TW201626938A - Cardiovascular health monitoring device and method - Google Patents
Cardiovascular health monitoring device and method Download PDFInfo
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本發明相關於一種心血管健康監測裝置及方法,更特別地是,相關於一種具有血壓以及心電訊號測量功能的心血管健康監測裝置,以及透過該裝置而監測心血管健康的方法。 The present invention relates to a cardiovascular health monitoring device and method, and more particularly to a cardiovascular health monitoring device having blood pressure and electrocardiographic signal measuring functions, and a method of monitoring cardiovascular health through the device.
現代人越來越注重自己的健康,尤其是心血管方面的健康,而血壓計則是日常生活中最常用來監測心血管健康的居家使用監測裝置之一,不僅是因為其使用方便,也由於高血壓是相關於如心臟病及糖尿病等各種慢性疾病的危險因子之一。 Modern people are paying more and more attention to their health, especially cardiovascular health, and sphygmomanometer is one of the most commonly used monitoring devices for monitoring cardiovascular health in daily life, not only because of its ease of use, but also because Hypertension is one of the risk factors associated with various chronic diseases such as heart disease and diabetes.
目前居家最常見的其中一種血壓計是電子式血壓計,其操作流程為先固定壓脈帶,之後再按下啟動鍵並等待血壓測量自動完成,這樣的簡單操作流程讓使用者可方便地每日定期紀錄血壓值變化,有效掌控自身心血管的健康狀況。 One of the most common sphygmomanometers at home is the electronic sphygmomanometer. The operation procedure is to first fix the pressure belt, then press the start button and wait for the blood pressure measurement to be completed automatically. This simple operation process allows the user to conveniently Regularly record changes in blood pressure values to effectively control your cardiovascular health.
最近,由於使用者需求及技術上的發展,除了測量血壓的功能之外,部分血壓計也開始提供更多相關於心血管系統的資訊,例如,由動脈脈搏衍生而得之相關心律不整的資訊,如US702514即提出了可提供有關心房顫動(AF,Atrial Fibrillation)資訊的血壓計。 Recently, due to user needs and technological developments, in addition to the function of measuring blood pressure, some sphygmomanometers have begun to provide more information about the cardiovascular system, for example, information related to arrhythmia derived from arterial pulse. A sphygmomanometer that provides information about atrial fibrillation (AF) is proposed, for example, in US702514.
一般而言,用以判斷心律不整的基礎是心電圖,且心電圖亦是目前最能準確反應心臟活動的資訊,在如第1圖所示的正常心電波形中, P波表示心房去極化的過程,QRS波反應了左右心室的快速去極化過程,T波表示心室的快速復極化過程,PR區間是指從P波開始至QRS波開始的時間,其反應了心臟的電訊號自竇房結發出後,通過房室結傳入心室所需的時間,ST段則表示心室緩慢復極化的過程,因此,透過觀察波形的形狀變化,就可得知相關心臟各個部位活動的資訊,並藉以區分症狀是由心臟的那個部位所引起。 In general, the basis for judging arrhythmia is the electrocardiogram, and the electrocardiogram is currently the most accurate response to cardiac activity. In the normal ECG waveform shown in Figure 1, The P wave represents the process of atrial depolarization, the QRS wave reflects the rapid depolarization process of the left and right ventricles, the T wave represents the rapid repolarization process of the ventricle, and the PR interval refers to the time from the start of the P wave to the start of the QRS wave. Responding to the time required for the heart's electrical signal to pass through the ventricular node and passing through the atrioventricular node, the ST segment represents the process of slow repolarization of the ventricle. Therefore, by observing the shape change of the waveform, it is known. Information about the activities of various parts of the heart, and to distinguish the symptoms caused by that part of the heart.
舉例而言,常見的一種心律不整症狀--早發性收縮(Premature Beats),即分為發生於心房的早發性心房收縮(Premature atrial contractions,PAC),以及發生在心室的早發性心室收縮(Premature ventricular contractions,PVC)兩種,在區分兩者時,通常可以透過觀察P波及/或QRS波的形狀是否出現異常而判斷收縮是來自心房或心室。而就此兩種早發性收縮而言,由於心室收縮是負責將血液打出心臟並輸送至身體各處,故當心室收縮出現不正常時,將使得血液無法正常地打出,造成身體無法獲得正常的血液供給,因此相較於心房收縮出現異常,心室收縮異常是更為嚴重的症狀。 For example, a common symptom of arrhythmia, Premature Beats, is divided into premature atrial contractions (PAC) that occur in the atria, and early onset ventricles that occur in the ventricles. Premature ventricular contractions (PVC). When distinguishing between the two, it is usually possible to determine whether the contraction is from the atria or the ventricle by observing whether the shape of the P wave and/or the QRS wave is abnormal. In the case of these two types of early-onset contractions, since the ventricular contraction is responsible for driving the blood out of the heart and transporting it to the body, when the ventricular contraction is abnormal, the blood will not be able to be played normally, resulting in the body not being able to obtain normal. Blood supply, therefore, abnormalities in ventricular contraction compared to atrial contraction are more serious symptoms.
然而,血壓計在提供心律不整相關資訊時,由於是以動脈脈搏為基礎取得心率後再進行心律不整的判定,一般而言觀察到心率出現異常時,經由動脈脈搏之波形往往難以區分如前所述之早發性收縮的發生是源自心房或心室,亦無法正確地讓使用者瞭解所偵測到之症狀的嚴重性;另外,由於動脈脈搏是心搏經由血液在血管中傳遞後於肢體上測得的結果,因此其亦存在著準確度無法與心電圖相比擬的問題,所以,即使血壓計確實能方便地先篩選出一部分的心律不整症狀,但無可避免地,心律不 整的最終判斷仍需藉由觀察心電圖而進行確認。 However, when the sphygmomanometer provides information on arrhythmia, the heart rate is determined based on the arterial pulse, and then the arrhythmia is determined. Generally, when the heart rate is abnormal, the waveform of the arterial pulse is often difficult to distinguish. The occurrence of early-onset contractions originates from the atrium or ventricle, and does not correctly inform the user of the severity of the detected symptoms. In addition, because the arterial pulse is the heartbeat, the blood is transmitted through the bloodstream and then to the limb. As a result of the above measurement, there is also a problem that the accuracy cannot be compared with the electrocardiogram. Therefore, even if the sphygmomanometer can easily screen out a part of the arrhythmia symptoms, it is inevitable that the heart rhythm is not The final final judgment still needs to be confirmed by observing the electrocardiogram.
此外,測量血壓期間,壓脈帶的充放氣過程中,會對手臂的血管產生不同的壓力,當壓力過大時,將可能因為壓迫到血管而造成動脈脈搏的振幅變小,而在此時所進行的脈搏測量就可能因此而出現遺漏,造成誤判,故由此可知,當利用血壓計的壓脈帶獲取動脈脈搏時,在使用上有較多的限制,必須考慮壓脈帶的壓力變化對於血管的影響,而且,當用以判斷心律不整時,還需考慮是否造成不正確的診斷結果。 In addition, during the measurement of blood pressure, during the process of filling and deflation of the cuff, different pressures will be exerted on the blood vessels of the arm. When the pressure is too high, the amplitude of the arterial pulse may become smaller due to compression to the blood vessel. The pulse measurement performed may cause omissions and cause misjudgment. Therefore, when using the pulsatometer to obtain the arterial pulse, there are more restrictions on the use, and the pressure change of the cuff must be considered. For the effects of blood vessels, and when used to determine arrhythmia, it is also necessary to consider whether to cause an incorrect diagnosis.
所以,根據前述可知,在討論心血管健康時,較佳是將血壓測量以及心電圖檢測同時列入考量。 Therefore, according to the foregoing, in discussing cardiovascular health, it is preferable to take blood pressure measurement and electrocardiogram detection into consideration at the same time.
因此,若能有一裝置可同時提供血壓測量及心電訊號測量兩種功能,相信將可為心血管健康監測領域,尤其是有關心律不整的篩選及判斷方面,帶來很大的改進,也可為臨床診斷提供相當之方便性。 Therefore, if there is a device that can provide both blood pressure measurement and ECG measurement, it is believed that it will bring great improvements to the field of cardiovascular health monitoring, especially the screening and judgment of arrhythmia. Provides considerable convenience for clinical diagnosis.
血壓計是目前家庭中最常見且具高普及度的心血管健康監測裝置之一,而相較於血壓計,居家使用的心電訊號測量裝置則較不為人所熟悉,因此,若可將心電測量與血壓計結合在一起,就可藉由一般使用者對於血壓測量操作流程的熟悉度而讓心電訊號測量更深入日常生活,有助於居家使用者更瞭解及掌握自身的心血管健康,也讓此兩種彼此相關的生理訊號可更有效地被利用。 The sphygmomanometer is one of the most common and highly popular cardiovascular health monitoring devices in the family. Compared with the sphygmomanometer, the ECG measuring device used at home is less familiar, so if you can The combination of ECG measurement and sphygmomanometer allows the ECG measurement to go deeper into daily life through the familiarity of the general user with the blood pressure measurement operation process, which helps home users understand and master their own cardiovascular system. Health also allows these two physiological signals that are related to each other to be used more effectively.
一般常見之可居家使用心電訊號測量裝置多為手持式心電檢測裝置,其可讓使用者以手握持檢測裝置的方式進行測量,所使用的是不需使用導電膏、直接接觸皮膚就可進行測量、且可重複使用的乾式電極,故對居家使用而言相當方便。 Commonly used home-use ECG signal measuring devices are mostly hand-held ECG detecting devices, which allow the user to measure by hand holding the detecting device, using no conductive paste and direct contact with the skin. A dry electrode that can be measured and reusable, so it is quite convenient for home use.
其中一種常見的操作方式是,在進行測量時,使用者一手握持裝置並同時接觸裝置表面的電極,再將另一個電極接觸另一手或是軀幹,如第2圖以及第3圖所示,以取得心電圖。 One of the common methods of operation is when the user is holding the device in one hand and simultaneously touching the electrode on the surface of the device, and then touching the other electrode to the other hand or the torso, as shown in Figures 2 and 3. To get an electrocardiogram.
然而,這樣的方式所面臨的最大問題卻也是因利用手進行操作所造成。當採用接觸雙手形式時,如第2圖所示,會面臨的問題是操作穩定度低,因以雙手進行測量的方式很容易在測量時發生如手部晃動等不穩定的現象,造成所測得之心電圖出現基線漂移、波形變形等情形,如第4A圖中所標示的部分,因此,相較於正常的心電訊號波形,其將導致不正確的分析結果;另外,當使用者希望手部維持穩定而肌肉緊張、或是特意用力以確保與電極間接觸時,也很容易因用力而產生肌電訊號,如第4B圖所示,同樣會造成訊號品質下降,進而導致不正確的心電圖分析結果。 However, the biggest problem faced by such a method is also caused by the use of hands. When using the form of contact hands, as shown in Fig. 2, the problem that is faced is that the operation stability is low, and the measurement by the two hands is easy to cause unstable phenomena such as hand shaking during measurement, resulting in instability. The measured ECG has a baseline drift, waveform distortion, etc., as indicated in Figure 4A. Therefore, compared to the normal ECG waveform, it will result in incorrect analysis results. In addition, when the user I hope that when the hand is stable and the muscles are tight, or if you want to use force to ensure contact with the electrodes, it is easy to generate myoelectric signals by force. As shown in Figure 4B, the signal quality will also be degraded, which will lead to incorrectness. The results of ECG analysis.
當採用一手握持裝置另一邊接觸胸膛的方式時,如第3圖所示,相較於雙手操作,可較為穩定,所取得的訊號也較強,只是這樣的操作方式有一個最大缺點,就是必須掀開衣服來接觸胸膛才能進行測量,會讓使用者有所顧忌,另外,胸腔因呼吸所產生的起伏,也會造成接觸胸膛之電極與接觸手之電極間產生相對移動,同樣容易造成基線漂移而影響所測得的心電圖。 When using the one hand holding device on the other side to touch the chest, as shown in Figure 3, compared with the two-hand operation, it can be more stable, and the obtained signal is stronger, but this operation mode has one of the biggest disadvantages. It is necessary to open the clothes to touch the chest to measure, which will make the user feel scrupulous. In addition, the fluctuation of the chest cavity caused by the breathing will also cause relative movement between the electrode contacting the chest and the electrode of the contact hand, which is also easy to cause. The baseline drift affects the measured ECG.
因此,在將心電測量與血壓計相結合時,必須考慮電極的種類及配置方式,以提供使用者自然且容易達成的操作方式,也進一步幫助獲得良好的訊號品質,其中,影響訊號品質的因素主要包括,外在環境干擾、皮膚與電極間接觸情形、以及使用者操作動作等,舉例而言,測量環境中的電磁波可能在所取得的心電訊號中產生雜訊(noises),以及測量期 間不穩定的接觸動作與過度肌肉緊張度所產生的肌電訊號可能成為人為干擾源(artifacts)等,這些都會影響訊號品質;再者,還需考慮的是接觸電極的動作是否可自然融入血壓計操作流程中,如此才能避免重新學習的麻煩,也提升操作的流暢度,更進一步增加使用意願。 Therefore, when combining ECG measurement with a sphygmomanometer, the type and arrangement of the electrodes must be considered to provide a natural and easy-to-achieve operation for the user, and further help to obtain good signal quality, which affects signal quality. The factors mainly include external environmental interference, skin-to-electrode contact, and user operation. For example, electromagnetic waves in the measurement environment may generate noises and measurements in the acquired ECG signals. period Unstable contact movements and excessive muscle tone may result in myoelectric signals, which may become artifacts, etc., which will affect the quality of the signal. Furthermore, it is also necessary to consider whether the action of the contact electrode can naturally be integrated into the blood pressure. In the operation process, this can avoid the trouble of re-learning, improve the smoothness of the operation, and further increase the willingness to use.
所以,在考慮將心電訊號測量與血壓計相結合時,確實有需要將上述的這些因素皆列入考慮,以得出最適合居家使用的心血管健康監測裝置。 Therefore, when considering the combination of ECG measurement and sphygmomanometer, it is indeed necessary to take all of these factors into consideration to arrive at a cardiovascular health monitoring device that is most suitable for home use.
此外,結合血壓測量及心電訊號測量的另一優勢則是,當可取得穩定且清晰的心電訊號時,就可獲得相關心率變異率(HRV,Heart Rate Variability)的資訊,進而瞭解自律神經活動,因此,基於自律神經系統亦是影響血壓的因素之一,就可藉由觀察自律神經活動與血壓值變化的關係而得知高血壓的成因是否與自律神經相關。 In addition, another advantage of combining blood pressure measurement and ECG measurement is that when a stable and clear ECG signal is obtained, information about the Heart Rate Variability (HRV) can be obtained, and then the autonomic nerve can be learned. Activity, therefore, based on the autonomic nervous system is also one of the factors affecting blood pressure, by observing the relationship between autonomic nerve activity and changes in blood pressure values, it is known whether the cause of hypertension is related to autonomic nerves.
本發明的目的即在於提供一種心血管健康監測裝置,其可提供血壓測量以及心電訊號測量兩種功能。 It is an object of the present invention to provide a cardiovascular health monitoring device that provides both blood pressure measurement and electrocardiographic measurement.
本發明的另一目的在於提供一種心血管健康監測裝置,其在已熟知的血壓測量操作流程中,自然地帶入心電訊號測量所需的電極接觸行為,以藉由降低使用複雜性而提升使用者接受度。 Another object of the present invention is to provide a cardiovascular health monitoring device that naturally takes into account the electrode contact behavior required for ECG measurement in a well-known blood pressure measurement operation flow, thereby improving use by reducing the complexity of use. Acceptance.
本發明的再一目的在於提供一種心血管健康監測裝置,其可有效且準確地提供有關判斷心律不整的資訊。 It is still another object of the present invention to provide a cardiovascular health monitoring apparatus which can efficiently and accurately provide information on the determination of arrhythmia.
本發明的另一目的在於提供一種心血管健康監測裝置,其透過充氣式壓脈帶偵測動脈脈搏,以判斷是否具有心律不整可能事件,並據 以通知使用者進行心電訊號測量,而讓使用者可即時取得心電圖,以有利於進一步確認心律不整的發生及類型。 Another object of the present invention is to provide a cardiovascular health monitoring device for detecting an arterial pulse through an inflatable cuff to determine whether there is a possible arrhythmia event, and In order to inform the user to perform ECG measurement, the user can obtain the ECG immediately, which is helpful to further confirm the occurrence and type of arrhythmia.
本發明的又一目的在於提供一種心血管健康監測裝置,其採用可主動對使用者耳朵及耳朵附近皮膚進行施力的耳戴結構,以提供位於其上之電極與皮膚間的穩定接觸。 It is still another object of the present invention to provide a cardiovascular health monitoring device that employs an ear-wearing structure that actively applies force to the skin of the user's ears and the vicinity of the ear to provide stable contact between the electrodes and the skin thereon.
本發明的又一目的在於提供一種心血管健康監測裝置,其採用可主動對使用者手指皮膚進行施力的指戴結構,以提供位於其上之電極與皮膚間的穩定接觸。 It is still another object of the present invention to provide a cardiovascular health monitoring device that employs a finger-wearing structure that actively applies force to the skin of a user's fingers to provide stable contact between the electrodes and the skin thereon.
本發明的又一目的在於提供一種心血管健康監測裝置,其將電極與血壓測量時所需的壓脈帶相結合,以在壓脈帶環繞手臂的同時完成電極與皮膚間的接觸。 It is still another object of the present invention to provide a cardiovascular health monitoring device that combines an electrode with a cuff that is required for blood pressure measurement to complete contact between the electrode and the skin while the cuff is wrapped around the arm.
本發明的又一目的在於提供一種心血管健康監測裝置,其將電極設置於殼體的表面,以讓使用者可在環繞壓脈帶的同時完成電極與皮膚間的接觸。 It is still another object of the present invention to provide a cardiovascular health monitoring device that has electrodes disposed on a surface of a housing to allow a user to complete contact between the electrodes and the skin while surrounding the cuff.
本發明的又一目的在於提供一種心血管健康監測裝置,其將電極設置於殼體的表面,以讓使用者可在按壓操作裝置的同時完成電極與皮膚間的接觸。 It is still another object of the present invention to provide a cardiovascular health monitoring device that has electrodes disposed on a surface of a housing to allow a user to complete contact between the electrodes and the skin while pressing the operating device.
本發明的又一目的在於提供一種心血管健康監測裝置,其透過穿戴結構而達成電極與皮膚間的接觸,適合長時間取得高品質測量心電訊號,有利於進行HRV分析,進而瞭解自律神經活動與血壓的關係。 Another object of the present invention is to provide a cardiovascular health monitoring device that achieves contact between the electrodes and the skin through the wearing structure, and is suitable for obtaining high-quality measuring ECG signals for a long time, which is advantageous for performing HRV analysis and thereby understanding autonomic nervous activity. The relationship with blood pressure.
10‧‧‧控制電路 10‧‧‧Control circuit
12‧‧‧壓脈帶 12‧‧‧Curve belt
113、14、202、90‧‧‧電極 113, 14, 202, 90‧‧‧ electrodes
100、201‧‧‧啟動鍵 100, 201‧‧‧ start button
101、20‧‧‧另一殼體 101, 20‧‧‧ another housing
111‧‧‧表面 111‧‧‧ surface
112‧‧‧承載結構 112‧‧‧bearing structure
113‧‧‧電極 113‧‧‧Electrode
114‧‧‧開口 114‧‧‧ openings
115‧‧‧凹槽結構 115‧‧‧ Groove structure
116‧‧‧另一電極 116‧‧‧Other electrode
第1圖顯示標準心電波形;第2圖顯示習知手持式心電檢測裝置的一種操作方式;第3圖顯示習知手持式心電檢測裝置的另一種操作方式;第4A圖顯示出現基線漂移的心電波形;第4B圖顯示受肌電訊號影響的心電波形;第5圖顯示根據本發明之心血管健康監測裝置的方塊示意圖;第6A-6C圖顯示根據本發明之耳戴結構的示範性實例;第7圖顯示根據本發明之耳戴結構可接觸之耳朵附近皮膚的示意圖;第8A-8B圖顯示根據本發明之指戴結構的示範性實例;第9圖顯示根據本發明之電極與壓脈帶的示範性結合實例;第10圖顯示根據本發明心血管健康裝置具有用以承載啟動鍵之另一殼體的示範性實例;第11A-11H圖顯示本發明之電極與殼體結合的示範性實例;第12-15圖顯示根據本發明心血管健康監測裝置,電極實施為位在耳戴結構上以及與壓脈帶相結合的示範性實例;第16圖顯示顯示根據本發明心血管健康監測裝置,電極實施為位在耳戴結構以及腕戴結構上的示範性實例;第17-19圖顯示根據本發明心血管健康監測裝置,電極實施為位在耳戴結構以及指戴結構上的示範性實例;第20圖顯示根據本發明心血管健康監測裝置,電極實施為位在指戴結構上以及與壓脈帶相結合的示範性實例;第21圖顯示根據本發明心血管健康監測裝置,電極實施為位在指戴式 結構上以及與殼體表面相結合的示範性實例;第22圖顯示根據本發明心血管健康監測裝置,電極實施為分別位在二個指戴結構上的示範性實例;第23-24圖顯示根據本發明心血管健康監測裝置,電極實施為位在耳戴結構上以及與殼體表面相結合的示範性實例;第25-27圖顯示根據本發明心血管健康監測裝置,電極實施為與殼體表面相結合之電極以及與壓脈帶相結合的示範性實例;第28圖顯示根據本發明心血管健康監測裝置,電極實施為位在耳戴結構上以及與殼體表面相結合的示範性實例;第29A圖顯示根據本發明心血管健康監測裝置,電極皆位於殼體表面的示範性實例;第30A-30B圖顯示根據本發明心血管健康監測裝置,一電極位於殼體表面,以及另一電極位在耳戴結構上、或在指戴結構上的示範性實例;第31圖顯示根據本發明心血管健康監測裝置的一操作流程圖;以及第32-34圖顯示根據本發明心血管健康監測裝置之通知資訊的示範性實例。 Figure 1 shows a standard ECG waveform; Figure 2 shows an operational mode of a conventional handheld ECG detection device; Figure 3 shows another mode of operation of a conventional handheld ECG detection device; Figure 4A shows the appearance of a baseline Drifting ECG waveform; Figure 4B shows the electrocardiogram waveform affected by the myoelectric signal; Figure 5 shows a block diagram of the cardiovascular health monitoring device according to the present invention; and Figs. 6A-6C show the ear worn structure according to the present invention Illustrative example; Figure 7 shows a schematic view of the skin near the ear that is accessible to the ear-worn structure in accordance with the present invention; Figures 8A-8B show an exemplary embodiment of the finger-wearing structure in accordance with the present invention; An exemplary example of the combination of an electrode and a cuff; FIG. 10 shows an exemplary embodiment of a cardiovascular health device having another housing for carrying a start button in accordance with the present invention; and FIGS. 11A-11H show the electrode of the present invention Illustrative example of housing combination; Figures 12-15 show an exemplary embodiment of an electrode implemented in an ear-wearing structure and in combination with a cuff, in accordance with the cardiovascular health monitoring device of the present invention; Shown in accordance with the cardiovascular health monitoring device of the present invention, the electrodes are embodied as exemplary examples of the ear-worn structure and the wrist-worn structure; Figures 17-19 show the cardiovascular health monitoring device according to the present invention, the electrodes being implemented in the ear Illustrative example of wearing structure and finger-wearing structure; Figure 20 shows an exemplary embodiment of an electrode according to the present invention, the electrode being embodied in a finger-wearing structure and in combination with a venous band; Figure 21 shows According to the cardiovascular health monitoring device of the present invention, the electrode is implemented in a finger-worn manner Exemplary examples of structural and combined with the surface of the housing; Figure 22 shows an exemplary embodiment in which the electrodes are implemented on two finger-worn structures, respectively, according to the cardiovascular health monitoring device of the present invention; Figures 23-24 show According to the cardiovascular health monitoring device of the present invention, the electrodes are embodied as an exemplary example of being placed on the ear-wearing structure and in combination with the surface of the casing; Figures 25-27 show the cardiovascular health monitoring device according to the present invention, the electrode being implemented as a shell An exemplary embodiment of a body surface combined electrode and a combination with a venous band; Figure 28 shows an exemplary embodiment of an electrode embodied in an ear worn structure and in combination with a surface of a housing in accordance with the cardiovascular health monitoring device of the present invention. Example; Figure 29A shows an exemplary embodiment of a cardiovascular health monitoring device according to the present invention, the electrodes are all located on the surface of the housing; Figures 30A-30B show a cardiovascular health monitoring device according to the present invention, an electrode is located on the surface of the housing, and another An exemplary embodiment of an electrode on an ear-worn structure or on a finger-worn structure; Figure 31 shows an operational flow of a cardiovascular health monitoring device in accordance with the present invention FIG.; And FIGS. 32-34 show an exemplary example of a notification of the health monitoring device according to the present invention is a cardiovascular information.
本發明相關於一種具有血壓測量及心電訊號測量二種功能的心血管健康監測裝置,其可在遵從血壓測量之操作習慣的情形下,讓使用者自然地記錄下心電圖,因此,透過操作單一個裝置就可獲得相關於心血管健康的多種重要資訊。 The invention relates to a cardiovascular health monitoring device with two functions of blood pressure measurement and electrocardiogram measurement, which allows a user to naturally record an electrocardiogram under the condition of observing the operation habit of blood pressure measurement, and therefore, through the operation list A device can get a variety of important information about cardiovascular health.
首先,請參閱第5圖,其為根據本發明心血管健康監測裝置 的一示意圖,如圖所示,該心血管健康監測裝置包括一控制電路10,一壓脈帶12,一幫浦,一氣閥,一壓力傳感器,以及至少二電極14,在此,該控制電路10實施為可經由所連接的壓脈帶12以及電極14而執行血壓測量與心電訊號測量,因此,該控制電路10亦會包括,但不限於,一些用來達成測量的常見電子元件,例如,處理器,至少一A/D轉換器,濾波器,放大器等,由於這些對本領域具通常知識者而言皆為常見之內容,故不再贅述。 First, please refer to FIG. 5, which is a cardiovascular health monitoring device according to the present invention. As shown in the figure, the cardiovascular health monitoring device includes a control circuit 10, a vascular belt 12, a pump, a gas valve, a pressure sensor, and at least two electrodes 14, where the control circuit 10 is implemented to perform blood pressure measurement and ECG measurement via the connected cuff 12 and electrode 14. Therefore, the control circuit 10 may also include, but is not limited to, some common electronic components used to achieve measurement, such as The processor, at least one A/D converter, filter, amplifier, etc., are common to those of ordinary skill in the art and will not be described again.
根據本發明的心血管健康監測裝置亦具有一殼體,以將該控制電路以及該幫浦等容置於其中,在此,該殼體可實施為與壓脈帶相結合而於測量期間設置於使用者身上,或者,也可實施為與壓脈帶分離,而不在測量時設置於使用者身上,另外,該殼體表面可實施為具有操作介面,例如,顯示元件、啟動鍵、輸入按鍵等。 The cardiovascular health monitoring device according to the present invention also has a housing for housing the control circuit and the pump, etc., wherein the housing can be implemented in combination with a cuff for setting during measurement Alternatively, it can be implemented to be separated from the cuff without being placed on the user during measurement. In addition, the surface of the housing can be implemented with an operation interface, for example, a display element, a start button, an input button. Wait.
由於根據本發明的心血管健康監測裝置是在測量血壓的基礎上添加利用心電電極進行心電訊號測量的功能,因此,本發明裝置在實施時,整體外觀結構上沒有特定的限制,只要是一般常見的電子血壓計皆是可作為本發明基礎的結構,例如,如第12圖所示的臂式血壓計以及如第13圖所示的腕式血壓計等都適用,而這樣的作法也在於讓使用者可在熟悉的操作行為中進行根據本發明概念的心電訊號測量。 Since the cardiovascular health monitoring device according to the present invention adds the function of measuring the electrocardiogram by using the electrocardiographic electrode on the basis of measuring the blood pressure, the device of the present invention has no specific limitation on the overall appearance structure, as long as it is A common electronic sphygmomanometer is a structure that can be used as a basis of the present invention. For example, an arm sphygmomanometer as shown in Fig. 12 and a wrist sphygmomanometer as shown in Fig. 13 are applicable, and such a method is also applicable. It is to enable the user to perform ECG measurement according to the inventive concept in a familiar operational behavior.
在本發明中,心電訊號的測量主要係採用透過直接接觸皮膚的方式就可取得心電訊號的乾式電極,當使用乾式電極時,相較於傳統的可重複使用濕式電極,使用者可在不需要導電膏的情形下,藉由皮膚直接接觸電極而進行心電訊號測量,因此測量可以在任何時間輕易方便地執行,另外,相較於拋棄式的電極貼片,由於乾式電極不容易損壞且保養簡 易,可重複使用,因此也減少了更換電極的不方便性及所增加的成本。在本發明中,乾式電極可實施為,但不限於,不銹鋼材質的電極,導電纖維布所製成的電極,導電橡膠電極等,沒有任何限制。再者,替代地,也可實施為不需直接接觸皮膚的電極,例如,利用電容方式、感應方式、或電磁方式而取得心電訊號的電極,同樣無須透過如導電膏的媒介就可進行心電訊號測量,具有使用方便性。 In the present invention, the measurement of the electrocardiogram signal mainly adopts a dry electrode which can obtain an electrocardiographic signal by directly contacting the skin. When using the dry electrode, the user can use the dry electrode compared with the conventional reusable wet electrode. In the case where the conductive paste is not required, the electrocardiographic signal measurement is performed by directly contacting the electrodes with the skin, so the measurement can be easily and conveniently performed at any time, and the dry electrode is not easy compared to the disposable electrode patch. Damaged and maintenance Easy to use, it also reduces the inconvenience of replacing the electrode and the added cost. In the present invention, the dry electrode can be implemented as, but not limited to, an electrode made of stainless steel, an electrode made of a conductive fiber cloth, a conductive rubber electrode, or the like without any limitation. In addition, alternatively, it can also be implemented as an electrode that does not need to directly contact the skin, for example, an electrode that obtains an electrocardiogram by capacitive, inductive, or electromagnetic means, and does not need to pass through a medium such as a conductive paste. Electrical signal measurement, easy to use.
至於如何將電極整合於血壓計中,本發明則是由血壓測量的操作流程著手,藉以提升使用方便性,且在設置心電電極時,亦進一步考量如何達成簡單且符合人體工學的操作方式,以確保電極與使用者皮膚間的穩定接觸。 As for how to integrate the electrodes into the sphygmomanometer, the present invention starts with the operation flow of the blood pressure measurement, thereby improving the convenience of use, and further considering how to achieve a simple and ergonomic operation when setting the electrocardiographic electrodes. To ensure stable contact between the electrode and the user's skin.
一般電子式血壓計的操作程序是:壓脈帶環繞於手臂或手腕後,在保持水平位置與心臟等高的情形下,按下啟動鍵並維持姿勢穩定而讓機器自動完成測量。 The operation procedure of the general electronic sphygmomanometer is: after the pressure pulse band surrounds the arm or the wrist, in the case where the horizontal position is kept at the same height as the heart, the start button is pressed and the posture is stabilized, and the machine automatically completes the measurement.
由上述可知,設置壓脈帶及按下啟動鍵為不可或缺的操作流程,而本發明的概念即在於將測量心電訊號所必須之接觸心電電極的動作,融入於進行血壓測量時一定會執行的操作動作中,以儘量避免操作步驟的增加,如此一來,使用者也就不需重新學習操作流程。 It can be seen from the above that the setting of the cuff and the pressing of the start button is an indispensable operation flow, and the concept of the present invention is to integrate the action of contacting the electrocardiographic electrode necessary for measuring the electrocardiogram signal into the blood pressure measurement. In the operation actions that will be performed, the operation steps are avoided as much as possible, so that the user does not need to relearn the operation flow.
再者,另一個考慮的重點是電極於血壓計上的結合位置。為了獲得良好的訊號品質,本發明在電極的設置位置及接觸方式的選擇上,主要採用了兩種概念,第一,透過選擇接觸位置以及設計電極結構,讓電極主動施力接觸使用者的皮膚,如此一來,電極與皮膚間的接觸即不再仰賴使用者施力,不但可提高接觸穩定性,也可避免肌電訊號以及人為干擾 源(artifact);第二,當需要使用者施力接觸電極時,藉由將電極設置在可容易且自然達成接觸的位置,而讓使用者能以輕鬆的姿勢進行電極接觸,以增加接觸時的穩定性,讓人為干擾源的影響降至最低,亦可降低肌肉緊張度,減少產生肌電訊號,另外,若再加上將電極接觸面實施為具有人體工學的表面,接觸穩定性還可進一步獲得確保,更有效提升訊號品質。 Furthermore, another consideration is the location of the electrodes on the sphygmomanometer. In order to obtain good signal quality, the present invention mainly adopts two concepts in the selection of the electrode placement position and the contact mode. First, the electrode is actively applied to contact the user's skin by selecting the contact position and designing the electrode structure. In this way, the contact between the electrode and the skin is no longer dependent on the user's force, which not only improves the stability of the contact, but also avoids the myoelectric signal and human interference. Artifact; secondly, when the user is required to apply the force to the contact electrode, the user can make the electrode contact in an easy posture by setting the electrode at a position where the contact can be easily and naturally achieved, thereby increasing the contact time. The stability of the device minimizes the effects of interference sources, reduces muscle tone and reduces the generation of myoelectric signals. In addition, if the electrode contact surface is implemented as an ergonomic surface, the contact stability is also improved. It can be further ensured to improve signal quality more effectively.
因此,本發明在決定電極位置及實施形式時即是以上述的概念作為基礎。而據以提出的其中一個可能即是將電極設置於耳朵上的構想。 Therefore, the present invention is based on the above concept in determining the position and embodiment of the electrode. One of the possibilities that has been proposed is the idea of placing the electrodes on the ears.
雖然,耳朵並非一般血壓測量時會參與的身體部位,然而,利用耳朵作為接觸電極的位置有一個優勢是,耳朵及其附近是肌電訊號極小的區域,再加上其與頭部之間相當穩定的相對位置關係,因此即使使用者在測量期間身體出現移動,例如,稍微轉動身體、或轉動脖子,電極與皮膚間的接觸仍可維持穩定,不會產生太多影響測量結果的干擾。 Although the ear is not the part of the body that will be involved in the measurement of blood pressure, the advantage of using the ear as the position of the contact electrode is that the ear and its vicinity are areas where the myoelectric signal is extremely small, plus it is equivalent to the head. A stable relative positional relationship, so even if the user moves during the measurement, for example, slightly turning the body or turning the neck, the contact between the electrodes and the skin can be maintained stably without causing too much interference affecting the measurement results.
另外,在一般日常生活中,相較於其他身體部位,耳朵是較少受到衣物覆蓋的部位,可以較容易地在有需要時直接接觸,避免掀衣服進行測量的困擾,再者,耳朵及其周圍的皮膚還具有毛髮較少的特性,電極與皮膚間的接觸可輕鬆無障礙的達成,因此,對使用者而言是相當方便的選擇。 In addition, in general daily life, compared with other body parts, the ear is a part that is less covered by clothing, and can be easily contacted directly when needed, to avoid the trouble of measuring the clothes, and the ear and its The surrounding skin also has less hair characteristics, and the contact between the electrodes and the skin can be easily achieved without barriers, and is therefore a convenient choice for the user.
此外,因耳朵構造而可提供的各種固定方式,例如,耳塞、耳夾、耳掛等,如第6A-6C圖所示,皆為一般日常生活中常見的固定方式,使用者不需要重新學習,可以很自然的進行配置,因此,使用者只需簡單地如平時戴耳機、或是將電極夾於耳垂上的動作,即可完成電極設置;而且,當透過上述之固定方式而將電極設置於耳朵上時,電極與皮膚的接觸 不需使用者施力即可達成,因此幾乎不會出現肌肉緊張,肌電訊號的干擾可被降至最低,可獲得良好的訊號品質。 In addition, various fixing methods that can be provided due to the ear structure, such as earplugs, ear clips, ear hooks, etc., as shown in Figures 6A-6C, are common fixing methods in daily life, and the user does not need to relearn. It can be configured naturally. Therefore, the user can simply complete the electrode setting by simply wearing the earphone or clamping the electrode on the earlobe. Moreover, the electrode is set by the above fixed manner. Contact of the electrode with the skin on the ear It can be achieved without the user's exertion, so there is almost no muscle tension, the interference of the EMG signal can be minimized, and good signal quality can be obtained.
至於要在耳朵上的哪個位置取得心電訊號,則是沒有限制,可以是耳朵本身的任何位置,例如,耳道內,耳垂,耳廓內面,例如,耳甲腔、耳道口附近區域等,耳輪,以及耳廓背面,以及如第7圖所示,耳朵附近的區域,例如,耳朵與頭殼交界處附近的皮膚等,這些位置都是可用以接觸電極並取得心電訊號的位置。 As for the position on the ear to obtain the ECG signal, there is no limit, and it can be any position of the ear itself, for example, in the ear canal, the earlobe, the inner surface of the auricle, for example, the ear cavity, the area near the ear canal, etc. The ear wheel, as well as the back of the auricle, and as shown in Fig. 7, the area near the ear, for example, the skin near the junction of the ear and the head shell, these positions are the locations where the electrodes can be contacted and the ECG signal is obtained.
因此,只需從主機或透過與壓脈帶的結構結合而延伸出可與耳朵相接觸的電極,讓使用者在設置完壓脈帶後戴上,就能夠很自然的完成電極設置,並得到良好的心電訊號。 Therefore, it is only necessary to extend the electrode that can be in contact with the ear from the host or through the structure of the cuff, so that the user can naturally complete the electrode setting after wearing the pressure band and obtain the electrode setting. Good ECG signal.
在此,兩個耳朵都是可以選擇的配戴位置,然而,經實驗後得知,另一電極的設置位置對於訊號品質有相當程度的影響,其中,當另一電極設置於左上肢時,所獲得之心電訊號的品質遠優於右上肢所取得的訊號,因此,在以接觸耳朵之方式而進行心電訊號測量時,較佳地是將另一電極接觸左上肢的皮膚,以避免因接觸右上肢而造成訊號品質不良,進而導致分析產生誤判。 Here, both ears are selectable wearing positions. However, after the experiment, it is known that the position of the other electrode has a considerable influence on the signal quality, wherein when the other electrode is disposed on the left upper limb, The quality of the obtained ECG signal is much better than that obtained by the right upper limb. Therefore, when the ECG measurement is performed in contact with the ear, it is preferable to contact the other electrode to the skin of the left upper limb to avoid The signal quality is poor due to contact with the right upper limb, which leads to misjudgment in the analysis.
在實際實施時,電極與耳朵間的接觸係透過一可與耳朵相結合的耳戴結構而達成,其中,電極被設置在該耳戴結構與耳朵相結合時會接觸到皮膚的位置,因此,當耳戴結構被固定於耳朵上時,電極與耳朵或其附近皮膚的接觸即同時完成。 In actual implementation, the contact between the electrode and the ear is achieved through an ear-wearing structure that can be combined with the ear, wherein the electrode is placed in contact with the skin when the ear-wearing structure is combined with the ear, therefore, When the ear-wearing structure is fixed to the ear, the contact of the electrode with the skin of the ear or its vicinity is completed simultaneously.
該耳戴結構可以有各種形式,舉例而言,當該耳戴結構實施為耳塞形式時,電極可設置於耳塞上,以自然達成與耳道內皮膚的接觸, 如第6A圖所示,另外,若經特殊設計,耳塞的構造亦可延伸而進一步符合耳廓的內面的曲線,提供另一種電極接觸位置選擇;當實施為耳夾形式時,例如,夾設於耳廓上或耳垂上(第6B圖),電極可設置於耳夾的內側,以在夾設的同時完成與耳廓或耳垂間的接觸;當實施為耳掛形式時,如6C圖所示,在一較佳實施例中,電極可實施為位在延伸至耳朵背面的掛鉤件上,而接觸耳廓背面的皮膚或是耳朵後方與頭部交接處的皮膚,在此,該掛鉤件可,舉例而言,藉由本身材質的彈性、或是透過結構上的設計,而具有朝向皮膚方向的施力,並與皮膚間產生穩定接觸。 The ear-wearing structure can have various forms. For example, when the ear-wearing structure is implemented in the form of an earplug, the electrode can be disposed on the earplug to naturally achieve contact with the skin in the ear canal. As shown in Fig. 6A, in addition, if specially designed, the structure of the earplug can also be extended to further conform to the curve of the inner surface of the auricle, providing another electrode contact position selection; when implemented in the form of an ear clip, for example, a clip Set on the auricle or on the earlobe (Fig. 6B), the electrode can be placed on the inner side of the ear clip to complete the contact with the auricle or earlobe while being clamped; when implemented as an ear hook form, such as 6C As shown, in a preferred embodiment, the electrode can be implemented on a hook member that extends to the back of the ear to contact the skin on the back of the auricle or the skin at the junction of the back of the ear and the head, where the hook For example, the elastic force of the material itself or the structural design may have a force applied to the skin direction and a stable contact with the skin.
或者,也可實施為利用磁力的方式而附著於耳朵上,舉例而言,可利用隔著耳朵彼此磁性相吸的兩個部件,並將電極設置於兩個部件或其中一部件上的方式而達成,在此,兩個部件可實施為具有磁性,例如,透過內部具有磁性物質、或本身即為磁性物質的方式,或是實施為由可受磁性吸引的材質所製成、或於內部設置可受磁性吸引的物質,舉例而言,可以一個部件實施為具有磁力,而另一個部件可被磁力吸引,或者,也可是二個部件皆實施為具有磁力,可以有各種實施可能,沒有限制。 Alternatively, it may be implemented to be attached to the ear by means of a magnetic force. For example, two members magnetically attracted to each other across the ear may be used, and the electrodes may be disposed on the two members or one of the members. In this case, the two components can be embodied as magnetic, for example, by means of a magnetic substance inside, or a magnetic substance itself, or by a material that can be magnetically attracted, or internally. The magnetically attractable substance may be, for example, one member implemented to have a magnetic force, and the other member may be magnetically attracted, or both members may be embodied to have a magnetic force, which may be variously implemented without limitation.
在此,需注意地是,上述有關耳戴結構的敘述僅作為舉例之用,並非作為限制,例如,也可實施為結合兩種形式的結構,例如,耳塞與耳掛形式結合實施,因此,可以依實際需求而變化,沒有限制。 Here, it should be noted that the above description of the ear-wearing structure is for example only, and is not intended to be limiting. For example, it may be implemented to combine two forms of structure, for example, the earplug is implemented in combination with the ear-hook form, and therefore, It can be changed according to actual needs, and there is no limit.
另外,在一較佳實施例中,該耳戴結構與其上的電極還可實施為透過連接埠而與壓脈帶或殼體相連接,如此一來,當使用者不需進行心電測量時,就可將耳戴結構移除。 In addition, in a preferred embodiment, the ear-worn structure and the electrodes thereon can also be implemented to be connected to the cuff or the housing through the connection port, so that when the user does not need to perform electrocardiographic measurement The earwear structure can be removed.
在此,為了避免所取得之心電訊號經由連接線感應環境雜 訊,可在取得訊號時於電極附近先行進行處理,例如,放大、緩衝、濾波、數位化等電路處理,以確保訊號的清晰度,並且,所需的電路還可進一步地實施為容置在該耳戴結構中,沒有限制。 Here, in order to avoid the ECG signal obtained by the connection line sensing environment The signal can be processed first in the vicinity of the electrode when the signal is obtained, for example, circuit processing such as amplification, buffering, filtering, digitization, etc., to ensure the clarity of the signal, and the required circuit can be further implemented to be accommodated in There is no limit to this ear-wearing structure.
再者,根據本發明另一方面的構想,電極亦可實施為由指戴結構所承載,例如,戒指式結構、或是環繞手指的帶體。指戴結構與耳戴結構具有同樣的優勢,因為指戴形式對一般使用者而言,亦是熟悉而無須重新學習的使用方式,只需在欲進行測量時直接將指戴結構結合於手指上即可完成電極與皮膚間的接觸,操作流程自然方便,而且,電極與皮膚間的接觸力是由指戴結構對手指施力而達成,只要使用者放鬆戴有電極的手,肌肉緊張度的影響同樣可被降至最低。 Furthermore, in accordance with the teachings of another aspect of the invention, the electrode can also be embodied as being carried by a finger-wearing structure, such as a ring-like structure, or a band around a finger. The wearing structure has the same advantages as the ear-wearing structure, because the finger-wearing form is familiar to the average user and does not need to be re-learned. It is only necessary to directly attach the finger-wearing structure to the finger when the measurement is to be performed. The contact between the electrode and the skin can be completed, and the operation process is natural and convenient. Moreover, the contact force between the electrode and the skin is achieved by applying a force to the finger by the finger-wearing structure, as long as the user relaxes the hand with the electrode, the muscle tension The impact can also be minimized.
在此,根據本發明的指戴結構於手指上的設置位置,較佳為近節指骨或中節指骨所在的指節,以避免因位置接近手指末端而發生因手部動作脫落的情形,在實際實施時,該指戴結構可如第8A圖所示,採用如一般戒指的形式,或者如第8B圖所示,實施為環繞手指的可撓曲帶體,沒有限制;在此,無論採用何種形式,都可進一步具有可調整環繞直徑的結構,以進一步確保電極與皮膚間的接觸穩定性,例如,戒指可實施為具有可變化戒圍的機構,以適應不同配戴者的手指,以及帶體可實施為具有可調整的固定位置,例如,透過設置魔鬼氈,以讓使用者選擇環繞時的緊度等,同樣可依實際情形而變化實施方式,沒有限制。另外,亦可採用夾子的形式,例如,可將夾子的結構設計為可夾住指尖或其他的指節,如近節指骨或中節指骨,如此就可透過夾子本身的彈性而達到固定的效果,同樣是很好的選擇。 Here, the position of the finger-wearing structure according to the present invention on the finger is preferably a knuckle in which the proximal phalanx or the middle phalanx is located to avoid the situation in which the hand movement is detached due to the position approaching the end of the finger. In actual implementation, the finger-wearing structure may be in the form of a general ring as shown in FIG. 8A, or as a flexible band around the finger as shown in FIG. 8B, without limitation; In any form, the structure may further have an adjustable wrap diameter to further ensure contact stability between the electrode and the skin. For example, the ring may be implemented as a mechanism with a variable ring to accommodate different wearer's fingers. And the belt body can be implemented to have an adjustable fixed position, for example, by setting a devil's felt, so that the user can select the tightness when wrapping, etc., and the embodiment can be changed according to the actual situation, without limitation. In addition, the form of a clip can also be used. For example, the structure of the clip can be designed to clamp the fingertip or other knuckles, such as the proximal phalanx or the middle phalanx, so that the elasticity of the clip itself can be fixed. The effect is also a good choice.
在此,與接觸耳朵相同,當透過接觸手指而進行心電訊號擷取時,亦可於訊號取得的位置附近即先行對訊號進行處理,以確保訊號的品質,而且,同樣地,電路可進一步地容置於該指戴結構中。 Here, as with the contact ear, when the ECG signal is extracted by touching the finger, the signal can be processed in the vicinity of the position where the signal is obtained to ensure the quality of the signal, and, similarly, the circuit can be further The ground content is placed in the finger-wearing structure.
另外,根據本發明再一方面的構想,另一個設置電極的位置選擇是該壓脈帶。由於安裝壓脈帶是測量血壓的必要行為,因此,當電極位於壓脈帶上時,讓電極接觸皮膚的動作就可透過安裝壓脈帶而一起完成,簡化操作步驟。在此,電極可結合於壓脈帶的任何部位,只需在壓脈帶被環繞至手臂或手腕上時可達成電極與皮膚間接觸的位置即可,例如,電極可結合於壓脈帶的內側,或是壓脈帶的邊緣等位置,沒有限制。 Further, according to the concept of still another aspect of the present invention, the position of the other set electrode is selected as the cuff. Since the installation of the cuff is a necessary behavior for measuring blood pressure, when the electrode is placed on the cuff, the action of contacting the electrode to the skin can be accomplished by installing the cuff, simplifying the procedure. Here, the electrode can be bonded to any part of the cuff, and the position where the electrode is in contact with the skin can be achieved only when the cuff is wrapped around the arm or wrist. For example, the electrode can be coupled to the cuff. There is no limit to the inside, or the edge of the cuff.
當電極結合於壓脈帶內側時,除了可採用常見的金屬電極片外,在一較佳實施例中,為了增進與皮膚間的接觸,電極亦可選擇採用具可撓曲性的材質,例如,導電纖維布、導電橡膠等,或者也可實施為壓脈帶內側表面上的一層導電塗層,以使電極可隨著壓脈帶而彎曲,進而達成與皮膚間的接觸。 When the electrode is bonded to the inside of the cuff, in addition to the usual metal electrode sheets, in a preferred embodiment, in order to improve the contact with the skin, the electrode may also be made of a flexible material, such as , conductive fiber cloth, conductive rubber, etc., or can also be implemented as a layer of conductive coating on the inner surface of the cuff, so that the electrode can be bent with the cuff, thereby achieving contact with the skin.
其中,為了確保電極與皮膚間的接觸,可設定為心電訊號測量在壓脈帶的充氣達一特定壓力值以上(也就是,與皮膚間的接觸力達一定程度後)才進行,以讓電極與皮膚間的接觸更為穩定。 In order to ensure the contact between the electrode and the skin, the ECG signal can be set to be measured when the inflation of the cuff is above a certain pressure value (that is, after the contact force with the skin reaches a certain level), so that The contact between the electrode and the skin is more stable.
在此,進一步地,亦可藉由設置額外的結構來確保電極與皮膚間的接觸,以避免壓脈帶於血壓測量期間進行充氣及放氣所可能造成之電極與皮膚間的接觸不穩定,舉例而言,可在壓脈帶上對應電極的位置處設置一支持結構,因而可在壓脈帶環繞手臂或手腕時,藉由環繞的力量、或藉由充氣時因充氣所產生的體積膨脹,而對該支持結構產生施力,造成 支持結構對電極施加朝向皮膚的力,進而確保電極與皮膚間的接觸,例如,該支持結構可實施為具有一定的厚度及硬度,以達成將壓脈帶環繞或充氣膨脹的力量傳遞至電極的效果,且進一步地,該支持結構可具有壓縮彈性,以讓施力的達成不會對使用者造成不舒適的壓迫感;另外,在一較佳實施例中,該支持結構則是實施為符合所接觸之皮膚位置的人體工學,例如,手臂的弧度,進一步確保接觸的穩定性。 Herein, further, it is also possible to ensure the contact between the electrode and the skin by providing an additional structure to avoid unstable contact between the electrode and the skin caused by the inflation and deflation of the cuff during the blood pressure measurement. For example, a support structure can be provided at the position of the corresponding electrode on the cuff, so that the volume can be expanded by the surrounding force or by inflation when the cuff is wrapped around the arm or wrist. And exerting a force on the support structure, resulting in The support structure applies a force to the skin to the electrode, thereby ensuring contact between the electrode and the skin. For example, the support structure can be implemented to have a certain thickness and hardness to achieve the transmission of the force of the cuff or the inflation of the cuff to the electrode. The effect, and further, the support structure may have compressive elasticity so that the force application is achieved without causing an uncomfortable feeling of pressure to the user; in addition, in a preferred embodiment, the support structure is implemented to comply with The ergonomics of the skin location in contact, for example, the curvature of the arm, further ensures the stability of the contact.
在另一較佳實施例中,如第9圖所示,電極90也可實施為結合於壓脈帶邊緣,夾設於壓脈帶的上緣,此時,電極與皮膚間的接觸方式亦有多種選擇,舉例而言,可透過選擇具彈性的電極材質而使電極有朝向皮膚方向的施力,因此當環繞上壓脈帶後,電極可自然緊貼皮膚,或者,可透過結構設計而使電極形狀符合手臂或手腕的人體工學,進而確保電極與皮膚間的接觸,因此,沒有限制,可依實際需求而改變。 In another preferred embodiment, as shown in FIG. 9, the electrode 90 can also be implemented to be bonded to the edge of the cuff, sandwiched between the upper edge of the cuff, and the contact between the electrode and the skin is also There are many options. For example, the electrode can be biased toward the skin by selecting an elastic electrode material, so that the electrode can naturally adhere to the skin after wrapping the upper venous band, or can be structurally designed. The shape of the electrode conforms to the ergonomics of the arm or wrist, thereby ensuring contact between the electrode and the skin. Therefore, there is no limitation and it can be changed according to actual needs.
在此,需要注意的是,當電極實施為與該壓脈帶相結合時,心電訊號測量可實施為在血壓測量期間同時進行,或者,亦可選擇與血壓測量分開進行,使用者可依實際情形而進行選擇。 Here, it should be noted that when the electrodes are implemented in combination with the cuff, the electrocardiographic measurement can be performed simultaneously during the blood pressure measurement, or alternatively, separately from the blood pressure measurement, the user can Choose the actual situation.
再者,根據本發明又一方面的構想,另一個設置電極的位置選擇是該殼體的表面,以讓使用者利用手指進行接觸。 Furthermore, in accordance with a further aspect of the present invention, the position of the other set electrode is selected to be the surface of the housing for the user to make contact with the finger.
當進行血壓測量時,在壓脈帶安裝完後,為了起始充氣及測量程序,按壓殼體上的啟動鍵是不可或缺的步驟,因此,若電極可設置於啟動鍵上,如此一來,只要使用者在按下啟動鍵後維持不動,就可同時間完成電極接觸,簡化了心電測量的操作步驟。 When blood pressure measurement is performed, pressing the start button on the housing is an indispensable step in order to initiate the inflation and measurement procedure after the cuff is installed. Therefore, if the electrode can be placed on the start button, this way As long as the user does not move after pressing the start button, the electrode contact can be completed at the same time, simplifying the operation steps of the electrocardiogram measurement.
而且,進一步地,手指按壓該啟動鍵的動作,還可實施為同 時起始心電訊號測量以及血壓測量,如此一來,單一個按壓動作就可同時完成三個程序,接觸心電電極,啟動血壓測量,以及啟動心電訊號測量,操作步驟複雜度可降至最低。 Moreover, further, the action of pressing the start button by the finger can also be implemented as the same At the beginning of the ECG measurement and blood pressure measurement, so that a single press can complete three procedures at the same time, contact ECG electrodes, start blood pressure measurement, and start ECG measurement, the complexity of the operation can be reduced lowest.
在此,該啟動鍵可以實施為是具按壓行程的按鍵、或是觸控式按鍵等各種形式,沒有限制,並且,啟動鍵的表面形狀亦可進一步實施為符合手指的人體工學,提供符合手指的弧度,讓接觸更穩定。 Herein, the start button can be implemented as a button with a pressing stroke or a touch button, and the like, and the surface shape of the start button can be further implemented to conform to the ergonomics of the finger. The curvature of the finger makes the contact more stable.
此外,使用者亦可選擇單獨進行血壓測量或心電訊號測量,或是同時進行兩者,舉例而言,可透過按壓該啟動鍵時達成不同的按壓行程、或不同的按壓時間的方式,例如,當短按時,表示無須電極接觸,即僅啟動血壓測量,當長按時,即啟動心電訊號測量,以及當短按後緊接長按時,即同時啟動兩種測量,因此,可依實際實施狀況而改變,沒有限制。 In addition, the user may choose to perform blood pressure measurement or ECG measurement separately, or both, for example, by pressing the start button to achieve different pressing strokes or different pressing times, for example, When short pressing, it means that no electrode contact is required, that is, only the blood pressure measurement is started. When the long press is pressed, the ECG signal measurement is started, and when the short press is followed by the long press, both measurements are started at the same time, so There are no restrictions depending on the actual implementation.
在一較佳實施例中,如第10圖所示,該啟動鍵100進一步實施為由該殼體以外的另一殼體101所承載,例如,一按壓啟動結構,透過這樣的方式,啟動鍵將可依照使用者的操作習慣而被移動到適合的不同位置,如此一來,使用者就能以更輕鬆的姿勢而進行電極接觸,同樣有助於取得品質良好的訊號。 In a preferred embodiment, as shown in FIG. 10, the activation key 100 is further implemented to be carried by another housing 101 other than the housing, for example, a pressing activation structure. In this manner, the activation key is It can be moved to different positions according to the user's operating habits, so that the user can make electrode contact in a more relaxed posture, which also helps to obtain good quality signals.
此外,根據本發明再一方面的構想,當殼體是由壓脈帶承載時,電極於殼體上的位置亦可有不同的選擇,可實施為位在當壓脈帶環繞於肢體上時殼體可接觸至皮膚的位置上。 In addition, according to a further aspect of the present invention, when the housing is carried by the cuff, the position of the electrode on the housing may be selected differently, and may be implemented when the cuff is wrapped around the limb. The housing can be in contact with the skin.
當殼體是由壓脈帶承載而環繞於上臂或前臂的情形時(如第13圖以及第14圖所示之操作情形),可更具有一承載結構112,設置於該殼體上,例如,位於該表面111上,如第11A-11C圖所示,以在壓脈帶環繞於 肢體上時接觸上臂或前臂的皮膚,因此,當電極113被設置於該承載結構112上時,電極接觸就同樣可在安裝壓脈帶的動作中完成。 When the housing is carried by the cuff and surrounds the upper arm or the forearm (as in the case of the operations shown in Figures 13 and 14), there may be further provided a load-bearing structure 112 disposed on the housing, for example , located on the surface 111, as shown in Figures 11A-11C, to surround the cuff When the limb is in contact with the skin of the upper arm or the forearm, when the electrode 113 is placed on the carrying structure 112, the electrode contact can also be completed in the action of mounting the cuff.
舉例而言,如第11A圖所示,該承載結構112可實施為位在接近壓脈帶的邊緣,且該壓脈帶在相對應該承載結構的位置處實施為具有一開口114,因此,藉由壓脈帶環繞上臂或前臂動作就能同時達成電極113於皮膚間的接觸,或者如第11B圖所示,該開口114也可實施為在壓脈帶之中,而該承載結構112則位於與其相對應的位置,再者,如第11C圖所示,該承載結構112亦可實施為位在壓脈帶的兩側外緣,如此一來就可在不改變壓脈帶之結構的情形下達成與皮膚的接觸,在此,雖然圖中顯示兩側外緣皆具有該承載結構,但不受限地,亦可實施為僅設置於單側外緣。 For example, as shown in FIG. 11A, the load-bearing structure 112 can be implemented to be located near the edge of the cuff, and the cuff is implemented to have an opening 114 at a position corresponding to the load-bearing structure, and therefore, The contact of the electrode 113 between the skin can be simultaneously achieved by the action of the cuff around the upper arm or the forearm, or as shown in Fig. 11B, the opening 114 can also be implemented in the cuff, and the support structure 112 is located Corresponding to the position, further, as shown in FIG. 11C, the bearing structure 112 can also be implemented on the outer edges of both sides of the cuff, so that the structure of the cuff can be changed without changing the structure of the cuff. The contact with the skin is achieved. Here, although the outer edges of both sides have the load-bearing structure, it is not limited to be provided only on the one-side outer edge.
另外,更進一步,該承載結構可實施為具彈性,以適應充氣期間所可能出現的變化,也確保電極與皮膚間接觸的穩定性,舉例而言,可採用具彈性的材質,例如,橡膠,矽膠等;或是採用可伸縮機構,例如,可受壓而產生移動行程的按鍵結構,因此,可以有各種可能。 In addition, further, the load-bearing structure can be implemented to be elastic to accommodate changes that may occur during inflation, and also to ensure stability of contact between the electrodes and the skin, for example, a resilient material such as rubber, Silicone rubber or the like; or a retractable mechanism, for example, a button structure that can be pressed to generate a moving stroke, and thus, various possibilities are possible.
在此,需要注意地是,雖然該承載結構可如圖所示的實施為凸起的形式,但並不受限於此,可視殼體與壓脈帶之間的結合方式不同而有所改變,例如,亦可以是與殼體表面同等高度的承載結構,只需可在壓脈帶環繞於手臂上時達成電極與皮膚間的接觸即可,沒有限制。 Here, it should be noted that although the bearing structure can be implemented as a convex form as shown, it is not limited thereto, and the combination of the visible housing and the cuff is changed. For example, it may be a load-bearing structure of the same height as the surface of the casing, and it is only necessary to achieve contact between the electrode and the skin when the cuff is wrapped around the arm, and there is no limitation.
另外,替代地,如第11D圖所示,該承載結構112亦可實施為位在一另一殼體20上,並透過該另一殼體與該殼體之間的機械結合而被設置於該殼體上進而使該電極113可在壓脈帶環繞於上臂或前臂時接觸其上的皮膚。 In addition, as shown in FIG. 11D, the carrying structure 112 can also be implemented to be placed on a further housing 20 and disposed through the mechanical coupling between the other housing and the housing. The housing in turn allows the electrode 113 to contact the skin thereon when the cuff is wrapped around the upper arm or forearm.
在此,該另一殼體與該殼體間除了進行機械結合外,很重要地是,亦會達成一電連接,以使該電極113可與另一電極共同合作而進行心電訊號測量,其中,該電連接可實施為透過分別位在該另一殼體以及該殼體上的一對連接器而達成,例如,USB連接器,mini USB連接器等,而在此情形下,該機械結合就可直接藉由該對電連接器而達成;或者,替代地,也可透過該另一殼體與該殼體彼此相對應的硬體結構而達成該機械結合,因此,沒有限制。 Here, in addition to the mechanical coupling between the other housing and the housing, it is important that an electrical connection is also made, so that the electrode 113 can cooperate with the other electrode to perform ECG measurement. Wherein, the electrical connection can be implemented by a pair of connectors respectively located on the other housing and the housing, for example, a USB connector, a mini USB connector, etc., and in this case, the machine The bonding can be achieved directly by the pair of electrical connectors; or alternatively, the mechanical coupling can be achieved by the hardware structure of the other housing and the housing corresponding to each other, and thus, without limitation.
該另一電極則可以是上述之各種形式的電極,只需確認其所接觸的位置是該壓脈帶所環繞之肢體以外的皮膚即可,例如,可以是耳戴式電極、指戴式電極、或是位於啟動鍵上的電極等。 The other electrode may be any of the above-mentioned types of electrodes, and it is only necessary to confirm that the contact position is the skin other than the limb surrounded by the cuff, for example, an ear-worn electrode or a finger-worn electrode. Or an electrode located on the start button.
且特別地是,該另一電極除了可連接至該殼體或位在該殼體上外,還可實施為透過連接線而連接至該另一殼體、或直接位在該另一殼體上,也就是,用以進行心電訊號測量的兩個電極皆由該另一殼體提供,舉例而言,除了位於該承載結構上的電極113外,該另一殼體可再連接一耳戴式電極(如第11E圖所示),或是連接一指戴式電極,另外,也可在該另一殼體上該電極113所在表面以外的另一表面上設置該另一電極,如第11F圖所示,以讓另一手按壓而進行心電訊號測量,而且,更進一步地,該另一電極所在的位置亦可實施為如上所述的該啟動鍵,以方便使用者的操作。 In particular, the other electrode may be connected to the housing or to the other housing directly through the connecting line, in addition to being connectable to the housing or located on the housing. Above, that is, the two electrodes for performing ECG measurement are provided by the other housing. For example, in addition to the electrode 113 on the carrying structure, the other housing can be connected to one ear. The wearable electrode (as shown in FIG. 11E) is connected to a finger-worn electrode, and the other electrode may be disposed on the other surface of the other casing other than the surface on which the electrode 113 is located, such as As shown in Fig. 11F, the electrocardiographic signal measurement is performed by pressing the other hand, and further, the position at which the other electrode is located can also be implemented as the start key as described above to facilitate the user's operation.
再者,如第11G-11H圖所示,還可將該另一殼體20實施為具有一凹槽結構115,例如,環狀或凹洞的形式,以供手指伸入而接觸設置於其內表面上的該另一電極116,其中,該內表面係實施為符合手指的表面,以在手指伸入時達成電極與手指皮膚間的接觸,在此,該凹槽結構可由具 彈性的材質所製成,例如,橡膠或矽膠,以達成電極與皮膚間的接觸,或者,也可形成為具有塑膠殼體,並於內部設置彈性材質而包覆手指,或是採用可提供向內施力的結構設計等方式,以確保內部電極與指尖皮膚間的良好接觸,因此,沒有限制。 Furthermore, as shown in FIG. 11G-11H, the other housing 20 can also be implemented to have a groove structure 115, for example, in the form of a ring or a recess for the fingers to protrude into contact with The other electrode 116 on the inner surface, wherein the inner surface is configured to conform to the surface of the finger to achieve contact between the electrode and the skin of the finger when the finger is extended, wherein the groove structure can be Made of elastic material, such as rubber or silicone, to achieve contact between the electrode and the skin, or it can be formed with a plastic case, and an elastic material is placed inside to cover the finger, or can be provided The structural design of the internal force is used to ensure good contact between the internal electrode and the skin of the fingertip, so there is no limit.
在此,較佳地是,至少一部份之用以擷取心電訊號的電路可實施為容置於該另一殼體中,例如,放大、緩衝、濾波、及/或數位化電路,而且,由於該另一殼體與該殼體可因機械結合的解除而彼此分離,因此,當兩個心電電極皆是透過該另一殼體而進行設置時,使用者只需透過結合上該另一殼體,就可在原本的血壓偵測裝置上再增加心電檢測的功能,相當方便。 Preferably, at least a portion of the circuitry for extracting the electrocardiographic signal is implemented to be received in the other housing, such as an amplification, buffering, filtering, and/or digitizing circuit. Moreover, since the other housing and the housing can be separated from each other by the mechanical coupling, when the two electrocardiographic electrodes are disposed through the other housing, the user only needs to pass through the coupling. The other housing can increase the function of the electrocardiogram detection on the original blood pressure detecting device, which is quite convenient.
除了上述所提及的電極設置位置及方式以外,根據本發明之心血管健康監測裝置亦可採用其他形式的電極,重點在於減少肌電訊號的產生以及增加接觸時的穩定度,舉例而言,透過腕戴結構承載電極而接觸手腕的方式亦是相當理想的選擇,其同樣不需要使用者施力即可維持與手腕皮膚間的接觸,因此,使用者只需在測量期間放鬆被環繞的肢體即可獲得良好品質的訊號。 In addition to the position and manner of electrode arrangement mentioned above, the cardiovascular health monitoring device according to the present invention may also employ other forms of electrodes, with an emphasis on reducing the generation of myoelectric signals and increasing the stability at the time of contact, for example, It is also an ideal choice to contact the wrist through the wrist-worn structure carrying electrode. It also does not require the user to apply force to maintain contact with the wrist skin. Therefore, the user only needs to relax the surrounded limb during the measurement. You can get good quality signals.
上述各種電極設置方式在實施上並無限制,可根據需求的不同而選擇地實施於任一個心電電極上。以下即利用一些實施例進行說明。 The above various electrode arrangement methods are not limited in implementation, and may be selectively applied to any of the electrocardiographic electrodes depending on the requirements. The following is explained using some embodiments.
請參閱第12圖以及第13圖,根據本發明的一實施例,用於心電訊號測量的二個電極分別設置在壓脈帶內側以及耳戴結構上,因此,當進行血壓測量時,使用者在環繞壓脈帶後,只需再將耳戴結構戴上,就完成了取得血壓讀值及心電圖的所有安裝程序,這幾乎與一般的血壓測量流 程無異,只增加了與一般配戴耳機方式一樣的耳戴動作而已,因此,使用者可輕易且無負擔地完成操作。在此,該耳戴結構可連接至壓脈帶或是殼體,沒有限制。 Referring to FIG. 12 and FIG. 13 , according to an embodiment of the present invention, two electrodes for ECG measurement are respectively disposed on the inner side of the cuff and on the ear wearing structure, and therefore, when performing blood pressure measurement, use After wrapping around the cuff, simply put the ear-worn structure on, and complete all the installation procedures for obtaining blood pressure readings and ECG, which is almost the same as the general blood pressure measurement flow. The process is the same, only adding the same ear-wearing action as the general way of wearing headphones, so the user can complete the operation easily and without burden. Here, the ear-wearing structure can be connected to the cuff or the housing without limitation.
另外,第14圖以及第15圖則顯示了利用外部裝置作為資訊顯示介面的配置,例如,可利用智慧型手機、平板電腦、智慧手錶等於外部進行顯示,如此一來,壓脈帶上所承載之殼體的體積將可被減至最小,提供使用者更舒適的使用體驗,在此,壓脈帶上的殼體與外部裝置間的連接可實施為有線或無線連接,例如,USB或藍芽、WIFI連接等,沒有限制。 In addition, FIG. 14 and FIG. 15 show the configuration using an external device as an information display interface, for example, a smart phone, a tablet computer, or a smart watch can be displayed externally, so that it is carried on the cuff. The volume of the housing can be minimized to provide a more comfortable user experience, where the connection between the housing on the cuff and the external device can be implemented as a wired or wireless connection, such as USB or blue. Bud, WIFI connection, etc., no restrictions.
在此,第14圖顯示了外部裝置為無線連接之智慧型手機的例子,以及第15圖顯示了外部裝置為有線連接之智慧手錶的例子,在此,該外部裝置除了即時接收資料、顯示等功能,例如,引導操作流程以及顯示測量結果,還可進一步實施為具有其他功能,例如,控制裝置的運作,啟動血壓及/或心電訊號測量,分析所接收的資料,儲存,輸出資料至另一裝置等,可提供進一步的方便性。而這樣的配置則尤其有利於殼體是由壓脈帶承載的情況,使用者可透過該外部裝置輕鬆地啟動測量、瞭解操作流程、及觀看測量結果,相當方便。 Here, FIG. 14 shows an example in which the external device is a wirelessly connected smart phone, and FIG. 15 shows an example in which the external device is a wired smart watch, in which the external device receives data, display, etc. in real time. Functions, for example, guiding the operational flow and displaying the measurement results, can be further implemented to have other functions, such as controlling the operation of the device, initiating blood pressure and/or ECG measurement, analyzing the received data, storing, and outputting the data to another A device or the like can provide further convenience. Such a configuration is particularly advantageous in the case where the housing is carried by the cuff, and the user can easily initiate measurement, understand the operation flow, and view the measurement result through the external device, which is quite convenient.
第16圖則是顯示了分別利用耳戴結構以及腕戴結構承載電極的實例,如圖所示,腕戴結構可實施為如手鐲的形式,或者,亦可實施為帶體的形式,或者,電極也可實施為位在如第15圖所顯示之智慧手錶之錶帶內側,因此,沒有限制,而在此情形下,使用者只需戴上耳戴結構及腕戴結構並達成電極接觸,即可進行心電訊號的測量,同樣操作簡易,且可取得品質良好的訊號。 Figure 16 is an example showing the use of an ear-worn structure and a wrist-worn structure carrying electrode, respectively, as shown, the wrist-worn structure may be implemented in the form of a bracelet, or may be implemented in the form of a belt, or The electrode can also be implemented inside the wristband of the smart watch as shown in Fig. 15, so there is no limitation, and in this case, the user only needs to wear the ear wearing structure and the wrist wearing structure and achieve electrode contact. The ECG signal can be measured, and the operation is simple and the signal with good quality can be obtained.
在上述所舉的實施例中,有利地是,在整個心電訊號測量過程中,電極與皮膚間接觸的達成皆不涉及使用者主動施力,可避免肌電訊號的干擾,相當有助於獲得具品質良好的訊號。在此,需要注意地是,如此的配置中,耳戴式電極可選擇地配戴於左耳或右耳,沒有限制,但如前所述,另一電極的設置位置對於訊號品質有相當程度的影響,因此,壓脈帶應選擇環繞左上肢,可獲得較好的訊號強度。 In the above-mentioned embodiments, it is advantageous that the contact between the electrodes and the skin is not involved in the active application of the force during the whole ECG measurement process, and the interference of the EMG signal can be avoided, which is quite helpful. Get a good quality signal. Here, it should be noted that in such a configuration, the ear-worn electrode can be selectively worn on the left or right ear, without limitation, but as described above, the position of the other electrode is quite similar to the signal quality. The effect, therefore, the cuff should be chosen to surround the left upper limb for better signal strength.
根據本發明一另一實施例,如第17-19圖所示,也可將兩個電極分別實施由耳戴結構以及指戴結構所承載,使用者只需於欲進行心電訊號測量時分別戴於耳朵及手指上,就可輕鬆地完成電極與皮膚間的接觸,而且,耳戴結構及指戴結構與皮膚間的接觸同樣亦不涉及使用者施力,可讓肌電訊號的干擾減至最低,另外,由於配戴的動作非常方便,加上無須使用壓脈帶,故也相當適合於僅進行心電訊號測量。 According to another embodiment of the present invention, as shown in FIGS. 17-19, the two electrodes may be respectively carried by the ear-wearing structure and the finger-wearing structure, and the user only needs to perform the ECG signal measurement separately. Wearing the ear and the finger, the contact between the electrode and the skin can be easily accomplished, and the contact between the ear-wearing structure and the finger-wearing structure and the skin does not involve the user's force, which can reduce the interference of the myoelectric signal. To the lowest, in addition, because the wearing action is very convenient, plus the need to use the cuff, it is also quite suitable for ECG only measurement.
另外,在使用指戴結構承載電極的情形下,亦可以搭配其他位置的電極一起使用,例如,與壓脈帶內的電極(第20圖),或與殼體表面的電極201(第21圖)一起配合而進行心電訊號測量,因此,使用者就只需要在測量血壓的操作流程中多增加將指戴結構戴於手指上的動作即可,相當方便。另外,兩個電極也可實施為皆由指戴結構所承載,如第22圖所示,對使用者而言同樣是相當方便的使用方式,而且因為無須使用壓脈帶,同樣適合僅進行心電訊號測量。 In addition, in the case of using the finger-bearing structure carrying electrode, it can also be used together with electrodes at other positions, for example, with electrodes in the cuff (Fig. 20), or with the electrode 201 on the surface of the casing (Fig. 21) The ECG signal measurement is performed together, so the user only needs to increase the action of wearing the finger-wearing structure on the finger in the operation process of measuring blood pressure, which is quite convenient. In addition, the two electrodes can also be implemented to be carried by the finger-wearing structure. As shown in Fig. 22, it is also a very convenient way for the user to use, and since it is not necessary to use a cuff, it is also suitable for heart-only. Electrical signal measurement.
根據本發明一另一實施例,如第23圖所示,用於心電訊號測量的二個電極分別實施為位在殼體操作介面所在表面上與啟動鍵相結合的電極201以及與耳戴結構結合的電極,而透過這樣的方式,使用者在環繞壓 脈帶後,只需再將耳戴結構戴上,按下啟動鍵,並維持手指與啟動鍵間的接觸,就可取得血壓讀值及心電圖。 According to another embodiment of the present invention, as shown in FIG. 23, the two electrodes for electrocardiographic signal measurement are respectively implemented as electrodes 201 combined with the activation key on the surface of the operation interface of the housing and with the ear Structure-bonded electrodes, and in this way, the user is surrounded by pressure After the pulse band, just wear the ear wearing structure, press the start button, and maintain the contact between the finger and the start button, you can get the blood pressure reading and ECG.
另外,如第24圖所示,即使實施為透過無線連接的方式而將資料傳輸至外部裝置的情形,亦可在上臂之殼體上設置與啟動鍵相結合的電極201,以藉由按壓的方式達成接觸並啟動心電測量,或者,替代地,啟動測量的操作亦可實施為由該外部裝置,如智慧型手機,進行控制,而位於殼體表面上的電極則僅實施用以進行心電測量,因此,沒有限制。 In addition, as shown in FIG. 24, even if the data is transmitted to the external device through the wireless connection, the electrode 201 combined with the activation key may be disposed on the housing of the upper arm to be pressed by The method achieves contact and initiates the electrocardiographic measurement, or, alternatively, the operation of initiating the measurement can also be implemented by the external device, such as a smart phone, while the electrodes on the surface of the housing are only implemented for the heart. Electrical measurements, therefore, are not limited.
根據本發明一再一實施例,用於心電訊號測量的二個電極分別實施為與啟動鍵相結合的電極以及與壓脈帶相結合的電極,如第25圖所示,使用者如一般利用臂式血壓計進行測量一樣,坐在桌前,左手上臂環繞壓脈帶並置於桌面上放鬆,再以右手按壓血壓計的啟動鍵201開始血壓測量,而透過本發明的設計,在這樣的血壓測量動作中,測量心電圖所需要的至少二個電極(也就是,壓脈帶內的電極以及位於殼體表面之啟動鍵上的電極)與不同部位皮膚接觸亦已同時完成,完全不需要額外的動作,一次的測量就可同時取得兩種生理訊號;或者,如第26圖所示,當血壓計實施為腕式血壓計時,殼體受到壓脈帶的承載而位在手腕上方,此時,使用者同樣可以在按下啟動鍵201的同時,接觸位在殼體表面上的電極,配合上壓脈帶內部的電極,在一次的測量中同時取得兩種生理訊號;又或者,如第27圖所示,在透過無線連接的方式而將資料傳輸至外部裝置的情形下,亦可在由綁帶承載之殼體上設置與啟動鍵相結合的電極201,再配合上結合於綁帶內側的電極,就可藉由按壓的方式達成接觸並啟動心電測量。 According to still another embodiment of the present invention, the two electrodes for electrocardiographic signal measurement are respectively implemented as an electrode combined with a start button and an electrode combined with a cuff, as shown in FIG. The arm sphygmomanometer performs the same measurement, sitting at the table, the left hand arm is wrapped around the cuff and placed on the table to relax, and then the right hand presses the sphygmomanometer start button 201 to start blood pressure measurement, and through the design of the present invention, in such blood pressure In the measurement operation, at least two electrodes required for measuring the electrocardiogram (that is, the electrodes in the cuff and the electrodes on the activation keys on the surface of the housing) are simultaneously in contact with different parts of the skin, and no additional need is required. Action, one measurement can obtain two physiological signals at the same time; or, as shown in Fig. 26, when the sphygmomanometer is implemented as a wrist blood pressure chronograph, the housing is carried by the venous belt and is located above the wrist. The user can also contact the electrode located on the surface of the casing while pressing the start button 201, and cooperate with the electrode inside the embossed belt to obtain two at the same time in one measurement. The physiological signal; or, as shown in FIG. 27, in the case of transmitting the data to the external device through the wireless connection, the electrode 201 combined with the activation key may be disposed on the casing carried by the strap. Then, in combination with the electrode bonded to the inner side of the strap, the contact can be achieved by pressing and the electrocardiographic measurement can be started.
在這樣的方式中,相較於單純進行血壓測量的程序,使用者 只需在欲測量心電訊號時,增加手指與啟動鍵之間的接觸時間即可,無須額外的動作,可輕易且無負擔地完成。 In such a manner, the user is compared to a program that simply performs blood pressure measurement. Just increase the contact time between the finger and the start button when you want to measure the ECG signal. It can be done easily and without burden without additional action.
在此,需要注意地是,雖然接觸啟動鍵的動作同時會接觸電極,但使用者仍可選擇僅進行血壓測量或心電訊號測量,例如,透過接觸時間的長短而決定選擇要進行的測量等,因此,沒有限制。 Here, it should be noted that although the action of contacting the start button contacts the electrode at the same time, the user can choose to perform only blood pressure measurement or ECG measurement, for example, determining the measurement to be performed through the length of the contact time. Therefore, there is no limit.
另外,電極除了如上所述地位在啟動鍵上外,亦可實施為位在啟動鍵以外的殼體表面上。如第28圖所示,其殼體具有如第11C圖所顯示的結構,電極位於殼體與壓脈帶結合之表面的承載結構上,因此,環繞綁帶的動作就可達成殼體上電極與上臂皮膚間的接觸,再配合戴上耳戴結構,同樣可在不需使用者施力的情形下完成所有的電極接觸,而且,相較於一般血壓測量的操作流程,僅多了配戴耳戴結構的動作,因此,相當方便。 Further, the electrode may be implemented on the surface of the casing other than the start key, in addition to being placed on the start key as described above. As shown in Fig. 28, the housing has a structure as shown in Fig. 11C, and the electrode is located on the bearing structure of the surface of the housing combined with the cuff, so that the action of the strap can achieve the upper electrode of the housing. The contact with the upper arm skin, coupled with the wearing of the ear wearing structure, can also complete all electrode contact without the user's force, and, compared with the general blood pressure measurement operation process, only wear more The action of the ear-wearing structure is therefore quite convenient.
此外,二電極亦可同時位在同一個殼體上,如第29圖所示,其中,殼體係採用如第11B圖所示的結構,因此,當壓脈帶環繞於上臂時,面對上臂的電極可自然地穿過壓脈帶而接觸上臂的皮膚,而另一個位於該殼體表面的電極202則是可接觸另一隻手,以達成心電訊號的測量,在此,需要注意地是,雖然電極202在圖中顯示為位在與面對該上臂的表面相對,但於實際實施時,其可位在任何一個表面,只要不同於面對該上臂的表面、且方便使用者的另一隻手進行接觸即可,例如,與面對該上臂之表面相鄰的側面,因此,沒有限制。 In addition, the two electrodes can also be positioned on the same housing at the same time, as shown in Fig. 29, wherein the housing adopts the structure as shown in Fig. 11B, so that when the cuff is wrapped around the upper arm, the upper arm is faced. The electrode can naturally pass through the cuff belt to contact the skin of the upper arm, and the other electrode 202 located on the surface of the housing can contact the other hand to achieve the measurement of the electrocardiogram signal. Yes, although the electrode 202 is shown in the figure as being opposite to the surface facing the upper arm, in practice, it can be positioned on any surface as long as it is different from the surface facing the upper arm and is convenient for the user. The other hand can be brought into contact, for example, a side adjacent to the surface facing the upper arm, and therefore, there is no limitation.
更進一步地,還可實施為讓使用者自行選擇欲使用的電極,舉例而言,面對上臂的電極可藉由切換開關(未顯示)或接上其他電極而 被取代,例如,具有電極的耳戴結構(如第30A圖所示),或是具有電極的指戴結構(如第30B圖所示),因此,透過這樣的方式,使用者就可依需求的不同而選擇適合自己的使用方式,更增加使用方便性。 Furthermore, it can also be implemented to allow the user to select the electrode to be used, for example, the electrode facing the upper arm can be switched by a switch (not shown) or connected to other electrodes. Replaced, for example, an ear-worn structure having an electrode (as shown in FIG. 30A) or a finger-wearing structure having an electrode (as shown in FIG. 30B), so that in this way, the user can The choice is suitable for your own use, which increases the ease of use.
進一步地,當有需要多於二個電極時,例如,將第三個電極作為接地或參考電極,以抑制共模雜訊,例如,來自電源之雜訊,則可實施為由上述各種電極設計中挑選出適合的多種方式。 Further, when more than two electrodes are required, for example, the third electrode is used as a ground or reference electrode to suppress common mode noise, for example, noise from a power source, which can be implemented by the above various electrode designs. Choose a variety of suitable methods.
此外,在本發明中,為了幫助心電圖測量,(部分或所有的)電極可實施為連接至一感測器,以偵測及通知使用者與電極間接觸是否恰當,舉例而言,一壓力偵測器可用來偵測施加於電極上之力量的大小,或者透過阻抗檢測(impedance check)而得知電極是否已被接觸以及接觸狀況是否良好等,或者,作為替代,也可以簡單地利用一開關來感測施加在電極上的力,據此,還可進一步實施為,當控制電路感測到電極上的接觸達到預設條件時,例如,施力夠大、已被接觸、及/或接觸狀態良好時,讓心電圖測量自動開始,或甚至可實施為裝置因此而被啟動。 In addition, in the present invention, in order to assist the electrocardiogram measurement, (partial or all) electrodes may be implemented to be connected to a sensor to detect and notify the user whether the contact with the electrodes is appropriate, for example, a stress detection The detector can be used to detect the magnitude of the force applied to the electrode, or to know whether the electrode has been touched and the contact condition is good through an impedance check, or alternatively, a switch can be simply used. To sense the force applied to the electrode, according to which, further, when the control circuit senses that the contact on the electrode reaches a preset condition, for example, the force is large enough, has been contacted, and/or contacted When the condition is good, the electrocardiogram measurement is automatically started, or even implemented as the device is thus activated.
另一方面,為了提供使用者更流暢且方便的操作流程,還可透過於電極附近設置感應器的方式而偵測電極是否已設置於預設的位置,例如,耳戴結構是否已配戴於耳朵上,指戴結構是否已配戴於手指上,承載結構上的電極是否已設置於手臂,以及壓脈帶是否已環繞於手臂等,在此,該感應器可為電容式、電阻式、光感應等形式,沒有限制,並且,還可進一步實施為利用如聲音或螢幕顯示等方式而通知使用者電極已設置於預設位置,亦有助於讓使用者更輕鬆地進行操作。 On the other hand, in order to provide a smoother and more convenient operation procedure for the user, it is also possible to detect whether the electrode has been set at a preset position by means of a sensor disposed near the electrode, for example, whether the earwear structure has been worn. On the ear, whether the wearing structure has been worn on the finger, whether the electrode on the bearing structure has been placed on the arm, and whether the pressure pulse band has been wrapped around the arm or the like, wherein the sensor can be capacitive, resistive, The form of light sensing or the like is not limited, and can be further implemented to notify the user that the electrode has been set at the preset position by means such as sound or screen display, and also helps the user to operate more easily.
如此一來,上述用以偵測電極接觸是否良好的感測或檢測, 就可進一步實施為在感應到電極已設置於預設位置上後再執行,並且,同樣可透過如聲音或螢幕顯示的方式再次通知使用者電極接觸已完成,讓整體操作流程更為順暢。 In this way, the above sensing or detecting for detecting whether the electrode contact is good, It can be further implemented to perform after the sensing electrode has been set at the preset position, and can also notify the user that the electrode contact has been completed again by means of sound or screen display, so that the overall operation flow is smoother.
因此,透過本發明上述與血壓計相結合的電極位置,使用者可輕鬆且方便地在使用血壓計的過程中完成進行心電訊號測量所需的電極設置,因而可自然地紀錄下心電圖,而也由於心電圖可提供詳細的心臟電氣活動,因此,本發明裝置所能提供之相關於心血管健康的資訊可更為詳細且精準,舉例而言,透過控制電路中之處理器執行一預載的演算式,或是將心電圖傳送至外部裝置後透過執行其所具備的一演算式,可判斷心律不整的種類為何,例如,分辨PAC與PVC,以及其他的心律不整症狀,例如,AF(心房顫動,Atrial Fibrillation)、心跳過慢、心跳過快、心跳暫停等,另外也可知道是否具有心律不整以外的症狀,例如,透過觀察ST值(ST level)可得知是否具有心肌梗塞症狀,或觀察QRS波的振幅而得知是否有心室肥大等。 Therefore, through the above-mentioned electrode position combined with the sphygmomanometer of the present invention, the user can easily and conveniently perform the electrode setting required for the electrocardiographic signal measurement in the process of using the sphygmomanometer, thereby naturally recording the electrocardiogram, and Also, since the electrocardiogram can provide detailed cardiac electrical activity, the information related to cardiovascular health that the device of the present invention can provide can be more detailed and precise, for example, by performing a preload on the processor in the control circuit. The calculus, or the transmission of an electrocardiogram to an external device, can be performed by performing a formula that can determine the type of arrhythmia, for example, distinguishing between PAC and PVC, and other symptoms of arrhythmia, such as AF (atrial fibrillation) , Atrial Fibrillation), slow heartbeat, fast heartbeat, heartbeat pause, etc., also know whether there are symptoms other than arrhythmia, for example, by observing the ST value (ST level) to know whether there is myocardial infarction, or observation The amplitude of the QRS wave is used to determine whether there is ventricular hypertrophy or the like.
進一步地,透過血壓讀值與心電圖間彼此的相關性,兩種訊號間將可進行相互參照,以獲得代表其他生理狀況的資訊,例如,PTT(脈波傳遞時間,脈波傳播通過一段動脈所花的時間),另外,動脈脈搏與心電訊號間的比較也有助於移除雜訊/人為干擾源,以取得正確之各式心血管資訊的判讀。 Further, through the correlation between the blood pressure reading and the electrocardiogram, the two signals can be cross-referenced to obtain information representing other physiological conditions, for example, PTT (pulse transit time, pulse wave propagation through a segment of the artery) In addition, the comparison between arterial pulse and ECG signal also helps to remove noise/human interference sources to obtain correct interpretation of various cardiovascular information.
此外,再進一步,根據本發明的心血管健康監測裝置亦可根據所取得的心電訊號而提供相關心率變異率(HRV,Heart rate variability)的資訊,以讓使用者藉此而瞭解自律神經活動,這是因為,自律神經系統 是影響血壓的因素之一,當交感神經的活性增加時,血管收縮會使得血壓上升,而副交感神經的活性增加則相反地可讓血壓下降。 In addition, the cardiovascular health monitoring device according to the present invention can also provide information about the heart rate variability (HRV) according to the obtained electrocardiogram signal, so that the user can understand the autonomic nerve activity. This is because the autonomic nervous system It is one of the factors that affect blood pressure. When the activity of sympathetic nerves increases, vasoconstriction causes blood pressure to rise, while the increase in parasympathetic activity decreases blood pressure.
所以,基於所具備的心電訊號測量功能,根據本發明的裝置可藉由取得精準的RRI(R-R Interval,R-R間隔)序列,亦即,心率變化,進而計算獲得HRV,並進行HRV分析,以提供相關自律神經活動的資訊,如此一來,當配合上血壓測量時,使用者就能即時瞭解血壓與自律神經之間的關係,舉例而言,可讓使用者知道高血壓的成因是否與自律神經有關,以及若已知有關,則可瞭解生理及心理上的調整,例如,放鬆,呼吸導引訓練等,是否正確地影響了自律神經,進而達成對血壓的影響。 Therefore, based on the ECG signal measurement function provided, the device according to the present invention can calculate and obtain the HRV by obtaining a precise RRI (RR Interval, RR interval) sequence, that is, a heart rate change, and perform HRV analysis to Provides information about the autonomic nervous activity, so that when combined with blood pressure measurements, the user can instantly understand the relationship between blood pressure and autonomic nerves. For example, let the user know if the cause of hypertension is self-disciplined. Nervous, and if known, can understand physiological and psychological adjustments, such as relaxation, breathing guidance training, etc., whether it correctly affects the autonomic nerves, and thus achieves an impact on blood pressure.
其中,所進行的該HRV分析可依需求而有不同選擇,例如,可進行頻域分析(Frequency domain),以獲得可用來評估整體心率變異度的總功率(Total Power,TP),可反應副交感神經活性的高頻功率(High Frequency Power,HF),可反應交感神經活性、或交感神經與副交感神經同時調控結果的低頻功率(Low Frequency Power,LF),以及可反應交感/副交感神經之活性平衡的LF/HF(低高頻功率比)等,另外,亦可在進行頻率分析後,藉由觀察頻率分佈的狀態而得知自律神經運作的和諧度;或者,也可進行時域分析(Time Domain),而獲得可作為整體心率變異度之指標的SDNN,可作為長期整體心率變異度之指標的SDANN,可作為短期整體心率變異度之指標的RMSSD,以及可用來評估心率變異度之中高頻變異的R-MSSD、NN50、及PNN50等。 The HRV analysis performed may be selected according to requirements. For example, a frequency domain may be performed to obtain total power (TP) that can be used to evaluate the overall heart rate variability, and the reaction may be reflected in the parasympathetic sense. High-frequency power (HF), which can reflect sympathetic nerve activity, or low-frequency power (LF) of sympathetic and parasympathetic nerves, and the balance of reactive sympathetic/parasympathetic nerves. LF/HF (low-frequency power ratio), etc. In addition, after performing frequency analysis, the degree of harmony of the operation of the autonomous nerve can be known by observing the state of the frequency distribution; or, time domain analysis can also be performed (Time Domain), which obtains an SDNN that can be used as an indicator of overall heart rate variability, can be used as an indicator of long-term overall heart rate variability, SDANN, as an indicator of short-term overall heart rate variability, and can be used to estimate high frequency in heart rate variability. Variant R-MSSD, NN50, and PNN50.
在此,需要注意地是,透過心電訊號而取得RRI序列的程序可在血壓測量之前或之後進行,只需能即時反應當下之血壓值與自律神經 間的關係即可,沒有限制;另外,由於進行HRV分析所需的取樣時間較長,例如,一般而言約需5分鐘的時間,且需要使用者處於放鬆的狀態,因此,可進一步選擇在電極與皮膚間的接觸不需使用者自行施力的情形下進行,例如,採用耳戴結構或指戴結構而承載電極時,或者在電極透過環繞壓脈帶而接觸皮膚的情形下進行,因此,同樣可依使用者使用習慣而選擇,沒有限制。 Here, it should be noted that the procedure for obtaining the RRI sequence through the ECG signal can be performed before or after the blood pressure measurement, and it is only necessary to immediately respond to the current blood pressure value and the autonomic nerve. The relationship between the two is OK, and there is no limitation; in addition, since the sampling time required for the HRV analysis is long, for example, it takes about 5 minutes in general, and the user is required to be in a relaxed state, it is further possible to select The contact between the electrode and the skin is performed without the user's own force, for example, when the electrode is carried by the ear-wearing structure or the finger-wearing structure, or when the electrode is in contact with the skin through the surrounding venous belt, , can also be selected according to user habits, no restrictions.
當執行完測量後,根據本發明的心血管健康監測裝置可透過顯示元件而讓使用者得知測量結果,例如,血壓讀值、平均心率、心律不整指示、心率變異率參數等;另外,進一步地,根據本發明的裝置亦可包括一記憶體,以用來儲存訊號、分析結果、及/或相關的資訊,而在一較佳實施例中,該記憶體則實施為可移除式記憶體的形式,以讓使用者可方便地進行資料傳輸、或可帶著儲存有測量/分析結果的可移除式記憶體至門診諮詢醫生;此外,根據本發明裝置亦可進一步包括一通訊模組,以執行一有線通訊,例如,USB連接,或無線通訊,例如,藍芽或WIFI,而將所取得的訊號、測量/分析結果等資料傳送至一外部裝置,例如,個人電腦,智慧型手機,平板電腦,智慧手錶等,以進行顯示及/或執行進一步的計算及分析,在此,與該外部裝置間的傳輸亦可進一步實施為即時傳輸,沒有限制。 After performing the measurement, the cardiovascular health monitoring device according to the present invention can let the user know the measurement result through the display element, for example, blood pressure reading, average heart rate, arrhythmia indication, heart rate variability parameter, etc.; The device according to the present invention may also include a memory for storing signals, analysis results, and/or related information. In a preferred embodiment, the memory is implemented as a removable memory. The form of the body is such that the user can conveniently carry out data transmission, or can bring the removable memory storing the measurement/analysis result to the clinic consultation doctor; furthermore, the device according to the invention can further comprise a communication module Grouping to perform a wired communication, such as a USB connection, or wireless communication, such as Bluetooth or WIFI, to transmit the acquired signals, measurement/analysis results, etc. to an external device, such as a personal computer, smart Mobile phones, tablets, smart watches, etc. for display and/or further calculations and analysis, where transmissions to and from the external device are also possible Step by step for the immediate transmission, there is no limit.
因此,由上述可知,透過本發明電極位置的設計,使用者可自然且方便地於測量血壓期間同時記錄下心電圖,然而,由於心律不整並非每次測量血壓時都會發生,但血壓值卻是需要每日定時且長期進行記錄的生理訊號,因此,在本發明另一方面的構想中,亦提供了在僅進行血壓 測量的情況下先行篩選是否具有心律不整事件的機制,如此一來,使用者就可選擇在篩選出有心律不整可能事件後再進行心電訊號的測量即可。 Therefore, it can be seen from the above that through the design of the electrode position of the present invention, the user can naturally and conveniently record the electrocardiogram while measuring the blood pressure. However, since the arrhythmia is not always generated every time the blood pressure is measured, the blood pressure value is required. Physiological signals recorded on a regular and long-term basis, therefore, in the concept of another aspect of the present invention, blood pressure is also provided only In the case of measurement, the mechanism for screening for arrhythmia event is first screened, so that the user can select the ECG signal after screening for a possible arrhythmia event.
而可進行如此之先行篩選的基礎則在於,測量血壓的過程中,壓脈帶的充氣除了可測得血壓值外,亦可偵測到動脈脈搏,因此,透過分析連續動脈脈搏就可得知與脈搏相對應之心臟跳動情形,進而篩選出是否有心律不整可能事件,例如,早發性收縮(Premature Beats),心室顫動(AF,Atrial Fibrillation),心跳過快(Tachycardia)、心跳過慢(Bradycardia)、心跳暫停(Pause)等各種症狀。 The basis for such an advance screening is that during the measurement of blood pressure, the inflation of the cuff can detect the arterial pulse in addition to the blood pressure value. Therefore, it can be known by analyzing the continuous arterial pulse. The heartbeat situation corresponding to the pulse, and then screen for possible arrhythmia possible events, such as Premature Beats, Atrial Fibrillation, Tachycardia, Slow Heartbeat Bradycardia), Pause and other symptoms.
所以,為了達到上述的目的,根據本發明的心血管健康監測裝置,進一步實施為具有心律不整偵測單元,通知資訊產生單元,以及心電圖分析單元。 Therefore, in order to achieve the above object, the cardiovascular health monitoring device according to the present invention is further implemented to have a cardiac arrhythmia detecting unit, a notification information generating unit, and an electrocardiogram analyzing unit.
其中,該心律不整偵測單元可根據血壓測量期間透過壓脈帶所取得的連續動脈脈搏而判斷是否具有一心律不整可能事件;該通知資訊產生單元可用以在血壓測量期間及/或結束後產生通知資訊,以供使用者瞭解已出現心律不整可能事件,並提醒使用者進行心電訊號測量;該心電圖分析單元則可藉由分析所取得之心電圖,而提供更多相關心臟的資訊,例如,透過分析波形可得知心律不整的種類以及是否有其他心臟症狀等資訊。 Wherein, the arrhythmia detecting unit can determine whether there is a cardiac arrhythmia possible event according to the continuous arterial pulse obtained through the cuff during the blood pressure measurement; the notification information generating unit can be used to generate during and/or after the blood pressure measurement Notification information for users to understand the possible occurrence of arrhythmia and remind the user to perform ECG measurement; the ECG analysis unit can provide more information about the heart by analyzing the obtained ECG, for example, By analyzing the waveform, you can find out the type of arrhythmia and whether there are other heart symptoms.
所以,如第31圖所示,當使用者進行血壓測量時,其可如一般進行血壓量測一樣,將充氣式綁帶設置於肢體上,例如,上臂或手腕,並開始充氣程序,此時,除了取得血壓讀值外,亦同時會取得動脈脈搏,因此該心律不整偵測單元即可利用所取得的脈搏而判定是否出現心律不整可能事件,之後,若判斷結果發現並未出現心律不整可能事件,則如一般 的血壓測量一樣,使用者可得知所測得的血壓值以及平均心率,而若判斷結果顯示具有心律不整可能事件時,則除了血壓讀值及平均心率等測量血壓時可獲得的資訊外,該通知資訊產生單元會藉由產生通知資訊而讓使用者即時得知已偵測到心律不整可能事件,並提醒使用者需進行心電訊號測量,同時間,根據本發明的心血管健康監測裝置即進入一可測量心電訊號的狀態,以讓使用者可因此而記錄下心電圖,之後,該心電圖分析單元即可藉由分析心電圖而進一步提供使用者更多有關心臟的資訊。 Therefore, as shown in Fig. 31, when the user performs blood pressure measurement, the inflatable strap can be placed on the limb, for example, the upper arm or the wrist, as in the general blood pressure measurement, and the inflation procedure is started. In addition to obtaining the blood pressure reading value, the arterial pulse is also acquired. Therefore, the arrhythmia detecting unit can use the obtained pulse to determine whether arrhythmia may occur. After the judgment, it is found that there is no arrhythmia. Event, as usual Like the blood pressure measurement, the user can know the measured blood pressure value and the average heart rate, and if the judgment result shows that there is a possible event of arrhythmia, in addition to the information available when blood pressure is measured, such as blood pressure reading and average heart rate, The notification information generating unit causes the user to immediately know that the arrhythmia possible event has been detected by generating the notification information, and reminds the user that the ECG signal measurement is required, and at the same time, the cardiovascular health monitoring device according to the present invention Entering a state in which the ECG signal can be measured, so that the user can record the electrocardiogram, and then the ECG analysis unit can further provide the user with more information about the heart by analyzing the electrocardiogram.
因此,透過這樣的方式,使用者無須改變使用習慣,可利用與測量血壓相同的操作方式進行血壓測量,只需在出現心律不整可能事件時藉由接觸與血壓計整合在一起的電極進行心電訊號測量而記錄下心電圖,就可立即得知根據心電圖的分析結果,故不僅操作使用上方便,亦有助於獲得更具正確性之相關心律不整的資訊。 Therefore, in this way, the user does not need to change the usage habits, and the blood pressure measurement can be performed by the same operation method as the blood pressure measurement, and the electrocardiogram can be performed by contacting the electrode integrated with the sphygmomanometer in the event of arrhythmia possible event. When the electrocardiogram is recorded and the electrocardiogram is recorded, the analysis result according to the electrocardiogram can be immediately known, so that it is not only convenient to use, but also helps to obtain more correct information about the irregular heart rhythm.
在此,需要注意地是,由於判斷心律不整可能事件的基礎在於分析動脈脈搏,因此,也可在不測量血壓的情形下,僅藉由壓脈帶的充氣而取得動脈脈搏,亦可達到同樣的效果,因此可依使用者的實際需求而變化,沒有限制。 Here, it should be noted that since the basis of the determination of the arrhythmia may be based on the analysis of the arterial pulse, it is also possible to obtain the arterial pulse only by inflation of the cuff without measuring the blood pressure. The effect can be changed according to the actual needs of the user, and there is no limit.
另外,亦需要注意地是,當於血壓測量期間、壓脈帶充氣狀態下取得動脈脈搏時,考慮到充氣不足時可能無法測得脈搏,以及充氣壓力過大時亦會對血管造成壓迫而影響測量的正確性,因此,在實際實施時,動脈脈搏的偵測可實施為僅在特定的壓脈帶充氣條件下才進行,舉例而言,可利用程式控制而設定在充氣壓力固定的情形下進行,或者,也可設定於充氣達一定壓力值(也就是,接觸力達一定程度)以上才進行脈搏測 量。 In addition, it should be noted that when the arterial pulse is obtained during the blood pressure measurement and the inflated state of the cuff, the pulse may not be measured when the inflation is insufficient, and the pressure may be impaired when the inflation pressure is too large. The correctness, therefore, in actual implementation, the detection of arterial pulse can be carried out only under a specific cuff inflation condition, for example, can be controlled by program control and set under the condition of fixed inflation pressure Or, it can be set to perform a pulse test after the inflation reaches a certain pressure value (that is, the contact force reaches a certain level). the amount.
取得連續動脈脈搏後,該心律不整偵測單元在分析該連續動脈脈搏時,採用的方式是,先分別計算出每個脈搏間的時間間隔,以得出脈搏的時間序列特徵,之後,再將此時間序列特徵與各種心律不整種類的時間序列特徵,例如,早發性收縮、AF、心跳過慢、心跳過快、心跳暫停等各種心律不整症狀的時間序列特徵進行比較,並在出現相符時,判斷為具有心律不整可能事件。 After obtaining the continuous arterial pulse, the arrhythmia detecting unit analyzes the continuous arterial pulse by first calculating the time interval between each pulse to obtain the time series characteristic of the pulse, and then This time series feature is compared with the time series features of various types of arrhythmia, such as early-onset contraction, AF, slow heartbeat, fast heartbeat, heartbeat pause, etc., and when there is a coincidence It is judged to have a possible event of arrhythmia.
在此,具優勢地,本發明在偵測是否具有心律不整可能事件時,可適度地透過調整演算式的參數值而提高偵測的靈敏度,因為只需透過分析隨後進行之心電訊號測量所獲得的心電圖,就可立即確認該心律不整可能事件的正確與否,如此一來,即使靈敏度提高亦不容易產生誤判,因此,透過本發明的概念,就可自然地達到高準確率的判斷結果,並有效改善習知技術所可能出現的判斷誤差。 Advantageously, the present invention can appropriately improve the sensitivity of the detection by adjusting the parameter values of the calculus when detecting whether there is a possible event of arrhythmia, because only the subsequent ECG measurement is performed through analysis. The obtained electrocardiogram can immediately confirm the correctness of the possible event of the arrhythmia, so that even if the sensitivity is improved, it is not easy to cause misjudgment. Therefore, the concept of the present invention can naturally achieve the high-accuracy judgment result. And effectively improve the judgment errors that may occur in the prior art.
當該心律不整偵測單元判斷為具有心律不整可能事件時,該通知資訊產生單元即產生通知資訊,以讓使用者得知已偵測到心律不整可能事件,並提醒使用者進行心電訊號測量,在此,該通知資訊可於脈搏測量期間及/或測量結束後產生,沒有限制,並且,通知資訊的內容及通知方式亦可依實際實施方式不同而改變,舉例而言,在一較佳實施例中,可在血壓測量完成後,如第32圖所示,於螢幕上亮起ECG測量提示符號,以讓使用者知道需要進一步進行心電訊號測量,且更進一步地,該ECG測量提示符號除了亮起外,亦可同時閃爍,並在使用者開始進行心電訊號測量後才熄滅,以加強提醒使用者的效果;在一另一較佳實施例中,可藉由另一 種符號來表示偵測到心律不整可能事件,而讓使用者知道出現了心律不整可能事件,需要進行心電訊號測量,例如,第33圖顯示利用RHYTHM表示偵測到有關心率方面的問題,例如,AF,心跳過快,心跳過慢,心跳暫停等;更進一步地,於再一較佳實施例中,則是可以藉由同時顯示ECG測量提示符號以及RHYTHM符號的方式,如第34圖所示,而提醒使用者進行心電訊號測量,因此,沒有限制,可以有各種可能,只需能夠清楚的讓使用者得知已測得心律不整可能事件,並達到提醒使用者進行心電訊號測量的效果即可。 When the arrhythmia detecting unit determines that there is a possible arrhythmia event, the notification information generating unit generates a notification information to let the user know that the arrhythmia event has been detected, and reminds the user to perform the ECG measurement. Here, the notification information may be generated during the pulse measurement period and/or after the measurement is completed, and there is no limitation, and the content of the notification information and the notification manner may also be changed according to actual implementation manners, for example, in a preferred implementation. In the example, after the blood pressure measurement is completed, as shown in Fig. 32, the ECG measurement prompt symbol is illuminated on the screen to let the user know that further ECG measurement is needed, and further, the ECG measurement prompt symbol In addition to being lit, it can also flash at the same time and is extinguished after the user starts measuring the ECG signal to enhance the effect of reminding the user; in another preferred embodiment, the other can be Symbols to indicate the detection of arrhythmia possible events, and let the user know that there is a possible arrhythmia event, ECG measurement is required. For example, Figure 33 shows the use of RHYTHM to detect problems related to heart rate, such as , AF, fast heartbeat, slow heartbeat, heartbeat pause, etc. Further, in still another preferred embodiment, the method of simultaneously displaying the ECG measurement prompt symbol and the RHYTHM symbol can be performed, as shown in FIG. The user is reminded to perform ECG measurement. Therefore, there is no limit, and there are various possibilities. It is only necessary to clearly let the user know that the arrhythmia has been detected, and to remind the user to measure the ECG signal. The effect is fine.
在此,該通知資訊的呈現可以透過聽覺訊號、視覺訊號、及/或觸覺訊號,沒有限制,舉例而言,可以如上所述地採用螢幕顯示的方式,例如,藉由符號或文字的變化,另外,也可透過其他方式呈現予使用者,例如,透過燈號變化,語音或聲音,或振動等方式,沒有限制,主要在於讓使用者可清楚地得知資訊的內容;另外,該通知資訊亦可透過外部裝置而呈現,例如,可無線傳送至智慧型手機、平板電腦、智慧手錶等進行顯示,以進一步方便使用者得知資訊。 Here, the notification information may be presented through an audible signal, a visual signal, and/or a haptic signal without limitation. For example, the display may be performed as described above, for example, by a symbol or a text change. In addition, it can be presented to the user in other ways, for example, by changing the signal, voice or sound, or vibrating, etc., without limitation, mainly to enable the user to clearly know the content of the information; It can also be presented through an external device, for example, wirelessly transmitted to a smart phone, tablet, smart watch, etc. for display to further facilitate the user to know the information.
而在產生通知資訊後,根據本發明的心血管健康監測裝置隨即進入可測量心電訊號的狀態,以讓使用者可藉由接觸電極而進行心電訊號測量。在此,基於電極設置位置的不同,操作程序會有些許差異,舉例而言,若已有電極結合於綁帶上,則使用者只需再接觸另一個電極即可,例如,戴上耳戴結構、指戴結構、腕戴結構、按壓在殼體表面的電極、或是按壓在綁帶外側的電極等;或者替代地,當綁帶上未結合有電極時,則可透過另外的兩個電極而進行心電訊號測量,例如,同時戴上耳戴結構及 指戴結構,兩手戴上指戴結構,戴上耳戴結構後手指按壓殼體表面上的電極,或一手戴上指戴結構後另一手按壓殼體表面的電極等;或者替代地,當二電極同時位在殼體表面上時,也可透過直接藉由手持殼體並接觸其中一個電極,再將另一電極接觸另一手或軀幹的方式而進行心電訊號測量;又或者替代地,當二個電極實施為同時位在連接至殼體的另一個可握持殼體上時,同樣可藉由手持該可握持殼體並接觸其中一電極,再將另一電極接觸另一手或軀幹的方式而執行心電訊號測量,因此,可依實際實施的情形而選用不同的電極設計及配置,沒有限制。 After the notification information is generated, the cardiovascular health monitoring device according to the present invention then enters a state in which the ECG signal can be measured, so that the user can perform ECG measurement by contacting the electrodes. Here, depending on the position of the electrodes, the operating procedure may be slightly different. For example, if an existing electrode is attached to the strap, the user only needs to touch another electrode, for example, wearing an ear. a structure, a finger-wearing structure, a wrist-worn structure, an electrode pressed against a surface of the casing, or an electrode pressed on the outside of the strap; or alternatively, when the strap is not bonded to the strap, the other two are Electrocardiographic measurement with electrodes, for example, wearing an ear-worn structure and Refers to the wearing structure, wearing the finger-wearing structure on both hands, pressing the electrode on the surface of the casing after wearing the ear-wearing structure, or pressing the electrode on the surface of the casing with the other hand after wearing the finger-wearing structure; or alternatively, when When the electrode is simultaneously positioned on the surface of the casing, the electrocardiographic signal can also be measured by directly contacting the one of the electrodes by touching the one of the electrodes, and then contacting the other electrode with the other hand or the torso; or alternatively, when When the two electrodes are simultaneously positioned on the other of the holdable housings connected to the housing, the other electrode or the torso can also be contacted by holding the handleable housing and contacting one of the electrodes The ECG measurement is performed in a manner such that different electrode designs and configurations can be selected depending on the actual implementation, without limitation.
此外,心電訊號測量的起始亦可有不同的選擇,舉例而言,可由使用者自行決定開始的時間而按下啟動鍵,或者可由阻抗檢測得知電極與皮膚間的接觸情形,並在確定電極接觸已可進行測量後,自動開始測量,舉例而言,當裝置進入可測量心電訊號狀態後,即開始進行阻抗檢測,等待使用者配戴及/或接觸電極,並在阻抗檢測的結果顯示電極接觸已可進行心電訊號測量時,自動開始測量,例如,藉由螢幕顯示或聲音通知使用者電極接觸已達成,心電訊號測量即將開始;或者,亦可在裝置進入可測量心電訊號狀態後,如前所述地,先藉由感應器感應電極是否已位在適當的接觸位置,之後再開始進行阻抗檢測,並於阻抗檢測結果顯示電極與皮膚間的接觸已完成時,自動開始測量。因此,沒有限制,可以有各種選擇 In addition, the start of the ECG signal measurement may also have different options. For example, the start time may be pressed by the user to determine the start time, or the contact between the electrode and the skin may be known by impedance detection, and After determining that the electrode contact has been measured, the measurement is automatically started. For example, when the device enters the measurable ECG state, the impedance detection is started, waiting for the user to wear and/or contact the electrode, and in the impedance detection. The result shows that when the electrode contact is ready for ECG measurement, the measurement is automatically started. For example, by the screen display or sound to inform the user that the electrode contact has been reached, the ECG signal measurement is about to start; or, the device can enter the measurable heart. After the state of the electrical signal, as described above, it is first sensed by the sensor whether the electrode is in the proper contact position, and then the impedance detection is started, and when the impedance detection result indicates that the contact between the electrode and the skin has been completed, The measurement starts automatically. Therefore, there is no limit and there are various options.
在取得心電圖後,該心電圖分析單元即針對所取得的心電圖而進行分析,以提供相關心臟的進一步資訊。由於心電圖可提供詳細的心臟電氣活動,因此,透過分析心電圖,首先,可確認該心律不整偵測單元所測得的心律不整可能事件的準確度,之後,還可得知心律不整的種類, 例如,分辨PAC以及PVC,以及準確地判斷心跳過慢、心跳過快、AF、心跳暫停等症狀,再者,亦可得知是否有其他的心臟疾病,例如,透過觀察ST值可得知是否具有心肌梗塞之症狀,以及觀察QRS波的振幅可得知是否有心室肥大等,如此一來,使用者在篩選出有心律不整可能的當下,就可立即藉由得自心電圖的進一步完整資訊而立即掌握心臟的狀況,以作為是否需要諮詢醫生的參考。 After obtaining the electrocardiogram, the electrocardiogram analysis unit analyzes the acquired electrocardiogram to provide further information about the relevant heart. Since the electrocardiogram can provide detailed cardiac electrical activity, by analyzing the electrocardiogram, firstly, the accuracy of the arrhythmia possible event measured by the arrhythmia detecting unit can be confirmed, and then the type of arrhythmia can be known. For example, distinguishing between PAC and PVC, and accurately determining symptoms such as slow heartbeat, fast heartbeat, AF, and heartbeat pause, and further, whether there are other heart diseases, for example, by observing the ST value, it is known whether With the symptoms of myocardial infarction, and observing the amplitude of the QRS wave, it can be known whether there is ventricular hypertrophy, etc., so that the user can immediately obtain further complete information from the electrocardiogram when screening for the possibility of arrhythmia. Immediately grasp the condition of the heart as a reference for the need to consult a doctor.
綜上所述,本發明提供了一種心血管健康監測裝置,其具有血壓測量及心電訊號測量兩種功能,且在遵從習知血壓計操作行為的原則下,將進行心電訊號測量所需的心電電極安裝步驟融入測量血壓的流程中,達成不增加操作複雜度的效果,再者,藉由血壓計於一般家庭中的普及性,可使心電訊號測量於居家有更高的接受度,而且,基於血壓及心電圖之間的關聯性,本發明還可據以提供更多相關心血管的資訊,以作為居家健康管理及臨床判斷的參考。 In summary, the present invention provides a cardiovascular health monitoring device having two functions of blood pressure measurement and electrocardiographic measurement, and is required for ECG measurement under the principle of obeying the operational behavior of a conventional sphygmomanometer. The ECG electrode installation step is integrated into the blood pressure measurement process to achieve the effect of not increasing the complexity of the operation. Furthermore, the popularity of the sphygmomanometer in the general household can make the ECG signal measurement more acceptable at home. Moreover, based on the correlation between blood pressure and electrocardiogram, the present invention can also provide more relevant cardiovascular information as a reference for home health management and clinical judgment.
再者,本發明亦進一步提供特殊的心電電極結構設計及設置位置選擇,以提高所取得之心電訊號的品質,更有利於獲得更準確的分析結果,其中,透過主動對皮膚施力的配戴結構,例如,耳戴結構,指戴結構,腕戴結構,以及透過環繞壓脈帶時可同時達成的結構設計,例如,殼體表面的承載結構,及與壓脈帶相結合的電極結構,根據本發明可提供穩定之電極與皮膚間的接觸,且可將肌電訊號與人為干擾源的影響降至最小。 Furthermore, the present invention further provides a special electrocardiographic electrode structure design and setting position selection to improve the quality of the obtained electrocardiogram signal, and is more conducive to obtaining more accurate analysis results, wherein the active force is applied to the skin. Wearing structure, for example, an ear-wearing structure, a finger-wearing structure, a wrist-worn structure, and a structural design that can be simultaneously achieved by wrapping around the cuff, for example, a bearing structure on the surface of the casing, and an electrode combined with the cuff The structure according to the present invention provides stable electrode-to-skin contact and minimizes the effects of myoelectric signals and sources of human interference.
此外,本發明亦提供了先行篩選是否具有心律不整可能事件後再測量心電圖進行確認的機制,因此,使用者同樣可以在不改變血壓測量之操作流程的情形下,自然地得知是否有心律不整可能事件,且只要在 察看測量結果時發現出現了提醒需進行心電訊號測量的訊號時,再進一步執行心電訊號測量,就可立即得知正確的相關心律不整資訊,而且,由於心電訊號測量所需之電極已整合於血壓計上,只需直接接觸即可進行測量,避免了使用其他裝置的不方便性,也節省了購置成本,確實為關心自身心血管健康的使用者提供了更自然且方便的選擇。 In addition, the present invention also provides a mechanism for screening whether the electrocardiogram is confirmed after having a possible arrhythmia event. Therefore, the user can naturally know whether there is arrhythmia without changing the operation procedure of the blood pressure measurement. Possible event, and as long as When you look at the measurement results and find that there is a signal to remind you that ECG measurement is needed, you can immediately know the correct related arrhythmia information by further performing the ECG measurement. Moreover, since the electrodes required for ECG measurement have been Integrated into the sphygmomanometer, it can be measured with direct contact, avoiding the inconvenience of using other devices, saving the cost of purchase, and providing a more natural and convenient choice for users who care about their cardiovascular health.
10‧‧‧控制電路 10‧‧‧Control circuit
12‧‧‧充氣式壓脈帶 12‧‧‧Inflatable cuff
14‧‧‧店 14‧‧‧ shop
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