JP2019092856A - Swallowing function measuring system - Google Patents

Abstract

To provide a swallowing function measuring system in which precise and clear swallowing associated data can be collected by detecting intratracheal sound and pressure with a few noise, and thereby a composite waveform of the intratracheal sound and pressure is acquired and visualized.SOLUTION: A swallowing function measuring system is configured as follows. In the first, a sensor 1, a PC3 and a display 4 are provided. In the second, the sensor 1 is provided in an exterior 10 by surrounding the pressure and sound detection elements 11 with a damping transmission material 5 where the external air vibration sound is absorbed and damped but the transmission of the intratracheal pressure and sound is possible. In the third, an abutment surface 12 of the metal plate capable of collecting the intratracheal pressure and sound is formed in the exterior 10, and the breathing pressure and swallowing pressure transmitted from the abutment surface 12 are transmitted to the detection elements 11. Also, an air chamber 6 is provided in the exterior 10, and the breath sound, swallowing sound and larynx remaining sound transmitted from the abutment surface are transmitted to the detection elements 11. In the fourth, the PC3 acquires the composite waveform based on the pressure and sound. In the fifth, the display 4 is a display device of the composite waveform acquired by the PC3.SELECTED DRAWING: Figure 1

Description

  The present invention relates to a swallowing function measurement system having a sensor, a waveform processing device, and an output device, and more specifically, the intratracheal respiratory pressure and swallowing detected by a pressure and sound detection element provided in the sensor. It is a system which acquires the synthetic waveform of pressure and sound based on information of pressure and breathing sound and swallowing sound and laryngeal residual sound, and displays the synthetic waveform by an output device.

  The swallowing function is easily reduced with age and disease, and aspiration pneumonia caused by the decrease in swallowing function is a problem that affects the life prognosis. Although swallowing angiography and swallowing endoscopy are commonly used to evaluate swallowing conditions, problems with specialized equipment and staff are limited. Therefore, the swallowing sound by the cervical auscultation method that can be done without invading swallowing and the breathing sound before and after swallowing are being collected.

  The collection of the swallowing sound and the breathing sound by the above method is performed by bringing a microphone into the inside of a sound collecting device such as a stethoscope and making it abut on the neck of the subject. However, since the microphones collect all the sounds present, it was difficult to collect accurate swallowing sounds and accurate breathing sounds. In addition, even if it was able to collect correctly, it was not possible to detect the subtle aspiration etc. only by collecting the sound.

  Therefore, as in Patent Document 1, a method for extracting swallowing sound data when breathing is stopped has been proposed, but the microphone collects sound existing outside even if the sound accompanying breathing is removed. It is difficult to determine the swallowing function simply and accurately. Furthermore, since the timing of respiration is also an important factor in the measurement of swallowing function, it was not desirable to ignore the data on respiration.

JP, 2015-51159, published patent publication

Therefore, in the present invention, in order to measure the swallowing function, for example, in order to perform RSST (repetitive saliva swallowing test), noise is reduced by using a sensor incorporating a transmitting material that absorbs and attenuates the external air vibration noise that becomes noise. By detecting less intratracheal respiratory sound data and detecting intratracheal respiratory pressure and swallowing pressure, it is possible to collect accurate and clear swallowing related data in consideration of non-sounding swallowing related data, The purpose is to obtain and visualize a synthetic waveform of sound and pressure in the trachea.

In order to solve the above-mentioned subject, the 1st invention constitutes a swallowing function measuring system as follows.
First, a swallowing function measurement system having a sensor, a waveform processing device, and an output device.
Second, the sensor is a pressure detection means for detecting respiration pressure and swallowing pressure which is pressure in the trachea, and pressure noise in the trachea, which is a pressure in the trachea while being in contact with a recess in the subject's thyroid cartilage in the exterior And pressure and sound detection elements serving as sound detection means for detecting swallowing sound and laryngeal residual sound, surrounded by a damping transmission material that can absorb external air vibration but absorb pressure and sound in the trachea Shall be provided.
Thirdly, on one surface of the exterior of the sensor, a metal plate capable of collecting pressure and sound in the trachea is formed into a dome-shaped round contact surface that easily contacts the recess, and the contact surface The respiratory pressure and the inspiratory pressure in the trachea transmitted from T. will be transmitted to the detection element. In the exterior of the sensor, an air chamber is provided between the exterior on the opposite side to the contact surface and the detection element, and the respiratory sound, swallowing sound and laryngeal residual sound in the trachea transmitted from the contact surface are detected. Shall be communicated to
Fourth, the waveform processing apparatus acquires a combined pressure and sound waveform based on the information on respiratory pressure and swallowing pressure, respiratory sound, swallowing sound, and laryngeal residual sound in the trachea detected by the pressure and sound detection element. It shall be.
Fifth, the output device is a display device that displays a composite waveform of pressure and sound acquired by the waveform processing device.

A second invention is a swallowing function measurement system to which an audio output device such as a speaker, an earphone, or a headphone is added as an output device in the first invention.
A third aspect of the invention is the swallowing function measurement system according to the first or the second aspect, wherein the connection between the sensor, the waveform processing device, and the output device is wired or wireless.
According to a fourth aspect of the present invention, in the first or second or third aspect, the combined pressure and sound waveform acquired by the waveform processing device is a pressure waveform of respiratory pressure and swallowing pressure in the trachea, respiratory sound and swallowing sound. And a swallowing function measurement system that is a synthetic waveform of the sound pressure of laryngeal residual sound.

The present invention has the following effects.
First, by acquiring a combined pressure and sound waveform based on the information of intratracheal respiratory pressure and swallowing pressure, respiratory sound, swallowing sound and laryngeal residual sound detected by pressure and sound detection elements, We have been able to provide a swallowing function measurement system that shows the presence of foreign matter and errors.
Second, the sensor forms a dome-shaped round contact surface on one surface of the sheath, which is capable of collecting pressure and sound in the trachea from a pit in the vicinity of the subject's thyroid cartilage. As a result, no space was created between the skin and the skin, and pressure and sound in the trachea could be accurately captured.

Thirdly, if the contact surface of the sensor is resin, the internal pressure of the sensor changes due to the strength of the external pressure to the sensor, and the pressure of the neck attachment pressure for detecting the pressure in the trachea correctly Although the adjustment is difficult and the usability is poor, in the present invention, since the contact surface is a metal plate, it is not difficult to adjust the pressure from the outside, and the contact surface of the sensor lightly adheres to the skin. External pressure enabled detection of intratracheal pressure and sound.
Fourth, the sensor detects pressure and sound detection elements in the exterior, noise is absorbed by the external air vibration noise, but attenuation is necessary data can be properly transmitted pressure and sound in the trachea Since it is provided by being surrounded by the transmission material, it is possible to block the surrounding noise, and the pressure and sound in the trachea can be detected easily and accurately.

Fifth, since an air chamber is provided between the exterior surface on the opposite side of the contact surface and the detection element in the exterior of the sensor, and the sound in the trachea transmitted from the contact surface is transmitted to the detection element, accurate swallowing It became possible to detect related sound information.
Sixth, the waveform processing device acquires a combined pressure and sound waveform based on the intratracheal respiratory pressure and swallowing pressure, respiratory sound, and swallowing sound and laryngeal residual sound information detected by the pressure and sound detection element, Since the output device is a display device that displays the combined waveform of pressure and sound acquired by the waveform processing device, visualization of the acquired information becomes possible, and wide-ranging information can be used.

Although it is an effect of the second invention, since it has an audio output device such as a speaker, an earphone, a headphone, etc. as an output device, it can be swallowed by eating it while listening to the sound of swallowing by oneself and the caregiver. As well as being able to concentrate, both became aware of how swallowed.
Although it is an effect of the third aspect of the invention, since the connection between the sensor, the waveform processing device, and the output device can be wired or wireless, only the sensor is recessed in the vicinity of the thyroid cartilage of the subject by making it wireless. It becomes a swallowing function measurement system that can be used in various ways, such as using it as telemedicine, collecting long-term swallowing function information, storing it, and analyzing it to understand the subject's health status. The

FIG. 1 is a schematic view showing a first embodiment of the present invention. The schematic diagram of 2nd Example which connected only PC and a display apparatus. The schematic diagram of the usage example which connected only the speaker. Explanatory drawing which shows the synthetic | combination waveform of the pressure in the state from swallowing to laryngeal residual and aspiration. The figure which shows the foreign substance residual state of laryngeal residual and aspiration.

Hereinafter, modes for carrying out the present invention will be described together with examples.
The present invention is a swallowing function measurement system, and FIG. 1 is a schematic view showing the first embodiment, and the swallowing function measurement system is a hardware interface including a sensor 1 and a speaker 20 as an audio output device. And a PC (personal computer) 3 serving as a waveform processing device, and a display 4 serving as an output device for visualization.

  As shown in FIG. 1, the sensor 1 is a pressure detection means for detecting respiratory pressure and swallowing pressure, which are pressures in the trachea, by being brought into contact with a recess in the vicinity of thyroid cartilage of a subject in the sheath 10 Pressure and sound detection element 11 that detects sound of breathing sound and swallowing sound and laryngeal residual sound, which is the sound of a sound, external air vibration sound is absorbed and attenuated, but intratracheal pressure and sound transmission are possible And the damping transmission material 5 is provided. That is, the sensor 1 can detect not only the sound but also the change in pressure in the trachea by the detection element 11.

  The exterior 10 of the sensor 1 is made of a metal plate on one outer surface, and has a dome-shaped round contact surface 12 with a size that easily contacts the recess near the thyroid cartilage of the subject. The abutment surface 12 has a dome-shaped round shape so that the pressure and sound in the trachea to be detected can be easily grasped by making the shape fit snugly in the depressions above and below the thyroid cartilage. .

  The contact surface 12 of the sensor 1 is made of metal plate in order to be able to collect respiratory pressure and swallowing pressure in the trachea, breathing noise, swallowing noise and laryngeal residual sound, and it is too stiff to make sound and pressure Hard metals that are hard to transmit are not suitable. In the first embodiment, an aluminum plate having a thickness of about 0.2 mm is used. The aluminum plate is used by using the contact surface 12 as a metal plate in order to prevent the pressure (respiratory pressure and swallowing pressure) of the collection target from being changed by the pressing force on the sensor 1. In the case of this contact surface 12, it may be light enough to lightly adhere to the skin.

  If the contact surface 12 is made of a soft material or a material such as a stethoscope, the detection result may differ depending on the person who applies the sensor 1 to a depression near the thyroid cartilage of the subject. For example, if the contact surface 12 is a thin resin plate, pressing the sensor 1 causes dents, and the change in internal pressure due to the strength of the external pressure becomes large, making it difficult to adjust the neck contact pressure and usability Deteriorate.

  A detection element 11 is mounted near the center of the interior of the exterior 10 (the center slightly lower part in the sensor 1 in FIG. 1). The detection element 11 is made of a piezoelectric element and is manufactured so that the upper surface in FIG. 1 can mainly detect the pressure in the trachea and the lower surface can easily detect the sound in the trachea. The detection element 11 is provided so as to be surrounded by a damping transmission material 5 capable of absorbing external air vibration noise but transmitting pressure and sound in the trachea.

  The pressure is detected by transmitting respiratory pressure and swallowing pressure in the trachea transmitted from the contact surface 12 to the detection element 11 through the attenuation transmission member 5. The detection of the pressure is performed mainly by sampling the pressure going straight from the center of the contact surface 12 to the detection element 11. With regard to respiratory pressure, the pressure of laryngeal residual is also detected in it, but it is too short as waveform processing data at laryngeal residual, so the waveform is synthesized with respiratory sound data at laryngeal residual described later and processed Be done. On the other hand, in the case of silent aspiration, there is almost no sound, and the difference in the pressure of respiration in the trachea makes the aspiration known, and waveform processing is performed only with respiratory pressure data.

  For detection of sound, an air chamber 6 is provided between the exterior surface 10 on the opposite side to the contact surface 12 and the detection element 11, and the respiratory sound and swallowing sound and laryngeal residual sound in the trachea transmitted from the contact surface 12 are detected elements 11 by transmitting through the damping transmission material 5. Note that since the external air vibration noise, which is noise, often intrudes from the exterior 10 on the side opposite to the contact surface 12, the air chamber 6 may be damped if it reaches the exterior 10 on the opposite side. It is preferable to make small the part of the exterior 10 in which the material 5 does not exist.

  Unlike the pressure detection, the sound detection is performed by the sound in the trachea transmitted from the entire contact surface 12. For the detection of sound, respiratory sound and swallowing sound and laryngeal residual sound are required as collected sounds as a swallowing function measurement system, but in the first embodiment, vocal sounds are also detected. As a result, it is possible to find people with speech problems.

  The detection element 11 is surrounded by the damping transmission material 5, and the damping transmission material 5 attenuates the external air vibration noise collected from the sheath 10, and the pressure to be detected in the trachea detected from the abutment surface 12 The detection target sound is accurately transmitted to the detection element 11. However, the attenuation transmission material 5 on the side of the contact surface 12 of the detection element 11 (upper part of the detection element 11 in FIG. 1) and the attenuation transmission material 5 on the opposite side (lower part of the detection element 11 in FIG. There is.

  In the first embodiment, the damping force transmitting member 5 in the contact surface 12 side of the detection element 11, that is, the exterior 10 on the front side is made of the elastic porous material 51, and the opposite side of the detection element 11 That is, the damping transmission material 5 in the exterior 10 on the back side is made of the gel 52 of high elastic modulus.

  The elastic porous material 51 is used as the damping transmission material 5 on the side of the contact surface 12 of the detection element 11 because the external air vibration sound is absorbed and damped, and the trachea to be detected received from the contact surface 12 Pressure and sound accurately to the detection element 11. It should be noted that if the porous material 51 is not elastic and too rigid, it will transmit noise and vibration from other than the contact surface 12, so by using the elastic porous material 51, the detection element is removed while removing the vibration. The pressure and sound transmitted to 11 are simplified, and the pressure and sound in the trachea to be detected are accurately detected.

  A gel 52 with a high elastic modulus is used as the damping transmission material 5 in the exterior 10 on the back side of the detection element 11. A material having a high strength and a high modulus of elasticity than at least the elasticity of the porous material 51 is used. There are two reasons. The first reason is that the external air vibration noise intruding from other than the contact surface 12 is largely blocked and attenuated. The porous material 51 also absorbs and attenuates external air vibration noise, but since the blocking power and sound absorption power is low, it is difficult for the detection element 11 to pick up the external air vibration noise by using the gel 52 having a high sound absorbing power. doing.

  The second reason is that the pressure in the trachea collected from the contact surface 12 can be accurately detected by the detection element 11. That is, if the gel 52 of high elastic modulus is not present on the back side of the detection element 11, the pressure in the trachea collected from the contact surface 12 is released from the detection element 11, and accurate detection can not be performed. .

  An interface 2 is provided between the sensor 1 and the PC 3. Although FIG. 1 shows the wired connection between the sensor 1 and the PC 3, it is needless to say that wireless connection such as Bluetooth (registered trademark) may be used. The interface 2 in the first embodiment is a wired connection with the PC 3 but is equipped with Bluetooth in preparation for use with a tablet PC or smart phone separately. Wireless communication makes it easy to use for telemedicine and continuous observation.

  Since the interface 2 in the first embodiment of FIG. 1 also has a function as an amplifier, a speaker 20 as an audio output device is provided. Of course, the audio output device is not limited to the speaker 20, and earphones and headphones can also be used. The PC 3 also includes a tablet PC and a smart phone.

  The PC 3 serving as the waveform processing device acquires a composite waveform of pressure and sound based on the respiratory pressure and swallowing pressure in the trachea detected by the pressure and sound detection element, and information on respiratory sound and swallowing sound and laryngeal residual sound. The synthetic waveform of pressure and sound acquired by this waveform processing device is a pressure waveform of respiratory pressure and swallowing pressure in the trachea, and a synthetic waveform of sound pressure of respiratory sound and swallowing sound and laryngeal residual sound. The PC 3 also has a role of storing waveform data and audio data. Of course, these data can also be stored in the cloud, and such storage makes it easy to share data.

  FIG. 4 is an explanatory view showing a synthetic waveform of pressure and sound in the state from swallowing to laryngeal residual and aspiration displayed on the display 4, and this synthetic waveform is acquired by PC3. As the waveform data, the larger one of pressure and sound (sound pressure) in the state from the above-mentioned swallowing to laryngeal residual and aspiration is used.

  As the output device, the display 4 is used as a display device for visualizing (displaying) a combined waveform of pressure and sound acquired by the waveform processing device. Of course, a smart phone or a tablet PC may be used. The synthesized waveform is displayed as shown in FIG.

  Part A in FIG. 4 is a waveform of respiration in a normal state, A1 shows a waveform in inspiration, and A2 shows a waveform in expiration. B part in FIG. 4 is a waveform at the time of swallowing, B1 is a waveform at the start of swallowing, and B2 is a waveform during swallowing.

  Part C in FIG. 4 is a composite waveform of respiratory sound and respiratory pressure when larynx remains, C1 is a waveform of inspiration when larynx remains, and C2 is a waveform of exhalation when larynx remains. A large longitudinal laryngeal residual respiratory pressure waveform appears, and thereafter, in the portion C2 in the figure, the waveform decays in a substantially triangular shape. In this part, the respiratory pressure decreases and a composite waveform of respiratory sound (sound pressure) and respiratory pressure appears. The laryngeal retention time is the time when something swallowed in the larynx above the vocal cords 7 adheres, as shown in FIG. The code | symbol 8 in FIG. 5 is laryngeal residue.

  Part D in FIG. 4 is a waveform showing a state in which laryngeal residue intrudes into the trachea and leads to an aspiration. D1 is an inspiratory waveform, D2 is a complex composite waveform of exhalation, and the waveform of D2 generally appears first with a large amplitude longitudinal respiratory pressure, and the pressure weakens at the time of decay and the respiratory sound (sound pressure) It becomes a waveform that is a composite waveform with respiratory pressure, and finally shows a state in which pressure is applied to the respiratory sound and the aspiration pressure continues. Part E in FIG. 4 is a waveform indicating an error time, E1 is a waveform of inspiration, and E2 is a waveform of expiration. The waveform of E2 is the waveform of respiratory pressure of exhaled breath at the time of aspiration, but the waveform of respiratory pressure is larger, so the waveform of respiratory pressure appears There is. At the time of the aspiration, it is a time when something swallowed in the trachea below the vocal cords adheres, and the code 9 in FIG.

  The first embodiment also includes the speaker 20 which is an audio output device as an output device, but as in the second embodiment shown in FIG. 2, the speaker 20 is removed from the interface 2 and the display is directly performed via the PC 3 It is also possible to connect to 4. Furthermore, as in the example of use shown in FIG. 3 for easy use, it is also possible to use one in which the speaker 20 is directly connected from the interface 2. The audio output device is not limited to the speaker, and may use earphones, headphones, and the like.

1 ··· Sensor 2 ··· Interface 3 · · · PC (personal computer)
4 ··· Display 5 · · · Damping transmission material 51 · · · Porous material 52 · · · Gel 6 · · · Air chamber 7 · · · Vocal cord 8 · · · · Laryngeal residue 9 ··· Aspiration deposit 10 · · · Exterior 11 · · · Detection element 12 · · · Abutment surface A · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · contact surface A · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · laryngeal residue 9 · · · aspiration deposit 10 · · · · · 11 · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · Synthetic waveform C1 of respiratory sound and respiratory pressure at laryngeal remnant waveform C2 of inspiratory waveform at laryngeal remnant waveform of exhalation at laryngeal residual D: laryngeal residue intrudes into trachea The waveform D1 showing a state leading to an error. The waveform D2 of the inspiratory waveform. The waveform E .. Waveform E2 ... breath of waveform

Claims (4)

A swallowing function measurement system comprising a sensor, a waveform processing device, and an output device,
The sensor includes pressure detection means for detecting respiratory pressure and swallowing pressure, which is pressure in the trachea, in a sheath and in contact with a recess in the vicinity of the thyroid cartilage of the subject, respiratory sound and swallowing sound, which is sound in the trachea Pressure and sound detection elements serving as sound detection means for detecting laryngeal residual sound, provided around a damping transmission material that can absorb external air vibration sound but allow transmission of pressure and sound in trachea;
A metal plate capable of collecting pressure and sound in the trachea is formed on one surface of the exterior of the sensor to form a dome-shaped round contact surface easily coming into contact with the recess, and the trachea transmitted from the contact surface Transmitting respiratory pressure and swallowing pressure to the detection element,
In the exterior of the sensor, an air chamber is provided between the exterior on the opposite side to the contact surface and the detection element, and the respiratory sound, swallowing sound and laryngeal residual sound in the trachea transmitted from the contact surface are transmitted to the detection element To be
The waveform processing device is configured to obtain a combined pressure and sound waveform based on the respiratory pressure and swallowing pressure in the trachea detected by the pressure and sound detection element, and information on respiratory sound, swallowing sound and laryngeal residual sound. ,
The swallowing function measurement system, wherein the output device is a display device that displays a combined waveform of pressure and sound acquired by the waveform processing device.
The swallowing function measurement system according to claim 1, wherein the output device includes an audio output device such as a speaker, an earphone, and a headphone.
The swallowing function measurement system according to claim 1 or 2, wherein the connection between the sensor, the waveform processing device, and the output device is wired or wireless.
  The synthetic waveform of pressure and sound acquired by the above-mentioned waveform processing apparatus is characterized by a pressure waveform of respiratory pressure and swallowing pressure in the trachea, and a synthetic waveform of sound pressure of respiratory sound and swallowing sound and laryngeal residual sound. The swallowing function measurement system according to claim 1 or 2.

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