JP2006075436A - Hemadynamometer - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a hemadynamometer in which cuff belts of a plurality of sizes can be easily and suitably changed and connected according to the upper arm of a person to be measured. <P>SOLUTION: The hemadynamometer is a hemadynamometer in which a blood pressure is measured based on the change the vibration of an arterial wall due to an arterial pulse drive accompanying the change of a cuff pressure, has an attachable and detachable cuff belt, a tube extended from the cuff belt and having a male type connector at its distal end, and a hemadynamometer body having a female type connector portion into which the male type connector of the tube is inserted, the male type connector has a leaf spring portion, an inserting bore diameter of the female type connector portion is smaller than the diameter of the leaf spring portion, and a click feeling is generated when the male connector and the female type connector portion are connected. <P>COPYRIGHT: (C)2006,JPO&NCIPI

Description

  The present invention relates to a sphygmomanometer used by a medical staff such as a nurse to measure a patient's blood pressure in a hospital or the like, and more particularly, to adapt a plurality of types of cuffs according to the size of the upper arm of a person to be measured. The present invention relates to a blood pressure monitor that can be exchanged.

  For example, Patent Documents 1 and 2 disclose a sphygmomanometer that sends air pressurized by an air balloon (rubber ball) to a cuff through a sphygmomanometer body.

  FIG. 1 shows a sphygmomanometer including the Korotkoff sound sensor disclosed in Patent Document 1. In the sphygmomanometer of FIG. 1, the main body 1301 and the cuff 1302 are coupled by a rubber tube 1304 and a lead wire 1305. A rubber ball 1303 for supplying air is connected to the cuff 1302.

FIG. 2 shows a sphygmomanometer disclosed in Patent Document 2. This sphygmomanometer includes a sphygmomanometer main body 1401 and a cuff 1404 or a sphygmomanometer main body 1401 and a flexible first air tube 1405 and a second air tube 1406, and the first air tube. 2 makes the tube less likely to be applied to the display unit 1402 or the operation unit 1403, so that the display is easy to see and the operability of the operation unit 1403 such as a power switch is improved. Get better.
JP-A-61-79440 JP 2004-81743 A

  However, the size of the cuff of the sphygmomanometer disclosed in Patent Documents 1 and 2 is constant, and the cuff is not appropriately replaced according to the size of the upper arm of the measurement subject. Therefore, when an adult is measured after measuring a child, it must be measured using another sphygmomanometer, which is inconvenient for the measurer. There is also a problem that it is necessary to prepare as many blood pressure monitors as the number corresponding to the upper arm size.

  Further, even if the cuff can be changed according to the upper arm size, it is necessary to prevent air leakage at the connection portion.

  The present invention has been made in view of the above problems, and an object of the present invention is to provide a sphygmomanometer in which a plurality of size cuffs can be easily exchanged and connected in accordance with the upper arm of the person to be measured.

  In order to achieve the above object, a sphygmomanometer according to the present invention is a sphygmomanometer that measures blood pressure based on a change in vibration of an arterial wall due to arterial wave drive accompanying a change in cuff pressure, and includes a removable cuff, A tube extending from the cuff and having a male connector at a tip thereof, and a sphygmomanometer body portion having a female connector portion into which the male connector of the tube is inserted, the male connector having an elastic portion. The female connector portion has an insertion diameter smaller than that of the elastic portion of the male connector, and a click feeling is generated when the male connector and the female connector portion are connected.

  The cuff has a large cuff for ischemia and a small cuff for detecting arterial pulsation.

  Further, the female connector portion engaged with the male connector communicates with the large cuff and the small cuff, respectively, and the large cuff communication portion and the small cuff communication portion are integrally formed. Is.

  Further, the male connector is connected to the small cuff communication portion.

  A plurality of detachable cuffs are prepared, and one of them is selected and used.

  Other features of the present invention will become apparent from the following description of the best mode for carrying out the invention and the accompanying drawings.

  According to the present invention, in the sphygmomanometer, a plurality of size cuff bands can be easily connected by being appropriately exchanged according to the upper arm of the person to be measured.

  Hereinafter, embodiments of the present invention will be described in detail with reference to the drawings.

<Appearance of sphygmomanometer>
FIG. 3 is a view showing the appearance of the sphygmomanometer 1 and the cuff belt 2 according to the present embodiment.

  In FIG. 3, reference numeral 10 denotes a housing of the sphygmomanometer body, and a substrate and a cuff (a large cuff (a large capacity air bag) 22 described later) on which an electric circuit for electrically operating the sphygmomanometer 1 is mounted. And a pipe (to be described later) for sending air to the cuff 23 (comprising a small capacity air bag) 2 and exhausting it from the cuff 2. Reference numeral 11 denotes a display unit on which the maximum and minimum blood pressure values, pulse, measurement mode, and the like are displayed. 12 is a power ON / OFF switch, and 13 is a mode switch. As will be described in detail later, the sphygmomanometer 1 of the present embodiment is provided with a plurality of (three) modes including a normal mode, a slow mode, and an auscultation mode as measurement modes. Reference numeral 14 denotes an exhaust switch. By pressing this switch, the air in the large cuff 22 can be forcibly exhausted. Reference numeral 15 denotes an air balloon (pressurized rubber balloon), which sends air to the cuff belt 2 via a pipe inside the housing 10 by repeatedly holding and releasing the balloon.

  Air from the air balloon 15 is fed into the cuff 2 via tubes 18 and 19 connected to the connector portion 16. Reference numeral 18 denotes a tube for feeding air into the large cuff 22 (large cuff tube), and 19 denotes a tube for feeding air into the small cuff 23 (small cuff tube).

  Reference numeral 17 denotes a tube holder for preventing the large cuff tube 18 and the small cuff tube 19 that are integrated toward the cuff 2 from being separated thereafter. Further, the small cuff tube 19 is made difficult to be removed from the connector portion 16 by bending the small cuff tube 19 between the connector portion 16 and the tube holder 17 (giving a margin). In other words, the small cuff tube 19 is detached from the connector portion 16 even if the small cuff tube 19 is provided with a margin so that the tube is drawn or pulled in such a direction that the large cuff tube 18 cannot be pulled out. Can be prevented.

  The cuff 2 is covered with a cuff cover 21, and is formed of a large cuff 22 made of a flexible material such as natural rubber, synthetic rubber or elastomer and a flexible material such as polyurethane (a ) There is a small cuff 23.

<Cuff configuration>
FIG. 4 is a diagram illustrating the configuration of the cuff 2. 4A shows the overall structure, and FIG. 4B shows the structure of the large cuff 22 and the small cuff 23. As shown in FIG. 4A, the cuff 2 includes a cuff cover 21 having a surface fastener (not shown) provided on the outer surface, and a large cuff 22 and a small cuff 23 that are covered with the cuff cover 21. The cuff 2 can be replaced, sterilized, etc. In that case, the large cuff 22 and the small cuff 23 can be easily taken out and inserted from the opening 2a of the cuff 2 in order to facilitate the removal. 22 is provided with a protrusion 22a having a tapered portion 22b. The protrusion 22a is adapted to correspond to the position of the opening 2a when inserted into the cuff 2. Further, in order to prevent reverse insertion, the protrusion 22a is provided at a position (L4> L5) deviated from the center in the longitudinal direction of the large cuff 22.

  As described above, air is sent to the large cuff 22 through the large cuff tube 18 and pressurized. When the large cuff 22 is pressurized and inflated, the arm of the measurement subject around which the cuff belt 2 is wound is hemostazed. Also, air is sent to the small cuff 23 through the small cuff tube 19 and pressurized. When the air in the large cuff 22 is depressurized by exhaust and the blood flow is resumed, the pressure in the small cuff 23 containing the air fluctuates, and a pulse wave corresponding to this fluctuation is a pressure sensor 92 described later (see FIG. 14). ) Is detected. Further, a PET back plate (not shown) is provided between the large cuff 22 and the small cuff 23, and is devised so that subtle pressure fluctuations in the small cuff 23 can be detected. That is, since the large cuff 22 in an inflated state is elastic, if the small cuff 23 is directly attached to the large cuff 22, it may not be detected even if there is pressure fluctuation in the small cuff 23. This is to prevent such a state. By connecting the small cuff tube 19 to the small cuff 22 so as to be loosened and twisted with respect to the large cuff tube 18 having an outer diameter larger than that, when removing from the cuff 2 and inserting into the cuff 2 This has the effect of preventing the small cuff tube 19 from coming off. Further, by absorbing the slack by twisting, there is an effect of preventing the small cuff tube 19 from being caught when being taken out from the cuff 2 and inserted into the cuff 2.

  In addition, a hook-and-loop fastener can be firmly fixed to the upper arm of a patient (subject) by a nurse. This ring 26 is not always necessary. It is provided because it becomes more difficult to wind or fix the cuff strip 2 when it becomes larger.

  Reference numeral 24 denotes a tube side connector which is connected to the connector portion 16 on the main body side. Reference numeral 25 denotes a forced exhaust valve, which is provided when the cuff size is large (for example, L and LL sizes (the cuff size will be described later)). When the cuff size is large, the large cuff 22 inevitably increases. However, it takes time to depressurize from a sufficiently pressurized state, and when the air is suddenly evacuated, the forced exhaust valve 25 is opened. Air can be extracted in a short time.

  In the present embodiment, cuffs having different sizes are prepared. SS, S, M, L, and LL in order from the smallest.

  For the cuff of the SS size, for example, the lateral length L1 & width W1 of the cuff cover 21 is (345 ± 5 mm, 100 ± 4 mm), the lateral length L2 & width W2 of the large cuff 22 is (130 ± 10 mm, 80 ± 5 mm), and the lateral length of the small cuff 23 L3 & width W3 are (30 ± 1 mm, 20 ± 1 mm).

  For the S size cuff, for example, the lateral length L1 & width W1 of the cuff cover 21 is (435 ± 5 mm, 130 ± 4 mm), the lateral length L2 & width W2 of the large cuff 22 is (170 ± 10 mm, 110 ± 5 mm), and the lateral length of the small cuff 23 L3 & width W3 are (40 ± 1 mm, 25 ± 1 mm).

  For the M size cuff, for example, the lateral length L1 & width W1 of the cuff cover 21 is (520 ± 5 mm, 150 ± 4 mm), the lateral length L2 & width W2 of the large cuff 22 is (240 ± 10 mm, 130 ± 5 mm), and the lateral length of the small cuff 23 L3 & width W3 are (60 ± 1 mm, 30 ± 1 mm).

  For the L size cuff, for example, the lateral length L1 & width W1 of the cuff cover 21 is (640 ± 5 mm, 190 ± 4 mm), the lateral length L2 & width W2 of the large cuff 22 is (320 ± 10 mm, 170 ± 5 mm), and the lateral length of the small cuff 23 L3 & width W3 are (80 ± 1 mm, 40 ± 1 mm).

  For the LL size cuff, for example, the lateral length L1 & width W1 of the cuff cover 21 is (220 ± 4 mm, 830 ± 5 mm), the lateral length L2 & width W2 of the large cuff 22 is (420 ± 10 mm, 200 ± 5 mm), and the lateral length of the small cuff 23 L3 & width W3 are (100 ± 1 mm, 50 ± 1 mm).

<Internal structure of blood pressure monitor body>
FIG. 5 is a view showing the internal structure of the blood pressure monitor main body 10.

  In FIG. 5, 31 is a manifold, 32 is a manifold branching section, 33 is a large cuff conducting pipe, 34 is a bypass pipe (small cuff conducting pipe), 35 conducting pipe branching section, 36 is a pressure sensor conducting pipe, 37 Is a coil for preventing bending, 38 is a solenoid valve, and 39 is a caulking ring. 161 is a large cuff male connector for connecting the large cuff conducting tube 33 and the large cuff tube 18, and 162 is a small cuff female for connecting the small cuff conducting tube 34 and the small cuff tube 19. It is a connector. The large cuff male connector 161 and the small cuff female connector 162 are integrally formed to form a connector portion 16.

  The air sent from the air balloon 15 passes through the manifold 31 and is discharged from the large cuff male connector 161 through the large cuff conducting tube 33. The air discharged from the large cuff male connector 161 passes through the large cuff tube 18 and is sent to the large cuff 22. As a result, the large cuff 22 is pressurized.

  A part of the air sent from the air balloon 15 enters the bypass pipe 34 from the manifold branch part 32 and is discharged from the small cuff female connector 162 through the bypass pipe 34. The air discharged from the small cuff female connector 162 passes through the small cuff tube 19 and is sent to the small cuff 23. As a result, the small cuff 23 is pressurized.

  The pressure sensor conducting pipe 36 branched from the conducting pipe branching section 35 is supplied with air, and sends a part of the air branched from the bypass pipe 34 to the pressure sensor (92 in the block diagram of FIG. 14) and during measurement. It is provided for sending air pushed out by the pressure of the small cuff 23 fluctuated by the pulse wave to the pressure sensor. A bending prevention coil spring (bending prevention member) 37 is provided inside the pressure sensor conducting tube 36. This has a function of preventing the pressure sensor conducting tube 36 from being broken when the pressure sensor conducting tube 36 is bent, thereby blocking the tube.

  The bypass pipe 34 is made of, for example, an olefin elastomer, has an inner diameter of about 0.4 mm, and is provided with a 0.4 mm thin metal pipe having the same inner diameter, such as stainless steel, inside the ends. It is reinforced so that the inner diameter can be maintained without being crushed even at the connecting portions at both ends. The solenoid valve 38 is closed while air is being supplied by the air balloon 15 so that the air is sufficiently fed into the cuff 2 and opened when the air is exhausted from the pressurized large cuff 22 and decompressed. (It is exhausted from the small cuff 22 but its capacity is very small compared to the large cuff 21). The opening / closing control of the electromagnetic valve 38 will be described later.

<Structure of connector portion 16>
6 to 8 are diagrams showing in detail the connecting portion between the cuff tubes 18 and 19 and the sphygmomanometer body 1, FIG. 6 shows the connector part 16, and FIG. 7 shows the structure of the connecting part in the sphygmomanometer body 1. FIG. 8 shows a state in which the connection portion with the cuff tube (before the cuff tube connection) is viewed from above with the connector portion 16 being housed in the blood pressure monitor main body 1. FIG. 9 is an enlarged view of the large cuff tube-side connector 24.

  In FIG. 6, 161 is a male connector for a large cuff, and 162 is a female connector for a small cuff. Reference numeral 163 denotes a small cuff conducting pipe connecting portion, 164 denotes a pressure sensor conducting pipe connecting portion, and 165 denotes a large cuff conducting pipe connecting portion. Reference numeral 166 denotes a plate-like portion, whereby the large cuff male connector 161 and the small cuff female connector 162 are integrated. Reference numeral 167 denotes an O-ring housed in the recess of the female connector 162 for small cuff.

  In FIG. 7, reference numeral 71 denotes a housing portion for the small cuff female connector 162, 72 denotes a housing portion for the plate-like portion 166 on the small cuff female connector side, and 73 denotes a housing portion for the plate-like portion 166 on the large cuff connector side. It is. Further, a groove (locking portion) 74 for locking the tube side connector 24 is provided in the main body side connecting portion. And since the groove | channel 74 was formed, the projection part 75 is also formed.

  The plate-like portion 166 of the connector portion 16 is placed in the storage portions 72 and 73 in FIG. 7 and is positioned so that the connector portion 16 is not displaced or rattled in the sphygmomanometer body 1. Further, the cylindrical small cuff female connector 162 is accommodated in the small cuff female connector accommodating portion 71. Thus, by providing the housing | casing part matched with the shape of the connector part 16 in the housing | casing of the blood pressure meter main body 1, the rattling of the connector part 16 can be prevented and a connection with a cuff tube can also be performed stably.

  Further, as shown in FIG. 8, when the upper housing and the lower housing of the sphygmomanometer body 1 are fitted together, a body-side connection portion is formed. The large cuff male connector 161 has a head portion slightly protruding from the sphygmomanometer body 1 (see FIG. 9 for the protruding state). Moreover, the convex part 75 forms an edge so that the circumference | surroundings of the part to which the tube side connector 24 is connected to the female connector 162 for small cuffs may be enclosed.

  Further, as shown in FIG. 9, the tube side connector 24 is used to fix the distal end portion 241 for transmitting the air pressure changed in the small cuff 23 to the main body side and the tube side connector 24 itself to the main body side connection portion. An elastic portion 242 and a protrusion 243 provided at the tip of the elastic portion 242. The elastic part 242 is configured by providing a plurality of notches in the circumferential direction in a part of the outer wall part 244 formed so as to surround the tip part 241. When the tube-side connector 24 is connected to the small cuff female connector 162, the leaf spring 243 is fitted into the groove 74, and the projection 243 and the convex portion 75 on the main body side are locked, whereby the tube-side connector 24 is It is designed to make it difficult to remove.

  Further, as described above, since the O-ring 167 is accommodated in the recess of the small cuff female connector 162, the gap formed between the tip 241 and the small cuff female connector 162 is eliminated, and air leakage is prevented. Can be done.

  When the projection 243 of the tube-side connector 24 is fitted into the groove 74 of the sphygmomanometer body 1, the diameter defined by the leaf spring projection 243 is larger than the diameter defined by the body-side projection 75, so that the elastic portion A click feeling is generated by the repulsive force of 242. The user can easily recognize that the tube-side connector 24 is connected to the sphygmomanometer body 1 by this click feeling.

<Structure of connection portion between air balloon 15 and sphygmomanometer body housing 10>
(First specific example of structure)
FIG. 10 is a diagram illustrating a structure of a connection portion between the air balloon 15 and the sphygmomanometer body housing 10. 10A shows a state when the air balloon 15 is mounted on the housing 10, FIG. 10B shows the air balloon 15 when it is detached from the housing 10, and FIG. 10C is an enlarged cross-sectional view of the air balloon connector.

  10A, 101 is an air balloon connector, 102a and 102b are O-rings, 103 is a mesh dust filter, and 104 is a filter cap. The small-diameter O-ring 102a has a sealing action in the radial direction, and the large-diameter O-ring 102b has a locking action by being compressed (collapsed) in the axial direction. By providing two O-rings 102a and 102b, Two effects can be obtained.

  As shown in FIG. 10B, the air balloon connector 101 is provided with a screw thread 1014, and the air balloon 15 is attached by turning it into the manifold 31.

  The air balloon connector 101 is inserted into the rubber air balloon 15 from the insertion portion 1010 to the flange portion 1012. The air balloon connector 101 is provided with an enlarged diameter step portion 1011, which becomes a resistance near the insertion opening of the rubber air balloon 15 and is difficult to come off. Further, by tightening the vicinity of the insertion portion of the air balloon 15 from the outside by the caulking ring 39 (see FIG. 10A), the air balloon connector 101 is more difficult to be removed from the air balloon 15. In other words, the air balloon 15 and the air balloon connector 71 are fixed from the inside and the outside by the enlarged diameter step portion 1011 and the caulking ring 39 of the air balloon connector 101.

  Further, a recess 1013 is formed on the outer periphery of the air balloon connector 101. Here, as shown in FIG. 10A, for example, rubber O-rings 102 a and 102 b are attached and sealed when the air balloon 15 is turned into the manifold 31. Further, the O-ring 102b serves to prevent loosening when it is turned in.

Further, the air balloon connector 101 has a filter mounting portion 1015, to which a filter cap 104 to which a dust filter 103 is attached is mounted. The dust filter 103 can prevent dust from entering the respective conductive tubes 33, 34 and 36, the electromagnetic valve 38, the tubes 18 and 19 connected to the cuff band 2, etc. in the sphygmomanometer 1. That is, it is possible to prevent each tube from being clogged with dust and malfunctioning of the electromagnetic valve 38 and the pressure sensor 92. Reference numeral 1020 denotes a check valve.
(Second specific example of structure)
FIGS. 11 and 12 are views showing a second specific example of the structure of the connecting portion between the air balloon 15 and the sphygmomanometer main body housing 10, and particularly FIG. 11 shows an air balloon connector according to the second specific example. 101 shows a structure 101, and FIG. 12 shows a one-way clutch ring 1201 according to a second specific example.

  In the first specific example, the O-ring 102b is attached to the recess 1013 of the air balloon connector 101. However, in the second specific example, a one-way clutch ring 1201 (see FIG. 12) is attached instead of the O-ring 102b. I have to.

  As shown in FIGS. 12A and 12B, for example, twelve trapezoidal notches 1202 are provided at equal intervals on the lower surface of the one-way clutch ring 1201. As shown in FIG. 12C, which is an enlarged view of the notch 1202 (portion indicated by Y), the angle of one end of the trapezoid in the notch 1202 is substantially a right angle, whereas the other end. Has an inclination, and the inclination angle forms a predetermined angle θ (for example, 15 to 30 °). Further, an elastic ring 1203 (for example, a foamed rubber ring, a sponge ring, a rubber ring, etc.) is attached to the upper surface of the one-way clutch ring 1202. The operation of the elastic ring 1203 will be described later.

  On the other hand, as shown in FIG. 11, for example, four trapezoidal convex portions 1102 are provided in the flange portion 1012 of the air balloon connector 101 at equal intervals. As shown in FIG. 11B, which is a partially enlarged view of the X portion, the angle of one end of the trapezoid in the convex portion is an ambassador, while the other end has an inclination, and the inclination angle is a predetermined angle. The angle θ (for example, 15 to 30 °), that is, the same angle as the angle θ of the notch 1202 is formed. Therefore, the trapezoidal convex part 1102 and the trapezoidal notch part 1202 are in a relationship that fits snugly.

  The one-way clutch ring 1201 having the above-described configuration is fitted into the stepped portion 1103 of the air balloon connector 101. Then, the air balloon 15 is turned into the manifold 31 in a state where the trapezoidal notch 1202 in the one-way clutch ring 1202 and the trapezoidal convex part 1102 in the air balloon connector 101 are fitted. When the air supply ball 15 approaches the state where the air supply ball 15 is tightly tightened, the elastic body ring 1203 of the one-way clutch ring 1201 comes into contact with the inner side surface of the manifold 31 and the rotation of the elastic body ring 1203 is suppressed by the friction. On the other hand, since the air balloon 15 is turned in, the inclined portion 1103 of the trapezoidal convex portion 1102 of the air balloon connector 101 gets over the inclined portion 1204 of the trapezoidal notch portion 1202 of the one-way clutch ring 1201. A tick is heard. When the air balloon 15 is turned into the manifold 31 until the end, the elastic ring 1203 is crushed, so that the one-way clutch ring 1203 is not idle, and the air balloon 15 is firmly fixed to the sphygmomanometer body 1.

<Details of display unit 11>
FIG. 13 is a diagram showing details of the display unit 11 of the sphygmomanometer 1.

  In FIG. 13, 110 is the display of the maximum blood pressure, 111 is the display of the minimum blood pressure, 112 is the display of the pulse, 113 is the display of the pulse wave signal, 114 is the display of the previous value, 115 is the display during exhausting, and 116 is the pressurization Insufficient display, 117 is an overpressurization display, and 118 is a display for the currently selected mode.

  The systolic blood pressure display 110 displays an instantaneous pressure during pressurization and decompression, and is finally a display of the systolic blood pressure. The minimum blood pressure display 111 is a display of the finally determined minimum blood pressure. For example, when the minimum blood pressure is determined to be 80, the operation is exhausted even if the pressure is exhausted and the pressure is reduced, and the operation is useless. Therefore, the solenoid valve 36 is controlled to exhaust rapidly from the pressure value 60. During the rapid exhaust, the exhaust display 115 flashes. Further, the in-exhaust display 115 also blinks when the exhaust switch 14 is pressed as described above. At that time, the solenoid valve is forcibly released and controlled to exhaust quickly. In the case of rapid exhaust, the exhaust speed is usually more than double that during decompression. The pulse display 112 displays the measured pulse value. The previous value display blinks or lights up when the power switch 12 is pressed to start up the sphygmomanometer, and the previously measured highest and lowest blood pressure values and pulse values are the highest blood pressure display 110, the lowest blood pressure display 111, and the pulse display 112. Each value is displayed in. Then, after a while or when insufflation is started by the insufflation balloon 15, those displays disappear and the previous value display lighting / flashing also disappears. Note that the pressure during pressurization may increase for a moment (the instantaneous pressure increases), and if the raw instantaneous pressure data is displayed on the display unit, the user may mistakenly recognize that the pressurization is sufficient. Therefore, in this embodiment, the raw instantaneous pressure data is not displayed on the display unit, but the pressure data that is intentionally blunted is displayed on the display unit (maximum blood pressure display 110) to prevent the user from misidentifying. ing.

  The pulse wave signal display 113 is a display indicating the magnitude of the detected pulse wave signal, and the magnitude is displayed in a bar shape. In the case of a subject having a normal pulse, the bar rhythmically increases or decreases from side to side. However, in the case of a subject having an arrhythmia, the bar display does not change rhythmically. By providing the pulse wave signal display 113 in this way, it is very convenient that it can be visually determined whether or not the measurement subject is the owner of the arrhythmia.

  When the under-pressurization display 116 is lit or flashing, it means that the pressure in the cuff 2 has not reached a level sufficient for measurement, and the user is encouraged to supply air by a balloon. Yes. When the overpressurization display 117 is lit or blinking, it means that the pressure in the cuff 2 is equal to or higher than a predetermined pressure (for example, 320 mmHg or higher). Will be prompted.

  The selection mode display 118 indicates what mode is selected by the mode switch 13. The mode indicates which mode is selected from “normal”, “slow”, and “auscultation”. In the present embodiment, the display is made by lighting or blinking the “▼” mark on the mode display printed on the sphygmomanometer body cover.

  By selecting this mode, the exhaust (decompression) speed can be changed. When the “normal” mode is selected, the exhaust speed is set to 5 ± α mmHg / second, for example. In this mode, since the exhaust speed is relatively fast, there is an advantage that the measurement time can be made relatively short. On the other hand, the pressure change measurement step is large, so there is no particular problem when measuring a person with stable pulse, but when measuring the blood pressure of a person with arrhythmia, the pulse is easily removed, so the measurement The error can be large. Therefore, in this embodiment, a “slow” mode is provided, and when this mode is selected, the exhaust speed is set to about half of that in the “normal” mode, for example, 2.0 to 2.5 mmHg / sec. is doing. In this manner, in the “slow” mode, the pressure change can be seen in detail by reducing the pressure more slowly than usual, so that the person with an arrhythmia that is likely to lose a pulse can be measured more accurately. Further, the “auscultation” mode is a mode in which measurement is performed manually using a stethoscope. In this case, the exhaust speed is set to about half of the “normal” mode, for example, 2.0 to 3.0 mmHg / sec. .

  In this embodiment, as described above, cuff sizes from SS to LL are prepared, but it is important that the exhaust speed is not affected by the cuff size. Therefore, the opening / closing of the electromagnetic valve 38 is controlled (feedback control) so that the larger the cuff size, the larger the volume of air exhausted every second.

  Although not shown, when the power switch 12 is pressed while pressing the mode switch 13 and the mode switch 13 is further pressed for about 1 second or longer in this state, the display is switched to the measurement number display. At this time, the maximum blood pressure display 110 displays a display indicating that the measurement number is displayed, and the minimum blood pressure display 111 displays the number of measurements. As the number of times of measurement, only a numerical value representing the hundreds or more may be displayed, and the number of tenths or less may not be displayed.

<Control system circuit block diagram of sphygmomanometer>
FIG. 14 is a diagram showing a control system circuit block diagram of the sphygmomanometer 1.

  In FIG. 14, 91 is a control unit (for example, CPU) for controlling the entire circuit, and 92 is a pressure sensor for detecting the pressure of the cuff 2 (large cuff 22 and small cuff 23). A ROM 93 stores control programs and various data in advance. A RAM 94 temporarily stores calculation results and measurement results. A drive unit 95 drives the electromagnetic valve 38 in accordance with a control signal from the control unit 91, and a buzzer 96 gives a predetermined warning. Reference numeral 97 denotes a battery power source, and 98 denotes a power source control unit for controlling the battery power source.

  First, the power switch 12 is pressed by the user, and the mode is selected by the mode switch 13. The display operation of the display unit 11 by pressing the power switch 12 and selecting the mode is as described above.

  As described above, the air from the air balloon 15 passes through the manifold 31 and is sent to the large cuff 22 through the manifold branching portion 32, the large cuff conducting tube 33, and the large cuff tube 18. Further, a part of the air from the air balloon is also supplied to the small cuff 23 via the bypass pipe 34, the conductive pipe branching portion 35 and the small cuff tube 19.

  Further, the air branched by the conducting pipe branching portion 35 is supplied to the pressure sensor 92 via the pressure sensor conducting pipe 36. At this time (at the time of pressurization), the pressure fluctuation value detected by the pressure sensor 92 is much larger than the pressure fluctuation value at the time of measurement (at the time of pressure reduction). Therefore, when the fluctuation value of the detected pressure is equal to or greater than the predetermined value, the control unit 91 determines that the pressurization is currently being performed and outputs a control signal that instructs the drive unit 95 to close the electromagnetic valve 38. . The drive unit 95 that has received this control signal closes the electromagnetic valve 38 to prevent air from leaking from the electromagnetic valve 38. In addition, since the air balloon 15 and the pressure sensor 92 are connected by the bypass pipe 34 thinner than the large cuff conducting pipe 33 as described above, there is an effect that an abrupt pressure change is dulled. That is, when the pressure suddenly increases, the display unit 11 displays a large pressure value, and there is a risk that the user misunderstands that the pressure is sufficient. Therefore, the user's misunderstanding can be prevented by slowing down the pressure change.

  The buzzer 96 emits a sound when the sphygmomanometer body is turned on and the display unit is turned on, when the mode is switched by the mode switch 13, when the blood pressure value is determined, or when an error occurs. It has become.

  The user looks at the value shown in the maximum blood pressure value display on the display unit 11 to determine whether the large cuff 22 and the small cuff 23 are sufficiently pressurized to measure. Air supply from 15 is stopped. At this time, the pressure sensor 92 detects that the pressure fluctuation value (increase value) is substantially zero or a reduced pressure state within a predetermined period. Then, the control unit 91 outputs a control signal instructing the drive unit 95 to open the electromagnetic valve 38, and the drive unit 95 that has received the control signal causes the electromagnetic valve 38 to have a predetermined pressure reduction speed. open. The operation of the sphygmomanometer shifts from the pressurization mode to the measurement mode.

  When the measurement mode is entered, the maximum blood pressure value and the minimum blood pressure value are measured according to the measurement program stored in the ROM 93. Since the determination operation of the blood pressure value and the like will be described in detail with reference to the flowchart of FIG. 17, only an outline will be given here.

  When the air supplied to the large cuff 22 is gradually exhausted to the outside in accordance with the reduced pressure, blood that has been blocked at a certain point starts to flow. And the pressure change is produced in the small cuff 23 by the blood flow start. The pressure change is detected by the pressure sensor 92, and is set as a rising detection point of the pulse wave signal. Further, pressure values for subsequent pulse wave detection are also sequentially stored in the RAM 94 as measured values. The pressure value at the rising detection point and the sequentially stored pressure value are used to determine the maximum blood pressure value and the minimum blood pressure value as will be described later.

  The pulse value is determined by detecting the number of beats in a predetermined period and converting it to 60 seconds.

<Maximum and minimum blood pressure value determination operation>
The operation for determining the maximum and minimum blood pressure values will be described with reference to FIGS. Here, FIG. 15 is a graph showing the pressure fluctuation during decompression, FIG. 16 is a graph showing the measured value and predicted value of the pressure fluctuation during decompression, and FIG. 17 is a diagram for explaining the operation for determining the systolic blood pressure and the systolic blood pressure. It is a flowchart.

  In the flowchart of FIG. 17, in step S101, the pressure value (DC waveform) at the time of pressure reduction is measured. The pressure value at the time of depressurization is represented by the characteristics of the graph of FIG. In this graph, there is a place where the pressure value changes abruptly, and this shows the change when the minimum blood pressure value is determined and exhausted rapidly after a predetermined time. Each measured pressure value is temporarily stored in the RAM 94. Also, t = 0 when the air supply ends.

  In step S <b> 102, a vibration component (variation value: AC component) included in the measured pressure during decompression is extracted, and the extracted value is stored in the RAM 93. The vibration component is extracted by filtering the pressure value. The extracted vibration component is represented in a graph as shown in FIG.

  In step S103, the first systolic blood pressure value candidate point (first SYS) is acquired based on the vibration characteristic obtained in step S102. During the predetermined period from the start of decompression, the arm of the person to be measured is blocked by the large cuff 21, so that the vibration component is very small. When the blood flow is resumed according to the decrease in the pressure in the large cuff 21, there is a point where the first rises rapidly (first SYS in FIG. 15). When the difference d1 between the actually measured amplitude value and the predicted amplitude value at the rising point (however, measured amplitude value> predicted amplitude value) is included within a predetermined ratio (for example, 5 to 15%) of the maximum pulse wave amplitude value. The blood pressure value (DC value) corresponding to this point is set as a first systolic blood pressure value candidate. The reason why it is within 15% is that if it is more than that, there is a high possibility of an abnormal value. As shown in FIG. 16, the predicted amplitude value is a value predicted from a temporally previous point (for example, up to three points before). In addition, the “candidate” is used here because the pulse wave is disturbed when the subject has an arrhythmia, etc., so the pressure value at the first rising point does not necessarily indicate the maximum blood pressure value. Because there is no. Therefore, in this embodiment, candidate values obtained by other methods are also taken into consideration.

  In step S104, a second systolic blood pressure value candidate point (second SYS) is acquired based on the vibration characteristic obtained in step S102. The second SYS is a point that falls sharply when viewed from the maximum pulse wave amplitude value. In the graph of FIG. 16, the difference d2 between the actually measured amplitude value and the predicted amplitude value (however, the actually measured amplitude value> the predicted amplitude value) is When viewed from the maximum pulse wave amplitude value point, the point first falls within a range of 5 to 15% of the maximum pulse wave amplitude value. The reason for setting it within 15% is as described above. The blood pressure value (DC value) corresponding to the second SYS is set as the second highest blood pressure value candidate.

  Next, in step S105, a third systolic blood pressure value candidate point (statistical SYS) is acquired. This statistical SYS is a point corresponding to a predetermined ratio of the maximum pulse wave amplitude value, and this is based on empirical certainty. Therefore, this statistical SYS is effective when there are a plurality of rising points and it is unclear where the rising points are likely.

  Subsequently, in step S106, if the difference between the first maximum blood pressure value candidate corresponding to the first SYS and the second maximum blood pressure value candidate corresponding to the second SYS is within a predetermined value (mmHg), the process is step. The process proceeds to S107, where the first systolic blood pressure value candidate is determined as the systolic blood pressure value.

  If the difference is outside the predetermined range, the process proceeds to step S108, and for example, the average value of the first to third maximum blood pressure value candidates is determined as the maximum blood pressure value. Note that three values may be weighted.

  In step S109, a minimum blood pressure value is calculated. As can be seen from FIG. 15, the envelope gradually decreases from the maximum pulse wave amplitude value point, but the point at which the predetermined ratio of the maximum pulse wave amplitude value becomes a point (DIA) indicating the minimum blood pressure value corresponds to that. The blood pressure value (DC value) to be determined is determined as the minimum blood pressure value. The calculation for determining the minimum blood pressure value is not necessarily performed after the determination of the maximum blood pressure value, and may be performed before or in parallel.

  The maximum and minimum blood pressure values obtained as described above are displayed on the display unit 11.

  Here, when the difference between the first systolic blood pressure value candidate and the second systolic blood pressure value candidate is outside the predetermined range, the average value of the first to third candidate values is set as the systolic blood pressure value. However, the average value of the first and third candidate values, or the third candidate value may be used as the systolic blood pressure value. Further, regardless of whether or not the difference between the first systolic blood pressure value candidate and the second systolic blood pressure value candidate is within a predetermined range, the average value of the first and third candidate values may be used as the systolic blood pressure value. good. Further, the first and second candidate values may be obtained, and the average value thereof may be used as the systolic blood pressure value.

  In the present embodiment, a plurality of rising points are basically detected at the time of depressurization, and finally the systolic blood pressure value is obtained as a candidate for the systolic blood pressure value. The algorithm shown may be used to determine the systolic blood pressure value and the diastolic blood pressure value. That is, the pressure fluctuation characteristic at the time of depressurization is as shown in FIG. 15, but the pressure fluctuation characteristic at the time of pressurization (pressure increase) shown in FIG. 23 is obtained to obtain a plurality of maximal blood pressure value candidates (first SYS, second SYS in the figure). Etc.) and the systolic blood pressure value is obtained by the same algorithm.

<Configuration and operation of electromagnetic valve 38>
The configuration and operation of the electromagnetic valve 38 used in this embodiment will be described with reference to FIGS. The opening / closing operation of the electromagnetic valve 38 is PWM controlled.

  FIG. 18 is a diagram showing a configuration of the electromagnetic valve 38 used in the present embodiment. In FIG. 18, 381 is a rubber valve, 382 is a first plunger, 383 is a plunger receiver, 384 is a spacer, and 385 is a second plunger.

  The rubber valve 381 protrudes by a space of S than the first plunger. The rubber valve 381 eliminates air leakage from the valve 38 by, for example, closing the flow path of the plunger receiver 383 during pressurization. Further, the rubber valve 381 is separated from the plunger receiver 383, for example, at the time of decompression, and the flow path is opened so as to exhaust. The plunger receiver 383 and the first and second plungers 382 and 385 are made of a conductive metal. Since a voltage is applied to both ends of the electromagnetic valve 38, an electromagnetic force acts between the metal plunger 382 and the plunger receiver 383, and the applied voltage increases (for example, 1.2V). From the maximum of 1.7 or 1.8 V) The magnitude of the electromagnetic force increases.

  FIG. 19 is a graph showing hysteresis characteristics when the electromagnetic valve 38 normally opens and closes. In the graph of FIG. 19, the horizontal axis indicates the voltage applied to the electromagnetic valve 38 (because PWM control is performed and is displayed in%), and the vertical axis indicates the valve opening stroke (when the valve is fully opened, “0”). ). In FIG. 19, a curve L1 shows hysteresis when the electromagnetic valve 38 is closed, and a curve L2 shows hysteresis when the valve is opened.

  When a voltage is gradually applied from the fully open state of the electromagnetic valve 38 (see curve L1), the electromagnetic valve 38 starts to close gradually from the point where PWM becomes about 40%. When the point P1 (PWM is about 50%) is reached, the flow path is closed by the rubber valve 381 (the opening stroke is about -195 μm). At this time, the rubber valve 381 is not completely closed yet, and the air is in a state of being released. As the voltage continues to be applied, the elastic rubber valve is crushed to completely seal the flow path. The stroke in a completely sealed state (point P2) is about −340 μm.

  When the electromagnetic valve 38 is opened from the completely sealed state (P2) (curve L2), the applied voltage is gradually lowered. As the applied voltage decreases, the crushed rubber valve 381 returns to its original shape, and air enters the gap between the rubber valve 381 and the plunger receiver 383 when entering the right end E1 of the control region. That is, the electromagnetic valve 38 is in a half-open state, and when the applied voltage (PWM) falls, the amount of air passing through the gap increases accordingly. The electromagnetic valve 38 is completely opened at the point P3 (PWM is about 44% and the opening stroke is about -200 μm). In this embodiment, the pressure reduction speed is controlled to 5 mmHg / sec. This control is executed within the control region in FIG.

  Here, the control region is a region sandwiched between E1 and E2, and is a region where exhaust is controlled at a pressure reduction speed of 5 mmHg / sec. Further, the voltage corresponding to the control region is referred to as a solenoid valve control voltage (for example, approximately 0.6 to approximately 1.0 V: approximately 50% to approximately 64% in PWM in this embodiment). The start point of entering the control region (PWM = E1) is the point at which the pressure reduction speed does not immediately reach 5 mmHg / sec, but the control toward it starts, and the exhaust is started. When the applied voltage is lowered, the rubber valve 381 is opened. When the reduced pressure speed reaches 5 mmHg / sec, the applied voltage is controlled so as to keep it. As pressure reduction progresses, the pressure in the cuff 2 also decreases, and the degree of opening of the rubber valve also increases. When the left end of the control region (PWM = E2) is reached, the control for maintaining the pressure reduction speed at 5 mmHg / sec ends, and rapid exhaust is executed. The pressure of the cuff 2 at this time is set to 20 to 30 mmHg, for example.

  The force that keeps the electromagnetic valve 38 closed between the points P1 and P2 and between P2 and P3 is an electromagnetic force between the first plunger 382 and the plunger receiver 383 by the applied voltage. Therefore, the change in the opening stroke between the points P2 and P3 is moderate, but after the opening (after the point P3), the influence of the electromagnetic force disappears, so the change in the opening stroke is abrupt.

  As described above, in this embodiment, the electromagnetic valve whose opening / closing operation is controlled by the applied voltage is used. Therefore, the electromagnetic valve 38 can be quickly closed when air is supplied by the air supply ball 15 (at the time of pressurization). It is possible to exhaust the air in the cuff 2 stably according to the above-described mode at the time of exhausting (at the time of decompression).

  However, in order to perform the opening / closing operation stably as described above, as shown in FIG. 18, the rubber valve 381 and the first plunger 382 are moved in the Y direction while being kept horizontal. Becomes important. Accordingly, as shown in FIG. 20, when the electromagnetic valve 38 is inclined (is likely to occur), the first plunger 382 and the plunger receiver 383 come into contact with each other, and both metals are fixed by the electromagnetic force generated between the two metals. Thus, even if a voltage that should originally be opened is applied (point P3), a problem that the electromagnetic valve 38 is not opened occurs.

  FIG. 21 is a diagram showing hysteresis characteristics when the electromagnetic valve 38 is closed in such a tilted state.

  When a voltage is gradually applied from the fully opened state of the electromagnetic valve 38 (see curve L3), the electromagnetic valve 38 starts to close from the point where PWM becomes about 40%. When the point P4 (PWM is about 55%) is reached, the flow path is closed by a rubber valve 381 (see FIG. 20) inclined obliquely (open stroke is about -230 μm). As the voltage continues to be applied, the elastic rubber valve is crushed so that the flow path is completely sealed, but at the point P5 until the completely sealed state (point P2) is reached, the first The plunger 382 and the plunger receiver 383 are in contact with each other, and both are adsorbed by the electromagnetic force generated by the applied voltage. And it arrives at the point P2 which is a sealed state with an adsorption state. The stroke at this time is about −340 μm as in FIG.

  When the electromagnetic valve 38 is opened from the completely sealed state (P2) (curve L4), the applied voltage is gradually lowered. As the applied voltage decreases, the crushed rubber valve 381 returns to its original shape, but even in this state, the first plunger 382 and the plunger receiver 383 remain fixed by electromagnetic force, and the point P6 ( The metal contact is released when the PWM is about 48% and the opening stroke is about -300 μm. That is, until reaching the point P6, even if the voltage enters the control region, the stroke of the rubber valve 381 hardly changes due to the influence of the sticking by the electromagnetic force. Then, after passing through the point P6, the first plunger 382 and the plunger receiver 383 are not firmly fixed, and the rubber valve 381 is suddenly opened. As a result, there is a sudden change in the hysteresis L4. After the point P6, the electromagnetic valve 38 is in a half-open state, and air begins to escape from the gap. Further, when the applied voltage is lowered, the tilted electromagnetic valve 38 is completely opened at the point P7 (PWM is about 43%, stroke is about -220 μm).

  Note that the force that keeps the electromagnetic valve 38 closed between the points P4-P5-P2 and between P2-P6 is the same between the first plunger 382 and the plunger receiver 383 depending on the applied voltage, as in FIG. Electromagnetic force between. Therefore, the change in the stroke between the points P2 and P6 is gradual. On the other hand, after the metal contact is released (after point P6), the applied voltage (PWM) at that time is supposed to gradually open the rubber valve 381, so that the stroke changes rapidly. Thus, the rubber valve 381 is completely opened at the point P7.

  Thus, when the metal sticking occurs, the rubber valve 381 starts to open suddenly (P6), so it is difficult to keep the pressure reduction speed at about 5 mmHg / sec. As shown in FIG. 21, it can be seen that the stroke of the rubber valve 381 from the start of the control region to the point P6 does not actually change, and almost no air has escaped.

  When a normal electromagnetic valve 38 that does not cause metal sticking is opened and closed, the difference between the PWM when the rubber valve 381 is closed and the PWM when the rubber valve 381 is opened is about 6%, whereas the metal sticking occurs. The difference in PWM is about 12%. If such metal sticking occurs, the valve opening / closing operation is abruptly performed as described above, so that the air in the cuff belt 2 cannot be stably exhausted (depressurized). Although the problem can be solved if the electromagnetic valve 38 can always be taken in and out horizontally, its control is very difficult.

  Therefore, in the improvement plan of the present embodiment, as shown in FIG. 22, the portion 386 that may be contacted is cut in the first plunger 382 of the electromagnetic valve 38 so that almost the entire circumferential direction is tapered. . The portion 386 that may contact the plunger receiver 383 by tilting the first plunger 382 in this manner is tapered to a certain degree between the first plunger 382 and the plunger receiver 383. Therefore, even if the electromagnetic valve 38 is slightly inclined, metal contact can be prevented. If the angle φ of the tapered portion (386) is set between about 5 degrees and about 8 degrees, the influence of the inclination can be suppressed, and the first plunger 382 and the plunger This is very effective in that the electromagnetic force with the receiver 383 is not weakened too much. However, it is not limited to this range, and if it is somewhat tapered, it is effective to some extent against the inclination.

In this way, if the first plunger 381 is tapered, even if the rubber valve 381 is inclined, the hysteresis has the characteristics shown in FIG. It becomes possible.

It is a figure which shows the 1st specific example which concerns on the conventional blood pressure meter. It is a figure which shows the 2nd specific example which concerns on the conventional blood pressure meter. It is a figure which shows the external appearance of the blood pressure meter which concerns on this invention. It is a figure which shows the structure of the cuff 2 which concerns on this invention. It is a figure which shows the internal structure of the blood pressure meter main body which concerns on this invention. It is a figure which shows the connector for connecting a blood pressure meter main body and a cuff tube. It is a figure which shows the structure of the part which accommodates the connector of FIG. 6 in a blood pressure meter main body. It is a figure which shows the external appearance of the part which connects a blood pressure meter main body and a cuff tube. It is a figure which shows a mode when the tube side connector 24 of a cuff tube (tube for small cuffs) is connected to the blood pressure meter main body. It is a figure which shows the structure of the connection part of the air balloon 15 and a main body side. It is a figure which shows the structure which concerns on another specific example of a connector about the connection part of the air balloon 15 and the blood pressure meter main body 10. FIG. It is a figure which shows the structure of the one-way clutch ring of a main body side about the connection part of the air balloon 15 and the blood pressure meter main body 10. FIG. It is a figure which shows the specific example of the display part of a blood pressure meter. It is a figure which shows the circuit block diagram of a blood pressure meter main body. It is a graph which shows the pressure fluctuation at the time of pressure reduction. It is a graph which shows the actual measurement value and prediction value of the pressure fluctuation at the time of pressure reduction. It is a flowchart for demonstrating the operation | movement which determines a maximum blood pressure and a minimum blood pressure. It is a figure which shows the structure of the solenoid valve 38 used with a blood pressure meter. It is a hysteresis characteristic which shows the relationship between the applied voltage and opening / closing stroke about the opening / closing of the solenoid valve 38 at the normal time. It is a figure which shows a mode when the inclination has arisen in the rubber valve 381 of the solenoid valve 38. FIG. It is a hysteresis characteristic which shows the relationship between the applied voltage and opening / closing stroke about opening / closing of the solenoid valve 38 at the time of inclination. It is a figure which shows the structure of the improvement plan of a solenoid valve. It is a graph which shows the pressure fluctuation at the time of pressurization.

Claims (5)

A sphygmomanometer that measures blood pressure based on changes in arterial wall vibration caused by arterial wave drive accompanying changes in cuff pressure,
A removable cuff,
A tube extending from the cuff and having a male connector at the tip;
A sphygmomanometer body portion having a female connector portion into which the male connector of the tube is inserted, and
The male connector has an elastic part, the insertion port diameter of the female connector part is smaller than the diameter of the elastic part of the male connector, and a click feeling when the male connector and the female connector part are connected A sphygmomanometer characterized by generating blood pressure.   The sphygmomanometer according to claim 1, wherein the cuff includes a large cuff for ischemia and a small cuff for detecting arterial pulsation.   The female connector portion that engages with the male connector communicates with the large cuff and the small cuff, and the large cuff communicating portion and the small cuff communicating portion are integrally formed. The sphygmomanometer according to claim 2, wherein the sphygmomanometer is provided.   The sphygmomanometer according to claim 3, wherein the male connector is connected to the small cuff communication portion.   The sphygmomanometer according to any one of claims 1 to 4, wherein a plurality of detachable cuffs are prepared, and one of them is selected and used.

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