JP2013066570A - Vital measuring instrument - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a vital measuring instrument capable of contributing to an early detection of worsening of subject's condition.SOLUTION: This vital measuring instrument 10 includes: a first detecting section 21 that detects respiration movement of a subject and acquires a first respiration waveform on the basis of the respiration movement; and a second detecting section 22 that detects the respiration movement of the subject in the lower extremity side of the subject with respect to the first detecting section and acquires a second respiration waveform on the basis of the respiration movement. When the first respiration waveform and the second respiration waveform have opposite phases, this vital measuring instrument outputs a waveform obtained by adding and averaging a phase-inverted waveform formed by inverting the phase of the first respiration waveform and the second respiration waveform, as an evaluation respiration waveform and, when detecting that the first respiration waveform and the second respiration waveform do not have opposite phases, outputs a waveform obtained by adding and averaging the first respiration waveform and the second respiration waveform, as the evaluation respiration waveform.

Description

  The present invention relates to a vital measuring instrument that measures vitals related to the respiratory function of a subject.

  Infectious diseases such as pneumonia and urinary tract infections currently account for the top causes of death among the elderly. In general, infectious diseases in elderly people often have few symptoms such as fever, and there are not a few cases of seriousness and death due to delay in coping. For this reason, it is important to start treatment by early detection. Regarding pneumonia, it is usually possible for a doctor to make a distinction by listening to the sound of the chest with a stethoscope, and a diagnosis can be made more reliably by performing a chest X-ray examination. A urinary tract infection can be diagnosed by performing a blood test, urine culture, abdominal CT examination, abdominal echo examination, or the like. In other words, an infectious disease can be said to be a disease that can be prevented from becoming serious if it is diagnosed by a doctor or the like under an appropriate examination facility. However, in the case of a hospital or a specific nursing care facility equipped with the above-mentioned inspection equipment and a doctor, the early diagnosis is possible, but the elderly who receive home care or general care In the first place, it is difficult to receive such a diagnosis at an early stage in the case of an elderly person in a facility or a medical depopulated area.

  In situations where there are no testing facilities and no doctor to judge, caregivers must distinguish signs of pneumonia and urinary tract infections from daily vital fluctuations, but caregivers should make such decisions. Is not easy. In fact, even if it is determined that there is a suspicion of an infectious disease, it is difficult to make a sufficient judgment on the severity, and it is often the case that the situation is dealt with after a while. For this reason, there is a need for a medical device that can be easily measured by caregivers and the like and can determine the deterioration of the condition at an early stage in the above-mentioned care sites and medical depopulated areas. Yes.

  In recent years, in early detection of infectious diseases such as pneumonia and urinary tract infections, diagnostic methods focusing on respiratory function evaluation have been attempted. In the respiratory function, the respiratory rate is counted as a basic vital together with the body temperature, blood pressure, and pulse, and is regarded as an extremely important item in judging the condition of the patient (subject). The respiration rate of a healthy person is about 20 times / minute, and if it exceeds 25 times / minute, it is treated as tachypnea, which is particularly important in infectious disease diagnosis, and is useful in determining the severity of a subject. It is an indicator. Specifically, in Port Score (see Non-Patent Document 1) and CURB-65 (see Non-Patent Document 2) which are criteria for determining the severity of pneumonia, respiratory rate ≧ 30 times / min is the criteria for determining the severity. It is taken up as an item.

  In addition, as a device for measuring respiration, an air bag in which a sensor is embedded as described in Patent Document 1 and Patent Document 2 because many elderly people who frequently have infectious diseases are bedridden. There has been proposed a mattress-type respiratory rate measuring device in which a patient is placed on the body, body vibration associated with the patient's respiratory motion is detected, and the respiratory rate is measured based on the detection result.

“The New ENGLAND JOURNAL OF MEDICINE”, 1997, Vol. 336, p. 243-250 “Thorax”, 2001, Vol. 56, p. 296-301

JP 2001-145605 A JP 2001-276019 A

  By the way, in order to properly evaluate the patient's health based on the respiratory function, instead of focusing only on the respiratory rate, the evaluation index is the respiratory balance of inspiration and expiration that appears in the respiratory waveform that changes over time. It becomes important to use as.

  However, the respiratory waveform may be detected as a waveform having different phases on the chest side and the abdomen side depending on the sensing method and the breathing method performed by the human body. In particular, when detecting fluctuations in body pressure due to breathing that occur between the bed and back of a subject in the supine position, in chest breathing, respiratory waveforms (body pressure vibrations) in the same phase on the chest and abdomen However, in abdominal breathing, it is known that respiratory waveforms with opposite phases are detected on the chest side and the abdomen side. Specifically, body pressure fluctuation derived from breathing detected on the abdominal side during abdominal breathing is detected as a pressure increase during inspiration and a pressure drop during expiration. Usually, medical staff use a graph that rises and falls during inspiration as a breathing curve to diagnose whether there is an abnormality in inspiration or expiration. If it is output, it may hinder early detection of physical deterioration.

  Up to now, there is no prior art that outputs a waveform that rises during inspiration and falls during exhalation in a device that installs a sensor under the body of a subject in a supine position and detects respiratory vibration, A technique for solving this has been demanded.

  The present invention has been made in view of the above problems, and an object of the present invention is to provide a vital measuring instrument that can contribute to early detection of deterioration of the condition of a subject.

  The above object of the present invention can be achieved by any of the following means.

(1) A vital measuring instrument for measuring vitals related to the respiratory function of a subject,
A first detector that detects a respiratory motion of the subject and obtains a first respiratory waveform based on the respiratory motion;
A second detector that detects the respiratory motion of the subject on the lower limb side of the subject relative to the first detector and acquires a second respiratory waveform based on the respiratory motion;
A phase detector for detecting a phase difference between the first respiratory waveform and the second respiratory waveform;
An output unit that generates and outputs an evaluation respiratory waveform representatively indicating the respiratory motion of the subject from the first respiratory waveform and the second respiratory waveform;
When the phase detector detects that the phase of the first respiratory waveform and the phase of the second respiratory waveform are opposite phases, the phase of the first respiratory waveform is inverted. A waveform obtained by averaging the inverted phase waveform and the second respiration waveform is output as the evaluation respiration waveform, and the phase detection unit calculates the phase of the first respiration waveform and the second respiration waveform. When it is not detected that the phase is in reverse phase, a vital measurement device is characterized in that a waveform obtained by averaging the first respiratory waveform and the second respiratory waveform is output as the respiratory waveform for evaluation. .

(2) It further includes a determination unit that determines whether or not the first detection unit has detected a respiratory motion, and whether or not the second detection unit has detected a respiratory motion,
The output unit outputs an inverted phase waveform obtained by inverting the phase of the first respiratory waveform as the evaluation respiratory waveform when the determination unit determines that only the first detection unit has detected respiratory motion. When the determination unit determines that only the second detection unit has detected respiratory motion, the second respiration waveform is output as the evaluation respiration waveform. The vital instrument described.

  (3) The information processing apparatus further includes a notification unit that notifies that no respiratory motion has been detected when the determination unit determines that the first detection unit and the second detection unit have not detected the respiratory motion. The vital measuring instrument according to (2) above, which is characterized.

(4) At least one of the first detection unit and the second detection unit is
Fluid is sealed inside, a fluid bag on which the back or waist of the subject is placed,
A sensor that acquires a respiration waveform from a change in pressure in the fluid bag due to body vibration based on a respiration motion of the subject, and any one of the above (1) to (3) The vital instrument described.

(5) At least one of the first detection unit and the second detection unit is
The vital measuring instrument according to any one of (1) to (4), wherein the vital measuring instrument is configured by any one of a piezoelectric film, a piezoelectric sheet, a capacitive pressure sensor, and a pressure sensitive sensor. .

  When the first and second detectors that detect respiratory motion in different parts of the subject respectively obtain respiratory waveforms in opposite phases, the vital measuring device of the present invention is on the lower limb side than the first detector. A respiratory waveform for evaluation representatively representing the respiratory motion of the subject is output in accordance with the phase of the respiratory waveform acquired by the second detector disposed in the. Therefore, regardless of the breathing method of the subject, a respiratory waveform acquired on the abdominal side of abdominal breathing and a waveform in phase with the respiratory waveform acquired in chest respiratory can be output as a respiratory waveform for evaluation. it can. This makes it possible to appropriately determine the health condition of the subject based on the respiratory waveform for evaluation, which can contribute to the early detection of the condition deterioration of the subject.

1A and 1B are diagrams schematically illustrating a usage state of a vital measuring device according to the embodiment, in which FIG. 1A is a perspective view and FIG. 1B is a side view. 2A and 2B are diagrams showing the overall configuration of the vital measuring instrument, FIG. 2A is a plan view of the vital measuring instrument, and FIG. 2B is a side view of the vital measuring instrument. FIG. 3 is a diagram illustrating a main part of the vital measuring device, FIG. 3A is a cross-sectional view of a fluid bag provided in the detection unit, and FIG. 3B is an enlarged view of a display unit. It is a block diagram which simplifies and shows the control system of a vital measuring device. 5A and 5B are diagrams for explaining the phase of the respiration waveform for each respiration method. FIG. 5A is a diagram illustrating the arrangement of detection units, and FIG. FIG. 5C is a diagram showing a respiratory waveform having an opposite phase. It is a figure which shows the relationship between arrangement | positioning of a detection part, and the respiration waveform acquired in each respiration method. It is a flowchart which shows the whole measurement procedure by a vital measuring device. It is a flowchart which shows the processing content shown to step 12 of FIG. It is a figure which shows simply the content of the measurement process which a vital measuring device performs. FIGS. 10A to 10C are diagrams showing a modification example (1) of the detection unit. FIGS. 11A to 11C are diagrams showing a modification example (1) of the detection unit. It is a figure which shows the modification example (2) of a detection part.

  Hereinafter, the present invention will be described based on embodiments with reference to the drawings. In the description of the drawings, the same elements are denoted by the same reference numerals, and redundant description is omitted. The dimensional ratios in the drawings are exaggerated for convenience of explanation, and may differ from actual ratios.

  FIG. 1 shows a usage example of a vital measuring instrument 10 according to an embodiment of the present invention. The vital measuring instrument 10 is used for the subject 90 in a state of being laid on a bed or a mattress, for example, and makes it possible to measure the respiratory rate of the subject 90 as a basic vital. Is. Examples of the subject 90 to be used include an elderly person receiving home care, and a supine patient suffering from an infection such as pneumonia or urinary tract infection.

  First, the overall configuration of the vital measuring instrument will be described.

  With reference to FIG. 1 and FIG. 2, the vital measuring device 10 according to the embodiment detects a respiratory motion of the subject 90 and acquires a respiratory waveform based on the respiratory motion and a second detector 21. A main body 30 that displays a respiratory waveform for evaluation indicating a typical respiratory motion of the subject 90 generated based on the detection results of the detection unit 22 and the first detection unit 21 and the second detection unit 22; ,have.

  As shown in FIG. 1, the second detection unit 22 is disposed on the lower limb side of the subject 90 with respect to the first detection unit 21. For example, the first detection unit 21 is disposed near the chest of the subject 90, and the second detection unit 22 is disposed near the abdomen of the subject 90. In addition, the broken line part of FIG. 1 illustrates the target range in which the respiratory waveform is detected by the first detection unit 21 and the second detection unit 22.

  It is desirable that the first detection unit 21 and the second detection unit 22 are arranged with a predetermined interval. As will be described later, when the subject 90 performs abdominal breathing, respiratory motion may not be detected in the vicinity of the subject 90. When the first detection unit 21 and the second detection unit 22 are arranged close to each other, and when both the detection units 21 and 22 are arranged near the groove, there is a possibility that the respiratory motion is not detected. For this reason, in this embodiment, the predetermined space | interval is provided between the 1st detection part 21 and the 2nd detection part 22 so that it may not become a measurement result that respiratory motion is not detected. Although the dimension of a space | interval is not specifically limited, It is preferable to provide the space | interval of at least 10 cm or more.

  The main body 30 includes a housing 31, a control unit 63 that is disposed in the housing 31 and controls the measurement system of the vital measuring device 10 (see FIG. 4), and a display unit that displays a respiratory rate and a respiratory waveform 32, and various operation switches 35 and 37 for operating switching of display contents and the like. As the material of the casing 31, for example, a hard plastic material generally used for a hard cover of electronic devices is used.

  Each of the first detection unit 21 and the second detection unit 22 encloses fluid therein, and fluid bags 51 and 52 on which the back or waist of the subject 90 is placed, and the breathing of the subject 90 And sensors 41 and 42 for acquiring a respiratory waveform from pressure fluctuations in the fluid bags 51 and 52 due to body vibration based on exercise.

  Each of the sensors 41 and 42 is used for measuring body vibration caused by the respiratory motion of the subject 90. For the sensors 41 and 42, a known omnidirectional microphone used for air pressure detection is used, but the present invention is not limited to this, and a condenser microphone, a pressure sensor, a PVDF (Poly Vinylidene Di Fluoride) sensor, Various piezoelectric films and piezoelectric sheets represented by EMFiT sensors, capacitive pressure sensors (capacitance type surface pressure sensors), pressure sensors (Force Resistor Sensor: FSR), strain gauges, etc. are matched to the characteristics of the fluid. It can be used as appropriate. As will be described later, when a piezoelectric film, a piezoelectric sheet, a capacitive pressure sensor, or a pressure sensor is used, the detection unit can be configured without using a fluid bag.

  Each sensor 41, 42 transmits the acquired respiratory waveform to the control unit 63 built in the main body unit 30 (see FIG. 4). The transmission of the respiration waveform is performed by the first lead 61 that electrically connects the sensor 41 and the control unit 63 provided in the first detection unit 21, and the sensor 42 and the control unit 63 provided by the second detection unit 22. Through a second lead wire 62 that electrically connects the two. In addition, transmission / reception of the respiration waveform performed between each sensor 41,42 and the control part 63 is not limited to the form using a lead wire, The transmission / reception method using a general electric cable, wireless It is also possible to adopt a transmission / reception method by a method. Moreover, in the example of illustration, although each sensor 41 and 42 is each arrange | positioned in the fluid bags 51 and 52, the arrangement | positioning location is not limited only in the fluid bag. For example, it is possible to adopt a form in which a fluid passage that communicates the inside of the fluid bag and the inside of the main body is provided and a sensor is installed in the fluid passage. It is also possible to install a sensor in the housing 31 provided in the main body 30.

  With reference to FIG. 3 (A), each fluid bag 51 and 52 is comprised from the sheet-like member which can enclose a fluid inside. Although the material of the fluid bags 51 and 52 is not particularly limited, for example, flexible rubber, plastic, cloth material or the like having airtightness can be used. The fluid bags 51 and 52 are formed in a comparatively small size, each side of the outer peripheral portion is about 3 cm and 15 cm, respectively, and the thickness at the time of maximum expansion is about 1 cm. As the fluid, for example, air, water, oil, polymer gel, or the like can be used.

  A support member 71 that elastically supports the fluid bags 51, 52 and a backing material 73 that prevents diffusion of body vibration transmitted to the fluid bags 51, 52 are attached to the fluid bags 51, 52.

  The support member 71 may be made of a material that can elastically support the fluid bags 51 and 52 such as a latex balloon, a sponge, and a gel. When a balloon is used, a fluid such as air or water is injected into the balloon via a fluid injection port (not shown in the drawing) and inflated. Further, after use, the fluid injected into the balloon can be discharged, and the balloon can be stored in a case or the like together with the deflated fluid bags 51 and 52.

  The support member 71 supports the fluid bags 51 and 52 so as to push up from the bed 80 side, and exhibits a function of stabilizing the contact between the fluid bags 51 and 52 and the subject 90. Since the fluid bags 51 and 52 are stably held with respect to the subject 90, it is possible to prevent the fluid bags 51 and 52 from being displaced even when the subject 90 turns over. .

  For the backing material 73, for example, a non-stretchable plastic film, a metallic thin plate, a film, or the like can be used. As the plastic film, for example, a resin plate or film made of PET resin, polyethylene resin, polypropylene resin, polyester resin, acrylic resin, nylon resin, urethane resin, vinyl chloride resin, or the like can be used. Also, copolymers of various vinyl monomers such as ethylene vinyl acetate copolymer can be used.

  The thickness of the backing material 73 is not particularly limited, but it is preferable to use a material having a thickness of about 1 mm from the viewpoint of reducing the size and thickness of the vital measuring instrument 10. The vital measuring instrument 10 may be configured to include only one of the support member 71 and the backing material 73. In the case of a configuration including both the support member 71 and the backing material 73, for example, the vertical relationship of the installation positions shown in FIG. 3A can be reversed.

  Referring to FIG. 4, the control unit 63 built in the main body 30 performs various arithmetic processes based on the waveform signals transmitted from the sensors 41 and 42 when the pressure in the fluid bags 51 and 52 fluctuates. An arithmetic processing unit to perform, a display control circuit that controls the content displayed on the display unit 32, and a control circuit that controls each of the sensors 41 and 42, the arithmetic processing unit, and the display control unit 63. .

  The arithmetic processing unit performs various calculations and processing on the waveform signals obtained by the sensors 41 and 42. The arithmetic processing unit also controls operations such as displaying the measured respiration rate on the display unit 32 and issuing a warning alarm from the audio output unit.

  The arithmetic processing unit functions as a phase detection unit, an output unit, and a determination unit. Here, the phase detector detects a phase difference between the first respiratory waveform acquired by the first detector 21 and the second respiratory waveform acquired by the second detector 22. The output unit generates and outputs a respiratory waveform for evaluation that typically represents the respiratory motion of the subject from the first respiratory waveform and the second respiratory waveform. The determination unit determines whether or not the first detection unit 21 has detected a respiratory motion, and whether or not the second detection unit 22 has detected a respiratory motion.

  The arithmetic processing unit is calculated with a ROM that stores a program corresponding to the phase detection unit, the output unit, and the determination unit, and a program that processes the waveform signals transmitted from the sensors 41 and 42 to predict and calculate the respiration rate. A RAM for storing respiratory waveform data in time series, and an EEPROM for storing predetermined audio data and the like. The functions of the phase detection unit, the output unit, and the determination unit are exhibited when the arithmetic processing unit executes a program corresponding to each of the functions.

  Referring to FIG. 3B, the power switch 33 provided in the main body 30 is for operating on / off of the power source of the vital measuring instrument 10. The mode switch 35 is used to switch between the real-time measurement mode and the memory data browsing mode. When using the real-time measurement mode, for example, a warning alarm function is used together. When the respiratory rate exceeding the setting is measured, a warning sound is emitted to notify the user of the occurrence of vital abnormality at an early stage. The warning alarm is preferably set so that a warning sound is emitted when the respiratory rate reaches 30 times / min or more, or when it reaches 8 times / min or less, for example. This is because the respiration rate of a healthy person is about 15 to 20 times / min, and when it exceeds 30 times / min, it is judged as serious.

  The waveform confirmation switch 37 is for confirming the respiratory movement waveform data stored in the RAM. By pressing the left and right waveform confirmation switches 37 in the memory data browsing mode, it is possible to display the waveform at the end of measurement from the waveform at the start of measurement on the display 31 in time series.

  At the right end of the display 31, it is possible to display the respiratory rate together with the respiratory waveform. As illustrated, for example, a respiratory rate (RR) for one minute is displayed. The respiration rate is calculated on the basis of data sampled at a predetermined time on the waveform measurement start side (knitted portion in the figure. For example, about 15 seconds), and displayed on the right end of the display unit 32 in real time. It is possible.

  In the vital measuring instrument 10 according to the embodiment, not only the respiration rate but also the balance between inspiration and expiration appearing in the respiration waveform and the temporal change of the respiration waveform are displayed on the display unit 32. In a healthy person's breath, there is a slight rest period between exhalation and inspiration, inspiration is slightly faster than exhalation, and the ratio is approximately 1: 1.5. However, changes such as tachycardia and polypnea almost disappear during the rest period, and in the case of expiratory dyspnea such as a bronchial asthma attack, extension of expiration may be observed. On the other hand, in the case of inspiratory dyspnea due to pulmonary edema or the like, it is known that the ratio of inspiration to expiration becomes about 1: 1, and breathing becomes faster. As described above, information on the periodicity of inspiration and expiration is useful for determining the condition of the subject 90, and therefore it is desirable that the evaluation can be performed with quantitativeness without relying on simple visual inspection.

  FIG. 5 shows the relationship between the installation position of the detection unit and the detected respiratory waveform. For example, in the case where the subject 90 performs abdominal breathing, if the detection units are arranged at points A and B near the lower abdomen, the respiratory waveform shown in FIG. 5B is acquired. The breathing waveform swings in the positive direction (upper side in the figure) during inspiration, and the respiratory waveform swings in the negative direction (lower side in the figure) during expiration. On the other hand, when a detection unit is installed at points D and E near the chest, a respiratory waveform shown in FIG. 5C is acquired. The breathing waveform swings in the positive direction (upper side in the figure) during expiration, and the respiratory waveform swings in the negative direction (lower side in the figure) during inspiration. In addition, when a detection unit is arranged at point C near the groove, a respiratory waveform is not acquired. This is because the respiration waveform is canceled by the diaphragm movement accompanying respiration. When the subject 90 performs chest-type breathing, the waveform oscillates in the positive direction during exhalation and the inspiration occurs when the detection unit is placed near the lower abdomen, the chest, or the groove. The waveform oscillates in the negative direction.

  Thus, when the subject 90 performs abdominal breathing, the respiratory waveform acquired in the vicinity of the chest is acquired from the respiratory waveform acquired in the vicinity of the lower abdomen or the subject 90 performing chest respiratory. It becomes a waveform having a phase opposite to that of the respiratory waveform (a waveform having a phase difference of −π).

  FIG. 6 shows the relationship between the breathing waveform acquired by the detection unit and each breathing method. As shown in this figure, depending on the breathing method of the subject 90 and the arrangement of the detection units, the respiratory waveform may not be acquired or the respiratory waveform may be output with a different phase.

  In addition, when the subject 90 is performing thoracoabdominal respiration combined with abdominal respiration and chest respiration, if the detection unit is disposed near the lower abdomen, The waveform fluctuates in the negative direction during exhalation, but if a detector is placed near the chest, a sine wave corresponding to inspiration and expiration may not be obtained. This is because respiratory vibrations derived from chest respiration and respiratory vibrations derived from abdominal breathing are mixed and both vibrations cancel each other. In addition, after breathing with the abdominal type, if the abdominal type and the chest type are out of timing during a single breath, for example, the breathing vibrations are added together, This is because it is output at a frequency twice as high as the respiration.

  In the medical field, medical examinations and diagnoses based on the output results of respiratory waveforms are empirically determined from waveforms obtained near the lower abdomen of abdominal breathing and waveforms (positive phase) obtained in chest breathing. Of respiration waveform). For this reason, it is not preferable from the viewpoint of early detection of the deterioration of the condition of the subject that the patient's health condition is determined based on the respiratory waveform output in the opposite phase. Therefore, the vital measuring instrument 10 can output an appropriate respiration waveform as an evaluation index according to the measurement process described below.

  With reference to FIG. 7, when using the vital measuring instrument 10, the first detection unit 21 and the second detection unit 22 are set on the subject 90. At this time, it is desirable that the first detection unit 21 and the second detection unit 22 are respectively arranged on the body axis of the subject 90. Since the body pressure of the subject 90 is equally applied to the first detection unit 21 and the second detection unit 22, the first detection unit 21 and the second detection unit 22 can breathe with a more uniform signal intensity. This is because a waveform can be acquired.

  In step 11, the sensor 41 (hereinafter referred to as “sensor H”) included in the first detection unit 21 and the sensor 42 (hereinafter referred to as “sensor L”) included in the second detection unit 22 provide the body pressure. Determine whether to detect.

  In step 11, when both the sensor H and the sensor L have detected body pressure, it progresses to step 12 which performs a measurement process. Step 12 will be described later.

  If either sensor H or sensor L does not detect body pressure, the process proceeds to step 13. In step 13, an instruction to change the installation location of the first detection unit 21 and the second detection unit 22 is given. That either sensor H or sensor L does not detect body pressure means that the first detection unit 21 and the second detection unit 22 are not arranged under the body of the subject 90 or from the body. It may be arranged at a position greatly deviated. In such a case, since the respiratory waveform cannot be acquired by the first detection unit 21 and the second detection unit 22, an instruction to change the installation location is given. The change instruction is performed, for example, by issuing a warning sound from the audio output unit or by displaying a warning image indicating that the change should be performed on the display unit 32.

  In step 12, various measurement processes based on the acquired respiratory waveform are performed. This measurement process is executed by a predetermined program stored in advance in the ROM of the control unit 63.

  Referring to FIG. In step 21, it is determined whether both the sensor H and the sensor L have detected a respiratory motion. When both the sensor H and the sensor L detect the respiratory motion, the process proceeds to step 22. If any of the sensors H and L has not detected a respiratory motion, the process proceeds to step 31. Step 31 will be described later.

  In step 22, the phase difference between the respiratory waveform acquired by the sensor H (hereinafter referred to as “first respiratory waveform”) and the respiratory waveform detected by the sensor L (hereinafter referred to as “second respiratory waveform”) is detected. And evaluate. Next, the process proceeds to step 23.

  In step 23, it is determined whether or not the phase of the first respiratory waveform is opposite to the phase of the second respiratory waveform (whether there is a phase difference of −π). If it is determined in step 23 that the waveform has an antiphase, the process proceeds to step 24. If it is determined in step 23 that the waveform is not in antiphase, the process proceeds to step 25.

  In step 24, the inverted phase waveform obtained by inverting the phase of the first respiratory waveform and the second respiratory waveform are added and averaged. Next, in step 26, the averaged waveform is output as an evaluation respiratory waveform. The output is performed, for example, in a form in which the respiratory waveform for evaluation is displayed on the display unit 32 of the vital measuring instrument 10.

  In step 25, the first respiratory waveform and the second respiratory waveform are added and averaged. Next, in step 26, the averaged waveform is output as an evaluation respiratory waveform.

  Next, in the case of proceeding to step 31, if it is determined that only the sensor H is detecting the respiratory motion, the process proceeds to step 32. When other determination results are obtained, the process proceeds to step 33.

  In step 32, an inverted phase waveform obtained by inverting the phase of the first respiratory waveform is output as an evaluation respiratory waveform.

  When it proceeds to step 33, when it is determined that only the sensor L is detecting respiratory motion, the process proceeds to step 34, and when other determination results are obtained, the process proceeds to step 35.

  In step 34, the second respiratory waveform is output as an evaluation respiratory waveform.

  In step 35, an instruction to change the installation location of the first detection unit 21 and the second detection unit 22 is given. The fact that both the detection units of the first detection unit 21 and the second detection unit 22 do not detect respiratory movement means that the breathing method of the subject 90 is thoracoabdominal breathing and the first detection unit 21 and the second detection unit 22 are considered to be disposed near the chest (see FIG. 6). In this case, since there is a possibility that an appropriate respiratory waveform for evaluation cannot be output, an instruction to change the installation location is given. The change instruction is given by a notification unit provided in the vital measuring instrument 10. An audio output unit is used as the notification unit. That is, the change instruction is notified by issuing a warning sound from the audio output unit. It is also possible to cause the display unit 32 to function as a notification unit by displaying a warning image indicating that a change should be made on the display unit 32.

  In the subroutine of the measurement process (step 12), the first detector 21 and the second detector 22 installed in the subject 90 are removed from the subject 90, or the vital measuring instrument 10 is turned off. It is executed until it is done. Thereby, the respiratory waveform for evaluation is displayed on the display unit 32 over time. In the chart of FIG. 9, the relationship between the detection results of the sensors H and L described in the flowchart of FIG. 8 and the measurement process is simply shown.

  According to the vital measuring instrument 10 according to the present embodiment, when the first and second detection units 21 and 22 that detect the respiratory motion in different parts of the subject 90 respectively obtain respiratory waveforms in opposite phases, An evaluation respiratory waveform representatively representing the respiratory motion of the subject 90 is output in accordance with the phase of the respiratory waveform acquired by the second detection unit 22 arranged on the lower limb side relative to the first detection unit 21. For this reason, regardless of the breathing method of the subject 90, a respiratory waveform acquired on the abdominal side of abdominal breathing and a waveform in phase with the respiratory waveform acquired in chest respiratory are output as a respiratory waveform for evaluation. Can do. This makes it possible to appropriately determine the health status of the subject 90 based on the respiratory waveform for evaluation, which can contribute to early detection of the condition deterioration of the subject 90.

  When only the first detection unit 21 detects the respiratory motion, an inverted respiratory waveform obtained by inverting the first respiratory waveform is output as an evaluation respiratory waveform, and only the second detection unit 22 performs the respiratory motion. Is detected, the second respiratory waveform is output as it is as an evaluation respiratory waveform. Therefore, when the respiratory waveform of either the first respiratory waveform or the second respiratory waveform is acquired, the positive-phase respiratory waveform is output as the evaluation respiratory waveform, and therefore, based on the positive-phase respiratory waveform. It is possible to determine the health status of the subject 90.

  In addition, when no respiratory motion is detected by the first detection unit 21 and the second detection unit 22, the notification unit notifies the user who observes the subject 90 and the vital measuring instrument that the respiratory motion has not been detected. Inform. By performing notification by the notification unit, it is possible to notify the subject 90 and the user that the respiratory waveform for evaluation is not output.

  In addition, each of the first detection unit 21 and the second detection unit 22 acquires a respiration waveform from fluctuations in pressure in the fluid bags 51 and 52 on which the back or waist of the subject 90 is placed. By using the fluid bags 51 and 52 as the detection unit, body vibration based on respiratory motion can be detected with high accuracy, so that the detection unit can be downsized, and thus the vital measuring instrument 10 can be downsized. Thereby, it becomes possible to provide the vital measuring instrument 10 with improved portability.

(Modification 1)
Next, modified examples of the first detection unit 21 and the second detection unit 22 will be described. In the above-described embodiment, the configuration in which the first detection unit 21 and the second detection unit 22 are arranged on the substantially rectangular support member 71 is shown. It is not limited to such a form. Hereinafter, a modification example of the detection unit will be described with reference to FIGS. 10 and 11. In addition, the same code | symbol is attached | subjected to the member same as embodiment mentioned above, and the description is abbreviate | omitted.

  In the modification shown in FIG. 10A, a substantially circular support member 71 is attached in accordance with the shapes of the first detection unit 21 and the second detection unit 22. Since the support member 71 is configured to be smaller, the support member 71 can be smoothly placed on the back or waist of the patient in the supine position.

  In the modified example shown in FIG. 10B, three detectors 21, 22, and 23 are provided along the body axis direction. According to such a configuration, the respiratory motion of the subject 90 can be detected at three locations. Then, by calculating and averaging the respiratory waveforms acquired by the three detectors 21, 22, and 23, it is possible to output a respiratory waveform for evaluation with higher reliability.

  In the modified example shown in FIG. 10C, three detection units 21, 22, and 23 are provided along the body axis direction, and three detection units 23, 24, and 25 are provided in a direction crossing the body axis direction. Yes. The respiratory waveforms acquired by the three detectors 23, 24, 25 provided in the direction intersecting the body axis direction are averaged, and further, the three detectors 21, 22, arranged in a line along the body axis direction By calculating and averaging the respiratory waveforms acquired by 23, it is possible to output a respiratory waveform for evaluation with higher reliability than the modified example shown in FIG.

  In the modified example shown in FIG. 11A, the fluid bags 51 and 52 are formed in a substantially rectangular outer shape instead of a round outer shape. Even when the fluid bags 51 and 52 having such a shape are used, it is possible to satisfactorily acquire a respiratory waveform.

  In the modified example shown in FIG. 11 (B), communication paths (bypasses) 81 are provided for communicating between the divided fluid bags 51 and between the divided fluid bags 52, respectively. By adopting such a configuration, when the subject 90 is placed on the fluid bags 51 and 52, the fluid bags 51 and 52 can be prevented from being crushed or kinked. Therefore, it is possible to prevent the measurement accuracy from being lowered due to the collapse or kinking of the fluid bags 51 and 52.

  In the modified example shown in FIG. 11C, the support member 71 is provided with a notch 83. As described in the above-described embodiment, there may occur a case where the respiratory motion is not detected and the respiratory waveform cannot be acquired in the vicinity of the dent of the subject 90. For example, as in this modification, if the notch 83 is provided as a guideline to be placed near the groove, the first detection unit 21 and the second detection unit 22 are placed near the groove when in use. Can be avoided. As a result, it is possible to provide the vital measuring instrument 10 with improved convenience.

(Modification 2)
In the above-described embodiment, the detection units 21 and 22 including the fluid bag and the sensor are applied to the vital measuring instrument 10, but the detection unit is not limited to such a configuration. In the form shown in FIG. 12, a piezoelectric film, a piezoelectric sheet, a capacitive pressure sensor, a pressure sensor, or the like is used as the sensors 41 and 42 for detecting body vibration, and each sensor 41 and 42 is a first detection unit. 21 and the second detection unit 22 respectively. In addition, it is also possible to use the same type of sensor among the above-mentioned sensors for the first detection unit 21 and the second detection unit 22, and different types of sensors are used for one sensor and the other sensor. It is also possible to do. Furthermore, it is also possible to configure one detection unit by a fluid bag and a sensor and to configure the other detection unit by any one of the sensors.

  In the description of the embodiment, the example in which the vital measuring device 10 is used for the subject 90 in the prone state has been shown. For example, the vital measuring device 10 is seated on a sitting patient, a chair, or the like. It is also possible to use it for the subject 90. In such a usage pattern, for example, measurement can be performed by sandwiching the detection unit of the vital measuring instrument between the belt of the trousers or installing it between the back or wall of the chair and the back of the subject.

10 vital measuring instruments,
21 1st detection part,
22 Second detector,
41 sensors,
42 sensors,
51 fluid bag,
52 fluid bag,
90 Subject.

Claims (5)

A vital measuring instrument for measuring vitals related to a subject's respiratory function,
A first detector that detects a respiratory motion of the subject and obtains a first respiratory waveform based on the respiratory motion;
A second detector that detects the respiratory motion of the subject on the lower limb side of the subject relative to the first detector and acquires a second respiratory waveform based on the respiratory motion;
A phase detector for detecting a phase difference between the first respiratory waveform and the second respiratory waveform;
An output unit that generates and outputs an evaluation respiratory waveform representatively indicating the respiratory motion of the subject from the first respiratory waveform and the second respiratory waveform;
When the phase detector detects that the phase of the first respiratory waveform and the phase of the second respiratory waveform are opposite phases, the phase of the first respiratory waveform is inverted. A waveform obtained by averaging the inverted phase waveform and the second respiration waveform is output as the evaluation respiration waveform, and the phase detection unit calculates the phase of the first respiration waveform and the second respiration waveform. When it is not detected that the phase is in reverse phase, a vital measurement device is characterized in that a waveform obtained by averaging the first respiratory waveform and the second respiratory waveform is output as the respiratory waveform for evaluation. . A determination unit that determines whether or not the first detection unit has detected a respiratory motion, and whether or not the second detection unit has detected a respiratory motion;
The output unit outputs an inverted phase waveform obtained by inverting the phase of the first respiratory waveform as the evaluation respiratory waveform when the determination unit determines that only the first detection unit has detected respiratory motion. When the determination unit determines that only the second detection unit has detected a respiratory motion, the second respiration waveform is output as the evaluation respiration waveform. Vital measuring instrument.   When the determination unit determines that the first detection unit and the second detection unit have not detected the respiratory motion, the determination unit further includes a notification unit that notifies that the respiratory motion has not been detected. The vital measuring device according to claim 2. At least one of the first detection unit and the second detection unit is:
Fluid is sealed inside, a fluid bag on which the back or waist of the subject is placed,
The sensor according to claim 1, further comprising: a sensor that acquires a respiratory waveform from pressure fluctuations in the fluid bag caused by body vibration based on respiratory motion of the subject. Measuring instrument. At least one of the first detection unit and the second detection unit is:
The vital measuring instrument according to any one of claims 1 to 4, comprising any one of a piezoelectric film, a piezoelectric sheet, a capacitive pressure sensor, and a pressure-sensitive sensor.

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