CN111772691A - Hysteroscope operation uterus expansion monitoring instrument and use method thereof - Google Patents
Hysteroscope operation uterus expansion monitoring instrument and use method thereof Download PDFInfo
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Abstract
The invention discloses a hysteroscopic operation uterus expansion monitoring instrument and a using method thereof, relating to the technical field of medical appliances; comprises a central processing part, a sensor and a man-machine interaction part. The sensor collects the flow and pressure data of the uterus swelling medium inlet and outlet in real time in the hysteroscope operation and the weight of the leakage liquid, and transmits the data to the central processing part in real time. The central processing part converts the data obtained from the sensor into real-time absorption rate of the uterus swelling medium, absorption capacity of the uterus swelling medium, actual pressure in a uterine cavity and uterus swelling time, and then compares the real-time absorption rate with a preset safety range to alarm if the real-time absorption rate exceeds the preset safety range. The invention realizes real-time monitoring and danger forecasting of uterus expansion key indexes. The invention can accurately obtain the total uterus expanding time, can help clinical workers to effectively avoid serious complications of hysteroscopic surgery, and reduces the risk of the surgery. Meanwhile, hardware equipment guarantee is provided for medical researchers to carry out significant clinical research.
Description
Technical Field
The invention relates to the technical field of medical instruments, in particular to a hysteroscope operation uterus expansion monitoring instrument and a using method thereof.
Background
The hysteroscope technique utilizes natural channels of human body: vagina-cervix uteri, and a minimally invasive endoscope technology for directly viewing the openings of a cervical canal, a uterine cavity and a uterine cavity of an oviduct and the lesion parts thereof through a hysteroscope and performing surgical operation by using related instruments. Because the uterus of a human body is a thick-wall muscular organ, the space of the uterine cavity is narrow, and the front wall and the rear wall of the uterine cavity are naturally attached, the hysteroscope operation needs to establish an operation space and keep a clear visual field by means of uterus swelling pressure and uterus swelling medium so as to ensure safe and effective operation.
The hysteroscopy technology is divided into hysteroscopy and hysteroscopy operation, which are important means for clinical diagnosis and treatment of gynecological diseases, and although the hysteroscopy operation has many advantages, complications also exist objectively as an operation. Hysteroscopic surgery, especially more complicated hysteroscopic resectioning surgery, such as 2 or 3 types of hysterosubmucosal myoma resectioning surgery with large volume, serious hysteromyoma adhesion decomposition surgery and the like, can cause serious and intractable complications in and after surgery due to large uterus swelling pressure and long duration, wherein transurethral excess absorption syndrome (TURP syndrome) is common.
The TURP syndrome is a series of serious complications such as fluid overload and (or) diluted hypoNa blood disease, acute pulmonary edema, left heart failure, cerebral edema, electrolyte disorder and the like caused by the fact that a large amount of liquid swelling medium is absorbed into a human body through a blood sinus opened by an endometrial muscular layer, peritoneum and peritoneum-blood vessel in the hysteroscopic operation due to the continuous existence of intrauterine pressure, and the incidence rate is 6%. Since the occurrence of TURP syndrome can cause serious consequences and even threaten the life of a patient, clinical workers also want to take corresponding measures from the occurrence mechanism to actively prevent, set proper uterine distention pressure, control operation time, monitor liquid absorption and human absorption rate of uterine distention medium.
The human absorption rate of the uterine expansion medium is the speed (ml/min) of the uterine expansion medium entering a circulatory system through the broken end of the damaged blood vessel by pressure perfusion in the process of hysteroscopic operation, which is generated and changed in real time and is related to the actual pressure in the uterine cavity and the hemostasis mechanism around the damaged blood vessel. Uterus swelling medium has a great difference between the human body absorption rate and the difference value of the uterus swelling medium. When the real-time absorption rate of the uterine distention medium in a human body is continuously increased, the uterine distention medium is considered to enter blood circulation, but the difference value of the uterine distention medium is not necessarily increased. Therefore, if the operator can obtain the human absorption rate of the uterine expansion medium in the hysteroscopic operation, when the value is increased, the operator can adjust the pressure in the uterine cavity or the uterine expansion time in real time even if the difference value of the uterine expansion medium is in an allowable range, so that the TURP syndrome can be greatly reduced or avoided.
The absorption rate of the uterus swelling medium in human body is closely related to the actual pressure in the uterine cavity, the input-output flow of the uterus swelling medium and the uterus swelling time, and no related report is found. And other parameters such as actual pressure in the uterine cavity and uterine expansion time have no quantitative monitoring method.
The uterine cavity pressure adopted by the current clinical and experimental researches is often the pressure value set by the uterine expansion device. The uterus expanding system (liquid uterus expanding pump) continuously injects uterus expanding medium into the uterine cavity by presetting pressure and connecting a perfusion tube with an injection port of a sheath, and then maintains and adjusts the pressure in the uterine cavity by adjusting the flow rate of the uterus expanding medium at the injection port and the discharge port. The pressure and the flow in the uterine cavity can be preset by the current advanced hysteroscope uterine-expanding system, and an alarm can be given when the pressure and the flow exceed the preset values.
In the current hysteroscopic operation, uterus expansion preset pressure, operation time and uterus expansion medium difference are three main objective safety indexes.
(1) The reasonable uterus expansion pressure is generally considered as that the uterus expansion pressure is within the range of 80-100mmHg or less than the mean arterial pressure of a patient. In practice, however, due to the lack of support of related instruments and equipment, the pressure in the uterine cavity is mainly realized by presetting the upper limit of the uterine distention pressure by the uterine distention system, and an operator manually adjusts a flow control handle of a uterine distention medium injection port or an outflow port according to the operation requirement. In the hysteroscopic operation, the actual pressure in the uterine cavity is the same as the absorption rate and is also constantly changed, and the hysteroscopic operation is influenced by factors such as the flow rate of uterine swelling medium at the input and output ports of the sheath, the looseness of the cervical canal, the patency of the fallopian tube and the like. Therefore, improper value of the key value of the actual pressure of the uterine cavity will influence the accuracy of the real-time absorption rate value of the uterine distension medium.
(2) Controlling the uterus expanding time is also a key factor for controlling the absorption amount of uterus expanding medium. The hysteroscope operation time is composed of uterus expansion operation time and non-uterus expansion operation time, but the uterus expansion time is not accurately measured after repeated uterus expansion in the operation process. At present, the operation time of the hysteroscope is considered to be less than 1 hour, but the uterus expansion operation time is actually closely related to the occurrence of TURP syndrome, and the current hysteroscope systems at home and abroad are lack of devices capable of accurately displaying the total uterus expansion time of the operation.
(3) The maximum liquid absorption amount MAFAlimit of the patient is 17.6ml/kg multiplied by the body weight (kg), when the difference value of perfusion media reaches 1000ml, electrolytes need to be monitored, and the indexes of the cardiopulmonary circulation system of the patient are closely concerned; when the difference is greater than 2000ml, the operation should be stopped immediately. However, the value cannot display the absorption state of uterine distention medium in real time, so as to prevent the occurrence of TRUP syndrome as soon as possible.
In conclusion, the TURP syndrome has become a typical risk in hysteroscopy and needs to be solved urgently, but the existing instruments cannot meet the requirement of indicating monitoring. At present, in the aspect of preventing TURP syndrome which is a main complication of hysteroscopic surgery, the general judgment of the total absorption amount of uterine distension media is mainly carried out by adopting a metering container or a weighing method, and the problems of inaccuracy and untimely operation exist; no instrument equipment is available at home and abroad for monitoring the absorption of the uterine distention medium in real time, effectively and comprehensively, and the TURP syndrome cannot be prevented as early as possible.
The invention can reflect the absorption amount and state of the uterine distention medium in real time by monitoring and calculating the real-time absorption rate of the uterine distention medium, and can prevent TURP syndrome as early as possible and effectively.
Disclosure of Invention
Aiming at the defects in the prior art, the invention aims to provide a hysteroscope operation uterus expansion monitoring instrument which can monitor the human body absorption rate of uterus expansion medium, the absorption capacity of the uterus expansion medium, the input-output flow rate of the uterus expansion medium and the actual pressure in a uterine cavity in real time in hysteroscope operation and accurately obtain the total uterus expansion time by monitoring the change of the pressure value in the uterine cavity, so that clinical workers are helped to effectively avoid serious complications of the hysteroscope operation and the operation risk is reduced.
In order to realize the invention, the invention provides the following technical scheme: a hysteroscope operation uterus expansion monitoring instrument comprises a central processing part, a sensor and a man-machine interaction part;
the sensor comprises a pressure sensor, a flow sensor and a leakage weighing sensor;
the central processing part is used for comparing data obtained by the sensor and converting the data into real-time absorption rate of the uterine distention medium, absorption capacity of the uterine distention medium, actual pressure in a uterine cavity and uterine distention time, and comparing the real-time absorption rate with a preset safety range.
Preferably, the sensors comprise two groups of pressure sensors, flow sensors and leakage weighing sensors which are respectively arranged at the inlet and the outlet of the uterus swelling medium.
Preferably, the central processing unit includes one of a host of a mobile phone, a tablet computer, a notebook computer, and a desktop computer.
Preferably, the human-computer interaction part comprises a signal indicator lamp, a buzzer and an emergency stop button.
A use method of a hysteroscope operation uterus expansion monitoring instrument comprises the following steps:
A. collecting actual pressure in the uterine cavity, input flow of the uterine swelling medium, output flow of the uterine swelling medium and uterine swelling time in the hysteroscopic operation by the uterine swelling monitoring instrument to establish a database, and determining an algorithm for calculating the absorptivity and absorptivity of the uterine swelling medium in real time; determining the absorption rate of the uterus swelling medium and the safe range of the absorption amount of the uterus swelling medium;
B. collecting actual pressure, input-output flow of uterus swelling medium and uterus swelling time data in a uterine cavity by the uterus swelling monitoring instrument in the hysteroscopic operation, and calculating the absorption rate and absorption amount of the uterus swelling medium in real time;
C. when the absorption rate and the absorption amount of the uterus swelling medium exceed the absorption rate and the absorption amount of the uterus swelling medium safety range, early warning is carried out through the human-computer interaction part.
The monitoring instrument is used for monitoring four main parameters of real-time absorption rate of uterine expansion medium, absorption capacity of uterine expansion medium, actual pressure in uterine cavity and uterine expansion time. The absorption rate of the uterine distention medium is a key parameter and needs to be obtained through real-time calculation. Based on the research of the existing literature, the real-time absorption rate of the uterus swelling medium is related to the input pressure and flow rate, the output pressure and flow rate of the uterus swelling medium. Based on the literature research result, the established experimental platform is utilized to verify the existing uterus swelling medium real-time absorption rate calculation method and obtain parameters.
In the experiment, different uterus swelling medium absorption rates are realized by arranging cavities with different sizes on the artificial uterus, the real-time uterus swelling medium absorption rate is measured in real time, the algorithm obtained in literature research is compared and verified by using the experiment result, and the uterus swelling medium absorption amount is obtained through the absorption rate. And an algorithm which is accurate, reliable and capable of calculating the absorption rate and the absorption amount of the uterine distention medium in real time is established by utilizing the fitting of the experimental result.
The algorithm is more detailed as follows: the real-time absorption rate of the uterus swelling medium is a function of four parameters of the input pressure and the flow rate of the uterus swelling medium, the output pressure and the flow rate, and the functional relation is found out. And under the condition of keeping three parameters in the four parameters unchanged, changing the fourth parameter to obtain the change relation between the parameter and the real-time absorption rate of the uterine distention medium. After the relation between the four parameters and the real-time absorption rate of the uterus swelling medium is obtained, the function of the real-time absorption rate of the uterus swelling medium can be represented by the four parameters.
Preferably, the neural network can be constructed through machine learning. The four parameters of the input pressure and the flow of the uterus swelling medium, the output pressure and the flow are collected as samples, and the real-time absorption rate of the uterus swelling medium is used as a mark of the samples. The purpose of accurate prediction of the machine is achieved by utilizing a neural network with supervised learning and training the model by using a large number of samples.
In summary, compared with the prior art, the invention has the following beneficial effects:
(1) the invention can reflect the absorption amount and state of the uterine distention medium in real time by monitoring the real-time absorption rate of the uterine distention medium in a calculation way, and can prevent TURP syndrome as early as possible and effectively;
(2) the womb swelling time monitoring device has the advantages that the womb swelling medium human body absorption rate, the womb swelling medium absorption capacity, the womb swelling medium input-output flow and the actual pressure in the womb cavity are monitored in real time, and the total womb swelling time is accurately calculated by monitoring the change of the pressure value in the womb cavity, so that the occurrence of serious complications of a hysteroscope operation is effectively avoided for clinical workers, and the operation risk is reduced.
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Other features, objects and advantages of the invention will become more apparent upon reading of the detailed description of non-limiting embodiments with reference to the following drawings:
FIG. 1 is a flow chart of a method of using the hysteroscopic uterine distention monitoring instrument of example 1;
Detailed Description
The following examples will assist those skilled in the art in further understanding the invention, but are not intended to limit the invention in any way. It will be apparent to those skilled in the art that various changes and modifications can be made without departing from the spirit and scope of the invention. The present invention will be described in detail with reference to the following specific examples:
example 1
As shown in figure 1, the uterus swelling monitoring instrument for the hysteroscope operation comprises a central processing part, a sensing part and a human-computer interaction part.
The sensing part comprises a pressure and flow sensor and a leakage weighing sensor which are positioned at the outlet and the inlet of the uterine distention medium.
The central processing part is used for receiving and processing the electric signals of the sensor in real time and obtaining four key parameters such as real-time absorption rate of the uterine distention medium according to a pre-input algorithm. All the inspection parameters are provided with safety ranges, and when the real-time absorption rate of the uterus swelling medium, the absorption capacity of the uterus swelling medium, the actual pressure in the uterine cavity and the uterus swelling time exceed the safety ranges, alarm signals are sent.
The man-machine interaction part comprises: alarm, real-time display, mode selection and the like.
The central processing part is a core, and the algorithm is as follows:
(1) through data statistics of early manual uterus swelling medium collection work, 500 recent clinical cases in a hospital are subjected to data collection, key indexes of uterus swelling medium absorption rate which can be collected at present in hysteroscopy operations are established, such as uterus swelling set pressure, operation time, uterus swelling medium difference values, operation complications and the like, and a database is established.
Through the analysis of data and the literature investigation, the safety index established clinically at present is compared and verified.
(2) A hysteroscope set of uterus swelling medium perfusion system is built by utilizing a gynecological uterine cavity model; the system comprises an artificial uterine cavity model, a hysteroscope surgical instrument, a perfusion system, a leakage liquid collecting device, a pressure monitoring system, a weighing system and a data acquisition-analysis-display system. By utilizing the experiment platform, simulation experiment can be carried out on the uterus swelling medium perfusion process in the hysteroscope operation, and key parameters in the operation can be conveniently obtained.
(3) Based on the investigation of the existing literature, the traditional uterus swelling medium real-time absorption rate algorithm is researched and corrected by carrying out data statistics on early manual uterus swelling medium collection work and combining the experimental result of a uterus swelling medium flowing system experimental platform, quantitative parameter values are obtained, and an algorithm capable of calculating the uterus swelling medium absorption rate and uterus swelling medium absorption rate in real time by monitoring the actual pressure in a uterine cavity, the input-output flow rate of the uterus swelling medium and the uterus swelling time is established.
And establishing a parameter verification test and a test platform for testing the parameter change range under abnormal conditions (such as perforation of uterus in an operation). And (4) building a comprehensive experiment platform for experimental research. Wherein, the artificial uterine cavity model adopts a gynecological operation simulator, and the hysteroscope operation instrument and the uterine distention medium perfusion system adopt the existing instruments. On the basis, the actual pressure in the uterine cavity, the uterine expansion medium input and output flow rate monitoring and monitoring display subsystem is developed and increased. The pressure monitoring system selects a disposable medical human body pressure receptor, accurately displays the uterus expanding time by monitoring the pressure, and is connected with data acquisition and display equipment.
The controller for carrying calculation and judgment tasks can be a mobile phone, a tablet personal computer, a notebook computer or a desktop host.
The operating system of the controller is provided with application software for the invention.
Taking a tablet computer of an android operating system as an example, the developed application software is APP, and the input of the application software is the signal of the sensor and the input of the software interface.
The pressure and flow sensors and the weighing sensors can be communicated through various interfaces, such as Ethernet, USB interfaces and IO-Link, and can also be communicated wirelessly.
The application software sets an input port according to the communication mode of the sensor, for example, the selected sensors are all in wireless communication, WiFi, 433MHZ, Zigbee (2.4G) and the like are all suitable for short-distance wireless communication, the sensors with the wireless communication are selected, and a corresponding intelligent sensing network is established.
After the real-time data of the sensor are collected, the application software obtains four key parameters such as the real-time absorption rate of the uterine distention medium and the like according to a predetermined algorithm.
The application software presets the safety range of the four key parameters, and the real-time absorption rate of the uterus swelling medium, the absorption capacity of the uterus swelling medium, the actual pressure in the uterine cavity and the uterus swelling time exceeding the safety range all prompt alarm.
The alarm mode can adopt sound and light. And setting an early warning value slightly lower than the danger value, wherein the sound intensity of early warning and alarming is slightly different from the light. For example, the early warning sound is intermittent dripping, and the alarming sound is continuous buzzing; the light of the early warning flashes in a yellow light, and the light of the warning flashes in a red light.
After receiving the alarm, the person can focus on the procedure of remedial action and withdrawal by pressing the near scram button to eliminate sound and light.
After each operation, the application software automatically backs up the data flow of the whole operation. After the operation is finished, the operator inputs feedback to the application software, the actual condition of the operation and the abnormal condition of the calculation result of the application software are mainly identified, and the software developer is reminded. The data is prepared for updating and perfecting the application software.
The man-machine interaction part comprises a signal indicator light, a buzzer, an emergency stop button and other auxiliary functional components.
The foregoing description of specific embodiments of the present invention has been presented. It is to be understood that the present invention is not limited to the specific embodiments described above, and that various changes or modifications may be made by one skilled in the art within the scope of the appended claims without departing from the spirit of the invention. The embodiments and features of the embodiments of the present application may be combined with each other arbitrarily without conflict.
Claims (5)
1. A hysteroscopic operation uterus expansion monitoring instrument is characterized by comprising a central processing part, a sensor and a human-computer interaction part;
the sensor comprises a pressure sensor, a flow sensor and a leakage weighing sensor;
the central processing part is used for comparing data obtained by the sensor and converting the data into uterus swelling medium real-time absorption rate, uterus swelling medium absorption capacity, actual pressure in a uterine cavity and uterus swelling time.
2. The hysteroscopic operation uterus swelling monitoring instrument according to claim 1, wherein the sensors comprise two sets of pressure sensors, flow sensors and leakage weighing sensors which are respectively arranged at the inlet and the outlet of the uterus swelling medium.
3. The hysteroscopic procedure uterus swelling monitoring instrument of claim 1, wherein the central processing portion comprises one of a mobile phone, a tablet computer, a notebook computer and a host computer of a desktop computer.
4. The hysteroscopic procedure uterus swelling monitoring instrument of claim 1, wherein the human-computer interaction portion comprises a signal indicator light, a buzzer, and an emergency stop button.
5. A method of using the hysteroscopic procedure uterine distension monitoring instrument of claim 1, comprising the steps of:
A. collecting actual pressure in the uterine cavity, input flow of the uterine swelling medium, output flow of the uterine swelling medium and uterine swelling time in the hysteroscopic operation by the uterine swelling monitoring instrument to establish a database, and determining an algorithm for calculating the absorptivity and absorptivity of the uterine swelling medium in real time; determining the absorption rate of the uterus swelling medium and the safe range of the absorption amount of the uterus swelling medium;
B. collecting actual pressure, input-output flow of uterus swelling medium and uterus swelling time data in a uterine cavity by the uterus swelling monitoring instrument in the hysteroscopic operation, and calculating the absorption rate and absorption amount of the uterus swelling medium in real time;
C. when the absorption rate and the absorption amount of the uterus swelling medium exceed the absorption rate and the absorption amount of the uterus swelling medium safety range, early warning is carried out through the human-computer interaction part.
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Cited By (5)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN112618842A (en) * | 2020-12-16 | 2021-04-09 | 成都市妇女儿童中心医院 | System and method for monitoring liquid inflow and outflow in hysteroscope operation |
| CN113974600A (en) * | 2021-09-30 | 2022-01-28 | 北京伯仲汇智科技有限公司 | Liquid supply device for hysteroscope uterus expansion and monitoring method |
| CN115413995A (en) * | 2022-08-10 | 2022-12-02 | 深圳市妇幼保健院 | Voice alarm liquid retention amount metering device and method for hysteroscope water inlet and outlet monitoring |
| CN115569253A (en) * | 2022-11-09 | 2023-01-06 | 英姿医疗科技（杭州）有限公司 | Liquid management method and system |
| CN116269688A (en) * | 2023-05-18 | 2023-06-23 | 新光维医疗科技(苏州)股份有限公司 | Data processing device, method and operation system for uterine cavity operation |
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2020
- 2020-06-29 CN CN202010604709.8A patent/CN111772691A/en active Pending
Cited By (6)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN112618842A (en) * | 2020-12-16 | 2021-04-09 | 成都市妇女儿童中心医院 | System and method for monitoring liquid inflow and outflow in hysteroscope operation |
| CN113974600A (en) * | 2021-09-30 | 2022-01-28 | 北京伯仲汇智科技有限公司 | Liquid supply device for hysteroscope uterus expansion and monitoring method |
| CN115413995A (en) * | 2022-08-10 | 2022-12-02 | 深圳市妇幼保健院 | Voice alarm liquid retention amount metering device and method for hysteroscope water inlet and outlet monitoring |
| CN115569253A (en) * | 2022-11-09 | 2023-01-06 | 英姿医疗科技（杭州）有限公司 | Liquid management method and system |
| CN116269688A (en) * | 2023-05-18 | 2023-06-23 | 新光维医疗科技(苏州)股份有限公司 | Data processing device, method and operation system for uterine cavity operation |
| CN116269688B (en) * | 2023-05-18 | 2023-07-21 | 新光维医疗科技(苏州)股份有限公司 | Data processing device, method and operation system for uterine cavity operation |
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