JP2014124498A - Gas injection device - Google Patents

Abstract

PROBLEM TO BE SOLVED: To automatically adjust gas pressure so as to be suitable for a patient in a gas injection device that expands an organ by using a pump to feed gas for contrast examination into the organ.SOLUTION: A gas injection device comprises: pressure setting means 5a for initializing a gas pressure; a pressure sensor 6 for detecting an internal pressure of an organ or gas feeding pressure; time counting means 4 for counting an elapsed time from pump operation; and control means 7 for controlling the pump on the basis of a pressure detection value of the pressure sensor, a pressure setting value of the pressure setting means and a time counting value of the time counting means. The control means 7 has a control for: stopping the pump when the pressure detection value after the pump operation reaches the pressure setting value; operating the pump when the pressure detection value after the pump stoppage decreases by a prescribed range from the pressure setting value; decreasing the pressure setting value by the prescribed range when the pressure detection value does not reach the pressure setting value during the elapsed time T; and increasing the pressure setting value by the prescribed range when the pressure detection value reaches the pressure setting value as many times as the prescribed number of times during elapsed time Tshorter than the elapsed time T.

Description

  The present invention relates to a gas injection device for expanding an organ by injecting a gas for contrast examination or organ expansion (carbon dioxide, air, etc.) into an organ such as an intestine or stomach of a patient. The present invention relates to a technique for automatically adjusting the pressure to a pressure suitable for a patient.

  For the purpose of diagnostic imaging of the large intestine, including the rectum, a contrast examination technique that injects gas into the intestinal tract has been performed. At that time, injection is performed while monitoring the gas pressure (intestinal pressure or gas supply pressure). This is one of the most important matters to be noted. When the pressure is low, the intestinal tract is not sufficiently expanded, and image information necessary for diagnosis cannot be obtained. On the other hand, if it is high, the gas inflow into the small intestine expands the small intestine, and the patient feels more pain than necessary. There is also a risk of developing serious complications such as intestinal rupture and intestinal perforation.

  To deal with these problems, conventional devices limit the amount of injection so that no more than a certain amount of gas can be injected, or optionally set an upper pressure limit before starting air supply, Some have added a function to repeat the gas supply and stop (or return) so as not to exceed the set pressure after measurement. However, the amount of gas received varies from person to person, and the value set before the start of air supply is not necessarily appropriate, resulting in insufficient expansion or in some cases leading to intestinal inflow.

  Therefore, it is necessary for the operator to adjust the pressure setting while performing gas supply based on experience while observing the captured image and the condition of the patient. In other words, the experience value of the operator is a very big factor for taking high-quality images and reducing patient pain, but it is not uniform, so it is not possible to set an appropriate pressure for each patient. It's not easy.

JP 2010-227484 A

  The problem to be solved by the present invention is to eliminate these conventional problems and to automatically adjust the gas pressure to a pressure suitable for the patient.

The configuration of the present invention that solves this problem is as follows.
1) Gas injection that inserts an air supply tube into the patient's mouth or anus and expands the organ by supplying gas for contrast examination or organ expansion into the organ with an air supply means consisting of a pump or a gas cylinder with an open / close valve A pressure setting means for initially setting a gas pressure; a pressure sensor for detecting an internal organ pressure or a gas supply pressure; a time counting means for counting an elapsed time from the start of operation of the air supply means; and a pressure sensor The control means for controlling the air supply means based on the pressure detection value of the pressure, the pressure setting value of the pressure setting means and the time count value of the time counting means is provided. Control for stopping the air supply means when the set value is reached, control for operating the air supply means when the pressure detection value after the air supply means stops falls below the pressure set value by a predetermined width, and the pressure detection value for the elapsed time T ₁ Pressure setpoint reached And a control to lower predetermined width pressure setpoint if no, if the detected pressure value to a predetermined number of times us pressure set value for a short lapse of time T ₂ than the elapsed time T ₁ and a control for increasing the predetermined width of pressure setpoint The gas injection device 2) The gas injection device according to 1), wherein the gas is carbon dioxide, 3) The gas injection device according to 1) or 2), wherein the organ is a large intestine and a rectum is there.

  In the present invention, when an air supply tube is inserted into the oral cavity or anus of a patient and the operator initially sets the pressure setting value with the pressure setting means and operates the air supply means, gas is supplied and the organ is expanded. The When the pressure detection value reaches the pressure set value, the air supply means stops, and when the pressure detection value falls below the pressure set value by a predetermined amount due to gas being absorbed by the organ, etc. When the value returns to the pressure set value, the air supply means stops. Hereinafter, this operation is basically repeated to maintain the expansion of the organ, but the operation is performed as in A) or B) below depending on the number of times the air supply means is stopped per unit time.

When the pressure detection value between A) the elapsed time T ₁ is not reached the pressure set point, the pressure setpoint is reduced a predetermined width. Thereafter, the detected pressure value during the elapsed time T ₁ is reached in the pressure setting value, the pressure setpoint of time is maintained, again the pressure setpoint not reach falls predetermined width. In this way, if the gas supply means does not stop even if gas is supplied for a certain period of time or longer, the initial pressure setting value is judged to be high for the patient, and the pressure is gradually reduced until the appropriate pressure is reached. Try to.

B) When the pressure detected value during the course shorter elapsed time than the time T ₁ T ₂ is a predetermined number of times us pressure setpoint, the pressure setpoint is increased a predetermined width. Thereafter, the detected pressure value during the elapsed time T ₂ does not reach the predetermined number of times the pressure setting value, the pressure setpoint of time is maintained, again the pressure setpoint when reaching a predetermined number of times is increased a predetermined width. In this way, when the air supply means frequently stops within a short time, it is determined that the initial pressure setting value is low for the patient, and an attempt is made to step up until an appropriate pressure is reached.

  As described above, according to the present invention, the pressure is set only at the beginning, and thereafter, the apparatus automatically adjusts according to the size of the patient's organ, the ease of expansion, etc. Regardless of the condition, it is possible to provide a pressure suitable for each patient, and to provide a device that is excellent in operability and safety.

It is a schematic diagram of the gas injection apparatus of an Example. It is a flow which shows operation | movement of the gas injection apparatus of an Example. It is a chart which shows the change of the pressure setting value and pressure detection value of an example. It is a chart which shows the change of the pressure setting value and pressure detection value of an example.

  DESCRIPTION OF EMBODIMENTS Hereinafter, embodiments for carrying out the present invention will be specifically described based on examples and drawings.

  The embodiment shown in FIGS. 1 to 4 is an example of a gas injection device that injects gas from the anus for contrast examination of the large intestine and the rectum. A gas injection apparatus A of this example is shown in FIG.

  In the figure, 1 is an air supply tube which is inserted into the anus Ha of the patient H and supplies gas, 2 is a pump with an open / close valve for supplying gas to the air supply tube 1 (air supply means), and 3 is an outside for storing gas Attached gas bag, 4 is a counter (time counting means) for counting the elapsed time from the start of operation of the pump 2, 5 is a pressure adjustment dial for setting an initial pressure value in the air pressure storage section 5a (pressure setting means), Reference numeral 6 denotes a pressure sensor for detecting an air supply pressure (intestinal pressure) in the air supply tube 1. Reference numeral 7 denotes a pump 2 based on a pressure detection value of the pressure sensor 6, a pressure setting value of the air supply storage section 5 a and a counter value of the counter 4. 8 is a gas input port for connecting the gas bag 3, 9 is a gas output port for connecting the air supply tube 1, 10 is an air supply button for starting the pump 2 that also serves as a stop, 11 is a power supply.

  The counter 4 includes a 30-second counter 4a, a 10-second counter 4b, and an arrival counter 4c. The 30-second counter 4a and the 10-second counter 4b are for individually counting the elapsed time from the start of operation of the pump 2, respectively. The arrival counter 4c is for counting the number of times the pressure detection value of the pressure sensor 6 has reached the pressure set value of the air pressure storage unit 5a. The 30-second counter 4a and the 10-second counter 4b are reset and re-counted when 30 seconds and 10 seconds are counted or when the pressure set value is changed during the counting. The arrival counter 4c is reset when the 10-second counter 4b counts 3 times or the 10-second counter 4b counts 10 seconds before counting 3 times, and re-counts.

The control circuit 7 controls the pump 2 to stop when the pressure detection value of the pressure sensor 6 after operation of the pump 2 reaches the pressure set value of the air pressure storage unit 5a, and the pressure detection value after stop of the pump 2 is the pressure set value. Control for operating the pump 2 when the pressure falls below a predetermined width, and control for lowering the pressure set value by 5 mmHg if the pressure detection value does not reach the pressure set value while the 30-second counter 4a counts 30 seconds (elapsed time T ₁ ) And a control that increases the pressure set value by 5 mmHg when the detected pressure value reaches the pressure set value three times while the 10-second counter 4b counts 10 seconds (elapsed time T ₂ ).

  In the control for lowering the pressure set value, the lower limit value is set to 2 mmHg. In the control to increase the pressure set value, the upper limit pressure value can be set with the pressure adjustment dial 5, and when the upper limit value is reached, the pump 2 is stopped and the pressure is reduced. The pressure adjustment dial 5 can be adjusted in the range of 0 to 25 mmHg. Carbon dioxide is used as the gas. In addition, it may replace with the pump 2 and the gas bag 3, and may use the gas cylinder provided with on-off valves, such as a solenoid valve.

  First, the gas bag 3 is connected to the gas input port 8, the air supply tube 1 is connected to the gas output port 9, inserted into the anus Ha of the patient H, and the power supply 11 is turned on. The operator initially sets an average pressure setting value according to sex, age, condition, etc. with the pressure adjustment dial 5 and stores it in the air pressure storage unit 5a. The information in the air pressure storage unit 5a is rewritten by the control circuit 7 after the initial setting.

  When the air supply button 10 is pressed, the pump 2 is activated to send out the gas in the gas bag 3 and is supplied through the air supply tube 1 to expand the rectum and the large intestine. When the pressure detection value of the pressure sensor 6 reaches the pressure setting value of the air pressure storage unit 5a, the pump 2 automatically stops, and then the gas is absorbed into the intestinal tract and the pressure detection value falls by a predetermined width from the pressure setting value. When the pump 2 automatically restarts and the pressure detection value recovers to the pressure set value, the pump 2 automatically stops. Hereinafter, this operation is basically repeated to maintain the expansion of the intestinal tract, but the gas injection device A operates as follows depending on the number of times the pump 2 is stopped per unit time.

<When the pump 2 stops frequently within a short time>
As shown in FIG. 3, in this example, the initial pressure set value was 15 mmHg. While the 10-second counter 4b counted 10 seconds, the pressure detection value reached the pressure setting value three times, and the pressure setting value increased by 5 mmHg to 20 mmHg. Thereafter, similarly, while the 10-second counter 4b counted 10 seconds, the pressure detection value reached the pressure setting value three times, and the pressure setting value increased again by 5 mmHg to 25 mmHg. However, the pressure detection value reached the pressure set value only once while the 10 second counter 4b counted 10 seconds thereafter, and the pressure set value was maintained. As described above, the pressure set value was increased stepwise until the pressure reached an appropriate pressure, and became stable and stable.

<When the pump 2 does not stop even if gas is supplied over a long time>
As shown in FIG. 4, in this example, the initial pressure set value was set to 25 mmHg. Even if the 30-second counter 4a counted 30 seconds, the pressure detection value did not reach the pressure set value, and the pressure set value decreased by 5 mmHg to 20 mmHg. Thereafter, while the 30-second counter 4a counted 30 seconds, the pressure detection value reached the pressure set value, and the pressure set value was maintained. Thereafter, while the 10-second counter 4b counted 10 seconds, the pressure detection value reached the pressure set value only once, and the pressure set value was maintained. In this way, the pressure set value was lowered until an appropriate pressure was reached, and the equilibrium was stabilized.

  As described above, according to the gas injection device A of this embodiment, the pressure is set only at the beginning, and thereafter, the control circuit 7 automatically activates the pump 2 in accordance with the size of the patient's intestinal tract and ease of expansion. Therefore, the pressure is suitable for each patient regardless of the experience value of the operator, and the device is excellent in operability and safety.

  The technique of the present invention can be applied not only to the intestinal tract but also to the use of expanding an organ by injecting a gas for contrast examination or organ expansion into an organ such as the stomach.

1 Air supply tube 2 Pump (air supply means)
3 Gas bag 4 Counter 4a 30-second counter 4b 10-second counter 4c Arrival counter 5 Pressure adjustment dial 5a Air pressure storage unit 6 Pressure sensor 7 Control circuit 8 Gas input port 9 Gas output port 10 Air supply button 11 Power supply H Patient Ha Anus

Claims (3)

A gas injection device that inserts an air supply tube into the patient's oral cavity or anus and expands the organ by supplying gas for contrast examination or organ expansion into the organ with an air supply means consisting of a pump or a gas cylinder with an open / close valve A pressure setting means for initially setting the gas pressure, a pressure sensor for detecting an internal organ pressure or a gas supply pressure, a time counting means for counting an elapsed time from the start of operation of the air supply means, and a pressure of the pressure sensor A control means is provided for controlling the air supply means based on the detected value, the pressure set value of the pressure setting means and the time count value of the time counting means, and the control means is configured such that the pressure detection value after the operation of the air supply means is the pressure set value. a control to stop the air supply means to reach a control stop after the pressure detection value of the air means activates the a blowing means falls predetermined width than the pressure setting value, while the pressure detection value of the elapsed time T ₁ Pressure setpoint not reached In this case, there is provided control for lowering the pressure set value by a predetermined width and control for increasing the pressure set value by a predetermined width when the detected pressure value reaches the pressure set value a predetermined number of times during the elapsed time T ₂ shorter than the elapsed time T _1. A gas injection device characterized by comprising:   The gas injection device according to claim 1, wherein the gas is carbon dioxide.   The gas injection device according to claim 1 or 2, wherein the organ is a large intestine and a rectum.

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