KR20220151740A - Urodynamic measurement apparatus for adjusting the height of the sensor - Google Patents

Abstract

The present invention provides a urodynamic examination device comprising: a urethral catheter that is inserted inside the bladder of a patient; a first sensor disposed spaced apart from the patient, and connected to the urethral catheter to measure an intravesical pressure; a rectal catheter that is inserted inside the rectum of the patient; a second sensor spaced apart from the patient, disposed adjacent to the first sensor, and connected to the rectal catheter to measure an abdominal pressure; and a first position adjusting part that adjusts the heights of the first sensor and the second sensor according to a posture of the patient. Therefore, the present invention enables a test result of the patient to be more accurately interpreted.

Description

Urodynamic test device for sensor height adjustment {URODYNAMIC MEASUREMENT APPARATUS FOR ADJUSTING THE HEIGHT OF THE SENSOR}

The present invention relates to a device capable of adjusting the positions of a bladder pressure sensor and an abdominal pressure sensor of a urodynamic examination device.

Proper storage and emptying of urine is achieved through the integration of the functions of the urinary bladder, urethral sphincter, and the nervous system that controls these organs. A urodynamic study is a precise test for diagnosing dysfunction of the bladder and urethral sphincter. Urodynamic tests include uroflowmetry, filling cystometry, pressure-flow study, urethral pressure profile, and urethral sphincter electromyography. ). In patients with dysuria and urinary incontinence, subtests are optionally performed.

Medical staff can obtain detailed information needed to accurately characterize lower urinary tract dysfunction through urodynamics. Medical staff can clearly distinguish various types of bladder and urethral dysfunction that can be clinically expressed even if it is a single disease entity based on the urodynamic test results.

The most important role of urodynamic examination is to provide detailed information necessary for medical staff to determine the prognosis of patients with specific urinary tract dysfunction and to establish a treatment plan. Based on this, it is possible to provide the best treatment method applicable to the patient.

Urodynamics is the most important single test in determining the prognosis and treatment of lower urinary tract dysfunction. Therefore, it is essential for medical staff to accurately interpret the patient's urodynamic test results.

Figure 1a shows intravesical pressure (Pves), abdominal pressure (Pabd), detrusor pressure (Pdet) and urethra measured during filling cystometry in a supine position (supine position) of the patient. It is a graph of sphincter electromyography (EMG) activity.

Referring to FIG. 1A , the urodynamic test includes several detailed measurements to identify various indicators related to the storage and emptying function of urine. The urodynamic test uses the patient's bladder pressure (11, Pves), abdominal pressure (12, Pabd), detrusor pressure (13, Pdet), and urinary sphincter activity (14, urinary sphincter activity) information measured by the urodynamic test device. It enables the medical staff to interpret the results and diagnose the patient's lower urinary tract dysfunction.

Here, since the detrusor pressure 13 cannot be directly measured by the urodynamics test device, it is displayed as a virtual value obtained by subtracting the abdominal pressure 12 from the intravesical pressure 11 in real time through computer calculation.

Basic preparations such as calibration and zeroing are necessary before performing a proper urodynamic test. Currently used urodynamic test indexes such as pressure or urinary flow are measured as electrical signals and then reinterpreted as actual values in real time. Therefore, it is not necessary to carry out every inspection, but it is necessary to perform standard calibration of the actual values and electrical signal measurement values periodically.

On the other hand, the zero-point adjustment process is not only necessary for each patient's examination, but also for each detailed examination of one patient's examination. In the case of the urodynamics test, since the pressure transducer is not one such as intravesical pressure and abdominal pressure, the electrical signal values of each pressure transducer have different conversion standards.

In particular, detrusor pressure in the urodynamics test is to calculate and observe the difference between intravesical pressure and abdominal pressure in real time. If the standards for these two values are different, the measured values may show completely different values. very important. Therefore, for each patient, right before the urodynamics test is performed, the patient is put in a supine position and the reference height of these transducers is zero-adjusted before the test is started. After performing filling cystometry in the supine position, the patient is usually asked to take a standing or sitting position for the urinary pressure-flow study. do. Therefore, if the patient's posture changes for each detailed examination, the zero point must be adjusted again.

To zero-adjust the pressure, first adjust the position of the pressure transducer to the standard height at atmospheric pressure, adjust the zero point here, set it to zero, and then measure the pressure. The International Continence Society (ICS) has established this reference level as the upper edge of the symphysis pubis, which is called the ICS reference level.

When performing detailed examinations of the urodynamic examination, the examination may be performed by changing the examination posture of the patient to a standing position, a sitting position, or a semi-Fowler's position. Whenever this position is changed, the position of the suprapubic bone changes, and each time, the reference height of the pressure transducer must be manually adjusted to the suprapubic position of the patient. On the other hand, during the urodynamics test, the patient can take a posture such as a supine position, a sitting position, or a standing position. In this process, the pressure transducer and the patient's bladder or rectum A difference in height between the positioned catheter ends occurs, which affects the measured intravesical pressure (11, Pves) and the measured abdominal pressure (12, Pabd).

However, the conventional urodynamics test apparatus has a problem in that the change in height of the catheter end caused by the change in the patient's posture is directly reflected in the measured value.

1B is a graph of intravesical pressure, abdominal pressure, detrusor pressure, and urethral sphincter activity measured when the patient changes from a supine position to a standing position during charging.

Referring further to FIG. 1B , at a time point (t1) when the patient changes posture from a supine position to a standing position, intravesical pressure (11, Pves) and abdominal pressure (12, Pabd) increase rapidly. can confirm that

That is, in the conventional urodynamic examination device, there is a problem in that the measurement of intravesical pressure (Pves) and the measurement of abdominal pressure (Pabd) are affected by changes in the position of the end of the catheter, and this problem may cause misdiagnosis by medical staff. .

The present invention has been created to solve the above problems, and provides a urodynamic examination device for adjusting the position of a sensor capable of precisely adjusting the positions of a sensor and an end of a catheter according to a patient's posture.

A urodynamics test apparatus according to an embodiment of the present invention includes a urethral catheter inserted into a bladder through the urethra of a patient to measure intravesical pressure (Pves); a first sensor disposed spaced apart from the patient and connected to the urinary catheter to measure intravesical pressure; A rectal catheter inserted into the rectum to measure the patient's abdominal pressure (Pabd); a second sensor spaced apart from the patient, disposed adjacent to the first sensor, and connected to the rectal catheter to measure abdominal pressure; and a first position adjusting unit for adjusting the heights of the first sensor and the second sensor according to the posture of the patient.

The first position adjusting unit, a transport rail, and a mounting frame coupled to be transportable in the vertical direction on the transport rail, on which the first sensor and the second sensor are installed, and the mounting frame and the mounting frame according to the posture of the patient The mounting frame may be moved in a vertical direction on the transfer rail so that a signal transmission/reception unit for measuring a distance between the patient's pubis and a distance between the mounting frame and the patient's pubic bone become the shortest distance.

The urodynamics testing device may further include a second position adjusting unit for adjusting the heights of the first sensor and the second sensor, respectively, according to positions of the tip of the urethral catheter and the tip of the rectal catheter.

The second position adjusting unit may include a first height adjusting unit installed on the mounting frame to adjust the height of the first sensor, and installed on the mounting frame adjacent to the first height adjusting unit to adjust the height of the first sensor. It may include a second height adjusting unit for adjusting the height of.

The urodynamics test apparatus further includes a posture detection unit for detecting a posture of the patient, and the first position adjusting unit adjusts heights of the first sensor and the second sensor according to the posture of the patient detected by the posture detection unit, respectively. It can be characterized as regulating.

The urodynamic examination device for adjusting the position of the sensor of the present invention can provide medical staff with data on intravesical pressure, abdominal pressure, and detrusor muscle pressure that are not affected by changes in the patient's posture, so that the medical staff can make errors in the zeroing test. can more accurately interpret the patient's test results without

1A is a graph of intravesical pressure, abdominal pressure, detrusor pressure, and urethral sphincter activity measured when a patient is filled in a supine position;
1B is a graph of intravesical pressure, abdominal pressure, detrusor pressure, and urethral sphincter activity measured when a patient changes from a supine position to a standing position during charging;
2 is a diagram for explaining a part of a urodynamics test apparatus for adjusting sensor position according to an embodiment of the present invention;
3 is a conceptual diagram of a urodynamic examination device for adjusting sensor position according to an embodiment of the present invention mounted on a patient in a supine position;
4 is a conceptual diagram of a urodynamic examination device for adjusting sensor position according to an embodiment of the present invention mounted on a patient in a standing position;
5 is a view for explaining the first position adjusting unit of the urodynamics test apparatus of FIG. 3;
FIG. 6 is a view showing the ends of the urinary catheter and the rectal catheter of the urodynamics testing device of FIG. 3 inserted into the bladder and the rectum, respectively, when the patient is lying down;
FIG. 7 is a view showing the ends of the urinary catheter and the rectal catheter of the urodynamics test device of FIG. 4 inserted into the bladder and the rectum, respectively, when the patient is standing;
8 is a block diagram of the urodynamics testing device of FIG. 3;
FIG. 9 is a view for explaining the second position adjusting unit of the urodynamics test apparatus of FIG. 3 .

Hereinafter, some embodiments of the present invention will be described in detail through exemplary drawings. In adding reference numerals to components of each drawing, it should be noted that the same components have the same numerals as much as possible even if they are displayed on different drawings.

And, in describing the embodiments of the present invention, if it is determined that a detailed description of a related known configuration or function interferes with understanding of the embodiment of the present invention, the detailed description will be omitted.

Also, terms such as first, second, A, B, (a), and (b) may be used to describe components of an embodiment of the present invention. These terms are only used to distinguish the component from other components, and the nature, order, or order of the corresponding component is not limited by the term.

Hereinafter, a urodynamic examination apparatus for adjusting a sensor position according to an embodiment of the present invention will be described in detail with reference to the drawings.

2 is a view for explaining a part of a urodynamics test apparatus for adjusting sensor position according to an embodiment of the present invention, and FIG. 3 is a sensor position according to an embodiment of the present invention mounted on a patient in a supine position. It is a conceptual diagram of a urodynamic examination device for adjustment, and FIG. 4 is a conceptual diagram of a urodynamic examination device for adjusting the position of a sensor according to an embodiment of the present invention mounted on a patient in a standing position.

Referring to FIGS. 2 to 4 , a urodynamic examination apparatus 100 (hereinafter, referred to as “urodynamic examination apparatus”) for adjusting the position of a sensor according to an embodiment of the present invention is inserted into the bladder 11 of a patient. The urethral catheter (110), the rectal catheter (130) inserted into the patient's rectum, and the urethral catheter (110) are connected to measure the internal pressure of the patient's bladder (11). A pressure transducer (120, hereinafter referred to as “first sensor”) and a second pressure transducer (140, hereinafter referred to as “second sensor”) connected to the rectal catheter (130, referred to as “second sensor”) to measure the abdominal pressure of the patient. And, the first sensor 120 and the second sensor 140 are respectively connected to the first sensor 120, the second sensor 140, the urinary catheter 110, and the rectal catheter ( 130) and a first bag 101 for supplying a fluid such as physiological saline, and a second bag 102 connected to the urinary catheter 110 and supplying a fluid such as physiological saline to the urinary catheter 110. .

The urinary catheter 110 may include a first flow path 111 connected to the first sensor 120 and a second flow path 112 connected to the second bag. In the urinary catheter 110, the first flow path 111 and the second flow path 112 may be formed independently inside one tube.

A pump 103 is provided between the second bag 102 and the second flow path 112, and the pump 103 pumps the fluid in the second bag 102 through the second flow path 112. It can be introduced into the patient's bladder (11).

FIG. 5 is a view for explaining a first position adjusting unit of the urodynamics test apparatus of FIG. 3 .

Referring further to FIG. 5 , the urodynamics test apparatus 100 further includes a first position adjusting unit 150 and a control unit 160 .

The urinary catheter 110 is inserted into the bladder 11 through the urethra of the patient so that the tip is positioned in the bladder 11 of the patient.

When the fluid in the first bag 101 is injected into the first sensor 120 and the first flow path 111, the fluid is discharged into the patient's bladder 111 at the end of the first flow path 111. , At this time, the first sensor 120 may measure the internal pressure of the patient's bladder 11 by measuring the hydraulic pressure of the first flow path 111 .

The first sensor 120 includes a filling phase in which a fluid such as physiological saline is supplied to the patient's bladder 11 through the second flow path 112 and the physiological saline solution filled in the patient's bladder 11. During a voiding phase in which fluid such as the back is discharged through the urethra, the internal pressure of the patient's bladder 11 may be measured.

The rectal catheter 130 is inserted into the rectum 12 through the anus of the patient so that the tip portion is positioned in the rectum 12 of the patient.

A rectal balloon 131 is provided at the tip of the rectal catheter 130, and a fluid such as physiological saline may be filled in the rectal balloon 131.

When the fluid in the first bag 101 is injected into the second sensor 140 and the rectal catheter 130, the fluid flows into the rectal balloon 131 located at the tip of the rectal catheter 130.

At this time, the second sensor 140 may measure the patient's abdominal pressure by measuring the hydraulic pressure of the rectal catheter 130 .

The urodynamics test apparatus 100 may further include an electromyography electrode 165 .

The EMG electrode 165 is attached adjacent to the patient's anus and measures the activity of the urethral sphincter, and the measured EMG activity indicates that detrusor contraction is synergic with urethral sphincter activity. or dyssynergic.

The controller 160 is connected to the first sensor 120, the second sensor 140, and the EMG electrode 165, and the first sensor 120, the second sensor 140, and the EMG electrode Based on the signal received from 165, intravesical pressure (11, Pves), abdominal pressure (12, Pabd), detrusor pressure (13, Pdet), and urethral sphincter activity (14) can be displayed on the display.

The first sensor 120 and the second sensor 140 are mounted on the first position adjusting unit 150 .

The first position adjusting unit 150 may adjust the heights of the first sensor 120 and the second sensor 140 according to an ICS reference level, which is a reference height.

That is, the first position adjusting unit 150 can change the heights of the first sensor 120 and the second sensor 140 by following the height of the upper lip of the patient's pubic bone, which changes according to the patient's posture.

To this end, the first position adjusting unit 150 includes a signal transmission/reception unit 151, a mounting frame 152, and a transfer rail 153.

The transfer rail 153 is disposed perpendicular to the ground, the first sensor 120 and the second sensor 140 are respectively installed on the mounting frame 152, and the mounting frame 152 is It can move in the vertical direction on the rail 153.

Specifically, the mounting frame 152 may move vertically on the transfer rail 153 by a driving force of an actuator such as a motor.

The signal transmission/reception unit 151 may measure the distance between the patient's upper lip 14 and the mounting frame 152 .

The signal transmission/reception unit 151 includes a reception unit 1511 and a transmission unit 1512.

One of the receiving unit 1511 and the transmitting unit 1512 is installed on the upper edge of the pubis 14 of the patient, and the other is installed on the mounting frame 152, so that the upper edge of the pubis 14 of the patient and the upper edge of the pubis 14 of the patient The distance between the mounting frames 152 can be measured.

For example, the receiver 1511 is installed on the upper edge of the pubis 14 of the patient, and the transmitter 1512 is installed on the mounting frame 152, and the upper edge of the pubis 14 of the patient and the mounting frame ( 152) can be measured.

A distance between the transmitter 1512 and the receiver 1511 may be measured as a time when a signal transmitted by the transmitter 1512 is received by the receiver 1511 .

Signals transmitted and received by the transmitting unit 1512 and the receiving unit 1511 may be any signal capable of measuring a distance, such as ultrasonic waves, vision, infrared rays, and visible light.

The control unit 160 controls the distance between the upper lip 14 of the patient and the mounting frame 152 based on the distance between the transmission unit 1512 and the reception unit 1511 measured by the signal transmission/reception unit 151. The position of the mounting frame 152 on the transfer rail 153 may be adjusted in the vertical direction so that the distance of is maintained at the shortest distance.

For example, when the heights of the first sensor 120 and the second sensor 140 are higher than that of the upper lip 14 of the patient, there is a height difference between the transmitter 1512 and the receiver 1511. occurs, and the distance L2 between the transmitter 1512 and the receiver 1511 becomes farther than the reference distance L1. In this case, the controller 160 transfers the transfer rail 153 downward from the mounting frame 152 so that the distance between the transmitter 1512 and the receiver 1511 becomes the reference distance L1. can

And even when the heights of the first sensor 120 and the second sensor 140 are lower than that of the upper lip 14 of the patient, a difference in height between the transmitter 1512 and the receiver 1511 occurs. Then, the distance L3 between the transmitter 1512 and the receiver 1511 becomes farther than the reference distance L1. In this case, the controller 160 moves the transfer rail 153 upward from the mounting frame 152 so that the distance between the transmitter 1512 and the receiver 1511 becomes the reference distance L1. can

Here, the reference distance L1 is when the height of the upper lip 14 of the patient and the heights of the first sensor 120 and the second sensor 140 are the same, the transmitting unit 1512 and the receiving unit ( 1511), and the control unit 160 transfers the transfer rail 153 in the vertical direction on the mounting frame 152 so that the distance between the transmitter 1512 and the receiver 1511 is the shortest The reference distance (L1) can be determined by finding a point that becomes the distance.

Therefore, according to the present invention, the height of the upper part of the pubis 14 of the patient is tracked according to the posture of the patient, and the heights of the first sensor 120 and the second sensor 140 are the heights of the upper part of the pubis 14 of the patient. You can control it to match the height.

Specifically, when the patient changes posture such as a supine position, a sitting position, and a standing position, of the receiver 1511 installed on the upper part of the pubic bone 14 The position is changed, and at this time, the transmission unit 1512 moves in the vertical direction by the mounting frame 152, and finds the shortest distance between the transmission unit 1512 and the reception unit 1511, and the upper edge of the pubic bone 14 of the patient. If the height of is traced, the height of the first sensor 120 and the second sensor 140 may follow the height of the upper part of the pubis 14 of the patient.

6 is a view showing the end of the urethral catheter and the rectal catheter of the urodynamics test device of FIG. 3 when the patient is lying down and inserted into the bladder and the rectum, respectively, and FIG. 7 is the urodynamics test device of FIG. 4 when the patient is standing Figure 8 is a block diagram of the urodynamic examination device of FIG. 3, Figure 9 is a second position adjustment of the urodynamic examination device of FIG. It is a drawing for explaining the part.

Further referring to FIGS. 6 to 9 , the urodynamics test apparatus 100 may further include a second position adjusting unit 170 .

The second position adjusting unit 170 adjusts the heights of the first sensor 120 and the second sensor 140 according to the positions of the tip of the urinary catheter 110 and the tip of the rectal catheter 130, respectively. can be adjusted

The second position adjusting unit 170 may be installed on the mounting frame 152 .

The second position adjusting unit 170 may include a first height adjusting unit 171 and a second height adjusting unit 172 .

Each of the first height adjusting unit 171 and the second height adjusting unit 172 is provided with an actuator such as a motor, and can slide in a vertical direction on the mounting frame.

The first sensor 120 is installed in the first height adjusting unit 171, and the first sensor 120 moves vertically from the mounting frame 152 by the first height adjusting unit 171. can be transported

The second sensor 140 is installed in the second height adjusting part 172 .

The second height adjusting unit 172 is adjacent to the first height adjusting unit 171 and can move vertically in the mounting frame 152 . The second sensor 140 may be moved vertically from the mounting frame 152 by the second height adjusting unit 172 .

That is, the second position adjusting unit 170 may individually transfer the height of the first sensor 120 and the height of the second sensor 140 .

The second position adjusting unit 170 may be characterized in that the heights of the first sensor 120 and the second sensor 140 are respectively adjusted according to the posture of the patient.

To this end, the urodynamics test apparatus 100 may further include a posture detection unit 180 .

The posture detection unit 180 detects the patient's posture, such as a supine position, a sitting position, and a standing position.

The attitude detector 180 may include an acceleration sensor and a gyro sensor.

The control unit 160 controls the second position adjusting unit 170 based on the information detected by the posture detection unit 180 to set the heights of the first sensor 120 and the second sensor 140, respectively. can be adjusted

Specifically, according to the change in the height of the tip of the urinary catheter 110 and the tip of the rectal catheter 130 caused by the difference in the height of the bladder 11 and the rectum 12 of the patient according to the patient's posture, the control unit ( 160 may control the second position adjusting unit 170 to adjust the heights of the first sensor 120 and the second sensor 140 respectively.

In the above, even though all the components constituting the embodiment of the present invention have been described as being combined or operated as one, the present invention is not necessarily limited to these embodiments. That is, within the scope of the object of the present invention, all of the components may be selectively combined with one or more to operate.

In addition, all terms including technical or scientific terms described above have the same meaning as commonly understood by one of ordinary skill in the art to which the present invention belongs, unless otherwise defined. Commonly used terms, such as terms defined in a dictionary, should be interpreted as being consistent with the contextual meaning of the related art, and unless explicitly defined in the present invention, they are not interpreted in an ideal or excessively formal meaning.

In addition, the above description is merely an example of the technical idea of the present invention, and various modifications and variations can be made to those skilled in the art without departing from the essential characteristics of the present invention. Therefore, the embodiments disclosed in the present invention are not intended to limit the technical idea of the present invention, but to explain, and the scope of the technical idea of the present invention is not limited by these embodiments. The protection scope of the present invention should be construed according to the claims below, and all technical ideas within the equivalent range should be construed as being included in the scope of the present invention.

100: urodynamics test device
110: urinary catheter
120: first sensor
130 rectal catheter
140: second sensor
150: first position control unit
160: control unit
170: second position adjusting unit

Claims (5)

a urethral catheter that is inserted into the patient's bladder;
a first sensor disposed spaced apart from the patient and connected to the urinary catheter to measure intravesical pressure;
a rectal catheter that is inserted into the patient's rectum;
a second sensor spaced apart from the patient, disposed adjacent to the first sensor, and connected to the rectal catheter to measure abdominal pressure; and
A urodynamic examination apparatus comprising a first position adjusting unit for adjusting the heights of the first sensor and the second sensor according to the patient's posture.
The method of claim 1,
The first position adjusting unit,
a transport rail;
A mounting frame coupled to be transportable in the vertical direction on the transport rail and on which the first sensor and the second sensor are installed;
According to the posture of the patient, a signal transmitting and receiving unit for measuring the distance between the mounting frame and the upper lip of the patient's pubic bone;
The urodynamic examination apparatus of claim 1 , wherein the mounting frame is transported in an up-and-down direction on the transfer rail so that a distance between the mounting frame and the upper edge of the pubic bone of the patient is the shortest distance.
The method of claim 2,
The urodynamics test device further comprises a second position adjusting unit for adjusting the heights of the first sensor and the second sensor, respectively, according to positions of the tip of the urinary catheter and the tip of the rectal catheter.
The method of claim 3,
The second position adjusting unit,
A first height adjusting unit installed on the mounting frame and adjusting the height of the first sensor;
and a second height adjusting unit installed on the mounting frame adjacent to the first height adjusting unit to adjust the height of the second sensor.
The method of claim 3,
Further comprising a posture detection unit for detecting the patient's posture,
The urodynamic examination apparatus according to claim 1 , wherein the first position adjusting unit adjusts heights of the first sensor and the second sensor according to the posture of the patient detected by the posture detection unit.

Images