Background technology
Ambulatory electrocardiogram (DCG) is succeeded in developing in nineteen fifty-seven by U.S. doctor physics NormanJ.Holter, and american heart association is the HOLTER system with this long-time electrocardiographic recording systematic naming method.In fact the HOLTER system is exactly long route cardiogram recording of information system.The HOLTER system that mainly is divided into standard and the implanted HOLTER system of clinical practice at present.
The considerable advantage of the HOLTER system of standard is continuously the electrocardiosignal of (24-72h) record patient under natural animation, the ecg information amount that it provides has improved 10000 times than standard cardioelectric figure, therefrom detect the probability of cardiac events such as myocardial ischemia and arrhythmia than the obvious increase of ordinary electrocardiogram (ECG), the dependency to some arrhythmia and symptom also has important judgement to be worth simultaneously.Along with the continuous development of electronic technology, DCG from the initial dual pathways, triple channel lead develop into extensively popularized in nearly ten years 12 lead the synchronous dynamic record.The 12 DCG systems that lead synchronous recording at utmost simulation conventional 12 lead electrocardiogram systems, not only have former generation system log (SYSLOG) myocardial ischemia, ARR function but also further have ischemia and ARR value in localization, be wide clinical application over past ten years.
The structure of the HOLTER system of standard: the Holter system is made up of recorder and computer analysis processing system.Recorder is the equipment of wearing record and storage electrocardiosignal with oneself, and circuit mainly is made up of sensor, A/D converter and memorizer.The external connection of recorder 4 (3 passage) or 12 (12 lead) leads are pasted on patient front (see figure 1) through electrode slice.Gather electrocardiosignal, after amplifier and filter process, convert digital signal record (tape, SD card, FC card, electronic hard disc etc.) on memorizer to by A/D converter.Transfer data to the computer analysis processing system after record is finished and carry out analyzing and processing.Analysis process system mainly is made up of hardware and software two parts.Hardware mainly is high computer and a high speed laser printer of joining, computer is supported the read data functions of plug and play, 24 hours electrocardiogram (ECG) data of recorder was read in calculator memory in 1 minute, carry out automatic analyzing and processing with computer image-recognizing method, Demix figures automatic high speed playback analytical method, finally form automatic analytic statistics content, show editor and analysis again, report output, page print and data base administration.
Though the HOLTER system monitoring lead number of standard increases, monitoring time further prolongs, and present recording system brings inconvenience in life especially outstanding to the patient, is the main barrier that influence is used.At present popular 12 lead HOLTER because 12 lines that lead have overworked the patient shirtfront, cause very inconvenience of action, the prolongation of monitoring time (from 24 hours to 48 even 72 hours) though more favourable to ARR diagnosis, the inconvenience of subject discomfort sense and life is also increased thereupon.The precordial electrode of electrocardiographic recording system also can cause quite a few application on human skin allergy in pasting process, people over half all has sense of discomfort behind the precordial electrode pasting 24 hours, itches, and redness has 1/3rd people irritated serious.The distorted signals of the HOLTER system of standard, artifact, poor anti jamming capability etc. appear, owing to long distance of signal transmission, repeatedly use the aging and anti-interference structure of lead easily reason such as destructions cause, comprise that also the violent body kinematics of patient causes electrode to relatively move and reason such as loose contact.Although 12 HOLTER mock standard 12 lead electrocardiogram to the full extent of leading, but distortion and the difference of attachment of electrodes position and the reason that the patient body position changes owing to signal, the ECG pattern of HOLTER record records with standard cardioelectric figure and still greatly differs from each other in the practical application, causes present 12 the lead real cost performances of HOLTER not high.
Although the invention of HOLTER can be rated as a revolution of electrocardio educational circles, but many arrhythmia are just shown effect once at interval for a long time, these arrhythmia also are the arrhythmia that is difficult to capture for the HOLTER technology, in the face of the arrhythmia implanted HOLTER technology of these very few outbreaks is arisen at the historic moment.Implanted HOLTER is a miniature cardioelectric monitor recording equipment that implants, can work in vivo 1.5-2.0 years after the implantation, from nineteen ninety-five its formally in clinical practice, now developed into second filial generation product.Say that from allomeric function it is made up of 3 parts: 1, miniature monitor.The similar bag chewing gum of its shape, its shell has pair of electrodes, by this two electrode detection and recording ecg, during application miniature monitor is embedded in the subcutaneous of left anterior pectorial region, and cyclicity records ecg information continuously, and after the automatic or manual mode triggered, the ecg information of its circulating storage was then frozen, can access and record for inquiry.2, trigger.The patient carries at any time, is used for the manual triggers monitor and carries out freezing of ecg information and store, and the success of triggering all has display lamp to point out with failure, is similar to cigarette case outward, in 2 years service life, can involve triggering 2000 times.3, program control instrument.Earlier with its probe placement above the monitor of having implanted is external, arrange again and the various parameters of program control monitor, and can inquiry, the electrocardiogram of playback, demonstration and the new storage of printing, itself and rate adaptive pacemakers instrument compatibility are operated similarly.Implantation process: can be under the outpatient service aseptic condition, do the otch of l~1.5cm between near left border of sternum 1-4 rib, and make the subcutaneous capsule bag that can place monitor in subcutaneous separation, after monitor is put into, sew up the incision, took out stitches in 7 days.Need the condition of analog recorder to carry out electrocardiographic recorder in this zone before implanting, two electrode spacing 38mm of record, the QRS wave-amplitude of record is than 2 times of T wave height, and is up to standard during than 5 times of P wave height, the one side of word will be arranged by the side when monitor is put into the capsule bag, the back side upwards.Implantation 10min can finish.
The technology of implanted HOLTER and applied defect: 1, expensive.The implanted HOLTER of the HOLTER system price of comparison with standard is obviously expensive, especially also far can not reach conventional and use in the clinical practice of China.2, need there be the technology of wound to implant.The body surface record is compared in the implantation of apparatus obviously increases operating difficulties, increases the complication of untoward reaction such as surgical injury, infection, hemorrhage hematoma, is difficult to Most patients and accepts.3, although writing time is long, but the recording mode complexity need be to patient and family members' training, the guidance of medical practitioner, follows up a case by regular visits to, and recording mode is not omnidistance record, because the restriction of memory capacity, ecg information record amount is limited, must " exhale the old and inhale the new ", so timely storage information, technical support costly.
The utility model content
(1) technical problem that will solve
The HOLTER system of standard has volume big, and is handicapped during use, causes the easy distortion of user skin allergy and signal easily, poor anti jamming capability shortcoming such as be not easy to wear for a long time, and need there be the implantation of wound in implanted HOLTER system, and the recording mode complexity, the cost costliness.
(2) technical scheme
In order to solve the problems of the technologies described above, this utility model provides a kind of miniature three-way road long-range dynamic electrocardiographic recording instrument, comprises crosslinking electrode, crust, shell, circuit board, wave filter, preamplifier, A/D converter, microprocessor, memorizer, USB output port and power supply.
Wherein, be connected with A/D converter, memorizer, USB output port and power supply on the microprocessor; A/D converter also is connected with preamplifier; Preamplifier also is connected with wave filter; Wave filter also is connected with crosslinking electrode; Wave filter, preamplifier, A/D converter, microprocessor, memorizer, USB output port and power supply all are installed in and constitute recording system on the circuit board, are installed in the shell.Lead and shell wrap in outer Intradermal, and crosslinking electrode partly wraps in outer Intradermal.
Wherein, the data transfer direction of recording system is that crosslinking electrode, wave filter, preamplifier, A/D converter, microprocessor and memorizer transmit successively.
Wherein, the recording system back side is equipped with switch.
Wherein, power supply has with the USB output port with preamplifier, A/D converter, microprocessor, memorizer and is connected.
Wherein, electrode perimeter scribbles the conduction viscose, and paste with protection sheet on the viscose surface.
Wherein, crust has the external thin film of waterproof outward.
Wherein, the lead that connects between each electrode does not intersect mutually.
(3) beneficial effect
Technique scheme of the present utility model has following advantage:
Adopt the lead encapsulation of electrode and pcb board to be fixed in the Silicone Rubber, and do not intersect mutually between lead, improved the capacity of resisting disturbance of system, the distortion factor is little, the signal quality height; Adopt seal encapsulation techniques, have functions of waterproof and dustproof, improve signal quality; Used high-performance CPU, the EGC pattern distortion factor is reduced; The silica gel package cover is peelable, and encapsulation again exposes the USB mouth and can transmit data to work station, or recording system can be packaged in Intradermal outside the silica gel again after the charging of USB mouth, can reuse, and reduces use cost; Volume is little, and is simple and compact for structure, wears conveniently, is conducive to wear for a long time, can wear 7-14 days; The Hardware Design adopts schemes such as low power consuming circuit, high capacity cell, mass storage, supports 7-14 days battery flying power and corresponding ecg information memory space.
The specific embodiment
Below in conjunction with drawings and Examples the specific embodiment of the present utility model is described in further detail.Following examples are used for explanation this utility model, but are not used for limiting scope of the present utility model.
This utility model miniature three-way road long-range dynamic electrocardiographic recording instrument comprises crosslinking electrode, crust, shell, circuit board, wave filter, preamplifier, A/D converter, microprocessor, memorizer, USB output port and power supply.
Wherein, be connected with A/D converter, memorizer, USB output port and power supply on the microprocessor; A/D converter also is connected with preamplifier; Preamplifier also is connected with wave filter; Wave filter also is connected with crosslinking electrode.
Wherein, wave filter, preamplifier, A/D converter, microprocessor, memorizer, USB output port and power supply all are installed in and constitute recording system on the circuit board, are installed in the shell, and lead and shell wrap in outer Intradermal, and crosslinking electrode partly wraps in outer Intradermal.
Wherein, the data transfer direction of recording system is that crosslinking electrode, wave filter, preamplifier, A/D converter, microprocessor and memorizer transmit successively.
Wherein, the recording system back side is equipped with switch, can start or close recording system, can also select record to lead pattern and writing time, and display lamp is arranged, by color and stroboscopic signal, display system duty.
Preferred embodiment be that the switch of recording system is touch.
Wherein, wave filter can filter out other signals interference except electrocardiosignal.
Wherein, preamplifier can amplify electrocardiosignal.
Wherein, A/D converter can be digital signal with analog-signal transitions by certain circuit.
Wherein, microprocessor can improve the work efficiency of A/D converter, can make the each second acquired signal greater than more than 6000 times, and the aliasing degree is reduced.Can accurate recording, analyze the pace-making electrograph, data converted can also be transferred to memorizer.
Wherein, memorizer can be stored the data that the A/D converter conversion is come.
Preferred embodiment be, use jumbo memorizer, store 7-14 days ecg information amount at least.
Wherein, the USB output port can receive the data in microprocessor and the memorizer, is transferred to computer, is convenient to the user reads data log.The USB mouth can also be used for charging the battery, and reaches the purpose of reusing electro-cardiograph.
Wherein, crust is base length of side 117mm, high 81mm, the isosceles triangle medical silica-gel skin of thick 8mm.
Wherein, the data of crust are non-limiting data, that is, the length of side, height and variable thickness must be 117mm, 81mm and 8mm surely, and they can be bigger than described data, also can be littler than described data.
Wherein, the shape of crust also is non-limiting shape, and it can also be rectangle, can be circular, can also be that other are irregularly shaped etc.
Wherein, the material of crust also is non-limiting material, and it can be silica gel, also can be other materials.
Wherein, I crosslinking electrode spacing is 77mm, and Simulation with I I, III crosslinking electrode spacing are 60mm.
Wherein, the crosslinking electrode spacing is non-limiting data, and it can be other data, but its data must satisfied make crosslinking electrode Intradermal outside.
Wherein, crosslinking electrode is exposed to outside the silica gel crust of encapsulation.Scribble the conduction viscose on the encapsulation crust of electrode perimeter, both can conduct electricity, whole device is attached on the skin, and make electrode closely be adjacent to skin.Paste with protection sheet on the viscose surface, prevents that viscose is dirty when not using, and influences its viscosity.
Wherein, power supply has with the USB output port with preamplifier, A/D converter, microprocessor, memorizer and is connected.
Wherein, power supply is dc source.
Preferred embodiment be that power supply is rechargeable lithium battary.
Like this can be more can strong support 7-14 days the battery flying power, with the demand that makes things convenient for user to wear for a long time.
Wherein, electrode is connected very short with the lead of circuit board, and encapsulation is fixed in the Silicone Rubber.
The conductor length that present embodiment adopts is not more than 25mm.
Preferred embodiment be that the lead that connects between each parts does not intersect mutually.
In order to allow the wearer can continue to use this device in a humid environment, can be on crust adds the external thin film of waterproof, to improve water resistance, can allow the wearer in moist environment such as normal shower, continue to use.
This matched with devices fractional pack adnexa comprises aseptic razor, alcohol swab, physiological saline solution, external waterproofing membrane.Before using this device, reject stickup position chaeta with razor, with alcohol swab cleaning local skin and defat, clean local skin with physiological saline solution.Taking miniature HOLTER silica gel front protecting paper before the use off pastes; with normal saline wiping electrode surface; the monitor top is affixed on third and fourth intercostal level of left front parasternal (male's the 4th intercostal vertically downward; women's the 3rd intercostal); the monitor inner edge is close to parasternal, firmly presses this device and makes viscose closely attach skin in 2 minutes.Press the back side touch-pressure switch that silica gel covers during startup, and to select logging mode still be three logging modes that lead for singly leading.
At this moment, system will start working.System can gather needed data automatically and be stored in the memorizer, when person to be used wants to check the data of its record, can insert micro USB output port in this device with the USB connecting line, and be connected with work station main frame USB interface, internal storage data can be transferred in the workstation computer, can consult, date processing such as retrieval, pattern classification, analysis, editor, statistics, and auxiliary the analysis automatically of systems soft ware finished report, via being arranged, qualification analyst examination provides report, printout.
This utility model volume is small and exquisite, is worn on the shirtfront, does not influence the work of user, daily routines such as move, have a bath, and life is convenient, can wear for a long time.Electrode is connected length with the lead of circuit board and is not more than 25mm, and the encapsulation be fixed in the Silicone Rubber, can not intersect mutually between lead, so capacity of resisting disturbance is strong, the signal quality height, the distortion factor is little.Adopt the medical silica-gel encapsulation technology, the complete closed system, good seal performance has water-proof function, and improves signal quality.The silica gel package cover is peelable, and encapsulation again exposes the USB mouth and can transmit data to work station, or recording system can be packaged in Intradermal outside the silica gel again after the charging of USB mouth, can reuse, and reduces use cost.The employing usb data spreads out of, charge function, and is easy to use, can read data fast.Use high-performance CPU that the AD conversion speed is improved greatly, each second acquired signal greater than more than 6000 times, make EGC pattern distortion factor minimum, and can record analysis pacer signal and pace-making electrograph.
The above only is preferred implementation of the present utility model; should be understood that; for those skilled in the art; under the prerequisite that does not break away from this utility model know-why; can also make some improvement and modification, these improve and modification also should be considered as protection domain of the present utility model.