JP3202735B2 - Shock wave therapy device and thermal therapy device - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a shock wave therapy apparatus for treating a target object in a living body, such as a cancer tissue or a calculus, by destroying the focused energy of the shock wave.

[0002] Also, the present invention relates to a thermal treatment apparatus for treating a cancer tissue or the like by destroying it with the focused energy of ultrasonic waves by the thermal action of continuous ultrasonic waves.

[0003]

2. Description of the Related Art In recent years, various developments have been made on a shock wave treatment apparatus for breaking a calculus or the like by irradiating a shock wave. For example, the applicant's earlier application for Japanese Patent Application No. 62-2
There is one described in 90158.

Hereinafter, this technique will be described with reference to the drawings. As shown in FIG. 9, the shock wave therapy apparatus shown in FIG. 9 has a shock wave transducer 15 for transmitting a shock wave composed of an ultrasonic wave and a sound wave different from a shock wave transmission region formed by the shock wave transducer 15. A shock wave applicator 17 including an ultrasonic transducer 16 for transmitting and receiving ultrasonic waves forming a field region, a pulser 18 for transmitting a pulse signal to the shock wave transducer 15, and a pulse signal for the ultrasonic transducer 16 To transmit and receive the echo signal from the ultrasonic transducer 16 based on the B-mode scan while exciting the ultrasonic transducer 16 to perform the B-mode scan.
9, a signal processing circuit 20 which receives an output signal of the transmission / reception circuit 19, performs amplitude detection on the output signal, and sends it as a video signal to a signal conversion system 21, and controls each section of the apparatus under predetermined parameters. A CPU (Central Processing Unit) 22; a controller 23 controlled by the CPU 22 to control the transmission / reception circuit 19, the signal processing circuit 20, the transmission / reception timing of pulse signals in the pulser 18, and the like;
A signal conversion system 21 (for example, a digital scan converter) which is controlled by U22 and performs signal conversion processing on output signals of the transmission / reception circuit 19 and the signal processing circuit 20, and an ultrasonic transducer 16 based on the output signal of the signal conversion system 21 Display means 27 including a fan-shaped sound field region 42, a body surface image, a kidney image, a kidney stone image, and the like of a living body, a shock wave transmission region of the shock wave transducer 15, a TV monitor for displaying a focusing point marker 26, and the like; A pulse generation switch 29 connected to a CPU 22 for setting the generation timing of a pulse signal sent from the pulsar 18 to the shock wave transducer 15, and a position controller for adjusting the relative position of the ultrasonic transducer 16 with respect to the shock wave transducer 15 30.

[0005] Next, referring to FIG.
Will be described in detail. The shock wave applicator 17 includes a shock wave transducer 15 that generates a shock wave (for example, an ultrasonic pulse of strong energy) that is focused on a focal point 41 a in the living body 32, and the shock wave transducer 15.
A water tank 33 provided on the side of the shock wave transmitting surface 15a, and a shock wave transmitting region 41 extending from the shock wave transmitting surface 15a of the shock wave transducer 15 to the focal point 41a,
An ultrasonic transducer 16 for forming a sound field area 42 including the focal point 41a in a state where the ultrasonic wave transmitting / receiving surface 16a is in contact with the living body surface 32s and collecting B-mode image (tomographic image) data of the living body 32 is provided. are doing.

More specifically, the shock wave transducer 15 includes a concave vibrator (not shown) having a constant curvature. At the center of the shock wave transducer 15, an ultrasonic transducer 16 is attached via a transducer support drive unit 36 so as to be movable in the direction of arrow B. Based on a control signal from a position controller 30 that adjusts the relative position of the ultrasonic transducer 16 with respect to the shock wave transducer 15, the transducer support driving unit 36 arbitrarily stops the ultrasonic transducer 16 in the direction indicated by the arrow B, and its mechanism. It has a drive source. For example, a rack member is fixed to a side surface of the ultrasonic transducer 16, and a transducer supporting / driving unit 36 including a motor having a pinion gear meshing with the rack attached to a driving shaft has a rotation angle of the motor controlled by the position controller 30. By being controlled, the relative positional relationship between the shock wave transducer 15 and the ultrasonic transducer 16 is adjusted. By the way, the shock wave transducer 15
On the side of the shock wave transmitting surface 15a, a water tank 33 filled with water as a shock wave transmitting liquid is provided. The water tank 33 has a cylindrical shape or a conical shape having a bottom surface substantially equal to the outer diameter of the shock wave transducer 15. Has become. A bellows 33a that can expand and contract in the direction of arrow B or within a predetermined angle from that direction is formed on the side surface, and the bottom portion 37 is a thin film having an acoustic impedance almost equal to that of water.

[0007] By using the shock wave treatment apparatus configured as described above, for example, a renal calculus 3 in the kidney shown by 38 in FIG.
When the destructive treatment is performed, the bottom 37 of the water tank 33 of the shock wave applicator 17 is first brought into close contact with the surface 32s of the living body 32, and in this state, the transmission / reception circuit 19, the signal processing circuit 20, and the signal conversion system 21 are controlled, Transducer 16
To display a tomographic image of the living body 32 on the screen of the display means 27. In this case, since the ultrasonic wave transmitting / receiving surface 16a of the ultrasonic transducer 16 directly contacts the living body surface 32s, a clear tomographic image can be obtained by eliminating the influence of the bottom of the water tank, water and the like. Next, when a kidney image 38 is drawn on this tomographic image, a kidney stone image 39 in the kidney image 38 is searched for. In this case, the signal conversion system 2 is displayed on the display means 27 from the CPU 22.
1, a shock wave transmission area 41
The focusing point marker 26 is displayed at the corresponding position, and the displayed portion of the tomographic image of the living body 32 displayed in real time changes with the movement of the shock wave applicator 17. Then, when the kidney stone image 39 is drawn in the tomographic image, the shock wave applicator 17 is further fine-tuned so that the kidney stone image 39 is positioned within the focusing point marker 26. Applicator 17
Is fixed. In this case, since the bellows 33a maintains the set posture, the shock wave applicator 17 can be easily fixed.

Next, the operator operates the pulse generation switch 29.
To send a control signal to the pulsar 18 via the CPU 22 and the controller 23. As a result, a pulse signal is transmitted to the shock wave transducer 15, and the shock wave transducer 15 directs strong energy to the ultrasonic pulse (shock wave for destroying the target treatment object) toward the renal calculus 39 existing at a position corresponding to the position of the focusing point marker 26. To transmit. This ultrasonic pulse becomes a shock wave at the position of the kidney stone 39 and destroys the kidney stone.

By repeating the generation of the ultrasonic pulse several times as necessary, the entire kidney stone 39 can be destroyed and treated.

[0010] Further, in the conventional thermal treatment apparatus, FIG.
Are similarly configured as a continuous ultrasonic transducer and a continuous oscillation circuit for generating continuous ultrasonic waves, respectively.
Then, the continuous ultrasonic wave from the continuous ultrasonic transducer is focused, and heat is generated at this focal point to destructively treat the target treatment object.

[0011]

When treating an object to be treated in a living body, the object to be treated usually moves by breathing or sometimes the living body itself moves. It is considered that performing treatment while confirming the therapeutic effect is a preferable operation method in terms of safety.

However, the conventional shock wave therapy apparatus and thermal therapy apparatus have a problem that the treatment cannot be performed while simply confirming the number of shock wave irradiations or the continuous ultrasonic irradiation time, the state of the living body, and the therapeutic effect.

The present invention has been made in view of the above circumstances, and an object of the present invention is to provide a shock wave therapy device and a thermal therapy device that can improve the treatment efficiency.

[0014]

According to a first aspect of the present invention, there is provided a shock wave therapy apparatus comprising a shock wave generating means for generating a shock wave focused on a target object in a living body. The driving voltage applied to the generating means is set to a predetermined value during the period from the start to the end of irradiation of the target treatment object.
It is characterized by having control means for controlling so as to gradually increase each shot number .

According to a second aspect of the present invention, there is provided a thermotherapy apparatus including a continuous ultrasonic wave generating means for generating a continuous ultrasonic wave focused on a target treatment object in a living body, wherein the continuous ultrasonic wave is applied to the continuous ultrasonic wave generating means. It is characterized by having control means for controlling the drive voltage to be gradually increased every predetermined irradiation time from the start to the end of irradiation of the target treatment object.

(Operation) The operation of the apparatus having the above configuration will be described.

In the apparatus according to the first aspect, the driving voltage applied to the shock wave generating means is changed from the start to the end of the irradiation.
Since control is performed so as to gradually increase the number of irradiations every predetermined number of times , safety can be improved and treatment efficiency can be improved.

In the apparatus according to the second aspect, the drive voltage of the continuous ultrasonic wave generating means is set between the start and end of irradiation.
Since the control is performed so as to gradually increase at every constant irradiation time, it is possible to improve safety and treatment efficiency.

[0019]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS An embodiment of the present invention will be described below in detail with reference to FIGS. The same components as those of the shock wave therapy apparatus described in the section of the related art are denoted by the same reference numerals, and detailed description thereof will be omitted.

FIG. 1 is a schematic overall perspective view of a shock wave treatment apparatus according to one embodiment of the present invention.

First, as components different from the conventional shock wave therapy apparatus, a shock wave irradiation condition setting apparatus 101 as a signal output means, an irradiation shock wave data output apparatus 102, and a display means 10
3. There is an audio output device 104.

The apparatus comprises a holding mechanism HM for tilting and moving the shock wave applicator 17 and a display means 10.
3. Shock wave irradiation condition setting device 101, sound output device 10
An imaging unit IU provided with an irradiation unit 4, a system controller SC provided with an irradiation shock wave data output device 102, a CPU 22, and the like; a holding mechanism operation panel 18 provided on the outer periphery of the shock wave applicator 17 for operating the holding mechanism HM; A water controller 34 for controlling the amount of water in a water tank 33 of the shock wave applicator 17 and a bed T for placing a living body (hereinafter also referred to as a “patient”). In the figure, reference numeral FS denotes a foot switch for operating the holding mechanism HM with an operator's foot.

FIG. 2 is a block diagram of the apparatus shown in FIG.
3 is a plan view showing a setting panel surface of the shock wave irradiation condition setting device 101. FIG.

The shock wave irradiation condition setting device 101 includes, for example, a shock wave irradiation number, a shock wave irradiation rate (hereinafter, simply referred to as a “pulse rate”), a shock wave driving voltage, a number of pauses (the number of shock waves generated), and the like. This is a device for the operator to set the shock wave irradiation conditions. Here, the number of shock wave irradiations is the total number of irradiations until the treatment is completed, and the pulse rate is the number of irradiations per unit time, for example, the pulse rate is 2.0.
If it is Hz, it is an amount that means to irradiate twice per second, and the number of pauses is one nail of shock wave treatment. For example, if the number of pauses is 300, the irradiation is 300 times. It will stop. As the shock wave irradiation condition setting items,
There are four types: irradiation number, shock wave drive voltage, pulse rate, and number of pauses.

First, the number of shock wave irradiations is set by appropriately pressing a push button for setting the number of shock wave irradiations, that is, an up button 201 and a down button 202. Here, each time the up button 201 or the down button 202 is pressed once, the number of shock wave irradiation increases or decreases by 100. If, for example, 3000 is set as the shock wave irradiation number in this way, 3000 is displayed on the display section 206 of the shock wave irradiation number (Maximum Shot No.) as can be seen from the figure. This number does not change until the setting is changed or canceled. Similarly, the number of pauses is also determined by appropriately pressing the up button 204 and the down button 205 for setting the number of pauses. In this case as well, the up button 204 and the down button 205
Increase or decrease in units. Then, the pause number display section (Pause / R
emaining ShotNo.) 207 displays, for example, 300. This number is decremented by one each time the shock pulse is emitted. That is, while the shock wave is being irradiated, the number of remaining shots up to the temporary stop is displayed, and at the time of the temporary stop, the instantaneous return to the initial set value is on the order of microseconds. Next, the shock wave drive voltage is set by rotating the shock wave drive voltage setting knob 213 left and right. In this case, 1 kV
If the voltage is increased or decreased in units of, for example, 15 kV, 15.0 is displayed on the display section 211 of the driving voltage. Similarly, in the case of the pulse rate, the knob 214 is set by rotating the knob left and right. Also in this case, it increases and decreases in units of 0.5 Hz. For example, if the set value is 2 Hz, the display unit 212 displays 002.0
Is displayed. In addition, the number of actually irradiated shock waves is displayed on the display unit 207. That is, it is increased by one each time the shock wave is irradiated. Note that the shoot lamp 209 is turned on every time the shock wave is irradiated. If the entire device is not in a state capable of irradiating a shock wave, the pulse ready lamp 21
0 lights up. The clear button 203 is for canceling the setting.

Next, the irradiation shock wave data output device 102 will be described. In this case, for example, a printer or the like used for a general personal computer or the like may be used, but this outputs, for example, the one shown in FIG.
Note that, in FIG. 5, the numbers indicated by... Indicate different focusing positions of the kidney stone 39 as shown in FIG. In this part, the first to 1000th shock wave pulses are recorded in association with the drive voltage. The same applies to 1001
From the 2000th to the 2000th, from the 2001st to the 3000th,
Records 3001 to 4000 shots. Here, the ordinates of... Are respectively set to drive voltages of 0 to 20 kV. However, the scale of the vertical and horizontal axes changes according to the setting conditions. In addition, the set irradiation conditions and patient information are recorded. The patient information is a part described as a patient ID in the figure, and is, for example, a part for recording a patient name, a position and a size of a calculus of the patient, or a symbolized version thereof. This is performed by an appropriate input device, for example, an attached keyboard or the like.

As can be seen from FIG. 4, the driving voltage is increased from 0 to the maximum driving voltage, that is, the set driving voltage, every 300 shock wave pulses. The 300 shots are the number of pause shots, which means that the shock wave irradiation stops every 300 shots. In the case of a temporary stop, the position of the focal point may be moved. In such a case, the CPU 22 is controlled to gradually increase the drive voltage to ensure higher safety. Specifically, if the total number of irradiations is 1000 to 4000, the maximum driving voltage is increased by 1 kV every 4 pulses of the shock wave, and if the total number of irradiations is 4001 to 8000, it is increased by 1 kV every 8 pulses. is there. Such an irradiation method may be set as one of the conditions.

Next, the display means 103 will be described. The display means 103 includes a TV monitor and the like, and displays the display contents of the display means 27 of the conventional apparatus shown in FIG. 9 and also displays the cumulative number N of the shock wave irradiation, the pulse rate R, and the drive voltage V.

Next, the audio output device 104 will be described.
The voice output device 104 includes a voice synthesis memory (not shown),
A speaker or the like is provided, and when irradiation of the set number of times of the shock wave is completed, a sound based on the sound information stored in the speech synthesis memory is output from the speaker to notify the operator of the suspension of the shock wave irradiation. That is, the shock wave irradiation condition setting device 101 outputs an end signal to the CPU 22 of the system controller SC when the irradiation of the number of shock waves set by operating the buttons 201 and 202 is completed. The CPU 22 inputs an audio output signal to the audio output device 104 arranged in the imaging unit IU based on the end signal from the shock wave irradiation condition setting device 101. The sound output device 104 outputs sound based on the sound output signal.

The operation of the shock wave therapy apparatus having the above-mentioned components is as follows. First, the operator operates the holding mechanism operation panel 18 on the patient's body surface to operate the shock wave applicator 1.
7 is placed. Then, the tomographic image displayed as the sound field area 42, the shock wave transmission area 41, and the convergence point marker 26 are displayed on the display means 103 after the signal processing in each component described above. The operator operates the shock wave applicator 17 while looking at the display means 103 to search for a kidney stone 39, for example. If a kidney stone 39 is found, the operator can find the stone 39
The shock wave irradiation condition is determined according to the position and the size of the shock wave, and set by the shock irradiation condition setting device 101. If the set values are, for example, the number of shock wave irradiations is 3000, the pulse rate is 2.0 Hz, the drive voltage is 15 kV, and the number of pauses is 200, as described above, the display means 103 is controlled by the CPU 22 via the signal conversion system 21. In the upper left corner, the irradiation state of the shock wave corresponding to the display image is displayed (see FIG. 6A). Here, the cumulative number N of the shock wave irradiation corresponds to the number shown on the display unit 207 of the shock wave irradiation condition setting device 101 described above,
Here, N = 0 is displayed because the light has not been irradiated yet. Shock wave irradiation starts, and the display unit 207
When the number shown in (1) becomes N = 1000, for example, as shown in FIG. 6B, N = 1000, R = 2.0 Hz, and V = 15 kV are displayed. Further, the pulse rate R is always a constant value during the treatment, so that R = 2 Hz. In addition, the driving voltage V
Is V = 15 kV here. As described above, when the shock wave irradiation is completed (in this case, the irradiation number is 3000), the operator presses an appropriate switch to print out the treatment record with the drive voltage of the shock wave to be actually irradiated. In this case, for example, the one shown in FIG. 4 is output.

Here, a simple example of the output control of the shock wave by the CPU 22 will be described with reference to the flowchart of FIG.

First, in step 301, the setting device 1
From 01, a shock wave irradiation number (m), a shock wave (maximum) drive voltage (W), a pulse rate (R), and a pause number (P) are set. Here, n is the display unit 207 of the setting device 101.
And the initial value is 0. Although the description of the pulse rate is omitted below, it is controlled by the input of a clock whose illustration is omitted. Next, steps 302 to 306 are steps for setting the increased irradiation number of the driving voltage. For example, if m is 3000, i = 4 is set by following the steps from 302 to 303. That is, the drive voltage (V) is increased by 1 every four shots.
This means increasing the voltage by kV. (Here, the case of increasing by 1 kV is taken as an example.
V or W / 10 kV may be used. Similarly, m
If = 8000, follow the steps 302 → 304 → 306 i
= 10 is set.

Next, 307 is the pulse generation switch 29 described above.
Waiting for the input, and when the input is made, the process proceeds to the next step 308. In step 308, the cumulative number of irradiations n and m are compared, and if n = m, the flow proceeds to step 309 to complete the treatment. If n <m, the process proceeds to step 310, where the number q of remaining shots up to the temporary stop is evaluated. If q = 0, the operation is temporarily stopped, and based on the end signal from the setting device 101, the CPU 22 controls the audio output device 104 to output audio from a speaker, and sets q = P, V = 0, j = 0. The process returns to step 307 to be reset. Here, j is a parameter for increasing V, and V is increased by comparing with i described above. If q> 0, the process proceeds to the next step 312. Hereinafter, steps 312 to 318 are steps for determining a drive voltage, and output a shock wave irradiation command to the controller 23. Also, in response to the parameter rewriting in steps 307 and 320, the numerical value displayed on the setting device 101 changes under the control of the CPU 22.

The shock wave transducer 15 and the pulsar 18 of the shock wave treatment apparatus shown in FIG. 2 are respectively a continuous ultrasonic transducer and a continuous oscillation circuit for generating continuous ultrasonic waves, and a continuous ultrasonic wave from the continuous ultrasonic transducer is focused on a focal point 41a. Then, a thermal treatment device which is similarly configured to generate heat at the focal point and treat the target treatment object has the same effect as the shock wave treatment device shown in FIG.

In addition, it is not always necessary to strictly deal with the shock wave irradiation state displayed simultaneously with the display image. For example, if the response has a time difference of several milliseconds or less, the result can be sufficiently exhibited.

According to the shock wave treatment apparatus according to the embodiment of the present invention having the above-described configuration, when the generation of the number of times of the suspension of the shock waves set by the shock wave irradiation condition setting apparatus is completed, the sound output apparatus outputs the shock wave. Since the voice is output to inform the patient and the operator, the patient can relax by this voice, and the operator can proceed to the next operation, so that the treatment can be performed efficiently.

Further, a treatment with high safety can be performed by gradually increasing the drive voltage of the shock wave, and excessive shock wave irradiation or unnecessary irradiation to the patient can be prevented by setting the number of times of suspension. be able to.

The present invention is not limited to the above-described embodiment, but can be variously modified and implemented. For example, the shock wave therapy device has been described, but as described in the section of the prior art, as another irradiation shock wave data output device,
Instead of printing out the treatment record, the treatment record may be output on a monitor.
3 or a dedicated display device may be provided. Further, this may be recorded on an appropriate recording medium, for example, a floppy disk or an optical disk.

The sound output device may output a sound such as a buzzer.

[0040]

According to the invention of claim 1, wherein the described above in detail, the drive voltage applied to the shock wave generating means, the control is to increase gradually at predetermined irradiation number between the start and end irradiation Thus, it is possible to provide a shock wave treatment apparatus capable of improving safety and treatment efficiency.

According to the second aspect of the present invention, the driving voltage of the continuous ultrasonic wave generating means is changed from the start to the end of the irradiation.
Since the temperature is controlled so as to be gradually increased every predetermined irradiation time, it is possible to provide a thermal treatment apparatus capable of improving safety and improving treatment efficiency.

[Brief description of the drawings]

FIG. 1 is a schematic overall perspective view of the apparatus of the present invention.

FIG. 2 is an overall block diagram.

FIG. 3 is a plan view showing a setting panel surface of the shock wave irradiation condition setting device.

FIG. 4 is a diagram showing an example of a treatment record.

FIG. 5 is a diagram illustrating an example of movement of a focal point in shock wave therapy.

FIG. 6 is a diagram showing a display example of a display means.

FIG. 7 is a flowchart showing the operation of the present apparatus.

FIG. 8 is a sectional view showing a configuration of a shock wave applicator.

FIG. 9 is a block diagram showing an overall configuration of a conventional shock wave therapy apparatus.

[Description of Signs] 15 Shock wave transducer (shock wave generating means) 101 Shock wave irradiation condition setting device (signal output means) 104 Audio output device

Continuation of the front page (56) References JP-A-1-270862 (JP, A) JP-A-1-91845 (JP, A) JP-A-1-185261 (JP, A) JP-A-62-183754 (JP) JP-A-63-99851 (JP, A) JP-A-1-46445 (JP, A) JP-A-1-250240 (JP, A) JP-A-1-250241 (JP, A) 1-1129845 (JP, A) JP-A-58-75542 (JP, A) (58) Fields investigated (Int. Cl. ⁷ , DB name) A61B 17/22 330 A61B 18/00 A61F 7/00 322

Claims (2)

(57) [Claims] 1. A shock wave therapy apparatus comprising a shock wave generating means for generating a shock wave focused on a target treatment object in a living body, wherein a drive voltage applied to the shock wave generation means is applied from the start to the end of irradiation of the target treatment object. And a control means for controlling to gradually increase the number of irradiation every predetermined number of times . 2. A thermotherapy apparatus comprising continuous ultrasonic wave generating means for generating continuous ultrasonic waves focused on a target treatment object in a living body, wherein a drive voltage applied to the continuous ultrasonic wave generation means is applied to the target treatment object. A thermal treatment apparatus comprising control means for controlling so as to gradually increase at predetermined irradiation times from the start to the end of the irradiation .