JPH10234737A - Metabolic information measuring probe - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a metabolic information measuring probe by which the measurement of the metabolic information of the pulsating cardiac muscle of heart can be accurately carried out with good operability. SOLUTION: The metabolic information measuring probe 10 being attachable and detachable to a control unit 1 is made up of a universal code 17 and its end part 18, and is provided with an irradiation fiber 11 for introducing the near infrared rays emitted from an irradiation means 2 of the control unit 1 up to the end part 18, a light-receiving fiber 15, through which the scattered light that has been radiated by the irradiation fiber 11 and has transmitted through the inside of the cardiac muscle is taken in from the end part 18 and is introduced up to the light-receiving means 4 of the control unit 1, and a belt-shaped holding means 19 for holding the end part 18 when it is brought into contact with the cardiac muscle by fitting it to the tip of an operator's finger.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a probe for measuring metabolic information, and more particularly, to a probe for measuring metabolic information which irradiates near-infrared light and detects scattered light transmitted through the inside of an object to be measured.

[0002]

2. Description of the Related Art Various types of metabolic information measurement probes for detecting scattered light transmitted through the inside of a measurement object by irradiating near-infrared light have hitherto been proposed. It is used when performing.

As an example of such a probe for measuring metabolic information, for example, Japanese Patent Laid-Open No. 7-380 discloses a flexible insertion portion and an emission end face for emitting light forward from the tip of the insertion portion. A light-receiving means provided on the distal end face of the insertion portion, the light-receiving means being provided on the distal end face of the insertion portion, and a light-receiving end face for receiving optical information of the observation object by light emitted from the light-emitting section. An oxygen metabolism measuring device is described in which the light receiving end faces are inclined outward in opposite directions.

[0004] In diagnosing the function of internal organs such as brain tissue, for example, whether or not the amount of oxygen in the internal organs is sufficient and used properly is a basic and important parameter. Become.

[0005] In order to quickly and easily diagnose the oxygen content of organs in the body, a means for obtaining metabolic information by measuring the absorbance of cytochrome, hemoglobin or the like has been conventionally developed. For example, US Pat.
No.45 explains its detailed principle and configuration.
A brief description of the contents described in U.S. Pat. No. 4,281,645 is disclosed in JP-A-63-27703.
No. 8 is cited as an example.

[0006]

However, when a metabolic measurement is performed from the epicardium side using a probe having the shape described in JP-A-7-380, the probe must be substantially perpendicular to the myocardium. However, it is difficult to keep the heart in contact with the beating heart in a nearly vertical state for a certain period of time, and the probe may be separated from the myocardium or the probe may be tilted. There were many things to roll around.

Further, since the irradiation end face and the light reception end face of the probe tip are provided so as to face in directions substantially opposite to each other, when the probe is brought into contact with the myocardium from the epicardium side, a fluorescent lamp or the like is used. In some cases, disturbance light is reflected by the myocardium, and the reflected light is incident from the light receiving end face to increase noise.

[0008] In this manner, when the metabolic measurement of the beating myocardium is performed from the epicardium side using the conventional probe for measuring metabolic information, the operability is not good. In other words, metabolic information could not be obtained, or even if obtained, reliability was low.

The present invention has been made in view of the above circumstances, and it is an object of the present invention to provide a metabolic information measuring probe capable of reliably measuring a fluctuating measurement object with good operability.

[0010]

In order to achieve the above object, a metabolic information measuring probe according to a first aspect of the present invention uses near-infrared light emitted from a light source for irradiating near-infrared light disposed at the tip of the probe. Irradiating light guide means for irradiating from the end face and guiding to the object to be measured, and scattered light radiated by the irradiating light guide means and transmitted through the inside of the object to be measured is incident from a light receiving end face provided at the tip of the probe. Scattered light guiding means for guiding to the detection means, and holding for holding the tip of the probe when the irradiation end face of the irradiation light guiding means and the light receiving end face of the scattered light guiding means are brought into contact with the object to be measured. Means.

The probe for measuring metabolic information according to the second invention is the probe for measuring metabolic information according to the first invention, wherein the holding means is formed in a band shape.

Further, a metabolic information measuring probe according to a third aspect of the present invention is the metabolic information measuring probe according to the first or second aspect of the present invention, wherein the holding means has a projection shape.

Therefore, the probe for measuring metabolic information according to the first aspect of the present invention, when bringing the irradiation end face of the irradiation light guide means and the light receiving end face of the scattered light guide means into contact with the object to be measured,
The tip of the probe is held by the holding means, and the irradiation light guide means irradiates near-infrared light emitted from the light source from the irradiation end face provided at the tip of the probe to guide the light to the measurement object, and the scattered light guide A means irradiates the scattered light radiated by the irradiating light guide means and transmitted through the inside of the object to be measured from the light receiving end face provided at the tip of the probe to guide the scattered light to the detecting means.

In the probe for measuring metabolic information according to the second invention, a surgeon attaches a band-shaped holding means to a fingertip for use.

Further, in the probe for measuring metabolic information according to the third aspect of the present invention, the surgeon uses a finger to pinch a protruding holding means with a finger.

[0016]

Embodiments of the present invention will be described below with reference to the drawings. 1 to 5 show a first embodiment of the present invention. FIG. 1 is a block diagram showing an overall configuration of a metabolic information measuring device, and FIG. 2 is a longitudinal sectional view showing a tip portion of a probe. FIG. 3 is a cross-sectional view showing the distal end of the probe, FIG. 4 is a perspective view showing the state where the holding means is attached to the operator's fingertip and the distal end is brought into contact with the myocardium, and its enlarged perspective view. It is sectional drawing which shows the state which attached the holding | maintenance means to an operator's fingertip, and made the front-end | tip part contact myocardium.

As shown in FIG. 1, the metabolic information measuring device has a control device 1 and a metabolic information measuring probe (hereinafter, referred to as a probe) 10 detachably connected to the control device 1. It is configured.

The control device 1 includes an irradiating means 2 having a plurality of light sources (not shown) (for example, a semiconductor laser, an LED, etc.) having different wavelengths, and measures the intensity of the irradiating light applied to the myocardium to be measured and converts the intensity into an electric signal. There is a reference light receiving unit 3 having a detecting unit (for example, PMT, PD, etc.) for conversion, and a detecting unit (for example, PMT, PD, etc.) for measuring the intensity of scattered light transmitted to the deep part of the myocardium and converting it into an electric signal. A light receiving means 4 and a control means 5 for controlling the irradiating means 2 and, in synchronization therewith, calculating and processing myocardial metabolic information from the electrical signals converted by the reference light receiving means 3 and the light receiving means 4 It is configured.

The probe 10 has an irradiation fiber 11 serving as an irradiation light guiding means for conducting the light from the irradiation means 2.
A detachable irradiation connector 12 attached to one end of the irradiation fiber 11, a reference fiber 13 for conducting reference light to the reference light receiving means 3, and one end of the reference fiber 13. The detachable reference connector 14 attached and the scattered light received
A light receiving fiber 15 serving as a scattered light guiding means that conducts to the
A detachable light-receiving connector 16 attached to one end of the light-receiving fiber 15;
1, a universal cord 17 composed of an extensible and small-diameter flexible tube that binds and covers the reference fiber 13 and the light receiving fiber 15, and holding means 19 provided on the distal end side of the universal cord 17.
And a distal end portion 18 having the same.

Next, referring to FIG. 2 and FIG.
8 will be described.

The tip 18 is connected to the irradiation fiber 1.
An irradiation end face 25, which is optically connected to the output end of the optical fiber 1 and is configured by a prism or the like for converting the light emission direction to a right angle direction, and to which the input end of the reference fiber 13 is connected, The input end of the optical fiber 15 is optically connected and similarly has a light receiving end surface 26 formed of a prism or the like that converts the incident direction of light into a right angle direction.

Further, the distal end portion 18 is provided on the opposite side to the side where the irradiation end face 25 and the light receiving end face 26, which are the myocardial contact surfaces, are provided. A (ring-shaped) holding means 19 is provided.
Length of the belt of this holding means 19 (length of the circumference of the ring)
Is desirably a length that can be worn on a finger and that does not come off the fingertip.

Next, the operation of such an embodiment will be described.

By operating the control device 1, pulse light of four different wavelengths is sequentially irradiated from the irradiation unit 2 under the control of the control unit 5. These wavelengths are near-infrared light of four wavelengths from 700 to 950 nm, which absorb cytochrome, hemoglobin, and the like related to oxygen metabolism information.

The irradiation light enters the irradiation fiber 11 via the irradiation connector 12, is guided by the irradiation fiber 11, and reaches the distal end 18. Then, the myocardium is sequentially irradiated through the irradiation end face 25 of the distal end portion 18.

Of the irradiation light applied to the myocardium, the reflected light from the myocardial surface or a portion shallow from the myocardial surface is received by the reference light receiving means 3 via the irradiation end face 25 and the reference fiber 13, and It is detected as irradiation light intensity.

On the other hand, the irradiation light applied to the myocardium is transmitted while diffusing in the myocardial tissue due to light scattering by the tissue. Part of this scattered light is approximately 5 mm from the irradiation end face 25.
The light enters through a light receiving end surface 26 which is about 1 cm away, is received by the light receiving means 4 via the light receiving fiber 15 and the light receiving connector 16, and is detected as scattered light intensity. Therefore, the intensity of the scattered light transmitted through the deep part of the myocardial tissue can be captured.

In this way, the irradiation light of four different wavelengths is sequentially detected, and the irradiation light intensity and the scattered light intensity of each wavelength are mutually processed by the control means 5, thereby obtaining the oxygen saturation of hemoglobin and cytochrome. Can be requested. The obtained result is displayed on a display unit (not shown) provided in the control device 1.

As described in the above prior art, the principle and means of obtaining metabolic information by measuring absorbance of cytochrome and hemoglobin are described in US Pat. No. 4,281,645.
The detailed description is described in the Japanese Patent Application Laid-Open No. 63-277038, and the brief description is described in Japanese Patent Application Laid-Open No. 63-277038.

That is, in the means described in these documents, the measurement object is determined based on the absorption spectrum of near-infrared light by hemoglobin, which is an oxygen transport medium in blood, and cytochromes a, a3 in cells that undergo an oxygen reduction reaction. The amount of oxygen is measured.

More specifically, hemoglobin (HbO 2) bound to oxygen and hemoglobin (H
b) differs from the absorption spectrum by near-infrared light having a wavelength of about 700 to 1300 nm. Similarly, the absorption spectra of oxidized cytochromes a and a3 (CyO2) and reduced cytochromes a and a3 (Cy) are similar. Are different. By utilizing this, for example, four types of different wavelengths (for example, 775 nm, 800 nm, 825 nm,
850 mn) of near-infrared light is radiated in a time-division manner, and the light transmitted through the object to be measured is detected and subjected to a predetermined arithmetic processing, whereby the above-mentioned four unknowns, namely, hemoglobin (HbO 2) combined with oxygen are obtained. , Deoxygenated hemoglobin (Hb), oxidized cytochromes a, a3 (CyO
2) The amount of change in each concentration of reduced cytochromes a and a3 (Cy) is calculated, and the change in the amount of oxygen to be measured is measured based on these.

Next, as an example of the method of use, a case where the metabolic information of the myocardium is measured, that is, a case where the myocardial viability (cardiac viability discrimination) evaluation method is performed will be described with reference to FIGS.

For example, when performing a surgical treatment such as CABG (coronary artery bypass surgery), the patient is opened as shown in FIG. 4 so that the heart can be directly treated.

Then, the holding means 19 is attached to the fingertip of the operator, and the distal end portion 18 of the probe 10 is brought into contact with the myocardial surface in the region where the myocardial viability (cardiac viability discrimination) evaluation is performed as shown in FIGS. Then, the irradiation means 2 sequentially irradiates near infrared light of four different wavelengths as described above. At this time,
It is confirmed on the display unit (not shown) of the control device 1 that data on metabolism of cytochrome, hemoglobin, and the like is stably obtained.

Thereafter, pacing is performed by a pacemaker or the like (not shown) to a heart rate faster than the current heart rate, thereby imposing a load on the heart, that is, giving a metabolic change. After giving a metabolic change for a certain period in this way, pacing is terminated.

In the above-described series of procedures, relative changes in parameters such as cytochrome and hemoglobin accompanied by metabolic changes are observed on the display unit.

When cytochrome changes with metabolic change, it is determined that viability is present (heart muscle survival). On the other hand, when cytochrome does not change despite metabolic change, it is determined that there is no viability (cardiac necrosis). .

The above procedure is sequentially performed while changing the position of the myocardium to determine the survival range or necrosis range of the myocardium, and perform necessary treatment based on the information.

In the above description, the irradiation end face 25 and the light receiving end face 2
6 is constituted by a prism to irradiate light to the myocardium and receive scattered light from the myocardium. However, the present invention is not limited to this. For example, the irradiation fiber 11, the reference fiber 13, and the light-receiving fiber By bending each of the fibers 15 inside the distal end portion 18, irradiation light may be directly applied to the myocardium from the end faces of these fibers, and reference light and scattered light may be directly received.

According to the first embodiment, since the holding means is provided at the tip of the probe, the tip is
It is possible to follow the beating heart without departing from the myocardium, and it is possible to reliably measure metabolic information.

Since the tip can be used in contact with the myocardium, it is possible to measure myocardial metabolic information of a desired region (local region).

FIGS. 6 to 9 show a second embodiment of the present invention. FIG. 6 is a perspective view showing the tip of the probe, and FIG. 7 is a longitudinal sectional view showing the tip of the probe. 8 is a cross-sectional view showing the distal end of the probe, and FIG. 9 is a cross-sectional view showing a state in which the holding means is pinched by the operator's fingertip to bring the distal end into contact with the myocardium.

In the second embodiment, the first
The same components as those of the first embodiment are denoted by the same reference numerals, and description thereof will be omitted. Only different points will be mainly described.

In the second embodiment, the shape of the holding means provided at the distal end portion 18 is different from that of the irradiation end face 2.
5 and the arrangement of the light receiving end face 26 are changed.

That is, the holding means 30 of the present embodiment comprises:
As shown in FIG. 6, FIG. 7, and FIG. 8, the operator grasps the distal end portion 18 with the finger on the side opposite to the side where the irradiation end surface 25 and the light receiving end surface 26, which are the myocardial contact surface side, are provided. in order to,
A holding means 30 composed of a columnar projection having a head end is provided.

Further, the irradiation end face 25 and the light receiving end face 26 provided at the distal end portion 18 are provided so as to be inclined in opposite directions when viewed from the front. That is, the irradiation end face 25 is directed outward so that the emission direction of the light is slightly away from the light receiving end face 26.
Are directed outward so that the light incident direction is slightly away from the irradiation end face 25.

Next, the operation of the metabolic information measuring apparatus of the second embodiment is almost the same as that of the above-described first embodiment. As shown, the operator grasps the holding means 30 with a finger, and
Is brought into contact with the myocardium.

The light irradiated from the irradiation end face 25 is
The light arrives at the light-receiving end face 26 by drawing an arc-shaped scattering path closer to a circle.

According to the second embodiment, substantially the same effects as those of the first embodiment can be obtained.
Since the holding means is of a finger-pick type, there is no need to attach it to the fingertip, and the holding operation is easy.

Further, since the irradiation end face and the light reception end face are arranged to be inclined in opposite directions to each other, the optical path of the scattered light transmitted through the myocardium becomes longer, and the irradiation end face and the light reception end face are arranged closer to each other. The size of the probe tip can be reduced.

FIGS. 10 to 14 show a third embodiment of the present invention. FIG. 10 is a perspective view showing the tip of the probe, FIG. 11 is a bottom view showing the tip of the probe, and FIG. Is a longitudinal sectional view showing the distal end of the probe, FIG. 13 is a transverse sectional view showing the distal end of the probe, and FIG. 14 is a sectional view showing a state where the distal end of the probe is brought into contact with the myocardium.

In the third embodiment, the same parts as those in the above-described first and second embodiments are denoted by the same reference numerals, and description thereof will be omitted. Only different points will be mainly described.

The tip 18 of the probe 10 according to the present embodiment
Has the same holding means 19 as in the above-described first embodiment, and has the irradiation end face 25 and the light receiving end face 26 in the above-described second embodiment.
And a light shielding means 35 for blocking disturbance light is provided on the myocardial contact surface.

The light shielding means 35 is provided on the myocardial contact surface of the distal end portion 18 as an outer peripheral wall-shaped projection surrounding the irradiation end face 25 and the light receiving end face 26. The light shielding means 3
As the height of 5, when the distal end portion 18 is brought into contact with the myocardium, the light shielding means 35 bites into the myocardium, and
It is desirable that the irradiation end face 25 and the light receiving end face 26 also have such a height that they come into contact with the myocardium (see FIG. 14).

Next, the operation of the metabolic information measuring apparatus of the third embodiment is almost the same as that of the above-described first and second embodiments. 1
As shown in FIG. 4, the irradiation end face 25 and the light receiving end face 26 come into contact with the myocardium, and the light shielding means 35 comes into contact with the myocardium while pressing the myocardium in a concave shape.

In such a state, the irradiation end face 25
The disturbance light such as a fluorescent lamp does not enter the myocardial contact surface of the distal end portion 18 by the action of the light shielding means 35 which forms a peripheral wall-shaped convex portion surrounding the light receiving end surface 26.

According to the third embodiment, substantially the same effects as those of the first and second embodiments can be obtained, and since the light shielding means is provided on the myocardial contact surface at the distal end, the disturbance can be improved. Without being affected by light, metabolic information of the myocardium can be accurately measured.

It should be noted that the present invention is not limited to the above-described embodiments, and various modifications and applications are of course possible without departing from the spirit of the invention.

[Appendix] According to the above-described embodiment of the present invention as described in detail above, the following configuration can be obtained.

(1) Irradiation light guide means for irradiating near-infrared light emitted from the light source from the irradiation end face provided at the tip of the probe to guide it to the object to be measured; Scattered light guiding means for guiding the scattered light transmitted through the inside of the measurement object from the light receiving end face disposed at the tip of the probe to the detecting means, the irradiation end face of the irradiation light guiding means and the scattered light guide A metabolic information measurement probe, comprising: a holding means for holding a tip of the probe when the light receiving end face of the means is brought into contact with the measurement object.

(2) The probe for measuring metabolic information according to (1), wherein the holding means is formed in a band shape.

(3) The metabolic information measurement probe according to (1), wherein the holding means is formed in a projecting shape.

(4) At the tip of the probe, a light shielding means for shielding the irradiation end face of the irradiation light guiding means and the light receiving end face of the scattered light guiding means from disturbance light is provided. The probe for measuring metabolic information according to 1).

According to this, the measurement can be performed with high accuracy without being affected by disturbance light.

(5) An additional feature (1) is that the irradiation end face of the irradiation light guide means and the light receiving end face of the scattered light guide means are slightly inclined so as to face in directions away from each other. And (2), (3) and (4).

According to this, the optical path of the scattered light transmitted through the object to be measured becomes longer, and the irradiation end face and the light reception end face can be arranged closer to each other. It becomes possible to plan.

[0067]

As described above, according to the probe for measuring metabolic information of the present invention, it is possible to reliably measure an object to be measured with good operability.

[Brief description of the drawings]

FIG. 1 is a block diagram showing an overall configuration of a metabolic information measuring device according to a first embodiment of the present invention.

FIG. 2 is a longitudinal sectional view showing a distal end portion of the probe according to the first embodiment.

FIG. 3 is a cross-sectional view showing a distal end portion of the probe according to the first embodiment.

FIG. 4 is a perspective view and a magnified perspective view showing a state in which a holding unit is attached to a fingertip of an operator and a distal end portion is brought into contact with a myocardium in the first embodiment.

FIG. 5 is a cross-sectional view showing a state in which the holding means is attached to the operator's fingertip and the distal end is brought into contact with the myocardium in the first embodiment.

FIG. 6 is a perspective view showing a distal end portion of a probe according to a second embodiment of the present invention.

FIG. 7 is a longitudinal sectional view showing a distal end portion of the probe according to the second embodiment.

FIG. 8 is a cross-sectional view showing a distal end portion of the probe according to the second embodiment.

FIG. 9 is a cross-sectional view showing a state in which the holding means is pinched by a fingertip of an operator to bring a distal end portion into contact with a myocardium in the second embodiment.

FIG. 10 is a perspective view showing a distal end portion of a probe according to a third embodiment of the present invention.

FIG. 11 is a bottom view showing the tip of the probe according to the third embodiment.

FIG. 12 is a longitudinal sectional view showing a distal end portion of the probe according to the third embodiment.

FIG. 13 is a cross-sectional view showing a distal end portion of the probe according to the third embodiment.

FIG. 14 is a cross-sectional view showing a state where the distal end of the probe according to the third embodiment is brought into contact with the myocardium.

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 1 ... Control apparatus 2 ... Irradiation means (light source) 3 ... Reference light receiving means 4 ... Light receiving means (detection means) 5 ... Control means 10 ... Metabolic information measurement probe 11 ... Irradiation fiber (irradiation light guide means) 15 ... Light reception Fiber (scattered light guiding means) 18 ... Tip 19, 30 ... Holding means 25 ... Irradiation end face 26 ... Light receiving end face 35 ... Light shielding means

Claims (3)

[Claims] 1. An irradiation light guide means for irradiating near infrared light emitted from a light source from an irradiation end face provided at the tip of the probe to guide the light to a measurement object. Scattered light guiding means for guiding the scattered light transmitted through the inside of the measurement object from the light receiving end face provided at the tip of the probe to the detecting means, the irradiation end face of the irradiation light guiding means and the scattered light guiding means A metabolic information measurement probe, comprising: holding means for holding the tip of the probe when the light-receiving end surface is brought into contact with the measurement object. 2. The metabolic information measurement probe according to claim 1, wherein the holding means is formed in a band shape. 3. The metabolic information measurement probe according to claim 1, wherein said holding means is formed in a projecting shape.