JP3480593B2 - Continuous blood pressure monitor - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION [0001] BACKGROUND OF THE INVENTION 1. Field of the Invention
Based on the pressure pulse wave detected by the pressure pulse wave sensor
Blood pressure monitor for continuously monitoring blood pressure
Things. [0002] 2. Description of the Related Art A cuff is attached to a part of a living body.
By changing the compression pressure of the cuff
Blood pressure value measuring means for measuring the blood pressure value of
Is pressed to the part downstream of the artery from the part to be attached
Pressure generated from the artery downstream of the artery
A pressure pulse wave sensor for detecting a pulse wave and the pressure pulse wave sensor
The magnitude of the pressure pulse wave detected and the blood pressure value measuring means.
To determine in advance the correspondence between the measured blood pressure values.
Engagement determination means, and the pressure pulse wave sensor
The blood pressure value of the living body based on the magnitude of the detected pressure pulse wave.
Continuous blood pressure value determining means for continuously determining the continuous blood pressure
A display for displaying the blood pressure value determined by the value determining means;
2. Description of the Related Art A continuous blood pressure monitoring device of the type provided with is known. And
For example, Japanese Utility Model Application No. 2-8, which was filed and filed by the applicant earlier.
No. 2,309, for example. [0003] By the way, the above conventional art
A continuous blood pressure monitoring device uses a pressure pulse wave sensor
The artery of the pressure pulse wave sensor may
Since it is inevitable that the pressing conditions change,
Increase the accuracy of the blood pressure value determined by the continuous blood pressure value determining means.
To be determined by the continuous blood pressure value determining means.
A blood pressure value and a blood pressure value measured by the blood pressure value measuring means;
Calibration to update the correspondence of
Is executed. In this calibration, the blood
The pressure of the cuff is changed in a predetermined procedure by the pressure measuring means.
The blood pressure value is measured in the process of
The blood pressure value obtained by
Correspondence with the magnitude of the pressure pulse wave detected by the pulse wave sensor
The engagement is newly determined by the relation determining means. However, the above calibration is
When executed, the pressure on the cuff can place a strain on the living body.
At the same time as the part where the cuff of the living body was attached
If a pressure pulse wave sensor is attached to the downstream part,
Determination of continuous blood pressure during calibration
There was a disadvantage that the blood pressure monitoring by means was interrupted. this
In order to increase the accuracy of continuous blood pressure monitoring,
The shorter the calibration cycle, the more noticeable
Because The present invention has been made in view of the above circumstances.
And the purpose is to
The burden is reduced and the blood pressure is determined by the continuous blood pressure value determining means.
To provide a continuous blood pressure monitoring device that reduces the interruption rate
It is to be. [0006] A first object of the present invention is to achieve the above object.
The gist of the present invention for performing
Has a cuff to be attached, changes the compression pressure by the cuff
Blood pressure measurement
Step and artery downstream from the site where the cuff of the living body is attached
Area on the downstream side of the artery
A pressure pulse wave sensor that detects a pressure pulse wave generated from the artery of
The magnitude and front of the pressure pulse wave detected by the pressure pulse wave sensor
Correspondence between the blood pressure value measured by the blood pressure value measuring means
Relationship determining means for determining the relationship in advance and the corresponding relationship
Based on the magnitude of the pressure pulse wave detected by the pressure pulse wave sensor
Blood pressure determination to determine the blood pressure of the living body continuously
A continuous blood pressure monitoring device of the type comprising:
Cuff pressure increase for increasing the compression pressure of the cuff at a predetermined speed
Pressure means, and (b) the cuff pressure by the cuff pressure increasing means.
In the process where the compression pressure is increased at a predetermined speed, the pressure pulse wave
Characteristic waveform that detects the characteristic waveform that occurs near the lower peak
Detection means, and (c) detected by the characteristic waveform detection means.
The pressure of the cuff corresponding to the inflection point of the change in the characteristic waveform
A diastolic blood pressure value determined by the continuous blood pressure value determining means;
Based on the relationship determined by the relationship determining means.
Relationship determination means for determining the suitability of the staff.
You. [0007] According to this structure, the cuff pressure increasing means increases the pressure.
Before the cuff pressure is increased at a predetermined speed,
The characteristic waveform generated near the lower peak of the pressure pulse wave is the characteristic waveform
Detected by the detecting means, and by the characteristic waveform detecting means
The cuff corresponding to an inflection point of a change in the detected characteristic waveform;
Pressure and the minimum determined by the continuous blood pressure value determining means.
Determined by the relation determining means based on the blood pressure value
The appropriateness of the corresponding relationship is determined by the relationship determining means. [0008] [Effect of the first invention] As described above, the relationship determining means
The correspondence determined by the
If it is determined to be correct,
This eliminates the need to execute the solution. Therefore, the caliber
Pressure on the living body due to compression of the cuff for
And the part where the cuff of the living body is attached
When the pressure pulse wave sensor is attached to the part downstream from the position
However, monitoring of blood pressure by the continuous blood pressure
And not. [0009] [0010] [0011] [0012] [0013] [0014] [0015] [0016] [0017] [0018] BRIEF DESCRIPTION OF THE DRAWINGS FIG.
This will be described in detail. FIG. 1 shows a configuration of a continuous blood pressure monitoring apparatus according to the present invention.
FIG. 7 is a diagram showing an example of a patient, for example, during and after surgery;
Used to monitor the condition of In the figure, 10
Is a cuff having a rubber bag in a cloth band bag,
For example, it is worn while being wound around the upper arm 12 of the patient.
The cuff 10 includes a pressure sensor 14, a switching valve 16, and an empty
Air pumps 18 are connected via pipes 20, respectively.
You. The switching valve 16 allows the supply of pressure into the cuff 10.
Pressure supply state, slow exhaust pressure to gradually exhaust the cuff 10
State and a rapid exhaust pressure state in which the cuff 10 is quickly exhausted.
It is configured to be able to switch between the three states. The pressure sensor 14 detects the pressure inside the cuff 10.
And outputs a pressure signal SP representing the pressure to the static pressure discriminating circuit 22.
And the pulse wave discrimination circuit 24. Static pressure discrimination
The circuit 22 includes a low-pass filter, and the pressure signal S
Discriminates cuff pressure signal SK indicating steady pressure contained in P
And controls the cuff pressure signal SK via the A / D converter 26.
It is supplied to the control device 28. The pulse wave discrimination circuit 24 is a band pass
A filter is provided, which is a vibration component of the pressure signal SP
Pulse wave signal SM₁ Pulse wave signal SM₁A / D
It is supplied to the control device 28 via the converter 30. This pulse wave
Signal SM₁ The cuff pulse wave represented by is synchronized with the patient's heartbeat.
Pressure generated from unshown brachial artery and transmitted to cuff 10
The pulse wave discrimination circuit 24 detects a cuff pulse wave.
It functions as a means. The control device 28 includes a CPU 29, a ROM
31, a RAM 33, and an I / O port (not shown)
It is composed of a so-called microcomputer equipped with
The CPU 29 is a program stored in the ROM 31 in advance.
Signal processing using the storage function of the RAM 33 in accordance with
Outputs drive signal from I / O port by executing
And a switching valve 16 and air through a drive circuit (not shown).
The pump 18 is controlled. Calibration for calibration
When measuring the blood pressure using the cuff 10, for example,
3mm after the internal pressure is rapidly increased to the specified target pressure
Slowly reduce the pressure at a speed of about Hg / sec.
Pulse wave signal SM sequentially sampled₁ Based on the change in the pulse wave
Oscillometric method for systolic and diastolic blood
Determines blood pressure value such as pressure value and displays the determined blood pressure value
Is displayed on the display 32. The pressure pulse wave detection probe 34 has a container shape.
The open end of the housing 36 faces the body surface 38 of the human body
In this state, it is detachably attached to the wrist 42 by the wearing band 40.
It can be attached. Inside the housing 36
Is the relative pressure pulse wave sensor 46 via the diaphragm 44
Movable and can protrude from the open end of housing 36
The housing 36 and the diamond
A pressure chamber 48 is formed by the flam 44 and the like. This
In the pressure chamber 48, a pressure regulating valve 52 is
Pressure air is supplied through the
The pressure pulse wave sensor 46 presses the pressure pulse 48 in accordance with the pressure in the pressure chamber 48.
Pressure P_HDIs pressed against the body surface 38. The pressure pulse wave sensor 46 is, for example,
On the pressing surface 54 of a semiconductor chip made of crystalline silicon
Semiconductor pressure-sensitive elements (not shown) are arranged and configured.
And is pressed onto the radial artery 56 on the body surface 38 of the wrist 42
As a result, the body surface 38 generated from the radial artery 56
To detect the pressure vibration wave or pressure pulse wave transmitted to the
Pressure pulse wave signal SM representing pressure pulse wave_Two Through the A / D converter 58
And supplies it to the controller 28. FIG. 2 shows the pressure pulse wave sensor 4
6 shows an example of the pressure pulse wave detected by the control unit 6. The CPU 29 of the control device 28 has a ROM 31
In the RAM 33 in accordance with a program stored in advance in the RAM 33
Perform signal processing while utilizing the functions, and
Drive signal to the pressure control valve 52 via a drive circuit (not shown)
Is output to adjust the pressure in the pressure chamber 48. Continuous blood pressure monitor
In visual observation, the pressure change in the pressure chamber 48 gradually changes
Optimal pressing of the pressure pulse wave sensor 46 based on the obtained pressure pulse wave
Force P_HDOIs determined, and the pressure regulating valve 52 is
Suitable pressing force P_HDOControl to maintain
Systolic blood pressure value BP measured using_SYSAnd most
Low blood pressure BP_{DI A}And the optimal pressing force P_HDOIs maintained
Of the pressure pulse wave detected by the pressure pulse
Value P_MmaxAnd the lowest value P_MminBlood measured based on
Pressure value BP and pressure pulse wave size P_M(Absolute value)
The relationship is obtained, and the pressure pulse wave sensor 46
The magnitude P of the pressure pulse wave detected successively_MIe the highest value
(Upper peak value) P_MmaxAnd the lowest value (lower peak value) P
_MminBased on systolic blood pressure value MBP_SYSAnd diastolic blood pressure
MBP_DIA(Monitor blood pressure value)
The monitor blood pressure value MBP is displayed on the display device 32. The above correspondence is, for example, as shown in FIG.
And is represented by Equation 1. In this equation 1,
A is a constant indicating the slope, and B is a constant indicating the intercept. [0026] ## EQU1 ## MBP = AP_M+ B FIG. 4 shows the continuous blood pressure configured as described above.
Explain the main part of the control function of the control device 28 in the monitoring device
FIG. 3 is a functional block diagram illustrating the operation of the embodiment. In the figure, the cuff 10
The compression pressure is detected by the pressure sensor 14. Blood pressure measurement
The setting means 72 changes the compression pressure by the cuff 10.
Thus, the blood pressure value of the living body is measured. Pressure pulse wave sensor 46
Is on the downstream side of the artery from the site where the cuff 10 of the living body is attached.
Of the area downstream of the artery
A pressure pulse wave generated from an artery is detected. Relationship determining means 74
Is the magnitude of the pressure pulse wave detected by the pressure pulse wave sensor 46
Between the blood pressure value measured by the blood pressure value measuring means 72 and
The correspondence is determined in advance. The continuous blood pressure value determining means 76
The pressure detected by the pressure pulse wave sensor 46 from the corresponding relationship
Continuously determine the blood pressure value of the living body based on the magnitude of the pulse wave
You. On the other hand, the cuff pressure increasing means 78 determines the compression pressure of the cuff 10.
Is increased continuously or stepwise at a predetermined speed. Characteristic
The waveform detecting means 80 is controlled by the cuff pressure increasing means 78.
In the process where the compression pressure of the head 10 is increased at a predetermined speed
A characteristic waveform generated near the lower peak of the pressure pulse wave is detected.
The relation determining means 82 is provided by the characteristic waveform detecting means 80.
Cuff 10 corresponding to the inflection point of the change of the detected characteristic waveform
Pressure and the latest blood pressure determined by the continuous blood pressure value determining means 76.
Based on the minimum blood pressure value of
Then, the appropriateness of the determined correspondence is determined. FIG. 5 shows the essential points of the control operation of the control device 28.
It is a flowchart explaining a part. Step S1 in FIG.
(Hereinafter, steps are omitted.) In the pressure chamber 48,
The pressure is gradually increased.
The amplitude of the pressure pulse wave sequentially detected by the pressure pulse wave sensor 46 is
The maximum pressure in the pressure chamber 48, that is, the pressure pulse wave sensor 4
Optimum pressing force P of 6_HDOIs determined and the pressure chamber 4
8 is the optimum pressing force P_HDOTo be held in
As a result, the pressing force of the pressure pulse wave sensor 46 is set to an optimal constant value.
Is In this embodiment, the air pump 5
0, pressure regulating valve 52, and step S1 (more precisely, C
PU29, ROM31, and RAM33
The part used to execute step S1) is
It corresponds to a knot means. At S2, the cuff 10 is mounted.
For the living body, the correspondence shown in FIG. 3 has already been determined.
Is determined. This judgment of S2 is affirmed.
If the relationship is appropriate, determine the appropriateness of the corresponding relationship
The routine is executed in S3 to S6, but initially
Since the determination in S2 is denied, the blood pressure by the cuff 10
S7 and subsequent steps for executing the measurement are executed. First, the blood pressure
In S7 corresponding to the value measuring means 72, the switching valve 16 is
Switch to supply state and operate air pump 18 to
The pressure in the chamber 10 is higher than the patient's expected systolic blood pressure value.
After raising the pressure to a target pressure (for example, 180 mmHg)
Stops the air pump 18 and sets the switching valve 16 to the slow exhaust pressure state
The pressure in the cuff 10 is switched to
By lowering at a constant speed, this slow down
Next obtained pulse wave signal SM₁ Changes in the amplitude of the pulse wave
Oscillometric blood pressure determination
The systolic blood pressure value BP according to the fixed algorithm_SYS, Mean blood pressure
Value BP_MEAN, And diastolic blood pressure BP_DIAIs measured
In both cases, the pulse rate is determined based on the pulse wave interval
It is. And the measured blood pressure value and pulse rate
Is displayed on the display 32 and the switching valve 16 is
It is switched to the quick exhaust pressure state, and the inside of the cuff 10 is quickly exhausted.
It is. Next, S corresponding to the relation determining means 74
8, the magnitude of the pressure pulse wave from the pressure pulse wave sensor 46 (absolute
Value, ie, pulse wave signal SM_Two Size) and S7 above
Blood pressure value BP by cuff 10 measured by_SYS, BP_DIA
Is required. That is, the pressure pulse wave sensor
One pulse is read from the pressure pulse wave from the
Maximum value P_MmaxAnd the lowest value P_MminIs determined
And the highest value P of these pressure pulse waves_MmaxAnd the lowest value P_MminWhen
Systolic blood pressure value BP measured by cuff 10 in S7_SYS
And diastolic blood pressure BP_DIAAnd the pressure shown in FIG.
The correspondence between pulse wave magnitude and blood pressure value is determined
It is. The correspondence is determined as described above.
Is executed in S9 and subsequent steps following the continuous blood pressure monitoring routine.
Is done. First, whether one pulse wave has been input in S9
It is determined whether or not. If the judgment in S9 is denied
Is made to wait until one pulse wave is input.
If the determination is affirmative, the continuous blood pressure value determining means
In S10 corresponding to 76, the optimal pressing force P_HDO
At the maximum value P of the pressure pulse wave from the pressure pulse wave sensor 46_Mmax
And the lowest value P_MminIs determined. Then, in S11
Is determined in S10 from the correspondence obtained in S8.
The maximum value P of the obtained pressure pulse wave_MmaxAnd the lowest value P_MminBased on
And systolic blood pressure MBP_SYSAnd diastolic blood pressure MBP
_DIA(Monitor blood pressure value) is determined and
The displayed monitor blood pressure value is displayed on the display 3 together with the continuous waveform of the pressure pulse wave.
2 is displayed. Next, in S12, the above-described step S7 is performed.
Has elapsed since the blood pressure was measured by the cuff 10
The interval passes through a preset cycle of about 10 to 20 minutes.
It is determined whether or not it has passed. The judgment in S12 is denied
In this case, the continuous blood pressure monitoring routine from S9 on is performed.
Repeatedly executed, systolic blood pressure value MBP_SYSAnd the lowest blood
Pressure value MBP_DIAIs determined and displayed continuously for each beat
It is. However, if the judgment in S12 is affirmed,
Is executed again from S2. The correspondence is once determined as described above.
In the control cycle that follows, the determination in S2 is affirmed.
In step S3 corresponding to the cuff pressure increasing means 78, the cuff is increased.
10 is atmospheric pressure at a predetermined speed of about 5 to 20 mmHg / sec
Is boosted. Next, the characteristic waveform detecting means 80
In corresponding S4, the pressure pulse signal SM_TwoPressure pulse represented by
Change of the characteristic waveform formed near the lower peak of the wave
It is determined whether an inflection point has occurred. This characteristic waveform
Is a rounded waveform as shown in FIG. 2F, for example.
For example, the lower peak point P_MminA few mmHg higher than
Value of P₁Depending on the length L of the pressure pulse wave in the portion below
And pressurization of the cuff 10 as shown in FIG.
Inflection of a change in the magnitude L of the characteristic waveform that changes with
Point K₁Is the maximum difference value of the magnitude L
It is determined by finding a value. The above characteristic waveform is generated by the compression of the cuff 10.
The low pressure side of the pressure wave propagating downstream from the cuff 10 is cut off
The inflection point K
₁Occurs corresponding to the diastolic blood pressure value. Initially S4 judgment
Is denied, so that S3 and subsequent steps are executed, and those steps are performed.
While the loop is repeatedly executed, the determination of S4 is affirmed.
And the inflection point of the change in the magnitude L of the characteristic waveform in S5
K₁Pressure P when detecting_CD1Is stored. This cuff pressure
P_CD1Represents the actual diastolic blood pressure value. And, it corresponds to the relation judging means 82.
In step S6, the latest value calculated in step S11 is used.
Low blood pressure value MBP_DIAAnd the characteristic waveform stored in S5
Cuff pressure P at detection_CD1(That is, the diastolic blood pressure BP_DIA)
Whether the correspondence determined in S8 based on
Is determined. That is, the minimum blood pressure value MBP_DIAAnd special
Cuff pressure P at detection of signature waveform_CD1Difference with MBP_DIA-P
_CD1| Is a preset criterion value ΔP₁Is less than
It is determined whether or not. This determination reference value ΔP₁Is continuously
Minimum blood pressure value MBP determined_DIAAnd measured with cuff 10
Minimum blood pressure value BP_DIATo determine the match with
The value is set to, for example, about 5 mmHg. But,
Minimum blood pressure value BP measured by cuff 10_DIAAnd characteristic waves
Cuff pressure P during shape detection_CD1If a difference is found,
判断 P₁Is corrected in advance. If the determination in S6 is affirmative,
It is not necessary to update blood pressure measurement and correspondence by
Therefore, the steps S7 and S8 are not executed,
The continuous blood pressure monitoring routine after step S9 is directly executed.
You. However, if the determination in S6 is denied,
S7 and S8 are executed because the engagement is inappropriate.
After the correspondence is updated, the continuous blood pressure monitoring
Chin runs. As described above, according to the present embodiment, the cuff pressure
Compression pressure of cuff 10 by S3 corresponding to pressure increasing means 78
Pressure rises at a predetermined speed,
The magnitude L of the characteristic waveform F formed near the
Detected by S4 corresponding to the detecting means 80,
The inflection point K of the change in the magnitude L of the characteristic waveform F₁But
Pressure P of cuff 10 when detected_CD1And continuous blood pressure determination
The latest value determined by S11 corresponding to the
Low blood pressure value MBP_DIABased on the relationship,
Whether the correspondence determined by the corresponding S8 is appropriate or not is determined.
The determination is made in S6 corresponding to the determination means 82. to this
Thus, the correspondence already determined in S8 is S6
If it is determined to be appropriate by
Calibration is no longer necessary,
Strain on the living body due to compression of the cuff 10 for ventilation
The forcing is eliminated and the living body cuff 10 is mounted.
A pressure pulse wave sensor 46 is provided at a portion downstream of the attached portion.
Blood pressure monitoring by continuous blood pressure value determination means even when worn
Is not interrupted. Further, according to the present embodiment, in S6
Is the latest diastolic blood pressure value MBP determined in S11.
_DIAAnd the inflection point K of the change of the magnitude L of the characteristic waveform F₁Is detected
Cuff 10 pressure P_CD1And the corresponding
Since the suitability of the person in charge is determined, the diastolic blood pressure M
BP_DIAAlternatively, the diastolic blood pressure value BP measured in S7
_{DI A}The judgment accuracy is further improved as compared with the case of using
There are advantages. Next, another embodiment of the present invention will be described. What
In the following description, parts common to the above-described embodiment will be described.
Are denoted by the same reference numerals and description thereof is omitted. FIG. 7 shows a control device 2 according to another embodiment.
8 shows the main part of the control function of FIG. Cuff pressure increasing means 84
Increases the compression pressure of the cuff 10 at a predetermined speed. phase
The difference calculating means 98 outputs the cuff 10
In the process where the compression pressure is increased at a predetermined speed, the pressure pulse
And the lower peak point of the pressure pulse wave detected by the wave sensor 46.
F pulse wave detection means (pulse wave discrimination circuit 24)
Calculate the phase difference T (msec) from the lower peak point of the cuff pulse wave
You. The relation determining means 86 calculates by the phase difference calculating means 98.
Inflection point K of change in phase difference T_TwoCorresponding to the
And the continuous blood pressure value determining means 76
Determined by the relationship determining means 74 on the basis of the
It is determined whether the determined correspondence is appropriate. FIG. 8 shows the control device in the embodiment of FIG.
3 shows a main part of a control operation of the device 28. In this embodiment
The control operation of the control device 28 according to the embodiment shown in FIG.
5 is the same as that shown in FIG. FIG.
In the step S14 in place of the step S4, a phase difference calculation
Outgoing means 98, where the pressure pulse
The phase difference T between the peak point and the lower peak point of the cuff pulse wave is calculated.
Will be issued. This phase difference T is, for example, as shown in FIG.
Yes, and as shown in FIG.
The inflection point K of the change of the phase difference T changing with the change_TwoOccurs
It is determined whether or not the maximum value of the difference value of the phase difference T has been obtained.
And so on. The phase difference T is
Propagation from cuff 10 to downstream side due to compression of cuff 10
Formed when the low pressure side of a falling pressure wave is cut off
And the inflection point K_TwoIs triggered according to the actual diastolic blood pressure value.
Live. As described above, according to this embodiment, the cuff pressure
The compression pressure of the cuff 10 by S3 corresponding to the pressure increasing means 84
Pressure rises at a predetermined speed,
The phase difference T between the point C and the lower peak point of the cuff pulse wave is calculated as the phase difference
S14 corresponding to the output means 98,
4, the inflection point K of the change of the phase difference T_TwoWas detected
The pressure P of the cuff 10 at the time_CD1And the continuous blood pressure value determining means 76
Latest diastolic blood pressure value M determined in S11 corresponding to
BP_DIABased on the relationship S
Whether the correspondence determined by step 8 is appropriate or not is determined by the relation determination means 8.
6 is determined in S6. Thereby, S8
The correspondence already determined by S6 is applied by S6.
If it is determined to be correct,
Calibration is not required
Pressure on the living body due to compression of the cuff
As well as the part where the cuff of the living body is attached
Continuous even when the pressure pulse wave sensor is installed on the downstream side
The blood pressure monitoring by the blood pressure value determining means is not interrupted.
No. FIG. 11 shows a control device 28 according to another embodiment.
3 shows the main part of the control function. Control in this embodiment
The apparatus 28 includes a pulse wave area calculating means 88 and an area halving determination.
The function block shown in FIG.
Different from the lock diagram, and the relation determining means of the present embodiment
92 functions as compared with the relation determining means 82 of the embodiment of FIG.
Are different, and the others are the same. That is, pulse wave area
The calculating means 88 calculates the pressure pulse detected by the pressure pulse wave sensor 46.
Wave area S_MIs calculated. The area half-decision determining means 90
Area S of pressure pulse wave calculated by wave area calculation means 88_M
It is determined whether or not has been reduced by half. The relation determining means 92
The area of the pressure pulse wave S_MHas been halved
And the continuous blood pressure value of the cuff 10 when
Based on the average blood pressure value determined by the determination means 76
The appropriateness of the correspondence determined by the relationship determination means 74
Is determined. FIG. 12 shows the control in the embodiment of FIG.
The main part of the control operation of the control device 28 is shown. In this embodiment
The control operation of the control device 28 in FIG.
Except the routine for determining the appropriateness of the correspondence in S3 to S6 in the embodiment.
12 is the same as that shown in FIG.
Another pair corresponding to S3 to S6 in FIG.
9 shows a response appropriateness determination routine. S23 in FIG.
In the state before the cuff 10 is boosted, the pressure pulse wave sensor 46
S of pressure pulse wave detected by_OIs calculated. this
Area S_OIs, for example, one cycle of a pulse wave as shown in FIG.
The baseline connecting the waveform in the period of
2 (shown by a two-dot chain line).
Is the integrated value of the sampling value of the pulse wave within one period of the wave
Is obtained by subtracting the integrated value of the baseline for one cycle from
You. In the following S24, the cuff 10 is moved in the same manner as in S3.
Is increased at a predetermined speed, and in subsequent S25, the cuff 10
Pressure P_CArea S of the pressure pulse wave when_MIs the above S
23. In this embodiment, the above S2
3 and S25 correspond to the pulse wave area calculation means 88
I have. Next, S corresponding to the area halving determination means 90
At 26, the area S of the pressure pulse wave during pressure increase_MAnd pressure pulse wave before pressure rise
Area S_ORatio S_M/ S_OIs calculated, and
Ratio S_M/ S_OIs equal to or less than a predetermined judgment reference value K.
Is determined. This criterion value K is determined by the cuff 10
Compression pressure P_CIs the average blood pressure BP of the living body_MEANReached
To determine whether or not
Is set. If the determination at S26 is negative, the previous
Step S24 and subsequent steps are repeatedly executed, but when affirmed
The pulse wave area S in S27_MIs the initial area S_OTo
Cuff pressure P when halved compared to_cm(That is, the flat
Is stored. Next, the relation determining means 92
In the corresponding S28, the continuous blood pressure value
The latest average blood pressure value continuously determined in corresponding S11
MBP_MEANAnd the pulse wave area S_MPressure when the pressure is reduced by half
P_cmDifference with MBP_MEAN-P_cm| Is a preset judgment
Reference value ΔP_TwoIt is determined whether or not: This judgment
Reference value ΔP_TwoIs the continuously determined mean blood pressure value MBP
_MEANBlood pressure value BP measured by cuff 10_MEANWhen
Is a value for judging the coincidence of, for example, about 5 mmHg.
Set to degree. However, the flatness measured by cuff 10
Equalizing blood pressure value BP_MEANAnd pulse wave area S_MIs the initial area S_OTo
Cuff pressure P when halved_cmWhere there is a gap between
In this case, the above criterion value ΔP is calculated by the difference._TwoIs corrected in advance
Is done. If the judgment in S28 is affirmative, S9 and below
Of the continuous blood pressure monitoring routine is executed directly,
In the case where the correspondence has been established, the correspondence is updated by S7 and S8.
After the update, the continuous blood pressure monitoring routine of S9 and below is executed.
It is. As described above, according to the present embodiment, the cuff 1
In the process where the compression pressure of 0 is increased at a predetermined speed,
It is calculated by S25 corresponding to the pulse wave area calculating means 88.
Pressure pulse wave area S_MIs the initial area S_OReduced by half
In S26 corresponding to the area halving determination means 90,
The area S of the pressure pulse wave is determined by the step S26._MIs half
The pressure P of the cuff 10 when it is determined that the pressure
_cmAnd S11 corresponding to the continuous blood pressure value determining means 76.
Average blood pressure value MBP determined_MEANAnd based on said
Correspondence determined in S8 corresponding to the relation determination means 74
Whether the relation is appropriate or not corresponds to S28 corresponding to the relation judging means 92.
Is determined by As a result, already determined by S8
Determined that the corresponding relationship is appropriate by S28
If so, execute the calibration at that time
Is not necessary, so the cuff for calibration
Compression will eliminate the burden on the living body
At the site downstream from the site where the living body cuff is attached.
Continuous blood pressure value determination means even when a pressure pulse wave sensor is attached
Monitoring of blood pressure is not interrupted. FIG. 13 shows a control device 28 according to another embodiment.
3 shows the main part of the control function. Control in this embodiment
The main part of the control function of the device 28 is a function block shown in FIG.
Similar to the lock diagram, but the cuff pressure increasing means of the present embodiment
The cuff pressure 94 and the relationship judging means 96 of the embodiment of FIG.
The control unit is compared with the boosting unit 78 and the relationship determining unit 92.
Noh content is different. That is, the cuff pressure increasing means 94
The compression pressure of the lever 10 is increased to a predetermined value. Pulse wave front integration
The output means 88 has an area S of the pressure pulse wave._MIs calculated. Relationship judge
The stage 96 is configured so that the cuff 10
When the force is increased to a predetermined value, the pulse wave area calculation
Area S of pressure pulse wave detected by step 88 _MBased on the size of
Of the correspondence determined by the relationship determining means 74
Judge the suitability. FIG. 14 shows the control in the embodiment of FIG.
The main part of the control operation of the control device 28 is shown. In this embodiment
The control operation of the control device 28 in FIG.
Correspondence suitability determination routine of S23 to S28 in the embodiment
1 is the same as that shown in FIG.
4 is another pair corresponding to S23 to S28 in FIG.
9 shows a response appropriateness determination routine. S33 in FIG.
In the same manner as in step S23, the surface of the pressure pulse wave before the pressure of the cuff 10 is increased.
Product S_OIs calculated, and in subsequent S34, similarly to S24 described above.
The cuff 10 is pressurized at a predetermined speed. Then, S3
5 is the pressure P of the cuff 10_CIs the preset target pressure P
_CMMIs determined. This target pressure P
_CMMIs the latest average blood pressure value calculated in S11
MBP_MEANFor example, 5 to 10 mmHg
The margin value β is set to the added value. In this embodiment,
S34 and S35 correspond to the cuff pressure increasing means 94.
ing. At first, since the determination at S35 is denied,
S34 and subsequent steps are executed again, but these steps are repeated.
If the determination in S35 is affirmative during the repeated execution,
At S36 corresponding to the pulse wave area calculation means 88, the pressure
Pulse wave area S_MMIs calculated and stored. Then before
In S37 corresponding to the relationship determination means 96, the pressure
Pulse wave area S_MMThe suitability of the correspondence is determined based on the
It is. That is, the area S of the pressure pulse wave_MMAnd rise of cuff 10
Area S of pressure pulse wave before compression_ORatio S_MM/ S_OIs preset
Criterion value R_MOIt is determined whether or not: This
Judgment criteria value R _MOMeans that the blood pressure value of the living body is equal to the target pressure P
_CMMA predetermined width around the center, for example, a pressure of 5 mmHg
Area S of the pressure pulse wave generated when_MMOf pressure pulse wave before pressure rise
Area S_OIs determined in advance so as to include the ratio.
If the determination in S37 is affirmative, the continuous blood after S9
If the pressure monitoring routine is executed directly,
In this case, the correspondence has been updated by S7 and S8.
Thereafter, the continuous blood pressure monitoring routine of S9 and thereafter is executed. As described above, according to the present embodiment, the cuff 1
Compression pressure P of 0_CIs a predetermined value P_CMMPressurized to
At the time, in S36 corresponding to the pulse wave area calculating means 88,
Area S of pressure pulse wave detected_MMInitial area S_OTo
Ratio S_MM/ S_OBased on the relationship,
Whether the correspondence determined by S8 corresponding to
It is determined by S37 corresponding to the
You. As a result, the response already determined by S8
If the relationship is determined to be appropriate by S37
Eliminates the need to perform calibration at that time
So raw due to compression of the cuff for calibration
The burden on the body is eliminated, and
Pressure pulse wave sensor on the downstream side of the part where the
Blood pressure monitoring by continuous blood pressure value determination means even when
Your vision is not interrupted. FIG. 15 shows another example of the cuff pulse wave detecting means.
are doing. In other words, a part of the living body is
The approaching cuff is attached to the upper arm like cuff 10 described above.
Some are worn on the wrist as well as others. FIG.
5 shows a cuff device 102 of a type to be attached to a wrist 100
are doing. The cuff device 102 is wrapped around the wrist 100
Belt 104 and a part of the belt 104
And a small inflatable bag 106 which can be inflated and bulged inward.
I have. In use, the inflatable bladder 106 is placed in the radial artery
The belt 104 is mounted so as to be positioned on the belt 104. this
According to the cuff device 102 configured as described above, the tendon and the radius
Between the radial arteries between the tendons and radius
There is an advantage that compression can be suitably performed without using. An embodiment of the present invention will now be described with reference to the drawings.
Although described, the present invention is applicable in other aspects.
You. For example, the aforementioned blood pressure value measuring means 72
According to the so-called oscillometric method, the pressure of the cuff 10
The blood changes based on the changing state of the magnitude of the pressure pulse wave
Although it was configured to determine the pressure value, the so-called Korotoko
According to the sound method, it is generated with the compression pressure of the cuff 10 and
Determine blood pressure value based on disappearing Korotkoff sounds
May be configured. Further, the above-mentioned relationship judging means 82 or 92
Then, the latest blood pressure determined by the continuous blood pressure
Diastolic blood pressure MBP_DIAOr MBP_MEANIs used
Diastolic blood pressure value MBP determined by the last few beats
_DIAOr MBP_MEANThe average value of
No. In this way, abnormal values caused by body movements, etc.
The sound can be reduced. In the continuous blood pressure monitoring device of the above embodiment,
Is the time after the blood pressure measurement is executed in step S7.
When the elapsed time passes a preset cycle,
Calibration was performed, but the continuous blood pressure value
The blood pressure value MBP determined by the determining means 76 changes abnormally.
A judgment step for judging whether or not the
Judge that blood pressure value MBP has changed abnormally by step
Even if it is configured so that S7 and subsequent steps are executed
Good. In addition, the present invention does not depart from the gist of the invention.
Various changes can be made in the boxes.

BRIEF DESCRIPTION OF THE DRAWINGS FIG. 1 is a block diagram showing a configuration of a continuous blood pressure monitoring device according to one embodiment of the present invention. FIG. 2 is a diagram illustrating a pressure pulse wave detected by the pressure pulse wave sensor according to the embodiment of FIG. 1; FIG. 3 is a diagram illustrating a correspondence relationship used in the embodiment of FIG. 1; FIG. 4 is a functional block diagram illustrating a control function of the control device of the embodiment of FIG. 1; FIG. 5 is a flowchart illustrating a control operation of the control device according to the embodiment of FIG. 1; FIG. 6 is a diagram showing the relationship between the magnitude L of the characteristic waveform and the pressure of the cuff. FIG. 7 is a functional block diagram illustrating a control function of a control device according to another embodiment of the present invention. FIG. 8 is a flowchart illustrating a main part of a control operation of the control device in the embodiment of FIG. 7; FIG. 9 is a diagram illustrating a phase difference T between a lower peak point of a pressure pulse wave and a lower peak point of a cuff pulse wave. FIG. 10 is a diagram showing a relationship between a phase difference T between a lower peak point of a pressure pulse wave and a lower peak point of a cuff pulse wave, and cuff pressure. FIG. 11 is a functional block diagram illustrating a control function of a control device according to another embodiment of the present invention. FIG. 12 is a flowchart illustrating a main part of a control operation of the control device in the embodiment of FIG. 11; FIG. 13 is a functional block diagram illustrating a control function of a control device according to another embodiment of the present invention. FIG. 14 is a flowchart illustrating a main part of a control operation of the control device in the embodiment of FIG. 13; FIG. 15 is a flowchart illustrating cuff pulse wave detection means according to another embodiment of the present invention. [Description of References] 10: Cuff 46: Pressure pulse wave sensor 72: Blood pressure value measuring means 74: Relationship determining means 76: Continuous blood pressure value determining means 78, 84, 94: Cuff pressure increasing means 80: Characteristic waveform detecting means 82, 86, 92, 96: relation determining means 88: pulse wave area calculating means 90: area halving determining means 98: phase difference calculating means

────────────────────────────────────────────────── ─── Continuation of the front page (56) References JP-A-3-7137 (JP, A) JP-A-62-183742 (JP, A) JP-A-1-17628 (JP, A) JP-A-5-183 269092 (JP, A) Hikaru 2-82309 (JP, U) (58) Field surveyed (Int. Cl. ⁷ , DB name) A61B 5/02-5/03

Claims (1)

(57) Claims: 1. A blood pressure value measuring means having a cuff attached to a part of a living body, and measuring a blood pressure value of the living body by changing a compression pressure by the cuff. A pressure pulse wave sensor configured to detect a pressure pulse wave generated from an artery at a site downstream of the artery by being pressed to a site downstream of the artery from a site where the cuff is attached to the living body; Relation determining means for determining in advance the correspondence between the magnitude of the pressure pulse wave detected by the wave sensor and the blood pressure value measured by the blood pressure value measuring means, and the relation being determined by the pressure pulse wave sensor from the correspondence. Continuous blood pressure value determining means for continuously determining the blood pressure value of the living body based on the magnitude of the pressure pulse wave, wherein the compression pressure of the cuff is increased at a predetermined speed. A cuff pressure increasing means for increasing the pressure; A characteristic waveform detecting means for detecting a characteristic waveform generated near a lower peak of the pressure pulse wave in a process in which the compression pressure of the cuff is increased at a predetermined speed; A relationship determining unit that determines whether the correspondence determined by the relationship determining unit is appropriate based on the pressure of the cuff corresponding to the inflection point of the change and the diastolic blood pressure value determined by the continuous blood pressure value determining unit; A continuous blood pressure monitoring device comprising: