JP5605534B2 - Palpation device, bed device, and abdominal diagnosis device using the same - Google Patents

Description

  The present invention relates to a palpation apparatus, a bed apparatus, and an abdominal diagnosis apparatus using these.

  In general, there are four diagnosis methods (four diagnoses) called diagnosis, interview, inquiry and excision (meaning palpation) in the diagnosis method of Wakahan medical science. In particular, the cross-examination is an examination method that examines the nature and shape of the pulse by hand (pulse examination) or directly touches the abdomen to examine the abdominal wall tension or responsiveness to stimulation (abdominal examination). Above all, it is a very characteristic diagnosis method in that the patient's biological information can be directly touched by hand.

  By the way, the examination method of the Wanhan Medical School is a subjective diagnosis that makes a diagnosis based on information obtained from the five senses and prescribes appropriate Chinese medicines according to the age and physique of the patient. In addition to experience-based guesses (so-called “intuitions”), it is very difficult to learn and sometimes lacks objectivity.

  In order to deal with such a problem, for example, Patent Document 1 below discloses a quantitative abdominal diagnosis apparatus that can measure the strength of the reaction force when the abdomen is pushed to a certain depth. Patent Document 2 listed below discloses a pulse diagnosis device capable of obtaining pulse pressure wave information by mechanically detecting wrist buoyancy, middle vein, and vein stagnation in Oriental medicine.

JP 2005-261546 A JP-A-11-19055

  However, the technique described in Patent Document 1 is useful in that it can be freely operated because the operation of the palpation device is left to the doctor's hand, but the reproducibility of the position to which the palpation device is applied and the reproduction of the angle to be pushed in. It depends on accuracy. All of these are very important information, and if the position and angle are different, the measurement results will change greatly and are not stable. There is also a problem that the pushing operation is limited to a straight line.

  Moreover, the technique described in Patent Document 2 is a pulse diagnosis of the wrist, and is not related to abdominal diagnosis. There is also a problem that the pressing angle is fixed and cannot be arbitrarily changed. Also, if the technique described in this patent document is to be applied to abdominal diagnosis, the probe and its drive mechanism are arranged on the mounting table, that is, a part of the patient's body is placed between the mounting table and the probe. Since the structure is sandwiched between them, there is a risk of anxiety to the patient. Furthermore, in the unlikely event that a malfunction occurs in the operation of the machine, there is a possibility that the patient will be in a dangerous state such as being unable to escape easily if the body is pinched.

  Accordingly, in view of the above problems, the present invention provides an abdominal examination apparatus that can freely operate a palpation instrument while ensuring position reproducibility and is less anxious to a patient, and a palpation apparatus and a bed apparatus used therefor. With the goal.

  The abdominal diagnosis apparatus according to the first aspect of the present invention includes: (1) a bed having a chest support part and a lower limb support part, and a space formed between the chest support part and the lower limb support part; A bed device having a plurality of legs that support the body, (2) a palpation unit that receives a load from above in the vertical direction, a height adjustment unit that adjusts the height of the palpation unit, and a palpation unit in the horizontal direction And a palpation device having a horizontal movement unit for moving the device. The palpation device is provided at the lower part of the bed device, and the palpation unit can be moved three-dimensionally in the vicinity of the space of the bed device by driving the horizontal direction moving unit and the height adjusting unit.

  Further, the palpation apparatus according to the second aspect of the present invention includes a palpation unit that receives a load from the vertical direction, a height adjustment unit that adjusts the height of the palpation unit, and a horizontal that moves the palpation unit in the horizontal direction. And a direction moving part.

  Moreover, the bed apparatus according to the third aspect of the present invention includes a chest support part and a lower limb support part, and a bed in which a space is formed between the chest support part and the lower limb support part, and supports the bed. A plurality of legs.

  As described above, according to the present invention, it is possible to provide a quantitative abdominal examination apparatus that can freely operate a palpation instrument while ensuring position reproducibility and is less anxious to a patient, and a palpation apparatus and a bed apparatus used therefor. .

  Embodiments of the present invention will be described below with reference to the drawings. However, the present invention can be implemented in many different modes and is not limited to the embodiments shown below.

(Embodiment 1)
FIG. 1 is a schematic cross-sectional view of the abdominal examination apparatus (hereinafter referred to as “abdominal examination apparatus”) 1 according to the present embodiment as viewed from the side (horizontal direction), and FIG. 2 is from above (B in FIG. 1). It is the schematic when seeing the arrow direction. As is apparent from these drawings, the abdominal examination apparatus 1 includes a bed apparatus 2 and a palpation apparatus 3. Specifically, (1) a bed 21 having a chest support portion 211 and a lower limb support portion 212, and a space 213 formed between the chest support portion 211 and the lower limb support portion 212, and the bed 21 are supported. A bed apparatus 2 having a plurality of legs 22, (2) a palpation unit 31 that receives a load from the vertical direction, a height adjustment unit 32 that adjusts the height of the palpation unit 31, and a palpation unit 31. A palpation device 3 having a horizontal movement unit 33 that moves in the horizontal direction. The palpation device 3 is provided in the lower part of the bed device 2, and the palpation unit 31 moves three-dimensionally in the vicinity of the space 213 of the bed device 2 by driving the horizontal movement unit 33 and the height adjustment unit 32. Is possible.

  The abdominal examination apparatus 1 according to the present embodiment includes a control device 4 that controls the palpation apparatus 3, and includes a palpation part position information acquisition unit 41 that acquires position information of the palpation part 31, and a height adjustment unit 32. And a palpation unit position control unit 42 for controlling the position of the contact unit arm 31 by driving the horizontal direction moving unit 32 and a weighted information acquisition unit 43 for acquiring weighted information detected by the palpation unit 31. . The control device 4 is not limited as long as it can realize the above functions. For example, a program capable of realizing each of the above functions is recorded on a recording medium such as a hard disk of a so-called personal computer. This can be realized by storing and executing this program.

  The bed apparatus 2 is a table for supporting a subject at the time of abdominal examination, and the bed 21 includes a chest support part 211 and a lower limb support part 212, and the chest support part 211 and the lower limb support part 212 A space 213 is formed between the two. At the time of abdominal examination, the subject gets on the bed apparatus 2 in a prone posture and hangs his / her abdomen downward in the abdominal space 213.

  The bed 21 is not limited as long as the space 213 can be formed between the chest support portion 211 and the lower limb support portion 212. For example, at least one of the chest support portion 211 and the lower limb support portion 212 is provided. It is preferable that a plurality of strip-shaped plates are combined. Furthermore, by making each of these plates removable, the position and size of the space 213 can be freely changed based on the body shape such as the position and size of the abdomen of the subject.

  Further, the palpation apparatus 3 of the present embodiment has the palpation unit 31 that receives a load from the vertical direction as described above, the height adjustment unit 32 that adjusts the height of the palpation unit 31, and the palpation unit that moves in the horizontal direction. And a horizontal movement unit 33 to be moved. The palpation device 3 is provided in the lower part of the couch device 2, and the palpation unit 31 is three-dimensionally in the vicinity of the space 213 of the couch device 2 by driving the horizontal movement unit 33 and the height adjustment unit 32. Can be moved to. By doing in this way, the palpation part 31 can be pressed on a test subject's abdomen. 3 shows a partially enlarged view of the palpation apparatus 3 when the abdominal examination apparatus 1 is viewed from the same direction as in FIG. 1, and FIG. 4 shows the abdominal examination apparatus 1 in the direction of the arrow from A in FIG. Partial enlarged views of the palpation device 3 when viewed are shown respectively.

  In the present embodiment, the palpation unit 31 can receive a load from the upper direction in the vertical direction, and a probe 311 and a load sensor 312 for detecting a load received by the probe 311 are provided at the tip. The weight sensor 312 is not limited, but is preferably a three-axis weight sensor that can acquire weight information in the X, Y, and Z axes, that is, the height and the horizontal direction. The weighting information detected by the weighting sensor is output as weighting data to the weighting information acquiring unit 43 in the control device 4, and thereafter various information processing such as recording of weighting data is performed. The palpation unit 31 is also connected to the palpation unit position information acquisition unit 41, and the position of the palpation unit 31 is constantly monitored by the control device. As a result, an instruction can be given to the palpation unit position control unit 42 described later, and the position of the palpation unit 31 can be adjusted by controlling the height adjustment unit 32 and the horizontal movement unit 33.

  The height adjustment unit 32 adjusts the height of the palpation unit 31 as described above, and is not limited, but the height direction axis 321 arranged in the vertical direction as in the present embodiment. A height-direction axis holding base 322 that holds the height-direction axis, and a height-holding arm 323 that is arranged on the height-direction axis 321 and can move the palpation part 31 up and down while supporting the palpation part 31; It is preferable that it is comprised. The height adjustment unit 32 is connected to and controlled by the palpation unit position control unit 42.

  In the case of adopting the height direction axis 321 and the height holding arm 323, the height direction axis 321 is not limited as long as it has the above function. For example, the height direction axis 321 is a long screw in which a groove is spirally arranged. A through hole having teeth corresponding to the groove of the long screw is formed in the height holding arm 323, the through hole and the long screw are engaged, and the long screw is attached using the height control motor 324 connected to the long screw. By rotating, the palpation part 31 can be moved up and down in the height direction (vertical direction). In this case, the height control motor 324 is connected to the palpation unit position control unit 42 in the control device 4 to control the rotation.

  The horizontal movement unit 33 is a unit that allows the palpation unit 31 to move in the horizontal direction, and is not limited, but in the present embodiment, supports the height adjustment unit 32 and the palpation unit 31, and increases the height. The height adjusting unit 32 and the palpation unit 31 are movable in the horizontal direction. The horizontal movement unit 33 is connected to and controlled by the palpation unit position control unit 42.

  The configuration of the horizontal movement unit 33 is not limited as long as it has the above-described function. For example, the short axis direction of the bed apparatus 2 (a direction substantially perpendicular to the direction of the subject's head, A first axis 331 extending in the direction “) and a direction substantially perpendicular to the first direction (a direction toward the subject's head (height direction), hereinafter referred to as“ second direction ”). A horizontal support base 332 connected to one shaft 331 and a second shaft 333 extending in the same direction as the horizontal support base 332 and connected to the height adjusting unit 32 are configured. By doing in this way, this palpation apparatus 3 can move the height adjustment part 32 and the palpation part 31 freely in a horizontal direction.

  The above-described configuration is not particularly limited. However, as an easy method, the first shaft 331 is a long screw having a spiral groove, and the horizontal support base 332 has this length. A through-hole having teeth corresponding to the groove of the screw is formed, the through-hole and the first shaft 331 which is a long screw are engaged, and the control motor 334 is connected to the first shaft 331 which is a long screw. By rotating the long screw, the palpation unit 31, the height adjustment unit 32, and the horizontal support base 332 can be freely moved in the first direction. In addition, while the second shaft 333 is a long screw having a spirally arranged groove, a through hole having teeth corresponding to the groove of the long screw is formed in the height direction holding base 322, and the through hole and The palpation unit 31 and the height adjustment unit 32 are engaged by engaging the second shaft 333 which is a long screw and rotating the long screw using a control motor 335 connected to the second shaft 333 which is a long screw. It can be freely moved in the second direction. In the present embodiment, one of the horizontal support bases is connected to the first shaft 311, but the other is supported by a base that supports the first shaft 311 via, for example, wheels. It is important for smoothness.

  In this embodiment, for convenience of explanation, the second shaft 333 is connected to the first shaft 331, and the height direction shaft 321 is connected to the second shaft 333. However, as long as it is movable. There is no limitation, for example, the first shaft may be connected to the second shaft, and the combination is free. However, since it is preferable that the height adjustment is performed after the horizontal movement adjustment is completed from the viewpoint of position adjustment and the stability of the apparatus, the height holding section 32 is supported by the horizontal movement section 33. It is preferable.

  As described above, according to this embodiment, pressurization in all directions can be realized with high reproduction accuracy. Furthermore, according to the abdominal diagnosis apparatus according to the present embodiment, it becomes possible to reproduce a complicated operation such as “push and move left and right”, which is one of the abdominal diagnosis actions of Wakayama medical science, and the change in weight at that time Can be recorded in detail. In addition, since abdominal examination can be performed in the prone position, the subject can be diagnosed without being physically restrained, and even if a malfunction occurs in the palpation device Since the subject can get up and evacuate immediately, safety can be ensured. That is, it is possible to provide a quantitative abdominal examination apparatus that can freely operate a palpation instrument while ensuring position reproducibility and is less likely to cause anxiety to a patient, and a palpation apparatus and a bed apparatus used therefor.

(Embodiment 2)
The above embodiment has been described on the assumption that the bed of the bed apparatus and the first axis and the second axis are placed on a plane parallel to the installation surface, but in this embodiment, the bed and the first axis and A feature is that the second axis is inclined at a predetermined angle from the installation surface. FIG. 5 shows a schematic diagram of the abdominal examination apparatus 1 according to the present embodiment.

  As is clear from this figure, the bed 21 is tilted by a predetermined angle with a difference in the length of the leg portion 22, and the palpation device 3 (palpation portion 31, height adjustment portion 32, horizontal movement is the same angle as that angle. By tilting the portion 33) using the table 34, the subject can more easily engage with the bed apparatus, and retreat in an emergency is also simplified. Furthermore, when it is required to diagnose a large number of subjects in a short time, such as a mass examination, it is more effective to perform the diagnosis in such a posture.

  In addition, as a method of tilting the bed apparatus and palpation unit, height adjustment unit, and horizontal movement unit, it is possible to simply prepare and tilt leg units having different lengths and a platform 34 for tilting, but a cylinder or the like. It is useful to provide an inclination adjustment unit that can adjust the inclination angle using the, since the degree of freedom of abdominal examination can be further increased.

  INDUSTRIAL APPLICABILITY The present invention has industrial applicability as an abdominal diagnosis apparatus and its constituent members.

It is a figure which shows the outline of the abdominal examination apparatus which concerns on Embodiment 1. FIG. It is a figure which shows the outline of the abdominal examination apparatus which concerns on Embodiment 1 (The figure which looked at the arrow direction from B of FIG. 1). 3 is a partially enlarged view of a palpation unit according to Embodiment 1. FIG. It is the elements on larger scale of the abdominal examination part which concerns on Embodiment 1 (The figure which looked at the arrow direction from A of FIG. 3). It is a figure which shows the outline of the abdominal examination apparatus which concerns on Embodiment 2. FIG.

DESCRIPTION OF SYMBOLS 1 ... Abdominal examination apparatus, 2 ... Bed apparatus, 3 ... Palpation apparatus, 4 ... Control apparatus

Claims (3)

A bed having a chest support portion and a lower limb support portion, and a space formed between the chest support portion and the lower limb support portion, a plurality of legs supporting the bed, and an inclination of the bed A bed apparatus having an adjustment unit to adjust;
A palpation unit that receives a load from an upper direction in the vertical direction, a horizontal direction movement unit that moves the palpation unit in a horizontal direction, and the palpation unit that is supported by the horizontal direction movement unit and arranged substantially perpendicularly to the horizontal direction movement unit A palpation apparatus comprising: a height adjustment unit that adjusts the height ; and a tilt adjustment unit that is provided at a lower portion of the horizontal movement unit and tilts the palpation unit at the same angle as the tilt of the bed ,
The bed apparatus is configured such that at least one of the chest support section and the lower limb support section of the bed apparatus is configured by detachably combining a plurality of strip-shaped plates, and thereby the chest support section and the lower limb support section. The size of the space between can be changed freely,
The palpation device is provided at the lower part of the bed apparatus, and the palpation unit is movable in a three-dimensional manner in the vicinity of the space of the bed apparatus by driving the horizontal movement unit and the height adjustment unit. apparatus. A palpation part position information acquisition unit for acquiring position information of the palpation part;
A palpation unit position control unit for controlling the position of the palpation unit by driving the height adjustment unit and the horizontal movement unit;
The abdominal diagnosis apparatus according to claim 1, further comprising a weighted information acquisition unit that acquires weighted information detected by the palpation unit.   2. The abdominal examination apparatus according to claim 1, wherein the palpation unit of the palpation apparatus has a probe at a tip and a weight sensor for detecting a weight on the probe.