JP2001238924A - Mattress for operating table - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a mattress for an operating table capable of preventing a bedsore generated during an operation and keeping a body temperature. SOLUTION: This mattress 10 mounted on the operating table for reducing a body pressure applied to a person to be operated and preventing body temperature decline during the operation is constituted of first foam 14 which is the sheet of a low restitution coefficient for mounting the person to be operated capable of securing a large body contact area to the person to be operated, second foam 16 which is the sheet of a high restitution coefficient mounted on the operating table for stably holding the person to be operated on the operating table by being positioned on the back side of the first foam, an electric heater 18 disposed between the first and second foam for heating the person to be operated through the first foam, first temperature sensors 22 disposed on the surface side of the first foam for detecting the body temperature of the person to be operated at plural parts and a controller 26 for comparing temperature information from the plural first temperature sensors with a target body temperature set for the person to be operated and controlling the energizing state of the electric heater.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a mattress for an operating table, and more particularly, to a mattress capable of preventing a pressure ulcer during the operation of a subject placed on an operating table and maintaining body temperature of the subject. It is about.

[0002]

2. Description of the Related Art In general, a surgical operation is performed by placing a subject on an operating table. However, with the recent advances in medical technology, long-term operations of 10 hours or more have been increasing. In addition, treatment techniques for diseases that are common in the elderly, such as cerebrovascular disorders, have advanced, and with this, the frequency of the elderly undergoing surgery has also increased. When the above-mentioned operation is performed over a long period of time while maintaining the position of the subject on the operating table constant, the subject is subject to body pressure (contact pressure between the operating table and the body) even if the subject is not an elderly person. ) Causes ischemic tissue destruction, one of the compressive gangrene, and forms a condition called pressure ulcer (so-called "tokozure"). If this is a bedridden elderly person or the like, by changing the body position every few hours, local pressure on the human body can be eliminated and blood flow can be restored to prevent pressure ulcers from occurring. However, the subject who has undergone general anesthesia on the operating table is in the same state as a sleep-absent patient in that his or her position is fixed, but during surgery, the subject is fixed on the operating table. It is not possible to change the position because it needs to be kept. Moreover, the mattress of the operating table has little consideration from the viewpoint of preventing such pressure ulcers, but is often made hard so that the subject's body is stabilized during the operation. For this reason, long-term surgery often induces pressure ulcers in the subject.

[0003] In addition, when the subject is given general anesthesia, the basal metabolism is reduced, and depending on the contents of the operation, the subject remains in the operating room (about 25 ° C to 28 ° C) for a long time without any clothes. Therefore, the body temperature of the subject is likely to be considerably low. Furthermore, in the case of laparotomy, latent heat is lost when the body fluid on the organ surface evaporates, which also contributes to a decrease in body temperature. If the body temperature of the subject is unduly lowered in this way, it is generally a cause of delay in awakening from anesthesia after surgery or trembling of shivering, which hinders a successful recovery after surgery. (Except when a hypothermic state is intentionally formed by brain surgery or the like). For this reason, a hot water blanket is widely used as a means for preventing the body temperature of a subject on an operating table from dropping. In this method, a mat having a pipe through which warm water flows is spread under the subject, and warm water heated externally is circulated through the pipe to warm the body of the subject.

[0004]

As described above, the subject on the operating table is susceptible to pressure ulcers during the operation because he cannot change positions. Moreover, in the field of lifesaving, such as surgery, the cure (treatment) that saves life is always given priority, and the care of preventing pressure ulcers is postponed and is likely to be postponed. Bedding such as an air mat developed for pressure ulcer prevention is made to fit the dimensions of the bed, and therefore cannot be used because it does not fit the dimensions of the operating table. Therefore, it has been proposed to place an air mat (especially with variable pressure) according to the dimensions of the operating table under the subject, but this may cause the subject's body to become unstable with respect to the operating table. Easy to be. Therefore, for example, when performing microsurgery using a microscope, such an air mat cannot be used. In addition, at the time of surgery, since various positions are selected in accordance with the operation position of the subject, there is a disadvantage that mats integrated for the whole body can be used only in a limited position.

In order to prevent pressure ulcers, in addition to the air mats described above, instruments for dispersing body pressure applied locally to the human body, such as urethane, mouton and bead cushions, have been put to practical use. However, even if these instruments are laid under an operating table, and a patient whose basal metabolism or peripheral blood flow is reduced under general anesthesia is placed on the surgery, the operation site is more confined than a general ward. At present, sufficient effects have not been obtained from the viewpoint of preventing pressure ulcers.

As described above, a hot water blanket for circulating and supplying hot water from an external unit through a pipe is most widely used as a means for maintaining the body temperature of a subject during an operation. However, the fact that the warm water can be circulated even if the subject is placed on the hot water blanket means that the pipe in the blanket has enough hardness so that it can not be crushed even if the pipe is added to that much weight. is there. Therefore, if the subject is directly laid on the hot water blanket, the risk of pressure ulcer occurrence is very high, as if the subject were lying on a hard board. Therefore, in order to prevent pressure ulcers, various cushions are used between the blanket and the subject. However, in this case, it is pointed out that the heat from the hot water is cut off by the cushions, and it is difficult to obtain the effect of maintaining the body temperature of the subject.

[0007] Other means for preventing pressure ulcers include a combination of an air mat and a planar heater, and a method of blowing warm air onto a subject on an operating table to keep the temperature warm. However, as described above, the air mat type has a problem that the subject's body cannot be stably held on the operating table, and a problem that it cannot cope with a position such as a crushed stone position because there is only a whole body. is there. Also, for warm air type,
There are problems such as a large restriction on the operative field during the operation, a possibility that the hot air dries the laparotomy of the subject, and a fear of bacterial infection.

[0008]

SUMMARY OF THE INVENTION The present invention has been proposed to solve the above-mentioned problem suitably, and is intended to prevent a pressure ulcer which may occur during a long operation of a subject placed on an operating table. It is an object of the present invention to provide an operating table mattress that can prevent and maintain the body temperature of a subject.

[0009]

SUMMARY OF THE INVENTION In order to overcome the above-mentioned problems and achieve the intended object, the present invention reduces the body pressure applied to a patient placed on an operating table, and also reduces the intraoperative pressure. A mattress that is configured to prevent a decrease in body temperature, wherein the first foam is a sheet on which the subject is placed and has a low coefficient of restitution, and can ensure a large body contact area with the subject; A second sheet that is placed on the operating table, has a high coefficient of restitution, and is positioned behind the first form to stably hold a subject on the operating table; and the first form. And an electric heater arranged between the first and second forms in a required pattern to heat the subject via the first form, and an electric heater disposed in a required pattern on the front side of the first form and A first temperature sensor for detecting an operator's body temperature at a plurality of sites; Wherein the plurality of temperature information from the first temperature sensor is compared with the target temperature set in a subject, characterized by being composed of a controller for controlling an energization state of the electric heater.

[0010]

BRIEF DESCRIPTION OF THE DRAWINGS FIG. 1 is a perspective view of a mattress for an operating table according to the present invention.

FIG. 2 shows the basic structure of the mattress.
FIG. 1 is a partially cutaway perspective view showing a schematic configuration of an operating table mattress according to an embodiment.
The size of the mattress 10a is set so that it can be placed on the upper body, and can be separated into a mattress 10a on which the upper body of the subject is mainly placed and a mattress 10b on which the lower body is placed. The reason for separating the upper body side mattress 10a and the lower body side mattress 10b in this manner is that the lower body side of the operating table 12 may be cut off depending on the operative position at the time of the operation, and accordingly. The operating table mattress 10 is covered with a thin waterproof cover having high elasticity (for example, a polyester knit obtained by applying urethane foam processing), and the operating table 12 is covered with a belt.
(Neither is shown).

The mattress 10 is basically made of urethane foam, and includes a first foam 14 serving as an upper sheet on which a subject is placed, and a lower sheet placed on the operating table 12. And the second form 16 to be formed. That is, the first foam 14 is made of urethane foam having a low coefficient of restitution, and is sufficiently deformed when the subject is placed thereon, so that a large body contact area can be secured for the subject. First form 1 as an example
Numeral 4 is an EGR-4 (25 mm thick, made by Inoac) urethane foam, which has a unique coefficient of restitution, which can exert a body pressure even if the subject is placed on the first foam 14 for a long time. The numerical value is selected to be low enough to be able to suppress the occurrence of pressure ulcer by dispersing the pressure ulcer. For example, the low restitution coefficient is 1
Those with 5% or less are preferably used.

The second foam 16 serving as a lower layer sheet has a high coefficient of restitution, and can be stably held on the operating table 12 by being located on the back side of the first foam 14. I have. As an example, the second form 16 is ERG-
S (inoac, 60 mm thick) urethane foam, which has a sufficiently high coefficient of restitution, so that the first foam 14 wrapping the subject with a large body contact area is placed on the operating table 12. In contrast, it can be stably held. As this high restitution coefficient, for example, one having 45% or more is suitably used. Mattress 1 like this
Numeral 0 has a layered structure of the first foam 14 and the second foam 16 as a whole, and the mattress 10 can be separated into the upper body side mattress 10a and the lower body side mattress 10b as described above. The upper body side mattress 10a is provided with an electric heater 18 as described later with reference to FIG.

(Regarding the Electric Heater) FIG. 1 is a perspective view showing a layered structure of the mattress 10a on the upper body side in a separated state, and the mattress 10a is on the side on which the subject is placed as described above. It is basically composed of a first foam 14 serving as an upper sheet and a second foam 16 serving as a lower sheet placed on the operating table 12. A linear electric heater 18 such as a sheathed heater in a required pattern is disposed as an intermediate layer between the first foam 14 and the second foam 16. Therefore, the subject placed on the mattress 10 is heated by the electric heater 18 via the first foam 14 to prevent a decrease in body temperature. As shown in FIG. 3, the electric heater 18 is divided into a plurality of blocks 20 in the height direction of the subject.
(In the example shown, there are four corresponding to the head, shoulder, back, and waist). Each block 20 is provided with at least one second temperature sensor 24 described later.

As described above, the arrangement of the electric heater 18 is divided into
The reason for dividing into a plurality of blocks 20 is as follows.
That is, depending on the subject and even the same person, the degree of weight gain and the degree of projection of the bone vary widely depending on the body part. Therefore, the way in which the first foam 14 is crushed between the electric heater 18 and the body is not uniform, and the distance between the electric heater 18 and the body surface is also different. As a result, where the body weight is heavy, the protruding parts of the bone are overheated, and the parts that are not so are not sufficiently heated. Therefore, the arrangement pattern of the electric heater 18 is divided into four blocks corresponding to the head, shoulder, back, and waist as shown in FIG. 3, for example, and the electric heater 18 in each block 20 is controlled independently. It is something that you get.

(Regarding First Temperature Sensor) FIGS. 1 and 4
As shown in FIG. 2, a first temperature sensor 22 for detecting a body temperature of a subject at a plurality of sites is provided on the surface side of the first foam 14.
Are arranged in a required pattern. That is, when the subject is heated by the electric heater 18, even if the temperature is not so high, it is known that a low-temperature burn occurs when the same part of the body is heated for a long time. I have. The danger of the low-temperature burn is said to occur at about 42 ° C., but the risk is further increased because the individual has no perception while the subject is under general anesthesia. Generally, in an electric blanket, an electric carpet, or the like, on / off control is performed by detecting a temperature near an electric heater with a sensor. Since the manner in which 14 is collapsed differs depending on the subject, the body surface temperature of the subject varies even when the temperature of the electric heater 18 is constant.

In this embodiment, based on the above findings, the first
Three temperature sensors 22 are provided in each block 20 of the electric heater 18 so that the temperature sensors 22 are located in a dotted state near the body surface of the subject. That is, in correspondence to the electric heater 18 being divided into four blocks of a head, a shoulder, a back, and a waist, as shown in FIG. 4, three first temperature sensors 22 are provided for each block. You. The reason why the three first temperature sensors 22 are provided for one block 20 in this way is that the body of the subject is not necessarily symmetrical, and if the patient takes a lateral position in lung cancer surgery or the like, the shoulders may be Because it comes near the center of the mattress in the width direction, and furthermore, in the supine position, the vicinity of the scapula sinks down most and the center part floats, so it is necessary to extend the sensing area also in the width direction of the mattress 10. . In this case, as shown in FIG. 1, the first temperature sensor 22 is provided so as to be located on the surface side of the first foam 14, so that the body of the subject lying on the operating table 12 is hardly detected by the temperature sensor 22. They come into contact with each other (actually, the highly elastic waterproof cover described above is interposed). Therefore, the first temperature sensor 2
2 is capable of detecting the temperature near the body surface of the subject, comparing the detected temperature information with a target body temperature set for the subject, and controlling the energization state of the electric heater 18 as described later. become.

(Regarding the Second Temperature Sensor) FIGS. 1 and 3
As shown in FIG. 2, near the electric heater 18 divided into the blocks 20, at least one second temperature sensor 24 for monitoring overheating of the heater 18 is provided. The second temperature sensor 24 is provided when a failure occurs in the control of the electric heater 18 by the first temperature sensor 22 (for example, when the temperature of a target body temperature set for the subject due to failure of one of the first temperature sensors 22). If the electric heater 18 is left unattended when it becomes impossible to perform the comparison, a runaway accident such as overheating of the electric heater 18 will occur.

(Regarding Controller) FIG. 5 is a control block diagram of a controller 26 for controlling the electric heater 18 provided for each block in the operating table mattress 10 according to the embodiment by the first temperature sensor 22 and the second temperature sensor 24. FIG. The controller 26 is supplied with power from a power supply unit 28, and a CPU 30 provided inside is connected to an external personal computer 32 so that data can be freely exchanged. The electric heater 18 provided in each of the four divided blocks 20 is connected to a corresponding relay 34,
The relay 34 is connected to the CPU 30. A first temperature sensor 22 (three in total) provided three in each of the four blocks 20 and a second temperature sensor 24 (four in total) provided one in each block 20 include a multiplexer 36 and an A / D It is connected to the CPU 30 via the converter 38. Further, an input key 40 and a temperature display unit 42 are connected to the CPU 30. By operating the input key 40, a target temperature (body temperature) required for the subject is stored in the CPU 30, and the set temperature is stored in the temperature display unit 4.
2 is displayed.

The controller 26 includes a plurality of first controllers.
The temperature information near the body surface of the subject detected by the temperature sensor 22 is compared with the target temperature of the subject set by the input key 40, and the target temperature to the electric heater 18 is set according to the comparison result. The energization state of the electric heater 18 is controlled by turning on / off the energization and increasing / decreasing the voltage. For example, the temperature near the body surface of the subject is detected by the first temperature sensor 22, and the temperature near the electric heater 18 is detected by the second temperature sensor 24,
The temperature information is output for each block 20. Data on the temperature information is stored in C
The processing is performed by the PU 30. In each block 20, when at least one of the four temperature sensors 22, 24 reaches the target temperature set by the input key 40, the CPU 30
Sends a command to the relay 34 to turn off the power to the electric heater 18. When the temperature detected by the temperature sensors 22 and 24 is lower than the target temperature by several degrees (also set in advance), a command is sent to the relay 34 again to set the electric heater 1.
8 is turned on.

Further, independently of the temperature detected by the first temperature sensor 22, when the second temperature sensor 24 detects that the temperature in the vicinity of the electric heater 18 has risen above normal (for example, 60 ° C.), it is determined that overheating has occurred. Judgment is made and control for turning off the electric heater 18 is simultaneously performed. If a short-circuit detection line (not shown) having a fuse function is run in parallel with the electric heater 18 and the controller 26 loses its function due to any cause and the electric heater 18 generates abnormal heat, The short-circuit detection line may be disconnected to cut off the power supply to the heater 18, thereby preventing runaway and ensuring safety.

(Test Example) The low resilience first foam 14 to be in contact with the subject was 25 mm thick, and the high resilience second foam 16 laminated thereunder was 60 mm thick. Other configurations were the same as those shown in the drawings, and the pressure applied to the sacrum of the subject was measured with an RB tonometer (Teikoku Organ Corp.). The measurement position at that time was a supine position and a crushed stone position (hip joint abduction angle 90 degrees, hip joint flexion degree 45 degrees). The sensor was started at 43 ° C. at the start of the operation, and the body temperature of the subject was measured by bladder temperature or esophageal temperature. Sacral pressure was measured by the cooperation of 10 volunteers, and body temperature was measured by two colorectal surgery patients.

A. The pressure applied to the sacrum of the subject was 13 to 23 mmHg in the supine position, and was less than the previously reported capillary pressure of 32 mmHg. B. The body temperature of the subject was 36.5 at the time of entry in the first case.
Temperature, body temperature at the time of exit 37.4 degrees, body temperature at the time of entry 3 in the second case
The body temperature was 6.1 degrees and the body temperature at the time of leaving the room was 36.2 degrees, which was useful for maintaining the body temperature. In summary, (1) it was suggested that the mattress according to the test example could maintain the pressure applied to the sacrum of the subject at 13 to 23 mmHg, and was therefore useful for prevention of pressure sores. (2) It was suggested that the mattress was useful for maintaining body temperature.

[0024]

As described above, the operating table mattress according to the present invention has the following advantageous effects. (1) During long-term surgery, it is possible to achieve both prevention of pressure ulcers of the subject and maintenance of the temperature of the subject, which could not be achieved by the conventional hot water blanket or the like. (2) By detecting the temperature at a plurality of sites and dividing the heater into a plurality of blocks, the risk of low-temperature burn can be minimized and the subject can be efficiently heated. (3) Since the mattress can be divided, which was impossible with a conventional air mat, it is possible to cope with operations in various positions according to the operation position.

[Brief description of the drawings]

FIG. 1 is a perspective view showing a layered structure of a mattress on an upper body side of an operating table mattress in a separated state.

FIG. 2 is a partially cutaway perspective view showing a schematic configuration of an operating table mattress according to a preferred embodiment.

FIG. 3 is a schematic plan view showing a state in which an electric heater is divided into a plurality of blocks in a height direction of a subject and arranged.

FIG. 4 is a plan view of a first temperature sensor provided in a required pattern on the front side of the first foam.

FIG. 5 is a control block diagram of a controller that controls an electric heater provided for each block in the mattress.

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 10 Operating table mattress 10a Upper body side mattress 10b Lower body side mattress 12 Operating table 14 First form 16 Second form 18 Electric heater 20 Block 22 First temperature sensor 24 Second temperature sensor 26 Controller

──────────────────────────────────────────────────続 き Continued on the front page (51) Int.Cl. ⁷ Identification symbol FI Theme coat ゛ (Reference) A61G 7/05 A61G 7/04

Claims (5)

[Claims] 1. A mattress (10) mounted on an operating table (12) to reduce body pressure applied to a subject and also prevent a decrease in body temperature during surgery. A first form (14) that has a low coefficient of restitution and can ensure a large body contact area with the subject; and a sheet that is placed on the operating table. A second form (16) having a high coefficient of restitution and positioned behind the first form (14) to stably hold a subject on an operating table; and the first form (14) and the second form. (16) are arranged in a required pattern, and an electric heater (18) for heating the subject via the first form (14); A first temperature sensor (22) that is arranged in a pattern and detects a body temperature of the subject at a plurality of sites; The degree information is compared with the target temperature set in a subject, mattress operating table, characterized by being configured from a controller (26) for controlling an energization state of the electric heater (18). 2. The coefficient of restitution of the first foam (14) can suppress the occurrence of pressure sores by dispersing body pressure even when the subject is placed on the first foam (14) for a long time. 2. The mattress for an operating table according to claim 1, which has a low numerical value. 3. The heater (1) is located near the electric heater (18).
8) At least one second temperature sensor (24) for monitoring overheating
And an electric heater provided by the first temperature sensor (22).
The operating table mattress according to claim 1, wherein the power supply to the electric heater (18) is cut off on condition that a failure occurs in the control of (18). 4. The first foam (14) and the second foam (16) include a mattress (10) for holding a subject's upper body side.
2. The operating table mattress according to claim 1, wherein the mattress can be separated into a) and a mattress holding the lower body side. 5. The electric heater (18) is provided only on the upper body mattress (10a), and is divided into a plurality of blocks (20) in the height direction of the subject, and each block (20) is provided. The operating table mattress according to claim 4, wherein at least one of the second temperature sensors (24) is provided in (20).