JPH0226531A - Method for stable measurement in non-blood-observing hemadynamometer - Google Patents

Abstract

PURPOSE:To execute a stable blood pressure measurement by removing the influence of an arhythmia from a cuff pulse pressure with the arhythmia detected with an arhythmia detecting part. CONSTITUTION:In a non-blood-observing hemadynamometer 3, a pressurizing pump to pressurize a cuff 1, an exhaust valve to execute a pressure reduction, a pressure sensor to detect the cuff pressure, etc., are built, a blood pressure value is detected and measured by an oscillometric method from the cuff pressure detected by the pressure sensor, and the result is numeric-value-dispayed on a display part 4. An electrocardiogram processing unit 7 detects the arhythmia from an electrocardiogram waveform obtained from an electrocardiogram electrode 5 and an electrocardiogram amplifier 6. By the non-blood- observing hemadynamometer 3, the influence of the pulse pressure due to the arhythmia is removed from the pulse pressure waveform with the oscillometric by means of an arhythmia detecting signal from the electrocardiogram processing unit 7.

Description

DETAILED DESCRIPTION OF THE INVENTION [Field of Industrial Application] The present invention relates to a stable measurement method when arrhythmia (extrasystole) occurs in a non-invasive sphygmomanometer.

[Summary of the invention]

The present invention provides a non-invasive blood pressure needle that measures blood pressure using the oscillometric link method with a cuff attached to the subject, and detects arrhythmia from the subject's pulse wave using, for example, an electrocardiogram. By using the output of the oscillometric pulse pressure waveform to remove the influence of pulse pressure caused by arrhythmia, stable blood pressure measurement can be performed.

[Conventional technology]

One type of automatic blood pressure measurement method using the J1 invasive blood pressure needle is the oscillometric method (vibration method).

First, the principle of this oscillometric method will be explained with reference to the graph of FIG.

For example, a cuff is wrapped around the upper arm of the subject, and the cuff is pressurized to make the cuff pressure higher than the arterial pressure (160w in this example).
Hg), and then gradually reduce the cuff pressure. If the cuff pressure is higher than the systolic blood pressure, blood will not flow, and in this case, only extremely small pressure fluctuations (pulse pressure) will be seen in the cuff.

Then, when the cuff pressure falls below the systolic blood pressure, blood begins to flow, and due to its effect on the artery wall, the cuff pulse pressure gradually becomes subject to large fluctuations.This increases as the cuff pressure decreases. It's coming.

Furthermore, when the cuff pressure falls below the diastolic blood pressure, the action of blood flow on the arterial wall has little effect, so the fluctuations in the cuff pulse pressure become significantly smaller.

In the above cuff pressure reduction process, the value at the point where the cuff pulse pressure starts to increase (120wHg in this example) is the fluid hypertension (systolic pressure), and the value at the point where the cuff pulse pressure stops decreasing (80m 1g)
is detected as the lowest blood pressure (diastolic pressure). Also, the value at the peak of the cuff pulse pressure is taken as the average blood pressure.

In a non-invasive sphygmomanometer that measures blood pressure using the oscillometric method as described above, when an arrhythmia (premature systole) occurs in the pulse wave, a pulse pressure with a small loss appears that is synchronized with the extra systole. Due to the principle of the oscillometric method, measurement errors occur due to changes in cuff pulse pressure. For example, as shown in Figure 5, an arrhythmia occurs at the point where the cuff pulse pressure begins to increase and at the point where it stops decreasing, and this occurs in synchronization. When a small pulse pressure appears, the detection point of the blood pressure value moves, and the systolic blood pressure is detected as low (< 1201 + 1111 g = 115 wmHg), and the diastolic blood pressure is detected as high (sow Hg → 85 wmHg). This will result in a significant measurement error.

Therefore, in order to reduce the influence of this arrhythmia, conventionally, as shown in FIG. 6, a method has been adopted in which the cuff pressure is reduced every two nights when an effective cuff pulse pressure is detected.

[Problem to be solved by the invention]

However, this conventional method has the disadvantage that the time required to decompress the cuff is approximately twice the usual time, resulting in a longer measurement time.

Conventionally, blood pressure was measured independently of electrocardiogram measurement, so even if an arrhythmia occurred, it was difficult to detect it from the pulse wave. Therefore, it is impossible to completely eliminate the influence of arrhythmia from cuff pulse pressure. It was impossible.

The present invention has been made in view of the above, and an object of the present invention is to provide a method that allows rapid and stable blood pressure measurement even when an arrhythmia occurs.

[°Means to solve the problem]

To achieve the above object, the present invention provides a non-invasive sphygmomanometer in which a cuff is attached to a subject and the blood pressure is measured by an oscillometric method. The arrhythmia is detected by a detection unit, for example, an electrocardiogram, and the influence of pulse pressure due to inffi pulse is removed from the cuff pulse pressure by the output thereof.

[Effect]

In this way, by utilizing the arrhythmia detected by the electrocardiogram to remove the influence of the pulse pressure due to the arrhythmia from the oscillometric cuff pulse pressure, stable measurements are performed without measurement errors.

〔Example〕

Embodiments of the present invention will be described below with reference to FIGS. 1 to 3.

FIG. 1 is a plotter diagram showing a configuration for carrying out the method of the present invention. In the figure, a cuff (1) is wound around the upper arm of a subject A, and this cuff (11 is a tube (2)). It is connected to a non-invasive sphygmomanometer (3) via the sphygmomanometer.

This non-invasive sphygmomanometer (3) has a built-in pressurizing pump that pressurizes the cuff (1), an exhaust valve that reduces the pressure, a pressure sensor that detects the cuff pressure, etc. The blood pressure value is detected and measured from the cuff pressure by the above-mentioned oscillometric method, and the result is displayed numerically on the display section (4).

On the other hand, Subject A has an electrocardiogram electrode (5) on his chest in addition to the cuff (1)! Ik# and this electric bridge (5)
The electrocardiogram signal detected in the electrocardiogram amplifier (6)
The signal is converted to a predetermined level and sent to the electrocardiogram processing device (7). This electrocardiogram processing device (7) has a function of detecting arrhythmia (extrasystole), and when an arrhythmia is detected from the electrocardiogram waveform of the subject, the detection signal is output to the non-invasive blood pressure monitor (3). be done.

The arrhythmia detected by this electrocardiogram processing device (7) is processed by the non-invasive sphygmomanometer (3) to remove the influence of pulse pressure caused by arrhythmia from the oscillometric pulse pressure waveform. It is done.

FIG. 2 shows an example of this, in which when an arrhythmia is detected, cuff pressure reduction is stopped until the next n)N pressure appears. That is, if an arrhythmia occurs, the cuff pressure is maintained and waited until a certain pressure of 1lli appears.
By not using the pulse wave caused by arrhythmia for measurement, the influence of arrhythmia is removed, thereby allowing accurate detection of systolic and diastolic blood pressure values and stable blood pressure measurement without errors.

2. In the embodiment shown in Fig. 2, the measurement time will be slightly longer due to stopping cuff decompression, but compared to the conventional 6th embodiment.
Compared to the measurement method shown in the figure, measurement can be performed in a much shorter time, and the influence of arrhythmia can be completely eliminated.

Further, FIG. 3 is an example in which the pulse pressure at the time of occurrence of an arrhythmia is interpolated by the pulse pressures before and after the occurrence of the arrhythmia.

In this case, although the influence of arrhythmia cannot be completely eliminated, it can be measured without stopping cuff decompression, so it has the advantage that the measurement time is shorter than in the example shown in FIG. 2 above.

Note that arrhythmia can be detected using 1. other than the electrocardiogram shown in this example.
:-Mo, for example, pulse waves such as a pulse oximeter can be used, and the measurement is not limited to an electrocardiogram, but any device that can detect irregularities (1; k) may be used.

〔Effect of the invention〕

As described above, the present invention eliminates or reduces the influence of arrhythmia on pulse pressure by using the output of an arrhythmia detection unit such as an electrocardiogram in non-invasive blood pressure measurement using the oscillometric method. Even if arrhythmia occurs during measurement, measurement errors do not occur, and stable measurements can be performed at all times. Furthermore, blood pressure measurement can be performed without increasing measurement time.

[Brief explanation of the drawing]

FIG. 1 is a block diagram showing an embodiment of the method of the present invention, FIG. 2 is an explanatory diagram of an example of measurement by the method of the present invention, and FIG.
An explanatory diagram of the other side, Figure 4 is an explanatory diagram of the oscillometric method,
Figure 5 is an explanatory diagram of the occurrence of arrhythmia, and Figure 6 is an explanatory diagram of the conventional measurement method.In the figure, (11 is a cuff, (3) is a non-invasive blood pressure needle, and (7) is an electrocardiogram process. It is a device.

Claims (1)

[Claims] A non-invasive sphygmomanometer that measures blood pressure using an oscillometric method with a cuff attached to the subject.
Arrhythmia is detected from the electrocardiogram waveform or pulse wave of the subject by an arrhythmia detection section provided separately from the cuff, and the influence of the arrhythmia is removed or reduced from the cuff pulse pressure by the output of this arrhythmia detection section. Stable measurement method with non-invasive blood pressure monitor.