JP2010063818A - Blood pressure measuring apparatus and cuff device - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a blood pressure measuring apparatus and a cuff device capable of starting accurate measurement of blood pressure in an optimal pressurized state when the blood pressure is optically measured by pressurizing and depressurizing the tragus as a blood pressure measurement region by cuffs. <P>SOLUTION: The blood pressure measuring apparatus includes: an inner cuff 6 to be inserted into the acoustic meatus; an outer cuff 7 to be located on the outer side of the tragus; a holding means 10 for holding the inner cuff and the outer cuff 7 in such a way as to face each other; and a pulse wave detecting means housed at least either in the inner cuff 6 or in the outer cuff 7 for detecting pulse wave signals from the blood flowing in the blood vessels. The holding means 10 includes: a main holding member 15 for holding the inner cuff; a movable member 20 which holds the outer cuff 7 and which has a guided part 15a to be guided by the main holding member in such a way as relatively movable to the inner cuff 6; and an applied pressure generating means for moving the movable member 20 by a worm gear mechanism 12. <P>COPYRIGHT: (C)2010,JPO&INPIT

Description

  The present invention relates to a blood pressure measurement device and a cuff device, and more particularly to a technique for measuring blood pressure using the outer ear and its surroundings as non-measurement sites.

  The blood pressure fluctuates every moment according to changes in the external environment and internal environment. For this reason, it would be ideal if the beats could be recorded continuously, but even if they could not be recorded continuously, the blood pressure in the day was measured continuously (intermittently) to measure the change in blood pressure over time. It is also important to perform health care by measuring.

  When blood pressure is regularly measured with a conventional blood pressure measurement device, for example, the blood pressure is measured by wrapping a cuff around the upper arm of the subject. In this case, it is necessary to wear on the body a large-sized cuff that covers the upper arm and the main body of the blood pressure measurement device connected to the cuff. For this reason, the subject needs to wear a cuff on the upper arm and send a daily life with the body of the blood pressure measurement device connected to the cuff attached to the body. In addition, the subject may be burdened by feeling pain because the upper arm is compressed each time pressure is measured.

In order to solve such a problem, the applicant can hold the inner cuff inserted into the ear canal and the outer cuff located outside the tragus and can adjust the relative position of the outer cuff with respect to the inner cuff. Has proposed a blood pressure measuring device having a configuration that can be made (Patent Document 1).
Japanese Patent Laid-Open No. 2006-288643

  According to the blood pressure measuring device proposed above, the cuff attached to the tragus is composed of a light transmissive elastic material, and has a configuration in which detection means for optically detecting a pulse wave is built in the cuff. Yes. Further, even when a cuff is exposed to the outside when the inner and outer cuffs are attached to the tragus, the blood pressure can be accurately measured without being affected by ambient light.

  However, according to the proposal, although the adjustment function corresponding to the tragus having a large individual difference is provided, the configuration is not configured to clamp the tragus in an optimal pressure state.

  Therefore, the present invention has been made in view of such circumstances, and in order to cope with tragus having a large individual difference, accurate blood pressure measurement is performed by pinching the tragus in an optimal pressure state. An object of the present invention is to provide a blood pressure measuring device and a cuff device capable of performing the above.

In order to solve the above-described problems and achieve the object, according to the blood pressure measurement device of the present invention, an inner cuff (inner cuff assembly) inserted into the ear canal and an outer cuff (outside of the tragus) ( An outer cuff assembly) and holding means for holding the inner cuff and the outer cuff opposite to each other;
A pulse wave detection unit that is incorporated in at least one of the inner cuff and the outer cuff and detects a pulse wave signal from blood flowing through a blood vessel, and the holding unit holds a main holding member that holds the inner cuff; A moving member having a guided portion that is guided by the main holding member so as to be movable relative to the inner cuff while holding the outer cuff, and the moving member that accompanies energization to a small DC motor. A cuff device comprising a worm gear mechanism having a worm gear mechanism for driving and holding the moving member in an immovable state when the energization is stopped, and air sent through a pipe between the inner cuff and the outer cuff. Pressurizing and depressurizing means for pressurizing and depressurizing, pressure detecting means for detecting the pressure of the inner cuff and the outer cuff connected to the pipe, and blood for measuring a blood pressure value based on the pulse wave signal A measurement control unit, is characterized in that it comprises a display means for displaying the blood pressure value.

  The worm gear mechanism includes a worm gear fixed to the output shaft of the small DC motor, a worm wheel pivotally supported so as to mesh with the worm gear, an eccentric cam member fixed to the worm wheel, a return A spring member, and increasing or decreasing a distance between a left end standing portion of the main holding member and a left end portion of the moving member by rotating the eccentric cam member by energizing the small DC motor, The moving member is returned to the original position by a return spring member.

  The small DC motor and the worm gear mechanism are fixed at the left end standing part of the main holding member or the left end part of the moving member, and the energization is performed to move the moving member so that the outer cuff is moved to the inner side. The cuff is provided with switch means for stopping the energization when the tragus is sandwiched by the measurement start pressure.

  And a pressure detecting means for moving the moving member with the energization and detecting that the outer cuff is pinched by the inner cuff at a pressure at which measurement is started, and the small DC according to the detection. And an energization control means for controlling energization of the motor.

  In addition, the outer cuff and the inner cuff have an oval or oval contact surface that is formed flat so as to be along the direction of insertion into the ear canal, and the contact surface is convex in the center and surroundings Is formed in a concave shape.

  And an inner cuff inserted into the ear canal, an outer cuff positioned outside the tragus, holding means for holding the inner cuff and the outer cuff opposite to each other, and the inner cuff And a pulse wave detection means that detects a pulse wave signal from blood flowing through a blood vessel, and is built in at least one of the outer cuffs, the holding means holding a main holding member that holds the inner cuff, and the outer While holding the cuff, the movable member having a guided portion guided by the main holding member so as to be relatively movable with respect to the inner cuff, and driving the moving member with energization to the small DC motor, Pressurization generating means having a worm gear mechanism for holding the moving member in an immovable state when the energization is stopped.

  According to the present invention, by setting the inner cuff to the external auditory canal and the outer cuff to the outside of the tragus, the blood pressure measurement is started in an optimal pressure generation state after being brought into contact with the tragus. It is possible to provide a blood pressure measurement device and a cuff device that can always perform accurate blood pressure measurement.

  First, the present invention uses a tragus which is a part of the pinna as a measurement site. Since this tragus is fixed to the head and used mainly for sound collection purposes, the amount of nerves present around the tragus is less than that of the upper arm and fingers used for complex tasks. For this reason, when measuring blood pressure using the outer ear and its peripheral part, the tragus is the least painful part, and the tragus is a small part, and a pair of cuffs sandwiching it can be made small, There is an advantage that pain at the time of blood pressure measurement can be reduced as compared with blood pressure measurement using an upper arm or a finger.

  However, since the tragus is a small part of the auricle, if the small blood pressure measurement unit cannot be fixed securely and stably to the tragus, the blood pressure detection unit will move during measurement and accuracy Blood pressure cannot be measured well.

  For example, the blood pressure detection unit includes a pipe for supplying pressurized fluid, pressurized air or pressurized liquid to the cuff for pressurizing the tragus, and power for driving the blood pressure detection unit and blood pressure measurement from the blood pressure detection unit It is connected to a wiring which is a signal line such as an output signal transmitted to the apparatus main body. The piping and wiring are connected to the main body of the blood pressure measurement device. For this reason, when blood pressure is measured over a long period of time, for example, when operating the main body of the blood pressure measurement device, if the hand touches the piping or wiring and the mounting position of the blood pressure detection unit is shifted, it is correct. Blood pressure cannot be measured.

  In addition to this, after setting the inner cuff on the external auditory canal and the outer cuff on the outside of the tragus so as to be in contact with the tragus, it is necessary to perform blood pressure measurement in an optimal pressure generation state.

  A blood pressure measuring device according to a preferred embodiment of the present invention will be described below with reference to the drawings. It should be noted that the configuration of each part of the blood pressure measurement device or cuff device of each embodiment described below is merely an example, and it goes without saying that the technical scope of the present invention is not construed in a limited manner.

<Overall configuration>
Fig.1 (a) is the front view which showed a mode that the cuff apparatus 200 of the ear-type sphygmomanometer 1 which is a blood-pressure measuring apparatus of this invention was used with respect to an auricle. Moreover, FIG.1 (b) is the front view which fractured | ruptured and illustrated about the cuff apparatus of another structure. First, in FIG. 1A, an auricle 220 which is a so-called ear includes an tragus 221, a pair of beads 222, a concha 223, a pair 224, a pair of earrings 225, and a pair formed continuously from an edge of the external auditory canal 230. The legs 226 have a mutual positional relationship as shown in the figure. In addition, an extension portion (not shown) may be formed on the back surface side of the pair of wheels 224 that serves as an ear-hanging portion continuous with the head side surface. It is known that the shape and size of each of these parts vary greatly by sex, sex, age, or individual type. It is also known that a superficial temporal artery is present in the vertical direction near the tragus 221.

  Next, the cuff device 200 of the ear-type sphygmomanometer 1 includes an inner cuff (inner cuff assembly) 6 that is one of the cuffs inserted into the ear canal 230 and set, and a cuff positioned outside the tragus 221. The other outer cuff (outer assembly) 7 is held by holding means 10 as shown. Further, the holding means 10 is connected to the pipe 4 and the wirings 5 and 40, respectively, and is connected to the apparatus main body 100 which is separately configured via the piping 4 and the wirings 5 and 40.

  Further, the outer cuff 7 may be fixed via a ball bearing (not shown). In this case, the outer cuff 7 can freely swing, so that it abuts against the tragus 221 evenly. become able to. On the other hand, the inner cuff 6 is set inside the ear hole 230 of the ear canal.

  The apparatus main body 100 configured as described above is accommodated in, for example, a subject's breast pocket or a dedicated pouch, put in a breast pocket of clothing, and then sandwiched with a clip or the like, so that it does not fall off during daily movement. . Further, the liquid crystal display unit 114 may be arranged on the side of the upper surface of the apparatus main body 100 so that the necessary operation required for blood pressure measurement can be performed without taking it out from a pocket or the like.

  Further, the outer cuff 7 is provided at the right end portion of the moving member 20 and between the left end portion of the moving member 20 and the left end standing portion 16 of the substantially U-shaped main holding member 15 of the holding means 10. Is provided with a worm gear mechanism 12 configured to be driven by a small DC motor 11 (shown by a broken line). Further, the moving member 20 is provided as described later so as to be reciprocally movable with respect to the main holding member 15. A return spring member 18 that returns the moving member 20 to its original position is provided so as to maintain a tension state between the left end standing portion 16 of the main holding member 15 and the moving member 20. In addition, a switch 13 configured to be turned off in a pressurized state is incorporated in the left end standing portion 16 of the main holding member 15.

  On the other hand, in FIG. 1B, a small DC motor 11 (shown by a broken line) and a worm gear mechanism 12 are provided in the left end upright portion 16 of the main holding member 15. Further, the switch 13 configured to be turned off in a pressurized state is built in the left end portion of the moving member 20.

  The cuff device 200 of the ear-type sphygmomanometer 1 configured as described above is provided between the inner cuff 6 and the outer cuff 7 in order to obtain a pressurized state by sandwiching the tragus between the inner cuff 6 and the outer cuff 7. The interval K is initialized and used. That is, after the initial setting of the inner cuff 6 and the outer cuff 7 corresponding to the variation in the thickness of the tragus having a large individual difference, the patient does not need to perform the initial setting again.

<Circuit configuration of photoelectric volume pulse wave sphygmomanometer>
Next, FIG. 2 is a block diagram showing a configuration of the apparatus main body 100 when the ear sphygmomanometer 1 of FIG. 1 is configured as a photoelectric volume pulse sphygmomanometer as one of the pressure pulse wave sphygmomanometers. In FIG. 2, an inner cuff assembly (inner cuff) 6 attached to the tragus 221 is provided with an air bag 8 (shown by a broken line) made of silicon rubber, in which a photoelectric sensor (pressure pulse wave sensor) A light receiving element 2a constituting a pulse wave sensor) is incorporated. The outer cuff 7 is provided with an air bag 8 (shown by a broken line) made of silicon rubber, in which the light emitting element 2b is incorporated.

  A pipe 4 shown by a double line in the drawing is an air tube, and forms a flow path of air into the inner cuff 6 and the outer cuff 7 and a flow path to the bag body 11. The pressure pump 103 uses a small electric motor as a drive source. The pressure pump 103 sends compressed air into a condenser tank (not shown), and pressurizes compressed air into the inner cuff assembly 6 and the outer cuff 7 after rectification. Send in.

  The quick exhaust valve 104 branched from the pipe 4 is provided with a solenoid valve mechanism (not shown) so as to rapidly reduce the pressure in the inner cuff 6 and the outer cuff 7. Further, the fine exhaust valve 105 branched and connected similarly reduces the pressure in the inner cuff 6 and the outer cuff 7 at a constant speed (for example, 2 to 3 mmHg / sec).

  Further, the pressure sensor 106 branched from the pipe 4 changes the electrical parameter in accordance with the pressure in the cuffs 6 and 7. A pressure detection amplifier (AMP) 107 connected to the pressure sensor 106 detects an electrical parameter of the pressure sensor 106, converts it into an electrical signal, amplifies it, and outputs an analog cuff pressure signal.

  The LED, which is the light emitting element 2b, irradiates light to the pulsating vascular blood flow, and the phototransistor, which is the light receiving element 2a, detects transmitted light from the vascular blood flow. On the other hand, the filter AMP 109 connected via the wiring 5 is a pulse wave detection amplifier, which amplifies the output signal of the phototransistor and outputs an analog pulse wave signal. Here, a light amount control unit 118 that automatically changes the light amount via the wiring 5 is connected to the LED, while the pulse wave detection amplifier 109 has a gain control unit 119a that automatically changes the gain, A time constant control unit 119b for changing the time constant of a filter amplifier (not shown) constituting the pulse wave detection filter / amplifier 109 is connected. An A / D converter (A / D) 110 connected as shown in the figure converts an analog signal into digital data.

  A control unit (CPU) 111 performs main control of the photoelectric volume pulse wave sphygmomanometer. The CPU 111 has an adjustment pressure register 111a that stores the adjustment pressure. The ROM 112 stores a later-described control program executed by the CPU 111. The RAM 113 includes a data memory, an image memory, and the like.

  A liquid crystal display (LCD) 114 displays the contents of the image memory. The start switch 116 is used for initial setting to a pressurized state, setting a measurement start command, an adjustment pressure value, and the like as described later by being operated by a user's operation. The buzzer 115 informs the user that the apparatus has sensed that the key in the operation unit 116 has been pressed, the measurement has been completed, or the like. In this example, the adjustment pressure register 111 a is provided in the CPU 111, but an adjustment pressure storage unit may be provided in the RAM 113.

  Further, since the LCD display panel 114 uses a dot matrix type display panel, it can display various information (for example, characters, figures, signal waveforms, etc.). It also has a measurement start switch 116 and a key for inputting a cuff pressure value and the like. Further, a power supply unit 121 and a power switch (not shown) that can replace the battery are further provided.

  Further, the apparatus main body 100 is provided with an external communication unit connected to a connector (not shown) or a cellular phone. By connecting to the personal computer, an operation control parameter setting unit, a data clear unit, a data storage unit, Various data can be exchanged between them and blood pressure measurement results can be saved.

  On the other hand, the CPU 111 is connected to a contact type switch 13 and a small DC motor 11 for driving the worm mechanism 12 and a wiring 40 connected to the position detection switch 17 via a motor driver circuit (not shown). Further, when the pressure sensor 130 shown by a broken line in the drawing is provided in place of the switch 13, the wiring 40 is similarly connected.

  Next, FIG. 3 is a three-dimensional exploded view based on the isometric projection of the inner cuff 6, the outer cuff 7, the moving member 20 and the main holding member 15 provided in the holding means 10 described in FIG. In this figure, the same reference numerals are given to the components or parts already described, and the description is omitted. The inner cuff 6 is held by the right end extending portion 14 of the main holding member 15 that is injection-molded using a resin material. And is configured to be set in the outer ear hole 230. The outer cuff 7 is also held at the right end of the moving member 20 that is also injection-molded using a resin material.

  Specifically, the outer cuff 7 is made of black silicone rubber, and includes an elliptical contact surface 7a formed flat along the direction of insertion into the ear canal, and the contact surface 7a has a center at the center. The convex shape and the periphery are formed in a concave shape, and an O-ring 30 is further set after insertion into the right end of the moving member 20 to prevent air leakage. A flow path 22 a for pressurizing and depressurizing the inside of the outer cuff 7 is formed in the moving member 20 (shown by a broken line), and the pipe 4 is set in the cylindrical portion 22. .

  On the other hand, after the inner cuff 6 is inserted into the member 31, the O-ring 30 is set to prevent air leakage, and after setting, a flow path (not shown) for pressurizing and depressurizing the inside cuff 6 ) And the pipe 4 is set in the cylindrical portion 33. Thereafter, the cylindrical portion 33 is positioned in the hollow portion (not shown) between the right end extending portion (right standing portion) 14 of the substantially U-shaped main holding member 15 of the holding means 10, and the protruding portion 32 enters. It is fixed in a fixed state.

  On the other hand, a shape portion 20 b extending in the longitudinal direction is integrally formed below the moving member 20, and can be reciprocated by setting the shape portion 20 b in a groove portion 15 a formed in the main holding member 15. Retained. The main holding member 15 has a built-in contact-type switch 13 that is turned on and off depending on the contact state of the eccentric cam of the worm gear mechanism 12 in the left end portion (left end standing portion) 16.

  4A is a front view illustrating a schematic configuration of the holding unit 10 described in FIG. 1, and FIG. 4B is a cross-sectional view of a main part of the contact switch 13. In FIG. 4, the same reference numerals are given to the components or parts that have already been described, and the description is omitted, but an example in which an eccentric cam is used as the worm gear mechanism 12 will be described. Any mechanism configuration may be used as long as it is converted. For example, a rack and pinion mechanism, a mechanism using a combination of bolts and nuts, or the like can be used.

  First, in FIG. 4A, for example, a small DC motor 11 that can obtain a high output while being small by using a neo-geo magnet is fixed to the moving member 20, and a worm gear 212 is fixed to the output shaft. . A worm wheel 214 is pivotally supported by a shaft body 213 at a shaft support portion of the moving member 20 so as to mesh with the worm gear 212, and an eccentric cam member 229 having a maximum radius R is fixed to the shaft body 213. ing.

  The eccentric cam member 229 and the contact switch 13 are always kept in contact with each other by the pulling action of the return spring member 18.

  In FIG. 4 (b), the contact switch 13 includes an actuator 13b that is protruded and moved in the direction of arrow D1 by a compression spring 13a, and a contact 13c fixed to the actuator and a contact fixed to the main body side. 13d is brought into contact with the wiring 40 so that conduction between the wirings 40 is achieved. Then, when the eccentric cam member 229 is rotated by energization of the small DC motor 11 and the distance between the left end standing portion 16 of the main holding member 15 and the left end portion of the moving member 20 is increased, a pressure generation state is obtained. When the actuator 13b is retracted in the direction of the arrow D2, the conduction state between the contacts is eliminated, so that the energization is stopped.

  Further, in FIG. 4A, a continuity may be controlled by an instruction from the CPU by incorporating a pressure sensor 130 capable of detecting a pressurized state in place of the contact switch 13.

  FIG. 5 is a flowchart for explaining the operation of the pressurization generating means, and shows the steps until the pressurization is generated using the pressure sensor 130 described above. In this figure, the same reference numerals are given to the components or parts already described, and the description is omitted. First, when the start switch 116 is pressed in step S1 in order to perform initial setting for a new patient after the previous use. In step S2, the small DC motor 11 is energized to rotate the eccentric cam member 229 in the clockwise direction. In step S3, the initial position sensor 17 detects that the initial position has been reached, and the original position is restored. Return to position.

  Then, although it sets to the tragus 221 at step S4, there exists a big clearance gap at this time. After that, when the start switch 116 is continuously pressed twice in step S5, energization to the motor 11 is resumed in step S6, and in step S7, the moving member 20 moves and the inner cuff 6 and the outer cuff 7 are moved. When the distance K between the cuffs is reduced, the tragus 221 is clamped.

  In subsequent step S8, the pressure is measured by the pressure sensor 130, and it is determined in step S9 whether or not a pressurization has been generated, and steps S6 to S8 are repeated until the pressurization has been generated. When the pressure is generated, energization to the motor 11 is stopped in the next step S10. In step S11, the movement of the moving member is stopped by the automatic rotation stopping action by the worm gear mechanism 12, thereby completing the initial setting. After the above, normal blood pressure measurement is performed.

  Thus, the tragus 221 can be held between the inner cuff 6 and the outer cuff 7. This adjustment work is performed by the patient himself and the nurse. After setting as described above, an optimum pressure generation state is obtained, so that accurate blood pressure measurement can always be performed.

(A) is the front view which showed a mode that the cuff apparatus 200 of one Embodiment of this invention was made into the use condition with respect to an auricle, FIG.1 (b) fractured | ruptured and illustrated one part about the cuff apparatus of another structure. It is a front view. It is a block diagram which shows the structural example of the ear-type blood pressure meter 1 of FIG. FIG. 3 is an exploded view of the inner cuff 6, the outer cuff 7, the moving member 20 and the main holding member 15 provided in the holding means 10 described in FIG. 1A is a front view illustrating a schematic configuration of the holding means 10 described in FIG. 1, and FIG. It is a flowchart explaining operation | movement of a pressurization generation means.

Explanation of symbols

1 Ear blood pressure monitor 4 Piping 5 Wiring (signal / power line)
6 Inner cuff 7 Outer cuff 10 Holding means 11 Small DC motor 12 Worm gear mechanism 13 Contact type switch 40 Wiring 229 Eccentric cam member

Claims (6)

An inner cuff inserted into the ear canal and an outer cuff located outside the tragus;
Holding means for holding the inner cuff and the outer cuff facing each other;
A pulse wave detection means that is incorporated in at least one of the inner cuff and the outer cuff and detects a pulse wave signal from blood flowing through a blood vessel,
The holding means is
A main holding member for holding the inner cuff;
A movable member that holds the outer cuff and has a guided portion that is guided by the main holding member so as to be relatively movable with respect to the inner cuff;
A cuff device comprising: a pressure generating means having a worm gear mechanism that drives the moving member with energization of a small DC motor and holds the moving member in an immovable state when the energization is stopped;
Pressurizing and depressurizing means for pressurizing and depressurizing the inner cuff and the outer cuff with air sent through a pipe;
Pressure detecting means connected to the pipe for detecting the pressure of the inner cuff and the outer cuff;
Blood pressure measurement control means for measuring a blood pressure value based on the pulse wave signal;
A blood pressure measurement apparatus comprising: a display unit configured to display the blood pressure value. The worm gear mechanism includes a worm gear fixed to the output shaft of the small DC motor, a worm wheel pivotally supported so as to mesh with the worm gear, an eccentric cam member fixed to the worm wheel, and a return spring member And consists of
By rotating the eccentric cam member by energizing the small DC motor, the distance between the left end standing portion of the main holding member and the left end portion of the moving member is increased or decreased, and the moving member is moved by the return spring member. The blood pressure measuring device according to claim 1, wherein the blood pressure is returned to the original position. The small DC motor and the worm gear mechanism are fixed at a left end standing part of the main holding member or a left end part of the moving member,
Switch means for stopping the energization when the outer cuff is moved to move the moving member and the outer cuff is clamped by the inner cuff at a pressure at which measurement is started. Item 3. The blood pressure measurement device according to item 1 or 2. A pressure detecting means for moving the moving member in accordance with the energization and detecting that the outer cuff is clamped by the inner cuff at a measurement start pressure;
Energization control means for energizing the small DC motor in response to the detection;
The blood pressure measurement device according to claim 1, comprising:   The outer cuff and the inner cuff are provided with an oval and oval contact surface that is formed flat so as to be inserted in the ear canal, and the contact surface is convex at the center and concave at the periphery. The blood pressure measurement device according to claim 1, wherein the blood pressure measurement device is formed as follows. An inner cuff inserted into the ear canal and an outer cuff located outside the tragus;
Holding means for holding the inner cuff and the outer cuff facing each other;
A pulse wave detection means that is incorporated in at least one of the inner cuff and the outer cuff and detects a pulse wave signal from blood flowing through a blood vessel,
The holding means is
A main holding member for holding the inner cuff;
A movable member that holds the outer cuff and has a guided portion that is guided by the main holding member so as to be relatively movable with respect to the inner cuff;
A pressure generating means having a worm gear mechanism that drives the moving member with energization of a small DC motor and holds the moving member in an immovable state when the energization is stopped;
A cuff device comprising:

Images