JP2017060624A - Shunt blood vessel detection device - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a shunt blood vessel detection device capable of detecting shunt vibration information such as a shunt sound in an arbitrary place.SOLUTION: A shunt blood vessel detection device 1 includes: a contact part 100 that can be brought into contact with an arbitrary place on a skin; a detection part 200 for detecting shunt vibration information at a place that the contact part 100 is brought into contact with; and a control part 340 for calculating a change between shunt vibration information detected by the detection part 200 when the contact part 100 is brought into contact with a first place on the skin, and shunt vibration information detected by the detection part 200 when the contact part 100 is brought into contact with a second place different from the first place on the skin, and controlling notification of the change in the shunt vibration information.SELECTED DRAWING: Figure 1

Description

  The present invention relates to a shunt blood vessel detection device that detects a blood vessel in which a shunt is formed for hemodialysis and the like.

  Conventionally, for the purpose of obtaining blood flow suitable for hemodialysis etc., it is possible to form a site called a shunt where an artery and vein such as a forearm or thigh of a living body such as a patient are anastomosed subcutaneously by surgery. Has been done. By forming such a shunt, arterial blood flows directly from the artery to the vein, so that sufficient blood flow is obtained by puncturing the vein downstream (hereinafter referred to as “shunt blood vessel”) from the shunt to a predetermined range. be able to.

  It is known that a shunt blood vessel emits a unique blood flow sound caused by a turbulent sound generated in the shunt blood vessel called a shunt sound. Therefore, when identifying the puncture position, auscultation with a stethoscope is generally used in addition to visual inspection and palpation. However, no matter which method is used, it is necessary to rely on the skills of medical personnel. In particular, patients with diabetic primary disease have narrow blood vessels and tend to be obese, so that the blood vessel position is deep and visual and palpation is difficult.

  By the way, it has been devised to detect the state of a shunt blood vessel by detecting shunt vibration information such as a shunt sound (for example, see Patent Document 1 and Patent Document 2). In Patent Document 1, a shunt sound is detected by a microphone fixed in proximity to the shunt formation site, and an alarm is issued when the detection value of the shunt sound satisfies a predetermined condition, whereby the blood circulation state at the shunt formation site is indicated. A monitoring device that can be monitored is disclosed. Patent Document 2 discloses a monitoring system that can convert a shunt sound into an electrical signal by a sensor fixed in the vicinity of a shunt portion of a dialysis patient and detect an abnormality according to the condition of the shunt sound. Yes.

Japanese Patent Laid-Open No. 5-115547 JP 2011-98090 A

  Since both of the monitoring device disclosed in Patent Document 1 and the monitoring system disclosed in Patent Document 2 detect a shunt sound by detection means fixed in the vicinity of the shunt blood vessel, the position of the shunt blood vessel is previously determined. There is a problem that it is necessary to fix the detecting means after searching, and it is impossible to detect even if an abnormality occurs in a portion of the shunt blood vessel away from the place where the detecting means is fixed.

  The present invention has been developed in view of the above-described present situation, and an object of the present invention is to provide a shunt blood vessel detection device that can detect shunt vibration information such as a shunt sound at an arbitrary location.

  In order to achieve the above object, a shunt blood vessel detection device of the present invention includes a contact portion that can be brought into contact with an arbitrary location on the skin, and a detection portion that detects shunt vibration information at the location where the contact portion contacts. , Shunt vibration information detected by the detection unit when the contact unit contacts the first location on the skin, and when the contact unit contacts a second location different from the first location on the skin And a control unit that calculates a change from the shunt vibration information detected by the detection unit and performs notification control of the change in the shunt vibration information.

  Here, in the shunt blood vessel detection device of the present invention, the control unit detects a shunt sound within a first frequency range among the shunt vibration information detected by the detection unit from a normal shunt sound and the first frequency range. It is preferable to perform notification control of the magnitude of each shunt sound within the second frequency range, which is a high frequency, as a narrowed shunt sound.

  Further, in the shunt blood vessel detection device of the present invention, the control unit reports and controls the maximum magnitude of the shunt sound during a predetermined period of the shunt vibration information detected by the detection unit as the magnitude of the shunt sound. It is preferable to do.

  Moreover, it is preferable that the shunt blood vessel detection device of the present invention further includes an ultrasonic inspection unit that detects the depth of the shunt blood vessel at a location on the skin where the contact portion contacts by ultrasonic inspection.

  Further, in the shunt blood vessel detection device of the present invention, the control unit detects the magnitude of the shunt sound detected by the detection unit at an arbitrary location on the skin where the contact unit contacts, and the ultrasonic inspection at the location. It is preferable to perform notification control of the depth of the shunt blood vessel detected by the unit.

  In the shunt blood vessel detection device of the present invention, the control unit calculates a change in the degree of stenosis of the shunt blood vessel detected by the ultrasonic examination unit at the first location and the second location, and the degree of stenosis. It is preferable to perform notification control of the change in the above.

  Further, in the shunt blood vessel detection device of the present invention, the control unit is configured to determine the frequency of the shunt sound detected by the detection unit, the magnitude of the shunt sound, and the predetermined shunt sound at the first location and the second location. Based on a change in one or more pieces of information selected from a frequency duration of a value greater than or equal to or a predetermined value band, a duration greater than or equal to a predetermined value of the shunt sound or a magnitude of the predetermined value band, and a periodic pattern of the shunt sound It is preferable to calculate a change in the degree of stenosis of the shunt blood vessel and perform notification control of the change in the degree of stenosis.

  Furthermore, in the shunt blood vessel detection device of the present invention, the contact portion includes a first contact portion and a second contact portion, and the detection portion detects shunt vibration information at a location where the first contact portion contacts. A first detection unit; and a second detection unit that detects shunt vibration information at a location where the second contact unit comes into contact; and the control unit detects shunt vibration information detected by the first detection unit; It is preferable to perform notification control on the shunt vibration information detected by the second detection unit.

  ADVANTAGE OF THE INVENTION According to this invention, the shunt blood vessel detection apparatus which can detect the shunt sound in arbitrary places can be provided.

1 is a block diagram of a shunt blood vessel detection device according to a first embodiment of the present invention. 1 is a perspective view illustrating an example of a shunt blood vessel detection device according to a first embodiment of the present invention. It is a flowchart which shows the operation example 1 of the shunt blood vessel detection apparatus which concerns on the 1st Embodiment of this invention. It is a flowchart which shows the operation example 2 of the shunt blood vessel detection apparatus which concerns on the 1st Embodiment of this invention. It is a flowchart which shows the operation example 3 of the shunt blood vessel detection apparatus which concerns on the 1st Embodiment of this invention. It is a flowchart which shows the operation example 4 of the shunt blood vessel detection apparatus which concerns on the 1st Embodiment of this invention. It is a flowchart which shows the operation example 5 of the shunt blood vessel detection apparatus which concerns on the 1st Embodiment of this invention. It is a flowchart which shows the operation example 6 of the shunt blood vessel detection apparatus which concerns on the 1st Embodiment of this invention. It is a block diagram of a shunt blood vessel detection device according to a second embodiment of the present invention. It is a perspective view which shows an example of the shunt blood vessel detection apparatus which concerns on the 2nd Embodiment of this invention.

(First embodiment)
Hereinafter, the shunt blood vessel detection device according to the first embodiment of the present invention will be described in detail with reference to FIGS. 1 to 8.

  FIG. 1 is a block diagram showing a schematic configuration of a shunt blood vessel detection device 1 according to the present embodiment. As shown in FIG. 1, the shunt blood vessel detection device 1 according to the present embodiment includes a contact unit 100, a detection unit 200, a vibration signal processing unit 300, a notification unit 400, a communication unit 500, and an ultrasonic examination unit. 600. Moreover, in FIG. 1, the arrow which connects each functional block represents the direction through which a sound wave (including an ultrasonic wave), information, or a control signal flows.

  The shunt blood vessel detection device 1 further includes a held portion that can be held by a human hand. That is, the held portion is a portion formed so that the shunt blood vessel detection device 1 can be held by a human hand through the held portion. The held portion may be, for example, a mounting portion that can be mounted on a human hand such that a finger of a human hand can be inserted by making the entire shape of the shunt blood vessel detection device 1 into a ring shape, or a human hand. It may be a gripping part coupled to the shunt blood vessel detection device 1 so that it can be gripped by the.

  The contact unit 100 is a device that is provided so that at least a part thereof is exposed to the outside of the shunt blood vessel detection device 1 and acquires shunt vibration information at an arbitrary location on the skin with which the exposed portion is in contact. The contact part 100 can be brought into contact with an arbitrary part on the skin, and after obtaining desired information, the contact part 100 can be separated from the contacted skin. Such an operation can be repeated. Here, shunt vibration information includes shunt sound information (shunt sound magnitude, frequency, periodic pattern, etc.) and vibration information generated when blood flow in the shunt blood vessel hits the blood vessel wall (vibration due to turbulence, Vibration etc. due to motion). Further, the contact unit 100 may include a cylindrical part configured to collect the acquired shunt vibration information in the detection unit 200 in order to increase the detection efficiency of the detection unit 200.

  The detection unit 200 is a device that detects shunt vibration information acquired by the contact unit 100. For example, when detecting the magnitude of the shunt sound as the shunt vibration information, the detection unit 200 can use a microphone or the like. Moreover, when detecting vibration information as shunt vibration information, the detection unit 200 can use a sensor. The detection unit 200 converts the detected shunt vibration information into an electric signal, and outputs the converted electric signal to the vibration signal processing unit 300 as a vibration signal.

  The vibration signal processing unit 300 includes a filter 310, a cutoff frequency adjustment unit 320, an amplification unit 330, an information processing unit 340, and a storage unit 350.

  The filter 310 is an electric circuit that extracts a specific frequency component from the vibration signal input from the detection unit 200. For example, a bandpass filter that transmits only a vibration signal having a specific frequency component can be used. Further, the cutoff frequency adjustment unit 320 can adjust the frequency of the vibration signal to be cut off by the filter 310, and the filter 310 can change the frequency of the vibration signal to be cut off based on an instruction from the cutoff frequency adjustment unit 320. The filter 310 outputs a vibration signal from which a specific frequency component has been extracted to the amplification unit 330.

  The amplification unit 330 is an electric circuit that amplifies the vibration signal input from the filter 310 and outputs the amplified vibration signal to the information processing unit 340.

  The information processing unit 340 includes, for example, a processor, and functions as a control unit that performs notification control on the shunt vibration information based on the vibration signal input from the amplification unit 330. Specifically, the information processing unit 340 notifies information according to the processing of each operation example described later using the notification unit 400 or the external device 2 connected via the communication unit 500. .

  The storage unit 350 is a storage device that stores control programs and data, and can be read and written by the information processing unit 340. The control program and data stored in the storage unit 350 can be used for the information processing unit 340 to perform notification control of the shunt vibration information according to the processing of each operation example.

  The alerting | reporting part 400 is a device alert | reported according to alerting | reporting control by the information processing part 340 or the information processing part 643 of the ultrasonic test | inspection part 600 mentioned later, For example, a display apparatus, a speaker, a vibrator etc. can be used.

  The communication unit 500 is a device that communicates with the external device 2 in order to cause the external device 2 to perform notification according to the notification control by the information processing unit 340 or 643. Communication performed by the communication unit 500 with the external device 2 may be wired communication or wireless communication. As the wireless communication, for example, short-range communication such as Bluetooth (registered trademark), infrared communication, wireless LAN communication, or communication via a network such as the Internet can be used. As the external device 2 with which the communication unit 500 communicates, for example, a personal computer, a smartphone, an earphone or the like can be used. When a personal computer is used, an earphone is used due to display on a display or generation of sound from a speaker. In some cases, it can be notified by the generation of sound. The shunt blood vessel detection device 1 and the external device 2 are combined to constitute a shunt blood vessel detection system 3.

  The ultrasonic inspection unit 600 is for detecting the depth of the shunt blood vessel at the location where the contact unit 100 contacts by ultrasonic inspection, and includes an ultrasonic generation unit 610, an output adjustment unit 620, and an ultrasonic reception unit. 630 and an ultrasonic signal processing unit 640.

  The ultrasonic generator 610 is a device that generates ultrasonic waves, and can emit ultrasonic waves outwardly through at least the exposed portion of the contact unit 100 that can contact the skin. The frequency of the ultrasonic wave generated by the ultrasonic wave generation unit 610 is 3.5 MHz or more and 15 MHz or less, and preferably 5 MHz or more and 10 MHz or less.

  The output adjustment unit 620 adjusts the intensity, frequency, and the like of the ultrasonic wave output from the ultrasonic wave generation unit 610.

  The ultrasonic receiving unit 630 is a device that receives ultrasonic waves that are reflected and returned through the contact unit 100 out of the ultrasonic waves radiated outward from the ultrasonic generation unit 610 through the contact unit 100. An ultrasonic receiving unit that can receive an ultrasonic frequency band can be used. The ultrasonic receiving unit 630 converts the received ultrasonic wave into an electric signal, and outputs the converted electric signal to the ultrasonic signal processing unit 640 as an ultrasonic signal.

  The ultrasonic signal processing unit 640 includes a filter 641, an amplification unit 642, an information processing unit 643, and a storage unit 644.

  The filter 641 is an electric circuit that extracts a specific frequency component from the ultrasonic signal input from the ultrasonic receiver 630. For example, a bandpass filter that transmits only the ultrasonic signal having the specific frequency component is used. Can do. The filter 641 outputs an ultrasonic signal from which a specific frequency component has been extracted to the amplifying unit 642.

  The amplification unit 642 is an electric circuit that amplifies the ultrasonic signal input from the filter 641 and outputs the amplified ultrasonic signal to the information processing unit 643.

  The information processing unit 643 includes, for example, a processor, acquires the generation time of the ultrasonic wave generated by the ultrasonic wave generation unit 610 and the reception time of the ultrasonic signal input from the amplification unit 642, and based on these, shunts It functions as a control unit that detects the depth of the blood vessel and performs notification control of the detection result, that is, the notification unit 400 or the external device 2 connected via the communication unit 500.

  The storage unit 644 is a storage device that stores control programs and data, and can be read and written by the information processing unit 643. The control program and data stored in the storage unit 644 can be used for the information processing unit 643 to perform notification control of information according to the processing of each operation example.

  FIG. 2 is a perspective view showing an example of the shunt blood vessel detection device 1 according to the present embodiment. As shown in FIG. 2, the shunt blood vessel detection device 1 includes a mounting portion 700 as a held portion that allows a human finger to be inserted with the entire shape of the device being a ring shape, and the contact portion 100 at one place on the outer periphery. And a display unit 400 ′ serving as a notification unit is provided at another location on the outer periphery.

  The contact part 100 is provided so as to protrude from the outer periphery of the shunt blood vessel detection device 1, and includes a cylindrical part formed in a truncated cone shape whose diameter decreases toward the tip. The contact portion 100 may be flush with the surrounding outer peripheral surface without protruding from the outer peripheral surface of the shunt blood vessel detection device 1, or the outer peripheral surface can contact the skin and the inner side of the outer peripheral surface does not contact the skin. It may be. Since the contact part 100 touches a patient's skin directly, it is preferable in terms of hygiene that it is disposable. The display unit 400 ′ displays information according to the shunt sound acquired by the contact unit 100 and detected by the detection unit 200, for example, the magnitude and frequency of the shunt sound.

  Such a shunt blood vessel detection device 1 is inserted into a finger such as an index finger by a medical worker or a patient, for example, and the contact unit 100 is brought into contact with an arbitrary place on the skin near the shunt blood vessel, thereby displaying the display unit 400 ′. Since the information corresponding to the shunt sound is displayed, the position of the shunt blood vessel and the state of the shunt blood vessel can be detected by appropriately moving the place where the contact portion 100 is brought into contact.

  Hereinafter, operation example 1 to operation example 6 of the shunt blood vessel detection device 1 according to the present embodiment will be described with reference to FIGS. 3 to 8.

  FIG. 3 is a flowchart showing an operation example 1 of the shunt blood vessel detection device 1 according to the present embodiment. First, when the information processing unit 340 detects a vibration signal based on the shunt vibration information acquired by the contact unit 100 and detected through the detection unit 200 (step S101), the maximum magnitude of the shunt sound for each predetermined period. Is detected (step S102). Here, the predetermined period may be a period stored in advance by the storage unit 350, or the information processing unit 340 may set a period according to an interval at which the peak of the shunt sound volume appears, for example.

  The information processing unit 340 detects the frequency when the loudness of the shunt sound is maximum (step S103). The information processing unit 340 then connects the information about the loudness of the shunt sound detected at step S102 and the frequency detected at step S103 using the notification unit 400 or via the communication unit 500. 2 (step S104), and the process is terminated.

  The information processing unit 340 detects the maximum shunt sound volume for each predetermined period (step S102) and then detects the frequency when the shunt sound volume is maximum (step S103). Instead of such a configuration, for example, after specifying the frequency band of the shunt sound detected every predetermined period, the magnitude of the shunt sound in the specified frequency band may be detected. Further, in step S103, the information processing unit 340 detects the shunt vibration information detected by the detection unit 200 when the shunt sound level is maximum, instead of detecting the frequency when the shunt sound level is maximum. Other information based on the above, for example, other shunt sound information (periodic pattern of shunt sound, etc.), vibration information generated when blood flow in the shunt blood vessel hits the blood vessel wall (vibration due to turbulence, vibration due to pulsation, etc.) ) And the like, and the detected information may be controlled in step S104.

  As described above, according to the operation example 1, in the shunt blood vessel detection device 1, the information processing unit 340 serving as the control unit uses the maximum magnitude of the shunt sound detected by the detection unit 200 in a predetermined period as the magnitude of the shunt sound. Since the notification control is performed, the magnitude and frequency of the shunt sound can be stably notified even if the magnitude of the shunt sound detected by the detection unit 200 varies according to pulsation or the like.

  FIG. 4 is a flowchart showing an operation example 2 of the shunt blood vessel detection device 1 according to the present embodiment. First, when the information processing unit 340 detects a vibration signal based on the shunt vibration information acquired by the contact unit 100 and detected through the detection unit 200 (step S201), the magnitude of the shunt sound within the first frequency range. The magnitude of the shunt sound within the second frequency range is detected (step S202).

  Here, the first frequency range is a frequency range of a shunt sound generated from a normal shunt blood vessel (hereinafter abbreviated as “normal shunt sound” as appropriate), and the second frequency range is higher in frequency than the first frequency range. This is a frequency range of a shunt sound generated from a stenosis site in a shunt blood vessel (hereinafter abbreviated as “stenosis shunt sound” as appropriate). The first frequency range and the second frequency range may be set for each living body such as a patient, the general frequency range as a normal shunt sound is set as the first frequency range, and the general frequency range is set as a narrowed shunt sound. Each of the second frequency ranges may be stored in the storage unit 350 in advance.

  The general frequency range of the normal shunt sound is, for example, 50 Hz to 300 Hz, and preferably 100 Hz to 150 Hz. Moreover, the general frequency range of a constriction shunt sound is 200 Hz or more and 2000 Hz or less, for example, Preferably, they are 700 Hz or more and 1400 Hz or less. Note that the general frequency range of normal shunt sounds and the general frequency range of stenotic shunt sounds overlap at 200 Hz or more and 300 Hz or less. This is due to individual differences between living bodies such as patients, for example. When the frequency ranges are actually set or stored in advance as the first frequency range and the second frequency range, the frequency ranges do not overlap.

  Further, the magnitude of the shunt sound within each frequency range may be the maximum magnitude of the shunt sound for each predetermined period within each frequency range as in the first operation example, or the magnitude of the shunt sound within each frequency range. The average value may be taken.

  After the process of step S202, the information processing unit 340 reports information on the magnitudes of the shunt sounds in the first frequency range as normal shunt sounds and the shunt sounds in the second frequency range as narrowed shunt sounds. Using the unit 400 or using the external device 2 connected via the communication unit 500, notification is made (step S203), and the process is terminated.

  In step S203, the information about the magnitude of the normal shunt sound and the magnitude of the stenosis shunt sound is reported, but instead of such a configuration, either the normal shunt sound or the stenosis shunt sound is notified. For example, only the larger information may be notified. In step S202, the information processing unit 340 detects other shunt sound information (for example, a shunt sound periodic pattern) in the first frequency range and the second frequency range, and performs notification control in step S203. Also good.

  Thus, according to the operation example 2, in the shunt blood vessel detection device 1, the information processing unit 340 as the control unit normalizes the magnitude of the shunt sound within the first frequency range of the shunt sound detected by the detection unit 200. Since the loudness of the shunt sound and the loudness of the shunt sound within the second frequency range are controlled as notifications of the narrowed shunt sound, the position of the shunt blood vessel is detected by appropriately moving the contact point 100. In addition, the stenosis site can be specified when there is a stenosis site in the shunt blood vessel.

  FIG. 5 is a flowchart showing an operation example 3 of the shunt blood vessel detection device 1 according to the present embodiment. First, when the information processing unit 340 detects a vibration signal based on the shunt vibration information detected through the detection unit 200 (step S301), the information processing unit 340 stores the shunt vibration information in the storage unit 350 and uses the notification unit 400. Alternatively, the shunt vibration information is notified using the external device 2 connected via the communication unit 500 (step S302). Here, when the magnitude of the shunt sound is notified as the shunt vibration information, for example, the maximum magnitude of the shunt sound for each predetermined period can be set as in the first operation example.

  When the shunt vibration information detected by the detection unit 200 for the immediately preceding location is stored in the storage unit 350 (Yes in step S303), the information processing unit 340 determines the immediately preceding location (hereinafter, “first location” as appropriate). Information on the change from the shunt vibration information on the current location (hereinafter also referred to as “second location” where appropriate) to the shunt vibration information on the current location, and the information on the change is combined with the notification control in step S302. Information control is performed (step S304). Note that the information processing unit 340 may perform only the notification control in step S304 without performing the notification control in step S302.

  Here, both the first place and the second place are places on the skin where the contact part 100 contacts, and are different places. Further, the information on the change between the shunt vibration information about the first location and the shunt vibration information about the second location includes information on the presence / absence of change, information on the increase / decrease, information on the amount of change, and the like.

  The information processing unit 340 moves after the process of step S304 or when the shunt vibration information about the first location is not stored in the storage unit 350 (No in step S303). It is determined whether or not it is detected (step S305).

  When the movement of the contact location is detected (Yes in step S305), the information processing unit 340 returns to the process in step S301. On the other hand, when the movement of the contact location is not detected (No in step S305), the information processing unit 340 ends the process.

  Here, in step S305, whether or not the contact location of the contact portion 100 has moved from the first location to the second location is determined by, for example, providing a sensor or the like that detects that the contact portion 100 is in contact with the object. The detection may be performed based on changes in shunt vibration information such as the magnitude and frequency of the shunt sound. Alternatively, the information processing unit 340 may determine that the user has moved by switching to a mode for measuring the amount of change by the user based on the user's determination that the user has moved from the first place to the second place. .

  Moreover, in this operation example, when the shunt vibration information is not detected by the detection unit 200 at the location on the skin where the contact unit 100 contacts, the detection unit 200 is not treated as the first location or the second location. Only when the contact part 100 comes into contact with the location where the shunt vibration information is detected by this, the location may be the first location or the second location.

  Further, in step S302, the magnitudes of the normal shunt sound and the stenosis shunt sound are stored and notified in the same manner as in the operation example 2, and in step S304, the normal shunt sound and the stenosis shunt sound are second to second. Information on changes to locations may be controlled.

  Furthermore, based on the change information of the shunt vibration information calculated in step S304, for example, if the normal shunt sound is larger in the second location than the first location, the normal shunt blood vessel is approaching, and if it is smaller, it is farther away. It may be determined that the stenosis portion is approaching if the stenosis shunt sound is larger at the second location than the first location, or farther away if the stenosis shunt is smaller.

  Thus, according to the operation example 3, in the shunt blood vessel detection device 1, the information processing unit 340 as the control unit stores the shunt vibration information detected by the detection unit 200 in the storage unit 350, and immediately before the contact unit 100. When the shunt vibration information of the location where the contact is made is stored in the storage unit 350, the information on the change from the previous contact location to the current contact location to the shunt vibration information is notified and controlled. By moving the position on the skin with which 100 is brought into contact, it becomes obvious whether or not the shunt blood vessel has been approached, and the position of the shunt blood vessel can be easily detected.

  FIG. 6 is a flowchart showing an operation example 4 of the shunt blood vessel detection device 1 according to the present embodiment. First, when the ultrasonic wave generation unit 610 generates an ultrasonic wave, the ultrasonic wave is emitted outward through the exposed portion of the contact unit 100 (step S401). Note that the generation time of the ultrasonic wave emitted at this time is transmitted to the information processing unit 643.

  The ultrasonic receiving unit 630 receives the ultrasonic wave reflected from the blood vessel and returned through the contact unit 100 among the emitted ultrasonic waves, and converts the received ultrasonic wave into an ultrasonic signal that is an electrical signal. The data is converted and output together with the reception time to the information processing unit 643 via the filter 641 and the amplification unit 642 (step S402).

  The information processing unit 643 detects the depth from the skin surface of the shunt blood vessel at the location where the contact unit 100 contacts based on the generation time and the reception time of the received ultrasonic wave, and notifies the notification unit 400 of the detected depth. Or using the external device 2 connected via the communication unit 500 (step S403).

  In step S402, when the ultrasonic wave receiving unit 630 cannot receive the ultrasonic wave reflected and returned to the blood vessel, the information processing unit 643 can detect immediately below the place where the contact unit 100 contacts. It may be determined that there is no blood vessel, and that effect may be notified using the notification unit 400 or using the external device 2 connected via the communication unit 500.

  As described above, according to the operation example 4, the shunt blood vessel detection device 1 radiates an ultrasonic wave outward through the exposed portion of the contact portion 100 and receives the reflected ultrasonic wave, whereby the contact portion 100 contacts. Since the depth of the shunt blood vessel from the surface of the skin is detected and controlled by the ultrasonic inspection unit 600, the depth of the shunt blood vessel can be detected.

  In the operation example 4, the information processing unit 643 as the control unit uses the first place and the second place specified in the same manner as the operation example 3, and the contact unit 100 contacts the first place on the skin. The change in the depth of the shunt blood vessel detected by the ultrasonic examination unit 600 and the depth of the shunt blood vessel detected by the ultrasonic examination unit 600 when the contact part 100 contacts the second location on the skin. The information may be calculated and the change information may be notified using the notification unit 400 or using the external device 2 connected via the communication unit 500.

  Here, the information on the change in the depth of the shunt blood vessel detected by the ultrasonic examination unit 600 includes information on the presence / absence of change, information on the increase / decrease, information on the change amount, and the like.

  Thereby, the location where the shunt blood vessel exists at a shallower position can be easily detected by moving the location on the skin with which the contact portion 100 contacts.

  In the operation example 4, in step S403, the information processing unit 643 detects the depth of the shunt blood vessel from the skin surface at the location where the contact unit 100 contacts. Instead of this, or in addition to this, The hardness of the shunt blood vessel immediately below the location where the contact part 100 contacts may be detected. Here, the hardness of the shunt blood vessel is determined by, for example, the information processing unit 643 drawing a tomographic image of the shunt blood vessel based on the received ultrasonic information and determining the hardness of the shunt blood vessel from the tomographic image. Can be detected. As a method for determining the hardness of the shunt blood vessel from the tomographic image, for example, the property that the hard part of the shunt blood vessel has high impedance and the brightness tends to be high in the tomographic image is used. It can be determined that it is hard.

  Each process in the operation example 4 can be executed simultaneously with each process in the operation example 1 to the operation example 3.

  For example, the information processing unit 340 as the control unit controls and notifies the shunt vibration information detected by the detection unit 200 at an arbitrary location on the skin with which the contact unit 100 contacts, and the information processing unit 643 as the control unit. In addition, the depth of the shunt blood vessel detected by the ultrasonic examination unit 600 may be notified and controlled at the location.

  Thereby, since the shunt vibration information and the information on the depth of the shunt blood vessel at any location on the skin can be obtained together, the position of the shunt blood vessel can be specified with higher accuracy.

  In addition, for example, the information processing unit 340 as a control unit notifies and controls a change in shunt vibration information detected by the detection unit 200 at the first location and the second location on the skin with which the contact unit 100 contacts. The information processing unit 643 as a unit may perform notification control of a change in the depth of the shunt blood vessel detected by the ultrasonic examination unit 600 at the first place and the second place.

  As a result, it is obvious whether or not the shunt blood vessel is approached by moving the part on the skin that the contact part 100 contacts, so that the position of the shunt blood vessel can be easily detected, and the shunt blood vessel exists at a shallower position. The place to do can be detected easily.

  FIG. 7 is a flowchart showing an operation example 5 of the shunt blood vessel detection device 1 according to the present embodiment. First, when the ultrasonic wave generation unit 610 generates an ultrasonic wave, the ultrasonic wave is emitted outward through the exposed portion of the contact unit 100 (step S501). Note that the generation time of the ultrasonic wave emitted at this time is transmitted to the information processing unit 643.

  Then, when the ultrasonic wave receiving unit 630 receives the ultrasonic wave reflected from the living tissue such as a blood vessel and returned through the contact unit 100 among the emitted ultrasonic waves, the received ultrasonic wave is an electric signal. It converts into an ultrasonic signal, and outputs it with the reception time to the information processing part 643 via the filter 641 and the amplification part 642 (step S502).

  The information processing unit 643 detects the degree of stenosis of the shunt blood vessel immediately below the location where the contact unit 100 contacts based on information such as the generation time, reception time, and intensity of the received ultrasonic wave, and the detected shunt blood vessel stenosis The degree information is stored in the storage unit 644 (step S503). Here, the degree of stenosis of the shunt blood vessel is determined by, for example, the information processing unit 643 drawing a tomographic image of the shunt blood vessel based on the received ultrasonic information and recognizing the diameter of the shunt blood vessel from the tomographic image. Can be detected.

  When information on the degree of stenosis of the shunt blood vessel is stored in the storage unit 644 for the immediately preceding location (first location) (Yes in step 504), the information processing unit 643 determines the degree of stenosis of the shunt blood vessel for the first location. Information on the change up to the degree of stenosis of the shunt blood vessel at the current location (second location) is calculated, and the information on the change is controlled (step S505).

  Here, the information on the change from the degree of stenosis of the shunt blood vessel at the first place to the degree of stenosis of the shunt blood vessel at the second place includes information on the presence / absence of change, information on increase / decrease, information on the amount of change, and the like.

  The information processing unit 643 makes contact with the contact unit 100 after the process of step S505 or when the information on the degree of stenosis of the shunt blood vessel at the first location is not stored in the storage unit 644 (No in step 504). It is determined whether or not the movement of the location is detected (step S506).

  When the movement of the contact location is detected (Yes in step S506), the information processing unit 643 returns to the process in step S501. On the other hand, when the movement of the contact location is not detected (No in step S506), the information processing unit 643 ends the process.

  Here, in step S506, whether or not the contact location of the contact unit 100 has moved from the first location to the second location can be detected based on the same process as in step S305 of the operation example 3. Further, when the degree of stenosis of the shunt blood vessel is not detected at the place on the skin where the contact unit 100 contacts, the part is not treated as the first place or the second place, and the degree of stenosis of the shunt blood vessel is detected. It is good also considering the location as the 1st location or the 2nd location only.

  As described above, according to the operation example 5, in the shunt blood vessel detection device 1, the information processing unit 643 as the control unit detects the degree of stenosis of the shunt blood vessel detected by the ultrasonic examination unit 600 in the first place and the second place. Therefore, the change in the degree of stenosis is reported and controlled, so that the stenosis part of the shunt blood vessel can be easily detected by moving the part on the skin with which the contact part 100 is brought into contact.

  In the operation example 5, the second location may be the same location as the first location at a time later than the first location. By doing so, for example, when PTA (percutaneous angioplasty) is performed on a stenotic site of a shunt blood vessel where stenosis is detected at the first location, a change in the degree of stenosis at the second location is confirmed. Thus, the effect of vasodilation by PTA can be confirmed.

  Each process in the operation example 5 can be executed simultaneously with each process in the operation example 1 to the operation example 4.

  For example, the information processing unit 643 as the control unit calculates a change in the stenosis degree of the shunt blood vessel detected by the ultrasonic examination unit 600 in the first place and the second place, and performs notification control of the change in the degree of stenosis. At the same time, the information processing unit 340 as a control unit may perform notification control of changes in the shunt vibration information detected by the detection unit 200 at the first location and the second location.

  As a result, it is possible to accurately identify a portion that is easier to puncture and a location that is difficult to puncture.

  FIG. 8 is a flowchart showing an operation example 6 of the shunt blood vessel detection device 1 according to the present embodiment. First, when the information processing unit 340 detects a vibration signal based on the shunt vibration information detected through the detection unit 200 (step S601), the shunt sound information, specifically, the frequency of the shunt sound and the shunt sound The storage unit 350 stores the magnitude, the duration of the frequency of a predetermined value or more of the shunt sound, the duration of the frequency of the predetermined value or more of the shunt sound, and the period pattern of the shunt sound. (Step S602). Here, the magnitude of the shunt sound can be set to the maximum magnitude of the shunt sound for each predetermined period, for example, as in the first operation example.

  When the shunt sound information as described above is stored in the storage unit 350 for the immediately preceding location (first location) (Yes in step 603), the information processing unit 340 presents the current information from the shunt sound information for the first location. Based on the change up to the shunt sound information for this point (second place), information on the change in the degree of stenosis of the shunt blood vessel is calculated, and the change information is notified and controlled (step S604).

  Here, the information on the change in the degree of stenosis of the shunt blood vessel includes the frequency of the shunt sound, the magnitude of the shunt sound, the duration of the frequency of the shunt sound that is a predetermined value or a predetermined value band, and the predetermined value of the shunt sound. It is calculated based on a change in one or more pieces of information selected from the duration of the size of the predetermined value band and the periodic pattern of the shunt sound. The information on the change in the degree of stenosis of the shunt blood vessel includes information on the presence / absence of change, information on increase / decrease, information on the change amount, and the like.

  The information processing unit 340 moves after the process of step S604 or when the information about the shunt sound at the first location is not stored in the storage unit 350 (No in step S603). Is detected (step S605).

  If the movement of the contact location is detected (Yes in step S605), the information processing unit 340 returns to the process in step S601. On the other hand, when the movement of the contact location is not detected (No in step S605), the information processing unit 340 ends the process.

  Here, in step S605, whether or not the contact location of the contact portion 100 has moved from the first location to the second location can be detected based on the same processing as in step S305 of the operation example 3. In addition, when shunt sound information is not detected at a location on the skin where the contact portion 100 contacts, the location is not treated as the first location or the second location, but only when shunt sound information is detected. The location may be the first location or the second location.

  As described above, according to the operation example 6, the shunt blood vessel detection device 1 is configured so that the information processing unit 340 serving as the control unit detects the frequency of the shunt sound detected by the detection unit 200 at the first location and the second location, and the shunt. It is selected from the loudness, the duration of the frequency of a predetermined value or more of a shunt sound, the duration of the frequency of a predetermined value or more of a shunt sound, and the period pattern of the shunt sound Since the change of the stenosis degree of the shunt blood vessel is calculated based on the change of one or more information and the change of the stenosis degree is notified and controlled, the location of the shunt blood vessel is moved by moving the location on the skin where the contact part 100 is contacted. A stenosis site can be easily detected.

  In the operation example 6, as in the operation example 5, the second location may be the same location as the first location at a time later than the first location. By doing in this way, the same effect as operation example 5 can be acquired.

(Second Embodiment)
Hereinafter, the shunt blood vessel detection device according to the second embodiment of the present invention will be described in detail with reference to FIGS. 9 and 10.

  FIG. 9 is a block diagram showing a schematic configuration of the shunt blood vessel detection device 1 ′ according to the present embodiment. As illustrated in FIG. 9, the shunt blood vessel detection device 1 ′ according to the present embodiment includes a first contact unit 100 a and a second contact unit 100 b as the contact unit 100, a first detection unit 200 a and a first detection unit 200 as the detection unit 200. 2 detection unit 200b, vibration signal processing unit 300 ′, notification unit 400, communication unit 500, and ultrasonic inspection unit 600 ′. In FIG. 9, an arrow connecting each functional block represents a direction in which sound waves (including ultrasonic waves), information, or control signals flow. In addition, since the alerting | reporting part 400 and the communication part 500 are the structures similar to the alerting | reporting part 400 and the communication part 500 with which the shunt blood vessel detection apparatus 1 which concerns on 1st Embodiment is provided, description is abbreviate | omitted. The shunt blood vessel detection device 1 ′ and the external device 2 are combined to form a shunt blood vessel detection system 3 ′.

  The shunt blood vessel detection device 1 ′ further includes a held portion similar to the shunt blood vessel detection device 1 according to the first embodiment.

  The first contact portion 100a and the second contact portion 100b as the contact portion 100 are devices having the same configuration as the contact portion 100 provided in the shunt blood vessel detection device 1 according to the first embodiment. The first contact part 100a and the second contact part 100b are exposed to the outside of the shunt blood vessel detection device 1 ′ at a predetermined distance from each other so that they can simultaneously contact any part on the skin. .

  The first detection unit 200a and the second detection unit 200b as the detection unit 200 are devices each having the same configuration as the detection unit 200 included in the shunt blood vessel detection device 1 according to the first embodiment, and each of the first contact units It is a device that detects the shunt sound acquired by the part 100a and the second contact part 100b.

  Except for processing the shunt vibration information based on the vibration signals input from the first detection unit 200a and the second detection unit 200b as the shunt vibration information based on the vibration signals input from the vibration signal processing unit 300 ′, The shunt blood vessel detection device 1 according to the first embodiment has the same configuration as the vibration signal processing unit 300 provided in the shunt blood vessel detection device 1.

  The ultrasonic inspection unit 600 ′ emits ultrasonic waves outward through the exposed portions of the first contact unit 100a and the second contact unit 100b, and receives the ultrasonic waves received through the first contact unit 100a and the second contact unit 100b, respectively. Is converted into an electric signal, and the converted electric signal is processed as an ultrasonic signal from each contact portion, and the configuration is the same as that of the ultrasonic examination unit 600 included in the shunt blood vessel detection device 1 according to the first embodiment. Consists of.

  FIG. 10 is a perspective view showing an example of the shunt blood vessel detection device 1 ′ according to the present embodiment. As illustrated in FIG. 10, the shunt blood vessel detection device 1 ′ includes a first contact unit 100 a and a second contact unit 100 b instead of the contact unit 100, and a first detection unit 200 a and a second detection unit 200 instead of the detection unit 200. Since it has the same configuration as the shunt blood vessel detection device 1 according to the first embodiment shown in FIG.

  The shunt blood vessel detection device 1 ′ includes the first contact portion 100a and the second contact portion 100b spaced apart from each other by a predetermined distance along a direction orthogonal to the circumferential direction on the outer periphery, that is, along the central axis direction. . In addition, the other structure of the 1st contact part 100a and the 2nd contact part 100b is the same as that of the contact part 100 with which the shunt blood vessel detection apparatus 1 which concerns on 1st Embodiment shown in FIG. 2 is provided.

  Such a shunt blood vessel detection device 1 ′ is inserted into a finger such as a forefinger by a medical worker or a patient, for example, and the first contact portion 100 a and the second contact portion 100 b are placed at any location on the skin near the shunt blood vessel. By making the contact, shunt vibration information at a location where each contact portion comes into contact is displayed on the display unit 400 ′, so that the position and state of the shunt blood vessel at the location where each contact portion comes into contact can be detected. The position and state of the shunt blood vessel can be detected in more detail by appropriately moving the place where the contact portion is brought into contact.

  The shunt blood vessel detection device 1 ′ according to the present embodiment can execute each operation according to the operation example 1 to the operation example 6 of the shunt blood vessel detection device 1 according to the first embodiment.

  For example, in the shunt blood vessel detection device 1 ′, the first detection unit 200a detects shunt vibration information at a location where the first contact unit 100a contacts, and the second detection unit 200b detects a shunt at a location where the second contact unit 100b contacts. The information processing unit 340, which detects vibration information, controls the shunt vibration information detected by the first detection unit 200a and the shunt vibration information detected by the second detection unit 200b, together with the notification control. The location where the contact portion 100a comes into contact and the location where the second contact portion 100b comes into contact are moved, so that shunt vibration information detected at the location touched immediately before, and shunt vibration information detected at the location touched after movement, Can be calculated and notification control can be performed.

  Thereby, the shunt vibration information at the location where the first contact portion 100a contacts and the shunt vibration information at the location where the second contact portion 100b contacts can be notified simultaneously, and the change of the shunt vibration information before and after the movement. Therefore, based on the position and information of the shunt blood vessel at the place where each contact portion comes into contact, it is possible to move the contact portion while predicting the direction in which the contact portion should be moved.

  Although the present invention has been described based on the drawings and embodiments, it should be noted that those skilled in the art can easily make various changes and modifications based on the present disclosure. Therefore, it should be noted that these variations and modifications are included in the scope of the present invention. For example, the functions included in each component, each step, etc. can be rearranged so that there is no logical contradiction, and multiple components, steps, etc. can be combined or divided into one It is.

  Moreover, although the present invention has been described mainly with respect to the shunt blood vessel detection device 1, the present invention records a method, program, or program executed by the information processing units 340 and 643 included in the shunt blood vessel detection device 1, 1 ′. It can be realized as a storage medium, and it should be understood that these are also included in the scope of the present invention.

DESCRIPTION OF SYMBOLS 1,1 'Shunt blood vessel detection apparatus 2 External apparatus 3, 3' Shunt blood vessel detection system 100, Contact part 100a 1st contact part 100b 2nd contact part 200 Detection part 200a 1st detection part 200b 2nd detection part 300,300 ' Vibration signal processing unit 310 Filter 320 Cut-off frequency adjustment unit 330 Amplification unit 340 Information processing unit (control unit)
350 Storage Unit 400 Notification Unit 400 ′ Display Unit 500 Communication Unit 600, 600 ′ Ultrasonic Inspection Unit 610 Ultrasonic Generation Unit 620 Output Adjustment Unit 630 Ultrasonic Reception Unit 640 Ultrasonic Signal Processing Unit 641 Filter 642 Amplification Unit 643 Information Processing Unit (Control part)
644 Storage unit 700 Mounting unit (held portion)

Claims (8)

A contact part that can contact any part of the skin;
A detection unit for detecting shunt vibration information at a place where the contact unit contacts;
Shunt vibration information detected by the detection unit when the contact unit contacts the first location on the skin, and when the contact unit contacts a second location different from the first location on the skin A control unit that calculates a change in the shunt vibration information detected by the detection unit, and notifies and controls the change in the shunt vibration information;
A shunt blood vessel detection device. In the shunt vibration information detected by the detection unit, the control unit outputs a shunt sound within a first frequency range as a normal shunt sound, and a shunt sound within a second frequency range that is higher than the first frequency range. Informing and controlling each magnitude as a stenosis shunt sound,
The shunt blood vessel detection device according to claim 1. The control unit performs notification control of the maximum magnitude of the shunt sound in a predetermined period of the shunt vibration information detected by the detection unit as the magnitude of the shunt sound.
The shunt blood vessel detection device according to claim 1 or 2.   The shunt blood vessel detection device according to any one of claims 1 to 3, further comprising an ultrasonic inspection unit that detects a depth of the shunt blood vessel at an arbitrary location on the skin with which the contact unit contacts by ultrasonic inspection. .   The control unit determines the magnitude of the shunt sound detected by the detection unit at an arbitrary location on the skin where the contact unit contacts, and the depth of the shunt blood vessel detected by the ultrasonic examination unit at the location. The shunt blood vessel detection device according to claim 4, which performs notification control.   The control unit calculates a change in the degree of stenosis of the shunt blood vessel detected by the ultrasonic examination unit in the first location and the second location, and performs notification control of the change in the degree of stenosis. 5. The shunt blood vessel detection device according to 5.   The control unit includes a frequency of a shunt sound detected by the detection unit, a magnitude of the shunt sound, and a duration of a frequency of a predetermined value or more of a predetermined value of the shunt sound in the first place and the second place. And a change in the degree of stenosis of the shunt blood vessel based on a change in one or more pieces of information selected from the duration of the predetermined value of the shunt sound or a predetermined value band and the periodic pattern of the shunt sound. The shunt blood vessel detection device according to any one of claims 1 to 5, which performs notification control of the change in the degree of stenosis. The contact portion includes a first contact portion and a second contact portion,
The detection unit includes a first detection unit that detects shunt vibration information at a location where the first contact unit contacts, and a second detection unit that detects shunt vibration information at a location where the second contact unit contacts. ,
The control unit controls and notifies the shunt vibration information detected by the first detection unit and the shunt vibration information detected by the second detection unit.
The shunt blood vessel detection device according to any one of claims 1 to 7.