JP2012075758A - Dysphagia detecting system - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a dysphagia detecting system which can quickly detect automatically that deglutition operation itself does not arise also to a cognitive deficit patient, and can thereby mitigate the burden of a patient and a care worker.SOLUTION: The dysphagia detecting system 1 includes a chewing detector 2, a motion detector 3, and a dysphagia determinator 4. The chewing detector detects the physical quantity about the chewing operation of a subject A, and outputs the detection result of whether chewing continues based on the physical quantity. The motion detector detects the physical quantity about the movement of a pharynx P or a larynx L of the subject, and outputs the detection result of whether the pharynx or larynx carries out predetermined movement based on the physical quantity. The dysphagia determinator outputs the determination result which shows that the subject has dysphagia when the detection result which shows that the pharynx or larynx does not carry out predetermined movement is output by the motion detector in spite of having output the detection result which shows that the chewing of the subject continues by the chewing detector.

Description

  The present invention relates to a dysphagia detection system, and more specifically, a dysphagia detection system that detects dysphagia in a patient with dementia who is difficult to understand words or whose situation is difficult to explain in words. It is about.

  The function of chewing and swallowing food, that is, chewing and swallowing, is the basis for nutrition. In particular, a decrease in swallowing function leads to a serious situation such as a lack of nutrition and consequently a decrease in immune function. For this reason, it is extremely important to take preventive measures before a patient becomes seriously ill by detecting swallowing disorders early on through testing.

By the way, in recent years, for example, a repetitive saliva swallowing test (RSST) or oral diad cokinesis is known as a test method for dysphagia.
The repeated saliva swallowing test allows patients (subjects) to swallow saliva repeatedly for 30 seconds, for example, and the doctor (examiner) counts the number of laryngeal elevations associated with swallowing the subject by palpation to evaluate dysphagia It is to do.
Oral diad cokinesis, for example, allows a subject to pronounce “pa”, “ta”, and “ka” as much as possible for 10 seconds, and the examiner counts the number of pronunciations to evaluate dysphagia. It is.
However, these test methods do not understand the examiner's instructions such as “please swallow saliva as much as possible for 30 seconds” or “pronounce pat, ta, and mosquito as much as possible for 10 seconds”, or It is difficult to test for dysphagia in patients with dementia who cannot understand but understand.

  Thus, various devices for testing dysphagia for such patients with dementia have been proposed (see, for example, Patent Documents 1 to 4).

Patent 4011071 JP 2008-301895 A JP 2009-160459 A JP 2008-018010 A

  According to the device described in Patent Document 1, swallowing disorder by capturing and analyzing the sound of opening and closing of the epiglottis and the passing sound of food at the esophageal entrance (swallowing sound), which are important in swallowing a subject, Determine. However, since the apparatus described in Patent Document 1 is premised on taking a swallowing sound accompanying swallowing motion, it cannot be examined that the subject's swallowing motion itself has not occurred.

  According to the device described in Patent Literature 2, the displacement and swallowing sound detected by detecting two displacements in the lateral direction of the subject's larynx and detecting the swallowing sound when the subject swallows. By displaying the waveform, it is possible to visually capture the degree of swallowing. However, since the device described in Patent Document 2 is based on the premise that a swallowing sound accompanying swallowing motion is taken, as in Patent Document 1, it cannot be inspected that the subject's swallowing motion itself has not occurred. .

  According to the device described in Patent Document 3, the swallowing motion when the subject swallows is detected using a plurality of pressure sensors arranged along the vertical movement direction of the thyroid cartilage in the larynx of the subject. To inspect the swallowing ability that occurs when a drink such as beer is swallowed. However, since the device described in Patent Document 3 is based on the premise that a swallowing sound accompanying a swallowing action is taken, as in Patent Documents 1 and 2, it is not possible to test that the subject's swallowing action itself has not occurred. Can not.

  According to the device described in Patent Document 4, the mastication motion is measured using an acceleration sensor attached to the subject's masseter muscle part, the swallowing motion is measured using the acceleration sensor attached to the subject's larynx, By analyzing the output of each acceleration sensor, dysphagia is determined. However, Patent Document 4 does not disclose any specific example of how to analyze the output of each acceleration sensor to determine dysphagia, and its realization requires trial and error. For this reason, it cannot be said that those skilled in the art can clearly determine dysphagia with reference to Patent Document 4. Furthermore, in the device described in Patent Document 4, the swallowing motion is measured by an acceleration sensor. However, in view of the fact that the laryngeal movement is examined by palpation in the medical field, the method using the acceleration sensor is an actual test. It is considered unsuitable for.

Furthermore, although the device described in Patent Document 4 is a device that measures the chewing action and swallowing action, the specification of Patent Document 4 discloses only the point of determining whether the chewing action is normal or abnormal. (See paragraph [0058], for example), and no technical matter of determining swallowing motion is disclosed.
By the way, a patient with dysphagia cannot actually perform a swallowing reflex (automatic swallowing operation) even if the chewing operation is normally performed during a meal. For this reason, even if the apparatus described in Patent Document 4 is used, the patient's caregiver is not aware that the swallowing reflex is not performed only because the chewing operation is normally performed. As a result, the caregiver is liable to perform inappropriate care such as causing the patient to continue the mastication operation. In addition, the burden on the patient and the caregiver is likely to increase, for example, the patient's meal time becomes unnecessarily long.

  Therefore, the present invention provides a dysphagia detection system that can automatically and quickly detect that a swallowing operation itself has not occurred even for a patient with dementia, and can reduce the burden on the patient and caregiver. .

  In order to solve the above problems, the present invention detects a physical quantity related to the mastication motion of the subject and outputs a detection result as to whether or not the subject continues to chew based on the physical quantity related to the chewing motion. Mastication detection means and a physical quantity related to movement of the subject's pharynx or larynx are detected, and based on the physical quantity related to movement of the pharynx or larynx, a detection result indicating whether the pharynx or larynx is performing a predetermined movement is obtained. A movement detection means for outputting; and a dysphagia determination means for outputting a determination result as to whether or not the subject has a dysphagia based on the detection results of the mastication detection means and the movement detection means, the swallowing The obstacle determination means outputs the detection result indicating that mastication of the subject is continued by the mastication detection means, but the movement detection means causes the pharynx or When a detection result indicating that the larynx does not perform a predetermined movement is output, a determination result indicating that the subject has a dysphagia is output. It is.

In the above configuration, the physical quantity related to the mastication operation includes sound in the mouth during mastication of the subject, position of the jaw that moves when the subject masticates, myoelectric potential of muscles involved in the mastication of the subject, and It is preferable that it is at least one or a combination of two or more of those related to blood flow of blood vessels involved in the mastication of the subject.
Alternatively, in the above configuration, the physical quantity related to the movement of the pharynx or larynx is preferably related to the position of the pharynx or larynx of the subject.

Further, in the above configuration, the mastication detecting means includes a sound sensor capable of measuring a sound in the mouth during mastication of the subject, and analyzing the output of the sound sensor to continuously chew the subject. The dysphagia determining means outputs the detection result indicating that the subject's mastication is continued by the sound analysis unit. First, when the detection result indicating that the pharynx or larynx is not moving in a predetermined manner is output by the motion detection means, a determination result indicating that the subject has a dysphagia is output. Is preferred.
Alternatively, in the above-described configuration, the mastication detection means includes a distance measuring sensor capable of measuring a position of a jaw that moves when the subject is chewed, and analysis of an output of the distance measuring sensor to continuously chew the subject. A distance analysis unit that outputs a detection result indicating whether or not the dysphagia determination means has output a detection result indicating that the subject's mastication is continued by the distance analysis unit. Regardless, when the detection result indicating that the pharynx or larynx does not move in a predetermined manner is output by the motion detection means, a determination result indicating that the subject has a dysphagia is output. It is preferable to do.

Further, in the above configuration, the movement detection means includes a pressure sensor capable of measuring the position of the larynx of the subject, and a detection result of whether the larynx is performing a predetermined movement by analyzing an output of the pressure sensor. The dysphagia determining means outputs the detection result indicating that the subject's mastication is continued even though the mastication detecting means outputs a detection result indicating that the subject continues to chew. When the analysis unit outputs a detection result indicating that the larynx is not performing a predetermined movement, it is preferable to output a determination result indicating that the subject has a dysphagia.
Alternatively, in the above-described configuration, the movement detecting unit may be a distance measuring sensor capable of measuring the position of the larynx of the subject and whether the larynx is performing a predetermined movement by analyzing an output of the distance measuring sensor. It consists of a distance analysis unit that outputs a detection result, and the dysphagia determining means, although the detection result indicating that the subject's mastication continues is output by the mastication detection means, When the distance analysis unit outputs a detection result indicating that the larynx is not performing a predetermined movement, it is preferable to output a determination result indicating that the subject has a dysphagia.
Alternatively, in the above-described configuration, the motion detection unit is configured to capture an image of a position of the subject's pharynx and acquire and output a fluoroscopic image, and analyze the output of the imaging camera to analyze the pharynx A detection result indicating that the subject's mastication is continued by the mastication detection means. Is output when a detection result indicating that the pharynx does not move in a predetermined manner is output by the image analysis unit. It is preferable to output the result.

In the present invention, the mastication detection means detects that the subject's mastication operation is continuously performed, and the movement detection means detects that the pharynx or larynx is not performing a predetermined movement, and swallowing The failure determination unit is configured to determine that the subject has a dysphagia based on only two detection results of the mastication detection unit and the motion detection unit. And this invention does not judge a swallowing disorder after detecting the swallowing operation | movement (swallowing sound etc.) of a subject like the prior art of said each patent documents 1-3, but before swallowing It is configured to detect a dysphagia by detecting that an automatic swallowing action due to the absence of pharyngeal or laryngeal movement, which is a stage, has not occurred. Therefore, according to the dysphagia detection system according to the present invention, it is possible to automatically and quickly detect that a swallowing motion itself has not occurred even for a patient with dementia.
Further, in the present invention, the mastication operation and the swallowing operation are accurately detected by the mastication detection means and the movement detection means, respectively. Therefore, even if the patient's mastication operation is normally performed, such as the conventional technique described in Patent Document 4, the caregiver performs an inappropriate care such as not noticing the abnormality of the patient's swallowing reflex, etc. The burden on caregivers and patients can be reduced.

It is a block diagram of the dysphagia detection system which concerns on this invention. It is a flowchart which shows operation | movement of the dysphagia determination means of FIG. It is the figure which showed the structure of the pharynx and the larynx. It is a block diagram of the dysphagia detection system by 1st Example of this invention. It is a graph which shows the output of the sound sensor of FIG. (A) is a side view showing a configuration example of the pressure sensor of FIG. 4, (B) is a top view of (A), (C) is a view showing the position of the subject's thyroid cartilage, (D) is a pressure The figure explaining the state which attaches a sensor to the skin surface of the vicinity of a thyroid cartilage, (E) is a side view which shows the other structural example of the pressure sensor of FIG. It is a flowchart which shows operation | movement of the dysphagia determination means of FIG. It is a block diagram of the dysphagia detection system by 2nd Example of this invention. (A) is a graph showing the output of the Doppler sensor of FIG. 8, (B) is a graph showing the Fourier analysis result of the output of (A), (C) is a graph showing the power spectrum of each Doppler sensor of FIG. . It is a figure for demonstrating the process of swallowing operation | movement. It is a flowchart which shows operation | movement of the dysphagia determination means of FIG.

  Hereinafter, a preferred embodiment of a dysphagia detection system according to the present invention will be described with reference to the drawings.

FIG. 1 is a configuration diagram of a dysphagia detection system according to the present invention. FIG. 2 is a flowchart showing the operation of the dysphagia determining means of FIG.
As shown in FIG. 1, the dysphagia detection system 1 includes a mastication detection unit 2, a motion detection unit 3, and a dysphagia determination unit 4.

  The mastication detection means 2 detects a physical quantity related to the mastication operation of the subject A, and outputs a detection result (detection signal) as to whether or not the mastication movement of the subject A continues based on the physical quantity related to the mastication operation. To do. Physical quantities related to the mastication operation include, for example, sound in the mouth of the subject A during mastication, position of the face (for example, chin) moved when the subject A is chewed, muscle muscles involved in the mastication of the subject A Examples thereof include those relating to the blood potential of blood vessels involved in the mastication of the subject A and the subject A.

The movement detection means 3 detects a physical quantity related to the movement of the pharynx P or larynx L of the subject A, and based on the physical quantity related to the movement of the pharynx P or larynx L, the pharynx P or larynx L performs a predetermined movement. A detection result (detection signal) is output. Examples of the physical quantity related to the movement of the pharynx P or larynx L include those related to the position of the pharynx P or larynx L of the subject A.
Here, FIG. 3 is a diagram showing the structure of the pharynx P and the larynx L. The book “Mechanism of feeding and swallowing” (publishing place: Ishiyaku Publishing Co., Ltd., author: Yoshiaki Yamada, p. 80 and FIG. 3-11 on page 81. As shown in FIG. 3, the pharynx P is a cylindrical space formed between the nasal cavity, the oral cavity, the larynx and the cervical spine, and is divided into the upper pharynx, the middle pharynx, and the lower pharynx. The larynx L has a structure in which laryngeal cartilage (thyroid cartilage, cricoid cartilage, epiglottis cartilage, etc.) is connected by a ligament and laryngeal muscle. The larynx L has a shape suspended from the hyoid bone by the thyroid hyoid muscle. During swallowing, the hyoid bone is pulled upward and forward by the upper hyoid muscle group such as the digastric muscle, and the thyroid hyoid muscle contracts and the larynx L (particularly the thyroid cartilage of the larynx L) moves upward and forward. . The epiglottis cartilage is cartilage that becomes a lid that closes the epiglottis during swallowing.

The dysphagia determining means 4 determines whether or not the subject A has a dysphagia based on the detection results (detection signals) of the mastication detecting means 2 and the motion detecting means 3 according to the procedure shown in FIG. (Judgment signal) is output.
In other words, the dysphagia determining means 4 uses the motion detecting means 3 to output the pharynx P or the larynx even though the detection result indicating that the subject A continues to chew is output by the chewing detection means 2 When a detection result indicating that L does not perform a predetermined movement is output, a determination result indicating that the subject A has a dysphagia is output.

  Various known ones can be used as the mastication detecting means 2 and the motion detecting means 3, but several preferred embodiments of the present invention will be described below.

(First embodiment)
FIG. 4 is a block diagram of the dysphagia detection system according to the first embodiment of the present invention. As shown in FIG. 4, the dysphagia detection system 1A includes a mastication detection unit 2A, a motion detection unit 3A, and a dysphagia determination unit 4A.

  In the present embodiment, the mastication detection means 2 </ b> A includes a sound sensor 5 and a sound analysis unit 6. The motion detection means 3A includes a pressure sensor 7 and a pressure analysis unit 12. The dysphagia determining means 4A determines dysphagia of the subject A according to the procedure shown in FIG. 7 as described later, based on the detection results (detection signals) of the mastication detecting means 2A and the motion detecting means 3A. It is.

First, the mastication detection means 2A will be described in detail with reference to FIG. 4 and FIG.
As shown in FIG. 4, the sound sensor 5 is composed of a known microphone and is attached to the skin surface in or near the ear of the subject A and measures the sound in the mouth when the subject A is chewed. To do.
The sound analysis unit 6 analyzes the output of the sound sensor 5 and outputs a detection result indicating whether or not the subject A continues to chew. The sound analysis unit 6 analyzes the output of the sound sensor 5 by the following method.

  FIG. 5 is a graph showing the output of the sound sensor 5 when the subject A is biting food. The sound analysis unit 6 further inputs the waveform of the graph of FIG. 5 into a low-pass filter (not shown) to obtain low-frequency components (for example, mastication points <1> to <5> shown in FIG. 5). Calculate the number of chewing times or chewing time from the start. Then, the sound analysis unit 6 gives a detection result (detection signal) that the mastication of the subject A continues when the calculated number of mastications or mastication time is equal to or greater than the predetermined number of mastications or equal to or greater than the predetermined mastication time. Output.

Next, the motion detection means 3A will be described in detail with reference to FIGS.
As shown in FIG. 4 and FIGS. 6A and 6B, the pressure sensor 7 includes at least one pressure sensor body 8, an urging means 9, a support member 10, and a band 11. . Each pressure sensor main body 8 is provided on one surface of the support member 10 via an urging means 9.
Alternatively, as shown in FIG. 6 (E), the pressure sensor 7 includes at least one pressure sensor main body 8, biasing means 9, first and second support members 10a and 10b, and a band 11. It may be configured. In this case, each pressure sensor main body 8 is directly provided on one surface of the first support member 10 a without the biasing means 9. Further, the first support member 10 a is provided on one surface of the second support member 10 b via the biasing means 9.
As shown in FIG. 6B, three pressure sensor main bodies 8 are provided on the upper part of the support member 10 (the face side of the subject A) and face the thyroid cartilage of the larynx L of the subject A. 3 on the side) and three on the lower side (the chest side of the subject A). Bands 11 are attached to both side surfaces of the support member 10. Then, the band 11 is wound around the neck of the subject A, and the pressure sensor main body 8 is brought into close contact with the skin surface near the thyroid cartilage of the larynx L of the subject A by the biasing force of the biasing means 9. It has come to be. Each pressure sensor body 8 outputs a sensor signal corresponding to the magnitude of the pressure received by the movement of the subject A's thyroid cartilage. Therefore, when the thyroid cartilage moves, the pressure level of each pressure sensor body 8 changes.
The type of the urging means 9 is not limited as long as it presses the plurality of pressure sensor bodies 8 against the skin surface in the vicinity of the thyroid cartilage of the subject A. For example, a spring or a rubber member There may be. The type of the pressure sensor body 8 is not limited as long as it is sensitive to pressure. For example, a piezoelectric element whose charge changes according to pressure, or a conductive element whose resistance value changes according to pressure. (For example, a piezoresistive element) may be an element whose capacitance changes according to pressure.

  The pressure analysis unit 12 analyzes, for example, the output fluctuation amount of each pressure sensor main body 8 accompanying the movement of the thyroid cartilage of the subject A, and outputs a detection result as to whether the larynx L is moving in a predetermined manner. . When it is determined that the output fluctuation amount of each pressure sensor main body 8 is equal to or less than the predetermined output fluctuation amount, the pressure analysis unit 12 does not perform the predetermined movement of the thyroid cartilage of the larynx L (the larynx L has the predetermined movement). A detection signal indicating that the device has not been operated is output.

Furthermore, the dysphagia determining means 4A will be described in detail with reference to FIG. 4 and FIG.
As shown in FIGS. 4 and 7, the dysphagia determining means 4A is such that the sound analysis unit 6 of the mastication detection means 2A continuously performs mastication of the subject A for a predetermined number of mastications or for a predetermined mastication time. The detection result indicating that the thyroid cartilage of the larynx L of the subject A is not performing a predetermined movement is output by the pressure analysis unit 12 of the movement detection means 3A, despite being detected. In this case, a determination result indicating that the subject has a dysphagia is output.

(Second embodiment)
By the way, in the dysphagia detection system 1A of the first embodiment, it is necessary to attach a sound sensor and a pressure sensor to the subject's ear and neck, respectively. May become larger. Therefore, in order to reduce the burden on the subject, the dysphagia detection system 1B of the second embodiment is configured to detect the chewing action and the movement of the pharynx or larynx in a non-contact manner.
FIG. 8 is a block diagram of a dysphagia detection system according to a second embodiment of the present invention. As shown in FIG. 8, the dysphagia detection system 1B includes mastication detection means 2B, motion detection means 3B, and dysphagia determination means 4B.

  In the present embodiment, the mastication detection means 2B includes two-frequency and two-wave type microwave Doppler sensors (ranging sensors) 13a and 13b and a distance analysis unit 14. The motion detection unit 3B includes an imaging camera 15 and an image analysis unit 16. The dysphagia determining means 4B determines dysphagia of the subject A according to the procedure shown in FIG. 11 as described later, based on the detection results (detection signals) of the mastication detecting means 2B and the motion detecting means 3B. It is.

First, the mastication detection means 2B will be described in detail with reference to FIGS.
As shown in FIG. 8, in general, it is considered that the vertical movement of the jaw J is periodically repeated in the mastication operation of the subject A. Therefore, the Doppler sensors 13a, 13b It is arranged below. The Doppler sensors 13a and 13b have different carrier frequencies. This is for discriminating the reflection position of the microwave and taking out only the reflection from the jaw position at a specific distance so as to distinguish the chewing action from other actions. The Doppler sensors 13a and 13b respectively output sensor signals corresponding to the vertical movement of the jaw J of the subject A. The sensor signals of the Doppler sensors 13a and 13b are out of phase.
The distance analysis unit 14 analyzes the sensor signals of the Doppler sensors 13a and 13b in the following procedure, detects the movement of the jaw J of the subject A, and determines the mastication operation.

(Step 1) Data Acquisition, Window Setting The distance analysis unit 14 creates a window (5 seconds) of a certain size shifted by a certain time (1 second) with respect to the obtained sensor signals of the Doppler sensors 13a, 13b. .

(Step 2) FFT, peak frequency measurement Since it is considered that the masticatory motion of the subject A is a repetition of a constant speed movement, the distance analysis unit 14 moves the moving body (chin J) at a constant speed. In this case, it is determined that the mastication operation is performed. This processing procedure is as follows.
[1] Fourier Transform of Sensor Signal The distance analyzer 14 multiplies a window as shown in FIG. 9A by a window function (hamming window) in consideration of the Gibbs condition, and performs Fourier transform of the sensor signal.
[2] Determination of Peak Frequency The distance analysis unit 14 checks whether or not the peak frequency is within the range of the mastication frequency based on the Fourier analysis result of the sensor signal as shown in FIG. It is known that the masticatory parallel speed of the first molars of various foods is 37 to 74 [mm / s]. For this reason, the distance analysis part 14 determines with it being a mastication frequency, when the peak of a Doppler frequency comes out in the mastication frequency vicinity.
[3] Comparison of peak frequencies of two sensors The distance analysis unit 14 determines whether or not the peak frequencies of the Doppler sensors 13a and 13b are the same. If they match, the mastication frequency is determined, and after applying a filter that extracts only the peak frequency, inverse Fourier transform is performed.

(Step 3) Judgment of the Number of Up and Down Movements The mastication action of the subject A is considered to be a repetition of the up and down movement of the jaw J at a certain distance. For this reason, the distance analysis part 14 determines with a chewing operation | movement, if the jaw J is moving up and down over a fixed frequency. The distance analysis unit 14 first calculates the power spectrum of each sensor signal output from the Doppler sensors 13a and 13b as shown in FIG. Then, it is determined whether or not a mastication operation is being performed by determining whether the jaw J approaches or separates from the Doppler sensors 13a and 13b from the phase shift of each sensor signal. This processing procedure is as follows.
[1] Amplitude value detection If the jaw J moves at a constant speed, the amplitude value of the voltage of the sensor signal at the peak frequency increases. Therefore, if the amplitude value at the peak frequency is greater than the predetermined amplitude value, the distance analysis unit 14 determines that the mastication operation is being performed.
[2] Approach / Separation Determination The distance analysis unit 14 performs approach / separation determination of the moving object from the phase shift of each sensor signal at an amplitude value equal to or greater than a certain threshold value.
[3] Detection / determination of the number of vertical movements The distance analysis unit 14 detects the number of vertical movements by analyzing the approach / separation waveform pattern as shown in the graph of FIG. When it exists, it determines with the chewing operation | movement being performed.

(Step 4) Distance Determination The distance analysis unit 14 distinguishes the mastication action from other actions by detecting only the reflection from the jaw position at the specific distance.

(Step 5) Action Determination The distance analysis unit 14 creates a “section” having a window width of 10 seconds, and takes the majority of action determinations of the six windows existing therein, thereby obtaining a final “section”. Determine the behavior. Then, the distance analysis unit 14 determines that the mastication operation is performed for 10 seconds if two or more of the six windows existing in the “section” satisfy the conditions of Steps 1 to 3 above, and the subject A detection result indicating whether chewing of A is continued is output.

Next, the motion detection means 3B will be described in detail with reference to FIGS.
As shown in FIG. 8, the imaging camera 15 includes an X-ray camera 15 and is arranged at a lateral position that is a fixed distance away from the subject A, and internally images the position of the pharynx P of the subject A. Obtain and output a fluoroscopic image.
The image analysis unit 16 analyzes a plurality of images captured by the X-ray camera 15 and detects the movement of the pharynx P of the subject A.

10 is a diagram for explaining the process of swallowing movement, and is a book “Mechanism of feeding and swallowing” (publishing place: Ishiyaku Publishing Co., Ltd., author: Yoshiaki Yamada, p. It was drawn with reference to -16). As shown in FIG. 10, when the subject A puts food in the mouth at the time of eating, chewing begins, the tongue lifts, a bolus is formed, and the tongue pushes the bolus into the pharynx P (same as above). (Refer figure (1)). Then, the space between the nasal cavity and the pharyngeal cavity is closed, and the muscles of the cartilage lid and pharynx P push the bolus downward (see (2) in the figure). Then, the pharynx P is attracted to the hyoid bone (see (3) in the same figure), and the epiglottis is inverted to close the laryngeal mouth (see (4) in the same figure). Further, the glottal is closed (see (5) in the figure) and the bolus moves to the esophagus.
Therefore, the image analysis unit 16 analyzes a plurality of images related to the pharynx P imaged by the X-ray camera 15 and outputs a detection result as to whether the movement of the epiglottis of the pharynx P described above performs a predetermined movement. The image analysis unit 16 outputs a detection signal indicating that the pharynx P does not perform a predetermined movement when it is determined that the position change of the pharynx P, for example, the epiglottis or the like is equal to or less than a predetermined change amount.

Furthermore, the dysphagia determining means 4B will be described in detail with reference to FIG. 8 and FIG.
As shown in FIG. 8 and FIG. 11, the dysphagia determining means 4B performs image analysis even though the distance analysis unit 14 outputs a detection result indicating that mastication of the subject A continues. When the detection result indicating that the pharynx P does not perform the predetermined movement is output by the unit 16, the determination result indicating that the subject A has a dysphagia is output.

The dysphagia detection system according to the present invention does not determine dysphagia after detecting the swallowing motion (swallowing sound, etc.) of the subject as in the prior art described in Patent Documents 1 to 3. It is configured to detect a dysphagia by detecting that an automatic swallowing movement due to the absence of movement of the pharynx or larynx, which is the previous stage of the above, is detected. Therefore, according to the dysphagia detection system according to the present invention, the swallowing motion itself occurs even for a demented patient who is difficult to understand words or who is difficult to explain his / her situation in words. Not automatically can be detected quickly.
Further, in the present invention, the mastication operation and the swallowing operation are accurately detected by the mastication detection means and the movement detection means, respectively. Therefore, even if the patient's chewing action is normally performed as in the prior art described in Patent Document 4 above, the caregiver does not care about an abnormal swallowing reflex of the patient, The burden on caregivers and patients, such as unnecessarily long meals, can be reduced.

  As mentioned above, although preferable embodiment of this invention was described, the structure of this invention is not limited to these embodiment.

The mastication detection means is not limited as long as it can detect whether or not the subject's mastication continues. As the mastication detection means, for example, the mastication detection means disclosed in Japanese Patent No. 3914480 may be used in addition to the above embodiment.
Further, instead of the microwave Doppler sensor of the second embodiment, a phased array radar, a laser radar, an infrared sensor, or an ultrasonic sensor may be used.

The movement detecting means is not limited as long as it can detect whether the pharynx or larynx is moving in a predetermined manner.
For example, an ultrasonic camera may be used instead of the X-ray camera of the second embodiment. In the second embodiment, the means for detecting the movement of the pharynx has been described. As a means for detecting the movement of the larynx, a visible ray capable of externally photographing the position of the subject's larynx (for example, the position of the throat) A camera or a stereo camera may be used.

1, 1A, 1B Dysphagia detection system 2, 2A, 2B Mastication detection means 3, 3A, 3B Motion detection means 4, 4A, 4B Dysphagia determination means 5 Sound sensor 6 Sound analysis unit 7 Pressure sensor 8 Pressure sensor body 9 Force member 10 Support member 10a First support member 10b Second support member 11 Band 12 Pressure analysis unit 13a, 13b Ranging sensor (Doppler sensor)
14 Distance analysis unit 15 Imaging camera (X-ray camera)
16 Image analysis part A Patient (subject)
L Larynx P Pharynx

Claims (8)

Mastication detecting means for detecting a physical quantity related to the mastication movement of the subject and outputting a detection result as to whether or not the subject's mastication continues based on the physical quantity related to the mastication movement;
A motion detection unit that detects a physical quantity related to movement of the pharynx or larynx of the subject and outputs a detection result indicating whether the pharynx or larynx is performing a predetermined movement based on the physical quantity related to movement of the pharynx or larynx. When,
Dysphagia determining means for outputting a determination result as to whether the subject has a dysphagia based on the detection results of the mastication detecting means and the motion detecting means, and
The dysphagia determining means outputs a detection result indicating that mastication of the subject is continued by the mastication detection means, but the pharynx or larynx is predetermined by the motion detection means. And a detection result indicating that the subject has a dysphagia when the detection result indicating that the subject is not moving is output.   The physical quantities related to the mastication operation are the sound in the mouth when the subject is chewed, the position of the jaw that moves when the subject is chewed, the myoelectric potential of the muscles involved in the subject's chewing, and the subject 2. The dysphagia detection system according to claim 1, wherein the dysphagia detection system is at least one of blood flow related to blood vessels involved in chewing.   The dysphagia detection system according to claim 1, wherein the physical quantity related to the movement of the pharynx or larynx is related to the position of the pharynx or larynx of the subject. The mastication detecting means outputs a detection result indicating whether or not mastication of the subject continues by analyzing a sound sensor capable of measuring a sound in the mouth during mastication of the subject and output of the sound sensor Sound analysis unit
The dysphagia determining means determines whether the pharynx or larynx is predetermined by the movement detecting means, although the detection result indicating that the subject continues to chew is output by the sound analysis unit. 2. The dysphagia detection system according to claim 1, wherein a determination result indicating that the subject has a dysphagia is output when a detection result indicating that the subject is not moving is output. . The mastication detecting means includes a distance measuring sensor capable of measuring a position of a jaw that moves when the subject is chewed, and a detection result of whether the mastication of the subject continues by analyzing an output of the distance measuring sensor And a distance analysis unit that outputs
The dysphagia determining means determines whether the pharynx or larynx is predetermined by the movement detecting means even though the distance analysis unit outputs a detection result indicating that the subject continues to chew. 2. The dysphagia detection system according to claim 1, wherein a determination result indicating that the subject has a dysphagia is output when a detection result indicating that the subject is not moving is output. . The movement detection means includes a pressure sensor capable of measuring the position of the larynx of the subject, and a pressure analysis unit that analyzes the output of the pressure sensor and outputs a detection result indicating whether the larynx is performing a predetermined movement. And consist of
The dysphagia determining means has a predetermined movement of the larynx by the pressure analysis unit even though the detection result indicating that the subject's mastication is continued is output by the mastication detecting means. 3. The dysphagia detection system according to claim 1, wherein when the detection result indicating that the subject has not performed is output, the determination result indicating that the subject has a dysphagia is output. . The movement detecting means is a distance measuring sensor capable of measuring the position of the larynx of the subject, and a distance for analyzing the output of the distance measuring sensor and outputting a detection result of whether the larynx is moving in a predetermined manner It consists of an analysis department,
The dysphagia determining means has a predetermined movement of the larynx by the distance analysis unit even though the detection result indicating that the subject's mastication is continued is output by the mastication detecting means. 3. The dysphagia detection system according to claim 1, wherein when the detection result indicating that the subject has not performed is output, the determination result indicating that the subject has a dysphagia is output. . The motion detection means includes an imaging camera that internally captures the position of the subject's pharynx and obtains and outputs a fluoroscopic image; and whether the pharynx is performing a predetermined motion by analyzing the output of the imaging camera And an image analysis unit that outputs the detection results of
The dysphagia determining means has a predetermined movement of the pharynx by the image analysis unit even though the detection result indicating that the subject's mastication is continued is output by the mastication detecting means. 3. The dysphagia detection system according to claim 1, wherein when the detection result indicating that the subject has not performed is output, the determination result indicating that the subject has a dysphagia is output. .

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