JP2006102264A - Blood pressure monitoring device and blood pressure monitoring method - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To speedily and accurately measure a blood pressure when the variation in the blood pressure of a subject is predicted. <P>SOLUTION: A blood pressure monitoring device measures the blood pressure at prescribed time intervals and displays the result of the measurement. The blood pressure monitoring device computes the propagation velocity (an estimated blood pressure value) from the propagation time obtained by continuously measuring the heart rate and the pulse wave while the blood pressure is not measured. The blood pressure monitoring device monitors the propagation velocity, and if there is a change in the propagation velocity, outputs an abnormality signal expressing that the variation of the blood pressure is predicted. Then, the blood pressure monitoring device speedily and accurately measures the blood pressure value at the time of emergency by urgently measuring the blood pressure value at the time point, and informs the subject of the measured blood pressure. <P>COPYRIGHT: (C)2006,JPO&NCIPI

Description

  The present invention relates to a blood pressure monitoring device, a blood pressure monitoring method, a control program for executing the blood pressure monitoring method, and a computer-readable storage medium storing the blood pressure monitoring device that can reduce the burden on the subject when changing the blood pressure while monitoring the blood pressure change. About.

  The propagation time and propagation speed between two predetermined sites are known as pulse wave propagation velocity information of a pulse wave propagating into a living artery, and this propagation time and the like may be approximately proportional to the blood pressure value of the living body. Are known. Thus, there is known an apparatus for measuring blood pressure when blood pressure value abnormality is predicted by continuously monitoring pulse wave propagation velocity information such as propagation time.

For example, in Japanese Patent No. 3054084, a detection unit for detecting an electrocardiogram (so-called electrocardiogram) is installed on the subject's chest, a detection unit for detecting pressure pulse waves on the finger, and a detection unit for measuring blood pressure on the upper arm. A blood pressure monitoring device is disclosed (Patent Document 1). That is, as shown in FIG. 6, an electrocardiographic wave indicating the myocardial active potential is continuously detected using an electrocardiographic device, while the photoelectric pulse wave propagating to the blood vessel (peripheral side) of the finger is continuously detected. By detecting automatically, the propagation time which is a time difference between two parts (heart and finger) is continuously monitored as pulse wave propagation velocity information. Then, when an abnormality in blood pressure is predicted from the propagation time, an apparatus for measuring a blood pressure value quickly and accurately by pressurizing a cuff attached to the upper arm and measuring the blood pressure is disclosed.
Patent No. 3054084

  The apparatus can be used as follows, for example, as an apparatus for monitoring a change in the condition of a patient after surgery. That is, while measuring blood pressure at regular time intervals (for example, every 30 minutes) and displaying the results, during the period when blood pressure measurement is not performed, the propagation time is calculated by measuring the heart rate and pulse wave, and this propagation time. When a change is observed in the monitored propagation time, a blood pressure change is predicted and the blood pressure at that time is urgently measured. In this way, the blood pressure value in an emergency can be notified quickly and accurately.

  However, when using the above-mentioned device, the detection unit for propagation time detection is fixed at the chest and finger positions, the detection unit for blood pressure measurement is fixed at the upper arm, and fixed at different positions. Since blood pressure is measured regularly while monitoring, it imposes a considerable burden on postoperative patients.

  In other words, the finger is the place where the patient moves best, and if the patient is fixed for a long period of time, the patient will unintentionally move the finger and the detection part will come off the finger, making it impossible to detect the finger. There is also a risk of feeling pain when pulled by the detection unit.

  Therefore, instead of installing a detection unit (pulse wave detection) for detecting the propagation time on the finger and measuring the propagation time, it is considered to install this detection unit on the upper arm and measure the propagation time as described above. It is done. In addition, since the upper arm is compressed when measuring the blood pressure in the upper arm, even a healthy subject feels pain when measuring the blood pressure, so it may be painful for patients after surgery to measure blood pressure regularly.

  As described above, monitoring the change in the condition of the patient after the operation using the above apparatus imposes a considerable burden on the patient after the operation. Therefore, in order to reduce the burden on the patient after surgery without reducing the measurement accuracy, there is a device that can reduce the measurement location and increase the freedom of movement of the patient, or can ease the patient's pain during blood pressure measurement It is desired.

  The present invention has been made in order to overcome the above-described problems of the prior art. The purpose of the present invention is, for example, to monitor a subject's burden during monitoring when monitoring changes in blood pressure of the subject such as a patient after surgery. To provide a blood pressure monitoring apparatus and a blood pressure monitoring method that can be reduced.

  In order to achieve the above object, a blood pressure monitoring apparatus according to an embodiment of the present invention has the following configuration. That is, a blood pressure monitoring apparatus that quickly measures blood pressure when a change in blood pressure is predicted, pressurizing means that pressurizes the cuff and compresses the outer ear and its surroundings, and pressure for detecting the cuff pressure in the cuff A sensor, a pulse wave measuring means for continuously measuring the pulse waves of the outer ear and its surroundings, and an electrocardiographic wave measuring means for continuously measuring an electrocardiographic wave indicating the action potential of the myocardium at the same time A pulse wave velocity information calculating means for calculating pulse wave velocity information from the measured pulse wave and the electrocardiogram induced wave, and a change in blood pressure is predicted based on the calculated pulse wave velocity information. When the blood pressure change notification means and the prediction of the blood pressure change are notified, the blood pressure is measured based on the pulse wave and the cuff pressure measured while the pressure is reduced after the cuff is pressurized to a predetermined pressure. Blood pressure measuring means for measuring The features.

  Here, for example, the outer ear and the periphery thereof are preferably the external auditory canal and / or pinna.

  Here, for example, the outer ear and the periphery thereof are preferably the tragus and / or the periphery thereof.

  Here, for example, the pulse wave measuring means includes: a light emitting element that irradiates light to the outer ear and its periphery; and a light receiving element that measures the amount of light reflected by the irradiated light inside the outer ear and its periphery. It is preferable to measure the pulse wave using

  Here, for example, the pulse wave propagation velocity information is preferably a propagation time or propagation velocity between two predetermined sites.

  Here, for example, the pulse wave propagation velocity information calculation means calculates a propagation time of the pulse wave between the two predetermined sites from the electrocardiographic induction wave and the pulse wave, and the blood pressure change notification means When the wave propagation time becomes less than a predetermined value, it is preferable to notify the prediction of the blood pressure change.

  Here, for example, it is preferable that the blood pressure change notifying unit further includes a heart rate calculating unit that calculates a heart rate, and a heart rate change notifying unit that notifies a heart rate change when the heart rate falls below a predetermined value. .

  Here, for example, it further includes a determination unit that determines whether or not both the prediction of the blood pressure change and the heart rate change are notified, and when both the blood pressure change and the heart rate change are notified, The blood pressure measuring means preferably measures blood pressure based on the pulse wave and the cuff pressure.

  Here, for example, the blood pressure change notifying means further includes a shape change calculating means for calculating the shape change of the pulse wave, the propagation time of the pulse wave is less than a predetermined value, and the shape change amount of the pulse wave Preferably, when the blood pressure exceeds a predetermined value, the prediction of the blood pressure change is notified.

  Here, for example, the pulse wave measuring means calculates a plurality of light emitting elements that irradiate light of different wavelengths, and an amount of light transmitted / reflected by the light emitted from the plurality of light emitting elements through and around the outer ear and the periphery thereof. It is preferable to have an oxygen saturation measuring means for measuring oxygen saturation in the blood based on the respective measured light amounts.

  In order to achieve the above object, a blood pressure monitoring apparatus according to an embodiment of the present invention has the following configuration. That is, a blood pressure monitoring apparatus that quickly measures blood pressure when a change in blood pressure is predicted, pressurizing means that pressurizes the cuff and compresses the outer ear and its surroundings, and pressure for detecting the cuff pressure in the cuff Sensor, pulse wave measuring means for continuously measuring the pulse waves of the outer ear and its surroundings, and pulse wave velocity information calculation for calculating pulse wave velocity information by measuring a delay from the reference time of the pulse wave When a change in blood pressure is predicted based on the means and the calculated pulse wave velocity information, the cuff is pressurized to a predetermined pressure and then measured based on the pulse wave and the cuff pressure measured while the pressure is reduced. Blood pressure measuring means for measuring blood pressure.

  In order to achieve the above object, a blood pressure monitoring method according to an embodiment of the present invention has the following configuration. That is, a pressurizing unit that pressurizes the cuff and presses the outer ear and the periphery thereof, a pressure sensor that detects the cuff pressure in the cuff, and a pulse wave measurement unit that continuously measures the pulse waves of the outer ear and the periphery thereof A blood pressure monitoring method for quickly measuring blood pressure when a change in blood pressure is predicted, in a blood pressure monitoring device having an electrocardiographic induction wave measuring means for continuously measuring an electrocardiographic induction wave indicating an action potential of the myocardium And based on the pulse wave velocity information calculation step for calculating pulse wave velocity information from the pulse wave and the electrocardiogram induced wave measured at the same time, and the calculated pulse wave velocity information, A blood pressure change notification step for notifying that a blood pressure change is predicted, and when the prediction of the blood pressure change is notified, the pulse wave and the cuff measured while reducing the pressure after pressurizing the cuff to a predetermined pressure. Measure blood pressure based on pressure A blood pressure measurement process that is characterized by having a.

  Here, for example, the outer ear and the periphery thereof are preferably the external auditory canal and / or pinna.

  Here, for example, the outer ear and the periphery thereof are preferably the tragus and / or the periphery thereof.

  Here, for example, the pulse wave measuring means includes: a light emitting element that irradiates light to the outer ear and its periphery; and a light receiving element that measures the amount of light reflected by the irradiated light inside the outer ear and its periphery. It is preferable to measure the pulse wave using

  Here, for example, the pulse wave propagation velocity information is preferably a propagation time or propagation velocity between two predetermined sites.

  Here, for example, the pulse wave propagation velocity information calculation step calculates a propagation time of the pulse wave between the two predetermined sites from the electrocardiogram induced wave and the pulse wave, and the blood pressure change notification step includes the pulse wave change notification step. When the wave propagation time is less than a predetermined value, it is preferable to notify that the blood pressure change is predicted.

  Here, for example, the blood pressure change notifying step preferably further includes a heart rate calculating step for calculating a heart rate, and a heart rate change notifying step for notifying a heart rate change when the heart rate becomes less than a predetermined value. .

  Here, for example, the method further includes a determination step of determining whether the blood pressure change prediction and the heart rate change are both notified, and when both the blood pressure change and the heart rate change are notified, The blood pressure measurement step preferably measures blood pressure based on the pulse wave and the cuff pressure.

  Here, for example, the blood pressure change notifying step further includes a shape change calculating step for calculating the shape change of the pulse wave, the propagation time of the pulse wave is less than a predetermined value, and the shape change amount of the pulse wave Preferably, when the blood pressure exceeds a predetermined value, the prediction of the blood pressure change is notified.

  Here, for example, the pulse wave measuring means calculates a plurality of light emitting elements that irradiate light of different wavelengths, and an amount of light transmitted / reflected by the light emitted from the plurality of light emitting elements through and around the outer ear and the periphery thereof. It is preferable to include an oxygen saturation measurement step of measuring oxygen saturation in the blood based on the respective light amounts measured.

  In order to achieve the above object, a blood pressure monitoring apparatus according to an embodiment of the present invention has the following configuration. That is, a pressurizing unit that pressurizes the cuff and presses the outer ear and the periphery thereof, a pressure sensor that detects the cuff pressure in the cuff, and a pulse wave measurement unit that continuously measures the pulse waves of the outer ear and the periphery thereof Is a blood pressure monitoring method for quickly measuring blood pressure when a change in blood pressure is predicted, and measuring pulse wave velocity information by measuring a delay from the reference time of the pulse wave When a change in blood pressure is predicted based on the calculated pulse wave velocity information calculation step and the calculated pulse wave velocity information, the pulse is measured while the cuff is pressurized to a predetermined pressure and then depressurized. And a blood pressure measuring step for measuring blood pressure based on the wave and the cuff pressure.

  In order to achieve the above object, a control program according to an embodiment of the present invention has the following arrangement. That is, a pressurizing unit that pressurizes the cuff and presses the outer ear and the periphery thereof, a pressure sensor that detects the cuff pressure in the cuff, and a pulse wave measurement unit that continuously measures the pulse waves of the outer ear and the periphery thereof A blood pressure monitoring method for quickly measuring a blood pressure when a change in blood pressure is predicted in a blood pressure monitoring apparatus having an electrocardiographic induction wave measuring means for continuously measuring an electrocardiographic induction wave indicating an action potential of the myocardium A control program for executing the pulse wave velocity information calculation step for calculating pulse wave velocity information from the pulse wave and the electrocardiogram induced wave measured at the same time, and the calculated program code Based on the pulse wave velocity information, the program code of the blood pressure change notification step for notifying that the blood pressure change is predicted, and when the blood pressure change prediction is notified, after pressurizing the cuff to a predetermined pressure And having a program code of the blood pressure measurement step of measuring blood pressure on the basis of said pulse wave and the cuff pressure to be measured while reducing the pressure.

  In order to achieve the above object, a control program according to an embodiment of the present invention has the following arrangement. That is, a pressurizing unit that pressurizes the cuff and presses the outer ear and the periphery thereof, a pressure sensor that detects the cuff pressure in the cuff, and a pulse wave measurement unit that continuously measures the pulse waves of the outer ear and the periphery thereof A control program for executing a blood pressure monitoring method for quickly measuring a blood pressure when a blood pressure change is predicted, and measuring a delay from a reference time of the pulse wave When a blood pressure change is predicted based on the program code of the pulse wave velocity information calculation step for calculating the pulse wave velocity information and the calculated pulse wave velocity information, the cuff is pressurized to a predetermined pressure. And a blood pressure measurement program code for measuring blood pressure based on the pulse wave and the cuff pressure measured while reducing pressure. Here, for example, the outer ear and the periphery thereof are preferably the external auditory canal and / or pinna.

  Here, for example, the outer ear and the periphery thereof are preferably the tragus and / or the periphery thereof.

  The present invention also provides a computer readable storage medium for storing the control program.

  According to the blood pressure monitoring device and the blood pressure monitoring method of the present invention, since the outer ear and its surroundings that are less likely to feel pain are used as the detection site, when monitoring the blood pressure change of the subject such as a patient after surgery, The burden can be reduced.

<First Embodiment>
A blood pressure monitoring apparatus according to a preferred embodiment of the present invention will be described below with reference to the drawings.

  The present blood pressure monitoring apparatus includes an external ear (the external ear includes the external auditory canal (the ear canal up to the eardrum) and the auricle (portion protruding to the cranial side) and its periphery, preferably the external auditory canal and / or the auricle, and more preferably. Is characterized in that a detector for pulse wave measurement and blood pressure measurement is installed in the tragus and / or its vicinity (including a part of the superficial temporal artery or its branch and a part of the ear canal). In the following description, the case where the detection unit is attached to the tragus will be described as an example.

[Usage of this blood pressure monitoring device]
Hereinafter, the usage and characteristics of the blood pressure monitoring apparatus will be described first. This blood pressure monitoring device, for example, continuously measures blood pressure information (estimated blood pressure value) during a period when blood pressure measurement is not performed while periodically measuring the blood pressure of a subject such as a patient after surgery, Blood pressure can be measured quickly and accurately in the event of an emergency in which the estimated blood pressure value changes, and the burden on the subject (pain, inconvenience) when measuring blood pressure or continuously measuring the estimated blood pressure value Etc.) can be reduced.

  For example, a usage example in a post-surgical patient in which the detection unit of the present apparatus is attached to the outer ear (for blood pressure measurement, photoelectric pulse wave measurement) and near the heart (for electrocardiographic wave measurement) will be described as shown in FIG. In addition, the blood pressure is measured at a constant time interval (for example, every 30 minutes), and the measurement result is displayed.

  On the other hand, during the period when blood pressure measurement is not performed (between the measurements), the propagation time (the propagation time is approximately proportional to the blood pressure. The estimated blood pressure value can be predicted from the time), and the continuously measured propagation time (or estimated blood pressure value) can be monitored, for example, displayed on the display screen of the display unit. Also, if there is a change in the propagation time during monitoring, such as when the patient's condition after surgery suddenly changes (point t in FIG. 9), an abnormal signal is output at that time even during periods when blood pressure measurement is not performed. Abnormality is notified, blood pressure is urgently measured, and the obtained blood pressure value can be notified.

  As described above, in the present apparatus, the blood pressure value at the time of emergency can be measured quickly and accurately, so that it is possible to promptly respond to an emergency.

  In addition, as shown in FIG. 11, in this apparatus, blood pressure is measured when both the propagation time (or estimated blood pressure value) and the heart rate are abnormal in order to improve the detection accuracy at the time of abnormality. You can also. In this way, it is possible to quickly and accurately monitor a change in the patient's condition during a period when blood pressure measurement is not performed, using the blood pressure value.

  In the present embodiment, as a means for detecting the pulse wave of the peripheral portion (tragus), a light emitting element that irradiates light having a wavelength reflected by hemoglobin in the blood toward the epidermis, and scattering by the hemoglobin. A pulse wave sensor including a light receiving element that detects scattered light from the skin is used. When this pulse wave sensor is used, a photoelectric pulse wave showing a change in blood volume for each beat, that is, a volume pulse wave can be easily detected.

[Features of blood pressure monitoring device]
The blood pressure monitoring apparatus of the present embodiment can reduce the pain of the subject when predicting a blood pressure change by periodically measuring the blood pressure and predicting a blood pressure change by using the following two features. . Hereinafter, first, two features of the blood pressure monitoring apparatus will be briefly described.

  The first feature of the blood pressure monitoring device is that pain is reduced by using a region with few nerves around the blood vessel for blood pressure measurement. As an example of such a region, in this embodiment, the tragus and its Use the periphery. Here, the pain difference between the case where the tragus used in this embodiment and its surroundings are used as the blood pressure measurement part and the case where the upper arm and the finger are used as in the past will be described. The upper arm and the finger are important parts of the body. In order to perform complicated operations, many nerves are stretched around these blood vessels so that these operations can be performed. On the other hand, the tragus which is a part of the pinna is fixed to the head and used for collecting sound. For this reason, since it is not used for complicated work like the upper arm and the finger, the amount of nerves around the arm is smaller than the amount of nerve in the upper arm and fingers. Therefore, when measuring blood pressure using the tragus and its surroundings, the amount of nerves compressed during blood pressure measurement is small, so that the pain during blood pressure measurement can be reduced compared to blood pressure measurement using the upper arm and fingers. Have.

  However, since the tragus is a small part of the auricle as shown in FIG. 1, if the small blood pressure measurement unit cannot be fixed securely and stably to the outer ear and its periphery, the detection unit moves during measurement. The blood pressure cannot be measured accurately. For this reason, the blood pressure monitoring apparatus according to the present embodiment has a structure including a detection unit, a hook-shaped support body, and a main body as shown in FIG. 2 so that the detection unit can be stably fixed to the outer ear and its periphery. As a result, it is possible to easily and stably measure the blood pressure in the outer ear and its surroundings for a long period of time while reducing the pain given to the subject.

  The second feature of the present blood pressure monitoring device is that a pressure pulse detected on the peripheral side from a site (for example, the epidermis in the vicinity of the heart) for detecting an electrocardiogram-induced waveform as means for detecting pulse wave propagation information of a living body When calculating the propagation time or propagation velocity from the time difference to the peripheral site where waves are detected, the tragus is used as the peripheral site. In this way, as the peripheral part, the tragus is fixed to the head and is not a part that moves well like fingers and upper arms, so when the detection part is attached to the tragus, the patient unconsciously puts the finger Even if it moves, the detection part does not come off, and the detection part is not pulled and does not feel pain. Therefore, the tragus and its surrounding pressure pulse wave can be measured easily and stably for a long period of time while reducing the pain given to the subject.

Next, in the blood pressure monitoring apparatus of the present embodiment described above,
1) Blood pressure measurement periodically performed 2) Continuous measurement of propagation time by photoelectric pulse wave and electrocardiographic wave, and blood pressure measurement in emergency will be described in detail.

<Performance of blood pressure regularly>
[Auricular structure: Fig. 1]
The site to which the detection unit of the blood pressure monitoring device is attached is the outer ear and its surroundings, preferably the ear canal and / or pinna, more preferably the tragus and / or its surroundings. First, referring to FIG. The structure of the auricle 20 (so-called ear) will be described. 21 is a tragus, 22 is an antitragus, 23 is a concha, 24 is an antipod, 25 is an earring, and 26 is an antipodal. In the present embodiment, a pair of cuffs 31 and 32 described later are mounted so as to sandwich the tragus 21 and cover the tragus 21 and its periphery. The peripheral portion includes at least a portion of the superficial temporal artery 28 or a branch vessel thereof and a portion of the ear canal shown by dotted lines in FIG.

[Appearance of blood pressure monitoring device: Fig. 2]
FIG. 2 is an external view showing an example of a blood pressure monitoring apparatus 100 according to a preferred embodiment of the present invention. The blood pressure monitoring device 100 includes a detection unit 30, an ear hook type support body 40, and a main body 50. The detection unit 30 is attached to the tragus 21 via the cuffs 31 and 32, and the plurality of electrodes 81 of the electrocardiogram unit 80 are attached to a predetermined part of the living body (for example, the epidermis near the heart). The main body 50 is accommodated in the subject's breast pocket, for example. Details of the detection unit 30 and the main body 50 will be described later with reference to FIGS.

[Ear hook support]
As shown in FIG. 2A, the ear hook-shaped support body 40 includes an ear hook portion 41 that is a hollow pipe and a connecting portion 42 that is a telescopic flexible tube. The detection portion 30 and the main body 50 are connected to each other. To be connected. As shown in FIG. 2B, the air hook 43 for supplying pressurized air supplied from the main body 50 to the detection unit 30 and the detection signal from the power and detection unit 30 to the main body 50 are transmitted inside the ear hook 41. The pipe 45 that accommodates the signal line 44 to be moved is fixed so as not to move, so that the air pipe 43 and the signal line 44 move when the subject operates the main body 50 so that the attachment of the detection unit 30 does not shift. The pipe 43 and the pipe 45 are held.

  The ear hook 41 is a hollow pipe made of a metal such as aluminum, a shape memory alloy or various resins, for example, and is processed into a shape similar to the pinna so as to be easily attached to the pinna as shown in the figure. It has a structure in which it is fixed by wrapping around from the base of the auricle to the back side of the ear ring. In this way, the ear hook 41 is made of metal or hard resin, and by making the shape similar to the auricle, flexibility can be given to a portion to be hooked on the ear, so the ear hook 41 is hung on the ear. Can be firmly fixed to the ear when In order to make it easier to fix the ear hook portion 41 to the ear, the ear hook portion 41 may be provided with a spring structure so that the ear hook portion 41 can be easily hooked to the ear and can be firmly fixed by the ear. Also, the connecting portion 42 connected to the ear hook portion 41 has the structure shown in FIG. 2B. However, the connecting portion 42 is a flexible tube made of a softer resin material than the ear hook portion 41 and having flexibility. For this reason, for example, even when the subject operates the body 50 by removing the body 50 from the chest pocket, the connecting portion 42 is deformed following the movement of the body, so the ear hook 41 is firmly fixed to the auricle and does not move. .

[Electroelectric Dielectric Section]
The electrocardiogram induction unit 80 continuously detects an electrocardiogram-induced wave indicating an action potential of the myocardium, that is, a so-called electrocardiogram, via a plurality of electrodes 81 attached to a predetermined part of the living body. A signal indicating a wave is supplied to the main body 50. The electrocardiogram induction unit 80 detects an R wave or a Q wave among the electrocardiogram induction waves corresponding to the time when the blood in the heart starts to be pumped toward the aorta.

[Detection unit: Fig. 3]
As shown in FIG. 3, the detection unit 30 includes a holding frame 46 that clamps the tragus 21 by the pressing force of the arms 38 and 39, and a cuff 31 that is disposed inside the arms 38 and 39 and changes the pressure applied to the tragus 21. 32, an air pipe 43 for supplying pressurized air to the cuffs 31 and 32, a casing for fixing the cuffs 31 and 32, a light emitting element 36a disposed in the vicinity of the cuff and irradiating the tragus 21 with irradiation light and a blood vessel. The pulse wave sensor 36 includes a light receiving element 36b that receives the reflected scattered light.

[Another detection unit: FIG. 13]
FIG. 13 shows an example of another detection unit 130. As shown in FIG. 13, 130 is a holding frame 46 that holds the tragus 21 by the pressing force of the arms 38 and 39, and cuffs 31 and 32 that are arranged inside the arms 38 and 39 and change the pressure applied to the tragus 21. An air pipe 43 that supplies pressurized air to the cuffs 31 and 32, a housing that fixes the cuffs 31 and 32, two light emitting elements 136a and 136b that are disposed in the vicinity of the cuff and irradiate the tragus 21 with irradiation light; The pulse wave sensor 136 includes a light receiving element 36b that receives scattered light reflected by the blood vessel.

  Here, the light emitting element 136a emits red light having a wavelength of about 660 nm, for example, and the light emitting element 136b emits infrared light having a wavelength of about 800 nm, for example. The light emitting element 136a and the light emitting element 136b are caused to emit light at a predetermined frequency in order for a certain period of time, and the light scattered from the light emitting elements 136a and 136b toward the inside of the tragus 21 and reflected by the blood vessels is common. The light is received by the light receiving element 36. Note that the wavelengths of light emitted by the light emitting elements 136a and 136b are not limited to the above values, the light emitting element 136a emits light having a wavelength that is significantly different from that of oxidized hemoglobin and reduced hemoglobin, and the light emitting element 136b has an absorption coefficient thereof. That emit light having wavelengths substantially equal to each other, that is, light having a wavelength reflected by oxyhemoglobin and reduced hemoglobin.

  By using the two types of light-emitting elements 136a and 136b having characteristic wavelengths as described above, the oxygen saturation level in blood can be measured by a known method (for example, Japanese Patent Laid-Open No. 3-15440).

[Control configuration of blood pressure monitoring device: Fig. 4]
FIG. 4 is a block diagram illustrating the entire control configuration of the blood pressure monitoring apparatus 100 including the detection unit 30 and the main body 50. In FIG. 4, 30 is a detection part with which a tragus and its periphery are mounted | worn. The detection unit 30 includes cuffs 31 and 32 and is fixed to the tragus so that the tragus and surrounding blood vessels can be compressed. Reference numeral 43 denotes an air pipe which forms a flow path of pressurized air into the cuffs 31 and 32. Reference numeral 53 denotes a pressure pump that feeds pressurized air into the cuffs 31 and 32. 54 is a rapid discharge valve that rapidly reduces the pressure in the cuffs 31 and 32. 55 is a fine exhaust valve that reduces the pressure in the cuffs 31 and 32 at a constant speed (for example, 2 to 3 mmHg / sec). Reference numeral 56 denotes a pressure sensor, which changes an electrical parameter according to the pressure in the cuffs 31 and 32. A pressure detection amplifier (AMP) 57 detects an electrical parameter of the pressure sensor 56, converts it to an electrical signal, amplifies it, and outputs an analog cuff pressure signal P.

  The pulse wave sensor 36 installed in the cuff 32 includes a light emitting element 36a (LED) that irradiates light to the pulsating vascular blood flow and a light receiving element 36b (phototransistor) that detects reflected light from the vascular blood flow. In addition, it is good also as a structure which arrange | positions the light receiving element 36b in the cuff 31, and detects the transmitted light which the light irradiated by the light emitting element 36a permeate | transmits the inside of a tragus. A pulse wave detection amplifier (AMP) 59 amplifies the output signal of the light receiving element 36 and outputs an analog pulse wave signal M (intravascular volume change signal). Here, a light amount control unit 68 that automatically changes the light amount is connected to the light emitting element 36a, while a pulse wave detection amplifier 59 and a gain control unit 69a that automatically changes the gain and a pulse wave detection (not shown). A time constant control unit 69b for changing the time constant of the filter amplifier constituting the filter amplifier is connected. Reference numeral 60 denotes an A / D converter (A / D), which converts the analog signals M and P into digital data D.

  A control unit (CPU) 61 performs main control of the blood pressure monitoring apparatus 100. The CPU 61 has an adjustment pressure register 61a that stores the adjustment pressure. Reference numeral 62 denotes a ROM which stores the control program shown in FIG. A RAM 63 includes a data memory, an image memory, and the like. A wave crystal display (LCD) 64 displays the contents of the image memory. Reference numeral 66 denotes a keyboard, which can perform a measurement start command, an adjustment pressure value setting, and the like by a user operation. Reference numeral 65 denotes a buzzer that informs the user that the device has sensed that a key in the keyboard 66 has been pressed, or that the measurement has been completed. Reference numeral 70 denotes an acceleration sensor which is attached to the subject and transmits the posture information of the subject to the CPU 61. Reference numeral 80 is an electrocardiographic portion, and 81 is an electrode thereof.

[Operation when measuring blood pressure]
Next, an operation at the time of blood pressure measurement by the blood pressure monitoring apparatus 100 having the above-described configuration will be described. The control unit 61 instructs to pressurize the cuffs 31 and 32 through the pressure pipe 43 by driving the pressure pump 53. The pressure sensor 56 measures the pressure that the pressure pump 53 supplies to the cuffs 31 and 32 through the pressure pipe 43, and transmits the measurement result to the control unit 61 through the signal line 44. The controller 61 controls the pressure pump 53 so that the pressure supplied to the pump measured by the pressure sensor 56 matches the pressure indicated by the controller 61. The control unit 61 transmits a signal to the light quantity control driving unit 68 and instructs the light quantity control driving unit 68 to cause the light emitting element 36a to emit light. The light quantity control unit 61 receives this signal and drives the light emitting element 36a. The light emitting element 36a irradiates a part of the auricle (the tragus) with light such as laser light, and the irradiated light is emitted from the capillaries in the tragus. When the light receiving element 36b receives the light that is absorbed and reflected by hemoglobin, the received light is converted into an electric signal and transmitted to the light quantity control drive unit 68 through the signal line 44.

[Principle of blood pressure measurement: Fig. 5]
Next, an example of the principle of blood pressure measurement of the outer ear and its surroundings (the outer ear and its surroundings) using the blood pressure monitoring apparatus 100 will be described with reference to FIG. In blood pressure measurement, first, the cuffs 31 and 32 are pressurized by the pressure pump 53 to reduce the pressure from the state where the blood flow of the blood vessel 37 is stopped. This depressurization process is shown as cuff pressure 70 in FIG. 5, and the cuff pressure 70 decreases with time.

  A pulse wave signal 71 shown in FIG. 5 is a pulsation waveform of the blood vessel 37 measured by the light receiving element 36 b of the detection unit 30 in the process of reducing the cuff pressure 70. When the cuff pressure 70 is sufficiently high, the blood flow is stopped and the blood vessel pulse wave signal 71 hardly appears, but the cuff pressure 70 is lowered and a small triangular pulsation waveform appears. The present time point (t1) of the pulse wave signal 71 of the blood vessel is indicated by point A. When the cuff pressure 70 is further decreased, the amplitude of the pulse wave signal 71 increases and becomes maximum at the point B. When the cuff pressure 70 is further lowered, the amplitude of the pulse wave signal 71 is gently reduced, and then the upper width portion of the pulse wave signal 71 becomes a constant value and becomes flat. After the upper width portion of the pulse wave signal 71 becomes a constant value, the pulse wave signal 71 changes from a reduced state to a constant value at the point C. The cuff pressure value corresponding to this point A is the maximum blood pressure (systolic blood pressure) P1, and the cuff pressure value corresponding to the point C is the minimum blood pressure (diastolic blood pressure) P2.

  (A), (b), and (c) of FIG. 5 are enlarged views of pulsation waveforms at points A, B, and C. One cycle is indicated by a solid line, and adjacent pulse waveforms are indicated by broken lines. Show. When the pulse-like waveforms constituting the pulse wave signal 71 are viewed individually, a triangular pulse-like waveform having many flat portions and a small amplitude as shown in FIG. The head of the triangle becomes sharper and the flat part decreases as the point B corresponding to the average blood pressure is approached. At the point B, as shown in FIG. It becomes a pulse-like waveform that can be said that the lower half of the triangular wave that vibrates up and down is cut off. Further, as the point C corresponding to the diastolic blood pressure is approached, the pulse-like waveform constituting the pulse wave signal 71 approaches a triangular wave, and at the point C, the rising part approaches vertical as shown in (c), and the falling part is gentle. It becomes a pulse-like waveform.

  As described above, each of the pulse-like waveforms constituting the pulse wave signal 71 has a shape having a very remarkable characteristic in the range from the point A corresponding to the systolic blood pressure to the point C corresponding to the systolic blood pressure. Yes. Further, the shape of the pulse wave signal 71 only changes in amplitude when the blood pressure changes, and the shape does not change. Therefore, the waveform for one cycle of the pulse waveform constituting the pulse wave signal 71 measured at an arbitrary time point is described in detail as each pulse waveform constituting the pulse wave signal 71 shown in FIG. By comparing, it can be determined which level the waveform corresponds to between the systolic blood pressure and the systolic blood pressure. Therefore, the times t1 and t2 corresponding to the systolic blood pressure and the systolic blood pressure can be determined from the pulse waveform of the pulse wave signal 71 by the above-described method. Therefore, by reading the cuff pressure 70 at this time, P1 and minimum blood pressure P2 can be determined. The blood pressure pulse value can be measured using a triangular pulse waveform included in the pulse wave signal 71.

[Blood pressure measurement processing: FIG. 6]
Next, the blood pressure measurement process described above will be described using the flowchart of the blood pressure measurement process procedure of FIG.

  When the apparatus is turned on by the power switch 20, a self-initial diagnosis process (not shown) is first performed to initialize the apparatus. Thereafter, the process is started by pressing the measurement start switch ST.

  In step S101, the cuff pressure P is read, and in step S102, it is determined whether or not the residual pressure of the cuff 1 is within a specified value. If the residual pressure exceeds the specified value, “residual pressure error” is displayed on the LCD 14 in step S123. If the residual pressure is within the specified value, a cuff pressure value (for example, a value larger than the maximum blood pressure value of 120 to 210 mmHg) is set using the keyboard 16 in step S103, and the light amount and gain are set to predetermined values in step S104. Set to.

  When the setting of the pressurization value and the light quantity / gain is completed, the quick exhaust valve 4 and the fine exhaust valve 5 are closed in steps S105 and S106. In step S107, driving of the pressure pump 3 is started and pressurization (pressure increase) is started. This is the start of the measurement process during pressurization, and the cuff pressure starts increasing at a constant speed (for example, 2 to 3 mmHg / sec). During this time, data processing by each functional block is performed in step S108, and the measurement of the minimum blood pressure and the maximum blood pressure is performed. When the maximum blood pressure is measured (S109), the pressurizing pump 3 is stopped in step S112. In step S110, it is determined whether or not the cuff pressure is higher than the pressure value U set in S103. If P> U, it is still in the normal measurement range and measurement is continued. On the other hand, when P> U, the cuff pressure is already higher than the set value, so that “measurement error” is displayed on the LCD 14 in step S111. If necessary, detailed information such as “signal abnormality during pressurization” is additionally displayed. In step S113, the light quantity and gain are adjusted based on the signal quality of the pulse wave signal obtained during pressurization.

  When the adjustment of the light quantity / gain is completed, the fine exhaust valve 5 is opened in step S114. This is the start of the measurement process at the time of pressure reduction (pressure reduction), and the cuff pressure starts to decrease at a constant speed (for example, 2 to 3 mmHg / sec). During this time, data processing by each functional block is performed in step S115, and the systolic blood pressure and the diastolic blood pressure are measured. In step S116, it is determined whether or not a minimum blood pressure value at the time of decompression is detected. If not detected, continue measurement. In step S117, it is determined whether or not the cuff pressure is lower than a predetermined value L (for example, 40 mmHg). If P <L, it is still in the normal measurement range, and the flow returns to step S115. On the other hand, when P <L, the cuff pressure is already lower than the normal measurement range, so “measurement error” is displayed on the LCD 14 in step S118. If necessary, display detailed information such as “signal anomaly during decompression”.

  When the measurement is completed in the determination in step S116, the measurement process is completed in the normal measurement range, and the maximum blood pressure value and the minimum blood pressure value measured are displayed on the LCD 14 in step S119, and the tone signal is displayed to the buzzer 15 in step S119. Send. Preferably, different tone signals are sent after normal termination and abnormal termination. In steps S120 and S121, the remaining air in the cuff 1 is quickly exhausted, and the next measurement start is awaited.

[Blood pressure calculation operation: FIG. 7]
A graph (schematic diagram) of a pulse wave signal when using a cuff pressure and a velocity (change amount detection) sensor in the time from the start of measurement during pressurization (step S108) to the end of measurement during depressurization (step S115) 7 shows. The blood pressure measurement is generally performed as follows for the graph of FIG. That is, in the measurement at the time of pressurization, the cuff pressure at the point (a) at which the change in the magnitude of the pulse wave signal has started is set as the minimum blood pressure, and the cuff pressure at the disappearance point (b) of the pulse wave signal is set as the maximum blood pressure. On the other hand, the blood pressure measurement at the time of decompression is opposite to the blood pressure measurement at the time of pressurization, and the cuff pressure at the present time (c) of the pulse wave signal is the maximum blood pressure, and the change in the magnitude of the pulse wave signal is eliminated (d). The cuff pressure is the minimum blood pressure.

  As described above, the blood pressure monitoring apparatus 100 can stably and accurately measure the blood pressure of the tragus and its surroundings by attaching a small blood pressure measurement unit to the tragus stably for a long period of time. it can.

<Continuous measurement of propagation time and blood pressure measurement in emergency>
Next, continuous measurement of propagation time by photoelectric pulse wave and electrocardiographic wave and blood pressure measurement in emergency will be described.

[Continuous measurement of propagation time: Fig. 8]
As shown in FIG. 8, photoelectric pulses sequentially detected by the tragus detection unit 30 from a predetermined part (for example, an R wave) generated every period of the electrocardiographic induction wave sequentially detected by the electrocardiogram induction unit 80. A time difference (pulse wave propagation time) DT _RP to a predetermined part (for example, a lower peak point) generated every wave period is sequentially calculated. The pulse wave propagation time obtained in this way is one piece of pulse wave velocity information of the pulse wave propagating in the blood vessel in the living body. Further, from the thus be measured pulse wave propagation time DT _RP, measure the distance L from the heart to the tragus by the following equation,
V _M = L / DT _RP
Calculating a pulse wave velocity V _M, it may be pulse-wave-velocity-related information.

  The photoelectric pulse wave described above is measured using the pulse wave sensor 36. That is, when the light emitting element 36a irradiates light having a wavelength reflected by hemoglobin in blood toward the epidermis, the light receiving element 36b detects scattered light scattered by the hemoglobin from the epidermis. In this manner, the pulse wave sensor 36 can easily detect a photoelectric pulse wave (that is, a volume pulse wave) indicating a change in blood volume for each beat.

[Monitoring of propagation velocity (estimated blood pressure value): FIG. 9]
The measured pulse wave velocity information (propagation time DT and propagation velocity V _M (m / s) between two predetermined sites) is within a predetermined range within the blood pressure value BP (mmHg) of the living body as shown below. ).

Estimated blood pressure value = a1 × propagation speed V _M + b1
Estimated blood pressure value = a2 / propagation time DT _RP + b2
Therefore, an example of a propagation velocity V _M which is measured continuously measured in Fig. Thus, continuously displayed on the display unit the propagation velocity V _M to be measured (or estimated blood pressure value), by continuously monitoring the propagation velocity V _M (or estimated blood pressure value), the propagation velocity V _M A change in blood pressure can be predicted from the change in blood pressure.

[Monitoring of propagation speed (estimated blood pressure value) and blood pressure measurement in emergency: FIG. 9]
Next, blood pressure measurement in an emergency will be described. Figure 9 is a diagram propagation velocity V _M which is measured as described above is decreased from the time t4, than a predetermined threshold value at time t will be described an emergency process when dropped.

That is, in the blood pressure monitoring device of the present embodiment, as shown in the blood pressure values in FIG. 9, monitors the blood pressure by measuring regularly blood pressure, do not measure blood pressure as indicated by the propagation velocity V _M in FIG. 9 The period is monitored using the propagation velocity V _M (or estimated blood pressure value).

For example, to measure the t1, t2, t3, t4 regular blood pressure in ... in FIG, t1 to t2, t2 to t3, monitoring the propagation velocity V _M which is continuously measured at t3 to t4 ... To predict changes in blood pressure. Accordingly, when there is no change in the propagation velocity V _M as shown in t1 to t4 in FIG. 9, the patient's condition after the operation is displayed by displaying blood pressure values periodically measured at times t1, t2, t3, and t4. The doctor can manage.

On the other hand, it reduces the propagation velocity V _M from the time t4 in FIG. 9, when lower than a preset threshold value at time t, as the emergency treatment, the propagation velocity V _M (or estimated blood pressure value) is predetermined An abnormal signal notifying that the value is less than or equal to the value is output to notify the estimated blood pressure change, and at the same time, blood pressure measurement in an emergency is started. The blood pressure at time t in FIG. 9 is measured in this way. By quickly and accurately informing the blood pressure value in an emergency, the doctor can perform a quick treatment in an emergency. In addition, t5, t6, and t7 in FIG. 9 indicate the blood pressure values measured periodically thereafter.

[Calculation of propagation speed and blood pressure measurement in emergency: FIG. 10]
Will now be described with reference to FIG. 10 the processing of calculation and emergency blood pressure measurement of the propagation velocity V _M which is described above. FIG. 10 is executed by the CPU 61 while controlling each unit using the RAM 63 based on the control program stored in the ROM 62.

  In step S150, control is performed to detect an electrocardiographic wave and a photoelectric pulse wave.

Next, in step S151, the calculated pulse wave propagation velocity V _M than the time difference DT _RP between the measured electrocardiogram dielectric wave and the photoelectric pulse wave.

Next, in step S152, the propagation velocity V _M which is calculated is checked whether more than a predetermined value, in the case of more than the predetermined value, the process proceeds to step S154, checks whether the time of blood pressure measurement, blood pressure measurement If it is not time, the process returns to step S150, and if it is time for blood pressure measurement, the process proceeds to step S155.

On the other hand, in step S152, if the propagation velocity V _M which is calculated is less than a predetermined value, the process proceeds to step S153, the propagation velocity V _M outputs an abnormality signal indicating that a predetermined value or less, the propagation velocity V _M is changed, that is, blood pressure change prediction (prediction of decrease in estimated blood pressure value) is notified.

  Next, in step S155, the blood pressure is measured, and in step S156, the measured blood pressure value is displayed.

Next, in step S157, checks whether there is an instruction to end the monitoring of the propagation velocity V _M, when an instruction is not returned to step S150, the when instructed to end the series of operations.

Through the processing described above, the blood pressure monitoring apparatus continuously measures the time difference DT _RP (pulse wave propagation time) during a period in which blood pressure measurement is not performed while periodically measuring the blood pressure of a subject such as a patient after surgery. measured, the change in the time difference DT _RP speed propagation obtained from V _M (or estimated blood pressure value) occurs, it urgently measure may quickly and accurately blood pressure.

<Second Embodiment>
In the second embodiment, both the propagation velocity V _M (or the estimated blood pressure value) (or the estimated blood pressure value) and the heart rate are detected so that the abnormality can be detected with higher accuracy than in the first embodiment. Control to measure blood pressure when there is an abnormality. By controlling in this way, it is possible to more accurately monitor changes in the patient's condition during a period when blood pressure measurement is not performed.

  In addition, the blood pressure monitoring apparatus of 2nd Embodiment is a blood pressure monitoring apparatus similar to the blood pressure monitoring apparatus of 1st Embodiment demonstrated using FIGS. Therefore, in the description of the blood pressure monitoring apparatus of the second embodiment described below, the description of the parts common to the blood pressure monitoring apparatus of the first embodiment will be omitted, and only the different parts will be described.

[Monitoring of propagation speed (estimated blood pressure value) and blood pressure measurement in emergency: FIG. 11]
The blood pressure measurement in emergency will be described. FIG. 11 is a diagram for explaining emergency processing when the measured propagation velocity V _M (or estimated blood pressure value) decreases from time t4 and falls below a preset threshold value at time t.

That is, in the blood pressure monitoring device of the present embodiment, as shown in the blood pressure value of FIG. 11, the blood pressure is periodically measured to monitor the blood pressure, and is indicated by the propagation velocity V _M (or estimated blood pressure value) of FIG. Thus, the period during which blood pressure is not measured is monitored using the propagation velocity V _M (or estimated blood pressure value) and heart rate.

For example, the blood pressure is periodically measured at t1, t2, t3, t4..., And the propagation velocity V _M and the heart rate are continuously measured at t1 to t2, t2 to t3, t3 to t4. Monitor the number to predict blood pressure changes. Therefore, patients after surgery for the, to display the time t1, t2, t3, periodically measured blood pressure values at time t4 when there is no change in the propagation velocity V _M and heart rate as t1~t4 of 11 The doctor can manage the condition.

On the other hand, it reduces the propagation velocity V _M from the time t4 in FIG. 11, when lower than a preset threshold value at time t, as the emergency treatment, the propagation velocity V _M (or estimated blood pressure value) is predetermined An abnormal signal for informing that the value is below the value is output. At this time, it is checked whether or not lower than a preset threshold value by similarly time t heart rate, if also the heart rate drops, as an emergency treatment, the speed V _M and the heart rate propagation An abnormal signal for notifying that the value is below the predetermined value is output. When this abnormal signal is received, blood pressure measurement in an emergency is started. The blood pressure at time t in FIG. 11 is measured in this way. By quickly and accurately informing the blood pressure value in an emergency, the doctor can perform a quick treatment in an emergency. In addition, t5, t6, and t7 in FIG. 11 display the blood pressure values measured periodically thereafter.

[Calculation of propagation speed and blood pressure measurement in emergency: FIG. 12]
Next, the above-described propagation speed, heart rate calculation and emergency blood pressure measurement processing will be described with reference to FIG. In FIG. 12, based on a control program stored in the ROM 62, the CPU 61 executes while controlling each unit using the RAM 63.

  In step S200, control is performed to detect an electrocardiographic wave, a heart rate, and a photoelectric pulse wave.

Next, in step S210, calculates a pulse-wave propagation velocity V _M than the time difference DT _RP between the measured electrocardiogram dielectric wave and the photoelectric pulse wave.

Next, in step S220, the propagation velocity V _M which is calculated is checked whether more than a predetermined value, in the case of more than the predetermined value, the process proceeds to step S240, checks whether the time of blood pressure measurement, blood pressure measurement If it is not time, the process returns to step S200, and if it is time for blood pressure measurement, the process proceeds to step S260.

On the other hand, in step S220, if the propagation velocity V _M which is calculated is not less than the predetermined value, the process proceeds to step S230, the heart rate is checked whether more than a predetermined value, in the case of more than the predetermined value, the step S240 If it is not the time for blood pressure measurement, the process returns to step S200, and if it is the time for blood pressure measurement, the process proceeds to step S260.

On the other hand, in step S230, the when the heart rate is less than a predetermined value, the process proceeds to step S250, the propagation velocity V _M and heart rate outputs an abnormality signal indicating that a predetermined value or less, the change in blood pressure predicted ( Prediction of decrease in estimated blood pressure value) is notified.

  Next, in step S260, the blood pressure is measured, and in step S270, the measured blood pressure value is displayed.

Next, in step S280, checks whether there is an instruction to end the monitoring of such propagation velocity V _M, when an instruction is not returns to step S200, when instructed to end the series of operations.

Through the processing described above, this blood pressure monitoring apparatus measures the time difference DT _RP (pulse wave propagation time) and heart rate during a period when blood pressure measurement is not performed while periodically measuring the blood pressure of a subject such as a patient after surgery. continuously measured, the change in propagation velocity V _M and heart rate occurs, it urgently measure may quickly and accurately blood pressure.

[Other Embodiments]
In the blood pressure monitoring apparatus described above, an electrocardiographic induction wave indicating the action potential of the myocardium measured by the electrocardiographic induction wave measuring unit is continuously measured, and this electrocardiographic induction wave (electrocardiogram) is as shown in FIG. As reference time, pulse wave velocity information was calculated from a time difference DT _RP (pulse wave propagation time) between a pulse wave (for example, a photoelectric pulse wave) measured at the same time and an electrocardiographic induction wave. Is not limited to an electrocardiogram-induced wave (electrocardiogram), but may be measured by another method as a reference time.

  Further, in the blood pressure monitoring apparatus described above, the pulse wave is detected using the light emitting element and the light receiving element, but a cuff for applying pressure to the tragus is provided, and the pulsation due to the pulse wave on the surface of the living body is pressurized with the cuff. A pulse wave can also be detected by capturing it as a change. That is, a pulsation obtained from a living body is converted into a pressure change in the cuff by a cuff to which pressure is applied, and the pressure change in the cuff is detected by a pressure detection device. Even with such a configuration, a pulse wave of a living body can be detected. In addition, a small microphone is installed in the cuff part in contact with the living body, Korotkoff sound generated when pressing with a partial cuff of the living body is detected, and blood pressure is measured based on the occurrence or disappearance of the Korotkoff sound above a predetermined level. It may be.

  In the present invention, a storage medium in which a program code of software that realizes the functions of the embodiments is recorded is provided to a system or apparatus, and a computer (or CPU or MPU) of the system or apparatus is stored in the storage medium. It is also achieved by reading and executing the program code. In this case, the program code itself read from the storage medium realizes the functions of the above-described embodiments, and the storage medium storing the program code constitutes the present invention. As a storage medium for supplying such a program code, for example, a floppy (registered trademark) disk, hard disk, optical disk, magneto-optical disk, CD-ROM, CD-R, magnetic tape, nonvolatile memory card, ROM Etc. can be used.

  Further, by executing the program code read by the computer, not only the functions of the above-described embodiments are realized, but also an OS (operating system) running on the computer based on the instruction of the program code Includes a case where the function of the above-described embodiment is realized by performing part or all of the actual processing.

  Furthermore, after the program code read from the storage medium is written to the memory provided in the function expansion board inserted into the computer or the function expansion unit connected to the computer, the function is based on the instruction of the program code. This includes the case where the CPU of the expansion board or function expansion unit performs part or all of the actual processing, and the functions of the above-described embodiments are realized by the processing.

  Further, the program code of the software that realizes the functions of the above embodiments is distributed via a network, so that it can be stored in a storage means such as a hard disk or memory of a system or apparatus or a storage medium such as a CD-RW or CD-R Needless to say, this can also be achieved by the computer (or CPU or MPU) stored in the system or apparatus reading and executing the program code stored in the storage means or the storage medium.

It is a figure explaining the structure of an auricle. (A) It is an external view of a blood-pressure monitoring apparatus, (b) is sectional drawing of an ear hook part. It is a figure which shows an example of a detection part. It is a figure explaining the control structure of a blood-pressure monitoring apparatus. It is a figure explaining the method of blood pressure measurement. It is a flowchart which shows a blood-pressure measurement process procedure. It is a figure explaining the relationship between a cuff pressure and a pulse wave signal. It is a figure explaining the time difference (pulse wave propagation time) of an electrocardiogram induction wave and a photoelectric pulse wave. It is a figure explaining monitoring of propagation speed (estimated blood pressure value) and blood pressure measurement in emergency. It is a flowchart explaining an example of the process of calculation of propagation speed and the blood pressure measurement in emergency. It is a figure explaining the monitoring of a propagation speed and a heart rate, and the blood pressure measurement in emergency. It is a flowchart explaining another example of the process of calculation of propagation speed, and the blood pressure measurement in emergency. It is a figure explaining another example of a detection part.

Explanation of symbols

DESCRIPTION OF SYMBOLS 100 Blood pressure monitor 21 Tragus 30 Detection part 31 Cuff 32 Cuff 36 Pulse wave sensor 36a Light emitting element 36b Light receiving element 37 Blood vessel 38 Arm 39 Arm 40 Ear hook type support body 41 Ear hook part 42 Connection part 46 Holding frame
50 body

Claims (30)

A blood pressure monitoring device that quickly measures blood pressure when a change in blood pressure is predicted,
A pressurizing means that pressurizes the cuff to compress the outer ear and its surroundings;
A pressure sensor for detecting the cuff pressure in the cuff;
Pulse wave measuring means for continuously measuring the pulse waves of the outer ear and its surroundings;
An electrocardiographic wave measuring means for continuously measuring an electrocardiographic wave indicating the action potential of the myocardium;
Pulse wave velocity information calculating means for calculating pulse wave velocity information from the pulse wave and the electrocardiogram induced wave measured at the same time;
When a blood pressure change is predicted based on the calculated pulse wave velocity information, the cuff is pressurized to a predetermined pressure, and then the blood pressure is measured based on the pulse wave and the cuff pressure measured while reducing the pressure. Blood pressure measuring means for measuring;
A blood pressure monitoring apparatus characterized by comprising:   The blood pressure monitoring apparatus according to claim 1, wherein the outer ear and the periphery thereof are an external auditory canal and / or an auricle.   The blood pressure monitoring apparatus according to claim 1, wherein the outer ear and its periphery are a tragus and / or its periphery.   The pulse wave measuring means uses the light emitting element that irradiates light to the outer ear and its surroundings, and the light receiving element that measures the amount of light reflected by the irradiated light inside the outer ear and its surroundings. The blood pressure monitoring apparatus according to any one of claims 1 to 3, wherein a pulse wave is measured.   The blood pressure monitoring apparatus according to any one of claims 1 to 4, further comprising blood pressure change notifying means for notifying the predicted blood pressure change.   The blood pressure monitoring apparatus according to any one of claims 1 to 5, wherein the pulse wave propagation velocity information is a propagation time or a propagation velocity between two predetermined sites.   The pulse wave velocity information calculating means calculates a propagation time of the pulse wave between the two predetermined sites from the electrocardiographic induction wave and the pulse wave, and the blood pressure change notifying means is a propagation time of the pulse wave. The blood pressure monitoring apparatus according to claim 5, wherein when the blood pressure becomes less than a predetermined value, the prediction of the blood pressure change is notified.   The blood pressure change notifying means further comprises a heart rate calculating means for calculating a heart rate, and a heart rate change notifying means for notifying a heart rate change when the heart rate falls below a predetermined value. 5. The blood pressure monitoring apparatus according to 5.   The blood pressure measurement unit further includes a determination unit that determines whether both the prediction of the blood pressure change and the heart rate change are notified, and when the blood pressure change and the heart rate change are both notified, The blood pressure monitoring apparatus according to claim 8, wherein blood pressure is measured based on the pulse wave and the cuff pressure.   The blood pressure change notifying means further includes a shape change calculating means for calculating the shape change of the pulse wave, the propagation time of the pulse wave is less than a predetermined value, and the shape change amount of the pulse wave is a predetermined value. The blood pressure monitoring apparatus according to claim 5, wherein when it exceeds, the prediction of the blood pressure change is notified.   The pulse wave measuring means includes a plurality of light emitting elements that emit light of different wavelengths, and a light receiving unit that measures the amount of light transmitted / reflected by the light emitted from the plurality of light emitting elements through and around the outer ear and its periphery. 11. The apparatus according to claim 1, further comprising an oxygen saturation measuring unit that measures oxygen saturation in the blood based on each of the measured amounts of light. 1. The blood pressure monitoring apparatus according to item 1. A blood pressure monitoring device that quickly measures blood pressure when a change in blood pressure is predicted,
A pressurizing means that pressurizes the cuff to compress the outer ear and its surroundings;
A pressure sensor for detecting the cuff pressure in the cuff;
Pulse wave measuring means for continuously measuring the pulse waves of the outer ear and its surroundings;
A pulse wave velocity information calculating means for calculating a pulse wave velocity information by measuring a delay from a reference time of the pulse wave;
When a blood pressure change is predicted based on the calculated pulse wave velocity information, the cuff is pressurized to a predetermined pressure, and then the blood pressure is measured based on the pulse wave and the cuff pressure measured while reducing the pressure. Blood pressure measuring means for measuring;
A blood pressure monitoring apparatus characterized by comprising: A pressurizing unit that pressurizes the outer ear and the periphery thereof by pressurizing the cuff; a pressure sensor that detects the cuff pressure in the cuff; and a pulse wave measuring unit that continuously measures the pulse waves of the outer ear and the periphery thereof; In a blood pressure monitoring apparatus having an electrocardiographic induction wave measuring means for continuously measuring an electrocardiographic induction wave indicating an action potential of a myocardium, a blood pressure monitoring method for quickly measuring a blood pressure when a blood pressure change is predicted, ,
A pulse wave velocity information calculating step for calculating pulse wave velocity information from the pulse wave and the electrocardiogram induced wave measured at the same time;
When a change in blood pressure is predicted based on the calculated pulse wave propagation velocity information, the blood pressure is measured based on the pulse wave and the cuff pressure measured while reducing the pressure after the cuff is pressurized to a predetermined pressure. Blood pressure measurement process for measuring,
A blood pressure monitoring method comprising:   The blood pressure monitoring method according to claim 13, wherein the outer ear and its periphery are an external auditory canal and / or an auricle.   The blood pressure monitoring method according to claim 13, wherein the outer ear and its periphery are a tragus and / or its periphery.   The pulse wave measuring means uses the light emitting element that irradiates light to the outer ear and its surroundings, and the light receiving element that measures the amount of light reflected by the irradiated light inside the outer ear and its surroundings. The blood pressure monitoring method according to any one of claims 13 to 15, wherein a pulse wave is measured.   The blood pressure monitoring method according to any one of claims 13 to 16, further comprising a blood pressure change notification step of notifying the predicted blood pressure change.   The blood pressure monitoring method according to any one of claims 13 to 17, wherein the pulse wave propagation velocity information is a propagation time or a propagation velocity between two predetermined parts.   The pulse wave propagation velocity information calculation step calculates a propagation time of the pulse wave between the two predetermined sites from the electrocardiographic induction wave and the pulse wave, and the blood pressure change notification step includes the propagation time of the pulse wave. The blood pressure monitoring method according to claim 17, further comprising: notifying that the blood pressure change is predicted when the blood pressure is less than a predetermined value.   The blood pressure change notifying step further includes a heart rate calculating step for calculating a heart rate, and a heart rate change notifying step for notifying a heart rate change when the heart rate becomes less than a predetermined value. The blood pressure monitoring method according to 17.   The blood pressure measurement step further includes a determination step of determining whether both the prediction of the blood pressure change and the heart rate change are notified, and when the blood pressure change and the heart rate change are both notified, 21. The blood pressure monitoring method according to claim 20, wherein blood pressure is measured based on the pulse wave and the cuff pressure.   The blood pressure change notifying step further includes a shape change calculating step for calculating the shape change of the pulse wave, the propagation time of the pulse wave is less than a predetermined value, and the shape change amount of the pulse wave is a predetermined value. 18. The blood pressure monitoring method according to claim 17, wherein when it exceeds, the prediction of the blood pressure change is notified.   The pulse wave measuring means includes a plurality of light emitting elements that emit light of different wavelengths, and a light receiving unit that measures the amount of light transmitted / reflected by the light emitted from the plurality of light emitting elements through and around the outer ear and its periphery. 23. The method according to claim 13, further comprising an oxygen saturation measurement step of measuring oxygen saturation in the blood based on the measured amounts of light. 2. The blood pressure monitoring method according to item 1. A pressurizing unit that pressurizes the outer ear and the periphery thereof by pressurizing the cuff; a pressure sensor that detects the cuff pressure in the cuff; and a pulse wave measuring unit that continuously measures the pulse waves of the outer ear and the periphery thereof; A blood pressure monitoring method for quickly measuring blood pressure when a blood pressure change is predicted,
When a blood pressure change is predicted based on a pulse wave velocity information calculation step of calculating pulse wave velocity information by measuring a delay from the reference time of the pulse wave, and the calculated pulse wave velocity information, A blood pressure measurement step of measuring blood pressure based on the pulse wave and the cuff pressure measured while reducing the pressure after pressurizing the cuff to a predetermined pressure;
A blood pressure monitoring method comprising: A pressurizing unit that pressurizes the outer ear and the periphery thereof by pressurizing the cuff; a pressure sensor that detects the cuff pressure in the cuff; and a pulse wave measuring unit that continuously measures the pulse waves of the outer ear and the periphery thereof; In a blood pressure monitoring apparatus having an electrocardiogram induced wave measuring means for continuously measuring an electrocardiogram induced wave indicating an action potential of the myocardium, a blood pressure monitoring method for quickly measuring the blood pressure when a blood pressure change is predicted is executed. A control program for
A program code of a pulse wave velocity information calculation step for calculating pulse wave velocity information from the pulse wave and the electrocardiogram induced wave measured at the same time;
Based on the calculated pulse wave velocity information, a program code for a blood pressure change notification step for notifying that a blood pressure change is predicted;
When the prediction of the blood pressure change is informed, a program code for a blood pressure measurement step for measuring blood pressure based on the pulse wave and the cuff pressure measured while reducing the pressure after pressurizing the cuff to a predetermined pressure; ,
A control program comprising: A pressurizing unit that pressurizes the outer ear and the periphery thereof by pressurizing the cuff; a pressure sensor that detects the cuff pressure in the cuff; and a pulse wave measuring unit that continuously measures the pulse waves of the outer ear and the periphery thereof; A control program for executing a blood pressure monitoring method for quickly measuring blood pressure when a change in blood pressure is predicted,
A program code of a pulse wave velocity information calculation step for calculating pulse wave velocity information by measuring a delay from a reference time of the pulse wave;
When a change in blood pressure is predicted based on the calculated pulse wave propagation velocity information, the blood pressure is measured based on the pulse wave and the cuff pressure measured while reducing the pressure after the cuff is pressurized to a predetermined pressure. Blood pressure measurement program code for measuring
A control program comprising:   27. The control program according to claim 25 or claim 26, wherein the outer ear and its periphery are an external auditory canal and / or an auricle.   27. The control program according to claim 25 or claim 26, wherein the outer ear and its periphery are a tragus and / or its periphery.   The pulse wave measuring means uses the light emitting element that irradiates light to the outer ear and its surroundings, and the light receiving element that measures the amount of light reflected by the irradiated light inside the outer ear and its surroundings. 27. The control program according to claim 25 or claim 26, wherein the pulse wave is measured.   A computer-readable storage medium storing the control program according to any one of claims 25 to 29.

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