TWI555513B - Monitoring device and monitoring method of stenosis - Google Patents

Monitoring device and monitoring method of stenosis Download PDF

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TWI555513B
TWI555513B TW103118455A TW103118455A TWI555513B TW I555513 B TWI555513 B TW I555513B TW 103118455 A TW103118455 A TW 103118455A TW 103118455 A TW103118455 A TW 103118455A TW I555513 B TWI555513 B TW I555513B
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tube
narrowing
transform
frequency domain
time domain
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TW103118455A
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TW201544078A (en
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王憲奕
王志中
林伯昰
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奇美醫療財團法人奇美醫院
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管體窄化監測裝置及其監測方法 Tube narrowing monitoring device and monitoring method thereof

本發明係有關於一種管體窄化監測裝置及其監測方法,尤指利用一音訊感測單元所設之隔音部消除外部噪音干擾以提高該管體之聲音訊信號擷取的精確性及完整性,以利後續訊號解析輔助窄化狀態判斷者。 The invention relates to a tube narrowing monitoring device and a monitoring method thereof, in particular to using an acoustical portion provided by an audio sensing unit to eliminate external noise interference to improve the accuracy and integrity of the sound signal acquisition of the tube body. Sex, in order to facilitate subsequent signal analysis to assist the narrow state judge.

按,目前藉由偵測管體內液體流動聲音以判斷管體窄化狀態的技術已被廣泛應用於各層面,其中包含對於需血液透析治療患者的動靜脈廔管窄化監測。百分之八十以上血液透析治療的動靜脈廔管常因為血管某處發生狹窄現象,造成血流不順的情形產生。這種問題較常發生在血管與人工血管的開刀吻合處、轉彎處或針頭屢次穿刺處,使得血液透析效能減低甚至無法進行。在臨床上,對於動靜脈廔管有些較輕微狹窄可透過較簡單的外科手術(通常為氣球擴張術)來使血管狹窄處恢復暢通。如血管窄化現象發現太晚,以致於血管完全阻塞後,病患可能被迫重新建立廔管或因無法即時進行透析治療,而有生命危險。 According to the current technology for detecting the narrowing state of the tube body by detecting the sound of the liquid flow in the tube body, it has been widely applied to various levels, including the monitoring of arteriovenous fistula narrowing for patients requiring hemodialysis treatment. More than 80% of hemodialysis treatment of arteriovenous fistula often occurs due to stenosis in some part of the blood vessel, resulting in blood flow. This problem occurs more frequently in the anastomosis of the blood vessel and the artificial blood vessel, at the turning point or at the repeated puncture of the needle, so that the hemodialysis performance is reduced or even impossible. Clinically, some of the minor stenosis of the arteriovenous fistula can be restored through a simpler surgical procedure (usually balloon dilation). If the phenomenon of narrowing of the blood vessels is found too late, so that the blood vessels are completely blocked, the patient may be forced to re-establish the fistula or may be life-threatening because of the inability to perform immediate dialysis treatment.

最早判斷動靜脈廔管是否狹窄,是利用聽診器聽廔管內的血流聲音,注意是否有因血管狹窄導致血液流動快速而產生的高頻血液流動聲音來判斷,但這個方法聽者必須要由有經驗者來做判讀,所以除非聽者為資深醫生或護士,其他人很難會判讀正確。當超音波發明後,就有人利用超音波的反射, 研究出能判斷某一點血管中的血流速和血流量,此方法為都卜勒超音波偵測技術。這個方法最大的好處是快速與非侵入性,但須專業的儀器操作者。更之後出現磁振攝影術、超音波稀釋技術,雖然這兩種判讀的成功率高,但這兩種皆是費時與相當昂貴。 The earliest judging whether the arteriovenous fistula is narrow or not is to use the stethoscope to listen to the blood flow sound in the fistula, and to pay attention to whether there is a high-frequency blood flow sound caused by the rapid blood flow caused by blood vessel stenosis, but this method must be judged by the listener. Experienced people come to interpret, so unless the listener is a senior doctor or nurse, it is difficult for others to correct it. When the ultrasonic wave was invented, some people used the reflection of ultrasonic waves. It was studied to determine the blood flow rate and blood flow in a certain blood vessel. This method is Doppler ultrasonic detection technology. The biggest benefit of this method is fast and non-invasive, but requires a professional instrument operator. Later, magnetic resonance photography and ultrasonic dilution techniques have appeared. Although the success rate of these two interpretations is high, both of them are time consuming and quite expensive.

目前,偵測動靜脈廔管是否狹窄,初步方法為經由醫師聽診或觸診,再依情況由其他非侵入式的醫用儀器檢查,如使用醫學超音波或血管攝影檢查的方式來觀察血流是否正常或有無狹窄,不過醫學超音波儀器成本昂貴,醫院擁有之儀器數量或也不多,且需要專門訓練之技術人員。除此之外,不論人力或這些儀器都無法對病患做長期性時間的動靜脈廔管狹窄監測。 At present, the detection of arteriovenous fistula is narrow. The initial method is to auscultate or palpate by doctor, and then check by other non-invasive medical instruments according to the situation, such as using medical ultrasound or angiography to observe blood flow. Whether it is normal or not, but medical ultrasound instruments are expensive, the number of instruments owned by hospitals is not much, and special trained technicians are needed. In addition, no manpower or these instruments can monitor patients with long-term arteriovenous fistula stenosis.

一般而言,根據2006年K-DOQI(腎臟病及透析病患治療指引)建議動靜脈廔管之功能監測可分為兩類,第一類是臨床上的監測,基本上建議每週一次,包括廔管之手臂有無水腫、廔管觸診有無血流震顫,以及透析過程中,廔管注射有無困難、廔管內有無血塊、是否不易止血及是否無法提供足夠血流量,其缺點為結果較無法一致或變動較大,可能會因人而異;而第二類是特殊儀器的監測,建議每個月一次,包括測量廔管內的血流量、測量廔管內的壓力、利用血管超音波檢視有無狹窄,其缺點為需要特殊儀器及專門訓練人員、額外花費(健保不給付),且無法於洗腎室操作。 In general, according to the 2006 K-DOQI (Guidelines for the Treatment of Kidney Diseases and Dialysis Patients), functional monitoring of arteriovenous fistulas can be divided into two categories. The first category is clinical monitoring, which is basically recommended once a week. Including the fistula arm has no edema, palpation palpation with or without blood flow tremor, and during the dialysis process, whether the fistula injection is difficult, whether there is blood clot in the fistula, whether it is difficult to stop bleeding and whether it can not provide sufficient blood flow, the shortcoming is the result Can not be consistent or variable, may vary from person to person; and the second category is the monitoring of special instruments, recommended once a month, including measuring blood flow in the fistula, measuring the pressure inside the fistula, using vascular ultrasound The presence or absence of stenosis is limited by the need for special equipment and specialized training personnel, additional costs (not covered by health insurance), and cannot be operated in the dialysis room.

中華民國專利證號I243048揭示一種監測血流聲音裝置,包括:一殼體;一麥克風,將音頻訊號轉換為具電訊號之特性的一種聲電轉換元件,可隱藏嵌裝於該殼體;一訊號處理電路單元,將音頻轉換元件輸出的電訊號傳送至訊號處理電路,做即時訊號處理並輸出訊號,可隱藏嵌裝於該殼體;一輸出單元,呈現由訊號處理電路裝置輸出訊號之結果;將該麥克風直接及長時間 放置於廔管外側,幫助患者監測廔管之血流流動現況或紀錄廔管之血流情形,使患者可以在廔管血流不通順時,第一時間到醫院進行診療。惟,該專利所揭示利用麥克風對廔管內血流偵測收音時,會一起將環境中的噪音收集進去,造成干擾而影響偵測的精確性,甚至影響後續分析判斷的結果;且前述訊號處理之方式係採用離散傅立葉演算做訊號頻譜分析,而使其頻譜分析的解析度不佳。 因此仍有相當改善的空間。 The Republic of China Patent No. I243048 discloses a device for monitoring blood flow sounds, comprising: a casing; a microphone for converting an audio signal into an acoustic-electrical conversion element having the characteristics of an electric signal, which can be hidden and embedded in the casing; The signal processing circuit unit transmits the electrical signal outputted by the audio conversion component to the signal processing circuit for instant signal processing and outputting signals, which can be hidden and embedded in the casing; an output unit presents the result of the signal output by the signal processing circuit device ; the microphone directly and for a long time Placed on the outside of the fistula to help the patient monitor the blood flow of the fistula or record the blood flow of the fistula, so that the patient can go to the hospital for treatment at the first time when the blood flow in the fistula is not smooth. However, the patent discloses that when the microphone is used to detect the blood flow in the fistula, the noise in the environment is collected together, causing interference and affecting the accuracy of the detection, and even affecting the results of subsequent analysis and judgment; The method of processing is to use discrete Fourier calculus for signal spectrum analysis, and the resolution of its spectrum analysis is not good. Therefore there is still considerable room for improvement.

爰此,本發明人有鑑於現有管體之聲音監測之缺失再予以研究,提供一種管體窄化監測裝置,以期達到提高聲音訊號擷取的精確性及完整性之目的。 Accordingly, the inventors have further studied the lack of sound monitoring of the existing pipe body, and provided a pipe narrowing monitoring device for the purpose of improving the accuracy and integrity of the sound signal acquisition.

首先,本發明提供一種管體窄化監測裝置,其包括有: 一音訊感測單元,包含一隔音部,該隔音部具一內側面且在該內側面設置有一音訊探頭,藉消除外部噪音干擾並收集受測之該管體之一聲音訊號;一音訊轉換模組,用以接收該聲音訊號並將其轉換為一電訊號;一微處理器,與該音訊轉換模組電性連接,用以接收該電訊號並透過運算處理,以獲得一時域-頻域特徵圖案;一圖案辨識模組,與該微處理器電性連接,包括有一資料儲存單元及一比對單元,該資料儲存單元儲存有一標準化時域-頻域特徵圖案資料,該比對單元則接收受測之該管體的時域-頻域特徵圖案並與該標準化時域-頻域特徵圖案資料進行比對,並輸出一比對結果至該微處理器;一顯示單元,與該微處理器電性連接,用以呈現該比對結果。 First, the present invention provides a tube narrowing monitoring device, which comprises: An audio sensing unit includes a soundproof portion having an inner side surface and an audio probe disposed on the inner side surface to eliminate external noise interference and collect an audio signal of the tube body to be tested; an audio conversion module a group for receiving the sound signal and converting it into a signal signal; a microprocessor electrically connected to the audio conversion module for receiving the electrical signal and performing an operation process to obtain a time domain-frequency domain a pattern recognition module, electrically connected to the microprocessor, comprising a data storage unit and a comparison unit, wherein the data storage unit stores a standardized time domain-frequency domain feature pattern data, and the comparison unit is Receiving a time domain-frequency domain feature pattern of the tested body and comparing the normalized time domain-frequency domain feature pattern data, and outputting a comparison result to the microprocessor; a display unit, and the micro The processor is electrically connected to present the comparison result.

進一步,更包括有分別與該微處理器電性連接之一前置過濾放大模組、一資料輸入模組、一無線傳輸模組以及一驅動電源。 Further, the method further includes a pre-filter amplification module, a data input module, a wireless transmission module, and a driving power source respectively electrically connected to the microprocessor.

進一步,該標準化時域-頻域特徵圖案資料包括有:在未窄化狀態下,該管體內液體流動產生的時域-頻域特徵圖案,以及該管體在各種不同窄化狀態下之液體流動所產生的複數時域-頻域特徵圖案。 Further, the standardized time domain-frequency domain characteristic pattern data includes: a time domain-frequency domain characteristic pattern generated by the liquid flow in the tube in an unnarrowed state, and a liquid of the tube body in various narrowing states. The complex time-domain-frequency domain pattern produced by the flow.

進一步,該隔音部係可撓性材質製成,且該隔音部之內側面設有一吸音材製成之消音層。 Further, the sound insulating portion is made of a flexible material, and the inner side surface of the sound insulating portion is provided with a sound absorbing layer made of a sound absorbing material.

進一步,該電訊號經運算處理之方式包括有短時距傅立葉變換(Short-Time Fourier Transform,STFT)、連續小波變換(Continuous Wavelet Transform,CWT)或S變換(S-Transform)其中之一。 Further, the manner in which the electrical signal is processed includes one of a Short-Time Fourier Transform (STFT), a Continuous Wavelet Transform (CWT), or an S-Transform (S-Transform).

進一步,所述之S變換(S-Transform)係採用: 其中,S(τf)表示該管體內液體流動之聲音x(t)的S變換值,τf分別表示S變換的時間位置和頻率。 Further, the S-transform (S-Transform) is: Where S( τ , f ) represents the S-transformed value of the sound x(t) of the liquid flow in the tube, and τ and f represent the time position and frequency of the S-transform, respectively.

本發明再提供一種管體窄化監測方法,其步驟包括有:利用一音訊感測單元偵測不受外部噪音干擾之一管體的一聲音訊號;將該聲音訊號轉換成為一電訊號並經濾波及放大增益處理;將該電訊號經運算處理以獲得一時域-頻域特徵圖案;將該時域-頻域特徵圖案與預先建立的一標準化時域-頻域特徵圖案資料進行比對,藉以輸出一比對結果。 The invention further provides a tube narrowing monitoring method, which comprises the steps of: detecting, by an audio sensing unit, an audio signal of a tube body that is not interfered by external noise; converting the sound signal into an electrical signal and Filtering and amplifying gain processing; the electrical signal is processed to obtain a time domain-frequency domain feature pattern; and the time domain-frequency domain feature pattern is compared with a pre-established normalized time domain-frequency domain feature pattern data, In order to output a comparison result.

進一步,該電訊號經運算處理之步驟進一步包括:擷取該電訊號中具週期性之區段作為後續分析的基塊;將該基塊進行時域-頻域(time-frequency domain)上的演算分析,並提取出其特徵;利用該特徵建立該時域-頻域特徵圖案。 Further, the step of processing the electrical signal further comprises: extracting a periodic segment of the electrical signal as a base block for subsequent analysis; and performing the base block on a time-frequency domain The calculus analysis and extracting its features; using the feature to establish the time domain-frequency domain feature pattern.

本發明的功效在於: The effect of the invention is:

1.本發明中該隔音部可隔絕或吸收外部噪音,且藉由該隔音部之可撓特性於套上該管體處後束緊,增加隔音效果,以減低對該音訊探頭收集聲音訊號所造成的干擾影響,進而提高聲音訊號信號擷取的精確性及完整性。 1. In the present invention, the sound insulation portion can isolate or absorb external noise, and the flexible property of the sound insulation portion is tightened after being placed on the tube body to increase the sound insulation effect, so as to reduce the sound signal collected by the audio probe. The resulting interference effects, which in turn improve the accuracy and integrity of the sound signal acquisition.

2.本發明之管體窄化監測裝置係以非侵入之方式進行監測,在監測過程中不會造成該管體的損傷。 2. The tube narrowing monitoring device of the present invention is monitored in a non-invasive manner, and the tube body is not damaged during the monitoring process.

3.本發明之管體窄化監測方法係採用前述運算處理方法對所偵測之聲音訊號進行時域-頻域的圖案轉換並擷取其圖案特徵作為後續比對的對象,以獲得較佳解析的比對結果。 3. The tube narrowing monitoring method of the present invention adopts the foregoing arithmetic processing method to perform time-frequency-frequency domain pattern conversion on the detected sound signal and extracts its pattern features as objects for subsequent comparison to obtain a better image. Analytical alignment results.

(1)‧‧‧管體窄化監測裝置 (1) ‧‧‧Tube narrowing monitoring device

(11)‧‧‧音訊感測單元 (11)‧‧‧Audio sensing unit

(111)‧‧‧音訊探頭 (111)‧‧‧Optical probe

(112)‧‧‧隔音部 (112) ‧ ‧ Soundproofing

(1121)‧‧‧消音層 (1121) ‧ ‧ muffler

(12)‧‧‧音訊轉換模組 (12)‧‧‧Audio conversion module

(13)‧‧‧微處理器 (13)‧‧‧Microprocessor

(14)‧‧‧圖案辨識模組 (14)‧‧‧ pattern recognition module

(141)‧‧‧資料儲存單元 (141)‧‧‧ Data Storage Unit

(142)‧‧‧比對單元 (142) ‧ ‧ aligning unit

(15)‧‧‧顯示單元 (15)‧‧‧Display unit

(16)‧‧‧前置過濾放大模組 (16)‧‧‧Pre-filter amplification module

(17)‧‧‧資料輸入模組 (17)‧‧‧ Data Input Module

(18)‧‧‧無線傳輸模組 (18)‧‧‧Wireless Transmission Module

(19)‧‧‧驅動電源 (19)‧‧‧Drive power supply

(2)‧‧‧筆記型電腦 (2) ‧‧‧Note Computer

(A)‧‧‧廔管 (A) ‧ ‧ 廔

[第一圖]係為本發明之管體窄化監測裝置立體圖。 [First figure] is a perspective view of the tube narrowing monitoring device of the present invention.

[第二圖]係為本發明之管體窄化監測裝置電路方塊圖。 [Second figure] is a circuit block diagram of the tube narrowing monitoring device of the present invention.

[第三圖]係為本發明之管體窄化監測方法流程圖。 [Third image] is a flow chart of the method for monitoring the narrowing of the pipe body of the present invention.

[第四圖]係為本發明之管體窄化監測裝置使用示意圖。 [Fourth figure] is a schematic view showing the use of the tube narrowing monitoring device of the present invention.

為了讓本發明之上述和其他目的、特徵、和優點能更明顯易懂,下文特舉較佳實施例,並配合所附圖示,作詳細說明如下:首先,請參閱第一圖及第二圖所示,係本發明之管體窄化監測裝置立體圖,本發明之管體窄化監測裝置(1),用於偵測一管體內液體流動之聲音,因此可廣泛應用於各層面,如輸水管或輸油管的堵塞窄化監測,亦或使用在需長期接受血液透析治療的患者上所設置之廔管的堵塞窄化監測,而本發明以下實施例中該管體係以廔管為範例說明,但不以此為限。該管體窄化監測 裝置(1)其包括有一音訊感測單元(11),其包含一音訊探頭(111)及一隔音部(112),該音訊探頭(111)係穿入至該隔音部(112)之內側面(圖中未表示),藉以消除外部噪音干擾並收集一管體之一聲音訊號,而該音訊探頭(111)穿入至該隔音部(112)之內側面的方式係在該隔音部(112)開設穿孔供該音訊探頭(111)穿設,使該該音訊探頭(111)與該隔音部(112)之內側面齊平;在本發明較佳實施例中,該隔音部(112)係以一可撓性材質製成之半圓形隔音罩為範例說明,但不以此為限,該隔音部(112)之內側面鋪設有一消音層(1121),該消音層(1121)係吸音材製成,用以加強消除外部噪音干擾之效果,且藉由該隔音部(112)之可撓特性可將該隔音部(112)往兩側撐開套上使用者之手臂上該管體處後因彈性回復力而束緊,使該消音層(1121)緊貼於手臂,以達較佳隔絕外部噪音的效果。 The above and other objects, features, and advantages of the present invention will become more apparent and understood. The figure shows a perspective view of the tube narrowing monitoring device of the present invention. The tube narrowing monitoring device (1) of the present invention is used for detecting the sound of liquid flow in a tube, and thus can be widely applied to various levels, such as The stagnation narrowing monitoring of the water pipe or the oil pipeline is also used, or the stagnation narrowing monitoring of the fistula provided on the patient who needs long-term hemodialysis treatment is used, and in the following embodiment of the present invention, the tube system is exemplified by the fistula tube. , but not limited to this. The tube narrowing monitoring The device (1) includes an audio sensing unit (11) including an audio probe (111) and a soundproof portion (112), the audio probe (111) penetrating into the inner side of the soundproof portion (112) (not shown), in order to eliminate external noise interference and collect an audio signal of a pipe body, and the manner in which the audio probe (111) penetrates into the inner side of the soundproof portion (112) is in the soundproof portion (112). a perforation is provided for the audio probe (111) to be disposed such that the audio probe (111) is flush with an inner side surface of the soundproof portion (112); in a preferred embodiment of the invention, the sound insulation portion (112) is A semi-circular soundproof cover made of a flexible material is exemplified, but not limited thereto, a sound-absorbing layer (1121) is disposed on the inner side of the sound-insulating portion (112), and the sound-absorbing layer (1121) is sound-absorbing. The material is made to enhance the effect of eliminating external noise interference, and the sound insulation portion (112) can be stretched on both sides of the user's arm by the flexible property of the sound insulation portion (112). After being tightened by the elastic restoring force, the sound-absorbing layer (1121) is tightly attached to the arm to achieve an effect of better shielding external noise.

一音訊轉換模組(12),用以接收該聲音訊號並將其轉換為一電訊號,而前述音訊轉換模組(12)將聲音轉換為電訊號之技術為習知之技術知識背景,如麥克風之原理,應為本發明所屬技術中具通常知識者所能瞭解,故不再詳述;一微處理器(13),係與該音訊轉換模組(12)電性連接,用以控制其他週邊電路並接收該電訊號並透過運算處理,以獲得一時域-頻域特徵圖案。 An audio conversion module (12) is configured to receive the audio signal and convert it into an electrical signal, and the audio conversion module (12) converts the sound into an electrical signal into a technical background such as a microphone. The principle of the present invention is known to those of ordinary skill in the art, and therefore will not be described in detail; a microprocessor (13) is electrically connected to the audio conversion module (12) for controlling other The peripheral circuit receives the electrical signal and performs an arithmetic process to obtain a time domain-frequency domain feature pattern.

一圖案辨識模組(14),與該微處理器(13)電性連接,包括有一資料儲存單元(141)及一比對單元(142),該資料儲存單元(141)儲存有一標準化時域-頻域特徵圖案資料,該標準化時域-頻域特徵圖案資料包括有:在未窄化狀態下,該管體內液體流動產生的時域-頻域特徵圖案,以 及該管體在各種不同窄化狀態下之液體流動所產生的複數時域-頻域特徵圖案,該比對單元(142)則接收受測之該管體的時域-頻域特徵圖案並與該標準化時域-頻域特徵圖案資料進行比對,並輸出一比對結果至該微處理器(13);一顯示單元(15),與該微處理器(13)電性連接,用以呈現該比對結果。 其中,該比對單元(142)為習知的一資料處理器,其資料處理之技術手段為本發明所屬技術領域中具通常知識者所能理解,故在此不再贅述。 A pattern recognition module (14) is electrically connected to the microprocessor (13), and includes a data storage unit (141) and a comparison unit (142). The data storage unit (141) stores a standardized time domain. a frequency domain characteristic pattern data, wherein the normalized time domain-frequency domain characteristic pattern data includes: a time domain-frequency domain characteristic pattern generated by the liquid flow in the tube in an unnarrowed state, And a complex time domain-frequency domain characteristic pattern generated by the liquid flow of the tube in various narrowed states, and the comparing unit (142) receives the time domain-frequency domain characteristic pattern of the tube to be tested and Comparing with the standardized time domain-frequency domain feature pattern data, and outputting a comparison result to the microprocessor (13); a display unit (15) electrically connected to the microprocessor (13) To present the alignment result. The aligning unit (142) is a conventional data processor. The technical means for data processing is understood by those skilled in the art, and therefore will not be described herein.

較佳的是,更包括有分別與該微處理器(13)電性連接之一前置過濾放大模組(16)、一資料輸入模組(17)、一無線傳輸模組(18)以及一驅動電源(19)。該前置過濾放大模組(16)用來將該電訊號進行放大增益及過濾高頻雜訊,使訊號無交疊情形,而前述有關聲音信號進行放大增益及過濾之技術手段係習知之技術背景知識,例如利用帶通濾波器(band-pass filter)來濾除高頻雜訊,其詳細手段內容在此便不再贅述;該資料輸入模組(17)可為按鈕、鍵盤或觸控式面板其中之一或其組合,用以操作本發明之管體窄化監測裝置(1)之選單以及輸入設定參數(如日期時間);該資料儲存單元(141)為RAM、ROM、FLASH DISK或硬碟等可儲存之相關裝置其中之一或其組合,用來儲存相關設定參數以及所量測到的各種關連性參數值及該分析結果訊號;該無線傳輸模組(18)為紅外線傳輸、無線電、Bluetooth、ZigBee、2G、2.5G、2.75G、3G、Wi-Fi或WiMAX之無線傳輸技術其中之一或其組合,用以傳輸該分析結果訊號至外部電腦或其他手持式裝置。該驅動電源(19)用以提供本發明之管體窄化監測裝置(1)所需驅動電力。其中,前述無線傳輸模組(18)為習知之技術知識,應為本發明所屬技術領域中具通常知識者所能理解,故不再詳述其技術內容。 Preferably, the method further includes a pre-filter amplification module (16), a data input module (17), and a wireless transmission module (18) electrically connected to the microprocessor (13), respectively. A drive power supply (19). The pre-filter amplifying module (16) is used for amplifying the gain of the electric signal and filtering the high-frequency noise so that the signal does not overlap, and the foregoing techniques for amplifying gain and filtering the sound signal are conventional techniques. Background information, such as the use of a band-pass filter to filter out high-frequency noise, the details of which will not be described here; the data input module (17) can be a button, keyboard or touch One or a combination of the panels for operating the menu of the tube narrowing monitoring device (1) of the present invention and inputting setting parameters (such as date and time); the data storage unit (141) is RAM, ROM, FLASH DISK Or one or a combination of storable related devices, such as a hard disk, for storing relevant setting parameters and measured correlation parameter values and the analysis result signals; the wireless transmission module (18) is infrared transmission One or a combination of wireless transmission technologies of radio, Bluetooth, ZigBee, 2G, 2.5G, 2.75G, 3G, Wi-Fi or WiMAX for transmitting the analysis result signal to an external computer or other handheld device. The driving power source (19) is for providing the driving power required for the tube narrowing monitoring device (1) of the present invention. The foregoing wireless transmission module (18) is a well-known technical knowledge and should be understood by those of ordinary skill in the art to which the present invention pertains, and the technical content thereof will not be described in detail.

再請參閱第二圖所示,係本發明之管體窄化監測裝置電路方塊圖,其中,該驅動電源(19)用以提供本發明之管體窄化監測裝置(1)所需驅動電力,該資料輸入模組(17)輸入設定參數後,該音訊感測單元(11)開始接收該管體之聲音訊號後傳送到該音訊轉換模組(12)以將該聲音訊號轉換為一電訊號,該前置過濾放大模組(16)則將該電訊號做訊號濾波及前級放大與增益調整,再將該電訊號傳送至該微處理器(13)做運算處理,以獲得一時域-頻域特徵圖案並與該資料儲存模組(141)內已預先儲存的一標準化時域-頻域特徵圖案資料進行比對,藉以輸出一比對結果至該顯示單元(15),以判斷該管體是否有堵塞窄化之情形產生。當然可同時透過該無線傳輸模組(18)將該比對結果傳送至外部電腦或其他手持式裝置,供更多人獲得該比對結果資訊。 Referring to FIG. 2 again, it is a circuit block diagram of the tube narrowing monitoring device of the present invention, wherein the driving power source (19) is used to provide the driving power required for the tube narrowing monitoring device (1) of the present invention. After the data input module (17) inputs the setting parameters, the audio sensing unit (11) starts to receive the audio signal of the tube and transmits the signal to the audio conversion module (12) to convert the audio signal into a telecommunication. No. The pre-filtering amplification module (16) performs signal filtering, pre-amplification and gain adjustment on the electrical signal, and transmits the electrical signal to the microprocessor (13) for arithmetic processing to obtain a time domain. - comparing the frequency domain feature pattern with a standardized time domain-frequency domain feature pattern data stored in the data storage module (141), thereby outputting a comparison result to the display unit (15) to determine Whether the pipe body has a narrowing of the blockage occurs. Of course, the comparison result can be transmitted to the external computer or other handheld device through the wireless transmission module (18) for more people to obtain the comparison result information.

又請參閱第三圖所示,係本發明之管體窄化監測方法,其步驟包括有:一音訊感測單元偵測不受外部噪音干擾之一管體的一聲音訊號;將該聲音訊號轉換成為一電訊號並經濾波及放大增益處理;將該電訊號經運算處理以獲得一時域-頻域特徵圖案;將該時域-頻域特徵圖案與預先建立的一標準化時域-頻域特徵圖案資料進行比對,藉以輸出一比對結果。其中,前述電訊號經運算處理之步驟進一步包含:將該電訊號進行分割以擷取某週期性區段作為後續分析的基塊;將該基塊進行時-頻域(time-frequency domain)上的演算分析,並提取出其特徵;利用該特徵建立出該時域-頻域特徵圖案(請參附件一)。 Referring to the third figure, the method for monitoring the narrowing of the tube body of the present invention includes the following steps: an audio sensing unit detects an audio signal of a tube body that is not interfered by external noise; and the sound signal is Converting into a signal and filtering and amplifying the gain processing; the signal is processed to obtain a time domain-frequency domain feature pattern; and the time domain-frequency domain feature pattern is pre-established with a standardized time domain-frequency domain The feature pattern data is compared to output a comparison result. The step of processing the electrical signal further includes: dividing the electrical signal to capture a periodic segment as a base block for subsequent analysis; and performing the base block on a time-frequency domain The calculus analysis and extraction of its features; using this feature to create the time domain-frequency domain feature pattern (see Annex I).

而前述時域-頻域(time-frequency domain)的演算分析方法,係可利用習知的短時距傅立葉變換(Short-Time Fourier Transform,STFT)、連續小波變換(Continuous Wavelet Transform,CWT)或S變換(S-Transform)等 演算方式進行分析。本發明係利用S變換(S-Transform)進行提取該管體內液體流動之聲音訊號在時間-頻率域的特徵圖案為範例說明,但不以此為限。S變換是一種運算量高的時頻分析工具,尤其在低頻部分,高斯窗(Gaussian Window)寬度變寬,頻域解析度更好,所以S變換對於低頻訊號分析比較有優勢。例如聲音訊號,人耳對高頻的部分(約大於3KHz)沒有太特別的感覺,但在低頻部分卻比較敏感,所以分析低頻訊號就顯得重要。此時,就可以使用S變換,來強調低頻訊號,而犧牲高頻訊號。S變換是一種使用漸進時頻分析的方法,類似於連續小波變換,藉以改善習知利用短時距傅立葉變換分析的解析度不佳問題。但S變換不同於小波變換,S變換相較小波變換能提供動靜脈廔管頻譜特徵更為精確的相位資訊。S變換窗ω(t)可被定義為一標準化的高斯窗函數,並使用如下公式導出: 其中,t是高斯轉換,而α是窗口寬度,其通常與頻譜的頻率f有關,因此可以被 定義為。因此,該管體內液體流動之聲音x(t)的S變換值S(τf)可用以 下公式導出: 其中τf分別表示S變換的時間位置和頻率。接著,將一個週期的聲音訊號之S變換值在時間和頻率域降低解析下建立50×10的特徵圖案。因為聲音訊號週期的時間間隔可能會有所不同,所以一個週期的聲音訊號之S變換值的時域係以10間 隔等距取樣,且在頻域係以50間隔等距取樣(請參附件二(b)圖中X軸為10間隔等距取樣之時域,Y軸為50間隔等距取樣之頻域),以建立一個標準化的特徵圖案。 藉此,如果某一次測量分析所得之特徵圖案的S變換值比標準化的特徵圖案之平均S變換值大,即判斷為異常(該管體有堵塞窄化情形);相反地,則為正常(管體無窄化情形)。換句話說,如果檢測出來所得之時域-頻域特徵圖案與標準化的時域-頻域特徵圖案不同,即可判斷該管體有堵塞窄化情形發生(請參附件二(b),上方代表未窄化管體的時域-頻域特徵圖案,下方代表管體已發生窄化的時域-頻域特徵圖案)。當然,後續還可以習知線性或非線性分類演算法(如徑向基函數神經網絡(Radial basis function neural network))來對前述時域-頻域特徵圖案進行更細部的分類和特徵圖案區分。 The aforementioned time-frequency domain calculus analysis method can utilize a known Short-Time Fourier Transform (STFT), Continuous Wavelet Transform (CWT), or S-transform (S-Transform) and other calculation methods are analyzed. The present invention uses the S-transform to extract the characteristic pattern of the sound signal of the liquid flow in the tube in the time-frequency domain as an example, but is not limited thereto. S-transformation is a time-frequency analysis tool with high computational complexity. Especially in the low-frequency part, the width of the Gaussian window is widened and the resolution in the frequency domain is better. Therefore, the S-transformation has advantages for low-frequency signal analysis. For example, the sound signal, the human ear does not have a special feeling for the high frequency part (about 3KHz), but it is sensitive in the low frequency part, so it is important to analyze the low frequency signal. At this point, you can use the S transform to emphasize low frequency signals while sacrificing high frequency signals. The S transform is a method using progressive time-frequency analysis, similar to continuous wavelet transform, to improve the poor resolution of conventional short-time Fourier transform analysis. However, the S transform is different from the wavelet transform, and the S transform phase smaller wave transform can provide more accurate phase information of the spectrum characteristics of the arteriovenous fistula. The S transform window ω(t) can be defined as a normalized Gaussian window function and derived using the following formula: Where t is the Gaussian transform and α is the window width, which is usually related to the frequency f of the spectrum and can therefore be defined as . Therefore, the S-transformed value S( τ , f ) of the sound x(t) of the liquid flow in the tube can be derived by the following formula: Where τ and f represent the time position and frequency of the S transform, respectively. Then, the S-transformed value of the sound signal of one cycle is reconstructed under the time and frequency domain to establish a 50×10 feature pattern. Because the time interval of the sound signal period may be different, the time domain of the S-transform value of the sound signal of one cycle is sampled at 10 intervals and equally spaced at 50 intervals in the frequency domain (see Annex II). (b) The X-axis in the figure is the time domain of 10 equally spaced samples, and the Y-axis is the frequency domain of 50 equally spaced samples to establish a standardized feature pattern. Therefore, if the S-transformed value of the characteristic pattern obtained by a certain measurement analysis is larger than the average S-transformed value of the normalized characteristic pattern, it is judged to be abnormal (the tube body has a blockage narrowing situation); conversely, it is normal ( There is no narrowing of the pipe body). In other words, if the detected time domain-frequency domain feature pattern is different from the normalized time domain-frequency domain feature pattern, it can be judged that the pipe body has a blockage narrowing situation (see Annex 2 (b), above. Representing the time-domain characteristic pattern of the unnarrowed tube, the lower part represents the time domain-frequency domain characteristic pattern in which the tube body has been narrowed. Of course, a linear or nonlinear classification algorithm (such as a Radial basis function neural network) may be conventionally used to perform finer classification and feature pattern discrimination on the aforementioned time domain-frequency domain feature patterns.

此外,本發明中亦針對S變換及連續小波變換與超聲檢查判斷進行成效評估,採用F度量(F-meature)值來進行評估,F度量是一種同時兼顧查準率(precision)與查全率(recall)的度量方式,應用於資訊檢索領域的成效評估,以方便不同技術或系統之間的成效比較。在此試驗中,前述查準率係陽性預測值(PPV),前述查全率係靈敏度(sensitivity),其F度量值可以用下列公式進行計算: 為計算陽性預測值和靈敏度,針對幾個二元分類測試參數進行了定義:真陽性(狹窄化的動靜脈廔管被正確識別為狹窄狀態),假陽性(非狹窄化的動靜脈廔管被錯誤的識別為狹窄狀態),真陰性(非狹窄化的動靜脈廔管被正確識別為非狹窄狀態),和假陰性(狹窄化的動靜脈廔管被錯誤的識別為非狹窄狀態)。 接著,開始針對分別利用S變換及連續小波變換進行檢測動靜脈廔管狹窄狀況之演算法進行了評價。共有228個非動靜脈廔管狹窄的試驗對象和251個動靜脈廔管狹窄的對象用於測試實驗,其測試結果如下: 經計算後發現,利用S變換之演算法其陽性預測值為87.84%(真陽性/(真陽性+假陽性總數)),靈敏度為89.24%(真陽性/超聲檢查判斷陽性總數),從而其F度量值為88.54%;另外利用連續小波變換之演算法其陽性預測值為74.74%,靈敏度為84.86%,從而其F度量值為79.48%。由上述結果可之,驗證了利用S變換之演算法來提取聲音訊號的時域-頻域特徵圖形進行比對的成效是優於連續小波變換之演算法。 In addition, in the present invention, the S-transformation and continuous wavelet transform and the ultrasonic examination are evaluated for effectiveness, and the F- meature value is used for evaluation. The F-metric is a simultaneous consideration of the precision and the recall rate. The measurement method of (recall) is applied to the effectiveness evaluation of the information retrieval field to facilitate the comparison of effects between different technologies or systems. In this test, the aforementioned precision is a positive predictive value (PPV), and the aforementioned recall rate is sensitivity, and the F metric can be calculated by the following formula: To calculate positive predictive value and sensitivity, several binary classification test parameters were defined: true positive (stenotic arteriovenous fistula is correctly identified as stenosis), false positive (non-stenotic arteriovenous fistula) The erroneous recognition is a stenosis state), a true negative (a non-stenotic arteriovenous fistula is correctly identified as a non-stenotic state), and a false negative (a narrowed arteriovenous fistula is incorrectly identified as a non-stenotic state). Next, an algorithm for detecting the stenosis of the arteriovenous fistula by S-transformation and continuous wavelet transform was started. A total of 228 subjects with non-arteriovenous fistula stenosis and 251 subjects with arteriovenous fistula stenosis were used for the test. The test results are as follows: After calculation, it is found that the positive predictive value of the algorithm using S transform is 87.84% (true positive / (true positive + false positive total)), the sensitivity is 89.24% (true positive / ultrasonic examination determines the total number of positive), thus its F The metric value is 88.54%; in addition, the algorithm using continuous wavelet transform has a positive predictive value of 74.74% and a sensitivity of 84.86%, so that its F metric is 79.48%. From the above results, it is verified that the performance of the S-transform algorithm to extract the time-frequency domain features of the audio signal is better than the continuous wavelet transform.

再請參閱第四圖所示,係本發明管體窄化監測裝置使用示意圖,係使用在廔管(A)的堵塞窄化監測,藉由該隔音部(112)之可撓特性,使用者將該隔音部(112)套在手臂上並使該音訊探頭(111)置於該廔管(A)處後藉彈性回復力而束緊,使該消音層(1121)(參第一圖所示)緊貼於手臂,達到隔絕外部噪音的效果後,即可藉由該資料輸入模組(17)輸入選單項目及參數設定以開始檢測作業,待檢測完成即可藉由該顯示單元(15)顯示該比對結果,同時藉由該無線傳輸模組(18)將該比對結果傳送至外部電腦或其他手持式裝置,本發明實施例中係以一筆記型電腦(2)為範例表示,供使用者或醫護人員監測記錄,令本發明之管體窄化監測裝置(1)整體使用上相當實用且便利。 Referring to FIG. 4 again, it is a schematic diagram of the use of the tube narrowing monitoring device of the present invention, which is used for clogging narrowing monitoring of the manifold (A), and the user is flexible by the flexible portion (112). The sound-insulating portion (112) is placed on the arm and the audio probe (111) is placed at the manifold (A), and then tightened by an elastic restoring force to make the sound-absorbing layer (1121) (refer to the first figure After being attached to the arm to achieve the effect of isolating the external noise, the data input module (17) can be used to input the menu item and the parameter setting to start the detection operation, and the display unit can be used after the detection is completed. The comparison result is displayed, and the comparison result is transmitted to the external computer or other handheld device by the wireless transmission module (18). In the embodiment of the present invention, a notebook computer (2) is taken as an example. For the user or the medical staff to monitor the record, the tube narrowing monitoring device (1) of the present invention is quite practical and convenient to use as a whole.

綜上所述,本發明中藉由該隔音部(112)可隔絕或吸收外部噪音,以減低對該音訊探頭(111)收集聲音訊號所造成的干擾影響,進而提高聲音訊號擷取的精確性及完整性,以利後續採用前述演算法對所偵測之聲音訊號進行時域-頻域的圖案轉換並擷取其圖案特徵作為進行比對的對象,以獲得較佳解析的比對結果。 In summary, in the present invention, the sound insulation portion (112) can isolate or absorb external noise to reduce the interference caused by the audio signal collected by the audio probe (111), thereby improving the accuracy of the sound signal acquisition. And integrity, in order to facilitate the time domain-frequency domain pattern conversion of the detected sound signal by using the foregoing algorithm and extracting the pattern features as objects for comparison, to obtain a better analytical alignment result.

雖然本發明已以較佳實施例揭露如上,然其並非用以限定本發明,任何熟習此技藝者,在不脫離本發明之精神和範圍內,當可作些許之更動與潤飾,因此本發明之保護範圍當視後附之申請專利範圍所界定者為準。 While the present invention has been described in its preferred embodiments, the present invention is not intended to limit the invention, and the present invention may be modified and modified without departing from the spirit and scope of the invention. The scope of protection is subject to the definition of the scope of the patent application.

(1)‧‧‧管體窄化監測裝置 (1) ‧‧‧Tube narrowing monitoring device

(11)‧‧‧音訊感測單元 (11)‧‧‧Audio sensing unit

(111)‧‧‧音訊探頭 (111)‧‧‧Optical probe

(112)‧‧‧隔音部 (112) ‧ ‧ Soundproofing

(1121)‧‧‧消音層 (1121) ‧ ‧ muffler

(12)‧‧‧音訊轉換模組 (12)‧‧‧Audio conversion module

(13)‧‧‧微處理器 (13)‧‧‧Microprocessor

(14)‧‧‧圖案辨識模組 (14)‧‧‧ pattern recognition module

(15)‧‧‧顯示單元 (15)‧‧‧Display unit

(16)‧‧‧前置過濾放大模組 (16)‧‧‧Pre-filter amplification module

(17)‧‧‧資料輸入模組 (17)‧‧‧ Data Input Module

(18)‧‧‧無線傳輸模組 (18)‧‧‧Wireless Transmission Module

(19)‧‧‧驅動電源 (19)‧‧‧Drive power supply

Claims (10)

一種管體窄化監測裝置,用於偵測一管體內液體流動之聲音,其包括有:一音訊感測單元,包含一隔音部,該隔音部具一內側面且在該內側面設置有一音訊探頭,藉以消除外部噪音干擾並收集受測之該管體之一聲音訊號;一音訊轉換模組,用以接收該聲音訊號並將其轉換為一電訊號;一微處理器,與該音訊轉換模組電性連接,用以接收該電訊號並透過運算處理,以獲得一時域-頻域特徵圖案;一圖案辨識模組,與該微處理器電性連接,包括有一資料儲存單元及一比對單元,該資料儲存單元儲存有一標準化時域-頻域特徵圖案資料,該比對單元則接收受測之該管體的時域-頻域特徵圖案並與該標準化時域-頻域特徵圖案資料進行比對,並輸出一比對結果至該微處理器;及一顯示單元,與該微處理器電性連接,用以呈現該比對結果。 A tube narrowing monitoring device for detecting the sound of a liquid flowing in a tube, comprising: an audio sensing unit comprising a sound insulating portion, the sound insulating portion having an inner side and an audio signal disposed on the inner side a probe for eliminating external noise interference and collecting an audio signal of the tube to be tested; an audio conversion module for receiving the audio signal and converting it into a signal; a microprocessor, and the audio conversion The module is electrically connected to receive the electrical signal and is processed to obtain a time domain-frequency domain feature pattern; a pattern recognition module electrically connected to the microprocessor, including a data storage unit and a ratio For the unit, the data storage unit stores a standardized time domain-frequency domain feature pattern data, and the comparison unit receives the time domain-frequency domain feature pattern of the tube body to be tested and the normalized time domain-frequency domain feature pattern The data is compared and a comparison result is output to the microprocessor; and a display unit is electrically connected to the microprocessor to present the comparison result. 如申請專利範圍第1項所述之管體窄化監測裝置,其中,更包括有分別與該微處理器電性連接之一前置過濾放大模組、一資料輸入模組、一無線傳輸模組以及一驅動電源。 The pipe narrowing monitoring device of claim 1, further comprising a pre-filtering amplification module, a data input module, and a wireless transmission module respectively electrically connected to the microprocessor. Group and a drive power supply. 如申請專利範圍第1項所述之管體窄化監測裝置,其中,該標準化時域-頻域特徵圖案資料包括有:在未窄化狀態下,該管體內液體流動產生的時域-頻域特徵圖案,以及該管體在各種不同窄化狀態下之液體流動所產生的複數時域-頻域特徵圖案。 The tube narrowing monitoring device according to claim 1, wherein the standardized time domain-frequency domain characteristic pattern data includes: a time domain-frequency generated by the liquid flow in the tube in an unnarrowed state. The domain feature pattern and the complex time-domain-frequency domain pattern produced by the liquid flow of the tube in various narrowed states. 如申請專利範圍第1項所述之管體窄化監測裝置,其中,該隔音部係可撓性材質製成,且該隔音部之內側面設有一吸音材製成之消音層。 The tube narrowing monitoring device according to claim 1, wherein the sound insulating portion is made of a flexible material, and a sound absorbing layer made of a sound absorbing material is disposed on an inner side surface of the sound insulating portion. 如申請專利範圍第1項所述之管體窄化監測裝置,其中,該電訊號經運算處理之方式包括有短時距傅立葉變換(Short-Time Fourier Transform,STFT)、連續小波變換(Continuous Wavelet Transform,CWT)或S變換(S-Transform)其中之一。 The device for narrowing the tube according to the first aspect of the invention, wherein the method for processing the electrical signal comprises short-time Fourier transform (STFT) and continuous wavelet transform (Continuous Wavelet) One of Transform, CWT) or S-Transform. 如申請專利範圍第5項所述之管體窄化監測裝置,其中,所述之S變換(S-Transform)係採用: 其中,S(τf)表示該管體內液體流動之聲音x(t)的S變換值,τf分別表示S變換的時間位置和頻率。 The pipe narrowing monitoring device according to claim 5, wherein the S-transform is: Where S( τ , f ) represents the S-transformed value of the sound x(t) of the liquid flow in the tube, and τ and f represent the time position and frequency of the S-transform, respectively. 一種管體窄化監測方法,係使用如申請專利範圍第1項所述之管體窄化監測裝置,其步驟包括有:該音訊感測單元偵測不受外部噪音干擾之該管體的一聲音訊號;將該聲音訊號轉換成為一電訊號並經濾波及放大增益處理;將該電訊號經運算處理以獲得一時域-頻域特徵圖案;及將該時域-頻域特徵圖案與預先建立的一標準化時域-頻域特徵圖案資料進行比對,藉以輸出一比對結果。 A tube narrowing monitoring method is the tube narrowing monitoring device according to claim 1, wherein the step comprises: the audio sensing unit detecting one of the tubes not interfered by external noise An audio signal; converting the audio signal into an electrical signal and filtering and amplifying the gain processing; processing the electrical signal to obtain a time domain-frequency domain characteristic pattern; and pre-establishing the time domain-frequency domain characteristic pattern A normalized time domain-frequency domain feature pattern data is compared to output a comparison result. 如申請專利範圍第7項所述之管體窄化監測方法,其中,該電訊號經運算處理之步驟進一步包括:擷取該電訊號中具週期性之區段作為後續分析的基塊;將該基塊進行時域-頻域(time-frequency domain)上的演算分析,並提取出其特 徵;及利用該特徵建立該時域-頻域的特徵圖案。 The method for monitoring a narrowing of a pipe body according to the seventh aspect of the invention, wherein the step of calculating the electrical signal further comprises: capturing a periodic segment of the electrical signal as a base block for subsequent analysis; The block performs calculus analysis on the time-frequency domain and extracts its special And using the feature to establish a feature pattern of the time domain-frequency domain. 如申請專利範圍第8項所述之管體窄化監測方法,其中,該電訊號經運算處理之方法包括有短時距傅立葉變換(Short-Time Fourier Transform,STFT)、連續小波變換(Continuous Wavelet Transform,CWT)或S變換(S-Transform)其中之一。 The method for monitoring a narrowing of a pipe body according to the eighth aspect of the invention, wherein the method for processing the electrical signal comprises: Short-Time Fourier Transform (STFT), Continuous Wavelet Transform (Continuous Wavelet) One of Transform, CWT) or S-Transform. 如申請專利範圍第9項所述之管體窄化監測方法,其中,所述之S變換(S-Transform)係採用: 其中,S(τf)表示該管體內液體流動之聲音x(t)的S變換值,τf分別表示S變換的時間位置和頻率。 The method for monitoring a narrowing of a pipe body according to claim 9, wherein the S-transform is: Where S( τ , f ) represents the S-transformed value of the sound x(t) of the liquid flow in the tube, and τ and f represent the time position and frequency of the S-transform, respectively.
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