JP5228189B2 - Organ shape measurement method - Google Patents

Description

The present invention relates to organ shape measuring how according to the shape measurement of the bladder. In particular, for patients with dysuria or urinary incontinence, measure the shape of the bladder to detect in advance the amount of urine collected in the bladder (urine accumulation) and inform the person or caregiver to encourage urination It relates to a suitable technique.

  There is a problem of whether excretion with dignity is performed for patients with dysuria or urinary incontinence, such as by managing diapers and catheters. Conventionally, a moisture sensor system or the like to be worn in a diaper is known, but it is still a coping therapy. The moisture sensor type has a structure in which the patient senses that the diaper gets wet after incontinence and informs the surroundings of the incontinence with a buzzer or the like.

  On the other hand, the first inventor previously measured the amount of urine stored in the bladder regularly in the A mode using ultrasonic waves in Patent Documents 1 and 2, and if there is a possibility of incontinence, the person and the caregiver And proposed an incontinence prevention sensor to prevent incontinence.

  Patent Documents 3 and 4 also propose a urination alarm device that measures whether the amount of urine stored in the bladder has reached the discharge level by the A mode using ultrasonic waves. Furthermore, in Patent Documents 5 and 6, an A-mode ultrasonic probe using a flexible polymer piezoelectric element is proposed in contrast to the devices proposed in Patent Documents 3 and 4.

Also, as a practical level, BladeScan ^™ BV16100 is sold by Symex, and there is a portable measuring device that non-invasively measures the intravesical volume by B mode using ultrasound. A portable urine volume monitoring device is sold by Takeshiba Electric under the trade name “Yuririn”. This device fixes the sensor part to the lower abdomen, intermittently measures the urine volume in the bladder, and notifies the urination timing when it reaches a specified value.

Japanese Unexamined Patent Publication No. 63-311952 JP 2003-190168 A JP-A-7-136167 Japanese Patent Laid-Open No. 7-171149 JP 2000-37384 A JP 2000-210286 A

  By the way, the sensor pad at the proposal stage of Patent Documents 1 and 2 is configured so that a plurality of ultrasonic transducers cover the lower abdomen in order to capture the bladder shape in three dimensions, and irradiates the ultrasound toward the bladder. Therefore, the number of effective vibrators for capturing the bladder shape decreases due to the peritoneum, pubic bone, pelvis, etc. inside the human body, and it becomes difficult to capture the bladder depending on the position of the observer.

  The ultrasonic probe used in the devices of Patent Documents 3 and 4 is configured by changing the irradiation angle of several ultrasonic transducers, and the ultrasonic waves are irradiated radially, hindered by the peritoneum and the pubic bone, The bladder cannot be measured in three dimensions and with high accuracy. The ultrasonic probes of Patent Documents 5 and 6 use the concept such as the irradiation angle of ultrasonic waves, and the same problem remains.

  Sysmex's portable measuring device is an expensive device used by doctors and nurses who have knowledge and experience to measure urine volume as needed. It is not designed for personal use. Moreover, since the above-mentioned portable urine volume monitor device uses the techniques of Patent Documents 3 and 4, there are similar problems.

The present invention is to provide an organ shape measuring how a limited from the gap of the bladder shape can sterically accurately measure between the peritoneum and the pubic bone.

Organ shape measuring method according to the present invention, using the ultrasonic probe in which a plurality of sensors by the ultrasonic transducers are placed two-dimensionally, each of the ultrasound central axis, the gap between the peritoneum and the pubic The ultrasound probe is directed to the posterior wall of the bladder, which is measured by spreading through and intersecting with one of the other ultrasound central axes in the vicinity of the anterior bladder wall as viewed from the side of the ultrasound probe. A tentacle is arranged on the surface of the lower abdomen, ultrasonic waves are emitted from a plurality of sensors, and ultrasonic waves reflected by the front wall and the rear wall of the bladder are received by each sensor to measure the three-dimensional shape of the bladder.

According to the organ shape measuring method according to the present invention, the central axis of the ultrasonic wave emitted from each of the two-dimensionally arranged sensors of the ultrasonic probe passes through the gap between the peritoneum and the pubic bone. As seen from the side of the ultrasound probe, it spreads in three-dimensional crossing with one of the other ultrasound central axes in the vicinity of the anterior wall of the bladder and directs to the posterior wall of the bladder. The rear wall can be captured in a wide range. Then, by receiving ultrasonic waves reflected by the front and rear walls of the bladder with a sensor, the positions of the front and rear walls of the bladder can be known from the time difference of the received signals, and the three-dimensional shape of the bladder can be accurately measured. .
The bladder shape can be measured (estimated) based on the bladder shape. Measurement errors due to the posture of the person being measured can also be reduced. It can also cope with the reduction of the gap between the peritoneum and the pubic bone due to the decrease in peritoneum found in postoperative patients such as digestive organs.

It is a block diagram which shows one Embodiment of the ultrasonic probe which concerns on this invention. It is an operation | movement drawing which shows the operation state of the state which looked at the ultrasonic probe from the side surface when the ultrasonic probe of this invention is used for the three-dimensional shape measurement of a bladder. It is a block diagram which shows the irradiation angle of each sensor of the ultrasonic probe seen from the side. It is an operation | movement drawing which shows the operation | movement state of the state which looked at the ultrasonic probe from the upper surface when the ultrasonic probe of this invention is used for the three-dimensional shape measurement of a bladder. It is a block diagram which shows the irradiation angle of each sensor of the ultrasonic probe seen from the upper surface. It is a block diagram which shows one Embodiment of the urination disorder countermeasure system which concerns on this invention.

  Embodiments of the present invention will be described below with reference to the drawings.

  First, an embodiment of an ultrasonic probe according to the present invention will be described. 1 to 3 show an embodiment of an ultrasonic probe according to the present invention developed for measuring a three-dimensional shape of a bladder. As shown in FIG. 1, the ultrasonic probe 1 of the present embodiment is configured by two-dimensionally arranging sensors 3 using a plurality of ultrasonic transducers on one surface of a support base 2. In this example, twelve ultrasonic transducers 3 [3A, 3B, 3C, 3D, 3E, 3F, 3G, 3H, 3I, 3J, 3K, 3L] are regularly spaced so as to be 4 × 3 horizontally. Ordered. Each of these sensors 3 [3A to 3L] is arranged at a required angle so as to irradiate ultrasonic waves in different directions.

In order to accurately capture the bladder 5 from the surface of the lower abdomen, it is necessary to irradiate ultrasonic waves from a limited gap 8 between the peritoneum 6 and the pubic bone 7, as shown in FIG. 2A. In the ultrasonic probe 1 of the present embodiment, the central axes 9A to 9L of ultrasonic waves from the sensors 3A to 3L that have passed through the gap 8 are viewed from the side of the ultrasonic probe (see FIG. 2A). A portion corresponding to the approximate center of the gap 8, for example, in the vicinity of the front wall 5 </ b> A of the bladder 5, once intersects with any of the other ultrasonic central axes , that is, three-dimensionally intersects without intersecting each other, and then spread (diffuse ) The irradiation angle of each sensor 3 (that is, its ultrasonic irradiation surface) is set so as to capture a wide range with respect to the rear wall 5B of the bladder 5. This irradiation angle will be described later.

  As shown in FIG. 2A, the ultrasonic probe 1 can be formed with an area wider than the area of the gap 8 between the peritoneum 6 and the pubic bone 7, and the sensors 3J, 3K, and 3L on the lowermost stage are attached. The lower end (bottom end) of the support base 2 is preferably attached to the lower abdominal surface so as to correspond to the upper end of the pubic bone 7. In this ultrasonic probe 1, as shown in FIGS. 2A and 3A, the upper sensor 3 captures the bladder bottom side from the lower side of the bladder rear wall 5B, and the lower sensor 3 detects the bladder rear wall 5B. The right side sensor 3 captures the left side of the urinary bladder rear wall 5B and the left side sensor 3 captures the right side of the urinary bladder rear wall 5B. An irradiation angle is set.

  An example of the irradiation angle of each sensor 3 [3A to 3L] is shown in FIGS. 2B and 3B. FIG. 2B shows a state in which the ultrasonic probe 1 is viewed from the side so as to correspond to FIG. 2A. For convenience, the sensors of the central vertical line [3B, 3E, 3H, 3K] and the sensor of the left vertical line are shown. [3A, 3D, 3G, 3J] and right-side vertical line sensors [3C, 3F, 3I, 3L] were drawn on one supporting substrate 2. All the ultrasonic waves of each sensor 3 are irradiated in the right direction of FIG. 2B.

  FIG. 3B shows a state in which the ultrasound probe 1 is viewed from the upper surface so as to correspond to FIG. 3A. For convenience, the sensors [3A, 3B, 3C] of the first horizontal line from the top and the second stage The horizontal line sensors [3D, 3E, 3F], the third-stage horizontal line sensors [3G, 3H, 3I], and the fourth-stage horizontal line sensors [3J, 3K, 3L] are mounted on one support substrate 2. I drew it. All ultrasonic waves from each sensor 3 are irradiated upward in FIG. 3A.

  Each sensor 3 has electrodes formed on both sides of an ultrasonic vibrator, that is, a piezoelectric element. When a voltage is applied between both electrodes, the piezoelectric element vibrates to transmit ultrasonic waves, and receives ultrasonic waves. Sometimes, a voltage is induced between both electrodes. For example, as shown in FIG. 1, the sensor 3 is formed in a circular thin plate shape. Each sensor 3 is supported on a support base so that the angle can be freely changed.

  As shown in FIG. 1, the ultrasonic probe 1 includes a plurality of sensors 3 arranged in a rectangular box-shaped support base 2 having an open upper surface, for example. In order to prevent large reflections of sound waves, the sensor 3 is embedded with a filler that serves as a matching layer. In addition, for example, an echo gel is used so that air does not exist between the ultrasound probe 1 and the lower abdomen.

  The above-described ultrasonic probe 1 can be used as, for example, a bladder shape exploration probe for estimating the amount of stored urine. This ultrasonic probe 1 is used in an A mode type in which ultrasonic waves are transmitted one by one while sequentially scanning each sensor 3 [3A to 3L]. In the case of bladder shape measurement, the sensor 3 may be any sensor that can emit an ultrasonic wave of about 1 MHz to 5 MHz.

  In the ultrasonic probe 1 of the present embodiment, as shown in FIGS. 2A and 3A, when the sensors 3 are sequentially driven by being attached to the lower abdomen, the ultrasonic waves transmitted from the sensors 3 are peritoneal 6. And radiated into the body through a limited gap 8 between the pubic bones 7. At this time, since the ultrasonic wave irradiation surface of each sensor 3 [3A to 3L] is disposed near the front wall 5A of the bladder 5 and substantially near the center of the gap 8, each sensor 3A to 3L. The ultrasonic waves from the three-dimensionally intersect in the vicinity of the front wall 5A of the bladder 5 and in the vicinity of the approximate center of the gap 8, and then spread to irradiate the rear wall 5B of the bladder 5 over a wide range. The ultrasonic waves reflected by the front wall 5 </ b> A and the rear wall 5 </ b> B of the bladder 5 are received by the sensor 3, and received signals corresponding to the positions of the front wall and the rear wall are detected by the sensor 3.

According to the above-described ultrasonic probe 1, it is possible to irradiate the rear wall 5 </ b> B of the bladder 5 over a wide range through the limited gap 8. In addition, the number of sensors can be reduced as compared with conventional sensor pads and ultrasonic probes, thereby enabling accurate measurement. The ultrasonic probe 1 is suitable for application to the measurement of the three-dimensional shape of the bladder , which is an organ.

  Next, a bladder shape measuring method and measuring apparatus according to an embodiment of the present invention applied to urination management for patients with urination disorders including urinary incontinence, and a urination disorder countermeasure system using them will be described. . In this embodiment, the above-described ultrasonic probe is used.

  FIG. 4 shows an example of the urination disorder countermeasure system of the present embodiment. The urination disorder countermeasure system 21 according to the present embodiment includes a bladder shape measuring device 22 including the above-described ultrasonic probe 1 attached to the lower abdomen of a patient (in the drawing, the ultrasonic transducer 1 is out of the frame for convenience. Urine volume determination means 23 for estimating the urine volume level from the bladder shape obtained by the bladder shape measuring device 22 and determining the urine volume level, and notification means 24 for informing the necessity of urination according to the urine volume. And comprising.

  The bladder shape measuring device 22 includes an ultrasonic probe 1 having a plurality of sensors 3, transmission control means 41 that sequentially transmits the plurality of sensors 3 of the ultrasonic probe 1, a front wall 5A of the bladder 5, Signal processing means for receiving the ultrasonic wave reflected by the rear wall 5B by the sensor 3, calculating the positions of the front wall 5A and the rear wall 5B of the bladder 5 from the time difference of the obtained reception signals, and measuring the three-dimensional shape of the bladder 5 42.

  That is, each sensor 3 [3 </ b> A to 3 </ b> L] of the ultrasonic probe 1 is connected to the ultrasonic transmission amplifier 32 and the ultrasonic reception amplifier 33 via the multiplexer 31. The ultrasonic transmission amplifier 32 is connected to a transmission command circuit 34 that sequentially issues a transmission command to the plurality of sensors 3. The ultrasonic transmission amplifier 32 has a function of amplifying a signal from the transmission command circuit 34 and increasing the electric energy sufficient to transmit the ultrasonic wave. The ultrasonic receiving amplifier 33 has a function of amplifying the received weak electric signal. The multiplexer 31 is located between the sensor 3 and the ultrasonic transmission amplifier 32 and the ultrasonic reception amplifier 33. The multiplexer 31 sequentially connects between the respective sensors 3 and the amplifiers 32 and 33, and all the sensors 3 are sequentially connected with one amplifier. Has a function to operate.

  The ultrasonic receiving amplifier 33 and the transmission command circuit 34 are connected to the signal processing circuit 35. In the signal processing circuit 35, only the sensor 3 that has received the ultrasonic wave reflected from the bladder is selected from the time difference between the transmission signal from the transmission command circuit 34 and the reception signal from the ultrasonic reception amplifier 33, and from the time difference at the selected sensor. The position of the front wall 5A and the position of the rear wall 5B of the bladder 5 is calculated, and the bladder wall surface is mapped using the spatial coordinates of the sensor 3 and the information of the direction vector. By performing the same operation on the transmission signals and reception signals of all the sensors 3, the three-dimensional shape of the bladder 5 is determined.

  A urine volume determination circuit 23 that measures (estimates) the bladder urine volume from the three-dimensional data of the bladder 5 obtained by the signal processing circuit 35 and determines whether or not urination is necessary is provided. Further, the urine volume determination circuit 23 is connected to a notification means 24 for notifying when the urine volume exceeds a predetermined risk value or when the urine volume exceeds a previously incontinence urine volume. The notification means 24 can be constituted by alarm means using sound (including sound), light, vibration or the like, or lamp display means. The three-dimensional shape of the measured bladder 5 can also be configured to be observed with a monitor.

  Next, a bladder shape measuring method will be described using the bladder shape measuring apparatus of the present embodiment described above, and the operation of the urination disorder countermeasure system will be described.

  On the basis of a transmission command from the transmission command circuit 34, ultrasonic waves are sequentially irradiated from the plurality of sensors 3 of the ultrasonic probe 1 to the bladder 5 side through the gap between the peritoneum and the pubic bone. The ultrasonic waves are reflected by the front wall 5A and the rear wall 5B of the bladder and received by the same sensor 3. In the signal processing circuit 35, only the sensor 3 that has received the reflected ultrasound from the bladder is selected from the time difference between the transmission signal from the transmission command circuit 34 and the reception signal from the ultrasonic reception amplifier 33. Further, the position of the front wall 5A and the rear wall 5B of the bladder is calculated from the time difference of the received signal in the selected sensor 3, and the bladder wall surface is mapped using the spatial coordinates of the sensor 3 and the information of the normal spectrum thereof together. As a result, the aforementioned three-dimensional shape of the bladder is measured.

  Next, the urine volume determination circuit 23 measures (estimates) the urine accumulation amount from the three-dimensional shape data of the bladder 5, and at the same time, whether or not the urine accumulation amount that requires urination (the so-called urine accumulation amount) has been reached. Is determined. When the urine volume reaches a dangerous value in the urine volume determination circuit 23, the patient or caregiver or nursing room is notified through the notification means 24 to prevent urination disorders including incontinence.

  According to the bladder shape measuring method and measuring apparatus of the present embodiment, a plurality of sensors 3 are sequentially driven using the ultrasonic probe 1 described above, and the ultrasonic waves from the sensors 3 are transmitted to the peritoneum 6 and the pubic bone. By irradiating the rear wall 5B of the bladder 5 over a wide range through a limited gap (narrow space) 7 between 7, the ultrasonic wave reflected by the bladder wall surface is received and processed by the sensor 3, and the three-dimensional shape of the bladder Can be measured with high accuracy. The bladder shape can be measured (estimated) based on the bladder shape. Measurement errors due to the patient's posture can also be reduced. Moreover, it can cope with the reduction of the gap between the peritoneum and the pubic bone caused by the drooping of the peritoneum seen in postoperative patients such as digestive organs.

  In addition, according to the urination disorder countermeasure system including incontinence prevention according to the present embodiment, since it is configured using the bladder shape measuring method and apparatus including the ultrasonic probe 1 described above, the urine accumulation amount is accurately determined. When the amount of accumulated urine reaches the discharge level, the patient is notified to the patient, the caregiver, or the nursing room, and the patient himself can be urged to urinate or conduct urine. Since this urination disorder countermeasure system has a simpler configuration than the conventional system, the cost burden is also reduced.

  In the present invention, the urine volume measuring device using the above-described system is composed of a measuring device having an internal CPU that measures and processes data from the sensor 3, and a personal computer that develops and executes a bladder shape / stored urine volume estimation algorithm. can do.

1. Ultrasonic probe 2. Support substrate 3 [3A to 3L]. Sensor 5 by ultrasonic transducer. Bladder 5A. Front bladder wall 5B. Rear bladder wall 6. Peritoneum 7. Pubic bone 8 .. gap 9 [9A to 9L] .. ultrasonic central axis 21 .. urination disorder countermeasure system 22 .. bladder shape measuring device 23 .. urine volume determination means 24 .. notification means 31. Ultrasonic transmission amplifier 33 .. Ultrasonic reception amplifier 34 .. Transmission command circuit 35 .. Signal processing circuit 41 .. Transmission control means 42 .. Signal processing means

Claims (1)

Using an ultrasonic probe in which a plurality of sensors based on ultrasonic transducers are arranged two-dimensionally,
Each ultrasound central axis passes through the gap between the peritoneum and the pubic bone and spreads in a three-dimensional intersection with one of the other ultrasound central axes in the vicinity of the anterior bladder wall as seen from the side of the ultrasound probe. Place the ultrasound probe on the surface of the lower abdomen so that it is directed to the posterior wall of the bladder to be measured,
An organ shape measuring method, comprising: emitting ultrasonic waves from the plurality of sensors, and receiving the ultrasonic waves reflected by the front wall and the rear wall of the bladder by each sensor and measuring the three-dimensional shape of the bladder.

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