JP2008149166A - Treatment device - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a treatment device which can execute advanced treatment to a patient in a medical facility where there is no specialist. <P>SOLUTION: An image data collection part 1, a TV camera 4, and a treatment part 2 are provided in a first medical facility 61 where there are an emergency patient 51 and a medical assistant 52. Image data of the emergency patient 51 acquired by the image data collection part 1 and the TV camera 4 are transported to a second medical facility 62 where there is a specialist (doctor 53) via transmission/reception parts 11, 21 to execute communication of medical information. The doctor 53 confirms the treatment preparation completion before inputting a treatment execution signal from a treatment execution signal input part 27. The treatment execution signal is transmitted to a treatment execution signal reception part 10 via the transmission/reception parts 11, 21 to instruct the treatment by the treatment part 2. <P>COPYRIGHT: (C)2008,JPO&INPIT

Description

The present invention relates to a treatment apparatus that enables emergency treatment in an ambulance or a remote medical facility.

Japan's emergency medical system is an excellent system for transporting patients to hospitals by selecting specialized medical institutions or disaster emergency centers according to their severity. For example, an emergency patient who has suffered a severe disability due to an accident or the like is first transported to the nearest disaster emergency center after undergoing a simple first aid treatment by a doctor or a paramedic dispatched to the accident site. In this case, the emergency patient receives emergency treatment by an emergency medical technician in an accident site, a medical facility near the accident site, or an ambulance on the way to the nearest disaster emergency center.

Lifesaving procedures performed on this emergency patient include tracheal intubation, artificial breathing, cardiopulmonary resuscitation and hemostasis using heart massage, etc., and an emergency medical technician performs these emergency procedures under the direction of a doctor. I have to.

On the other hand, emergency patients are CT devices prepared in advance when they arrive at the disaster emergency center,
Alternatively, full-scale treatment is started after receiving a detailed examination of the damaged site using an image diagnostic apparatus such as an MRI apparatus. However, since this test takes a lot of time, the treatment is delayed and the survival probability of the patient is reduced.

With respect to such problems, a proposal has been made to shorten the examination time at a disaster emergency center by performing image diagnosis in an ambulance in which an emergency patient is transported (see, for example, Patent Document 1). ). According to this technology, an image diagnostic apparatus is mounted in a large ambulance, image data of a damaged part is collected during transportation of an emergency patient, and the image data is transmitted to a disaster emergency center by wireless communication means. The doctor of the disaster emergency center observes the image of the damaged part of the emergency patient displayed based on the image data, and after making a diagnosis, starts preparation for treatment. By collecting and transmitting image data in an ambulance on the way in this way, emergency treatment can be started promptly when an emergency patient arrives at a disaster emergency center.

By the way, some of the above-mentioned emergency patients present internal bleeding, and emergency hemostasis is often required for this. However, a method using focused high-intensity ultrasound has been studied as a hemostasis method. In the hemostasis experiment of pigs using this method, it has been reported that complete hemostasis can be realized by irradiating the internal bleeding site specified by the ultrasonic Doppler method with strong ultrasonic waves for 13 seconds (for example, Non-Patent Document 1). reference.).

In addition, as a treatment device using focused powerful ultrasound, a method of converging and cauterizing the ultrasound irradiated from the piezoelectric vibrator to the malignant tumor has already been proposed. It is the same (for example, refer patent document 2).
JP 2001-299743 A (page 4-5, Fig. 1-3) JP-A-11-226046 (page 3-4, Fig. 1-2) Roy W. Martin et.al. “Hemostasis of punctured Vessels using Doppler-guided high-intensity ultrasound” Ultrasound in Med. & Biol., Vol. 25, No. 6, pp. 985-990, 1999

As already mentioned, the technique described in Patent Document 1 proposes a method of diagnosing an emergency patient before arrival at the disaster emergency center, but the most desirable is an emergency before being brought into the disaster emergency center. It is treatment. For example, if the breathing of an emergency patient who encounters an accident stops for more than 4 minutes, the oxygen supply to the brain is cut off, so that irreversible damage remains in the brain, and death occurs if the stop time is long. It is said.

For this reason, cardiopulmonary resuscitation is important before or during transport to a disaster emergency center. The same applies to emergency hemostasis, and in some cases, treatment using a complicated treatment device may be required in an ambulance being transported or in a remote medical facility before transport.

However, because of the complexity, doctors who should perform treatment using risky treatment devices are often not in depopulated medical facilities due to the lack of absolute numbers, and it is difficult to ride in ambulances.

On the other hand, according to Article 44, Paragraph 1 of the Current Paramedic Act, "A paramedic must not carry out the paramedic treatment specified by the Ordinance of the Ministry of Health and Welfare unless it receives specific instructions from a doctor." And
It is illegal to perform advanced medical treatments performed by a paramedic without a doctor's instruction.

For this reason, even if there is a possibility that an emergency patient may die of bleeding, an emergency medical technician cannot obtain a doctor's instructions and cannot perform advanced treatment, leading to an emergency patient who can be saved There was also fear.

The present invention has been made in view of the above problems, and is a medical assistant such as a paramedic for a depopulated medical facility without a doctor or a patient who requires advanced emergency treatment in an ambulance vehicle. However, it is providing the treatment apparatus which enables an emergency treatment according to a doctor's instruction.

In order to solve the above-mentioned problem, the treatment apparatus of the present invention according to claim 1 is provided in a first facility connected via a communication line to a second facility for giving a treatment start instruction to a subject. An ultrasonic probe comprising an ultrasonic transducer for transmitting and receiving ultrasonic waves,
The ultrasonic treatment means includes ultrasonic transmission / reception means for transmitting / receiving the ultrasonic transducer to generate image data, and ultrasonic treatment means for irradiating a subject with high-power ultrasonic waves to perform treatment. ,
Treatment for the subject is started in accordance with a treatment execution signal supplied from the second facility based on the image data transmitted to the second facility via the communication line.

  ADVANTAGE OF THE INVENTION According to this invention, the treatment apparatus which can perform a treatment via a communication line can be provided.

  Embodiments of the present invention will be described below with reference to the drawings.

A first embodiment of the present invention will be described with reference to FIGS. However, FIG. 1 is a schematic configuration diagram of the entire treatment system in the first embodiment, and FIG. 2 is a configuration diagram of a treatment apparatus used in this treatment system.

The treatment system includes an emergency patient 51 as a subject and a medical assistant 52 for assisting emergency treatment.
The first facility 61 where there is and the second facility 6 where there is a doctor 53 who is qualified to perform advanced treatment.
These two facilities 61 and 62 are capable of communicating medical information in both directions via a wireless communication network having a relay station or a communication network such as the Internet. However, the medical assistant 52 in this case refers to a paramedic or the like who cannot perform advanced medical practices on the emergency patient 51 without an instruction from the doctor 53. The second facility 62 is a disaster emergency center where the emergency treatment specialist (doctor 53) is present, and the first facility 61 is a medical facility in a depopulated area where there is no specialist (doctor 53). Or emergency patient 51 to disaster emergency center
Even if it is in an ambulance on the way of transporting, and is a normal medical facility, if the doctor of the facility is not familiar with emergency treatment, this medical facility is included in the first facility.

The treatment system in the first facility 61 includes a treatment apparatus 100 that diagnoses and treats an emergency patient 51 as a subject, and biological information measurement that collects various biological information signals from the emergency patient 51 before or during treatment. The apparatus 3, the TV camera 4 that captures the status of treatment for the emergency patient 51, the image data processing unit 5 that synthesizes image data obtained by the therapy apparatus 100 and the TV camera 4, and an image for displaying the image data A display unit 6 is provided.

The first facility 61 includes a voice input / output unit 7 for performing voice communication with a second facility 62 (to be described later), and a treatment preparation completion signal input unit 9 for inputting that treatment preparation is completed.
And a diagnosis / treatment storage unit 8 in which the status of diagnosis and treatment is stored, and a first transmission / reception unit 11 that transmits and receives audio and images between the second facility 62.

On the other hand, the second facility 62 transmits / receives sound and images to / from the first facility 61, and transmits from the first facility 61 via the second transmitter / receiver 21. An image display unit 23 that displays image data obtained by the treatment apparatus 100 and the TV camera 4, an instruction input unit 24 that inputs instruction information to the display image, and an image that superimposes the instruction information on the image data A data processing unit 22 is provided. Further, the second facility 62 includes a biological information output unit 26 that outputs various biological signals sent from the first facility 61, and a voice input for performing voice communication with the first facility 61. The output unit 25 and the treatment apparatus 100 of the first facility 61
A treatment execution signal input unit 27 for supplying a treatment execution signal to the patient, and an authentication unit 2 for the doctor 53
8 is provided.

The treatment apparatus 100 performs an initial diagnosis and position determination of a treatment site, and further collects medical image data for confirming a treatment effect, and a treatment unit 2 for treating the treatment site. And a treatment execution signal receiving unit 10 that receives a treatment execution signal supplied from the second facility 62 and instructs the treatment unit 2 to perform treatment.

The treatment execution signal receiving unit 10 has a gate function, and is sent from the second facility 62 only when the preparation completion signal from the treatment preparation completion signal input unit 9 is input to the treatment execution signal reception unit 10. The coming treatment execution signal is sent to the treatment unit 2 via the treatment execution signal receiving unit 10, and a predetermined treatment is executed. The details of the image data collection unit 1 and the treatment unit 2 in the treatment apparatus 100 will be described later.

The biological information measuring device 3 is a measuring device that monitors biological information such as an electrocardiogram waveform, an electroencephalogram, respiratory information, and blood pressure of the emergency patient 51. Each data measured here is the first
In addition to being observed by the medical assistant 52 of the facility 61, it is output from the biological information output unit 26 of the second facility 62 and can be observed by the doctor 53. Further, each biological information obtained by this apparatus is stored in the diagnosis / treatment storage unit 8 of the first facility 61.

The TV camera 4 photographs the state of the emergency patient 51 and the state of treatment preparation by the medical assistant 52. In particular, the state of the damaged part in the emergency patient 51 and the treatment device 100 for this damaged part.
The setting status of is taken.

The image data processing unit 5 includes an image memory, and combines the medical image data of the damaged portion obtained by the treatment apparatus 100 and the image data obtained by the TV camera 4 or alternately displays them on the image display unit 6. . These image data are stored in the diagnosis / treatment storage unit 8.
Saved at.

The image display unit 6 includes a monitor such as a liquid crystal display or a CRT. The image data once stored in the image memory of the image data processing unit 5 is D / A converted, converted to a TV format, and displayed on the image display unit 6.

The voice input / output unit 7 and the voice input / output unit 25 include a microphone and a speaker, respectively, and a conversation between the medical assistant 52 and the doctor 53 is possible via the first transmission / reception unit 11 and the second transmission / reception unit 21. ing. For example, the medical assistant 52 sequentially reports the state of the emergency patient 51 and the preparation status of the treatment apparatus 100 to the doctor 53, and the doctor 53 notifies the medical assistant 52 how to set the treatment apparatus 100 and the emergency patient 51. It is used to indicate various countermeasures for. The content of the conversation between the doctor 53 and the medical assistant 52 at this time is recorded and stored in the diagnosis / treatment storage unit 8.

The diagnosis / treatment storage unit 8 sets initial treatment of the emergency patient 51 by the medical assistant 52 of the first facility 61, setting of the treatment apparatus 100, treatment by the doctor 53 of the second facility 62, or giving an instruction. In order to confirm after treatment whether or not is appropriate, the TV camera 4 and the treatment apparatus 1
The image data obtained by 00, the voice information from the voice input / output unit 7, and the biological information by the biological information measuring device 3 are stored.

The treatment preparation completion signal input unit 9 sends a preparation completion signal to the doctor when the medical assistant 52 of the first facility 61 completes the setting of the treatment device 100 while following the instructions of the doctor 53 of the second facility 62. 53 to inform that the treatment can be performed. Furthermore, a preparation completion signal is also supplied to a treatment execution signal receiving unit 10 to be described later, and a treatment execution signal transmitted from the doctor 53 in the second facility 62 is sent to the treatment apparatus 100 via the treatment execution signal receiving unit 10. The state which can be supplied is formed.

The first transmission / reception unit 11 and the second transmission / reception unit 21 are connected by a wired or wireless network, and transmit / receive image data, audio data, and various biological information signals. In particular, bidirectional transmission / reception of image data and audio data is possible. These transmission / reception units 11
, And 12 are provided with an A / D converter and an image data compressor (not shown), while the receiving side is provided with a circuit for restoring the converted data.

When the first facility 61 is an ambulance, the first transceiver 11 and the second transceiver 21 are used.
Are connected by wireless communication means. Regarding communication technology, due to the recent broadbandization of mobile wireless communication technology, not only voice data and character data but also still image data is used for communication between the mobile terminal on the ambulance side and the terminal on the disaster emergency center side. Furthermore, communication of moving image data is becoming possible. It is also possible to connect to the Internet from a portable terminal via a ground station.

The image display unit 23 of the second facility 62 includes a monitor such as a liquid crystal or a CRT, and the first facility 61.
The living body image data transmitted from the image data processing unit 5 and the image data obtained by the TV camera 4 are D / A converted, then converted to the TV format, and displayed on the monitor.

The instruction input unit 24 includes an input device such as a mouse or a light pen, and inputs an instruction signal to a biological image displayed on the image display unit 23 or an image from a TV camera. The image data processing unit 22 combines the input signal from the instruction input unit 24 with the image data,
The image is displayed on the image display unit 23. The combined image data is also displayed on the image display unit 6 of the first facility 61 via the second transmission / reception unit 21 and the first transmission / reception unit 11.

The biological information output unit 26 is measured by the biological information measuring device 3 of the first facility 61, and the first information
The biometric information of the emergency patient 51 sent via the transmitting / receiving unit 11 and the second transmitting / receiving unit 21 is displayed or printed.

The treatment execution signal input unit 27 is a signal input unit that inputs a treatment execution signal to instruct the start of the operation of the treatment unit 2, and the doctor 53 uses the image display unit 23 and the voice input / output unit 25 to perform the first facility. After confirming the completion of the preparation for treatment in 61, a treatment execution start signal is input in the treatment execution signal input unit 27.

The authentication unit 28 includes a biometric authentication device for inspecting whether or not the doctor 53 has a use qualification for the treatment device 100. As this biometric authentication device, "Iris (iris) authentication enrollment room management of Matsushita Electric Industrial Co., Ltd." System "iris authentication control unit, NEC Corporation's fingerprint authentication unit PU800-1, Nuance Communications' voiceprint authentication verifier, and a device that recognizes individuals by reading the back of the hand and the vein pattern of the finger, A personal recognition device that uses the characteristics of a palm shape can be used.

Next, a specific configuration of the treatment apparatus 100 in the treatment system of the present embodiment will be described with reference to FIG. The treatment apparatus 100 in this embodiment includes an ultrasound image unit 90 as the image data collection unit 1, an ultrasound treatment unit 91 using high-intensity ultrasound as the treatment unit 2, and a treatment sent from the second facility. A treatment execution signal receiving unit 10 that receives an execution signal and instructs the ultrasonic treatment unit 91 to execute the treatment is provided.

The ultrasound image unit 90 of the treatment apparatus 100 is configured to display, for example, a hemostatic site 55 of a blood vessel of the emergency patient 51.
An ultrasonic probe 41 for transmitting and receiving imaging ultrasonic waves in order to obtain an ultrasonic image, a transmission signal is supplied to the ultrasonic probe 41, and an ultrasonic wave is received from a reception signal obtained from the ultrasonic probe 41. An ultrasonic transmission / reception unit 42 that generates image data is provided.

On the other hand, the ultrasonic treatment unit 91 of the treatment apparatus 100 includes an applicator 44 having a piezoelectric vibrator 43 that irradiates a strong ultrasonic wave to the hemostatic site 55 and a vibrator drive that drives the piezoelectric vibrator 43 of the applicator 44. Part 45.

The ultrasonic probe 41 is provided to monitor the irradiation state of the strong ultrasonic wave to the hemostatic site 55 of the blood vessel to be treated and the effect of hemostasis by using an ultrasonic image. The ultrasonic probe 41 is the same as that used for normal ultrasonic diagnosis, but a small ultrasonic probe is used so as not to interfere with the irradiation of strong ultrasonic waves by the piezoelectric vibrator 43. An ultrasonic probe 41 for sector scanning capable of imaging a wide range on the acoustic wave transmitting / receiving surface is preferable.

In the present embodiment, a sector electronic scanning type ultrasonic probe 41 that electronically controls the transmission / reception direction of an ultrasonic beam to obtain a fan-shaped image region is used. That is, the tip of the ultrasonic probe 41 has, for example, M micro-piezoelectric transducers arranged in a one-dimensional manner, and a plurality of micro-piezoelectric transducers (not shown) convert electrical pulses into ultrasonic pulses at the time of transmission for emergency. Sent to the diagnosis site of patient 51,
Moreover, it has the function to convert the ultrasonic signal from the emergency patient 51 into an electrical signal at the time of reception.

As shown in FIG. 3, the ultrasonic transmission / reception unit 42 generates the drive signal for radiating ultrasonic waves from the ultrasonic probe 41 to the emergency patient 51, and receives from the emergency patient 51. An ultrasonic receiving unit 72 that receives ultrasonic waves via the ultrasonic probe 41, an image data generating unit 73 that generates ultrasonic image data based on the received signal, and an image data storage unit 74 that stores the image data. And a system control unit 85 that controls these units in an integrated manner and transmits image data to the image data processing unit 5 of the first facility 61.

Here, the ultrasonic transmission unit 71 includes a rate pulse generator 76, a transmission delay circuit 77, and a pulser 78, and the rate pulse generator 76 determines a repetition period of ultrasonic pulses radiated to the emergency patient 51. The rate pulse to be transmitted is supplied to the transmission delay circuit 77. Transmission delay circuit 77
Is composed of M-channel independent delay circuits, and in order to obtain a narrow transmission ultrasonic beam width in the ultrasonic probe 41, a delay time for converging the ultrasonic wave to a predetermined depth and an ultrasonic wave in a predetermined direction. A delay time for deflection is given to the rate pulse and supplied to the pulser 78. The pulser 78 has an M-channel independent drive circuit, drives M piezoelectric vibrators built in the ultrasonic probe 41, and generates drive pulses for transmitting ultrasonic waves to the emergency patient 51. To do.

On the other hand, the ultrasonic receiving unit 72 includes a preamplifier 79 that amplifies a minute signal converted into an electric signal by an ultrasonic transducer and ensures sufficient S / N, a reception delay circuit 80, and an adder 81. Yes. The reception delay circuit 80 scans the emergency patient 51 by controlling the convergence delay time for converging the ultrasonic wave from a predetermined depth and the reception directivity of the ultrasonic beam in order to obtain a narrow reception beam width. Is supplied to the output of the preamplifier 79, and then sent to the adder 81. The adder 81 adds the M channel received signals and combines them.

The image data generation unit 73 includes a logarithmic converter 82, an envelope detector 83, and an A / D converter 84.
And. The input signal of the image data generation unit 73 has a function of logarithmically converting the amplitude of the received signal by the logarithmic converter 82 to relatively emphasize the weak signal. In general, the received signal from the emergency patient 51 has an amplitude with a wide dynamic range of 80 dB or more.
In order to display on an ordinary television monitor having a dynamic range of about 3 dB, amplitude compression that emphasizes a weak signal is required. The envelope detector 83 performs envelope detection on the logarithmically converted received signal, removes the ultrasonic frequency component, and detects only the magnitude of the amplitude. A
The / D converter 84 A / D converts the output signal of the envelope detector 83 to generate ultrasonic image data.

The image data storage unit 74 is a storage circuit that temporarily stores the ultrasonic image data generated by the image data generation unit 73. Data obtained while changing the transmission / reception direction of the ultrasonic waves is sequentially stored, and the two-dimensional data is stored. Construct image data.

Returning to FIG. 2, the applicator 44 of the ultrasonic treatment unit 91 is filled with, for example, a coupling liquid 40 made of deaerated water, and a piezoelectric vibrator 43 that emits strong ultrasonic waves on the upper part thereof.
The ultrasonic probe 41 of the ultrasonic image section 90 can be mounted in a hole opening at a substantially central portion.

On the other hand, the contact portion of the applicator 44 with the emergency patient 51 is the coupling liquid 40.
Coupling film 3 using a polymer material having acoustic impedance and flexibility substantially equal to
9. That is, high-power ultrasonic waves emitted from the piezoelectric vibrator 43 and ultrasonic waves for images transmitted and received by the ultrasonic probe 41 are transmitted through the coupling film 39 and the coupling liquid 40 having acoustic characteristics substantially equal to those of the emergency patient 51. Thus, the emergency patient 51 is efficiently transmitted and received.

The piezoelectric vibrator 43 is made of, for example, concave piezoelectric ceramics, and electrodes for supplying drive signals are mounted on the first surface (convex surface) and the second surface (concave surface), respectively. The electrode on the convex side is fixed to the support base. On the other hand, the concave electrode is provided with an acoustic matching layer for efficiently radiating intense ultrasonic waves, and the surface thereof is covered with a protective film.

The vibrator driving unit 45 has a function of supplying a driving signal to the piezoelectric vibrator 43 in order to irradiate a powerful ultrasonic wave for treatment, and generates a continuous wave having a frequency corresponding to the resonance frequency of the piezoelectric vibrator 43. A CW generator 48 that generates the power, a power amplifier 47 that amplifies the continuous wave, and a matching circuit 46 that performs impedance matching in order to efficiently supply the output signal of the power amplifier 47 to the piezoelectric vibrator 43 are provided. The treatment execution signal receiving unit 10 has already been described in the description of FIG.

Next, a first embodiment of the present invention using the treatment apparatus 100 of FIG. 2 will be described with reference to FIGS. That is, the treatment apparatus 100 shown in FIG. 4 is intended for an emergency patient 51 in which urgent hemostasis is required in the body.

In this embodiment configured as described above, the doctor 53 of the second facility 62 directly inputs a treatment execution signal based on the ultrasound image data transmitted from the first facility 61 via a line. It becomes possible to do. For this reason, for an emergency patient 51 who encounters a traffic accident at a place far away from the second facility 62 represented by a disaster emergency center or a specialized hospital in an urban area and requires emergency hemostasis treatment. Effective treatment.

FIG. 4 is a diagram showing the overall configuration of the treatment system as described above, and FIG. 5 shows a flowchart of the treatment procedure in the first facility 61 of the present embodiment.

For example, when an emergency patient 51 who has encountered an accident has been transported to a first facility 61 which is a medical facility in a depopulated area where a doctor 53 does not exist, the medical assistant 52 of the first facility 61 can use the emergency patient 51. Rest at rest and give first aid as possible. Furthermore, if there is a possibility of bleeding in the body (internal bleeding) from the situation of an accident or trauma, further detailed examination is performed. In this case, urgent hemostasis treatment may be necessary depending on the state of bleeding, but as already mentioned, the medical assistant 52 such as an emergency lifesaving person says, “If you do not receive specific instructions from the doctor, It is said that medical treatment accompanied by "cannot be performed", and hemostatic treatment using high-intensity ultrasound described later also belongs to this medical practice.

Therefore, the medical assistant 52 of the first facility 61 is not allowed to perform the therapeutic action by operating the installed treatment apparatus 100 alone. For this reason, in this embodiment, the treatment action is entrusted to the doctor 53 of the second facility 62 who is sufficiently familiar with this treatment method.

That is, the medical assistant 52, if the need for emergency hemostasis is anticipated, the nearest second facility 6
2 is contacted to ensure that medical information can be exchanged between the first facility 61 and the second facility 62, and emergency treatment is started (step S1 in FIG. 5). The medical information in this case is ultrasound image data transmitted from the first facility 61, biological information measurement data such as an electrocardiogram waveform and an electroencephalogram,
These are image data from the TV camera 4 and audio data.

First, the status of the emergency patient 51 in the first facility 61 is transmitted to the second facility 62 by the TV camera 4 and the voice input / output unit (microphone) 7-2, and the image by the TV camera 4 is displayed by the image display unit 23. The voice signal from the voice input / output unit (microphone) 7-2 is sent to the voice input / output unit (speaker).
It is transmitted to the doctor 53 by 25-1. On the other hand, the doctor 53 uses a voice input / output unit (microphone) 2.
5-2 and the voice input / output unit (speaker) 7-1 can be used to give instructions to the medical assistant 52 at all times. In particular, the ultrasonic wave transmitting / receiving unit 42 and the applicator 44 are provided. In the used ultrasound image data collection, an instruction is given regarding a setting method for the emergency patient 51 of the applicator 44.

The medical assistant 52 installs the applicator 44 at a position instructed by the doctor 53, switches the ultrasonic transmission / reception unit 42 to the operating state, and starts collecting ultrasonic image data. The ultrasonic image data obtained at this time is supplied to the image data processing unit 5, for example, combined with an image obtained by the TV camera 4 and sent to the first transmission / reception unit 11.

The image data is compressed by the first transmission / reception unit 11 and then directly by wire, or as shown in FIG. 4, the antenna 31 and the ground relay station 32 of the first facility 61.
The second transmitting / receiving unit 21 of the second facility 62 by a wireless network via the antenna 33 of the second facility 62
Sent to. The compressed image data is restored in the second transmitting / receiving unit 21 and displayed on the image display unit 23 via the image data processing unit 22 (step S2 in FIG. 5).

FIG. 6 shows a specific example of an image displayed on the monitor of the image display unit 23. FIG.
a) shows a TV camera image in which the state of treatment preparation for the emergency patient 51 is taken, and FIG. 6B shows an ultrasonic image of the treatment site obtained at this time side by side on the same monitor. Is done. In particular, in FIG. 6B, the irradiation region and the focal point of the powerful ultrasonic wave obtained by drawing are superimposed and displayed on the ultrasonic image including the hemostatic site 55 of the blood vessel. The medical assistant 52 of the first facility 61 receives an instruction from the doctor 53 of the second facility 62 so that the focal point of the powerful ultrasound coincides with the hemostatic site 55 of the emergency patient 51 on the ultrasound image. The applicator 44 is moved.

In this case, the instruction input unit 24 can be used when it is difficult for the doctor 53 to convey the content to the medical assistant 52 only by voice instructions. That is, the doctor 53 uses an input device such as a light pen or a mouse in the instruction input unit 24, and an instruction symbol such as an arrow indicating the position of the focused point of the strong ultrasonic wave on the ultrasonic image displayed on the image display unit 23. Is superimposed. At this time, the ultrasonic image data and the instruction symbol are combined in the image data processing unit 22 and displayed on the image display unit 23, and the second transmission / reception unit 21, the first transmission / reception unit 11,
Further, the image is displayed on the image display unit 6 via the image data processing unit 5. Therefore, the instruction of the doctor 53 is accurately transmitted to the medical assistant 52 (step S3 in FIG. 5).

Based on the instruction from the doctor 53 transmitted by sound and image, the medical assistant 52
The focused point of the powerful ultrasonic wave is moved to the hemostatic site 55 of the blood vessel, and the doctor 53 always grasps this situation from the ultrasonic image displayed on the image display unit 23 and the image by the TV camera 4 (step of FIG. 5). S4).

If the doctor 53 confirms from the image displayed on the image display unit 23 that the irradiation position has been optimized by the powerful ultrasonic wave, the doctor 53 uses the voice input / output unit 25 to indicate that effect.
The medical assistant 52 supplies the preparation completion signal to the treatment execution signal receiving unit 10 from the treatment preparation completion signal input unit 9 of the first facility 61 according to this instruction. By this preparation completion signal, the gate function of the treatment execution signal receiving unit 10 is turned on, that is, in a standby state with respect to the start of treatment by the treatment execution signal described later (step S5 in FIG. 5).

The supply of the preparation completion signal to the treatment execution signal receiving unit 10 is transmitted to the treatment execution signal input unit 27 via the first transmission / reception unit 11 and the second transmission / reception unit 21, and the treatment execution signal input unit 2.
7 is transmitted to the doctor 53 by, for example, lighting of an LED on the panel 7. If the doctor 53 confirms that the treatment preparation is completed from the LED display, the same treatment execution signal input unit 27
The treatment execution signal is input from the signal input unit (step S6 in FIG. 5). This treatment execution signal is sent to the treatment execution signal receiving unit 10 via the second transmission / reception unit 21 and the first transmission / reception unit 11, and is further supplied to the system control circuit 49 of the transducer driving unit 45.

Next, upon receiving the treatment execution signal, the system control circuit 49 controls the CW generator 48 to generate a continuous wave having substantially the same frequency as the resonance frequency of the piezoelectric vibrator 43. Then, this continuous wave drives the piezoelectric vibrator 43 through the power amplifier 47 and the matching circuit 46, and irradiates the focused ultrasonic wave to the focal point determined by the curvature of the piezoelectric vibrator 43. That is, the powerful ultrasonic wave is irradiated to the hemostatic site 55 of the blood vessel located at the focal point, and the damaged blood vessel is hemostatically caused by the heat generation action and blood coagulation action of the strong ultrasonic wave (step of FIG. 5). S7).

In the standby state of Step S5, the doctor 53 who inputs the treatment execution signal from the treatment execution signal input unit 27 of the second facility 62 needs to be familiar with this treatment method. For this reason, before the doctor 53 inputs the treatment execution signal, the authentication unit 28 provided on or near the panel of the treatment execution signal input unit 27 authenticates that the doctor 53 has a treatment qualification. Only when authenticated, the doctor 53 can input a treatment execution signal.

The doctor 53 continuously observes the treatment status displayed on the image display unit 23, and when the irradiation position or dose is inappropriate, the treatment is interrupted by voice and the applicator 44 is reset or the irradiation power is set. Is reset to the medical assistant 52 (step S8 in FIG. 5). Meanwhile, doctor 53
If the sufficient therapeutic effect by the powerful ultrasonic wave is confirmed on the ultrasonic image, the therapeutic action is terminated (step S9 in FIG. 5).

During treatment, image data and audio data transmitted / received between the first facility 61 and the second facility 62, and further, biological information measurement data and the like are stored in the diagnosis / treatment storage unit 8, and this treatment action is performed. Is used as evidence data indicating that the determination is made by the doctor 53.

According to the first embodiment described above, the medical assistant 52 along with the emergency patient 51 is devoted to assisting in the treatment, and the treatment execution signal is directly input by the doctor 53 via the line.
Emergency treatment within the scope of the current paramedic will be possible. Therefore, even in a depopulated medical facility where there is no doctor 53, emergency treatment by the doctor 53 is possible.

  Next, a second embodiment of the present invention will be described with reference to FIGS.

In the first embodiment, the doctor 53 performs the treatment by inputting a treatment execution signal to the treatment apparatus 100 using the communication line. In the second embodiment, the doctor 53 uses the communication line. The medical assistant 52 who has received an instruction for treatment directly inputs a treatment execution signal to the treatment apparatus 100 and performs treatment.

FIG. 7 is a diagram showing the overall configuration of the treatment system in the second embodiment. In this case as well, the treatment unit 2 uses the ultrasonic treatment unit 91 and the image data collection unit 1 uses the ultrasonic image unit 90, It is intended for an emergency patient 51 requiring emergency hemostasis. FIG. 8 is a flowchart showing a treatment procedure in the first medical facility 61 of the second embodiment.

The medical assistant 52 contacts the second facility 62 nearest to the first facility when emergency hemostasis treatment is expected as a result of diagnosis of the emergency patient 51 who has encountered a traffic accident or the like. 6
An emergency treatment system is prepared by securing a state where medical information can be exchanged between the first facility 62 and the second facility 62 (step S11 in FIG. 8). First, from the medical assistant 52 of the first facility 61 to the second facility 62.
Ultrasound image data, biological information measurement data such as electrocardiogram waveform and electroencephalogram, TV
Image data from the camera 4 and further audio data are transmitted.

That is, the situation of the first facility 61 where the emergency patient 51 and the medical assistant 52 are present is transmitted to the second facility 62 by the TV camera 4 and the voice input / output (microphone) 7-2, and the image by the TV camera 4 is an image. The voice signal from the voice input / output (microphone) 7-2 is transmitted to the doctor 53 by the voice input / output unit (speaker) 25-1. On the other hand, the doctor 53 is a medical assistant 52.
On the other hand, the procedure of ultrasonic image data collection by the ultrasonic transmission / reception unit 42 of the ultrasonic image unit 90 and the applicator 44 of the ultrasonic treatment unit 91 is performed using the voice input / output unit (microphone) 25-2. Give instructions.

The medical assistant 52 sets the applicator 44 of the ultrasonic treatment unit 91 to the instructed position,
The ultrasonic wave transmission / reception unit 42 of the ultrasonic image unit 90 is switched to the operating state to collect image data. The image data obtained at this time is supplied to the image data processing unit 5, for example, the TV camera 4
And is sent to the first transmission / reception unit 11.

After the image data is compressed in the first transmission / reception unit 11, the image data is
To the second transmitting / receiving unit 21 of the second facility 62 via the antenna 31 of the facility 61 and the antenna 33 of the ground relay station 32. The compressed image data is restored in the second transmitting / receiving unit 21 and displayed on the image display unit 23 via the image data processing unit 22 (step S12 in FIG. 8).

The doctor 53 observes the ultrasound image displayed on the image display unit 23, and on this image, the medical assistant 5 so that the bleeding site 55 of the emergency patient 51 and the position of the focal point of the powerful ultrasound coincide with each other.
2 is instructed about the setting method of the applicator 44.

At this time, the doctor 53 can also use the instruction input unit 24 as necessary. That is, when the instruction only by voice is insufficient, the doctor 53 uses an input device such as a light pen or a mouse in the instruction input unit 24, and performs an ultrasonic image displayed on the image display unit 23 with respect to the ultrasonic image. A symbol or figure such as an arrow indicating the set position or moving direction of the focused point of the powerful ultrasonic wave is input.

The instruction signal is combined with the ultrasonic image data in the image data processing unit 22 and superimposed on the image display unit 23, and is also displayed on the second transmission / reception unit 21, the first transmission / reception unit 11, and the image data processing unit 5. Is also displayed on the image display unit 6. In this way, the instruction from the doctor 53 is accurately transmitted to the medical assistant 52 (step S13 in FIG. 8).

The medical assistant 52 moves the focus point of the powerful ultrasonic wave to the treatment site based on the voice and the instruction from the doctor 53 received by the image, and the doctor 53 displays the situation at this time on the image display unit 23. Always grasped by the ultrasonic image and the image of the TV camera 4 (step S in FIG. 8).
14).

If the image displayed on the image display unit 23 is observed and it is confirmed that the irradiation position is optimized by the powerful ultrasonic wave, the doctor 53 uses the voice input / output unit 25 to indicate that the irradiation position has been optimized. The assistant 52 is informed that the treatment can be performed (step S15 in FIG. 8), and the medical assistant 52 inputs the treatment execution signal from the treatment execution signal input unit 27 of the first facility 61 according to this instruction. (Step S16 in FIG. 8).

The treatment execution signal is supplied to the system control circuit 49 of the vibrator driving unit 45, and the system control circuit 49 that has received the treatment execution signal drives the CW generator 48 and is substantially the same as the resonance frequency of the piezoelectric vibrator 43. A continuous wave having a frequency of Then, this continuous wave drives the piezoelectric vibrator 43 via the power amplifier 47 and the matching circuit 46, and irradiates the focused ultrasonic wave to the focal point determined by the curvature of the piezoelectric vibrator 43 (FIG. 8). Step S17)
.

The doctor 53 continuously observes the treatment status displayed on the image display unit 23, and when the irradiation position or dose is inappropriate, the treatment is interrupted by voice and the applicator 44 is reset or the irradiation power is set. To the medical assistant 52. Upon receiving the reset instruction, the medical assistant 52 temporarily stops the irradiation of the strong ultrasonic wave, resets the applicator 44, and then starts the irradiation again according to the instruction of the doctor 53 (step S18 in FIG. 8).

On the other hand, when the doctor 53 confirms a sufficient therapeutic effect by the powerful ultrasound on the ultrasound image (step S19 in FIG. 8), the doctor 53 notifies the medical assistant 52 of the end of the therapeutic action, and the medical assistant 52 stops hemostasis. The treatment is terminated (step S20 in FIG. 8).

In the hemostasis treatment performed in this way, image data and voice data transmitted between the first facility 61 and the second facility 62, and further, biological information measurement data are diagnosed / treated 8
And records that this treatment action was performed under the direction of the doctor 53.

According to the second embodiment described above, all treatment actions performed by the medical assistant 52 are based on instructions from the doctor 53, and emergency treatment within the scope of the current paramedic is possible. For this reason, even in a depopulated medical facility where there is no doctor 53, emergency treatment can be performed according to the instruction of the doctor 53.

As mentioned above, although the Example of this invention has been described, this invention is not limited to said Example, It can change and implement. For example, the first facility 61 in the description of the above embodiment has been described as a depopulated medical facility, but the emergency patient 51 is referred to as the second facility 62.
The present embodiment is also effective in the case of an ambulance or an emergency helicopter for transporting to a vehicle.

In the present embodiment, the case where an ultrasonic diagnostic apparatus (ultrasonic image section 90) is used as the image data collection unit 1 has been described. However, other image diagnostics such as an X-ray apparatus and an X-ray CT apparatus are used. It may be a device.

Furthermore, although the ultrasonic treatment unit 91 for the purpose of hemostasis has been described as the treatment unit 2, the present invention is not limited thereto, and may be, for example, tracheal intubation under observation with a laryngoscope, or defibrillation. It may be a vessel.

On the other hand, the diagnostic treatment storage unit 8 has been shown as being installed in the first facility 61 in the present embodiment, but may be installed in the second facility 62, and more preferably if installed in both facilities. It is.

The figure which shows schematic structure of the whole treatment system in 1st Example of this invention. The figure which shows the structure of the treatment apparatus in the Example. The figure which shows the structure of the ultrasonic transmission / reception part in the Example. The figure which shows the specific structure of the treatment system in the Example. The flowchart which shows the treatment procedure in the Example. The figure which shows the example of a display of the ultrasonic image and TV camera image in the Example. The figure which shows the structure of the treatment system in the 2nd Example of this invention. The flowchart which shows the treatment procedure in the Example.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 ... Image data collection part 2 ... Treatment part 3 ... Biological information measuring device 4 ... TV camera 5, 22 ... Image data processing part 6, 23 ... Image display part 7, 25 ... Voice input / output part 8 ... Diagnosis / treatment storage part DESCRIPTION OF SYMBOLS 9 ... Treatment preparation completion signal input part 10 ... Treatment execution signal receiving part 11, 21 ... Transmission / reception part 24 ... Instruction input part 26 ... Biological information output part 27 ... Treatment execution signal input part 28 ... Authentication part 61 ... First facility 62 ... second facility 51 ... emergency patient 52 ... medical assistant 53 ... doctor 100 ... treatment device

Claims (2)

A treatment apparatus provided in a first facility connected via a communication line to a second facility for giving an instruction to start treatment to a subject, comprising an ultrasonic transducer for transmitting and receiving ultrasonic waves An ultrasonic probe, an ultrasonic wave transmitting / receiving unit that generates image data by transmitting / receiving to / from the ultrasonic transducer, and an ultrasonic therapeutic unit that irradiates a subject with a powerful ultrasonic wave to perform treatment, The ultrasonic treatment means starts treatment for the subject according to a treatment execution signal supplied from the second facility based on the image data transmitted to the second facility via the communication line. A therapeutic device characterized by the above. A treatment execution signal receiving means is further provided, and the treatment execution signal receiving means instructs the ultrasonic treatment means to start treatment based on the treatment execution signal supplied from the second facility via the communication line. The treatment device according to claim 1, wherein:

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