JP3142534B2 - Ultrasound therapy equipment - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an ultrasonic treatment device such as a calculus crushing device for crushing and treating a calculus by irradiating a shock wave from outside the patient to a calculus in the body.

[0002]

2. Description of the Related Art As a device for treating calculus without surgery, an electric spark or an ultrasonic oscillator generates a shocking high-pressure wave (shock wave) and irradiates it to calculi such as kidney stones and gallstones in the body. Ultrasonic therapy devices such as calculus crushing devices for crushing and treatment are being developed. In such an ultrasonic treatment apparatus such as a calculus crushing apparatus, a shock wave source is provided in a mounting device called an applicator, and a medium for propagating the shock wave (particularly degassed water) is filled therein, and the patient's waist or Devices that adhere to the abdomen have been developed. With this type of device, the patient does not need to enter the bathtub.

As described above, ultrasonic treatment apparatuses such as calculus crushing apparatuses using an applicator include a method in which the applicator is brought into close contact with the patient from below, and a method in which the applicator is brought into close contact with the patient as shown in FIG. . In the former method, when the applicator is erroneously operated or the medium is excessively supplied with water, the patient is forced up from below. In most cases, the patient's weight can withstand these forces.

The latter method is suitable for reducing the size of the applicator 1 and allows easy confirmation and operation of the direction of irradiation of the shock wave.
Since it is similar to the method of operating a radiation therapy apparatus or an image diagnostic apparatus, it has an advantage that doctors and technicians who are proficient in using these apparatuses can easily use them. But on the other hand,
When performing the positioning operation of the applicator 31 in order to match the calculus and the focal position of the shock wave source, the operation of the position control mechanism 32 of the applicator 31 is erroneously pushed down, or the applicator 31 is pushed down abnormally. In order to improve the close contact between the provided rubber film and the body surface of the patient 34, the medium 34 may be excessively supplied with the medium water, and the patient 34 may be strongly pressed against the bed 33.

That is, as shown in FIG.
Is applied to the patient 34 from above by the applicator 3
If the relationship between the position 1 and the amount of medium water is within the set range,
The patient 34 can receive a pleasant treatment without feeling the weight of the applicator 31 and the medium water, but outside the setting range, the patient is significantly compressed by being pressed between the applicator 31 and the bed 33, In extreme cases, there is a danger that respiratory movements may be impaired or that a strong force may be applied to a fracture.

[0006]

As described above, in an ultrasonic treatment apparatus such as a calculus crushing apparatus in which an applicator provided with a shock wave generating source is brought into close contact with a patient from above,
When the position of the applicator and the amount of the medium are out of the set range, the patient may feel discomfort, and in extreme cases, the respiratory movement may be disturbed or the force may be so strong as to cause a fracture. Was.

[0007] The present invention has been made in view of the above points, and a calculus crushing apparatus that does not apply abnormal pressure to a patient regardless of erroneous operation or malfunction of an applicator or a medium water supply / drainage apparatus. And the like.

[0008]

(1) An ultrasonic therapy apparatus according to the present invention comprises: an ultrasonic source for generating ultrasonic waves for treatment; and an ultrasonic source between the ultrasonic source and a subject. Medium water holding means for holding medium water for transmitting ultrasonic waves, a pressure sensor provided on the back side of the ultrasonic source, for detecting pressure applied to the medium water, and the medium water holding means A drain pump for draining medium water from the water, and a water amount control circuit for controlling the drain pump to turn on and off according to the pressure detected by the pressure sensor. (2) In the ultrasonic therapy apparatus according to (1), the present invention may further include a unit for generating an alarm while the pressure detected by the pressure sensor is equal to or higher than a predetermined threshold value. It is characterized by. (3) An ultrasonic therapy apparatus according to the present invention includes an ultrasonic source for generating ultrasonic waves for treatment, and a medium for transmitting the ultrasonic waves for treatment between the ultrasonic source and a subject. A medium water holding means for holding water, a pressure sensor provided on the back side of the ultrasonic source, for detecting a pressure applied to the medium water, and a pressure detected by the pressure sensor being a predetermined value.
Means for generating an alarm during a period of time equal to or more than the threshold value . (4) The present invention provides the ultrasonic therapy apparatus according to (3), wherein the drainage pump for draining the medium water from the medium water holding means and the drainage pump according to the pressure detected by the pressure sensor. A water amount control circuit for performing on / off control. (Operation) The internal pressure of the applicator, particularly the pressure above the water surface of the medium water, is a negative pressure according to the depth of the medium water in a normal treatment state because the applicator has a closed structure. When the applicator is brought closer to the body surface of the patient or the medium water is increased from this state, the pressure increases and goes to a positive pressure. Accordingly, in the present invention, for example, the internal pressure of the applicator at which the patient below the applicator starts to feel the weight of the medium water and begins to feel discomfort is determined as a predetermined threshold value , and the internal pressure is set to this threshold value. When the above occurs, the drain pump for forcibly draining the medium water is started.

Further, in the present invention, for example, the internal pressure of the applicator at which the patient below the applicator feels the weight of the medium water and begins to feel discomfort is determined as a predetermined threshold value. When the threshold value is exceeded, an alarm is generated and the operator can be urged to take measures.

[0010]

Embodiments of the present invention will be described below with reference to the drawings. Here, as an ultrasonic treatment apparatus, a calculus crushing apparatus will be described as an example. FIG.
1 is a configuration diagram of an ultrasonic therapy device such as a calculus crushing device according to an embodiment of the present invention. In the figure, applicator 1
The shock wave generation source 3 and the base end of the bellows 4 are attached to the opening of the cylindrical support 2 having one end opened, and the body surface contact film 5 is attached to the tip of the bellows 4. A space surrounded by the source 3, the bellows 4, and the body surface contact film 5 is filled with a medium water (degassed water) 6 for propagating a shock wave.

The shock wave generation source 3 is, for example, a ring-shaped piezo element arranged concentrically and configured in a spherical shell as a whole, and is driven by a high voltage pulse from a drive circuit 7 to generate a shock wave. The body surface contact film 5 is, for example, a rubber film, and is brought into contact with the body surface of the patient 9 on the bed 8 during treatment as shown in the figure. As a result, the shock wave from the shock wave generation source 3 is focused and irradiated on the calculus 10 in the patient 9 via the medium water 6 and the body surface contact film 5.

An applicator driving device 12 is connected to a support 2 of the applicator 1 via a holding arm 11. The applicator driving device 12 moves the applicator 1 up and down as indicated by arrows in accordance with a command input through the console 13.

A water tank 19 is connected to the medium water filling chamber of the applicator 1 via a water tube 15, a branching device 16, a water supply pump 17 and a drainage pump 18. In the water tank 19, degassed water serving as the medium water 6 is stored.

On the other hand, in the support 2 of the applicator 1,
A pressure sensor 21 connected to the upper part of the medium water filling chamber of the applicator 1 via a pressure conduit 20 is provided. The pressure sensor 22 detects the pressure of the medium water filling chamber (hereinafter, this is referred to as the internal pressure of the applicator 1).
An electric signal corresponding to the pressure value is generated. The output signal of the pressure sensor 21 is input to the water amount control circuit 22.
The water amount control circuit 22 compares the output signal (pressure value) of the pressure sensor 21 with a predetermined set value to determine a magnitude relationship, and turns on / off the water supply pump 17 and the drainage pump 18 according to the determination result. By controlling, the amount of the medium water 6 in the applicator 1 is controlled.

Next, the operation of the ultrasonic treatment apparatus such as the calculus crushing apparatus of the present embodiment will be described with reference to FIG. 2A shows a change (a) in the internal pressure of the applicator 1 detected by the pressure sensor 21, a change (b) in the height position of the body surface contact film 5, and an operation state of the drainage pump 18 (FIG. c)
And the operating state (d) of the water supply pump 17.

First, at the start of the treatment, the applicator 1 is not in contact with the patient 9 and the medium water 6 in the applicator 1 has accumulated below due to gravity, so that the pressure sensor 21 detects the negative pressure. I have. In this state, the applicator drive 1
2, the applicator 1 is gradually lowered and held until time A when the applicator 1 contacts the patient 9, during which time the pressure sensor 21
Continues to detect a constant negative pressure.

At time A, when the body surface contact film 5 at the tip of the applicator 1 comes into contact with the body surface of the patient 9, the internal pressure of the applicator 1 gradually increases, and eventually reaches a set value at time B. Here, the set value is a pressure at which the patient 9 feels uncomfortable with the pressure given from the applicator 1 or a pressure at which the patient 9 starts to feel the weight of the medium water 6 (0 kg / c).
m ² ). When the internal pressure of the applicator 1 reaches this set value at the time B, the water amount control circuit 22 turns on the drain pump 18 to start draining the medium water 6 in the applicator 1. Thereby, the internal pressure of the applicator 1 gradually decreases.

When the internal pressure of the applicator 1 drops below the set value at time C, the water amount control circuit 22
Returns the drain pump 18 to the off state. As a result, the patient 6 hardly feels the weight of the medium water 6, and can receive treatment without feeling uncomfortable.

Next, at time D, the applicator 1 is driven by the applicator driving device 12 according to an instruction from the operator.
Starts moving upward, and at time E, the body surface contact film 5
Is separated from the patient 9, the operator inputs a start command of the water supply pump 17 at time F via the console 13 to increase the amount of the medium water 6 in the applicator 1. Accordingly, the water supply pump 17 is turned on, and the medium water 6 starts to be supplied into the applicator 1.

If the operator inputs a stop command of the water supply pump 17 when the amount of the medium water 6 reaches an appropriate amount, the patient 9 can receive the treatment without feeling the burden of the pressure from the applicator 1. If you did not enter
The internal pressure of the applicator 1 continues to increase, and the time G
Exceeds the set value. At this time, since the water pressure control circuit 22 detects that the internal pressure of the applicator 1 has exceeded the set value via the pressure sensor 21, the drain pump 18 is turned on again, and the internal pressure of the applicator 1 becomes descend. In this case, if the water supply pump 17 is turned off at the same time at the time G as shown in FIG. 2, the time for the patient to feel the pressure from the applicator 1 can be reduced, and better results can be obtained.

As described above, the water amount control circuit 22 turns on the drain pump 18 when the internal pressure of the applicator 1 detected by the pressure sensor 21 is equal to or higher than the set value, and switches the drain pump 18 when the internal pressure is lower than the set value. Control to return to the off state is performed. If the water supply pump 17 is operating when the internal pressure of the applicator 1 is equal to or higher than the set value, control is performed to turn on the drainage pump 18 and turn off the water supply pump 17. By such control, the patient 9 can receive treatment without feeling discomfort due to the pressure from the applicator 1.

In this embodiment, the pressure sensor 2
The function of generating an alarm signal is provided to the water amount control circuit 22 for a period in which the internal pressure of the applicator 1 detected in step 1 is equal to or higher than a set value, for example, visual means using the display 14 on the operation panel 13 or sound. If an alarm is generated by an appropriate means, it is possible to notify the operator that the patient 9 feels uncomfortable weight and to prompt the input operation of a necessary command, which is more effective.

[0023]

According to the present invention, it is possible to avoid a situation in which the water bag is excessively filled with the medium water, the pressure increases, and the patient is excessively compressed. Moreover, since the pressure sensor for detecting the pressure inside the water bag is provided on the side opposite to the ultrasonic irradiation side of the ultrasonic source, the therapeutic ultrasonic waves generated from the ultrasonic source are directly transmitted. Alternatively, it is possible to avoid or at least reduce a situation in which the pressure sensor reaches the pressure sensor indirectly and causes a detection error, or damages the pressure sensor. Pressure and the like can be prevented.

[Brief description of the drawings]

FIG. 1 is a configuration diagram of an ultrasonic therapy apparatus such as a calculus crushing apparatus according to an embodiment of the present invention.

FIG. 2 is a time chart for explaining the operation of the embodiment.

FIG. 3 is a diagram showing a schematic configuration of a conventional ultrasonic therapy device such as a calculus crushing device.

[Explanation of symbols]

1 ... applicator, 3 ... shock wave source, 4 ... bellows, 5 ...
Body surface contact membrane, 6: medium water, 9: patient, 10: calculus, 13
... operation console, 14 ... display, 17 ... water pump, 1
8 ... drain pump, 19 ... water tank, 21 ... pressure sensor (pressure detecting means), 22 ... water amount control circuit (control means).

──────────────────────────────────────────────────続 き Continued on the front page (58) Field surveyed (Int. Cl. ⁷ , DB name) A61B 18/00-18/28 A61F 7/00

Claims (4)

(57) [Claims] 1. An ultrasonic source for generating ultrasonic waves for treatment, and a medium water holding medium medium for propagating the ultrasonic waves for treatment between the ultrasonic source and a subject Means, a pressure sensor provided on the back side of the ultrasonic source, for detecting the pressure applied to the medium water, a drain pump for draining the medium water from the medium water holding means, and the pressure sensor An ultrasonic treatment apparatus comprising: a water amount control circuit that controls on / off of the drain pump in accordance with the pressure detected by the ultrasonic treatment apparatus. 2. The pressure detected by the pressure sensor is
2. The ultrasonic therapy apparatus according to claim 1, further comprising means for generating an alarm during a period of time equal to or greater than a predetermined threshold . 3. An ultrasonic source for generating an ultrasonic wave for treatment, and a medium water holding medium for transmitting a medium for transmitting the ultrasonic wave for treatment between the ultrasonic source and a subject. Means, a pressure sensor provided on the back side of the ultrasonic source, for detecting pressure applied to the medium water, and a period in which the pressure detected by the pressure sensor is equal to or more than a predetermined threshold value And a means for generating an alarm. 4. The apparatus according to claim 1, further comprising a drain pump for draining the medium water from the medium water holding means, and a water amount control circuit for controlling the drain pump to turn on and off in accordance with the pressure detected by the pressure sensor. The ultrasonic therapy apparatus according to claim 3, wherein