JP2021062133A - Deglutition function measurement apparatus and deglutition function measurement system - Google Patents

Abstract

To provide a deglutition function measurement apparatus and a deglutition function measurement system which simply acquire information for allowing suitable determination of the deglutition function of a person without complicated inspection externally, and display the information.SOLUTION: A deglutition function measurement apparatus 1 according to an embodiment comprises an electrode part 11, a measurement part 12, and an output part 13. The electrode part is attached from the outside to the body surface in the vicinity of the laryngeal of a subject. The measurement part receives a signal from the electrode part and acquires information indicating a movement from the laryngeal to the upper esophagus part when the subject swallows a substance. The output part outputs to an external apparatus the information indicating the movement from the laryngeal to the upper esophagus part acquired by the measurement part.SELECTED DRAWING: Figure 1

Description

Embodiments of the present invention relate to a swallowing function measuring device and a swallowing function measuring system.

When a person swallows something, a swallowing activity is performed in which the object is sent from the oral cavity to the esophagus and then to the stomach. Physiologically, this swallowing activity is an active movement that sends things in the oral cavity to the pharynx by the tongue, a reflex movement that passes things from the pharynx to the esophagus (swallowing reflex), and an involuntary movement that transports things from the esophagus to the stomach. (Peristaltic movement) is a phenomenon that occurs continuously. Therefore, it can be said that swallowing activity is a complex coordination of the activities of the muscles and organs involved.

If this swallowing activity is not performed smoothly due to aging or some kind of disorder, not only is it difficult to swallow things, but also swallowing disorders such as aspiration are caused. For example, aspiration can have very serious consequences for some people, and how to identify, diagnose, and treat dysphagia is a major issue.

As a method of diagnosing dysphagia, in addition to interviews and palpations by doctors, various medical image diagnoses such as endoscopic ultrasonography, ultrasonic imaging equipment, X-ray diagnostic equipment, and X-ray CT equipment (computed tomography) There is a method using an apparatus or a multi-channel internal pressure measurement HRM (High resolution diagnostic) method. However, the diagnostic method using this medical image diagnostic apparatus may not always be an appropriate diagnostic method because the examination is complicated and the burden on the subject to be examined is heavy.

On the other hand, a method of evaluating the swallowing function by measuring the impedance from the pharynx to the upper esophagus during swallowing activity has also been proposed. In the case of this method, the swallowing function is evaluated by using not only the impedance but also the sound of swallowing.

"Measurement of Cervical Electrical Impedance and Evaluation of Swallowing Function" Takao Nakamura, Toshimasa Kusuhara, Naotake Yamamoto Journal of Japanese Society of Biorheology (B & R) Vol. 19, No. 3, 2005

However, considering that the sound of swallowing reverberates from the pharynx to the upper esophagus, it is unclear whether an appropriate diagnosis can be made using voice information. In addition, the relationship between the measured impedance and the sound information also varies from subject to subject, or even if the subject is the same, each swallowing measurement varies, making it impossible to make a quantitative diagnosis.

Furthermore, the measured impedance will be indicated by a waveform, but it may be difficult to understand even if only the waveform is presented to the doctor making the diagnosis.

The present invention has been made to solve the above problems, and an object of the present invention is to easily obtain and display information capable of appropriately determining a person's swallowing function from the outside without performing a complicated examination. It is an object of the present invention to provide a swallowing function measuring device and a swallowing function measuring system.

The swallowing function measuring device according to the embodiment includes an electrode unit, a measuring unit, and an output unit. The electrode portion is attached to the body surface from the outside near the larynx of the subject. The measuring unit receives a signal from the electrode unit and acquires information indicating the movement of the upper esophagus from the pharynx when the subject swallows an object. The output unit outputs information indicating the movement of the upper esophagus from the pharynx acquired by the measurement unit to an external device.

The swallowing function measuring system according to the embodiment includes a swallowing function measuring device (including an electrode unit, a measuring unit, and an output unit) and a diagnostic support device (including an inspection unit and a display control unit). Be prepared. In the swallowing function measuring device, the electrode portion is attached to the body surface from the outside near the larynx of the subject. The measuring unit receives a signal from the electrode unit and acquires information indicating the movement of the upper esophagus from the pharynx when the subject swallows an object. The output unit outputs information indicating the movement of the upper esophagus from the pharynx acquired by the measurement unit to an external device. In the diagnostic support device, the examination unit acquires the pressure when an object passes from the pharynx of the subject through the upper esophagus from a sensor arranged along the longitudinal direction of the upper esophagus from the pharynx. The display control unit displays the inspection result acquired by the inspection unit on the display unit.

Since the present invention adopts such a configuration, it is possible to easily obtain and display information capable of appropriately determining a person's swallowing function from the outside without performing a complicated examination.

It is a block diagram which shows the whole structure of the swallowing function measuring apparatus in 1st Embodiment. It is explanatory drawing which shows an example of the state which attached the electrode part of the swallowing function measuring apparatus to the vicinity of the larynx of a subject from the outside in 1st Embodiment. It is a flowchart which shows the flow of the examination using the swallowing function measuring apparatus in 1st Embodiment. It is a display example of the waveform which shows the inspection result acquired by the swallowing function measuring apparatus in 1st Embodiment. It is a block diagram which shows the whole structure of the swallowing function measurement system in 2nd Embodiment. This is a display example showing the test results acquired in the swallowing function measurement system according to the second embodiment. It is a flowchart which shows the flow of the examination using the swallowing function measurement system in 2nd Embodiment.

Hereinafter, embodiments will be described in detail with reference to the drawings.

(First Embodiment)
[Configuration of diagnostic support device]
FIG. 1 is a block diagram showing an overall configuration of the swallowing function measuring device 1 according to the first embodiment. The swallowing function measuring device 1 is a laboratory technician or a doctor who makes a diagnosis when inspecting whether or not the swallowing function is normally performed (hereinafter, these persons are collectively referred to as a "medical worker"). Is a device used by.

Therefore, the swallowing function measuring device 1 is arranged in a so-called examination room, examination room, or the like. However, it is possible to adopt a portable type or a portable type in consideration of not only the use in such a deferred manner but also the use in, for example, a visit inspection.

The medical worker uses the swallowing function measuring device 1 to inspect and diagnose the swallowing function. Therefore, the site to be inspected is near the larynx of the subject. In the test, the subject may be tested while awake or lying down.

The swallowing function measuring device 1 according to the first embodiment includes an electrode unit 11, a measuring unit 12, an output unit 13, an input unit 14, a storage unit 15, and a control unit 16. Further, each of these parts except the electrode part 11 is connected to each other via the bus B.

The electrode portion 11 is attached to the body surface near the larynx of the subject from the outside when inspecting the swallowing function of the subject. The electrode unit 11 measures the impedance when the subject swallows an object and also measures the movement of myoelectricity. Specifically, for example, when measuring impedance, a plurality of electrode portions 11 are used on the body surface near the larynx of the subject, for example, the upper esophageal sphincter (hereinafter, appropriately referred to as “UES”). It is mounted in the vicinity and a current is passed between the electrode portions 11 at both ends. Then, the change in potential is measured by the electrode portions 11 mounted between the electrode portions 11 at both ends.

On the other hand, regarding the movement of myoelectricity, the electrode portion 11 measures the movement of the muscle in the vicinity of the larynx during swallowing. At this time, the electrode portion 11 used for measuring the impedance and measuring the movement of the myoelectric may be provided separately. Further, in order to reduce the number of electrode portions 11 mounted near the larynx of the subject, the function of measuring impedance and myoelectric movement may be combined.

FIG. 2 is an explanatory view showing an example of a state in which the electrode portion 11 of the swallowing function measuring device 1 is attached to the body surface near the larynx of the subject from the outside in the first embodiment. In FIG. 2, the subject is facing to the upper right and the larynx is visible in front. A plurality (five here) of electrode portions 11 are attached to the larynx under the lower chin of the subject.

Further, the cord of the electrode portion 11 is lowered from the larynx toward the chest and is fixed to the skin with tape. The position where the electrode portion 11 is attached near the larynx is not limited to the position shown in FIG. Further, the number of electrode portions 11 to be attached is not limited to five.

The electrode unit 11 is electrically connected to the measuring unit 12, and the signal measured by the electrode unit 11 is transmitted to the measuring unit 12. The measuring unit 12 receives the signal from the electrode unit 11 and acquires information indicating the movement of the upper esophagus from the pharynx when the subject swallows the object. Here, the "information indicating the movement from the pharynx to the upper esophagus" is, for example, the above-mentioned information indicating the movement of impedance and myoelectricity.

The output unit 13 outputs the information indicating the movement of the upper esophagus from the pharynx acquired by the measurement unit 12 to the external device P. This is to present information indicating the movement of the upper esophagus from the pharynx to the medical staff. Therefore, the output unit 13 is connected to the external device P wirelessly or by wire.

In FIG. 1, an information terminal is shown as an external device P. Examples of the information terminal include a personal computer. Further, for example, it may be a workstation that can be connected to various network systems constructed in a medical institution. Further, the information terminal may be a diagnostic support device which is a dedicated device for diagnostic support configured to be able to execute various functions described later.

As described above, the swallowing function measuring device 1 described here is not provided with a so-called display unit such as a display. However, it is not excluded that the swallowing function measuring device 1 is provided with a display unit.

The input unit 14 is composed of, for example, various switches and knobs for adjusting the power supply, amplifier phase adjustment, and output balance, and receives various input operations by medical professionals. The operation of the medical staff input via the input unit 14 is converted into an input signal and transmitted to the control unit 16 and the like via the bus B.

In addition to the switches described above, the input unit 14 can use, for example, a GUI (Graphical User Interface) or various types of input devices such as buttons, keyboards, and trackballs.

The storage unit 15 is composed of, for example, a semiconductor or a magnetic disk, and stores programs and data executed by the control unit 16 and the like. Further, when the electrode unit 11 is attached to the subject and the test is performed, a signal transmitted from the electrode unit 11, for example, the test result is stored.

In the embodiment of the present invention, the description will be described below on the premise that the storage unit 15 is provided in the swallowing function measuring device 1. However, an external storage medium such as a server device or a hard disk drive, which is connected to the swallowing function measuring device 1 wirelessly or by wire, may be used as the storage unit.

Further, here, it is premised that all the information and the like indicating the movement of the upper esophagus from the pharynx acquired by the measuring unit 12 are stored in the storage unit 15. However, it is also possible to provide a plurality of storage units 15 and store, for example, impedance information, information indicating the movement of myoelectricity, and the like separately.

The control unit 16 comprehensively controls each unit of the swallowing function measuring device 1. The control unit 16 receives, for example, an operation instruction from a medical worker via the input unit 14 as an input signal, and controls each unit so that a desired operation is performed.

The control unit 16 includes, for example, a CPU (Central Processing Unit), a ROM (Read Only Memory), and a RAM (Random Access Memory) (not shown).

The CPU reads and executes a boot program for activating the swallowing function measuring device 1 from the ROM based on the input signal from the input unit 14, and reads various operating systems stored in the storage unit 15. Further, the CPU controls various devices based on input signals from other external devices (not shown in FIG. 1) via the input unit 14 and the like. Further, the CPU reads the program and data stored in the RAM, the storage unit 15, and the like and loads them into the RAM, and also performs a series of processes such as calculation and processing of the data based on the command of the program read from the RAM. It is a processing device to be realized.

[motion]
Next, the process in the swallowing function measuring device 1 will be described with reference to FIGS. 3 and 4. FIG. 3 is a flowchart showing a flow of an examination using the swallowing function measuring device 1 according to the first embodiment. That is, it is a flow of examination in which a medical worker measures the swallowing function of a subject.

As a preparation before the examination is started, the electrode portion 11 is attached from the outside to the body surface near the larynx of the subject. The mounting position depends on the physique of the subject and the like, but is, for example, the position shown in FIG. Further, as described above, the electrode unit 11 is connected to the measuring unit 12.

Before the subject actually swallows an object (here, for example, a liquid), measurement is performed in a state where the liquid is not swallowed (ST1). Further, the measured result is stored in, for example, a storage unit 15 via the measurement unit 12.

Next, the subject swallows the liquid further, and a test for measuring the change in impedance from the pharynx to the upper esophagus and the movement of myoelectricity at this time is started (ST2). When the test is started, the swallowing function measuring device 1 acquires a signal indicating the test result from the electrode unit 11 via the measuring unit 12 (ST3).

The measuring unit 12 determines whether or not the information indicating the change in impedance and the information indicating the movement of myoelectricity, which are the information indicating the movement of the upper esophagus from the pharynx, have been transmitted from the electrode unit 11 (ST4). , If all the information has not been transmitted, it will stand by as it is (NO in ST4). On the other hand, if it is determined that the information indicating the movement of the upper esophagus has been sent from the pharynx without omission (YES in ST4), one test is completed, and the obtained test result is stored in the storage unit. It is transmitted to 15 and stored (ST5).

The test for determining the swallowing function of the subject is performed a predetermined number of times, for example, 10 times. Then, the inspection is continuously performed. Therefore, the measuring unit 12 continuously stores the inspection results for a predetermined number of times in the storage unit 15.

The measurement unit 12 has acquired the inspection results of 10 measurement times from the 1st inspection to, for example, the 10th inspection, that is, 10 inspections by confirming that the 10th inspection has been executed. Is determined whether or not all of the above is completed (ST6).

When the measurement unit 12 does not receive the test completion signal from the medical staff via the input unit 14 (NO in ST6), the test processing step described so far is executed again. On the other hand, when the signal of the completion of the test is received from the medical staff via the input unit 14 (YES in ST6), the test for the subject is completed.

Instead of receiving the inspection completion signal from the medical staff via the input unit 14, the measurement unit 12 can determine the inspection completion. In this case, if the measuring unit 12 determines that all the inspections have not been completed, the inspection processing step described so far is executed again. On the other hand, when it is determined that all the tests have been completed, the tests for the subject are completed.

When the examination is completed, the control unit 16 outputs the information indicating the movement of the upper esophagus from the pharynx obtained in the examination to the external device P via the output unit 13 (ST7). The external device P displays information indicating the movement of the upper esophagus from the pharynx output from the swallowing function measuring device 1.

Here, the case where information indicating the movement of the upper esophagus from the pharynx is output to the swallowing function measuring device 1 after all the examinations are completed has been described. For example, the swallowing function measuring device 1 can be used in real time during the examination. It is also possible to have the external device P output information indicating the movement of the upper esophagus from the pharynx. In this case, for example, the information indicating the movement of the upper esophagus from the pharynx acquired by the measuring unit 12 is transmitted to the storage unit 15 and also transmitted to the output unit 13 and transmitted to the external device P. Will be done.

FIG. 4 is a display example of a waveform showing the test results acquired by the swallowing function measuring device 1 according to the first embodiment. The waveform is displayed on the display unit of the external device P. The waveform is shown in two upper and lower stages, and the upper stage is an electromyographic waveform (unit: “μV”, for example). On the other hand, the lower row is a waveform showing impedance (unit is, for example, "Ω"). In addition, a scale is displayed at the bottom of the display unit. This scale indicates the elapsed time, and the unit is, for example, seconds. Here, one second is shown between the large scales.

Looking at the impedance waveform in the lower row, there is a part where the waveform is greatly depressed. This is because when the subject swallows, a potential difference occurs between the plurality of electrode portions 11, and this potential difference appears in the waveform. On the other hand, when the subject is not swallowing, the waveform is maintained in a generally flat state because no impedance potential difference is generated.

On the other hand, regarding the EMG waveform shown in the upper row, the movement of the muscle from the pharynx to the upper esophagus, that is, the contraction and relaxation of the muscle appears as the EMG waveform. In addition, the greater the movement of the muscle, the larger the waveform appears. Here, since the electrode portion 11 is attached near the larynx of the subject, the movement of the muscles around the upper esophagus from the pharynx of the subject contracting and relaxing becomes the waveform shown in the upper part of FIG. It is appearing.

Looking at the upper myoelectric waveform and the lower impedance waveform, it can be seen that the myoelectric waveform changes significantly up and down while the impedance waveform begins to drop and the drop returns to its original state. This is because, as described above, when the subject swallows, the muscles around the upper esophagus from the pharynx contract and relax.

That is, from the waveform showing the movement of myoelectricity and the waveform of impedance, it can be understood that they are related to each other and that the change shown by the waveform is caused by the subject swallowing.

Therefore, the medical staff can grasp the swallowing state of the subject by observing these waveforms. The waveform shown in FIG. 4 shows a normal swallowing state. For example, when the movement of myoelectricity is small and the drop in impedance waveform is small during swallowing, normal swallowing is not performed for some reason. Can be estimated.

From the above, by measuring the movement and impedance of myoelectricity from the pharynx to the upper esophagus, the movement from the pharynx to the upper esophagus when the subject necessary for diagnosing swallowing function swallows is shown. Information can be obtained. Moreover, since the information indicating the movement of the upper esophagus from the pharynx is acquired via the electrode portion externally attached to the body surface near the larynx of the subject, the swallowing function of a person is appropriately performed. Information that can be determined can be easily acquired and displayed from the outside without performing complicated inspections.

In addition, the test is a minimally invasive test for the subject because it is possible to obtain information indicating the movement of the upper esophagus from the pharynx by attaching an electrode portion to the subject from the outside. It can be said that.

(Second Embodiment)
Next, a second embodiment of the present invention will be described. In the second embodiment, the same components as those described in the first embodiment described above are designated by the same reference numerals, and the description of the same components will be omitted because they are duplicated.

FIG. 5 is a block diagram showing the overall configuration of the swallowing function measurement system S according to the second embodiment. The swallowing function measuring system S is composed of a swallowing function measuring device 1 and a diagnostic support device 2. Here, in the second embodiment, the diagnosis support device 2 corresponds to the external device P to which the swallowing function measuring device 1 described in the first embodiment outputs the measurement result.

Since the configuration of the swallowing function measuring device 1 in the second embodiment is as described in the first embodiment, the configuration of the diagnostic support device 2 will be described below. Therefore, in FIG. 5, the details of the configuration of the swallowing function measuring device 1 are omitted.

[Configuration of diagnostic support device]
FIG. 5 shows the overall configuration of the diagnostic support device 2 according to the second embodiment. The diagnosis support device 2 is, for example, a personal computer. Further, for example, it may be a workstation that can be connected to various network systems constructed in a medical institution. Further, the diagnostic support device 2 may be a dedicated device for diagnostic support configured to be able to execute various functions described later.

Since the diagnosis support device 2 is a device used by a medical worker who inspects and diagnoses the swallowing function of a subject, it is arranged in a so-called examination room, examination room, or the like. However, it is possible to adopt a portable type or a portable type in consideration of not only the use in such a deferred manner but also the use in, for example, a visit inspection.

The diagnostic support device 2 according to the embodiment includes an input unit 21, a display 22, a storage unit 23, a communication control unit 24, a removable disk 25, an inspection unit 26, a display control unit 27, and a control unit 28. It has. Further, each of these parts is connected to each other via a bus B1.

The input unit 21 accepts various input operations by medical professionals such as image display, image switching, mode designation, and various settings. The operation of the medical staff input via the input unit 21 is converted into an input signal and transmitted to the control unit 28 and the like via the bus B1.

As the input unit 21, for example, a GUI (Graphical User Interface) or an input device such as a button, a keyboard, a trackball, or a touch panel displayed on the display 22 can be used.

The display 22 displays the processing result of the control unit 28 and the like. In addition, the analysis results based on the inspection conditions and inspection results are displayed. Further, an output signal is received from the display control unit 27 via the bus B1, and for example, a topography when a subject, which will be described later, swallows an object is displayed.

As the display 22, a liquid crystal display, an organic EL (Electroluminescence) display, or the like can be used. In addition to the display 22, the display 22 constitutes a part of the display unit, including an external display device such as a printing machine connected to the diagnosis support device 2 described later.

In the embodiment of the present invention, as shown in FIG. 5, the input unit 21 and the display 22 are described as one component of the diagnosis support device 2, but the configuration is not limited to this. For example, the display 22 may be configured separately from the diagnostic support device 2 instead of being a component of the diagnostic support device 2. Further, the input unit 21 can be a touch panel using the separate display.

The storage unit 23 is composed of, for example, a semiconductor or a magnetic disk, and stores programs and data executed by the control unit 28 and the like. Further, for example, when the above-mentioned sensor C is connected to the diagnosis support device 2, a signal transmitted from the sensor C, for example, an inspection result is stored. Alternatively, a reference value (threshold value) or the like used when analysis or diagnosis processing is performed is stored.

Further, the storage unit 23 stores a test program and a diagnostic support program used when measuring the swallowing function of the subject. Although the examination program and the diagnosis support program are shown as separate programs here, they may be configured as one program and stored in the storage unit 23.

In the embodiment of the present invention, the description will be described below on the premise that the storage unit 23 is provided in the diagnosis support device 2. However, an external storage medium such as a server device or a hard disk drive, which is connected to the diagnosis support device 2 wirelessly or by wire, may be used as the storage unit.

Further, here, it is premised that all the above-mentioned inspection programs, diagnosis support programs, signals transmitted from the sensor C, and the like are stored in the storage unit 23. However, it is also possible to provide a plurality of storage units 23 to separately store the inspection program, the diagnosis support program, the signal transmitted from the sensor C, and the like.

The communication control unit 24 is responsible for the connection with the swallowing function measuring device 1, for example, and controls the exchange of information. The connection between the swallowing function measuring device 1 and the diagnostic support device 2 may be wired or wireless. Further, the communication control unit 24 plays a role of connecting the diagnostic support device 2 to, for example, a medical image diagnostic device (modality), a server device, a workstation, etc., which are connected to each other in a communication network (not shown). .. Examples of the communication network N include networks such as LAN (Local Area Network) and the Internet.

Further, the standard regarding information and medical images exchanged with other devices via the communication control unit 24 and the communication network may be any standard such as DICOM (Digital Imaging and Communication in Medicine). In addition, when connecting to a communication network or the like, it does not matter whether it is wired or wireless.

The removable disk 25 is an optical disk or a flexible disk, and signals read and written by the disk drive are transmitted to and received from the control unit 28 via the bus B1. It is also possible to use the removable disk 25 as a part of the storage unit 23 described above.

The examination unit 26 executes an examination for diagnosing the swallowing function of the subject. Here, the inspection is performed by the method of HRM. In this test, a catheter (described later) is inserted through the nose of the subject to have the subject swallow a liquid such as water, and the change in pressure from the pharynx to the upper esophagus is observed. Therefore, the sensor provided on the catheter measures the pressure (internal pressure from the pharynx to the upper esophagus) when the liquid is drunk.

Moreover, when this HRM inspection method is used, not only the change in pressure from the pharynx to various parts in the upper esophagus is displayed in a waveform, but also the pressure is displayed, for example, the high pressure region is red and the low pressure region is blue. It is also possible to display the change as an image (topography display) by changing the color.

The test itself is performed multiple times and is the basis of the diagnosis. Also, instead of performing multiple times in succession, it is performed by drinking the liquid (starting measurement), ending the measurement, and repeating the interval. A waveform is acquired for each measurement. Then, analysis is performed based on the acquired waveform, and for example, the analysis result is represented by color-topography and displayed on the display 22. Further, the diagnosis result can be displayed on the display 22 by using the analysis result.

A sensor C is connected to the inspection unit 26. This sensor C is, for example, a device called a catheter, which is different from the diagnostic support device 2. When the swallowing function of the subject is examined, the catheter is inserted from the nose into the inside of the subject (from the pharynx to the upper esophagus), so that the sensor C is placed from the pharynx to the upper esophagus. The pressure at the time of contraction in each part is measured.

As described above, the sensor C is a pressure measuring sensor for measuring the internal pressure of the upper esophagus from the pharynx provided on the catheter. As long as it is a pressure measurement sensor, its form does not matter. Since, for example, 36 sensors C are provided in the catheter along the longitudinal direction of the catheter, the sensor C is attached to the upper part of the pharynx when the catheter is inserted from the pharynx into the upper esophagus. It will be placed between the esophagus and the border with the esophagus.

The specific processing of the inspection unit 26 is as follows. That is, for example, when the inspection unit 26 receives a signal of inspection execution from a medical worker via the input unit 21, the inspection unit 26 displays an input screen such as an inspection condition on the display 22 via the display control unit 27 or the like. Further, when the inspection conditions and the like are determined and the inspection is actually started, the information (waveform data) regarding the internal pressure of the upper esophagus from the pharynx measured by the sensor C is acquired as the inspection result. The acquired inspection result is transmitted to, for example, the storage unit 23 and stored.

In the test necessary for diagnosing swallowing function, as described above, a plurality of measurements are performed. The inspection unit 26 transmits and stores the inspection result for each measurement to the storage unit 23 each time. However, the inspection results of a plurality of measurement times may be collectively transmitted to the storage unit 23.

By performing the test using the HRM test method in this way, the movement of muscles and the like from the pharynx to the upper esophagus can be easily and appropriately grasped, and the swallowing function can be evaluated.

The display control unit 27 controls the display unit including the display 22 and the printing machine to display, for example, an analysis result or a diagnosis result. Further, the display of the topography based on the test result using the sensor C and the waveform showing the myoelectric information and the impedance measured by the swallowing function measuring device 1 are displayed together.

FIG. 6 is a display example showing the test results acquired by the swallowing function measurement system S in the second embodiment. In the display example, the display control unit 27 displays the inspection result on the display 22, the topography is displayed in the upper row, and the waveforms of the myoelectric information and the impedance are displayed in the lower row.

The image of the inspection result shown in the upper part of FIG. 6 is so-called color topography. Therefore, the measured pressure from the pharynx to the upper esophagus is displayed in different colors for each pressure value. However, in FIG. 6, color coding is shown by drawing by hatching instead of displaying in color.

In addition, a scale is displayed at the bottom of the display unit. This scale indicates the elapsed time, and the unit is, for example, seconds. Here, one second is shown between the large scales. Therefore, with respect to the topographic image and the like displayed on the display 22, the time elapses from left to right, and the pressure, myoelectricity, and impedance in the pharynx to the upper esophagus as the subject swallows the object. Changes are shown.

In topography, the center of the upper esophagus is indicated by a broken line and the outside is indicated by a dot, and the part above the broken line is the pharynx. Then, swallowing raises and lowers the center of the upper esophagus. That is, when the subject swallows an object, the upper esophagus rises and the object passes through. In the central part of the topography, the part where the broken line rises indicates the elevation of the upper esophagus, and this object is swallowed when the object passes through the formed space.

In FIG. 6, each region is shown by hatching of a mesh, diagonal lines, and dots in descending order of pressure. For example, although the pressure is low before swallowing, the pressure in the center of the UES increases when the swallowing motion is started, and the pressure from the pharynx to the upper esophagus is highest immediately after the subject finishes swallowing. It turns out that is high.

In this way, as is clear from the topographic display, the pressure in the UES section increases for a while before and after the UES elevation occurs. Furthermore, it is clearly shown that the myoelectricity and impedance also change significantly as described above before and after the UES elevation occurs.

In other words, as is clear by displaying the movement of the UES appearing on the topography display together with the changes in myoelectricity and impedance, it is possible to fully infer the occurrence of UES elevation from the changes in myoelectricity and impedance. I can say.

In this way, the fact that the occurrence of UES elevation can be sufficiently inferred from changes in myoelectricity and impedance means that by measuring changes in myoelectricity and impedance, the swallowing function of the subject to be inspected can be improved. It will be possible to obtain information for making a judgment.

Further, by displaying the test result using the diagnostic support device 2 as topography, it is possible to more accurately grasp the movement of the subject from the pharynx to the upper esophagus during swallowing.

[motion]
Next, processing in the swallowing function measurement system S will be described with reference to FIG. 7. FIG. 7 is a flowchart showing a flow of an examination using the swallowing function measurement system S in the second embodiment.

That is, in the second embodiment, the swallowing function measuring device 1 measures myoelectricity and impedance, and the diagnostic support device 2 measures the pressure from the pharynx to the upper esophagus. Then, the topography generated based on the waveforms of myoelectricity and impedance and the pressure in the upper esophagus from the pharynx is displayed as shown in FIG.

Therefore, it is necessary to synchronize the swallowing function measuring device 1 and the diagnostic support device 2. By synchronizing, it is possible to provide the medical staff with appropriate information for judging the swallowing function of the subject from the waveform and topography.

Therefore, both devices are synchronized before starting the inspection (ST21). Specifically, first, a pulse signal is simultaneously input to the input unit 14 of the swallowing function measuring device 1 and the input unit 21 (analog unit) of the diagnosis support device 2. The diagnosis support device 2 synchronizes based on the time difference caused by the input. As a method of synchronizing, for example, the slow channel of one of the signals is synchronized by delaying the deviation of the fast channel.

Since the myoelectricity and impedance are measured at the same time as the swallowing function is measured, there is no time lag between them and they are synchronized in the first place. Therefore, at the start of the examination, by synchronizing the swallowing function measuring device 1 and the diagnosis support device 2, all the information acquired in the subsequent examination can be synchronized.

After synchronizing the swallowing function measuring device 1 and the diagnostic support device 2 in this way, the swallowing state without drinking the liquid is measured (ST1). The flow of the subsequent inspection is as described in the first embodiment. The swallowing function measuring device 1 and the diagnostic support device 2 are inspected in the same flow (ST2 to ST6).

Then, in the step of outputting the test result to the outside (ST22), the test result is output from the swallowing function measuring device 1 to the diagnosis support device 2, and together with the test result acquired by the diagnosis support device 2, for example, FIG. It is displayed on the display 22 in the manner shown.

According to at least one embodiment described above, information capable of appropriately determining a person's swallowing function can be easily acquired and displayed from the body surface without performing a complicated examination.

That is, the swallowing function of a person can be appropriately determined from the waveform showing the movement of myoelectricity and the waveform of impedance. Furthermore, by displaying the topography together with the waveform showing the movement of the myoelectric and the waveform of the impedance, it is possible to show the mode of the swallowing function to the medical staff in an easy-to-understand manner and support the judgment.

Although some embodiments of the present invention have been described, these embodiments are presented as examples and are not intended to limit the scope of the invention. These embodiments can be implemented in various other embodiments, and various omissions, replacements, and changes can be made without departing from the gist of the invention. These embodiments and modifications thereof are included in the scope and gist of the invention, as well as in the scope of the invention described in the claims and the equivalent scope thereof.

1 Swallowing function measurement device 11 Electrode unit 12 Measurement unit 13 Output unit 14 Input unit 15 Storage unit 16 Control unit 18 Analysis diagnosis unit 19 Display control unit 20 Control unit 2 Diagnosis support device 21 Input unit 22 Display 23 Storage unit 24 Communication control unit 25 Removable disk 26 Inspection unit 27 Display control unit 28 Control unit P Information terminal C Sensor

Claims (6)

A plurality of electrodes attached to the body surface from the outside near the larynx of the subject,
A measuring unit that receives a signal from the electrode unit and acquires information indicating the movement of the upper esophagus from the pharynx when the subject swallows an object.
An output unit that outputs information indicating the movement of the upper esophagus from the pharynx acquired by the measurement unit to an external device.
A swallowing function measuring device characterized by being equipped with. The swallowing function measuring device according to claim 1, wherein the information indicating the movement from the pharynx to the upper esophagus is information on impedance and myoelectricity. The swallowing function measuring device according to claim 2, wherein the impedance is calculated based on a potential difference between the plurality of electrode portions. The swallowing function measuring device according to any one of claims 1 to 3.
The pressure when an object passes from the pharynx of the subject to the upper esophagus is acquired by the inspection unit and the inspection unit that acquires the pressure from the pharynx along the longitudinal direction of the upper esophagus. A diagnostic support device consisting of a display control unit that displays the test results on the display unit, and
A swallowing function measurement system characterized by being equipped with. The swallowing function according to claim 4, wherein the information indicating the movement of the upper esophagus from the pharynx in the swallowing function measuring device and the pressure in the diagnostic support device are acquired in synchronization with each other. Measurement system. The swallowing function according to claim 4 or 5, wherein the display control unit collectively displays information indicating the movement of the upper esophagus from the pharynx and the test result on the display unit. Measurement system.

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