JP3714100B2 - Electronic blood pressure monitor - Google Patents

Description

[0001]
BACKGROUND OF THE INVENTION
The present invention relates to an electronic sphygmomanometer that can adjust the cuff decompression speed during measurement.
[0002]
[Prior art]
The blood pressure monitor, which has been known for a long time, compresses the blood vessel by cuff pressurization, and in the subsequent decompression process by cuff pressure exhaustion, visual observation of mercury drop and K sound by the stethoscope of the measurer (doctor, etc.) There is a mercury-type sphygmomanometer that measures systolic blood pressure by detecting (Korotkoff sound) and measures diastolic blood pressure by disappearance of K sound. There is also an electronic sphygmomanometer that detects a K sound by a sensor and electronically measures blood pressure.
[0003]
In these sphygmomanometers, in order to reliably and easily detect the K sound, the decompression process performs a relatively slow exhaust, that is, a slow exhaust. However, in the slow exhaust, there is a problem that it takes a long time from the detection of the K sound until the disappearance of the K sound, it takes too much measurement time and is painful to the measurement subject. Therefore, a skilled measurer, when performing blood pressure measurement using a mercury sphygmomanometer, first decreases the cuff pressure at a constant pressure reduction rate, determines the maximum blood pressure from the first appearing K sound, and then exhausts the valve. Open the valve, increase the decompression speed, drop the pressure to a pressure slightly higher than the expected minimum blood pressure, close the exhaust valve again, slow down the decompression speed and decrease the cuff pressure, and disappear The minimum blood pressure is determined by checking the K sound.
[0004]
In addition, when the electronic blood pressure monitor enters the decompression process, it detects the K sound by slow exhaust, determines the maximum blood pressure from the corresponding cuff pressure, then switches to a constant high decompression speed, and slightly higher than the predicted minimum blood pressure. And then return to the original slow decompression rate to confirm the disappearance of the K sound and determine the minimum blood pressure (Japanese Patent Publication No. 57-5540).
[0005]
[Problems to be solved by the invention]
The pressure reduction speed adjustment of the conventional mercury sphygmomanometer described above is to adjust the opening degree of the exhaust valve by turning the knob directly by hand, so it should be closed when the pressure reduction speed is increased and returned to the original slow pressure reduction speed. However, the decompression stops or becomes too slow, which may increase the measurement time. In addition, the switching of the decompression speed in the electronic sphygmomanometer is the switching of the constant decompression speed at the constant cuff pressure, and conversely, the skilled person cannot select the switching of the decompression speed according to his / her own experience or the person being measured There was a problem.
[0006]
The present invention has been made paying attention to the above-mentioned problems, and an electronic sphygmomanometer that can easily adjust the decompression speed even if it is not an expert, yet can freely adjust the decompression speed in order to shorten the measurement time. The purpose is to provide.
[0007]
[Means for Solving the Problems]
An electronic sphygmomanometer according to the present invention measures a blood pressure in a depressurization process after pressurizing a cuff for blood vessel compression. In the depressurization process, a depressurization speed control means during depressurization in response to this operation by manual operation Manual operation means for electronically controlling and a mode switching means for switching between a manual measurement mode and another measurement mode, and when the manual measurement mode is selected, responding to this operation by operating the manual operation means Thus, the decompression speed control means is controlled electronically .
[0008]
In this electronic sphygmomanometer, after the cuff is pressurized, the pressure reducing process is started. In the depressurization process, first, exhaust is performed at a low speed at a predetermined depressurization speed (for example, 2 to 3 mmHg / sec). By operating the manual operation means in the process, the pressure reduction speed control means during the pressure reduction is electronically controlled, and the pressure is reduced to a pressure reduction speed (for example, 4 mmHg / sec) higher than the predetermined pressure reduction speed by one touch. it can.
[000 9 ]
DETAILED DESCRIPTION OF THE INVENTION
Hereinafter, the present invention will be described in more detail with reference to embodiments. FIG. 1 is an external view of an electronic sphygmomanometer for clinics and hospitals according to an embodiment of the present invention. This electronic sphygmomanometer is composed of a main body part 20 and an arm band (cuff) part 30. In the main body part 20, in addition to display parts such as a systolic blood pressure display part 10a, a diastolic blood pressure display part 10b, a pulse rate display part 10c, In addition to those provided in a normal electronic blood pressure monitor, such as a power switch 1, a pressure switch 2, a stop switch 13 key, a pressure target value setting knob 14, a continuous measurement interval setting knob 15, etc., a pressure reduction speed adjustment knob 21 It has. The provision of the decompression speed adjusting knob 21 is one major feature of the electronic blood pressure monitor of this embodiment. In FIG. 1, many key switches and indicators are further provided as those normally provided. However, since they are not directly related to the present invention, individual references are omitted.
[00 10 ]
FIG. 2 is a block diagram showing a circuit configuration of the electronic blood pressure monitor according to this embodiment. This embodiment of the electronic blood pressure monitor includes a power switch 1, a pressure switch 2, a pressure reduction speed setting unit 3, a power supply unit 4, a CPU 5, an air supply unit 6 for supplying air pressure to the cuff, and a cuff air pressure. An exhaust section 7 for exhausting air, a pressure detection section 9 for detecting the air pressure of the cuff 8, a display section 10 for displaying data such as systolic blood pressure and diastolic blood pressure, a K sound sensor 11, and an air supply Part 6, exhaust part 7, cuff 8 and air passage 12 communicating with pressure detection part 9. Some of the keys, knobs, etc. shown in FIG. 1 are not shown.
[00 11 ]
When the decompression speed setting unit 3 enters the decompression process, a standard decompression speed voltage corresponding to the slow exhaust speed is output, and an external control signal voltage added by the knob 21 is superimposed on the standard decompression speed voltage and output. The voltage output from the decompression speed setting unit 3 is applied to the valve of the exhaust unit 7, and the valve is opened according to the driving voltage, so that the decompression speed increases.
[00 12 ]
FIG. 3 is a functional block diagram focusing on pressure reduction speed control of the electronic blood pressure monitor of this embodiment. The standard decompression speed voltage 3a preset by the decompression speed setting unit 3 and the external control signal voltage 3b corresponding to the operation position of the knob 21 are added by the adder 5a, and the target decompression speed voltage is output. On the other hand, the output of the pressure sensor 9a is differentiated by the differentiation circuit 5b to obtain the current decompression speed, the subtractor 5c obtains the deviation between the current decompression speed and the target decompression speed, and the decompression control unit 5d determines the valve 7a according to the decompression speed deviation. A drive voltage is applied to adjust the opening, and control is performed so that the decompression speed matches the target decompression speed.
[00 13 ]
Next, the overall operation of the electronic sphygmomanometer according to this embodiment will be described with reference to the flowchart shown in FIG. When the power is turned on by the power switch 1, it is first determined whether the mode setting switch is in the “manual measurement” mode or the “automatic measurement” mode (steps ST1 and ST9). When the “manual measurement” mode is selected, the pressurization switch 2 is waited to be depressed (step ST2). When the pressurization switch 2 is depressed, the air pressure is supplied to the cuff 8 from the air supply section 6 through the air passage 12. Feeding and pressurization are started (step ST3). After pressurizing to a predetermined value set in advance, pressure reduction is started (time t0 in FIG. 5), and blood pressure measurement is started (step ST4). Since the decompression speed at the start of decompression is a state where the knob 21 is not operated, only the standard decompression speed voltage is applied to the valve 7a of the exhaust section 7, and decompression is performed at a slow decompression speed. When the measurer detects the patient's K sound with a stethoscope, the cuff pressure (time t1 in FIG. 5) at that time is measured as the systolic blood pressure (SYS). When the measurer detects the K sound with the stethoscope, the K sound sensor 11 detects the K sound, and the instrument simultaneously measures the blood pressure. SYS or the like determined by the sphygmomanometer may be displayed on the display device 10 depending on the setting, or may not be displayed.
[00 14 ]
After the determination of the maximum blood pressure, when the measurer manually turns the knob 21 to increase the decompression speed, it is determined whether the decompression speed is adjusted (step ST5), and the decompression speed setting unit 3 sets the knob 21 to the standard decompression speed voltage. The external control signal voltage determined by the position of the exhaust gas is added and outputted, and is added to the valve 7a of the exhaust section 7. As a result, the decompression speed becomes a value faster than the standard decompression speed (step ST6). As long as the knob 21 remains in the rotated position, the depressurization speed remains at the changed high speed. This state corresponds to t1 to t2 in FIG.
[00 15 ]
When the depressurization speed is accelerated and the cuff pressure drops to near the minimum blood pressure value, the measurer returns the position of the knob 21 to the original position. Thereby, only the standard decompression speed voltage is output again from the decompression speed setting unit 3, and the decompression speed of the exhaust unit 7 becomes the standard decompression speed that is the original slow decompression. T2 in FIG. 5 corresponds to this point. When the measurer confirms the disappearance of the K sound with a stethoscope and determines the cuff pressure at that time as the minimum blood pressure, the measurement is completed (step ST7), and the results of the maximum blood pressure and the minimum blood pressure are displayed (step ST8). When the knob 21 is turned to full scale at the end of measurement, the cuff pressure is rapidly exhausted (time points t3 to t4 in FIG. 5).
[00 16 ]
On the other hand, if the “automatic measurement” mode is set when the power is turned on, the automatic blood pressure measurement is performed after the pressurization of the pressurization switch (step ST10). In this case, in the decompression process, decompression is performed at a constant standard decompression rate, and the occurrence and disappearance of the K sound are automatically detected to determine the systolic blood pressure and the systolic blood pressure (t0 to t5 in FIG. 5). As can be seen from FIG. 5, the measurement time is reduced from t4 to t6 compared to the "automatic measurement" mode by setting t1 to t2 to a high pressure reduction in the "manual measurement" mode. However, in the “automatic setting” mode, the degree of decompression may be automatically increased at an intermediate stage of measurement as disclosed in Japanese Patent Publication No. 57-5540.
[00 17 ]
Note that, as shown in FIG. 6A, the knob 21 for adjusting the reduced pressure measurement is at the reference position when not manually operated, and in this case, the reduced pressure speed is the standard reduced pressure speed. When turned to the position shown in FIG. 6B, the depressurization speed is increased by a voltage corresponding to the rotational position. When the knob 21 is returned to the original position as shown in FIG. 6C, the decompression speed becomes the standard decompression speed. In this embodiment of the electronic blood pressure monitor, the decompression speed does not become lower than the standard decompression speed no matter where the knob 21 is rotated.
[00 18 ]
As another embodiment, instead of the decompression speed adjustment knob 21, a slide-type knob 22 is used as shown in FIG. 7, and the position of FIG. As shown in (b) of FIG. 7, the pressure reduction speed increases as the knob 22 is raised upward, and when the knob 22 is returned to the original reference position as shown in FIG. 7C, the pressure reduction speed becomes the standard pressure reduction speed. It may be made to become. Also in this case, the depressurization speed does not become lower than the standard depressurization speed no matter which position the knob 22 is rotated.
[00 19 ]
Further, a return force is applied to the knobs 21 and 22 shown in FIGS. 6 and 7 by a spring or the like in the reference position direction, and the knob 21 is rotated by a finger, or the knob 22 is raised upward and held by the finger. The pressure stays at that position while the pressure is reduced, and the pressure reduction speed is increased. However, when the finger is released, the pressure reduction speed may return to the reference position, and the pressure reduction speed may automatically return to the standard pressure reduction speed. Even in this case, when the measurer lifts his / her finger, the decompression speed does not become smaller than the standard decompression speed. Therefore, the measurer can lift the finger with peace of mind.
[00 20 ]
In the above-described sphygmomanometer, the volume type in FIG. 6 and the slide type in FIG. 7 are used to return to the reference position when the knob is returned. Instead, FIG. As shown in (a) and (b) of FIG. 8, when the finger is released from the knob, it stays in that position and returns to its original position or moves the knob again to change to another value. May be used.
[00 21 ]
In the above-described sphygmomanometer, the target speed control is performed by setting from the outside with a knob or the like to perform the decompression control. Instead, the exhaust time control by step exhaust is performed. Also good. For example, in order to increase the pressure reduction rate during the period t1 to t2 in FIG. 5, the exhaust valve is turned on at one duty every time interval at constant time intervals t11, t12,..., T21 as shown in FIG. . In this case, the exhaust valve duty is set to be naturally larger than before the quick exhaust is entered. In some cases, the time until the exhaust valve is turned on with the passage of time may be changed, or the time until the exhaust valve is turned on may be constant, and the period until the next ON time may be changed. Each ON time or each cycle of these exhaust valves may be stored in a table as time passes, as shown in FIG. The data held in the table may be flow rate or voltage instead of each ON time and each cycle.
[00 22 ]
As another method of pressure reduction control, for example, a key switch is turned on at a required cuff pressure, a predetermined quick exhaust is performed, and while the key switch is turned on, rapid pressure reduction is continued and the key switch is turned off. An exhaust pressure control method in which the decompression speed is normal may be employed. Further, when the key switch is turned on, the current cuff pressure may be rapidly reduced automatically to a pressure lower by a predetermined value, and thereafter, the normal pressure reduction speed may be restored.
[00 23 ]
As another example of the decompression control, as shown in FIG. 11 and FIG. 12, after detecting the K sound corresponding to the systolic blood pressure SYS, from t1 to the normal decompression speed v0 to t2 (or a predetermined cuff pressure) If you want to depressurize and depressurize faster than usual, select the strong rapid depressurization switch and depressurize at the depressurization speed v1 (v1> v0). Conversely, if you want to depressurize slightly later than normal, select the weak rapid depressurization switch. Then, the pressure may be reduced at the pressure reduction speed v2 (v2 <v0).
[00 24 ]
FIG. 13 is a block diagram showing a main body of an electronic sphygmomanometer according to still another embodiment of the present invention. This embodiment of the electronic blood pressure monitor includes a blood pressure determination switch 16. In the electronic blood pressure monitor of this embodiment, the electronic blood pressure monitor shown in FIG. 1 includes the K sound sensor 10, and the signal of the K sound sensor 10 is taken into the CPU 5, whereas in this electronic blood pressure monitor, the K sound sensor 10 is not provided.
[00 25 ]
In this electronic sphygmomanometer, when the pressure switch 2 is turned on after the power switch 1 is turned on, pressurization is started from the air supply section 6 under the control of the CPU 5 and the pressure of the cuff 8 is increased. After rising to a predetermined cuff pressure, the supply of air from the air supply unit 6 is stopped, and the pressure of the cuff 8 is exhausted at a slight speed from the exhaust unit 7 and gradually reduced in pressure. A measurer (such as a doctor) enters a decompression process, detects a K sound with a stethoscope, and turns on the blood pressure determination switch 16 when the first K sound is detected. As a result, the cuff pressure taken into the CPU 5 from the pressure detection unit 9 at that time is determined as the maximum blood pressure, stored in the memory of the CPU 5 and displayed on the display unit 10.
[00 26 ]
Thereafter, similarly to the case shown in FIG. 1, predetermined rapid exhaust is performed, and the state of disappearance of the K sound is detected in a state where the exhaust is returned to the slow exhaust again. Then, the measurer turns on the blood pressure determination switch 16 in accordance with the disappearance detection at the time of disappearance. As a result, the cuff pressure at that time is taken into the CPU 5 from the pressure detection unit 9, determined as the minimum blood pressure value, stored in the memory and displayed on the display unit 10.
[00 27 ]
According to this embodiment of the electronic blood pressure monitor, blood pressure can be accurately measured with a simple configuration, and after the maximum blood pressure is determined, it is automatically exhausted automatically or manually, so the conventional screw is manually rotated to reduce the pressure. Compared to adjusting the speed, anyone can easily perform the operation.
[00 28 ]
Also, in the electronic sphygmomanometer according to this embodiment, the various decompression control methods described above can be used. In the electronic blood pressure monitor according to this embodiment, the main body does not necessarily have the automatic blood pressure measurement function by the vibration method. However, when the main body part has the automatic blood pressure measurement function, the measurement result and the blood pressure determination value by the operation of the blood pressure determination switch 16 Can be calibrated.
[00 29 ]
FIG. 14 is a diagram showing a front surface portion 40 of a main body portion 20 of an electronic sphygmomanometer for clinics and hospitals according to another embodiment of the present invention. Although the electronic blood pressure monitor of this embodiment is not shown in the figure, it has an arm band 30 similar to the electronic blood pressure monitor shown in FIG.
[00 30 ]
On the front face 40 of the main body 20, a systolic blood pressure display unit 41, a diastolic blood pressure display unit 42, a pulse rate display unit 43, a measurement number display unit 44 of the pulse rate, a pulse wave level 45, a rechargeable battery or an external power source In addition to a display unit 46 indicating a different display, a display 47 indicating the completion of measurement preparation, a button switch group such as a power switch 48, a start switch 49, an exhaust control switch 50, a stop switch 51, a mode switching knob 52, A pressure setting knob 53 is provided.
[00 31 ]
The mode switching knob 52 can select each mode of “single measurement”, “average”, “auscultation”, and “calibration”. The pressurization setting knob 53 is set to “100”, “140”, “180”, “220”, “260”, “280” pressurization target values and “automatic”. For example, when the pressurization setting knob 53 is set to “automatic” and the mode switching knob 51 is set to “single measurement”, when the start switch 49 is turned on in the power switch 48 ON state, automatic pressurization, One blood pressure measurement is performed by automatic decompression.
[00 32 ]
When the mode changeover switch 51 is set to the “auscultation” mode, similarly to the “manual measurement” described in the previous embodiment, the measurer applies the stethoscope to the artery and detects the K sound while listening to the K sound. By operating the flow rate control 50, rapid pressure reduction can be performed as indicated by t1 to t2 in FIG. Here, the flow rate control switch 50 can control the flow rate in four stages of average, 1st, 2nd, and 3nd. However, in place of such a flow rate control switch, a manual operating device shown in FIGS. 6, 7, 8 and the like may be used to perform pressure reduction speed control by electronic control although it is manual operation.
[00 33 ]
When the mode switch 51 is set to “average”, for example, three blood pressure measurements are continuously performed, and the average value is taken as the measured blood pressure.
[00 34 ]
FIG. 15 is a flowchart showing an electronic blood pressure monitor according to still another embodiment of the present invention. The electronic blood pressure monitor according to this embodiment calculates the first and second measurement results for the same subject, and determines whether or not to perform the third measurement based on the result.
[00 35 ]
In general, in an outpatient, when the blood pressure is continuously measured, the first measurement result may be high. Examples include when the subject is nervous or when he / she walks to the hospital and immediately measures blood pressure. At this time, in order to determine a normal blood pressure, the first measurement result is discarded and the second and third measurement results are adopted in the medical field. However, there are problems that nurses calculate and judge at present, which is troublesome and the judgment varies from person to person. In order to solve this problem, here, it is automatically determined whether to perform the third measurement.
[00 36 ]
When the operation is started, first, the variable n is cleared (step ST20), and the first measurement is started (step ST21). Then, the variable n is incremented by 1 (step ST22). Since n = 0 at the start, n = 1. Then, when the current measurement, that is, the first measurement is completed (step ST23), the current measurement value (first time) is stored (step ST24). Subsequently, it is determined whether the variable n is 2 or more (step ST25). Since n = 1, the determination is NO and the process returns to step ST21. After a predetermined time, the second measurement is started (step ST21). Then, the variable n is incremented by 1 (step ST22), n = 2, the measurement is completed (step ST23), and the current measurement result, that is, the second measurement result is stored (step ST24). Then, it is determined whether n is 2 or more (step ST25). Since n = 2 this time, the determination is YES in step ST25, and the process proceeds to step ST26.
[00 37 ]
In step ST26, it is determined whether n = 2. Since this determination is also YES, the difference between the first and second measurement results is calculated (step ST28). Subsequently, it is determined whether or not the calculation result (difference) is equal to or less than a preset reference, here 20 mmHg (step ST29). If the first time is high and the difference is greater than 20 mmHg, the determination is NO in step ST29, the process proceeds to step ST21, and the third measurement is performed. When entering the third measurement, the subsequent processing is the same as the second processing until step ST26. However, since the determination in step ST26 is n = 3, the determination is NO and the first measurement value is not adopted. The average value of the second and third measurement values is calculated (step ST27), and the operation is terminated.
[00 38 ]
If the calculation result (difference) is 20 mmHg or less in step ST29, the average value of the first and second measurement values is calculated (step ST30), assuming that the third measurement is not necessary. Exit.
[00 39 ]
【The invention's effect】
According to the present invention, the depressurization process is started at a predetermined depressurization speed, and the depressurization speed adjusting means for manually adjusting the depressurization speed within a range larger than the predetermined depressurization speed is provided. Since the acceleration can be adjusted without making it smaller than this value, the decompression speed can be easily adjusted even if it does not require skill. Further, the reduced pressure acceleration adjustment can be freely selected according to the own experience and the subject to be measured by the manual operation amount and the operation time of the decompression adjusting means.
[Brief description of the drawings]
FIG. 1 is an external perspective view of an electronic blood pressure monitor according to an embodiment of the present invention.
FIG. 2 is a block diagram showing an internal circuit configuration of the electronic blood pressure monitor according to the embodiment.
FIG. 3 is a block diagram showing a functional configuration focusing on pressure reduction speed control of the electronic blood pressure monitor according to the embodiment;
FIG. 4 is a flowchart for explaining the overall operation of the electronic blood pressure monitor according to the embodiment;
FIG. 5 is a diagram showing a change in cuff pressure in the “manual measurement” mode and the “automatic measurement” mode of the electronic blood pressure monitor according to the embodiment.
FIG. 6 is a diagram illustrating an operation of a rotary knob used in the electronic blood pressure monitor according to the embodiment.
FIG. 7 is a diagram for explaining the operation of a slide-type knob for adjusting a decompression speed used in an electronic blood pressure monitor according to another embodiment.
FIG. 8 is a view showing a knob for adjusting a decompression speed used in an electronic sphygmomanometer according to still another embodiment of the present invention.
FIG. 9 is a time chart explaining pressure reduction speed control by step control of the electronic blood pressure monitor of the embodiment.
FIG. 10 is a diagram showing a table used for pressure reduction speed control by step control.
FIG. 11 is a diagram for explaining another decompression speed control.
12 is a diagram showing a switch used for the decompression speed control shown in FIG. 11. FIG.
FIG. 13 is a block diagram showing a configuration of a main body portion of an electronic sphygmomanometer according to still another embodiment of the present invention.
FIG. 14 is a view showing a front surface portion of a main body portion of an electronic blood pressure monitor according to another embodiment of the present invention.
FIG. 15 is a flowchart for explaining the operation of an electronic sphygmomanometer according to still another embodiment of the present invention.
[Explanation of symbols]
20 sphygmomanometer body 21 decompression speed acceleration adjustment knob 30 cuff 3a standard decompression speed voltage supply unit 3b external control signal supply unit 5a adder 5d decompression control unit 7a valve

Claims (2)

In an electronic sphygmomanometer that measures blood pressure in the decompression process after pressurizing the cuff for blood vessel compression,
In the depressurization process, it comprises manual operation means for electronically controlling the depressurization speed control means during depressurization in response to this operation by manual operation, and mode switching means for switching between the manual measurement mode and another measurement mode, An electronic sphygmomanometer , wherein when the manual measurement mode is selected, the decompression speed control means is electronically controlled in response to the operation of the manual operation means . The electronic sphygmomanometer according to claim 1 , wherein the manual operation means accelerates the decompression speed by manual operation, and when the manual operation is released, the decompression speed is set to the original predetermined decompression speed .

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