JP2006102266A - Hemadynamometer and control method therefor - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To relieve the pain of a subject at the measurement of blood pressure when the blood pressure of the same person is measured again. <P>SOLUTION: The pain of the subject at the measurement of blood pressure is relieved by using an antilobium where less pain is felt than an upper arm or a finger as the measured region in the measurement of blood pressure. If the time between the first and second blood pressure measuring times is short, a target pressurizing value in the second measuring time is set, for example, at the maximum blood pressure +α (lower than a target pressure value in the first measuring time) based on the maximum blood pressure in the first measuring time, and the pressurizing speed in the second measuring time is set higher than that in the first measuring time. Accordingly, the pain of the subject at the measurement of blood pressure can further be relieved. <P>COPYRIGHT: (C)2006,JPO&NCIPI

Description

  The present invention relates to a sphygmomanometer, and in particular, a sphygmomanometer and a sphygmomanometer control method capable of reducing pain of a subject at the time of re-measurement of blood pressure, continuous measurement, and the like, and a control program for executing the sphygmomanometer control method And a computer-readable storage medium storing the same.

  In a conventional electronic sphygmomanometer that measures blood pressure by wrapping a cuff around an upper arm or the like, as shown in FIG. 1 (a), the measurer sets a pressurization target value (PC1 in the figure) in advance in consideration of his / her maximum blood pressure. Then, when the measurement is started, the cuff is pressurized to the pressurization target value (time b in the figure), and the measurement is started. However, when insufficient pressurization is detected during the measurement (for example, K immediately after the measurement is started) When no sound is detected (time c in the figure), a value obtained by adding a predetermined value to the pressure target value is repressurized as the second pressure target value (PC2 in the figure) (time d in the figure), and then the pressure is reduced. However, what measures a systolic blood pressure (SBP) and a systolic blood pressure (DBP) is known.

  Further, when blood pressure is measured by the method of FIG. 1A, if the blood pressure value is too high or too low against the expectation of the measurer or the like even if the blood pressure is measured correctly, the measurer May wish to remeasure blood pressure. However, if the measurement method of FIG. 1A is repeated at the time of re-measurement, the same measurement time as the first measurement time is required, so that the time for re-pressing the nerve near the artery at the time of pressurization becomes longer. Thus, when the pressurization time becomes long, not only the time when the subject feels pain is lengthened, but also congestion occurs and the measurement accuracy is lowered.

Therefore, as a method of shortening the measurement time in the case of such re-measurement of the same person, as shown in FIG. 1 (b), by changing to the second pressurization target value at the previous measurement, A method for shortening the pressure time is known (Japanese Patent Publication No. 7-47022).
Japanese Examined Patent Publication No. 7-47022

  However, even in the method of FIG. 1B (Japanese Patent Publication No. 7-47022), the subject does not eliminate the pain at the time of pressurization in the second blood pressure measurement, so there is a blood pressure measurement method for reducing further pain. desired. The cause of pain in blood pressure measurement using the upper arm is considered to be because not only the artery but also the nerves around it are compressed during measurement because the pressure cuff is large, so it is difficult to feel pain instead of the upper arm Blood pressure measurement using a region is also desired.

  As one of the countermeasures, blood pressure measurement using a finger that reduces the area compressed by the cuff instead of the upper arm when pressed is conceivable. However, because fingers are used for complicated tasks, many nerves also pass through the fingers, and blood pressure measurement with fingers has problems such as changes in blood pressure values measured depending on the position of the finger from the heart. Therefore, blood pressure measurement is desired at a site where the pain of the subject at the time of measurement can be reduced.

  The present invention has been made to solve the problems of the prior art as described above, and its purpose is to reduce the pain of the subject at the time of blood pressure measurement when the same person performs blood pressure remeasurement or continuous measurement. It is an object to provide a sphygmomanometer and a control method thereof.

  In order to achieve the above object, a sphygmomanometer according to an embodiment of the present invention has the following configuration. That is, a cuff that compresses the outer ear and its peripheral part, a pressurizing means that pressurizes the cuff, a pressure sensor that detects the pressure in the cuff, and a pulse that detects a pulse wave obtained from the outer ear and its peripheral part. A wave detection means, a time interval measurement means for measuring a time interval between a previous blood pressure measurement time and a current blood pressure measurement time, and when the time interval is less than a predetermined time, A pressurization target value determining means for determining a current pressurization target value based on the measured blood pressure value; a control means for controlling the pressurization means so as to pressurize to the determined pressurization target value; Blood pressure measuring means for measuring blood pressure based on the pulse wave and the cuff pressure measured while reducing pressure after pressurizing to the determined pressurization target value.

  Here, for example, it is preferable that the outer ear and the peripheral portion thereof are an external auditory canal and / or an auricle.

  Here, for example, the outer ear and its peripheral part are preferably tragus and / or its peripheral part.

  Here, for example, the pulse wave measuring means uses the light emitting element that irradiates light to the outer ear and the periphery thereof and the light receiving element that measures the amount of light that transmits / reflects the outer ear and the periphery thereof. Is preferably detected.

  Here, for example, it is preferable that the control unit controls the pressurizing unit to pressurize at a pressurization speed faster than a normal pressurization speed to the determined pressurization target value.

  In order to achieve the above object, a method of controlling a sphygmomanometer according to an embodiment of the present invention has the following configuration. That is, a cuff that compresses the outer ear and its peripheral part, a pressurizing means that pressurizes the cuff, a pressure sensor that detects the pressure in the cuff, and a pulse that detects a pulse wave obtained from the outer ear and its peripheral part. And a time interval measuring step for measuring a time interval between the previous blood pressure measurement time and the current blood pressure measurement time, and the time interval is a predetermined time. The pressure target value determination step for determining the current pressure target value based on the blood pressure value measured in the previous blood pressure measurement, and the pressure so as to pressurize to the determined pressure target value A control step for controlling the pressurizing means, and a blood pressure measuring step for measuring blood pressure based on the pulse wave and the cuff pressure measured while reducing pressure after pressurizing to the pressurization target value. It is characterized by.

  Here, for example, it is preferable that the outer ear and the peripheral portion thereof are an external auditory canal and / or an auricle.

  Here, for example, the outer ear and its peripheral part are preferably tragus and / or its peripheral part.

  Here, for example, the pulse wave detecting means uses the light emitting element that irradiates light to the outer ear and its periphery and the light receiving element that measures the amount of light that transmits / reflects the outer ear and its periphery. Is preferably detected.

  Here, for example, it is preferable that the control step controls the pressurizing unit so as to pressurize at a pressurization speed higher than a normal pressurization speed to the determined pressurization target value.

  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 cuff that compresses the outer ear and its peripheral part, a pressurizing means that pressurizes the cuff, a pressure sensor that detects the pressure in the cuff, and a pulse that detects a pulse wave obtained from the outer ear and its peripheral part. A control program for controlling a sphygmomanometer having a wave detection means for executing a time interval measurement step for measuring a time interval between a previous blood pressure measurement time and a current blood pressure measurement time And a program code for executing a pressurization target value determination step of determining a current pressurization target value based on a blood pressure value measured in the previous blood pressure measurement when the time interval is less than a predetermined time And a program code for executing a control process for controlling the pressurizing means to pressurize to the determined pressurization target value, and after pressurizing to the pressurization target value, measurement is performed while reducing pressure. And having a program code for performing the blood pressure measurement step of measuring a blood pressure based on said cuff pressure and the pulse wave.

  Here, for example, it is preferable that the outer ear and the peripheral portion thereof are an external auditory canal and / or an auricle.

  Here, for example, the outer ear and its peripheral part are preferably tragus and / or its peripheral part.

  Here, for example, the pulse wave detecting means uses the light emitting element that irradiates light to the outer ear and its periphery and the light receiving element that measures the amount of light that transmits / reflects the outer ear and its periphery. Is preferably detected.

  Here, for example, it is preferable that the control step controls the pressurizing unit so as to pressurize at a pressurization speed faster than a normal pressurization speed to the determined pressurization target value.

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

  According to the sphygmomanometer and the control method thereof according to the present invention, when the same person performs re-measurement or continuous measurement of blood pressure, the outer ear and its peripheral part are used as blood pressure measurement sites, and the pressurization conditions during blood pressure measurement are appropriate. Thus, pain of the subject at the time of blood pressure measurement can be reduced.

  A blood pressure monitor according to a preferred embodiment of the present invention will be described below with reference to the drawings. In the description of the present embodiment, “re-measurement of blood pressure” means, for example, when the measured blood pressure is high or low contrary to the expectation of the measurer even though the blood pressure is normally measured. It shall mean blood pressure measurement performed again for confirmation of blood pressure.

<First Embodiment>
The sphygmomanometer of the present embodiment can reduce the pain of the subject at the time of re-measurement of blood pressure using the following two features. Hereinafter, first, two features of the blood pressure monitor of the present embodiment will be briefly described.

[Features of blood pressure monitor]
The first feature of the sphygmomanometer according to the present embodiment is that a region with less nerves is used around a blood vessel used for blood pressure measurement to reduce pain. As an example of such a region, in the present embodiment, the outer ear is used. And its periphery (preferably the tragus and / or its periphery). Here, the difference between the case where the outer ear and its peripheral part used in the present embodiment are used as blood pressure measurement parts and the case where the upper arm and fingers are used as in the past will be described. The upper arm and fingers 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 blood pressure is measured using the outer ear and its surroundings (preferably the tragus and / or its surroundings), the blood pressure is lower than that of blood pressure measurement using the upper arm and fingers because the amount of nerves compressed during blood pressure measurement is small. It has the advantage that pain during measurement can be reduced.

  However, since the tragus is a small part of the auricle as shown in FIG. 2, if the small blood pressure measuring unit cannot be fixed securely and stably around the outer ear and its surroundings, It moves and cannot measure blood pressure accurately. Therefore, in the sphygmomanometer according to the present embodiment, the blood pressure detection unit, the ear support, and the main body as shown in FIG. 3 are used, and the blood pressure detection unit is the outer ear and its periphery (preferably the tragus and / or its periphery). ) Part can be fixed stably. As a result, the blood pressure in the outer ear and its surroundings (preferably the tragus and / or its surroundings) can be measured easily and stably over a long period of time while reducing the pain given to the subject.

  The second feature of the sphygmomanometer according to the present embodiment is that, from the first blood pressure measurement to the blood pressure re-measurement (second measurement), when the blood pressure is re-measured for the same person (or during continuous measurement, etc.). The pressurization condition at the time of the second blood pressure measurement is optimized according to the time interval to reduce the pain of the subject at the time of blood pressure remeasurement. For example, when the time interval from the end of the first blood pressure measurement to the second blood pressure measurement is short (within a predetermined time, for example, within one minute) as shown in FIG. The pressurization condition at the time of the second blood pressure measurement is controlled so as to reduce the time of pain and the amount of pain than the time.

  Here, the time to feel pain and the amount of pain will be described with reference to FIG. 7. 701 in FIG. 7 shows the change in cuff pressure during the first pressurization measurement, and 702 is the second pressurization. Indicates the change in cuff pressure during measurement. For the sake of simplicity, assuming that the subject feels pain when the pressure is increased to a pressure P or higher in FIG. 7, the time to feel pain at the first blood pressure measurement 701 is TP1, and the amount of pain is It is represented as a triangular area S1 in the figure. Similarly, the time when the user feels pain during the second blood pressure measurement 702 is represented by TP2 in the figure, and the amount of pain is represented by a triangular area S2 in the figure.

  Therefore, as shown in FIG. 7, the time for feeling the pain is shortened (TP1> TP2), and the pressure condition is controlled so as to reduce the amount of pain (S1> S2). Can be reduced as compared with the pain at the time of the first blood pressure measurement 701.

That is, when the time interval from the end of the first blood pressure measurement to the second blood pressure measurement is short, the pressurization condition in the second blood pressure measurement is the first pressurization condition and the measurement result. Based on, set as follows. First, the second pressurization target value is set to a value lower than the first pressurization target value by using the maximum blood pressure value SBP measured in the first blood pressure measurement (for example, SBP + α). Next, the second pressurization speed is set to be faster than the first pressurization speed. In this way, by setting the second pressurization condition (pressurization target value, pressurization speed), the time and amount of pain at the time of the second blood pressure measurement can be set as the first blood pressure. Since each can be made smaller than at the time of measurement, pain during the second blood pressure measurement can be reduced.
Hereinafter, the two features of the sphygmomanometer of the present embodiment described above will be sequentially described in detail. First, the first feature (reducing pain at the time of remeasurement using the outer ear and its surroundings (preferably the tragus and / or its surroundings) will be described with reference to FIGS. Next, the second feature (controlling the pressurizing condition to reduce pain during remeasurement) will be described with reference to FIGS.

[Description of First Feature]
[Name of pinna: Fig. 2]
First, the names of the pinna 20 (so-called ears) will be described with reference to FIG. 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.

[Appearance of blood pressure monitor: Fig. 3]
FIG. 3 is an external view showing an example of a sphygmomanometer according to a preferred embodiment of the present invention. The sphygmomanometer 100 includes a blood pressure detection unit 30, an ear support 40, and a main body 50. The blood pressure detection unit 30 is attached to the tragus 21 via the cuffs 31 and 32, and the main body 50 is accommodated in the breast pocket of the subject, for example. Details of the blood pressure detection unit 30 and the main body 50 will be described later with reference to FIGS.

  As shown in FIG. 3A, 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 an elastic flexible tube, and includes a blood pressure detection unit 30, a main body 50, and the like. Are connected. As shown in FIG. 3 (b), an air pipe 43 for pressurized air supplied from the main body 50 to the blood pressure detection unit 30 and a detection signal from the power and blood pressure detection unit 30 to the main body 50 are provided inside the ear hook 41. The pipe 45 that accommodates the signal line 44 that transmits the signal is fixed so as not to move, and the blood pressure detection unit 30 is not worn even if the air pipe 43 or the signal line 44 moves when the subject operates the main body 50. Thus, the air 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. Further, the connecting portion 42 connected to the ear hook portion 41 has a structure shown in FIG. 3B, but is a flexible tube made of a soft resin material compared to 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. .

[Blood pressure detector: Fig. 4]
As shown in FIG. 4, the blood pressure detection unit 30 is disposed inside the holding frame 46 and the arms 38 and 39 that hold the tragus 21 by the pressing force of the arms 38 and 39, and the cuff that changes the pressure applied to the tragus 21. 31, 32, an air pipe 43 that supplies pressurized air to the cuffs 31, 32, a housing 33 that fixes the cuffs 31, 32, a light emitting element 36 a that is arranged in the vicinity of the cuff and irradiates light to the tragus 21, capillary The pulse wave sensor 36 includes a light emitting element 36b that receives light reflected by the blood vessel.

[Control configuration of blood pressure monitor: Fig. 5]
FIG. 5 is a block diagram showing the entire control configuration of the sphygmomanometer 100 including the blood pressure detection unit 30 and the main body 50. In FIG. 5, 30 is a tragus detection part, 43 is an air pipe, and the flow path of the pressurized air into the cuffs 31 and 32 is comprised. 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 in the blood pressure detection unit 30 includes a light emitting element 36a (LED) that irradiates light to the pulsating blood flow and a light emitting element 36b (photo) that detects reflected light from the blood flow. Transistor). In addition, it is good also as a structure which arrange | positions the light emitting 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 emitting element 36b 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 sphygmomanometer 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 position information of the subject to the CPU 61.

[Operation when measuring blood pressure]
Next, the operation at the time of blood pressure measurement by the sphygmomanometer 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 (a tragus) with light such as laser light, and the irradiated light is emitted from the capillaries in the tragus. When the light-emitting element 36 b receives light that is absorbed and reflected by hemoglobin, the received light is converted into an electric signal and transmitted to the light amount control drive unit 68 through the signal line 44.

[Principle of blood pressure measurement using outer ear and surrounding area: Fig. 6]
Next, an example of the principle of blood pressure measurement of the outer ear and its surroundings (preferably the tragus and / or its surroundings) using the sphygmomanometer 100 will be described with reference to FIG. In the 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 in the capillary 37 is stopped. This depressurization process is shown as the cuff pressure 70 in FIG. 6, and the cuff pressure 70 decreases with time.

  A pulsation waveform 71 shown in FIG. 6 is a pulsation waveform of the capillary 37 measured by the light emitting element 36 b of the blood pressure detection unit 30 in the process of reducing the cuff pressure 70. When the cuff pressure 70 is sufficiently high, blood flow stops and the pulsation waveform 71 of the blood vessel hardly appears, but the cuff pressure 70 is reduced and a small triangular pulsation waveform appears. The present time point (t1) of the capillary pulsation waveform 71 is indicated by point A. When the pressure 70 of the cuff is further decreased, the amplitude of the pulsation waveform 71 increases and becomes maximum at the point B. When the cuff pressure 70 is further reduced, the amplitude of the pulsation waveform 71 is gradually reduced, and then the upper width portion of the pulsation waveform 71 becomes a constant value and becomes flat. After the upper width portion of the pulsation waveform 71 becomes a constant value, the pulsation waveform 71 changes from a reduced state to a constant value at 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. 6 are enlarged views of pulsation waveforms at points A, B, and C. One period is indicated by a solid line, and adjacent pulse waveforms are indicated by broken lines. Show. When the pulse-like waveforms constituting the pulsation waveform 71 are individually viewed, a triangle-like pulse-like waveform with many flat portions and a small amplitude is obtained near the point A corresponding to the systolic blood pressure, as shown in FIG. Yes, the triangle head 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 to have been cut off the lower half of the triangular wave that vibrates. Further, as the point C corresponding to the diastolic blood pressure is approached, the pulse-like waveform constituting the pulsating waveform 71 approaches a triangular wave, and at the point C, a rising portion approaches a vertical as shown in (c), and a falling portion has a gentle pulse. It becomes a waveform.

  As described above, each of the pulse-like waveforms constituting the pulsation waveform 71 has a shape with very remarkable characteristics in the range from the point A corresponding to the systolic blood pressure to the point C corresponding to the diastolic blood pressure. . Further, the shape of the pulsation waveform 71 only changes in amplitude when the blood pressure changes, and the shape does not change. Therefore, the waveform of one cycle of the pulse waveform constituting the pulsation waveform 71 measured at an arbitrary time point is compared in detail with each of the pulse waveforms constituting the pulsation waveform 71 shown in FIG. Thus, 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 pulsation waveform 71 by the method described above, and the systolic blood pressure P1 is read by reading the cuff pressure 70 at this time. And the minimum blood pressure P2 can be determined. Further, the blood pressure pulse value can be measured using a triangular pulse waveform included in the pulsation waveform 71.

  As described above, in the sphygmomanometer 100, a small blood pressure measurement unit is attached to the tragus, and the blood pressure of the outer ear and its surroundings (preferably the tragus and / or its surroundings) is easily and accurately measured. Can do.

[Description of Second Feature]
[Control of pressurization conditions during blood pressure measurement]
Next, the second feature will be described. When the same person remeasures blood pressure (or continuously measures) using the sphygmomanometer of the present embodiment, the second time according to the time interval from the first blood pressure measurement to the blood pressure remeasurement time By optimizing the pressurizing conditions at the time of blood pressure measurement, the pain of the subject at the time of blood pressure remeasurement can be reduced. FIG. 7 shows the pressurization condition for reducing the pain of the subject when the time interval until blood pressure remeasurement is short. FIG. 7 shows the pressurization condition when the time interval until blood pressure remeasurement is long. FIG. 9 is a flowchart showing a process for optimizing the pressurizing condition during the second blood pressure measurement according to the time interval from the first blood pressure measurement to the blood pressure remeasurement time.

[When the time until re-measurement is short: Fig. 7]
First, referring to FIG. 7, when the time interval Δt from the end of the first blood pressure measurement to the remeasurement (second blood pressure measurement) is short (within a predetermined time Δt <t0, for example, within one minute: The setting of the pressurizing condition during the second blood pressure measurement at Δt <1) will be described.

The pressurizing condition when the time interval Δt until remeasurement is short is:
1) The pressurization target value for re-measurement is an amount obtained by adding a predetermined value α to the systolic blood pressure SBP obtained by the first blood pressure measurement,
2) The pressurization speed at the time of re-measurement is set to be faster than the first pressurization speed.

  By setting the pressurizing condition in this way, it is possible to reduce the time and amount of pain to feel pain at the time of remeasurement than at the time of the first blood pressure measurement.

  FIG. 7 shows an example of a change in cuff pressure in the first time and blood pressure measurement at the time of re-measurement when the pressurization condition described above is performed. In FIG. 7, reference numeral 701 denotes a change in cuff pressure in the first blood pressure measurement, P1 denotes a first pressurization target value, SBP1 denotes a maximum blood pressure value, and DBP1 denotes a minimum blood pressure value. Similarly, 702 indicates a change in cuff pressure in the second blood pressure remeasurement, P2 is a second pressurization target value, and a predetermined value α is added to the maximum blood pressure value SBP1 obtained by the first blood pressure measurement. , That is, P2 = SBP1 + α. The pressurization speeds in the first and second blood pressure measurements are v1 and v2 (v1 <v2), and the pressurization times at that time are Δt1 and Δt2 (Δt1> Δt2). In addition, TP1, TP2, S1, and S2 in the figure are the period of pain and the amount of pain when it is assumed that the subject feels pain at a pressure P or higher, as described above.

  From FIG. 7, since TP1> TP2 and S1> S2, by setting the pressurization condition as described above, the period of feeling pain and the amount of feeling pain at the second blood pressure measurement are determined for the first time. It can be reduced compared to the blood pressure measurement.

  In addition, when the point which sets the 2nd pressurization target value using the maximum blood pressure value in the last blood pressure measurement is demonstrated, the heart rate of a day exists between 50,000-100,000 beats, and the blood pressure is 1 It is known that a healthy person fluctuates 20 to 60 mmHg and a hypertensive person 30 to 100 mmHg every day. However, as shown in FIG. 10, the two blood pressures measured in a close time even when the blood pressure fluctuation in one day is large show substantially the same value except in special cases. From this, when the time interval from the first blood pressure measurement to the second (re-measurement) is short, it is assumed that the highest blood pressure measured by the re-measurement is almost the same as the first highest blood pressure measured. it can.

[When the time until remeasurement is long: Fig. 8]
Next, with reference to FIG. 8, when the time interval Δt from the end of the first blood pressure measurement to the remeasurement (second blood pressure measurement) is long (for example, 1 minute or more: Δt> 1) The setting of the pressurizing condition during the second blood pressure measurement will be described.

The pressurizing condition when the time interval Δt until remeasurement is long is:
1) The re-measurement pressure target value is set as the pressure target value used in the first measurement.
2) The pressurization rate at the time of re-measurement is the same as the first pressurization rate.

  The reason for setting the pressure condition in this way will be described. If the time interval Δt from the end of the first blood pressure measurement to the remeasurement (second blood pressure measurement) is long, it is considered that the blood pressure of the subject may have changed over time. Therefore, if the second pressurization target value is set based on the knowledge obtained during the first blood pressure measurement, it is assumed that the blood pressure measurement during the remeasurement may be underpressurized. Sometimes, the pressurization target value set at the time of the first blood pressure measurement is used again. In this case, the pain of the subject cannot be reduced at the time of re-measurement of the blood pressure, but priority is given to measurement of the blood pressure, and adjustment is performed so that insufficient pressurization is not performed at the time of re-measurement.

  FIG. 8 shows an example of the change in the cuff pressure in the blood pressure measurement at the first time and the remeasurement when the pressurization condition described above is performed. In FIG. 8, 701 indicates the change in cuff pressure in the first blood pressure measurement, P1 indicates the first pressurization target value, SBP1 indicates the maximum blood pressure value, and DBP1 indicates the minimum blood pressure value. Similarly, 703 indicates a change in cuff pressure in the second blood pressure remeasurement, P3 is the second pressurization target value, and in this embodiment, the pressurization set by the first blood pressure measurement The target value P1 is used. The pressurization speeds in the first and second blood pressure measurements are v1 and v3 (v1 = v3), and the pressurization times at that time are Δt1 and Δt3 (Δt1 = Δt3). Further, as described above, TP1, TP3, S1, and S3 in the figure are the period of pain and the amount of pain when assuming that the subject feels pain at pressure P or higher (TP1). = TP3, S1 = S3). As is clear from FIG. 8, the period of feeling pain and the amount of feeling pain in the blood pressure measurement at the first time and remeasurement are the same.

[Control of pressurization conditions during blood pressure re-measurement: Fig. 9]
FIG. 9 is a flowchart showing the control process of the pressurization condition at the time of blood pressure remeasurement described above. The processing in FIG. 9 is executed by the control unit (CPU) 61 controlling each unit while using the RAM 63 as a work area based on a control program stored in the ROM 62.

  First, in step S100, the control unit 61 receives a cuff pressure value (pressurization target value) set by a measurer.

  Next, in step S110, the controller 61 pressurizes at a predetermined pressurization speed v1 to the set cuff pressure value (pressurization target value), and then depressurizes at a constant speed as indicated by 701 in FIG. However, each part is controlled so that the maximum blood pressure and the minimum blood pressure can be measured according to the blood pressure measurement method described in FIG. 6 (so that the first blood pressure measurement is performed).

  Next, in step S <b> 120, the control unit 61 controls to display the measured blood pressure value on the display unit (LCD) 64.

  Next, in step S130, the control unit 61 detects whether or not the remeasurement is set by the measurer. When the remeasurement is not set, the control unit 61 ends the series of operations, and when the remeasurement is set. Advances to step S140.

  Next, in step S140, the control unit 61 checks whether or not the time from the end of the first blood pressure measurement to the remeasurement is within a predetermined time (for example, within 1 minute). The process proceeds to step S150, and if a predetermined time or more has elapsed, the process proceeds to step S170.

  Next, in step S150, since the time from the end of the first blood pressure measurement to the remeasurement is within a predetermined time, the control unit 61 sets the maximum blood pressure value (SPB1) obtained from the end of the first blood pressure measurement. A value obtained by adding the predetermined value (α) is set as the second pressurization target value P2 (P2 = SPB1 + α).

  Next, in step S160, control is performed so as to pressurize at a rapid pressurization speed v2 (speed faster than the first pressurization speed) to the set pressurization target value P2 (P2 = SPB1 + α), and then step S180. Proceed to

  On the other hand, in step S170, since the time from the end of the first blood pressure measurement to the re-measurement has passed for a predetermined time or more, the cuff pressure value (pressure target value) set at the time of the first blood pressure measurement. The process proceeds to step S180 after controlling to pressurize at a predetermined pressurization speed v1.

  Next, in step S180, the controller 61 reduces the pressure at a constant speed from the pressure increased to the set cuff pressure value (pressure target value at the time of remeasurement) as indicated by reference numeral 701 in FIG. Each part is controlled so that the maximum blood pressure and the minimum blood pressure can be measured according to the blood pressure measurement method described in FIG. 6 (so that the second blood pressure remeasurement is performed).

  Next, in step S190, the control unit 61 performs control so that the measured blood pressure value is displayed on the display unit (LCD) 64, and ends a series of operations.

As described above, in the sphygmomanometer 100 of the present embodiment,
1) Use the outer ear and its surroundings (preferably the tragus and / or its surroundings) that are difficult to feel pain as the site used for blood pressure measurement,
2) Change the pressurization target value and pressurization speed at the time of remeasurement according to the time until remeasurement.
Thus, even when the blood pressure needs to be remeasured, the pain of the subject at the time of the blood pressure remeasurement can be reduced.
In addition, this invention is not restricted to an Example, A change and application are possible suitably.

[Other Embodiments]
In addition, the sphygmomanometer described so far detects a pulse wave using a light emitting element and a light receiving element, but has a cuff for applying pressure to the tragus, and the pulsation due to the pulse wave on the surface of the living body is changed in pressure by the cuff. The pulse wave can also be detected by capturing as 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.

(A) It is a figure explaining the repressurization process at the time of insufficient pressurization in the conventional sphygmomanometer, (b) The figure explaining the shortening method of the pressurization time in the case of re-measurement of blood pressure for the same person It is. It is a figure explaining the name of an auricle. (A) It is an external view of a blood pressure monitor, (b) is sectional drawing of an ear hook part. It is a figure which shows an example of a blood-pressure detection part. It is a figure explaining the control composition of a sphygmomanometer. It is a figure explaining the method of blood pressure measurement. In the sphygmomanometer of this embodiment, it is a figure explaining an example of control of the pressurization condition when performing the remeasurement of the blood pressure of the same person when the time until remeasurement is short. In the sphygmomanometer of this embodiment, it is a figure explaining an example of control of the pressurization condition when performing the remeasurement of the blood pressure of the same person when the time until remeasurement is long. It is a flowchart explaining an example of the process at the time of re-measuring the blood pressure of the same person in the blood pressure monitor of this embodiment. It is a figure explaining an example of the change of the blood pressure on the 1st.

Explanation of symbols

DESCRIPTION OF SYMBOLS 100 Blood pressure monitor 21 Tragus 30 Blood pressure detection part 31 Cuff 32 Cuff 33 Case 36 Pulse wave sensor 36a Light emitting element 36b Light receiving element 37 Capillary blood vessel 38 Arm 39 Arm 40 Ear hook type support body 41 Ear hook part 42 Connecting part 46 Holding frame
50 body

Claims (16)

A cuff that compresses the outer ear and its surroundings,
A pressurizing means for pressurizing the cuff;
A pressure sensor for detecting the pressure in the cuff;
A pulse wave detecting means for detecting a pulse wave obtained from the outer ear and its peripheral part;
A time interval measuring means for measuring a time interval between the previous blood pressure measurement time and the current blood pressure measurement time;
Pressurization target value determining means for determining the current pressurization target value based on the blood pressure value measured in the previous blood pressure measurement when the time interval is less than a predetermined time;
Control means for controlling the pressurizing means to pressurize to the determined pressurization target value;
Blood pressure measuring means for measuring blood pressure based on the pulse wave and the cuff pressure measured while reducing pressure after pressurizing to the determined target pressure value;
A sphygmomanometer, comprising:   The sphygmomanometer according to claim 1, wherein the outer ear and its peripheral part are an external auditory canal and / or an auricle.   The sphygmomanometer according to claim 1, wherein the outer ear and its peripheral part are tragus and / or its peripheral part.   The pulse wave measuring means detects the pulse wave using a light emitting element that irradiates light to the outer ear and its surroundings and a light receiving element that measures the amount of light that is transmitted / reflected through the outer ear and its surroundings. The sphygmomanometer according to any one of claims 1 to 3, wherein:   5. The control unit according to claim 1, wherein the control unit controls the pressurizing unit to pressurize at a pressurization speed faster than a normal pressurization speed to the determined pressurization target value. The sphygmomanometer according to claim 1. A cuff for compressing the outer ear and its peripheral part, a pressure means for pressurizing the cuff, a pressure sensor for detecting the pressure in the cuff, and a pulse wave detection for detecting a pulse wave obtained from the outer ear and its peripheral part A blood pressure monitor control method comprising:
A time interval measuring step for measuring a time interval between the time of the previous blood pressure measurement and the time of the current blood pressure measurement;
A pressurization target value determination step of determining a current pressurization target value based on a blood pressure value measured in the previous blood pressure measurement when the time interval is less than a predetermined time;
A control step of controlling the pressurizing means to pressurize to the determined pressurization target value;
A blood pressure measurement step of measuring blood pressure based on the pulse wave and the cuff pressure measured while reducing pressure after pressurizing to the pressurization target value;
A method for controlling a sphygmomanometer, comprising:   The sphygmomanometer control method according to claim 6, wherein the outer ear and its peripheral part are an external auditory canal and / or an auricle.   The sphygmomanometer control method according to claim 6, wherein the outer ear and its peripheral part are tragus and / or its peripheral part.   The pulse wave detection means detects the pulse wave by using a light emitting element that irradiates light to the outer ear and its surroundings and a light receiving element that measures the amount of light that transmits / reflects the outer ear and its surroundings. The method for controlling a sphygmomanometer according to any one of claims 6 to 8, wherein:   The said control process controls the said pressurization means to pressurize at the pressurization speed faster than a normal pressurization speed to the determined pressurization target value. The method for controlling a blood pressure monitor according to claim 1. A cuff for compressing the outer ear and its peripheral part, a pressure means for pressurizing the cuff, a pressure sensor for detecting the pressure in the cuff, and a pulse wave detection for detecting a pulse wave obtained from the outer ear and its peripheral part A control program for controlling a sphygmomanometer, comprising:
A program code for executing a time interval measurement step for measuring a time interval between the time of the previous blood pressure measurement and the time of the current blood pressure measurement;
A program code for executing a pressurization target value determination step of determining a current pressurization target value based on a blood pressure value measured in the previous blood pressure measurement when the time interval is less than a predetermined time;
Program code for executing a control step of controlling the pressurizing means so as to pressurize to the determined pressurization target value;
A program code for executing a blood pressure measurement step of measuring blood pressure based on the pulse wave and the cuff pressure measured while reducing pressure after pressurizing to the pressurization target value;
A control program comprising:   The control program according to claim 11, wherein the outer ear and its peripheral part are an external auditory canal and / or an auricle.   The control program according to claim 11, wherein the outer ear and its peripheral part are a tragus and / or its peripheral part.   The pulse wave detection means detects the pulse wave by using a light emitting element that irradiates light to the outer ear and its surroundings and a light receiving element that measures the amount of light that transmits / reflects the outer ear and its surroundings. The control program according to any one of claims 11 to 13, wherein:   The said control process controls the said pressurizing means so that it may pressurize at the pressurization speed faster than a normal pressurization speed to the determined pressurization target value. The control program according to claim 1.   A computer-readable storage medium storing the control program according to any one of claims 11 to 15.

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