WO2013046556A1 - Sphygmomanomètre - Google Patents

Sphygmomanomètre Download PDF

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Publication number
WO2013046556A1
WO2013046556A1 PCT/JP2012/005696 JP2012005696W WO2013046556A1 WO 2013046556 A1 WO2013046556 A1 WO 2013046556A1 JP 2012005696 W JP2012005696 W JP 2012005696W WO 2013046556 A1 WO2013046556 A1 WO 2013046556A1
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WO
WIPO (PCT)
Prior art keywords
blood pressure
pulse wave
air bag
air
armband
Prior art date
Application number
PCT/JP2012/005696
Other languages
English (en)
Japanese (ja)
Inventor
克美 築田
剛 冨田
小澤　仁
Original Assignee
テルモ株式会社
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by テルモ株式会社 filed Critical テルモ株式会社
Publication of WO2013046556A1 publication Critical patent/WO2013046556A1/fr

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/02—Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
    • A61B5/021—Measuring pressure in heart or blood vessels
    • A61B5/022—Measuring pressure in heart or blood vessels by applying pressure to close blood vessels, e.g. against the skin; Ophthalmodynamometers
    • A61B5/02233—Occluders specially adapted therefor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/02—Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
    • A61B5/021—Measuring pressure in heart or blood vessels
    • A61B5/022—Measuring pressure in heart or blood vessels by applying pressure to close blood vessels, e.g. against the skin; Ophthalmodynamometers
    • A61B5/02225—Measuring pressure in heart or blood vessels by applying pressure to close blood vessels, e.g. against the skin; Ophthalmodynamometers using the oscillometric method
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/72—Signal processing specially adapted for physiological signals or for diagnostic purposes
    • A61B5/7235—Details of waveform analysis
    • A61B5/7264—Classification of physiological signals or data, e.g. using neural networks, statistical classifiers, expert systems or fuzzy systems
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B2560/00—Constructional details of operational features of apparatus; Accessories for medical measuring apparatus
    • A61B2560/04—Constructional details of apparatus
    • A61B2560/0406—Constructional details of apparatus specially shaped apparatus housings
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/02—Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
    • A61B5/021—Measuring pressure in heart or blood vessels
    • A61B5/022—Measuring pressure in heart or blood vessels by applying pressure to close blood vessels, e.g. against the skin; Ophthalmodynamometers
    • A61B5/0225—Measuring pressure in heart or blood vessels by applying pressure to close blood vessels, e.g. against the skin; Ophthalmodynamometers the pressure being controlled by electric signals, e.g. derived from Korotkoff sounds
    • G—PHYSICS
    • G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H50/00—ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics
    • G16H50/20—ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics for computer-aided diagnosis, e.g. based on medical expert systems

Definitions

  • the present invention relates to a sphygmomanometer capable of measuring blood pressure even if a person to be measured (user) is a heart transplant patient transplanted with a living heart transplant or an auxiliary artificial heart or a pulse weak person such as a person with weak pulse wave. .
  • ⁇ A problem with this type of sphygmomanometer is how to wear the armband on the arm.
  • the position of the air bag in the armband is not appropriate for the upper arm or when the wrapping strength is not appropriate for the upper arm, the pressure of the air bag in the armband is not correctly applied to the upper arm, and the blood pressure is high. May be.
  • the air bag for ischemia of the armband is automatically placed at the correct position of the arm, with the correct winding strength.
  • An electronic sphygmomanometer has been developed that integrates a sphygmomanometer body and an armband that can measure blood pressure (see Patent Document 1).
  • the arm band part into which the arm is inserted is integrated with the sphygmomanometer body, so that the position of the sphygmomanometer body is separated from the front of the person to be measured.
  • the person being measured is likely to perform measurement in a leaning state. For this reason, the abdomen of the person to be measured is compressed and the abdominal pressure increases, and as a result, a phenomenon in which the blood pressure increases may be seen. This increase in blood pressure is pointed out as the occurrence of new pseudohypertension.
  • the armband portion is formed separately from the main body of the sphygmomanometer, and the armband portion has a rigid case, and an air bag for ischemia is disposed in this case. ing.
  • This allows the armband part to be separated from the sphygmomanometer main body when the person to be measured measures blood pressure in the sitting position, so that the blood pressure meter does not lose the convenience of being able to measure by simply inserting the upper arm into the armband part. Even if the installation location of the main body is far away from the person to be measured, the blood pressure can be measured in a state where the measurer is correct and the abdominal pressure is not applied when the back is stretched.
  • the pulse wave of the weak pulse person is weak and the pulse pressure is extremely low.
  • a person with pulse weakness tries to automatically determine the blood pressure using an oscillometric sphygmomanometer that uses pulse waves, the blood pressure value cannot be determined and the blood pressure value measurement error is displayed. As a result, it is impossible to measure the blood pressure of a weak pulse person.
  • the present invention provides a blood pressure that can measure the blood pressure value even when measuring the blood pressure of a heart transplant patient transplanted with a living heart transplant, an auxiliary artificial heart, or a weak pulse person such as a person with weak pulse waves.
  • the purpose is to provide a total.
  • the sphygmomanometer according to the present invention includes an armband portion having an air bag for ischemia for compressing the upper arm of the subject and an air bag for detecting a pulse wave for detecting the pulse wave of the subject, and the air bag for ischemia
  • a sphygmomanometer having a plurality of blood pressure measurement modes, including a pressure sensor for detecting the pressure in the air bag, and a control unit for detecting a blood pressure value and a pulse wave by a signal from the pressure sensor,
  • the blood pressure measurement mode includes an average blood pressure measurement mode
  • the control unit has a pulse weakness measurement mode, and by selecting a predetermined blood pressure measurement mode from a plurality of blood pressure measurement modes, the control unit as a person to be measured as a pulse weak, A blood pressure measurement mode for measuring the mean blood pressure can be selected for a heart transplant patient or a person having a weak pulse wave transplanted with an auxiliary artificial heart.
  • the blood pressure inside the air bag for ischemia when the maximum amplitude of the pulse wave is generated Since the pressure is determined as the average blood pressure value of the person to be measured, this average blood pressure value can be used as the blood pressure value of the pulse weak person.
  • the apparatus has a memory for storing the pulse wave generated when the inside of the air bag for ischemia and the inside of the air bag for pulse wave detection is decompressed, and the control unit is configured to determine the pulse wave having an opposite phase and a predetermined value.
  • the pulse wave having a narrower width in the time axis direction than the above value is deleted from the memory as an abnormal pulse wave.
  • the pulse wave having the opposite phase and the pulse wave whose width in the time axis direction is narrower than a predetermined value can be deleted as an abnormal pulse wave, so that the amount of data in the memory can be reduced,
  • the pressure in the air bag for ischemia when the maximum amplitude of the wave is generated can be easily determined as the average blood pressure value of the measurement subject.
  • the control unit when the generation of the maximum amplitude of the pulse wave is confirmed, the control unit has the pulse wave having a smaller amplitude than the pulse wave of the maximum amplitude before and after the pulse wave of the maximum amplitude. It is characterized by confirming that each exists. According to the said structure, based on generation
  • the armband portion is separate from the blood pressure monitor main body, and the armband portion is disposed so as to face the ischemic air bag when the armband portion is attached to the upper arm.
  • a plurality of the pulse wave detection air bags are housed. According to the above configuration, one of the pulse wave detection air bags can be applied to the artery of the upper arm, and the detection of the pulse wave is facilitated.
  • the control unit determines the average blood pressure value of the measurement subject
  • the control unit includes a display unit that displays the average blood pressure value
  • the display unit is disposed in the blood pressure monitor main body.
  • a to-be-measured person can confirm an average blood pressure value visually by looking the display part of a blood pressure meter main body.
  • the armband portion of the present invention is an armband portion for blood pressure measurement, comprising a cuff cover made of an outer cloth and an inner cloth inside the outer cloth, and an air bag inside the cuff cover, A weight is provided at the terminal end where the upper end of the armband portion is wound. According to the above configuration, when the medical staff finishes wrapping the armband portion around the patient's upper arm, the weight of the weight at the end of the armband portion is applied in the direction in which the armband portion is wound. Can be wrapped around.
  • the armband portion of the present invention is also an armband portion for blood pressure measurement, comprising a cuff cover made of an outer cloth and an inner cloth inside the outer cloth, and an air bag inside the cuff cover, An anti-slip portion for stopping slipping with respect to the upper arm is provided on the inner side of the starting end portion where the arm belt portion starts to be wound around the upper arm. According to the above configuration, the armband portion can be wound around the patient's upper arm while being easily positioned.
  • the slip prevention part for stopping slipping with respect to the upper arm is provided inside the start end part of the arm band part, when the medical worker wraps the arm band part around the upper arm of the patient, the slip prevention part is The armband portion can be positioned by stopping so that the starting end portion of the armband portion does not slide with respect to the upper arm.
  • the sphygmomanometer according to the present invention includes a cuff cover made of an outer cloth and an inner cloth inside the outer cloth, an air bag inside the cuff cover, and a blood pressure provided with a weight at a terminal portion that is wound around the upper arm.
  • the medical staff when the medical staff finishes wrapping the armband portion around the patient's upper arm, the weight of the weight at the end of the armband portion is applied in the direction in which the armband portion is wound.
  • the blood pressure can be easily measured.
  • the medical worker can wrap the armband portion while easily positioning the armband portion on the upper arm with only one other hand while the medical worker has the air balloon with one hand. Winding workability can be improved.
  • the sphygmomanometer according to the present invention includes a cuff cover including an outer cloth and an inner cloth inside the outer cloth, an air bag inside the cuff cover, and a slip with respect to the upper arm on the inner side of a starting end portion where the upper arm starts to be wound.
  • An armband portion provided with an anti-slip portion for stopping the blood pressure, and a blood pressure monitor body connected to the air bag of the armband portion via a tube, And an air supply balloon that sends air to the air bag through the tube by being attached to the housing and pushed.
  • the armband portion can be wound around the patient's upper arm while being easily positioned. That is, since a slip prevention part for stopping slipping with respect to the upper arm is provided inside the start end part of the arm band part, when the medical worker wraps the arm band part around the upper arm of the patient, the slip prevention part is Since the armband portion can be positioned by being stopped without slipping with respect to the upper arm, the armband portion can be wound around the upper arm while being easily positioned. According to the above configuration, the medical worker can wrap the armband portion while easily positioning the armband portion on the upper arm with only one other hand while the medical worker has the air balloon with one hand. Winding workability can be improved.
  • the present invention relates to a sphygmomanometer capable of measuring a blood pressure value even when measuring the blood pressure of a heart transplant patient transplanted with a living heart transplant or an auxiliary artificial heart or a pulse weak person such as a person with weak pulse wave. Can be provided.
  • FIG. 2A is a perspective view of the sphygmomanometer body of the sphygmomanometer shown in FIG. 1 as viewed from the left rear side.
  • FIG. 2B is a perspective view of the sphygmomanometer body of the sphygmomanometer shown in FIG. 1 as viewed from the right rear side.
  • 3A is a cross-sectional view showing an example of the internal structure of the armband
  • FIG. 3B is a front view showing a state in which the armband is folded
  • FIG. 3C is an arm. It is a perspective view which shows the state which folded the belt
  • FIG. 5 It is a side view which shows a mode that the folded armband part is detachably accommodated in the back side of a housing
  • FIG. 5 It is a block diagram which shows the electrical structural example of embodiment of the blood pressure meter of this invention.
  • the pressure sensor shown in FIG. 5 changes the blood pressure value obtained from the fluctuation of the air pressure of the air bag for ischemia, and the pressure sensor shown in FIG. 5 shows the pressure pulse wave obtained from the fluctuation of the air pressure of the pulse wave detection air bag. It is a figure which shows an example of appearance. It is a flowchart which shows the blood pressure measurement operation
  • FIG. 8A illustrates a normal pulse wave WW having a proper phase
  • FIG. 8B illustrates an abnormal pulse wave WW1 having an opposite phase. Illustrated in FIG. 4 is an abnormal pulse wave WW2 having a narrow width in the time axis direction even if the phase is a valid pulse wave.
  • FIG. 16A shows the inner surface side of the armband portion
  • FIG. 16B is a perspective view showing the outer surface side of the armband portion
  • FIG. 17A is a plan view showing the outer surface side of the armband portion
  • FIG. 17B shows an air bag for ischemia and an air bag for detecting arterial pulsation arranged inside the armband portion.
  • the top view which shows the example of a shape.
  • the figure which shows the example from which the pressure applied with respect to an upper arm by the air bag for ischemia changes with time passage.
  • FIG. 1 is a perspective view showing the entire embodiment of the blood pressure monitor of the present invention.
  • FIG. 2A is a perspective view of the sphygmomanometer body of the sphygmomanometer shown in FIG. 1 as viewed from the left rear side.
  • FIG. 2B is a perspective view of the sphygmomanometer body of the sphygmomanometer shown in FIG. 1 as viewed from the right rear side.
  • the sphygmomanometer 1 shown in FIGS. 1 and 2 is a preferred example of the sphygmomanometer of the present invention, and is also called an electronic sphygmomanometer.
  • the armband part 2 and the sphygmomanometer body 10 are separate, and the armband part 2 shown in FIG. 1 is used separately from the sphygmomanometer body 10 shown in FIGS. 1 and 2.
  • the blood pressure monitor 1 is different from the integrated blood pressure monitor in which the armband portion and the main body are integrated, and the place where the blood pressure monitor main body 10 is installed is forward of the measured person when the measured person measures in the sitting position.
  • the sphygmomanometer 1 can measure not only the maximum blood pressure value and the minimum blood pressure value of a normal general user's blood pressure in the same manner as an ordinary sphygmomanometer, but also a heart transplantation in which a measured person transplants an auxiliary artificial heart.
  • the patient is a weak person such as a patient or a person with weak pulse wave
  • the average blood pressure value of these persons can be measured by a method described in detail later.
  • the sphygmomanometer 1 detects pressure and a pulse wave (also referred to as a pressure pulse wave) from the artery of the upper arm T in the process of pressing the upper arm T by the armband portion 2 and releasing the compression, and from the pressure, This is a sphygmomanometer using a so-called pressure pulse wave (oscillometric) method for calculating a maximum blood pressure (systolic blood pressure) and a minimum blood pressure (diastolic blood pressure).
  • a pulse wave also referred to as a pressure pulse wave
  • the armband part 2 shown in FIG. 1 is also called a cuff, and the armband part 2 has a constant (predetermined) outer peripheral length, and is a soft cylinder body that is made of a foldable and soft material. Yes, it has two openings 11P and 11R. As shown in FIG. 1, when the armband 2 is attached to the upper arm T of the measurement subject, the opening 11P is positioned on the finger side, and the opening 11R on the opposite side is positioned on the shoulder side. The inner diameter of the opening 11R is larger than the inner diameter of the opening 11P. As a result, the finger of the person to be measured can be easily inserted from the opening 11R side to the opening 11P, and the armband 2 is held on the upper arm T above the elbow of the person to be measured and blood pressure is maintained. It comes to measure.
  • the armband portion 2 incorporates a blood-insulating air bag 14 for blood-blocking the upper arm T and a pulse-wave detecting air bag 250 for detecting a pulse wave.
  • Two pulse wave detection air bags 250 are preferably incorporated.
  • the air bag 14 for ischemia compresses the upper arm T when air is supplied from the sphygmomanometer body 10 side, and releases the air to compress the upper arm T.
  • DC direct current
  • the two pulse wave detection air bags 250 are disposed so as to face each other with the upper arm T interposed therebetween.
  • These air bags 250 for detecting pulse waves are supplied with air from the sphygmomanometer main body 10 side so as to pressurize the upper arm T and then release the air, and then pulse waves (pressure pulse waves) from the arteries of the upper arm T. It is an air bag for detecting.
  • the pulse wave detection air bag 250 detects the pressure pulse wave based on the vibration of the arterial wall due to the pulsation of the artery accompanying the change in pressure on the upper arm T in the armband portion 2.
  • the pressure pulse wave increases the internal pressure of the air bag 14 for the ischemia of the armband 2 above the maximum blood pressure and once closes the blood vessel. Then, the internal pressure is gradually decreased to the internal blood pressure below the maximum blood pressure, and the blood vessel begins to open. This is an AC (alternating current) waveform signal that can be detected until the internal pressure falls below the minimum blood pressure and the occlusion of the blood vessel disappears.
  • the air accommodation capacity of the air bag 14 for ischemia is larger than the air accommodation capacity of the air bag 250 for detecting a pulse wave in order to exert a force for pressing around the upper arm T.
  • the armband 2 and the sphygmomanometer body 10 are connected via air tubes 4 and 5 and an air plug 6.
  • the air tubes 4 and 5 are preferably flexible elastomer tubes that constitute a multiple cylinder tube (also referred to as a multiple conduit).
  • the air tubes 4 and 5 are integrally formed over the entire length (or substantially over the entire length). Thereby, when using the arm band part 2 apart from the blood pressure monitor main body 10, the air tubes 4 and 5 can be easily handled.
  • the air tube 4 as the first air tube is used for supplying and exhausting air to and from the air bag 14 for the ischemia of the armband portion 2, and the air tube 5 as the second air tube has two pulse wave detection air bags. Used to supply / exhaust air to 250.
  • the air tube 4 is a thicker tube than the air tube 5, and the inner diameter and outer diameter of the air tube 4 are set larger than the inner diameter and outer diameter of the air tube 5. As a result, the air tube 4 can quickly supply and exhaust air to and from the air bag 14 having a large air capacity.
  • FIG. 3A is a cross-sectional view showing an example of the internal structure of the armband portion 2
  • FIG. 3B is a front view showing a state in which the armband portion 2 is folded
  • FIG. It is a perspective view which shows the state which folded the armband part 2.
  • the armband portion 2 is a cylindrical member that is not cut along the outer circumferential direction, and has an outer periphery of a predetermined (constant) length.
  • the upper arm T of the person to be measured can be passed through the part 2.
  • the armband portion 2 has the flexibility that the person to be measured can easily fold, and as shown in FIG. 1 and FIG. 3 (A), For example, it has an outer cloth 16, an inner cloth 17, a hemostasis air bag 14 for isolating the upper arm T, and two pulse wave detection air bags 250.
  • the air bag 14 for ischemia of the armband portion 2 is used to compress the artery of the upper arm T, and the two pulse wave detection air bags 250 of the armband portion 2 are used for the artery. It is used to detect the pulse wave.
  • the inner surface of the outer cloth 16 and the outer surface of the inner cloth 17 enclose the air bag 14 for ischemia and the two air bags 250 for detecting pulse waves.
  • the ends of the outer cloth 16 and both ends of the inner cloth 17 are, for example, They are joined by sewing or integral molding.
  • the two pulse wave detection air bags 250 are preferably positioned closer to the opening 11P side than the intermediate position in the longitudinal direction (axial direction) of the armband portion 2 (see FIG. It is better to place it at a position closer to the finger than the shoulder side.
  • one of the two pulse wave detection air bags 250 can be applied to the portion of the upper arm T corresponding to the artery.
  • the pulse wave detection air bag 250 can detect the pulse wave in a state where the upper arm T is surely pressurized and the artery is blocked. Since the two pulse wave detection air bladders 250 are disposed at opposing positions, one of the pulse wave detection air bladders 250 can be applied to the artery of the upper arm T, and the pulse wave can be easily detected.
  • the outer cloth 16 shown in FIG. 3 (A) is a cylindrical body that covers the outer surface of the air bag 14 for ischemia, and is formed of a non-stretchable material in the circumferential direction and the longitudinal direction. It is a fabric member that has very low or no properties.
  • the outer fabric 16 supplies air into the ischemic air bladder 14 and the two pulse wave detecting air bags 250, the ischemic air bag 14 and the two pulse wave detecting air bags 250 become armbands.
  • the air bag 14 and the two pulse wave detection air bags 250 are inflated to the upper arm T side which is the inner side in the radial direction.
  • the pressure of the air bag 14 for the ischemia and the two air bags 250 for detecting the pulse wave can be applied to the upper arm T without escaping to the outside of the armband portion 2, and accurate blood pressure measurement can be performed. it can.
  • the outer fabric 16 shown in FIG. 3A for example, a fabric that is difficult to stretch (201BE) can be adopted, and the tensile strength is a value measured by the JIS L1096-A method with a warp of 1430 N / in to 1460 N / in, Is 810 N / in to 8250 N / in. Further, it is preferable that the length is 1430 N / in to 1460 N / in and the width is 810 N / in to 8250 N / in.
  • both the length and the width are smaller than this numerical range, the suppression of the outward expansion of the air bag 14 is weakened, and if it is larger than this numerical range, the insertion of the upper arm T may be affected.
  • the outer cloth 16 for example, when a 100% polyester fabric is used, the length is 1445 N / in and the width is 827 N / in.
  • the inner cloth 17 shown in FIG. 3 (A) is a cylindrical body that covers the inner surfaces of the ischemic air bladder 14 and the two pulse wave detecting air bladders 250, is deformable, has elasticity, and has an upper arm T. It is a contact cloth part contact
  • the inner fabric 17 can be a stretchable fabric member that is elastic and has elasticity, for example, and can have a tensile strength of 94.9 N / in as measured by the JIS L1096-A method.
  • the width is 1250.7 N / in.
  • the tensile elongation is 517% in length and 400% in width as measured by the JIS L1096-A method.
  • the inner fabric is, for example, a fabric made of 80% nylon and 20% polyurethane.
  • the inner cloth 17 is made of a material having elasticity so that the air bag 14 for the ischemia and the air bag 250 for detecting the pulse wave can expand toward the surface to be measured of the upper arm T, and covers the arm band portion 2. Since it is necessary to insert it from the hand of the measurer and slide it to the upper arm T above the elbow, a smooth material such as a jersey material is used.
  • the opening closing member 30 is on the opening 11P side inside the armband portion 2, and the air tube 4 and the air tube 5 are led out. It is provided on the (connected) side.
  • the opening closing member 30 can use, for example, a removable surface fastener, and has a male member 31 and a female member 32 of the surface fastener.
  • the male member 31 and the female member 32 are fixed at positions facing each other inside the armband portion 2, and the male member 31 and the female member 32 are attached and detached as shown in FIGS. 3 (B) and 3 (C).
  • the opening closing member 30 for the armband part 2, when the person to be measured tries to measure blood pressure through the hand with respect to the armband part 2, from the closed opening part 11P side. Without passing the hand, it is possible to pass the hand without getting lost from the open opening 11R side. For this reason, it can prevent that a to-be-measured person inserts a hand back into the armband part 2 accidentally from the opening part 11P side. If the measured person inserts the armband part 2 back from the opening 11P side, the pulse wave detection air bag 250 does not properly hit the artery of the upper arm T, and the pressure pulse wave is accurately measured. There is a risk that it will not be possible. Further, by providing the opening closing member 30 with respect to the armband portion 2, it can be easily folded when the armband portion 2 is not used.
  • the armband portion 2 preferably has a tag 33 that is a member for visually recognizing a direction.
  • the tag 33 is on the opening 11R side, and is fixed to the outer fabric 16 by using, for example, an adhesive or by sewing.
  • the tag 33 is provided so as to protrude along the V direction from the end of the armband portion 2 on the opening 11R side, and can be made of, for example, a cloth member or a plastic member.
  • FIG. 3A when the person to be measured inserts his left arm into the armband portion 2 and measures blood pressure, for example, the user grasps the tag 33 with the finger F of the right arm and holds the armband portion 2 in the V direction. Can be moved to.
  • the tag 33 can preferably be labeled with a “shoulder side” display 33S.
  • the measurement subject can easily attach the armband portion 2 to the upper arm T simply by grasping the tag 33 and moving in the V direction, and the attachment direction of the armband portion 2 is clear. Therefore, it is possible to pass the hand without hesitation from the opening 11R side. For this reason, it can prevent that a to-be-measured person inserts a hand back into the armband part 2 accidentally from the opening part 11P side. That is, since only the opening 11P on the side of the air tubes 4 and 5 can be closed, it is possible to easily prevent the person to be measured from wearing in the reverse direction with respect to the upper arm, and the person to be measured is against the upper arm T. Can be installed in the correct direction.
  • the sphygmomanometer body 10 includes a housing part 60, a display surface part 61, and a holding part 62 for the armband part 2.
  • the housing part 60, the display surface part 61, and the holding part 62 are made of an electrically insulating material such as plastic.
  • the display surface portion 61 is provided on the front surface side of the housing portion 60 and is inclined so that the measurement subject can easily see the display content displayed on the display portion 63.
  • the inclination angle ⁇ of the display surface portion 61 is, for example, 60 degrees. Is set to about.
  • the housing 60 includes side surfaces 68 and 69, a back surface 66, a rectangular front opening 70 indicated by a broken line, and a housing 60. It has an upper surface portion 71 projecting from the bottom portion 72 and a bottom portion 72.
  • the display surface unit 61 includes a display unit 63, a transparent protective plate 64 such as an acrylic plate, and a frame-shaped holding member 65.
  • the display unit 63 is held by a holding member 65, and the protective plate 64 is fixed to the holding member 65 to protect the surface of the display unit 63.
  • the holding member 65 is detachably attached to the front surface side opening 70 indicated by a broken line of the housing portion 60.
  • the inside of the housing unit 60 can be exposed through the front side opening 70 indicated by a broken line of the housing unit 60. Thereby, repair and replacement
  • casing part 60 can be performed easily.
  • FIG. 4 shows a state in which the folded armband portion 2 is detachably stored on the back surface 66 side of the housing portion 60 using the holding portion 62.
  • the holding part 62 of the armband part has a holding surface 62A and a leg part 62B.
  • An insertion port 67 is formed on the lower side of the housing unit 60.
  • the distal end portion 62C of the leg portion 62B is inserted into the insertion port 67, whereby the arm belt portion holding portion 62 can be detachably attached to the back surface 66 side of the housing portion 60.
  • the folded armband portion 2 can be detachably accommodated. Thereby, when the person to be measured does not use the armband portion 2, the folded armband portion 2 can be easily and reliably stored between the holding surface 62 ⁇ / b> A and the back surface 66 of the housing portion 60. it can.
  • the armband part 2 is held on the back side of the housing part 60, so that the person to be measured is not obstructed by the armband part 2, and FIG.
  • the display content of the display unit 63 such as time and room temperature can be visually confirmed.
  • the person to be measured can easily confirm whether or not the temperature is suitable for blood pressure measurement (environmental temperature) by visually observing the display temperature of the display unit 63.
  • the armband portion 2 is held on the back side of the housing portion 60, so that the appearance of the sphygmomanometer 1 can be improved. For this reason, the sphygmomanometer body 10 can be displayed in a living room or the like as a clock when not in use.
  • an air plug difference provided with an O-ring (not shown) is provided at a lower position of a side surface portion 68 (a left side surface portion facing the front surface of the housing portion 60) 68 of the housing portion 60.
  • a slot 73 is formed.
  • the air plug 6 can be detachably attached to the air plug insertion port 73.
  • the width d1 of the linear upper portion 73A is set larger than the width d2 of the semicircular lower portion 73B in accordance with the shape of the air plug 6.
  • insertion holes 73G and 73H are provided inside the air plug insertion port 73.
  • the air plug 6 is made of plastic, for example, and includes a housing 6A, connecting cylinder portions 6B and 6C, and a connecting guide portion 6F as shown in FIG.
  • the connecting cylinder portions 6B and 6C are formed to protrude in parallel from one surface of the housing 6A. These connecting cylinder portions 6B and 6C are detachably inserted into the insertion holes 73G and 73H of the air plug insertion port 73, respectively.
  • the upper part of the connection guide part 6F is guided and inserted into the upper part 73A of the air plug insertion port 73 shown in FIG. 2A, and the lower part of the connection guide part 6F is the air plug difference shown in FIG. It is inserted into the lower portion 73B of the inlet 73 while being guided.
  • the air plug 6 is prevented from being mounted upside down with respect to the air plug insertion port 73, and the blood pressure monitor body 10 side is connected to the air bag 14 for the ischemia and the air bag 250 for detecting the pulse wave. Conversely, no air is supplied.
  • the armband portion 2 connected to the air plug 6 has a plurality of sizes, for example, three sizes of large, medium and small, so that the most suitable one can be selected according to the size of the upper arm of the user. It has become.
  • the air plug 6 is provided not on the front side but on the side of the sphygmomanometer body 10, so that even if the drive pump 110 runs away and the armband part 2 is abnormally pressurized, a complicated electronic circuit or an abnormal time is required. Since the air supply can be cut off by the person to be measured withdrawing the air plug 6 without providing the switch, abnormal pressurization of the armband portion 2 can be avoided very easily.
  • a speaker 85 and an AC adapter are connected to a side surface 69 (the side opposite to the side surface 68 where the air plug insertion port 73 is formed) 69 of the housing 60.
  • a connection hole 86 is provided.
  • the connection hole 86 shown in FIG. 2B is completely different from the air plug insertion port 73 shown in FIG. Thereby, it is possible to prevent the air plug 6 from being erroneously inserted into the connection hole 86.
  • an upper surface 71 provided on the upper surface of the housing 60 projects from the right side toward the front of the housing 60, and a start / stop switch 88 and a function selection key.
  • Various operation buttons such as 400 are arranged side by side.
  • FIG. 5 is a block diagram of the sphygmomanometer 1 shown in FIG.
  • the air bag 14 for the ischemia of the armband part 2 is connected to an air filter 130 in the sphygmomanometer body 10, a pressure sensor 140 as a pressure detection unit, two drive pumps 110, a control through an air tube 4. It is connected to the valve 111 and the exhaust valve 112.
  • Two pulse wave detection air bags 250 for detecting a pulse wave are, through the air tube 5, a pressure sensor 140 as a pressure detection unit in the sphygmomanometer body 10, an air filter 130, two drive pumps 110, The control valve 111 and the exhaust valve 112 are connected.
  • the pressure sensor 140 detects a change in the air pressure of the air bag 14 for ischemia, and the pressure sensor 140 detects a change in the air pressure of the pulse wave detection air bag 250.
  • the control unit 120 calculates a maximum blood pressure value (systolic blood pressure) and a minimum blood pressure value (diastolic blood pressure) based on a DC waveform signal from the pressure sensor 140 based on a change in air pressure in the air bag 14 for ischemia.
  • the control unit 120 detects a pulse wave (pressure pulse wave) based on an AC waveform signal from the pressure sensor 140 based on a change in air pressure in the pulse wave detection air bladder 250.
  • the two drive pumps 110 shown in FIG. 5 supply air to the ischemic air bag 14 and the two pulse wave detection air bags 250 in the armband 2 to add the upper arm in the armband 2. It is a pressurizing mechanism that presses. As described above, the two drive pumps 110 are used when the size of the armband portion 2 is large, so that the two drive pumps are driven, and when the size of the armband portion 2 is small, one drive pump is used. In order to supply air to the air bag 14 for ischemia and the two air bags 250 for detecting pulse waves.
  • control valve 111 and the exhaust valve 112 are depressurization mechanisms that depressurize the upper arm T that has been pressurized by extracting air from the air bag 14 for the ischemia 14 in the armband portion 2 and the two air bags 250 for detecting the pulse wave.
  • . 5 drives two drive pumps 110 according to a command from the control unit 120
  • the drive unit 151 drives the control valve 111 and the exhaust valve 112 according to a command from the control unit 120.
  • the control unit 120 shown in FIG. 5 gives a command to the display unit 63, and for example, temperature display, time display, systolic blood pressure value, systolic blood pressure value, pulse, average blood pressure value PM, etc. as shown in FIG. Display the displayed contents.
  • a storage unit 153 and a data memory 154 are connected to the control unit 120.
  • the display unit 63 a liquid crystal display device, an organic EL device, or the like can be adopted.
  • a pre-measurement music generation mode for generating music to be heard by the measurement subject in order to put the measurement subject in a relaxed state, and the blood pressure is measured.
  • a measuring music generation mode for generating music to be heard by the measurement subject in order to bring the measurement subject into a relaxed state.
  • the music data generated in the pre-measurement music generation mode and the music data generated in the in-measurement music generation mode are stored in advance in the storage unit 153 that stores the music data. Thereby, the person to be measured can hear music before and during the measurement, and the person to be measured can be in a relaxed state.
  • the data memory 154 shown in FIG. 5 stores a program for performing a series of operations necessary for blood pressure measurement, and the control unit 120 performs a blood pressure measurement operation according to this program.
  • a start / stop switch 88 and a function selection key 400 as a function selection unit are electrically connected to the control unit 120.
  • the function selection key 400 is selected from a plurality of blood pressure measurement modes including 1) systolic blood pressure / diastolic blood pressure measurement mode, 2) systolic blood pressure / diastolic blood pressure / average blood pressure measurement mode, 3) average blood pressure measurement mode, and 4) auscultation mode.
  • the blood pressure measurement mode and the exhaust speed can be selected from a normal mode (4 mmHg / second) or a slow mode (4 mmHg / second).
  • the speaker 85 in FIG. 5 is an example of a notification unit for reporting relaxation music and voice guidance content, and is electrically connected to the control unit 120 via the filter 164.
  • the power control unit 160 is electrically connected to the battery 93 and the AC adapter 87 and supplies a predetermined DC voltage to the control unit 120.
  • the power supply control unit 160 and the pressure sensor 140 are electrically connected to the control unit 120.
  • FIG. 6A shows a change in blood pressure value obtained by the pressure sensor 140 shown in FIG. 5 from the fluctuation of the air pressure in the air bag 14 for ischemia
  • FIG. 6B shows the pressure sensor 140 shown in FIG.
  • variation of the air pressure of the air bag 250 for the pulse wave detection is shown.
  • the vertical axis indicates pressure and the peak value
  • the horizontal axis indicates time.
  • the control unit 120 detects the systolic blood pressure (systolic blood pressure) and the systolic blood pressure (diastolic blood pressure), and then operates the exhaust valve 112 to connect the air bag 14 for ischemia.
  • the air in the two pulse wave detection air bladders 250 is extracted.
  • the control unit 120 obtains a blood pressure waveform (DC waveform) WS illustrated in FIG. 6A from the pressure sensor 140.
  • FIG. 6B shows an example of an AC pulse waveform (AC waveform) WT obtained corresponding to the blood pressure waveform WS.
  • This AC pulse wave waveform WT is obtained from the change in pressure of the pulse wave detection air bladder 250 by the pressure sensor 140, and the control unit 120, for example, the pulse wave group M1 of the A group, the pulse wave group M2 of the B group, and A pulse wave group M3 of group C is obtained.
  • the pulse wave group M1 of the A group, the pulse wave group M2 of the B group, and the pulse wave group M3 of the C group each detect the maximum peak value by taking a peak from the pulse wave to form a linear spike waveform. It is made easy.
  • the blood pressure waveform WS illustrates an average pressure value PM described later.
  • This average blood pressure value PM is an average blood pressure value used when the person to be measured is a weak heart person such as a heart transplant patient transplanted with a living heart transplant or an auxiliary artificial heart or a person with weak pulse wave, for example, This is the blood pressure on the artery on average, usually obtained from the systolic blood pressure (systolic blood pressure) and the diastolic blood pressure (diastolic blood pressure).
  • systolic blood pressure systolic blood pressure
  • diastolic blood pressure diastolic blood pressure
  • This average pressure value PM is a value corresponding to the maximum pulse wave (maximum pulse wave height value) MM of the B pulse wave group M2 of the AC pulse wave waveform WT.
  • the sphygmomanometer 1 can measure not only the maximum blood pressure value and the minimum blood pressure value of a normal general user's blood pressure in the same manner as an ordinary blood pressure meter, but also the person to be measured can receive a living heart transplant or an auxiliary artificial heart. If the patient is a pulse weak person such as a transplanted heart transplant patient or a person with weak pulse wave, the average blood pressure value of these persons can be measured.
  • FIG. 7 is a flowchart showing an example of a blood pressure measurement operation when such an average blood pressure value detection operation is performed in accordance with an instruction from the control unit 120 of the sphygmomanometer 1.
  • the measurement subject presses the start / stop switch 88 shown in FIG. 2 to start the operation of the sphygmomanometer 1.
  • the person to be measured presses the function selection key 400 shown in FIGS. 2 and 5 to 1) the maximum blood pressure / minimum blood pressure measurement mode, 2) the maximum blood pressure / minimum blood pressure / average blood pressure measurement mode, and 3) the average blood pressure measurement.
  • the average blood pressure measurement mode 3) is selected from a plurality of blood pressure measurement modes consisting of the auscultation mode.
  • the control unit 120 in FIG. 5 When the subject himself / herself or a medical worker, a caregiver or the like selects the average blood pressure measurement mode, in the blood pressure measurement operation by the sphygmomanometer 1, the control unit 120 in FIG.
  • the drive pump 110 is operated to supply air to the air bag 14 for ischemia shown in FIG. 5 to pressurize the upper arm T until the time tr shown in FIG. Thereafter, the control unit 120 in FIG. 5 instructs, and the control valve 111 is operated to reduce the air pressure so that the inclination of the air pressure in the air bag 14 is constant.
  • the control unit 120 detects the maximum blood pressure value and the minimum blood pressure value based on the appearance of the pulse wave. Thereafter, the control unit 120 operates the exhaust valve 112 to release the air in the ischemic air bag 14 and the two pulse wave detecting air bags 250.
  • step 5 determines whether or not the measurement of the highest blood pressure value and the lowest blood pressure value of the measurement subject has succeeded in the blood pressure measurement operation of step SP2. If the subject is a normal heart transplant patient who is transplanted with a living heart transplant, an auxiliary artificial heart, or a normal person who is not weak, such as a person with weak pulse waves, the pulse pressure (difference between the maximum blood pressure and the minimum blood pressure) ) And a large number of pulse waves can be detected, so that the maximum blood pressure value and the minimum blood pressure value corresponding to the detected pulse wave can be measured. That is, the pressure sensor 140 detects a change in the pressure of the air bag 14 for ischemia, and the control unit 120 obtains a blood pressure waveform (DC waveform) WS illustrated in FIG.
  • DC waveform blood pressure waveform
  • step SP3 the control unit 120 displays the systolic blood pressure value, the diastolic blood pressure value, and the pulse on the display unit 63 shown in FIG. 5, and ends the blood pressure measurement operation.
  • step SP2 if the control unit 120 in FIG. 5 determines that the measurement of the maximum blood pressure value and the minimum blood pressure value in the blood pressure measurement in step SP2 is not successful, the control unit 120 Then, it is determined that the patient is a heart transplant patient transplanted with a living heart transplant or an auxiliary artificial heart or a person with weak pulse wave, and the process proceeds to the mean blood pressure measurement mode of step SP4.
  • the control unit 120 is a mode for detecting the maximum pulse wave MM shown in FIG. 6B, and is performed in steps SP5 to SP11 described below.
  • step SP5 the control unit 120 detects a change in the pressure of the pulse wave detection air bladder 250 of FIG. 5 and recognizes the AC pulse wave waveform WT shown in FIG. 6B.
  • the control unit 120 sets a threshold SHD in advance as illustrated in FIG. 7 with respect to the amplitude of the pulse wave (or the height of the pulse wave).
  • a pulse wave WW whose pulse wave amplitude is greater than or equal to the threshold value SHD is selected, and the data memory 154 shown in FIG. 5 is sequentially displayed corresponding to the pressure of the blood pressure waveform (DC waveform) WS illustrated in FIG. Let me remember.
  • the control unit 120 in FIG. 5 recognizes the AC pulse wave waveform WT shown in FIG.
  • step SP6 the process proceeds to step SP6, and the control unit 120 determines whether each AC pulse wave waveform WT pulse wave WW is an abnormal wave or a normal wave. Check if it is. That is, it is determined whether the phase of the pulse wave WW that is equal to or greater than the threshold value SHD stored in the data memory 154 in step SP5 is a positive phase and appropriate, or the width of the pulse wave WW is not narrow and appropriate. To do.
  • FIG. 8A illustrates a normal pulse wave WW having a positive phase and an appropriate phase
  • FIG. 8B illustrates an abnormal pulse wave WW1 having an opposite phase
  • FIG. 8C illustrates an abnormal pulse whose width (one cycle) in the time axis direction of the pulse wave is narrower than a predetermined width (one cycle) even if the pulse wave has an appropriate phase.
  • Wave WW2 As shown in FIG. 8B, in the case of the pulse wave WW1 whose phase is not valid or in the case of the pulse wave WW2 whose width shown in FIG. 8C is not valid, in step SP7 of FIG.
  • the control unit 120 deletes the pulse wave detection data from the data memory 154 shown in FIG.
  • step SP8 the pressure sensor 140 obtains, for example, pulse wave groups M1, M2, and M3 as shown in FIG. 6B, and the control unit 120 has pulse wave groups M1, M2, and so on as shown in FIG.
  • M3 it is determined from the detected pulse wave groups M1, M2, and M3 whether the maximum pulse wave amplitude (or maximum pulse wave height) has periodicity (trend). That is, as shown in FIG.
  • the control unit 120 determines whether there are pulse waves MM1 and MM2 having a pulse wave amplitude smaller than the maximum pulse wave MM at positions before and after the maximum pulse wave MM.
  • a pulse wave group M2 having pulse waves MM1 and MM2 having a pulse wave amplitude smaller than the maximum pulse wave MM at positions before and after the pulse wave MM is selected from the detected pulse wave groups M1, M2, and M3. Thereby, the position of the generated pulse wave of the maximum amplitude MM of the pulse wave can be confirmed.
  • the average blood pressure value PM of the measurement subject corresponding to MM can be accurately determined.
  • step SP10 of FIG. 7 the control unit 120 illustrates the blood pressure waveform illustrated in FIG. 6A corresponding to the generation position of the maximum pulse wave MM in the selected pulse wave group M2 illustrated in FIG.
  • the pressure in the WS (armband pressure, cuff pressure) is confirmed, and this pressure is confirmed and determined as the average blood pressure value PM for the maximum pulse wave MM.
  • the control part 120 displays the determined average blood pressure value PM with respect to a to-be-measured person in the display part 63 shown in FIG. 5 and FIG. Thereby, the person to be measured can visually confirm the average blood pressure value PM displayed on the display unit 63.
  • examples of voice guidance contents to be notified during blood pressure measurement include
  • the speaker 85 can send, for example, a notification content “measuring the average blood pressure value” in accordance with a command from the control unit 120.
  • the average blood pressure value PM can be notified to the person to be measured by voice guidance through the speaker 85 as necessary. Thereby, even if the person to be measured cannot visually confirm the average blood pressure value PM on the display unit 63, it can be confirmed by listening to the average blood pressure value PM.
  • the blood pressure measurement operation using the sphygmomanometer 1 is performed and the operation is terminated.
  • a medical worker can prescribe the measurement subject based on the value of the average blood pressure value PM.
  • the measurement subject can determine whether or not to consult a medical institution as necessary with reference to the average blood pressure value PM.
  • the present inventors have determined that an oscillometric method using a pulse wave is used even if a person to be measured is a heart transplant patient transplanted with a living heart transplant or an auxiliary artificial heart or a person with weak pulse such as a person with weak pulse wave.
  • produces has high correlation with average blood pressure.
  • the person to be measured is a heart transplant patient transplanted with a living heart transplant or auxiliary artificial heart or a person with weak pulse such as a person with weak pulse wave
  • an oscillometric person using a pulse wave is used even for a normal subject, a heart transplant patient transplanted with a living heart transplant, an auxiliary artificial heart, or a person with weak pulse wave.
  • the blood pressure value can be determined using the method.
  • This average blood pressure value can be displayed using only the pressure pulse wave (maximum amplitude of the pulse wave) because the measured subject's pulse weakness such as a heart transplant patient who has a living heart transplant or an auxiliary artificial heart transplanted or a person with weak pulse waves Is highly effective in the medical field.
  • FIGS. 9A and 9B show, as reference examples of blood pressure measurement, changes in blood pressure obtained from fluctuations in the air pressure of the ischemic bladder 14, and the pressure sensor 140 shown in FIG.
  • variation of the air pressure of the air bag 250 is shown.
  • the blood pressure value could not be determined because only a large pulse wave MX of one beat could be detected.
  • the normal mode is a mode in which the blood pressure is automatically measured while the air introduced into the ischemic air bladder 14 and the pulse wave detecting air bladder 250 is exhausted at a predetermined exhaust speed.
  • the slow mode is a mode in which the blood pressure is automatically measured by setting the exhaust speed of the air introduced into the ischemic air bladder 14 and the pulse wave detecting air bladder 250 to approximately half the predetermined exhaust speed of the normal speed. is there.
  • FIG. 10 is a perspective view showing a second embodiment of the sphygmomanometer of the present invention.
  • the drive pump 110 automatically compresses the upper arm T by supplying air into the ischemic air bag 14 in the armband portion 2.
  • the sphygmomanometer 1 ⁇ / b> A shown in FIG. 10 includes a sphygmomanometer main body 1001, an arm band part (also referred to as a cuff) 1002, and an air balloon 1003.
  • the sphygmomanometer main body 1001 has a display unit 1063.
  • a blood-insufficiency air bag 14 and a pulse wave detection air bag 250 are arranged.
  • the ischemic air bladder 14 and the pulse wave detecting air bladder 250 in the armband 1002 are connected to the air balloon 1003 by air tubes 1004 and 1006.
  • a person to be measured or a medical worker presses the air balloon 1003 to supply air to the air bag 14 for ischemia in the arm band portion 1002 to press the upper arm, and the arm band portion 1002 Air can be supplied to the inner air bag 250 for detecting pulse waves.
  • the manual compression type sphygmomanometer 1A shown in FIG. 10 is similar to the sphygmomanometer 1 shown in FIGS. 1 to 8, and the subject is a heart transplant patient having a living heart transplant or an auxiliary artificial heart or a weak pulse wave. Even a person with weakness such as a person can obtain an average blood pressure value.
  • the sphygmomanometer 1 measures a blood pressure value even when measuring blood pressure of a heart transplant patient transplanted with a living heart transplantation or an auxiliary artificial heart or a pulse weak person such as a person with weak pulse wave. can do. That is, when the pulse weak person cannot measure the maximum blood pressure value and the minimum blood pressure value even if the blood pressure is measured, the control unit determines the pressure in the air bag for ischemia when the maximum amplitude of the pulse wave is generated. Therefore, the average blood pressure value can be used as the blood pressure value of the weak pulse person.
  • a person with weak pulse is a heart transplant patient who has been transplanted with a living heart transplant or auxiliary artificial heart or a person with weak pulse wave, but a heart transplant patient or pulse who has been transplanted with a living heart transplant or auxiliary artificial heart. Even in a person with weak waves, the pressure in the air bag for ischemia when the maximum amplitude of the pulse wave occurs is determined as the average blood pressure value of the person being measured. Can be used as
  • the present invention is not limited to the above embodiment, and various modifications can be made without departing from the scope of the claims.
  • a part of each configuration of the above embodiment can be omitted, or can be arbitrarily combined so as to be different from the above.
  • two pulse wave detection air bags 250 are provided in the armband part 2, but one pulse wave detection air bag 250 may be provided in the armband part 2.
  • the blood pressure monitor of the present invention can be applied to either a so-called double cuff or triple cuff.
  • the sphygmomanometer of the present invention may have a structure in which the armband portion is provided integrally with the sphygmomanometer body.
  • FIG. 11 is a perspective view showing a preferred embodiment of the sphygmomanometer of the present invention.
  • 12 is a front view of the sphygmomanometer shown in FIG.
  • the blood pressure monitor preferably measures a patient's blood pressure by pressurizing an air bag in an arm band attached to the upper arm T of a patient by a manual pressurization method by a medical staff such as a nurse. It can be performed.
  • This manual pressurization type sphygmomanometer 501 has an integrated air balloon (pressurizing unit) and a sphygmomanometer body, so that a medical worker can pressurize the air balloon with one hand, and the motor sound can be heard. Because there is no, blood pressure can be measured quietly even at night.
  • the three measurement modes are a normal mode, a slow mode, and an auscultation mode.
  • the normal mode is a mode in which blood pressure measurement can be performed more quickly by automatic measurement.
  • slow mode the decompression speed (exhaust speed) after pressurization is set to be slower than the decompression speed after pressurization in normal mode by automatic measurement, and blood pressure is measured in patients with low blood pressure or patients with weak pulses. It is a mode that can.
  • the auscultation mode is a mode in which a medical worker measures blood pressure by an auscultation method using a stethoscope without performing automatic measurement.
  • the measurement method in the sphygmomanometer 501 shown in FIGS. 11 and 12 is an oscillometric method (so-called double cuff method), and as shown in FIG. 11, the measurement target site is the upper arm T of a patient who is a subject.
  • a power source to be used for example, a dry battery is used.
  • the sphygmomanometer 501 has a sphygmomanometer body 502 and an armband 503.
  • the sphygmomanometer main body 1 includes a housing 504 and an air balloon 505.
  • the air balloon 505 is made of, for example, a material having chemical resistance and stretchability such as silicone resin so that a medical worker can pressurize the inside air.
  • the air balloon 505 is a rubber balloon, for example.
  • the housing 504 of the sphygmomanometer main body 502 shown in FIGS. 11 and 12 is made of plastic, and has a rectangular display portion 508, a power switch 509, a mode switch 510, and an exhaust switch 511.
  • the display unit 508 is, for example, a liquid crystal display device or an organic EL (electroluminescence) display device, and may be a single color display or a color display.
  • the display unit 508 can display the maximum blood pressure value, the minimum blood pressure value, the pulse rate, and which of the three measurement modes described above is selected.
  • the power switch 509 can be turned on or off by the medical staff when pressed.
  • the mode switch 510 can switch the measurement mode to any of the above-described normal mode, slow mode, and auscultation mode when pressed by a medical staff.
  • a medical worker By pressing the exhaust switch 511, a medical worker can forcibly exhaust the air in the air bag for ischemia and the air bag for detecting arterial pulsation in the armband 503 described later.
  • the two tubes 506 and 507 are flexible tubes that connect the housing 504 and the armband 503 of the sphygmomanometer main body 502.
  • the tube 506 is thicker than the tube 507.
  • One end portion 506 ⁇ / b> B of the tube 506 is connected to the upper portion of the housing 504 via the connector portion 512.
  • One end portion 507B of the tube 507 is connected to the upper portion of the housing 504 via a plug 50507C and a connector portion 512.
  • the ends 506B and 7B side of the tubes 506 and 507 are fixed by a holder 513.
  • the tubes 506 and 507 are fixed by the holder 513 so that the tubes 506 and 507 are not separated, but one end portion 507B of the thin tube 507 is connected to one end portion 506B of the thick tube 506.
  • the length of the tube 506 is provided with a margin so that the movement of the tube 507 can follow the movement of the tube 506 by loosening it. As a result, even if the thick tube 506 is pulled in a somewhat unreasonable direction by pulling the thick tube 506, the thin tube 507 is not pulled by being pulled by the thick tube 506.
  • an extension 514 protrudes downward from the lower portion of the housing 504.
  • the extension portion 514 is a thin plate-like member that covers a part of the front portion 50505S of the air balloon 505.
  • the medical staff repeats the operation of grasping or releasing the air balloon 505 while supporting the extension 514 with the finger of the hand H, so that the air from the air balloon 505 is contained in the blood pressure monitor main body 502.
  • the air bag for ischemia and the air bag for detecting arterial pulsation in the armband portion 503 can be supplied through the pipe and the tubes 506 and 507. Projections 4T are formed on both sides of the housing 504.
  • FIG. 13 shows an example of display items that can be displayed by the display unit 508.
  • the display unit 508 includes a maximum blood pressure value display area 508A, a minimum blood pressure value display area 508B, a pulse display area 508C, a pulse wave signal display area 508D, a previous value display area 508E, and a display area during exhaust. 508F, underpressurized display area 508G, overpressurized display area 508H, and selected mode display area 508K.
  • the maximum blood pressure value display area 508A displays the instantaneous blood pressure during pressurization and decompression, and finally displays the maximum blood pressure value.
  • the lowest blood pressure value display area 508B displays the lowest blood pressure value finally determined.
  • surrounding brightness may be automatically detected, and the display unit 508 may be brightened with a backlight during measurement at night.
  • the pulse display area 508C shown in FIG. 13 displays the measured pulse value.
  • the pulse wave signal display area 508D displays the magnitude of the detected pulse wave signal, and the magnitude of the pulse wave signal is displayed in a bar shape that moves to the left and right.
  • the display of the magnitude of the pulse wave signal rhythmically increases or decreases from side to side, but in the case of a patient with arrhythmia, the display of the magnitude of the pulse wave signal Rhythmically does not increase or decrease from side to side.
  • the previous value display area 508E shown in FIG. 13 blinks or lights up when the power switch 509 is pressed to activate the operation of the sphygmomanometer main body 502, and the highest blood pressure value, the lowest blood pressure value, and the pulse value measured last time are the highest blood pressure.
  • the values are displayed in a value display area 508A, a minimum blood pressure value display area 508B, and a pulse display area 508C. Then, after a while or when air is supplied by operating the air balloon 505, the display of the previously measured maximum blood pressure value, minimum blood pressure value, and pulse value disappears, and the previous value display area 508E is displayed.
  • the display area 508 ⁇ / b> F during exhausting blinks when the air of the air bag for ischemia in the armband 503 and the air bag for detecting arterial pulsation is rapidly exhausted.
  • the display area 508F during exhaust also blinks when the exhaust switch 511 is pressed.
  • the underpressurized display area 5050508G shown in FIG. 13 When the underpressurized display area 5050508G shown in FIG. 13 is lit or flashing, it indicates that the pressure in the armband 503 has not reached a level sufficient for blood pressure measurement. The air balloon 505 can be further urged to send air.
  • the overpressurization display area 508H When the overpressurization display area 508H is lit or blinking, it indicates that the pressure in the armband 503 is equal to or higher than a predetermined pressure (for example, 320 mmHg or higher), By confirming the display area 508H, it is possible to prompt the user to stop the pressurizing operation.
  • a predetermined pressure for example, 320 mmHg or higher
  • the selected mode display area 508K displays which mode is selected from the normal mode, the slow mode and the auscultation mode by pressing the mode switch 510. By selecting this mode, the exhaust (decompression) speed can be changed.
  • the exhaust speed is set to about 4 to 6 mmHg / second, for example. In the normal mode, there is an advantage that the measurement time can be made relatively short because the exhaust speed is relatively fast.
  • the increment of the pressure change measurement is large, there is no particular problem when measuring a person with stable pulse, but when measuring the blood pressure of a person with arrhythmia, the pulse is easily lost. Measurement error may increase.
  • a slow mode is provided.
  • the exhaust speed is set to approximately half of the normal mode, for example, 2 to 3 mmHg / sec.
  • the quick mode the exhaust speed is set to 6 to 8 mmHg / second, for example.
  • the auscultation mode is a mode in which measurement is performed manually using a stethoscope.
  • the exhaust speed is set to about half of the normal mode, for example, 2.0 to 3.0 mmHg / sec. The user may arbitrarily change the setting between 2 and 6 mmHg / sec depending on the patient.
  • FIG. 14 shows a control circuit block example arranged in the sphygmomanometer body 502 and a configuration example of the armband 503.
  • a control unit 600 is arranged inside a housing 504 of the sphygmomanometer main body 502 shown in FIG. 14, and the control unit 600 has a central processing unit (CPU) 601.
  • CPU central processing unit
  • the control unit 600 includes a display unit 508, a power control unit 602, a power switch 509, a mode switch 510, an exhaust switch 511, a pressure sensor 610, a ROM (read only memory) 611, and a RAM (random access memory). ) 112, the driving unit 613, and the buzzer 614.
  • the power of the battery 615 shown in FIG. 14 is supplied to the controller 600 by being controlled by the power controller 602.
  • the battery 615 may be a dry battery or a secondary battery (rechargeable battery).
  • the power consumption during measurement is Since it is about 0.5 W, as a power source to be used, for example, only one AA dry battery (DC1.5V) or AA rechargeable battery (DC1.5V) is used. Therefore, when a new AA battery (DC1.5V) is used, blood pressure can be measured about 1000 times, and the entire sphygmomanometer 501 can be reduced in size and weight (about 135 g).
  • the display unit 508 displays the display items described with reference to FIG.
  • the pressure sensor 610 detects the pressure in the air bag 520 for ischemia of the armband 503 and the pressure in the air bag 540 for detecting arterial pulsation, which will be described later.
  • the pressure sensor 610 detects a change in pressure in the air bag for ischemia 520.
  • the pressure in the air bag for detecting arterial pulsation (referred to as “arterial pulsation detecting air bag”) 540 is caused by vibration of the arterial wall due to arterial pulsation of the upper arm T during blood pressure measurement, that is, the upper arm. Although it fluctuates due to the pulse wave of the T artery, the pressure sensor 610 detects this pressure fluctuation.
  • the air bag for ischemia 520 is also called a large cuff, and the air bag for detecting arterial pulsation 540 is also called a small cuff.
  • the pressure sensor 610 detects a change in the air pressure of the ischemic air bladder 520, and the pressure sensor 610 detects a change in the air pressure of the pulse wave detecting air bladder 540.
  • the control unit 600 calculates a maximum blood pressure value (systolic blood pressure) and a minimum blood pressure value (diastolic blood pressure) based on a DC waveform signal from the pressure sensor 610 based on a change in air pressure in the air bag 520 for ischemia.
  • the controller 600 detects a pulse wave (pressure pulse wave) based on an AC waveform signal from the pressure sensor 600 based on a change in air pressure of the pulse wave detection air bladder 540.
  • the ROM 611 stores a control program and various data in advance.
  • the RAM 612 temporarily stores calculation results and measurement results.
  • the drive unit 613 drives the electromagnetic valve 616 according to a command from the control unit 600.
  • the control unit 600 determines that the pressure fluctuation value detected by the pressure sensor 610 is equal to or greater than a predetermined value, the control unit 600 determines that the pressurization is currently being performed and instructs the drive unit 613 to Valve 616 is closed.
  • the control unit 600 determines that the pressure fluctuation value (increase value) is substantially zero or in a reduced pressure state within a predetermined period with respect to the pressure detected by the pressure sensor 610, the control unit 600 instructs the drive unit 613 to Then, the electromagnetic valve 616 is opened so that the pressure reduction speed becomes a predetermined value.
  • the operation of the sphygmomanometer 501 shifts from the pressurization mode to the measurement mode.
  • the forced exhaust valve 617 is opened by a command from the control unit 600 when the exhaust switch 511 is pressed.
  • the buzzer 614 generates a predetermined warning sound according to a command from the control unit 600.
  • the 14 is arranged between one end 506B of the tube 506 and the conducting tube 120.
  • the air supply bulb 505 is connected to one end 506B of the tube 506 through the manifold 618, the branching portion 619, the conducting tube 120, and the forced exhaust valve 617.
  • the other end 506A of the tube 506 is connected to the air bag 520 for ischemia.
  • the air balloon 505 is connected to the pressure sensor 610 via a manifold 618, a branch portion 619, a manifold 621, and a branch portion 622.
  • the branch portion 622 is connected to one end portion 507B of the tube 507.
  • the other end 507A of the tube 507 is connected to an air bag 540 for detecting arterial pulsation.
  • the pressure sensor 610 can detect the fluctuation of the pressure in the air bag 520 for ischemia and the fluctuation of the pressure in the air bag 540 for detecting arterial pulsation.
  • a medical worker grasps or releases the air balloon 505
  • the air enters the ischemic bladder 520 through the manifold 618, the branch 619, the conducting tube 120, the forced exhaust valve 617, and the tube 506.
  • air can be sent into the air bag 540 for detecting arterial pulsation through the manifold 618, the branching part 619, the manifold 621, the branching part 622, and the tube 507.
  • the sphygmomanometer according to the third embodiment has the following configuration in order to realize a measurement mode similar to the measurement mode according to the first embodiment.
  • a storage unit 702 and a data memory 701 are connected to the control unit 600.
  • the display unit 508 a liquid crystal display device, an organic EL device, or the like can be used.
  • a pre-measurement music generation mode for generating music to be heard by the measurement subject in order to put the measurement subject in a relaxed state
  • a blood pressure measurement during measurement for example, a pre-measurement music generation mode for generating music to be heard by the measurement subject in order to put the measurement subject in a relaxed state
  • a measurement-in-progress music generation mode for generating music to be heard by the measurement subject in order to put the measurement person in a relaxed state.
  • the music data generated in the pre-measurement music generation mode and the music data generated in the in-measurement music generation mode are stored in advance in the storage unit 153 that stores the music data. Thereby, the person to be measured can hear music before and during the measurement, and the person to be measured can be in a relaxed state.
  • the data memory 701 stores a program for performing a series of operations necessary for blood pressure measurement, and the control unit 600 performs a blood pressure measurement operation according to the program.
  • the mode switch 510 is electrically connected to the control unit 600.
  • a predetermined blood pressure measurement mode is selected from a plurality of blood pressure measurement modes including 1) systolic blood pressure / diastolic blood pressure measurement mode, 2) systolic blood pressure / diastolic blood pressure / average blood pressure measurement mode, 3) average blood pressure measurement mode, and 4) auscultation mode.
  • the exhaust speed can be selected from a normal mode (4 mmHg / sec) and a slow mode (4 mmHg / sec).
  • the speaker 704 is an example of an informing unit for informing relaxing music and voice guidance contents, and is electrically connected to the control unit 600 via the filter 703.
  • FIG. 15 is a perspective view showing a state in which the armband portion 503 is about to be wound.
  • FIG. 16A shows the inner surface side of the armband portion 503, and
  • FIG. 16B is a perspective view showing the outer surface side of the armband portion 503.
  • FIG. 17A is a plan view showing the outer surface side of the armband portion 503, and
  • FIG. 17B is a diagram showing an air bag for ischemia 520 disposed inside the armband portion 503 and for detecting arterial pulsation.
  • 5 is a plan view showing a shape example of an air bag 540.
  • the armband 503 includes a cuff cover 550, a blood cuff 520 for ischemia that is a large cuff, and an air bag 540 for detecting arterial pulsation that is a small cuff. have.
  • the cuff cover 550 covers the ischemic air bladder 520 and the arterial pulsation detecting air bladder 540 in a detachable manner.
  • the cuff cover 550 includes an outer cloth 551 and an inner cloth 552, and the outer cloth 551 and the inner cloth 552 are rectangular. The end of the outer cloth 551 and the end of the inner cloth 552 are fixed by, for example, sewing with a thread.
  • an air bag for ischemia 520 and an arterial pulsation detection are provided in the outer cloth 551 and the inner cloth 552.
  • the air bag 540 can be detachably stored.
  • the cuff cover 550 can be removed from the air bag for ischemia 520 and the air bag for detecting arterial pulsation 540 for replacement or disinfection.
  • the outer cloth 551 and the inner cloth 552 of the cuff cover 550 shown in FIGS. 15, 16, and 17 (A) constitute a storage body that covers the outer surface of the air bag for ischemia and are not stretched in the circumferential direction and the longitudinal direction. It is a cloth member that is made of a flexible material and is deformable but has very low or almost no stretchability. Accordingly, when the outer cloth 551 and the inner cloth 552 supply air into the ischemic air bladder 520 and the arterial pulsation detecting air bladder 540, the ischemic air bladder 520 and the arterial pulsating air bladder are detected. It is possible to prevent 540 from expanding outward in the radial direction of the armband portion 503.
  • the ischemic air bladder 520 and the arterial pulsation detecting air bladder 540 can apply pressure to the upper arm T side, which is the inner side in the radial direction, and the pressure generated by the ischemic air bladder 520 and arterial pulsation detection.
  • the pressure generated by the air bag 540 can be pressurized against the upper arm T without escaping to the outside of the armband 503, and accurate blood pressure measurement can be performed.
  • the cuff cover 550 has an opening 550P for taking out.
  • the opening 550P for taking out is a gap between the outer cloth 551 and the inner cloth 552, and is used to take out the air bag 520 for detecting ischemia and the air bag 540 for detecting arterial pulsation housed in the cuff cover 550.
  • it is provided to be inserted into the cuff cover 550.
  • a rectangular blood bag for ischemia is used.
  • 520 has a trapezoidal extension 521.
  • the trapezoidal extension portion 521 is located at a position corresponding to the opening portion 550P, and has an inclined portion 522 so that the extension portion 521 decreases in width toward the outside.
  • the extended portion 521 is formed so that its position is slightly shifted from the center with respect to the longitudinal direction of the air bag 520 for ischemia. For this reason, when the air bag for ischemia 520 and the air bag for detecting arterial pulsation 540 are inserted into the cuff cover 550 from the opening portion 550P, they are prevented from being inserted in the opposite directions. That is, if the ischemic bladder 520 and the arterial pulsation detecting bladder 540 are inserted in the cuff cover 550 from the opening portion 550P in the correct direction, the extension portion 521 coincides with the position of the opening portion 550P.
  • the extension portion 521 does not coincide with the position of the opening portion 550P. From this, the medical staff can determine whether or not the ischemic air bladder 520 and the arterial pulsation detecting air bladder 540 are correctly inserted into the cuff cover 550.
  • the size of the armband 503 is, for example, from small to large, SS size (applicable to upper arm circumference 13 to 20 cm), S size (applicable to upper arm circumference 17 to 26 cm), M size (upper arm circumference 24 to 32 cm), L size (applicable to upper arm circumference 32 to 42 cm), and LL size (applicable to upper arm circumference 42 to 50 cm).
  • SS size applicable to upper arm circumference 13 to 20 cm
  • S size applicable to upper arm circumference 17 to 26 cm
  • M size upper arm circumference 24 to 32 cm
  • L size applicable to upper arm circumference 32 to 42 cm
  • LL size applicable to upper arm circumference 42 to 50 cm
  • the lateral length L1 and width W1 of the cuff cover 550 of the SS size armband 503 are (345 ⁇ 5 mm, 100 ⁇ 4 mm), and the lateral length L2 and width W2 of the ischemic air bladder 520 are (130).
  • the lateral length L3 and the width W3 of the air bag 540 for detecting arterial pulsation are (30 ⁇ 1 mm, 20 ⁇ 1 mm).
  • the lateral length L1 and width W1 of the cuff cover 550 of the armband 503 are (435 ⁇ 5 mm, 130 ⁇ 4 mm), and the lateral length L2 and width W2 of the air bag 520 for ischemia.
  • the lateral length L3 and width W3 of the air bag 540 for detecting arterial pulsation are (40 ⁇ 1 mm, 25 ⁇ 1 mm).
  • the lateral length L1 and width W1 of the cuff cover 550 of the armband 503 are (520 ⁇ 5 mm, 150 ⁇ 4 mm), and the lateral length L2 and width W2 of the air bag 520 for ischemia.
  • the lateral length L3 and the width W3 of the air bag 540 for detecting arterial pulsation are (60 ⁇ 1 mm, 30 ⁇ 1 mm).
  • the lateral length L1 and width W1 of the cuff cover 550 of the armband 503 are (640 ⁇ 5 mm, 190 ⁇ 4 mm), and the lateral length L2 and width W2 of the air bag 520 for ischemia. (320 ⁇ 10 mm, 170 ⁇ 5 mm), the lateral length L3 and width W3 of the air bag 540 for detecting arterial pulsation are (80 ⁇ 1 mm, 40 ⁇ 1 mm).
  • the lateral length L1 and width W1 of the cuff cover 550 of the armband portion 503 are (220 ⁇ 4 mm, 830 ⁇ 5 mm), and the lateral length L2 and width W2 of the air bag 520 for ischemia. (420 ⁇ 10 mm, 200 ⁇ 5 mm), the lateral length L3 and width W3 of the air bag 540 for detecting arterial pulsation are (100 ⁇ 1 mm, 50 ⁇ 1 mm).
  • the outer cloth 551 of the cuff cover 550 is provided with a female (loop) portion 553 of a hook-and-loop fastener.
  • the female portion 553 of the surface fastener is a rectangular member, and is arranged from the start end 554 side of the outer cloth 551 to the substantially central position of the outer cloth 551.
  • Two recognition marks 555 indicating the start end portion 554 are provided on the start end portion 554 side of the outer cloth 551.
  • the two recognition marks 555 are triangular, for example.
  • a ring-shaped recognition mark 556 is provided in the vicinity of the opening 550P of the outer cloth 551.
  • This recognition mark 556 indicates a position where the artery of the patient's upper arm T shown in FIG. 11 is compressed. For this reason, as shown in FIG. 15, when the arm band portion 503 is wound around the upper arm T and fixed, the recognition mark 556 is positioned on the artery of the upper arm T. Accordingly, the air bag 540 for detecting arterial pulsation can be accurately positioned on the artery, and accurate blood pressure measurement can be performed.
  • the inner cloth 552 of the cuff cover 550 is provided with a male portion 557 of a hook-and-loop fastener.
  • the male (hook) portion 557 of the hook-and-loop fastener is attached to and detached from the female portion 553 of the hook-and-loop fastener described above.
  • the arm band portion 503 can be formed in a cylindrical shape by being attached so that the arm band portion 503 is not displaced with respect to the upper arm T.
  • the male portion 557 of the surface fastener is provided at a position closer to the end portion 558 side of the inner cloth 552.
  • two arrow marks 559 are provided at the center position of the inner cloth 552. Two arrow marks 559 indicate that the armband portion 503 is a surface that is in direct contact with the upper arm T and the direction in which the armband portion 503 is wound.
  • a weight 560 is disposed inside the cuff cover 550 on the end portion 558 side.
  • the weight 560 is a member made of, for example, a metal round bar, and is fixed along the direction of the end portion 558 so that the end portion 558 of the cuff cover 550 is not sandwiched between the outer cloth 551 and the inner cloth 552 and moved. Has been. Since the air bag 520 for ischemia is not disposed in the terminal portion 558, the weight 560 can be easily accommodated in the terminal portion 558.
  • the weight of the weight 560 is used when the medical worker wraps and fixes the upper arm T of the patient as shown in FIG.
  • the male part 557 of the hook and loop fastener can be detachably attached to the female part 553 of the hook and loop fastener described above. That is, when the medical staff finishes wrapping the armband portion 503 around the patient's upper arm T, the weight of the weight 560 at the terminal portion 558 of the armband portion 503 is applied in the direction in which the armband portion 503 is wound. Can be easily wound. For this reason, it is possible to increase the efficiency of wrapping and fixing the arm band 503 of the medical staff, particularly for a patient whose upper arm circumference is greater than 42 cm.
  • the weight 560 is disposed inside the end portion 558 of the cuff cover 550, a protruding portion can be formed on the end portion 558 of the cuff cover 550, and a medical worker can serve as a handle for gripping the weight 560 with a finger. Can also fulfill. For this reason, since a medical worker can hold the terminal portion 558 of the arm band portion 503 with his / her hand, the terminal portion 558 of the arm band portion 503 is not detached from the hand. For this reason, the winding fixing work efficiency of the arm band part 503 of a medical worker can be raised.
  • the weight 560 is made of a metal bar having a circular cross section (outside diameter of about 3 to 5 mm), the length is slightly shorter than the width of the cuff cover 550, and 15% of the weight of the arm band portion 503 of about 150 g. By setting it to less than about 18 to 22 g, the patient will not feel uncomfortable when the armband 503 is attached to the upper arm.
  • an anti-slip portion 561 is preferably attached to the start end portion 554 side of the inner cloth 552 of the cuff cover 550, for example, using an adhesive. Is fixed.
  • the anti-slip portion 561 is, for example, a belt-like thin member, and can be made of, for example, synthetic rubber, polyurethane, elastomer, or the like, which is a material that is difficult to slip by being in close contact with the upper arm T.
  • the material of the non-slip portion 561 is a material that exhibits a high frictional force against the skin surface of the upper arm T and does not impose a burden on the skin surface of the upper arm T.
  • the medical worker winds the armband portion 503 around the upper arm T of the patient.
  • the start end portion 554 of the armband portion 503 can be prevented from slipping from the bare skin of the upper arm T, and the air bag 540 for detecting arterial pulsation can be prevented from being displaced from the artery of the upper arm T. For this reason, accurate blood pressure measurement can be performed.
  • the air bag for ischemia 520 and the air bag for detecting arterial pulsation 540 shown in FIG. 17B are bag-like members formed of a flexible material.
  • the air bag for ischemia 520 is made of natural rubber, synthetic rubber, elastomer, or the like.
  • the air bag 540 for detecting arterial pulsation is made of polyurethane or the like.
  • a hard plate 65 is disposed between the air bag 520 for ischemia and the air bag 540 for detecting arterial pulsation. By arranging the hard plate 65, minute pressure fluctuations in the air bag 540 for detecting arterial pulsation can be detected without being influenced by large pressure fluctuations in the air bag 520 for ischemia. .
  • the extended portion 521 of the ischemic bladder 520 is connected to the other end 506A of the tube 506, and the arterial pulsation detecting bladder 540 is connected to the other end 507A of the tube 507. ing. Since the other end 507A of the tube 507 having a small diameter is loosened with respect to the other end 506A of the tube 506 having a large diameter, the air bag for ischemia 520 and arterial pulsation detection are provided through the opening 550P of the cuff cover 550.
  • the other end 507A of the tube 507 having a small diameter is large when the air bag 540 and the air bag 540 for detecting arterial pulsation are accommodated through the opening portion 550P of the cuff cover 550.
  • the tube 506 is prevented from being damaged by being pulled by the other end 506A of the tube 506.
  • FIG. 18 shows an example of a procedure for winding the armband 503 directly around the skin of the upper arm T of the patient.
  • the arm band portion 503 to be wound around the upper arm T has the outer cloth 551 side down and the inner cloth 552 up.
  • FIG. 18B to 18B the inner cloth 552 side is applied from the lower side of the upper arm T.
  • the medical worker holds the start end portion 554 of the armband portion 503 by hand and winds the armband portion 503 around the upper arm T along the R1 direction.
  • the recognition mark 556 shown in FIGS. 15 and 16A is positioned according to the position of the artery of the upper arm T as shown in FIG. 540 can be accurately positioned relative to the artery of the upper arm T.
  • the anti-slip portion 561 on the start end portion 554 side directly contacts the bare skin of the upper arm T, so that the start end portion 554 can be held so as not to be displaced from the upper arm T.
  • the anti-slip portion 561 exhibits a high frictional force against the skin surface of the upper arm T, and the medical staff slips from the bare skin of the upper arm T when the arm band portion 503 is wound around the upper arm T of the patient. prevent.
  • the air bag 540 for detecting arterial pulsation can be prevented from deviating from the artery of the upper arm T, and the pressure sensor 610 shown in FIG. 14 accurately detects the fluctuation of the air pressure in the air bag 540 for detecting arterial pulsation. Therefore, accurate blood pressure measurement can be performed.
  • the medical worker holds the end portion 558 of the armband portion 503 by hand and winds the armband portion 503 around the upper arm T along the R2 direction.
  • the arm band portion 503 is provided inside the end portion 558.
  • the male part 557 of the surface fastener on the terminal end 558 side is detachably attached to the female part 553 of the surface fastener described above. Therefore, the medical staff wraps the end portion 558 of the armband portion 503 around the upper arm T until the end, and holds the end portion 558 of the armband portion 503 by hand and holds the male portion 557 of the fastener and the hook-and-loop fastener. Since the labor of attaching the knife portion 553 is eliminated, the work of the medical staff can be reduced.
  • the arm band portion 503 can be directly wound around the skin of the upper arm T and fixed so as not to be displaced.
  • the weight 560 is disposed at the end portion 558 of the cuff cover 550, the weight 560 is a protruding portion at the end portion 558 of the cuff cover 550.
  • the medical staff can also play a role as a handle for gripping the protruding portion of the cuff cover 550 covering the weight 560 with a finger.
  • the medical staff can surely have the protruding portion of the cuff cover 550 covering the weight 560, so that the end portion 558 of the armband portion 503 can be removed from the hand. It will not come off.
  • the medical staff presses the power switch 509 shown in FIG. 13 and further presses the mode switch 510 with the armband 503 held in the correct posture with respect to the upper arm T. Select the desired mode with.
  • the air from the air balloon 505 is exchanged with a pipe and a tube in the sphygmomanometer body 502 by repeating the operation of grasping or separating the air balloon 505 while supporting the extension 514 with the finger of the hand H. Air is fed into the air bag 520 for ischemia and the air bag 540 for detecting arterial pulsation in the armband 503 through 506 and 507, respectively.
  • FIG. 19 shows an example in which the pressure applied to the upper arm T by the air bag for ischemia 520 changes with time.
  • air is sent into the air bag 520 for detecting ischemia and the air bag 540 for detecting arterial pulsation shown in FIG. Therefore, as shown in FIG. 19, the pressure in the air bag for ischemia 520 in the armband 503 increases during the pressure increase period t1.
  • the control unit 600 in FIG. 14 determines that the pressurization is currently being performed, and instructs the drive unit 613 to close the electromagnetic valve 616. And the operation
  • the controller 600 waits for the natural pressure reduction period t2 and then determines that the pressure detected by the pressure sensor 610 in FIG. 14 is in the pressure reduction state in the optimum speed pressure reduction period t3.
  • the unit 613 is instructed to open the electromagnetic valve 616 so that the pressure reduction speed becomes a predetermined value.
  • the control unit 600 shown in FIG. 14 receives a maximum blood pressure value (SYS) based on a signal from the pressure sensor 610.
  • SYS maximum blood pressure value
  • a minimum blood pressure value (D1A) and a pulse value are acquired.
  • the control unit 600 in FIG. 14 operates the forced exhaust valve 617 to force the air in the air bag 520 for ischemia in the armband 503 and the air bag 540 for detecting arterial pulsation. Evacuate to eliminate pressure.
  • the medical staff may remove the armband 503 from the patient's upper arm T in the order of FIG. 18C, FIG. 18B, and FIG. That is, as shown in FIG. 18C, the medical worker holds the portion of the weight 560 of the end portion 558 of the arm band portion 503 by hand, and peels off the end portion 558 of the arm band portion 503 along the R3 direction. . Accordingly, as shown in FIG. 18B, the male part 557 of the surface fastener on the terminal end 558 side of the armband part 503 is peeled off from the female part 553 of the surface fastener on the start end part 554 side of the armband part 503.
  • the end portion 558 side of the armband portion 503 can be easily separated from the upper arm T.
  • the medical staff holds the starting end portion 554 of the armband portion 503 by hand and separates it from the upper arm T in the R4 direction, so that the anti-slip portion 561 on the starting end portion 554 side becomes the upper arm.
  • the arm band portion 503 can be easily detached from the upper arm T as shown in FIG.
  • the sphygmomanometer 501 of the embodiment of the present invention has an armband portion 503.
  • the armband portion 503 When the blood pressure is measured by winding the armband portion 503 around the patient's upper arm T, which is a patient, and pressurizing the armband portion 503, the armband portion 503 starts to be wound around the upper arm T.
  • An anti-slip portion 561 is provided for stopping the upper arm T from slipping. For this reason, the armband 503 can be wound around the patient's upper arm T while being easily positioned. That is, an anti-slip portion 561 for stopping slipping on the upper arm T is provided inside the start end portion 554 of the arm band portion 503.
  • the anti-slip portion 561 can stop the start end portion 554 of the armband portion 503 so as not to slide with respect to the upper arm T.
  • the belt 503 can be wound around the upper arm T while being easily positioned. Therefore, blood pressure can be accurately measured.
  • a weight 560 is provided at the terminal end 558 where the arm band 503 is wound around the upper arm T. For this reason, when the medical staff wraps the arm band 503 around the patient's upper arm T and finishes wrapping, the weight of the weight 560 at the terminal portion 558 of the arm band 503 is applied in the direction in which the arm band 503 is wound. Can be easily wound.
  • the armband portion 503 includes an air bag 520 for blocking the upper arm T by supplying air, and an air bag 540 for detecting arterial pulsation that detects the pulsation of the artery of the upper arm T by supplying air.
  • the arm cloth portion cover 50 is composed of an outer cloth 551 and an inner cloth on the inner side of the outer cloth 52 and accommodates an air bag 520 for ischemia and an air bag 540 for detecting arterial pulsation. For this reason, even if it is the arm band part 503 which accommodated the air bag 520 for ischemia and the air bag 540 for arterial pulsation detection in the arm band part cover 50, it can wind around, positioning easily. Therefore, blood pressure can be accurately measured.
  • the non-slip portion is disposed on the inner cloth of the armband portion cover. For this reason, it is possible to stop the start end portion 554 of the arm band portion 503 so that the anti-slip portion 561 does not slip with respect to the upper arm T only by arranging the anti-slip portion 561 on the inner cloth 552.
  • the weight 560 is disposed between the outer cloth 551 and the inner cloth 552 at the end portion 558 of the armband portion 503. For this reason, the weight 560 can be easily provided only by arranging the weight 560 between the outer cloth 551 and the inner cloth 552. For this reason, the blood pressure monitor main body 502 that supplies air to the air bag 520 for ischemia of the armband 503 and the air bag 540 for detecting arterial pulsation is provided.
  • the blood pressure monitor main body 502 includes a housing 504 and a housing 504. , And the tubes 506 and 507 for sending air to the ischemic air bladder 520 and the arterial pulsation detecting bladder 540 by manually pressing the air balloon 505. Therefore, in a state where the medical worker holds the air balloon 505 with one hand, the medical worker can wrap the armband portion 503 around the upper arm 5 with only the other hand while winding the armband portion. The winding workability of 503 can be improved.
  • the maximum blood pressure value and the minimum blood pressure value are measured in the same manner as an ordinary sphygmomanometer for the blood pressure of a normal general user.
  • the person being measured is a heart transplant patient with a living heart transplant, an auxiliary artificial heart, or a pulse weak person such as a person with weak pulse waves it can. This point will be described with reference to the contents of FIGS. FIG.
  • step SP1 the person to be measured presses the mode switch 510 described in FIG. 14, 1) the maximum blood pressure / minimum blood pressure measurement mode, 2) the maximum blood pressure / minimum blood pressure / average blood pressure measurement mode, 3) the average blood pressure measurement mode, 4 3)
  • the average blood pressure measurement mode 3) is selected from a plurality of blood pressure measurement modes including the auscultation mode.
  • the control unit 600 in FIG. 14 instructs and uses the air balloon 505 in FIG. Air is supplied to the air bag 550 shown in FIG. 14 to pressurize the upper arm T until the time tr shown in FIG. Thereafter, the control unit 600 in FIG. 14 instructs to reduce the air pressure so that the inclination of the air pressure in the ischemic bladder 520 becomes constant. In the process of reducing the air pressure, the control unit 600 detects the maximum blood pressure value and the minimum blood pressure value based on the appearance of the pulse wave. Thereafter, the control unit 600 removes the air in the ischemic air bag 520 and the pulse wave detecting air bag 540.
  • step SP2 determines whether the measurement of the highest blood pressure value and the lowest blood pressure value of the measurement subject has succeeded in the blood pressure measurement operation of step SP2. If the subject is a normal heart transplant patient who is transplanted with a living heart transplant, an auxiliary artificial heart, or a normal person who is not weak, such as a person with weak pulse waves, the pulse pressure (difference between the maximum blood pressure and the minimum blood pressure) ) And a large number of pulse waves can be detected, so that the maximum blood pressure value and the minimum blood pressure value corresponding to the detected pulse wave can be measured. That is, the pressure sensor 610 detects a change in the pressure of the air bag 520 for ischemia, the control unit 600 obtains a blood pressure waveform (DC waveform) WS illustrated in FIG.
  • DC waveform blood pressure waveform
  • step SP3 the control unit 600 displays the highest blood pressure value, the lowest blood pressure value, and the pulse on the display unit 508 shown in FIG. 14, and ends the blood pressure measurement operation.
  • step SP2 when the control unit 600 in FIG. 14 determines that the measurement of the maximum blood pressure value and the minimum blood pressure value in the blood pressure measurement in step SP2 is not successful, the control unit 600 determines that the measurement subject has Then, it is determined that the patient is a heart transplant patient transplanted with a living heart transplant or an auxiliary artificial heart or a person with weak pulse wave, and the process proceeds to the mean blood pressure measurement mode of step SP4.
  • the control unit 600 is a mode for detecting the maximum pulse wave MM shown in FIG. 6B, and is performed in steps SP5 to SP11 described below.
  • control unit 600 detects a change in pressure of pulse wave detection air bladder 540 and recognizes AC pulse wave waveform WT shown in FIG. 6B.
  • the control unit 600 sets a threshold value SHD in advance as illustrated in FIG. 7 for the amplitude of the pulse wave (or the height of the pulse wave).
  • a pulse wave WW whose pulse wave amplitude is greater than or equal to the threshold value SHD is selected, and sequentially corresponds to the pressure of the blood pressure waveform (DC waveform) WS illustrated in FIG. Let me remember.
  • controller 600 in FIG. 14 recognizes AC pulse wave waveform WT shown in FIG.
  • step SP6 controller 600 determines whether each AC pulse wave waveform WT pulse wave WW is an abnormal wave or a normal wave. Check if it is. That is, it is determined whether the phase of the pulse wave WW that is equal to or greater than the threshold value SHD stored in the data memory 701 in step SP5 is a positive phase and valid, or the width of the pulse wave WW is not narrow and valid. To do.
  • FIG. 8A illustrates a normal pulse wave WW having a positive phase and an appropriate phase
  • FIG. 8B illustrates an abnormal pulse wave WW1 having an opposite phase
  • FIG. 8C illustrates an abnormal pulse whose width (one cycle) in the time axis direction of the pulse wave is narrower than a predetermined width (one cycle) even if the pulse wave has an appropriate phase.
  • Wave WW2 As shown in FIG. 8B, in the case of the pulse wave WW1 whose phase is not valid or in the case of the pulse wave WW2 whose width shown in FIG. 8C is not valid, in step SP7 of FIG.
  • the control unit 600 deletes the pulse wave detection data from the data memory 701 shown in FIG.
  • step SP8 the pressure sensor 610 obtains, for example, pulse wave groups M1, M2, and M3 as shown in FIG. 6B, and the control unit 600 causes the pulse wave groups M1, M2, and so on as shown in FIG.
  • M3 it is determined from the detected pulse wave groups M1, M2, and M3 whether the maximum pulse wave amplitude (or maximum pulse wave height) has periodicity (trend). That is, as shown in FIG.
  • the control unit 600 determines whether there are pulse waves MM1 and MM2 having a pulse wave amplitude smaller than the maximum pulse wave MM at positions before and after the maximum pulse wave MM.
  • a pulse wave group M2 having pulse waves MM1 and MM2 having a pulse wave amplitude smaller than the maximum pulse wave MM at positions before and after the pulse wave MM is selected from the detected pulse wave groups M1, M2, and M3. Thereby, the position of the generated pulse wave of the maximum amplitude MM of the pulse wave can be confirmed.
  • the average blood pressure value PM of the measurement subject corresponding to MM can be accurately determined.
  • step SP10 of FIG. 7 the control unit 600 illustrates the blood pressure waveform illustrated in FIG. 6A corresponding to the generation position of the maximum pulse wave MM in the selected pulse wave group M2 illustrated in FIG.
  • the pressure in the WS (armband pressure, cuff pressure) is confirmed, and this pressure is confirmed and determined as the average blood pressure value PM for the maximum pulse wave MM.
  • the control part 600 displays the determined average blood pressure value PM with respect to a to-be-measured person in the display part 508 shown in FIG. Thereby, the measurement subject can visually confirm the average blood pressure value PM displayed on the display unit 508.
  • examples of voice guidance contents to be notified during blood pressure measurement include
  • the speaker 704 can send a notification content such as “measuring the average blood pressure value”, for example, according to a command from the control unit 600.
  • the average blood pressure value PM can be notified to the person to be measured by voice guidance through the speaker 704 as necessary. Thereby, even if the person to be measured cannot visually confirm the average blood pressure value PM on the display unit 508, it can be confirmed by listening to the average blood pressure value PM.
  • the blood pressure measurement operation using the sphygmomanometer 501 is performed and the operation is terminated.
  • a medical worker can prescribe the measurement subject based on the value of the average blood pressure value PM.
  • the measurement subject can determine whether or not to consult a medical institution as necessary with reference to the average blood pressure value PM.
  • the present inventors have determined that an oscillometric method using a pulse wave is used even if a person to be measured is a heart transplant patient transplanted with a living heart transplant or an auxiliary artificial heart or a person with weak pulse such as a person with weak pulse wave.
  • the pressure at which the maximum pulse wave MM is generated has a high correlation with the average blood pressure.
  • the present invention is not limited to the above embodiment, and various modifications can be made without departing from the scope of the claims.
  • the illustrated sphygmomanometer is of a manual pressurization type, but the sphygmomanometer of the present invention is not limited to this.
  • the automatic sphygmomanometer 501 has an arm band portion 503 and the arm band portion 503 has a separate sphygmomanometer body 502, and the arm band portion is wound around the upper arm of a patient (a person to be measured).
  • the pressurized air from the sphygmomanometer body 502 is passed through the tubes 506 and 507. 520 and the arterial pulse detection air bag 540 (see FIG. 14).
  • a power source to be used for example, about four AA dry batteries (DC1.5V) or AA rechargeable batteries (DC1.5V) are used, or a nickel-cadmium rechargeable battery is used.
  • a microphone (not shown) is provided, and by detecting the Korotkoff sound, the maximum blood pressure (systolic blood pressure) and the minimum blood pressure (diastolic blood pressure) are calculated. It may be.
  • a circuit for detecting a pulse wave from the pressure pulse wave from the ischemic air bag 520 is provided without providing the air bag 540 for detecting the arterial pulsation, and the highest blood pressure (systolic blood pressure), the lowest blood pressure is detected from the detected pulse wave. Blood pressure (diastolic blood pressure) may be calculated.
  • the round bar-shaped weight 560 is housed and disposed inside the terminal portion 558 of the cuff cover 550, but this is an example, and the shape of the weight can be arbitrarily selected.
  • a metal weight 560M is exposed to the outside of the end portion 558 of the cuff cover 550, and this weight 560M is used by a medical worker to hold it with a finger. It also plays the role of a handle. Thereby, the medical staff can also play a role as a handle for grasping the weight 560 with a finger.
  • an anti-slip portion 561 is preferably attached to the start end portion 554 side of the inner cloth 552 of the cuff cover 550, for example, using an adhesive. Is fixed.
  • the present invention is not limited to this, and the anti-slip portion 561 can be made of a material having an anti-slip ability at the start end portion 554 of the inner cloth 552 itself. A part of each configuration of the above embodiment can be omitted, or can be arbitrarily combined so as to be different from the above.

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  • Measuring Pulse, Heart Rate, Blood Pressure Or Blood Flow (AREA)

Abstract

L'invention concerne un sphygmomanomètre au moyen duquel la pression sanguine d'un sujet peut être mesurée même dans un cas où le sujet est une personne ayant un faible pouls, par exemple, un patient à greffe de cœur vitale, un patient à greffe de cœur artificiel auxiliaire ou un patient à pouls faible. Le sphygmomanomètre (1) comprend une partie de bande de bras (2) comportant une poche d'air ischémique (14) pour presser le bras supérieur d'un sujet et une poche d'air de détection d'onde de pouls (250) pour détecter l'onde de pouls du sujet, un mécanisme de mise sous pression (110) pour mettre sous pression l'intérieur de la poche d'air ischémique et de la poche d'air de détection d'onde de pouls, des mécanismes de dépressurisation (111, 112) pour dépressuriser l'intérieur de la poche d'air ischémique et de la poche d'air de détection d'onde de pouls, un capteur de pression (140) pour détecter la pression dans la poche d'air ischémique et la pression dans la poche d'air de détection d'onde de pouls, et une partie de commande (120) pour détecter la pression sanguine et l'onde de pouls sur la base de signaux provenant du capteur de pression, où, dans le cas où le sujet est une personne ayant un pouls faible, la partie de commande (120) détermine la pression sanguine moyenne (PM) du sujet en tant que pression dans la poche d'air ischémique (14) au moment où l'amplitude maximale (MM) de l'onde de pouls se produit au cours de la dépressurisation de l'intérieur de la poche d'air ischémique et de la poche d'air de détection d'onde de pouls.
PCT/JP2012/005696 2011-09-26 2012-09-07 Sphygmomanomètre WO2013046556A1 (fr)

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CN111343912A (zh) * 2017-09-14 2020-06-26 皇家飞利浦有限公司 基于充气的无创血压监测器的充气装置和操作其的方法
CN111426004A (zh) * 2020-03-25 2020-07-17 江苏安捷鹿检测科技有限公司 一种分布式室内空气监测方法

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CN111343912A (zh) * 2017-09-14 2020-06-26 皇家飞利浦有限公司 基于充气的无创血压监测器的充气装置和操作其的方法
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CN111426004A (zh) * 2020-03-25 2020-07-17 江苏安捷鹿检测科技有限公司 一种分布式室内空气监测方法

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