DE102009058509A1 - Medical diagnosis- and/or therapy system for use in e.g. angiography field to examine patient, has diagnosis- and/or therapy device with movable component, where system causes interception or braking of automatic movement of component - Google Patents

Abstract

The system has a diagnosis- and/or therapy device provided with an automatic movable component and a patient bench (13) for positioning a patient (14), where the system causes interception or braking of automatic movement of the component and/or triggering of a warning signal during movement of the patient. A movement sensor recognizes movement of the patient. A handgrip is arranged on the bench, and the system controller is triggered by a signal of the interception of movement of the component. An independent claim is also included for a method for controlling a medical diagnosis- and/or therapy system.

Description

The invention relates to a medical diagnosis and / or therapy system according to the patent claim 1 and a method for its control according to the patent claim 10.

Medical diagnostic and intervention systems in angiography, cardiology and neurology today often use a so-called C-arm as a carrier for imaging components such as X-ray detector and X-ray tube. A C-arm can be motor driven for both 2D and 3D imaging and positioned very flexibly around the patient. So z. As part of a Rotationsangiographie (a circular arc-shaped ride of the C-arm to a patient) series images, so up to a few hundred images taken, which can be reconstructed after imaging by means of algorithms in a 3D volume. For this purpose, maximum rotational speeds of 60 ° / s are usually used; for future applications (eg perfusion) even higher speeds ≥ 100 ° / s are medically necessary.

At such speeds, the stopping distances are significantly prolonged, whereby the risk of collisions especially with severe injuries. a. is increased with respect to unplanned movements of the patient bringing them into the mechanical danger zone of the C-arm. Because of these and other applications that require rapid C-arm movements, it must be ensured that a collision between a motor-driven medical device and the patient is avoided. In the case of rotations about the patient's head or trunk, in addition to the head and trunk, the patient's arms and hands are in particular at risk.

In industrial applications, the risks are eliminated by not approving persons in the endangered area.

In the medical application, this is not feasible. To minimize the risks of a collision of the medical device with the patient, the speed in manual mode is currently being reduced so much that an operator in manual mode can still control the overall situation. For automatic rides, z. B. Rotation angiographies in which there is a need to exceed these speeds, a slow, manual ride is performed prior to the actual, fast imaging ride to exclude collisions with material and people. In addition, envelopes for the patient and other system components are implemented in the system software, within which the speed is additionally throttled. However, spontaneous movements of the patient are not taken into account here. Also known are Auffahrschutzmechanismen (eg., In the form of rubber trim strips) to stop the system in a collision, or other sensors (eg: capacitive sensors, infrared or ultrasonic sensors) that minimize the risks, but not completely avoid can. In addition, it is possible to fix the patient mechanically, z. B. with straps. In the non-stunned state, this is in some countries only with effort, z. B. written informed consent and often uncomfortable for the patient.

It is an object of the present invention to provide a medical diagnostic and / or therapy system which minimizes the risk of collision with respect to unplanned movements of a patient. Furthermore, it is an object of the invention to provide a method for controlling the medical diagnosis and / or therapy system.

The object is achieved by a medical diagnosis and / or therapy system according to claim 1 and a method for its control according to claim 11 and a method according to claim 12. Advantageous embodiments of the invention are the subject of the dependent claims.

In the medical diagnosis and / or therapy system according to the invention for examining a patient with a diagnosis and / or therapy device with at least one automatically movable component, with a storage device, in particular a patient bed, for supporting the patient and with at least one sensor for detecting a movement the patient, the diagnostic and / or therapy system is adapted to cause an interruption or deceleration of the automatic movement of the at least one component and / or the triggering of a warning signal during a movement of the patient. As a result, unplanned, spontaneous movements of the patient can no longer lead to collisions with the component and injuries or damage. The invention, which is easy and easy to install, high security for the medical diagnostic and / or therapy system is achieved. Advantageously, the medical diagnostic and / or therapy system has a system control.

The storage device may also be a chair, wheelchair or a device on which the patient is standing.

According to one embodiment of the invention, the medical diagnostic and / or therapy system has at least one motion sensor Detecting a patient movement, wherein the motion sensor is adapted to transmit a signal to the system controller upon detection of a movement of the patient and the system controller is configured to interrupt or slow down the automatic movement of the at least one component or upon registration of the signal cause the triggering of a warning signal. The motion sensor may be detachably attached to the patient, for example the patient's arms or legs. A motion sensor can control the movement of the patient z. B. measure by acceleration.

According to a further embodiment of the invention, the medical diagnosis and / or therapy system has at least one element with at least one touch-sensitive sensor and is designed to interrupt or stop the automatic movement of the at least one patient if the element is interrupted by the patient Component and / or cause the triggering of a warning signal. The element with the sensor works on the principle of a "deadman switch". The patient grasps or touches the element, particularly a handle, or places his hand on the element in a particular manner, and as soon as he releases the element or interrupts or alters the contact, all movements of the component are stopped or at least slowed down. Such a sensor system creates a particularly pronounced patient safety with regard to collisions with moving components of the diagnosis and / or therapy system. In addition, an element with such a sensor is simple and inexpensive to produce and can be arranged with little effort on the medical diagnostic and / or therapy system.

According to a further embodiment of the invention, the touch-sensitive sensor is adapted to transmit a signal to the system controller in case of interruption of a touch of the element by the patient and the system controller is adapted to interrupt or decelerate the automatic movement of the signal upon registration of the signal effect at least one component or the triggering of a warning signal. The signal transmission can be done via a radio connection or X-ray transparent cable. For example, the system controller then sends a control signal to the component so that it immediately stops or brakes its motion.

In an advantageous manner, at least two elements, in particular two handles, are provided, so that the patient can hold them with both hands.

According to a further embodiment of the invention, the diagnosis and / or therapy device has an automatically movable C-arm with an X-ray detector and an X-ray tube. Such C-arms are particularly suitable for 3D imaging in, among others, angiography, cardiology and neurology.

In an advantageous manner for additional collision protection, the medical diagnosis and / or therapy system has at least one further motion sensor for detecting a patient movement. Such a motion sensor may measure the patient's motion based on, for example, acceleration, gyroscope, micro GPS, or other physical principles or technologies. An embodiment of the motion sensor can for example be detachably attached to the patient, in particular to his arms, hands or chest.

According to a further embodiment of the invention, the motion sensor is adapted to send a further signal to the system controller upon detection of a patient movement and the system controller is adapted to cause an interruption or deceleration of the automatic movement of the at least one component upon registration of the further signal.

Advantageously, for a particularly good accessibility on the part of the patient, the at least one handle is arranged on the patient bed. In particular, two handles can each be arranged laterally on the patient bed, so that a lying patient can easily grasp the handles with his hands and hold or touch them.

• - Überwachung einer Patientenberührung von dem berührungssensitiven Sensor,
• – Übermittlung eines Signals an die Systemsteuerung bei Detektierung einer Unterbrechung der Patientenberührung durch den berührungssensitiven Sensor, und
• – Bewirken einer Unterbrechung oder Abbremsung einer Komponentenbewegung durch die Systemsteuerung und/oder Ausgabe eines Warnsignals, ausgelöst durch das Signal.

An inventive method for controlling the medical diagnosis and / or therapy system with an element having at least one touch-sensitive sensor includes the steps:

• Monitoring a patient touch from the touch-sensitive sensor,
• Transmitting a signal to the system controller upon detection of an interruption in patient touch by the touch-sensitive sensor, and
• - causing an interruption or deceleration of a component movement by the system controller and / or output of a warning signal, triggered by the signal.

• – Übermittlung eines Signals an die Systemsteuerung bei Detektierung einer Patientenbewegung durch den Bewegungssensor, und
• – Bewirken einer Unterbrechung oder Abbremsung einer Komponentenbewegung durch die Systemsteuerung und/oder Ausgabe eines Warnsignals, ausgelöst durch das Signal.

Another method according to the invention for controlling the medical diagnosis and / or therapy system with a motion sensor comprises the steps:

• Transmitting a signal to the system controller upon detection of patient motion by the motion sensor, and
• - causing an interruption or deceleration of a component movement by the system controller and / or output of a warning signal, triggered by the signal.

The two methods can also be performed simultaneously or sequentially by the medical diagnosis and / or therapy system.

The invention and further advantageous embodiments according to features of the subclaims are explained in more detail below with reference to schematically illustrated embodiments in the drawing, without thereby limiting the invention to these embodiments. Show it:

1 a rear view of the danger zone of a medical diagnostic system with a C-arm,

2 a side view of the danger zone of a medical diagnostic system with a C-arm,

3 a view of a medical diagnostic system according to the invention,

4 a view of another medical diagnostic system according to the invention,

5 a view of a medical diagnostic system according to the invention with additional motion sensor and

6 a rear view of the diagnostic system according to 5 ,

In the 1 and the 2 is a medical diagnostic and / or therapy system with a C-arm 10 or a section of this from the back and from the side shown. The C-arm 10 holds an x-ray tube 12 with a collimator (not shown) and an x-ray detector 11 and is arranged to be around one on a patient couch 13 arranged patients 14 can be rotated. The C-arm 10 may for example be attached to a robot arm (not shown). Dashed lines each show the danger zone for the patient; the arrow indicates the movement of the C-arm 10 at. For example, if the patient comes into the area of danger with his arms or hands due to a spontaneous movement, serious injury or damage to the component may occur.

In the 3 is an inventive medical diagnostic and / or therapy system with an automatically movable C-arm 10 , a patient bed 13 , a system control 16 and a handle 15 shown with at least one touch sensor. At the C-arm 10 are an x-ray tube 12 and an x-ray detector 11 arranged at opposite ends. The C-arm 10 is arranged on a holder or a robot arm and can, for example, be rotated and moved translationally. The robot arm can be formed, for example, by an articulated robot, by means of which the C-arm can be arbitrarily spatially adjustable. In particular, there are two handles, each with at least one or more touch sensors, so that both hands of the patient can be monitored. The touch sensors detect a hand touch by the patient. When or as long as the patient has his hand or hands on the handle, there is a movement of the C-arm 10 released, so a movement can be initiated or continued. As long as the patient's hands are on the handles, the range of movement of the patient's arms is limited and they can not enter the mechanical hazard area.

If the patient removes his hands from the respective handle, the interruption of the contact is detected and a corresponding signal to the system control 16 transmitted. This automatically causes an immediate stop of the movements of the C-arm or a slowing down of the movement. Additionally or alternatively, the triggering of a warning signal, for example acoustically or optically, may be provided.

The handle with the sensor is interpreted as a so-called deadman switch. This ensures that a braking operation is initiated in good time before a patient's hand or arm can enter a hazardous area. For example, signal transmission from the sensors to the system controller may be via a radio link (the handle with the sensor is wireless in this case and includes self-contained battery power) or X-ray transparent cables (eg, carbon fiber cables) simultaneously ensure a permanent power supply. To completely avoid misdetections and to allow any grip position, several touch sensors z. B. along the handle can be arranged. In addition, redundancy can be achieved by sensors based on different physical principles (eg pressure, inductance, capacitance, infrared, ultrasound, physiological evaluation eg pulse ...). It can be provided that the detection of the contact by the touch sensor or sensors is carried out continuously or clocked. In addition to a handle, a touch pad or other element may be provided with one or more sensors on or on which the patient's hand lies or rests in a special way.

If the patient's arms are relatively quiet, movement of other parts of the normally lying patient is usually precluded so that elements or the handles provide a relatively high level of safety for the entire patient.

In the 4 is next to the handle 15 a control panel 17 shown which can be operated by an operator. In addition to the designed as a dead man's handle can be provided that the operator z. B. on the control panel 17 must release a component movement before it can be done automatically. In such a case, the component movement can only take place when both the release has been carried out by the operator and the patient's hands are located on the handles. Both a signal from the operator and an interruption of the patient's touch of the handles interrupt the component movement.

To provide additional security, for example, in patient movements that are not recognized by the touch sensor, such as a movement of elbows or legs, motion sensors may additionally or alternatively be used. Such motion sensors can be releasably attached to the patient, for example his elbow or legs. In the 5 and the 6 a medical diagnostic and / or therapy system is shown in which one or more motion sensors 18 on the patient and a corresponding recipient 19 for example, are arranged on the patient bed. The motion sensors can measure the movement of the patient by various physical principles (eg, acceleration, gyroscope, micro GPS). The signal transmission can be done via a radio connection or X-ray transparent cable. The transaction data is sent to the system controller and evaluated there. If z. B. a defined termination condition is exceeded, the component movement is interrupted or slowed down. The motion sensor system described can also autonomously, ie without the above-described "deadman switch-like" handle used. In both cases, it may be provided that the evaluation of the sensor or the handle is optionally only on fast trips, which entail an increased risk potential is activated, while conventional "slow" automatic trips can get along without these additional safeguards.

The invention provides a technically simple solution for monitoring different body parts of the patient during automatic component movements with long braking distances. The invention offers a particularly high spatial resolution and is inexpensive relative to patient-external collision / movement sensors. Compared to other systems, the invention can be used in systems with a high security potential (potentially also safety-relevant, ie first-fail-safe). The handles and sensors can be mounted quickly and are hardly disturbing the clinical workflow.

Relative to other technologies, the invention focuses on movements of the patient in which spontaneous movements can take place. An increased security is ensured by early detection of the release of the handle before the hand comes in the danger zone. Especially by a flexible attachment of the handle on the table top longitudinal side, which allows a stretched arm position (along the body) and thus allows almost no arm movement without the touch sensors are released, any collisions can be avoided.

The invention can be briefly summarized in the following way: To reduce the risk of collision of a patient with a movable component, a medical diagnosis and / or therapy system for examining a patient with a diagnostic and / or therapeutic device with at least one automatically movable component, with a storage device, in particular a patient bed, for the storage of the patient and provided with at least one sensor for detecting a movement of the patient, wherein the diagnostic and / or therapy system is adapted to a movement of the patient, an interruption or a deceleration of the automatic movement of the effect at least one component and / or the triggering of a warning signal.

Claims (12)

Medical diagnosis and / or therapy system for examining a patient with a diagnostic and / or therapeutic device with at least one automatically movable component, with a storage device, in particular a patient couch ( 13 ), for storage of the patient ( 14 ) and with at least one sensor for detecting a movement of the patient, wherein the diagnostic and / or therapy system is adapted to interrupt or slow down the automatic movement of the at least one component and / or the triggering of a warning signal during a movement of the patient cause. Medical diagnostic and / or therapy system according to claim 1, which has a system control ( 16 ) having. Medical diagnostic and / or therapy system according to claim 2, comprising at least one motion sensor for detecting a patient movement, wherein the motion sensor is adapted to a signal to the system controller upon detection of a movement of the patient ( 16 ) and the system control ( 16 ) is designed to cause interruption or deceleration of the automatic movement of the at least one component or the triggering of a warning signal upon registration of the signal. Medical diagnostic and / or therapy system according to one of claims 1 to 3, comprising at least one element with at least one touch-sensitive sensor, wherein the diagnostic and / or therapy system is adapted to interrupt or interruption of contact of the element by the patient to cause a deceleration of the automatic movement of the at least one component and / or the triggering of a warning signal. A medical diagnostic and / or therapy system according to claim 4, wherein the touch-sensitive sensor is adapted to signal to the system controller upon interruption of a touch of the element by the patient ( 16 ) and the system control ( 16 ) is designed to cause interruption or deceleration of the automatic movement of the at least one component or the triggering of a warning signal upon registration of the signal. A medical diagnostic and / or therapy system according to any one of the preceding claims, wherein the motion sensor is disposed on the patient. A medical diagnostic and / or therapy system according to any one of the preceding claims, wherein the element is controlled by a handle ( 15 ) or a bearing surface is formed. Medical diagnostic and / or therapy system according to one of the preceding claims, wherein at least two elements, in particular two handles ( 15 ), each with at least one touch-sensitive sensor are provided. Medical diagnostic and / or therapy system according to one of the preceding claims, comprising an automatically movable C-arm ( 10 ) with an X-ray detector ( 11 ) and an x-ray tube ( 12 ). Medical diagnostic and / or therapy system according to one of the preceding claims, wherein the at least one handle on the patient couch ( 13 ) is arranged. Method for controlling a medical diagnosis and / or therapy system for examining a patient with a diagnosis and / or therapy device with at least one automatically movable component, with a system control ( 16 ), with a patient couch ( 13 ) for storage of the patient ( 14 ) and with a motion sensor for detecting a movement of the patient, wherein - upon detection of a patient movement by the motion sensor, a signal to the system control ( 16 ), and - the system controller ( 16 ) triggered by the signal causes an interruption or a deceleration of a component movement and / or a warning signal. Method for controlling a medical diagnosis and / or therapy system for examining a patient with a diagnosis and / or therapy device with at least one automatically movable component, with a system control ( 16 ), with a patient couch ( 13 ) for storage of the patient ( 14 ) and with an element having at least one touch-sensitive sensor, wherein - a touch is monitored by the touch-sensitive sensor, - a signal to the system control (detection of an interruption of the patient touch by the touch-sensitive sensor) 16 ), and - the system controller ( 16 ) triggered by the signal causes an interruption or a deceleration of a component movement and / or a warning signal.

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