JP2850415B2 - Stone crushing equipment - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION [Industrial applications]

According to the present invention, a pulse-like sound wave (vibration) energy having a very large peak such as a shock wave and a sharp waveform is generated outside a living body, and this energy is focused on the calculus as energy for crushing the calculus generated inside the living body. And a crushing device for crushing the calculus.

[Prior art]

In a calculus crushing device, it is necessary to input pulse-like vibrational energy with a very large peak into the living body, and a shock wave generated by an explosion may be used. , A pulse-shaped sound wave (ultrasonic wave) having a large peak is generated, and this is focused on a calculus position in a living body and is often used as energy for crushing the calculus.

[Problems to be solved by the invention]

However, in any case, it is unavoidable to cause pain to the patient due to the incidence of very large vibration energy into a living body. In particular, when the crushing energy entered into the living body is not effectively irradiated to the calculus but is irradiated to other tissues such as bones, the pain becomes serious, which is a serious problem. Irradiation of crushing energy to bones or the like means that the energy is hindered by the irradiation and does not effectively reach the calculus, and there is also a problem that the therapeutic effect of calculus crushing is not clear. The present invention makes it possible for energy for calculus crushing to effectively reach a calculus avoiding obstacles such as bones, thereby reducing the pain of a patient and obtaining a reliable therapeutic effect. It is intended to provide a device.

[Means for Solving the Problems]

In order to achieve the above object, in the calculus crushing device according to the present invention, a plurality of crushing energy generating means, a means for focusing crushing energy from the crushing energy generating means to a calculus position, and a plurality of crushing energy generating means The crushing energy generating means that generates crushing energy that is sequentially generated from each and captures the reflected wave to generate crushing energy hindered by obstacles in the body is detected, and drives other crushing energy generating means except the crushing energy generating means And a means for performing the operation.

[Action]

A plurality of crushing energy generating means are provided, and when these are driven simultaneously or almost simultaneously with a slight time delay, crushing energy converging at the calculus position as a whole is generated. Rather than simultaneously generating the crushing energy from the plurality of crushing energy generating means as described above, the crushing energy is generated sequentially in time and the reflected waves are received.
Then, when crushing energy is generated from the crushing energy generating means where there is no biological obstacle such as bone between the calculus and the calculus, only the reflected wave from the calculus is received with a large intensity, When crushing energy is generated from the crushing energy generating means in which an in-vivo obstacle such as bone is present, the intensity of the reflected wave from the obstacle is higher than that of the calculus. Therefore, a crushing energy generating means that generates crushing energy from this received signal so that it does not reach the calculus because it is obstructed by obstacles, or that sufficient energy is reached without any obstacles to the calculus It is possible to determine whether it is a crushing energy generating means for generating crushing energy. Based on this determination, the former crushing energy generating means is excluded, and if the latter generates energy for calculus breaking by driving the effective crushing energy generating means,
It is not necessary to generate crushing energy that is hindered by bones, etc., and only crushing energy that is effective for calculus crushing can be generated. A therapeutic effect can be obtained. In addition, since crushing energy that causes pain by irradiating a bone or the like is not generated, pain of a patient can be reduced.

【Example】

Next, an embodiment of the present invention will be described with reference to the drawings. In FIG. 1, it is assumed that a calculus 11 is present in the living body 1 and some bones 12 are present near the body surface. The shock wave generation source 2 is arranged so that the shock wave is focused on the calculus 11. The shock wave generating source 2 is specifically composed of a piezoelectric element or the like that generates an ultrasonic pulse, and is arranged in a large number on a spherical spherical support plate 21. Water for acoustic impedance matching filled in a water bag 22 is interposed between the support plate 21 and the surface of the living body 1. A high voltage pulse circuit 4 is connected to each of the many shock wave sources 2. The high voltage pulse circuit 4 simultaneously generates a high voltage pulse for generating a shock wave at a timing according to a trigger signal under control by a control signal from the main control circuit 5. By simultaneously driving the shock wave generation source 2 by the high voltage pulse, a shock wave is generated from each of them, and this shock wave is made to enter the living body 1 through the water bag 22. On the other hand, the support plate 21 supporting the shock wave generation source 2 has
An ultrasonic tomographic probe 3 for determining the position of the calculus 11 in the living body 1 is also attached. The ultrasonic tomographic probe 3 is connected to a transmission / reception circuit 6, transmits and receives an ultrasonic beam to and from the living body 1, and scans the ultrasonic beam at a predetermined cross section. The received echo signal is transmitted from the transmitting / receiving circuit 6.
After being sent to the A / D converter 7 and converted into a digital signal, it is sent to the digital scan converter 8. The digital scan converter 8 converts the echo data obtained from the transmission / reception circuit 6 into a display method of the CRT display device 9 because the echo data is based on the ultrasonic beam scan method. In this way, the CRT display device 9 displays an ultrasonic tomographic image in a predetermined section of the living body 1. When performing a treatment for crushing the calculus 11, first, transmission and reception of an ultrasonic beam and scanning are performed by the ultrasonic tomographic probe 3, and an ultrasonic tomographic image is obtained. The image of the calculus 11 is obtained from the image, and the entire position of the support plate 21 is adjusted so that the focal point of the shock wave is located at that position. Next, a number of high voltage pulse circuits 4 and shock wave generation sources 2
Control signals for sequentially operating each of the high voltage pulse circuits 4 from the main control circuit 5 to generate a pulse having a small peak before the shock wave converging on the calculus 11 is generated by simultaneously operating all of them. Send. As a result, a relatively weak shock wave is sequentially generated from many shock wave sources 2 in time, and this is made to enter the living body 1. Then, the echo reflected by the calculus 11 or the like of the shock wave is received by the ultrasonic probe 3, and the echo signal is transmitted to the transmission / reception circuit 6.
And to the digital scan converter 8 via the A / D converter 7. The received echo signal is as shown in FIGS. 2A and 2B, and data showing this waveform is stored in the digital scan converter 8. If there is no obstacle in the path from the shock wave source 2 to the calculus 11 located at the focal position, the echo is mostly reflected by the calculus 11, and as shown in FIG.
A large peak appears in the time zone t1 to t2 corresponding to the position. The time required for the shock wave generated from the shock wave source 2 to be reflected by the calculus 11 and returned to the ultrasonic tomography probe 3 is the time required for the calculus from the shock wave source 2 and the ultrasonic tomography probe 3 to be measured.
Given that the distance to 11 is 1 and the average sound velocity is v, 2l / v, the above-mentioned times t1 and t2 are set, for example, as t1 = (2l / v) −10 μsec t2 = (2l / v) +10 μsec You. On the other hand, when an obstacle such as the bone support 12 is present in the path from the shock wave generation source 2 to the calculus 11 located at the focal position, the shock wave is mainly reflected by the support bone 12 and the like, and the calculus 11 Only a few reach. Therefore, in such a case, the received echo signal is as shown in FIG. 2B, and only a small peak appears in the time zone t1 to t2 corresponding to the position of the calculus 11, and the time zone other than the time zone ( A large peak appears at a time zone corresponding to the position of the auxiliary bone 12). Therefore, a predetermined threshold level L is provided, and it is determined whether or not the echo signal intensity has exceeded the level L in the time period t1 to t2. This determination operation is performed for all the shock wave sources 2 by reading out the echo data stored in the digital scan converter 8 by the main control circuit 5. After the sequential generation of weak shock waves from all the shock wave sources 2 and the discrimination of the received echo data are completed, the main control circuit 5 sets the echo signal intensity to the level L in the time zone t1 to t2 based on the discrimination result. Only the high voltage pulse circuit 4 connected to the shock wave generation source 2 that has exceeded the threshold is sent a control signal for setting an operation state for generating a very high peak high voltage pulse. Then, a trigger signal is sent to generate a strong shock wave only from the selected shock wave generation source 2 and form them in a calculus.
Focus on 11. At this time, since the shock wave hindered by the auxiliary bone 12 and the like is not generated, all the generated shock waves can be effectively used for calculus breaking. In addition, since extra energy is not irradiated to the auxiliary bone 12, the pain of the patient can be reduced. Since the shock wave generated here is not hindered by obstacles and almost all acts on calculus breaking, it is possible to accurately estimate the amount of crushing energy. The amount of crushing energy is given by p × n, where p is the shock wave energy generated from a single shock wave source 2 and n is the number of sources 2 generating a shock wave. 5 and display it, or warn when the effective energy is below the level that is too weak to crush stones. In such a case, stop the shock wave generation itself and support plate It is also preferable to adopt a configuration that encourages readjustment of the position of 21 and the like. In the above embodiment, the shock wave is simultaneously generated from the shock wave source 2 and focused on a predetermined focal position. However, the shock wave is provided in a delay control circuit to control the delay of each drive pulse to reach the focal position. The focus position may be adjusted by controlling the transfer of the shock wave. Also, the reflected waves of the weak shock waves from the shock wave sources 2 one by one are received by the ultrasonic tomographic probe 3 for obtaining an ultrasonic tomographic image for calculus detection. Instead of using an ultrasonic tomographic probe, it is also possible to receive waves with the shock wave source 2 itself.

【The invention's effect】

ADVANTAGE OF THE INVENTION According to the calculus crushing apparatus of this invention, since the crushing energy which does not act effectively for calculus crushing does not generate | occur | produce, a patient's pain can be reduced. In addition, since only the crushing energy that works effectively for calculus crushing can be injected into the living body, it is possible to accurately estimate the amount of energy that actually works for calculus crushing, and to achieve a reliable calculus crushing treatment effect. Obtainable.

[Brief description of the drawings]

FIG. 1 is a block diagram of one embodiment of the present invention, and FIGS.
FIG. 2 is a waveform diagram of a signal received by the ultrasonic tomographic probe of FIG. DESCRIPTION OF SYMBOLS 1 ... Living body, 11 ... Calculus, 12 ... Assist bone, 2 ... Shock wave source, 21 ... Support plate, 22 ... Water bag, 3 ... Ultrasonic tomography probe, 4 ... High voltage pulse circuit 5, the main control circuit,
6. Transmitter / receiver circuit, 7 A / D converter, 8 Digital scan converter, 9 CRT display device.

Claims (1)

(57) [Claims] 1. A plurality of crushing energy generating means, a means for focusing crushing energy from the crushing energy generating means to a calculus position, and a crushing energy generated sequentially from each of the plurality of crushing energy generating means and reflected waves thereof A calculus which detects crushing energy generating means for generating crushing energy hindered by an obstacle in a living body, and drives other crushing energy generating means excluding the crushing energy generating means. Crushing equipment.