palm portion), when patient's end-expiratory cough, slightly pressurizes the chest wall in pointing to with both hands, and the upper abdomen is upwards strikeed to both palms inside fast, assists the patient to arrange phlegm.

The sputum aspirator method mainly comprises main components such as a controller, a pump, a shell, an inner cavity suction assembly, a liquid storage bottle and the like, and the working principle is as follows: the controller controls the pump to generate a negative pressure suction source, the negative pressure suction source is connected to the throat cavity of a patient through the breathing pipeline and corresponding auxiliary equipment, sputum, pus and the like in the cavity of the patient are sucked out and collected into a liquid storage bottle made by the equipment, so that the respiratory tract is kept unobstructed, and complications such as aspiration pneumonia, atelectasis, asphyxia and the like are prevented.

In addition, there is a recent method for generating cough reflex by electrical stimulation, which specifically operates as follows: an electrode made of stainless steel wires with the diameter of 0.1 mm is adopted, a polyethylene film is coated on the surface of the electrode, the electrode penetrates through tracheal mucosa from a position 4 cm below the thyroid cartilage by means of a guide sleeve and enters the trachea, then the guide sleeve is drawn out, the parameters of electrical stimulation are 1-3V and 20 Hz, square wave pulse is 1 millisecond and stimulation is 5 seconds, the electrode can move up and down to select a proper stimulation point so as to generate 3-5 times of cough, and the cough times are recorded on paper from a sensing device on the chest cavity through a tracing amplifier.

However, the above method still has the following disadvantages: when the Heimlich technique or the abdominal percussion technique is adopted, the effect of accurate and controllable gas flow is difficult to achieve due to the inconvenience in movement of the high paraplegia patient and the pure manual technique; adverse reactions such as retching and the like of a patient can be caused when the sputum aspirator sucks sputum, if the sputum aspirator is improperly used, the respiratory tract of the patient is damaged and is suffered from drowsiness, and the quality of life of the patient is greatly influenced due to the influence on the body and the mind of the patient caused by the uncomfortable degree and the potential safety hazard of the product; when the reflex nerve and the muscle nerve of the cough are damaged, the triggering of the cough cannot be performed by means of external stimulation. In addition, the process of assisting sputum excretion is inefficient, the comfort and the convenience are poor, and the body feeling of the patient is poor when the patient uses the sputum excretion machine.

Therefore, in view of the defects in the prior art, it is an urgent need to solve the problem of providing a expectoration assisting device.

Disclosure of Invention

In view of the above, the invention provides a diaphragm pacing expectoration assisting device, which comprises a nerve electrical stimulation channel and an acquisition channel, wherein the nerve electrical stimulation channel comprises two ways of diaphragm nerves and two ways of intercostal nerves, the acquisition channel comprises a diaphragm nerve electrical signal acquisition channel and an intercostal muscle electrical signal acquisition channel, and the diaphragm muscles generate contraction and relaxation pacing actions by adopting an external electrical stimulation mode of the diaphragm nerves, so that the effects of simulating human cough and stimulating expectoration are achieved.

In order to achieve the purpose, the invention adopts the following technical scheme:

a diaphragm pacing expectoration assisting device comprising: the device comprises a gas source, an exhaust port, a pneumatic reversing valve, a gas flowmeter, an oxygen mask, a nerve electrical stimulation system, a probe and a collection card;

the pneumatic reversing valve comprises a first pneumatic reversing valve and a second pneumatic reversing valve; the first pneumatic reversing valve is connected with the gas source, the second pneumatic reversing valve is connected with the gas outlet, the first pneumatic reversing valve, the second pneumatic reversing valve and the gas flowmeter are communicated through a three-way pipe, and the gas flowmeter is connected with the oxygen mask;

the acquisition card is respectively connected with the nerve electrical stimulation system and the gas flowmeter;

the nerve electrical stimulation system is connected with the probe.

Preferably, the system further comprises an acquisition electrode, and the acquisition electrode is connected with the acquisition card.

Preferably, the collecting electrode is provided with a plurality of electrodes, including: a diaphragm muscle collecting electrode, a left area intercostal muscle collecting electrode and a right area intercostal muscle collecting electrode; the diaphragm muscle collecting electrode, the left area intercostal muscle collecting electrode and the right area intercostal muscle collecting electrode collect myoelectric signals generated during muscle contraction and relaxation actions and transmit the myoelectric signals to an analog quantity input channel of the collecting card.

In the invention, myoelectric signals of diaphragm muscle, left intercostal muscle and right intercostal muscle are transmitted to an analog input channel of a collecting card through a collecting electrode and a shielding electric lead, and the specific transmission process is as follows: the collecting electrodes are always arranged on muscles, when each muscle generates contraction and relaxation actions, an electromyographic signal can be generated, and the electromyographic signal is amplified and filtered and is transmitted to a collecting card.

Preferably, the probes include a plurality of diaphragmatic stimulation probes and a plurality of intercostal muscle stimulation probes, the probes cooperating during stimulation.

Preferably, the nerve electrical stimulation system leads out the diaphragmatic nerve stimulation probe and the intercostal muscle stimulation probe according to an externally set trigger instruction, outputs corresponding probes through the probes, and sends down stimulation current, and the diaphragmatic nerve stimulation probe and the intercostal muscle stimulation probe are connected with the protuberant site.

In the invention, the nerve electrical stimulation system is provided with a single electrical stimulation system, and the electrical stimulation system comprises a pulse receiver which can receive an electrical stimulation trigger signal; the device comprises a data calculation unit, a data processing unit and a control unit, wherein the data calculation unit is generally composed of a core chip with a calculation unit (CPU) and can accurately calculate electric stimulation parameters such as current amplitude, pulse interval and the like; the device comprises a current signal amplifying unit, and can accurately control electrical stimulation parameters such as current amplitude, pulse interval and the like.

In the using process, the nerve electrical stimulation system sends stimulation current with certain parameters such as pulse width, amplitude, frequency and the like through the output probe according to an externally set triggering instruction. In addition, the nerve electrical stimulation system can be provided with a plurality of output channels, and parameters such as pulse width, amplitude and frequency of the nerve electrical stimulation system can be set randomly within a required threshold value range.

The invention also provides a use method of the diaphragm pacing expectoration auxiliary device, which comprises the following steps:

s1, collecting myoelectric signals including intercostal myoelectric signals and diaphragmatic electric signals in real time through the collecting electrodes, and processing and analyzing the signals;

s2, obtaining electrical stimulation intensity and an electromyographic reaction safety threshold according to the collected electromyographic signal data; the nerve electrical stimulation system sends a trigger instruction of required electrical stimulation intensity, and the stimulation intensity is output through the probe, so that the motion process of simulating cough is realized;

s3, collecting the simulated myoelectric signals including intercostal myoelectric signals and diaphragmatic electric signals by the collecting electrodes in real time, transmitting the myoelectric signals to the collecting card, and comparing and analyzing the motion feedback quantity signal data;

s4, collecting the gas flow signal of the gas flowmeter by the collecting electrode, judging the dynamic response of the gas flow signal, and adjusting the triggering instruction of the electrical stimulation intensity sent by the nerve electrical stimulation system in real time according to the comparison and analysis result of the motion feedback quantity signal data to complete the motion process of simulating the cough.

Further, in step S2, the period of the phrenic nerve electrical stimulation is 6-24 times/min; the current intensity is 0.32 mA-2.08 mA; the pulse interval is 40-130 ms.

Further, in step S2, the period of the intercostal muscle nerve electrical stimulation is 6 to 24 times/min; the current intensity is 0.32 mA-2.08 mA; the pulse interval is 40-130 ms.

Further, the step S2 includes: stimulating the phrenic nerve to contract and sink the diaphragm and expand the thoracic cavity; switching a pneumatic reversing valve on the respirator, stimulating the phrenic nerve and the intercostal nerve, performing motion relaxation on the phrenic nerve and the intercostal nerve, and extruding the thoracic cavity; and the pneumatic reversing valve is quickly opened to discharge the gas, so that the cough simulation is realized.

Through the technical scheme, compared with the prior art, the beneficial effects of the invention comprise the following points:

(1) the invention firstly provides a method for stimulating relevant muscles of cough, simulates the cough process of the whole human body, adopts an electric control mode in the whole auxiliary expectoration process, and has more accurate flow control, high automation degree and great manpower and material resources conservation compared with the current artificial auxiliary expectoration mode;

(2) the invention adopts the mode of electrical stimulation sputum excretion to stimulate the diaphragm to produce contraction and relaxation, so that the change of the pressure in the thoracic cavity is consistent with the normal cough process of a human body, and compared with the existing sputum suction pipe sputum suction and suction-expiration type sputum excretion systems, the system has higher safety and higher comfort for users;

(3) in the diaphragm pacing process, the whole process of collecting respiration related signals comprises diaphragm electric signals, intercostal electromyographic signals and gas flow signals, the effects of comparison and analysis processing are achieved, the mode of signal data analysis processing is adopted to increase system control feedback, quantitative indexes are more clear, the form of data calculation is more scientific, the requirements of patients can be accurately met, and effective reference evaluation data are provided for the health state of the patients.

Drawings

In order to more clearly illustrate the embodiments of the present invention or the technical solutions in the prior art, the drawings used in the description of the embodiments or the prior art will be briefly described below, it is obvious that the drawings in the following description are only embodiments of the present invention, and for those skilled in the art, other drawings can be obtained according to the provided drawings without creative efforts.

Fig. 1 is a schematic diagram of the working principle provided by the present invention.

In the figure, 1 is a gas source, 2 is an exhaust port, 3 is a pneumatic reversing valve, 31 is a first pneumatic reversing valve, 32 is a second pneumatic reversing valve, 4 is a gas flowmeter, 5 is an oxygen mask, 6 is a nerve electrical stimulation system, 7 is a probe, 8 is a signal, 81 is a diaphragm nerve feedback signal, 82 is a left intercostal nerve feedback signal, 83 is a right intercostal nerve feedback signal, 84 is a gas flow signal, and 9 is a collection card.

Detailed Description

The technical solutions in the embodiments of the present invention will be clearly and completely described below with reference to the drawings in the embodiments of the present invention, and it is obvious that the described embodiments are only a part of the embodiments of the present invention, and not all of the embodiments. All other embodiments, which can be derived by a person skilled in the art from the embodiments given herein without making any creative effort, shall fall within the protection scope of the present invention.

Example 1

The embodiment discloses a diaphragm pacing expectoration auxiliary device, as shown in fig. 1, includes: the device comprises a gas source 1, an exhaust port 2, a pneumatic reversing valve 3, a gas flowmeter 4, an oxygen mask 5, a nerve electrical stimulation system 6, a probe 7 and a collection card 9;

the pneumatic directional control valve 3 includes a first pneumatic directional control valve 31 and a second pneumatic directional control valve 32; the pneumatic reversing valve 3 is provided with an air flow switch valve; the first pneumatic reversing valve 31 is connected with the gas source 1, the second pneumatic reversing valve 32 is connected with the exhaust port 2, the first pneumatic reversing valve 31, the second pneumatic reversing valve 31 and the gas flowmeter 4 are communicated through a three-way pipe, and the gas flowmeter 4 is connected with the oxygen mask 5.

The acquisition card 9 is respectively connected with the nerve electrical stimulation system 6 and the gas flowmeter 5; the nerve electrical stimulation system 6 is connected to a probe 7, and the probe 7 is connected to a protrusion site, namely a nerve fiber.

The diaphragm pacing expectoration auxiliary device of this embodiment still includes the collection electrode, and the collection electrode is connected with collection card 9, and the collection electrode is provided with threely, includes: a diaphragm muscle collecting electrode, a left area intercostal muscle collecting electrode and a right area intercostal muscle collecting electrode; the diaphragm muscle collecting electrode, the left intercostal muscle collecting electrode and the right intercostal muscle collecting electrode collect myoelectric signals generated during muscle contraction and relaxation actions, and transmit the myoelectric signals to an analog input channel of the collecting card 9.

The probes 7 include two diaphragmatic stimulation probes and if two intercostal muscle stimulation probes, the probes cooperate during stimulation.

The acquisition card 9 is connected with the flow meter 4 and the acquisition electrode through a lead, the acquisition card 9 acquires signals 8, and the signals 8 comprise diaphragm muscle nerve feedback signals 81, left region intercostal muscle nerve feedback signals 82, right region intercostal muscle nerve feedback signals 83 and gas flow signals 84.

The nerve electrical stimulation system 6 is used for leading out the diaphragmatic nerve stimulation probe and the intercostal muscle stimulation probe according to an externally set triggering instruction, outputting corresponding probes through the probes and sending down stimulation current, wherein the diaphragmatic nerve stimulation probe and the intercostal muscle stimulation probe are connected with a protuberant site.

Example 2

The embodiment discloses a using method of the diaphragm pacing expectoration auxiliary device, which comprises the following steps:

s2, obtaining the electrical stimulation intensity of the phrenic nerve and the intercostal nerve and the myoelectric reaction safety threshold according to the collected myoelectric signal data; the nerve electrical stimulation system 6 sends a trigger instruction of required electrical stimulation intensity, and outputs the stimulation intensity through a probe to realize the motion process of simulating cough; the method specifically comprises the following steps: stimulating the phrenic nerve to contract and sink the diaphragm and expand the thoracic cavity; switching a first reversing valve 31 on the breathing machine, stimulating the phrenic nerve and the intercostal nerve, performing motion relaxation on the phrenic nerve and the intercostal nerve, and squeezing the thoracic cavity; rapidly opening the second reversing valve 32 to discharge the gas, thereby realizing the simulation of cough;

wherein the stimulation intensity cycle of the nerve electrical stimulation system is 6-24 times/min; the current intensity is 0.32 mA-2.08 mA; the pulse interval is 40-130 ms;

s3, collecting the simulated myoelectric signals including intercostal myoelectric signals and diaphragmatic electric signals by the collecting electrodes in real time, transmitting the myoelectric signals to the collecting card 9, and comparing and analyzing the motion feedback quantity signal data;

s4, collecting the gas flow signal of the gas flowmeter by the collecting electrode, judging the dynamic response of the gas flow signal, and adjusting the triggering instruction of the electrical stimulation intensity sent by the nerve electrical stimulation system 6 in real time according to the comparison and analysis result of the motion feedback quantity signal data to complete the motion process of simulating the cough.

The embodiments in the present description are described in a progressive manner, each embodiment focuses on differences from other embodiments, and the same and similar parts among the embodiments are referred to each other. The device disclosed by the embodiment corresponds to the method disclosed by the embodiment, so that the description is simple, and the relevant points can be referred to the method part for description.

The previous description of the disclosed embodiments is provided to enable any person skilled in the art to make or use the present invention. Various modifications to these embodiments will be readily apparent to those skilled in the art, and the generic principles defined herein may be applied to other embodiments without departing from the spirit or scope of the invention. Thus, the present invention is not intended to be limited to the embodiments shown herein but is to be accorded the widest scope consistent with the principles and novel features disclosed herein.

Claims

1. A diaphragm pacing expectoration auxiliary device is characterized by comprising: the device comprises a gas source, an exhaust port, a pneumatic reversing valve, a gas flowmeter, an oxygen mask, a nerve electrical stimulation system, a probe and a collection card;

the nerve electrical stimulation system is connected with the probe;

the device also comprises an acquisition electrode, wherein the acquisition electrode is connected with the acquisition card;

the collection electrode is provided with a plurality of, includes: a diaphragm muscle collecting electrode, a left area intercostal muscle collecting electrode and a right area intercostal muscle collecting electrode; the diaphragm muscle collecting electrode, the left intercostal muscle collecting electrode and the right intercostal muscle collecting electrode are used for collecting myoelectric signals generated during muscle contraction and relaxation actions and transmitting the myoelectric signals to an analog quantity input channel of the collecting card;

the acquisition electrodes acquire simulated myoelectric signals including intercostal myoelectric signals and diaphragm electric signals in real time, transmit the myoelectric signals to the acquisition card, and compare and analyze the motion feedback quantity signal data;

the collecting electrode collects a gas flow signal of the gas flowmeter, judges the dynamic response of the gas flow signal, and adjusts a triggering instruction of electrical stimulation intensity sent by the nerve electrical stimulation system in real time according to the comparison and analysis result of the motion feedback quantity signal data to complete the motion process of simulating cough;

the probes comprise a plurality of diaphragmatic muscle stimulation probes and a plurality of intercostal muscle stimulation probes; the stimulation intensity cycle of the nerve electrical stimulation system is 6-24 times/min; the current intensity is 0.32 mA-2.08 mA; the pulse interval is 40-130 ms.