FR2731340A1 - Equipment for assisting medical diagnosis - Google Patents

Abstract

A number of sensors (10-18) are used to capture vital or physiological data from a patient which are recorded and memorised (22,21) under the control of a computer (20) and clock (23). Groups of parameters may then be displayed in correct time relationship to each other. Some of the sensors and their associated recorders and clock may be made portable. The parameters recorded include electroencephalograph data, electrocardiograph data, blood pressure, respiratory data temperatures, eye pressure, blood pressure in a lower member and blood pressure in sexual organs.

Description

 The invention relates to an apparatus and a method for assisting in the establishment of a medical diagnosis.

 In a privileged application, it is in particular a question of establishing a synchronous polygraphy in ambulatory aiming very particularly at making it possible to associate the affections or deficiencies of cardiac origin (that is to say related to the cardiac rhythm and / or blood pressure in a part or place of a patient's body, or even breathing), those of cerebral origin (i.e. neurological or related to mental activity).

 An object of the invention is thus, in particular, to record in humans, over long periods (several hours, even several days) and on an outpatient basis (therefore under conditions close to the normal living conditions of a patient) , some of the most important vital or physiological parameters, such as electrocardiographic, blood pressure (blood or vascular pressure) and electroencephalographic activity, or even other parameters.

 Currently, it is notably known to record on an outpatient basis (that is to say without interrupting normal activity) the encephalographic phenomena of a human patient. Some devices are even equipped so that one of the electrodes of an electroencephalograph can be used to record the electrocardiographic signal. However, it is not therefore possible to obtain the necessary details and sufficient data to deduce any correlation, or medical link, between cardiac or vascular activity and brain activity.

 In general, to the knowledge of the applicant, there is currently no device making it possible to supply data from various sensors capable of acquiring various vital or physiological parameters in a patient, in order to then supply to the operator (that is to say in practice, to a doctor or a group of specialist doctors) of data allowing diagnostic aid.

 The apparatus of the invention precisely solves this problem by providing consistent data, which can be linked together and which allows a doctor (or a group of specialist doctors) to establish a very serious diagnosis thanks in particular to the possible association consistent physiological parameters of various origins, such as blood pressure, electroencephalography or electrocardiography data, even data of body temperature, eye pressure, oxygen levels in the blood or in the flow respiratory ...

To allow this, the diagnostic aid device of the invention is such that it comprises
- sensors of vital or physiological parameters,
memory recorder means for recording in memory and in common the parameters acquired by the sensors,
a record synchronization clock for acquiring and recording said parameters, according to a common time scale, and
- a synchronized display unit of the acquired and recorded parameters, to display at least some of said parameters.

 Very advantageously, at least some of the sensors, associated recording means, and / or the aforementioned clock, will be ambulatory means.

 As for said sensors, they will also very advantageously belong to the following list device for electroencephalogram, device for electrocardiogram, arterial (or vascular) pressure sensor, device for recording respiration (of the gas flow aspirated and / or exhaled), sensor-analyzer the level of oxygen in the respiratory flow, sensor of the state (erect or not) of the penis or blood flow in a sexual organ), thermometer, sensor of the ocular pressure (blood pressure with one eye), or blood or blood pressure in the lower extremities (for example, blood pressure in the toe or ankle).

 Another characteristic of the invention relates to a method of assistance in establishing the diagnosis to be established by the specialist.

According to the invention, this process is such that
first of all, sensors of various parameters relating preferably to cardiac or vascular activity or to cereal or neurological activity are connected to the patient, in order to acquire these parameters,
- a synchronous recording of the parameters to be acquired by these sensors is triggered, at the same time for at least one series of sensors,
- And said synchronous records are displayed on the aforementioned display unit, so that the order of appearance over time, on the display unit, of records revealing possible symptoms of a condition or impairment of a patient's function, helps the operator to establish the diagnosis.

 In the hypothesis where one wishes to discern the origin of an affection between, for example, the heart and the brain, if the clock of setting in time of the recording of the parameters is not the same for the measurement of all these parameters, it will in practice be impossible to know who (which organ or which vital center) was at the origin of the anomalies recorded.

 In addition, in particular in the case of the heart, it is important for the practitioner to know when we are in the contraction phase of the heart muscle (diastole, systole, ...), this in relation to possible brain repercussions.

 In other words, one of the essential characteristics of the invention is to be able to obtain precise synchronism in the recording of various parameters, in order to be able to better determine "who does what".

 Thus, it will in particular be possible to establish better diagnoses, particularly in the field of dementias due to heart disease and cardiac rhythm disturbances, as well as for certain neuropsychiatric diseases wrongly attributed to dysfunctions of the nervous system, when the heart is primarily responsible. and causes secondary neuropsychiatric manifestations. Also, it can certainly be noted that various cardiac arrhythmias are caused by paroxysmal alterations of the brain. We also plan to develop the understanding and treatment of the causes of impotence in humans with nocturnal plethysmography, as well as which relates to studies of sleep and apnea, in relation to the heart rate and electroencephalography activity, the etiological research of dementias, in particular those due to cardiac rhythm disturbances, but also those linked to ill-defined discomfort often put on the account of anxio-depressive, spasmophilic or epileptic disorders.

 As illustrated in the attached figure, the diagnostic aid device of the invention comprises a series of sensors or measuring devices 10, 11, 12, ... 18, connected to a control unit 20 for recording data supplied by these sensors in an electronic memory unit 21, by means of a recording device or recorder 22. According to the invention, a clock 23 for synchronizing the recordings is provided for acquiring and recording the parameters which will be supplied by the sensors 10, 11, ... 18, according to a common time scale. The role of this electronic clock is therefore to initiate or trigger, at a predetermined time, the operation of all or part of the sensors 10, 11, ... 18 and this, for a given period of time, continuously or sequentially, so that the collected data thus timed are recorded separately in one or more electronic memories s, such as 21, in a synchronous mode and that they can be displayed on the display unit 24, with, in the case of a printer, a timed curve by triggered sensor.

In practice, the sensors chosen may themselves include an integrated electronic control unit, as well as a memory unit and a recording unit (as is currently the case with electrocardiogram or electroencephalogram reading devices. ; see, for example, the "DMSCIENTIFIC" and "MEDILOG" devices from "OXFORD
INSTRUMENTS "; Trademarks).

 In the example illustrated in the attached figure, these sensors (to be placed on the patient's body) consist of an electroencephalogram reading device 10, an electrocardiogram reading device 11, a blood pressure measuring device 12 ( preferably in the upper part of the body, for example on the arm), a device for measuring the patient's respiratory flow 13, a sensor / analyzer of the oxygen level in this respiratory flow 14, a thermometer 15 (for reading the temperature of the patient's body), an ocular blood pressure sensor 16, and a lower extremity blood pressure sensor 17 (for example, taken at the ankle, or even at the toe), as well that another sensor 18 for taking the blood pressure at one end, in particular at the location of a sexual organ.

 It will be noted that the three blood pressure sensors / recorders (upper limbs 12, lower extremity of the body: 17 and sexual organ 18) can be made on the same type, that is to say on the model of the sphygmotensiometer (measurement pulse).

 Thus, by means of the clock 23 common to all the recording tracks of the sensors with their integrated recorder, or the common recorder 22, it will be possible to display the recordings in question on the unit 24, the synchronism making it possible to locate who, of the heart or the brain, was the first to manifest the dysfunctions which will have been revealed on the display. We can also record, so display precisely and at the right time, systolic and diastolic pressures. By providing as many recording tracks as there are sensors, we understand that in practice we will be able to isolate the parameter that changes first and measure the consequence on the others.

 In the above example, the sensor 10 could be constituted by an electroencephalographic interpreter capable of analyzing the main electroencephalographic disorders usually encountered in current pathology. As for sensor 11, it could be an electroencephalography interpreter capable of analyzing the main electrocardiological disorders also encountered in current pathology. And the sensor 12 could be constituted by a tensiometer of the oscillometric type.

 The control unit 20 may consist of a computer associated with a control program intended to trigger the synchronized operation and the stopping of the sensors in connection with the memory 21, the recorder 22 and the synchronization clock 23, l recorder 22 having as many tracks as there are sensors, likewise for the display unit 24, so that the readings obtained continuously or sequentially from each sensor can be displayed on as many "tracks" of the display unit 24. If this unit is a printer, there will therefore be as many curves as there are sensors, with, on the abscissa, a common time scale.

 Still in relation to the heart / brain correlations, the invention should make it possible to widen the field of use of pacemakers, which until now have been very essentially used in cardiac disorders which have caused syncopes or involving the prognosis. vital. However, research has already established that there are new therapeutic applications, in particular in the nervous system and, in certain proportions, in other fields such as in dementia syndromes (improvement of cognitive intellectual functions), disorders of the walking and balance, certain sexual disorders (certain impotence in men or frigidity in women), applications to certain forms of depression and anxiety in mature subjects, probably in the field of certain disorders of sight and in the area of arteritis. Studies also seem to show that certain heart rhythm disorders are caused by paroxysmal changes in the brain.

Claims (8)

 1. Apparatus for assisting a medical diagnosis comprising  - sensors (10, 11, ... 18) of vital or physiological parameters,  - memory recording means (22) (21) for recording in memory and in common the parameters acquired by the sensors,  a recording synchronization clock (23) for acquiring and recording said parameters according to a common time scale, and  - a unit (24) for synchronized display of the parameters acquired and recorded in order to display at least some of said parameters.  2. Apparatus according to claim 1, characterized in that at least some of the sensors (10, 11, 12, ... 18), the associated recording means (21, 22) and the clock (23) are ambulatory means .  3. Apparatus according to claim 1 or claim 2, characterized in that the sensors (10, 11, 12, ... 18) belong to the following list device for electroencephalogram (10), device for electrocardiogram (11), sensor pressure monitor (12), device (13) for measuring a patient's respiratory flow, sensor-analyzer for oxygen level (14) in a respiratory flow, thermometer (15), ocular blood pressure sensor ( 16), blood pressure sensor (17) at the location of a lower limb such as the ankle or a toe, blood pressure sensor at the location of the sexual organs (18).  4. Method for assisting in the establishment of a medical diagnosis, in which  - sensors (10, 11, ... 18) of various vital or physiological parameters are connected to the patient to acquire these parameters,  - a synchronized recording of said parameters is triggered at a given time, for at least one series of sensors,  - And said synchronous records are displayed on a display unit (24), so that the order of appearance over time on this display unit of records revealing possible symptoms of a condition or impaired patient function assists the operator in establishing a diagnosis.  5. Method according to claim 4, characterized in that said parameters are recorded over time periods of several hours or several days.  6. Method according to claim 4 or claim 5, characterized in that the sensors (10, 11, ... 18) and the associated recording means (21, 22, 23) are arranged on an outpatient basis.  7. Method according to any one of claims 4 to 6, characterized in that the recording step comprises the recording of parameters belonging to the following list: device (10) for electroencephalogram, device (11) for electrocardiogram, blood pressure sensor (12), device (13) for measuring a patient's respiratory flow, sensor-analyzer for oxygen level (14) in a respiratory flow, thermometer (15), ocular blood pressure sensor (16), blood pressure sensor at the location of a lower limb (17) such as the ankle or a toe, blood pressure sensor at the location of the sexual organs (18).  8. Method according to any one of claims 4 to 7, characterized in that the parameters recorded are linked to the cerebral and cardiac or vascular activity of the patient.