WO2022131038A1 - 血流管理装置および血流管理システム - Google Patents
血流管理装置および血流管理システム Download PDFInfo
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- WO2022131038A1 WO2022131038A1 PCT/JP2021/044607 JP2021044607W WO2022131038A1 WO 2022131038 A1 WO2022131038 A1 WO 2022131038A1 JP 2021044607 W JP2021044607 W JP 2021044607W WO 2022131038 A1 WO2022131038 A1 WO 2022131038A1
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- 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
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Definitions
- This disclosure relates to a blood flow control device.
- peripheral neuropathy chemotherapy-induced peripheral neuropathy: CIPN
- hypoesthesia and paresthesia can be caused in the periphery of the extremities. It has been known.
- Cooling therapy has been proposed as an example.
- the cooling therapy locally cools the periphery of the extremities that may cause symptoms of CIPN, reduces blood flow, reduces drug exposure in the periphery, and reduces the occurrence of CIPN.
- Patent Document 1 discloses a damage suppression cooling device.
- the damage suppression cooling device controls the cooling capacity or cooling temperature for each site (damage suppression site) where damage is caused by the anticancer drug or the blood flow system site (damage suppression target site) of the damage suppression site, and suppresses damage. Perform cooling.
- compression therapy has been proposed as another example.
- the compression therapy compresses the periphery of the extremities that may cause symptoms of CIPN, reduces blood flow, reduces drug exposure in the periphery, and reduces the occurrence of CIPN.
- a method of reducing blood flow in the hand is used by wearing two elastic gloves having a size smaller than the size of the patient's hand.
- the blood flow management device includes a blood flow sensor which is arranged in direct or indirect contact with a measured portion at a target site and can acquire blood flow data which is data related to blood flow, and the above-mentioned blood flow sensor.
- a blood flow regulating means for regulating the blood flow of the target site according to the blood flow data is provided.
- FIG. 2 is a cross-sectional view taken along the line II-II of FIG.
- FIG. 3 is a cross-sectional view taken along the line III-III of FIG.
- It is a functional block diagram which shows an example of the structure of the cooling management system which concerns on Embodiment 1 of this disclosure.
- It is a flowchart which shows an example of the flow of the cooling process by the said cooling apparatus.
- It is a flowchart which shows an example of the flow of the cooling process by the said cooling apparatus.
- FIG. 2 is a cross-sectional view taken along the line II-II of FIG. It is a functional block diagram which shows an example of the structure of the pressurization management system which concerns on Embodiment 1 of this disclosure.
- FIG. It is a flowchart which shows an example of the flow of the pressurization management process by the pressurizing apparatus shown in FIG. It is a functional block diagram which shows the modification of the structure of the pressurization management system which concerns on Embodiment 2 of this disclosure. It is a flowchart which shows an example of the flow of the pressurization management process by the pressurizing apparatus shown in FIG. It is a figure which shows the power spectrum in the state which the hand is not pressed. It is a figure which shows the power spectrum in the state of pressing a hand.
- the conventional method in compression therapy may cause ischemic symptoms due to excessive compression, and control of blood flow at the compression site is desired.
- the blood flow control device of the present disclosure can provide a blood flow control device with improved accuracy of measurement by a sensor.
- the blood flow control device of the present disclosure will be described in detail.
- the blood flow control device of the present disclosure is, for example, a device that can be used for performing blood flow control as a therapeutic preventive strategy for CIPN, which is a side effect of an anticancer drug.
- the blood flow control device of the present disclosure is a device that manages the blood flow of the target site.
- the target site is, for example, a site for which the possibility of developing CIPN symptoms is to be reduced, for example, the peripheral part of the limb, typically the hand (from the wrist to the fingertip) or the foot (ankle). From to the tip of the toe).
- the target site is not limited to the exemplified portion, and may include a lower arm portion or a lower leg portion.
- the subject means a person who requires a blood flow control procedure, for example, a patient.
- An exemplary embodiment of the blood flow control device of the present disclosure is a cooling device that changes the blood flow by cooling the target site and manages the blood flow in the target site, for example.
- Another exemplary embodiment of the present disclosure is to alter blood flow by compressing the target site and, if necessary, upstream (closer to the heart) of the target site and to control blood flow at the target site. It is a compression device.
- the cooling device will be described in detail in the first embodiment, and the compression device will be described in detail in the second embodiment.
- the cooling device 500 of the present disclosure is a device that can be used to perform cooling treatment as a therapeutic preventive strategy for CIPN.
- the cooling device 500 of the present disclosure is a cooling device 500 that cools a cooling target portion that needs to be cooled in order to perform the above cooling treatment.
- the cooling target site is an example of the target site according to the present disclosure.
- FIG. 1 is a schematic diagram showing an outline of the cooling device 500 according to the first embodiment.
- FIG. 2 is a cross-sectional view taken along the line II-II of FIG.
- FIG. 3 is a cross-sectional view taken along the line III-III of FIG.
- FIG. 4 is a functional block diagram showing an example of the configuration of the cooling management system 700.
- the cooling management system 700 includes a cooling device 500 and an external terminal 600 that performs notification based on information from the cooling device 500.
- the cooling device 500 is an example of the blood flow control device according to the present disclosure.
- the cooling control system 700 is an example of the blood flow control system according to the present disclosure.
- the cooling device 500 includes at least one temperature control device 1, a control device 2, and a second blood flow sensor 13.
- the temperature control device 1 includes a Pelche element 11 (heat transfer module), a first blood flow sensor 12, and an altitude detection sensor 17. More specifically, as shown in FIG. 1, the temperature control device 1 includes an exterior body 15, and the Pelche element 11 may be arranged inside the exterior body 15 as shown in FIG.
- the first blood flow sensor 12 may be detachably fixed to the sensor fastener 120 as shown in FIG.
- the altitude detection sensor 17 may be arranged on the exterior body 15 as shown in FIG.
- the Pelche element 11 may be connected to the control device 2 by a connection cable 101.
- the first blood flow sensor 12 may be connected to the control device 2 by the connection cable 102.
- the second blood flow sensor 13 may be connected to the control device 2 by the connection cable 103.
- the altitude detection sensor 17 may be connected to the control device 2 by a connection cable 104.
- the connection between the first blood flow sensor 12, the second blood flow sensor 13, and the altitude detection sensor 17 and the control device 2 may be wired or wireless.
- the temperature control device 1 is applied to each cooling target part, and includes a cooling mechanism for cooling each cooling target part and a monitoring mechanism for monitoring the blood flow in each cooling target part.
- the cooling mechanism may be realized by the Pelche element 11 and the monitoring mechanism may be realized by the first blood flow sensor 12.
- FIG. 1 shows, as an example, the temperature control device 1H in which the subject's right hand is the cooling target portion. Although only the temperature control device 1H is shown in FIG. 1, a plurality of temperature control devices 1 may be connected to the control device 2. For example, when the cooling target portion is both hands, two temperature control devices 1 may be connected to the control device 2. When the parts to be cooled are both hands and feet, four temperature control devices 1 may be connected to the control device 2.
- temperature control device 1H whose cooling target portion is other than the right hand also have the same configuration by appropriately changing the shape of the exterior body 15. What can be done can be easily understood by those skilled in the art.
- the Pelche element 11 is an example of a heat transfer module capable of adjusting the surface temperature by controlling the applied voltage or current.
- the heat transfer module is an example of the blood flow regulating means according to the present disclosure. That is, by using the Pelche element 11, the cooling intensity can be adjusted (controlled) by controlling the applied voltage or current. Further, by using the Pelche element 11 as the heat transfer module, the temperature can be quickly adjusted.
- the Pelche element 11 has, for example, a plate-like shape, and has a first surface 11A and a second surface 11B as shown in the cross-sectional view of FIG.
- the first surface 11A is a surface on the internal space R side of the exterior body 15H into which the subject's hand H can be inserted.
- the first surface 11A is a surface on the side facing the body surface.
- the second surface 11B is a surface opposite to the first surface 11A.
- a heat sink 112 may be joined to the second surface 11B. When a direct current is passed through the Pelche element 11 so as to cool the first surface 11A, the second surface 11B generates heat.
- the heat sink 112 is a member capable of dissipating heat generated on the second surface 11B, and has a structure having, for example, a large number of fins in an aluminum alloy.
- the exterior body 15 may include a fan 113 inside the exterior body 15H in order to circulate the air warmed by the heat radiated by the heat sink 112 and improve the efficiency of heat dissipation.
- the shape, size and number of the Pelche elements 11 arranged in the exterior body 15H are not particularly limited. Depending on the shape of the cooling target portion and / or the shape of the exterior body 15, any shape, size and number of Pelche elements 11 may be arranged in the exterior body 15. As shown in FIG. 3, in the temperature control device 1H, an example in which the Pelche element 11 is arranged only on one side of the space R is shown, but the Pelche element 11 may be arranged on both sides of the space R. good. Further, the positional relationship between the Pelche element 11 and the first blood flow sensor 12 is not particularly limited.
- the Pelche element 11 is arranged so as to overlap the first blood flow sensor 12 in a plan view when the exterior body 15H is viewed from the back side of the hand with the hand H equipped with the first blood flow sensor 12 inserted. May be good.
- the Pelche element 11 and the first blood flow sensor 12 are arranged apart from each other in a plan view when the exterior body 15H is viewed from the back side of the hand with the hand H equipped with the first blood flow sensor 12 inserted. May be done.
- the Pelche element 11 and the first blood flow sensor 12 are arranged apart from each other, it is possible to reduce the influence of the temperature change due to the Pelche element 11 on the performance such as the circuit characteristics of the first blood flow sensor 12. .. Thereby, the accuracy of the measurement by the first blood flow sensor 12 can be further improved.
- the temperature control device 1 may include a cushion material 16 between the Pelche element 11 and the cooling target portion.
- the cushion material 16 reduces the possibility of skin damage due to direct contact of the cooling target portion with the first surface 11A when the surface temperature of the first surface 11A of the Pelche element 11 drops.
- the cushion material 16 can be formed so as to cover the entire cooling target portion.
- the cushion material 16 may be any material that can reduce excessive irritation caused by direct contact with the first surface 11A.
- the cushion material 16 is composed of, for example, a non-woven fabric, an elastic knitted fabric, or a polyethylene sheet.
- the nonwoven fabric is a medical nonwoven fabric obtained by a production method such as a spunlace method, a melt blown method, SMS (Spunbonded-Meltblown-Spunbond), or a flash span method.
- the elastic knitted fabric is, for example, a knitted fabric having elasticity formed by using elastic fibers, elastic fibers and the like.
- FIG. 3 shows an exemplary configuration of the cushion material 16.
- the exterior body 15 may include a cushion material 16 between the Pelche element 11 and the region R.
- the configuration of the cushion material 16 is not limited to the example shown in FIG. 3, and for example, when the cooling target portion is a hand, the hand wearing the first blood flow sensor 12 is a glove (or mittens) type cushion material. It may be covered with 16 and inserted into the exterior body 15.
- the cooling by the Pelche element 11 can be diffused to the entire cooling target portion. As a result, the entire cooling target portion can be cooled. In addition, the possibility of frostbite due to local cooling can be reduced.
- the temperature control device 1 may include a temperature sensor 14 that measures the surface temperature of the first surface 11A of the Pelche element 11.
- the temperature sensor 14 is arranged adjacent to the Pelche element 11 and may be connected to the control device 2 by wire or wirelessly.
- the temperature sensor 14 may be built in the Pelche element 11. That is, on the first surface 11A of the Pelche element 11, for example, it may be arranged between rows of thermoelectric elements composed of a plurality of thermoelectric elements.
- the temperature of the Pelche element 11 can be controlled by controlling the applied voltage.
- the surface temperature of the first surface 11A of the Pelche element 11 can be grasped. By grasping the actual temperature of the first surface 11A using the temperature sensor 14, the temperature can be controlled more appropriately.
- the surface temperature of the first surface 11A measured by the temperature sensor 14 may be displayed on, for example, a display unit 22 described later.
- the exterior body 15H is an example of the exterior body 15, and is a member having a space inside which at least a cooling target portion, a Pelche element 11, and a first blood flow sensor 12 can be accommodated.
- FIG. 1 shows, as an example, the exterior body 15H when the cooling target portion is a hand.
- the exterior body 15H has a mittens-shaped shape into which the patient's hand H can be inserted.
- the exterior body 15H is formed by using a material that is unlikely to be deformed or deteriorated due to a temperature change of the Pelche element 11. Further, in order to improve the cooling efficiency of the Pelche element 11, the material of the exterior body 15H may be a material having heat insulating properties. More specifically, the exterior body 15H can be formed by using, for example, a batting cloth or a urethane material.
- the exterior body 15H is an example of the exterior body 15, and the exterior body 15 may have an appropriate shape depending on the shape of the cooling target portion.
- the exterior body 15 may be a glove type having a branched shape for each finger portion.
- the exterior body 15 may have, for example, a sock-shaped shape.
- the first blood flow sensor 12 is a sensor capable of acquiring blood flow data in the measured portion (first measured portion) of the cooling target portion.
- the data related to the blood flow acquired by the first blood flow sensor 12 is referred to as the first blood flow data.
- the first blood flow sensor 12 may be, for example, a flow rate calculation device using the Doppler effect of light.
- a flow rate calculation device includes a light emitting element, a light receiving element, and a flow rate calculation unit.
- the light emitting element emits light having a wavelength of 600 to 900 nm to the measurement target.
- the light receiving element receives all of the light emitted from the light emitting element, which is scattered by the substance including the object to be measured.
- the flow rate calculation unit calculates the flow rate of the fluid based on the frequency component of the scattered light received by the light receiving element, the total power of the light receiving signal, and the proportionality constant K.
- the total power of the received light signal means the value of the light intensity I 2 .
- the frequency of the scattered light scattered by the fluid is shifted (Doppler shift) by the Doppler effect proportional to the moving speed of the fluid, and the flow rate can be measured by using the Doppler effect. That is, the flow rate calculation device can acquire a beat signal (beat signal) generated by the interference of light from a stationary substance and scattered light from a moving substance by the Doppler effect.
- the beat signal is a relationship between intensity and time, and a power spectrum showing the relationship between power and frequency can be obtained by performing a Fourier transform. That is, it can be said that the flow rate calculation device has a power spectrum generation unit that derives a power spectrum showing the relationship between power and frequency based on the frequency component of scattered light.
- the primary moment of this power spectrum becomes the flow rate equivalent value.
- the primary moment can be obtained from the following integral equation (1). Since the output values actually obtained are discrete, the calculation is performed based on the following equation (2) as an operation corresponding to the integral (Equation 1).
- Q indicates a flow rate equivalent value
- f indicates a frequency
- P indicates a power.
- a and b indicate the lower limit and the upper limit of the frequency f used in the calculation.
- the frequency component of the scattered light (first blood flow data) acquired in the first measured unit, the total power of the received light signal, and the proportionality constant K are used in the first measured unit.
- the blood flow rate (first blood flow rate) can be calculated.
- the first blood flow sensor 12 is fixed to the first measured portion by the sensor fastener 120.
- the sensor fastener 120 is a member that fixes the first blood flow sensor 12 to the first measured portion.
- the sensor fastener 120 includes a sensor support portion 121 to which the first blood flow sensor 12 is attached, and a band portion 122 for fixing the first blood flow sensor and the sensor support portion 121 to the first measured portion.
- the band portion 122 is a band-shaped member capable of fixing the first blood flow sensor 12 according to the shape of the first measured portion, and may be configured by using, for example, a hook-and-loop fastener such as a magic tape (registered trademark).
- the sensor fastener 120 is not limited to the above configuration, and may be any configuration as long as the first blood flow sensor 12 can be fixed to the first measured portion.
- the first blood flow sensor 12 can reduce the possibility that the first blood flow sensor 12 deviates from the first measured portion. This makes it possible to further improve the accuracy of measurement by the sensor.
- a plate-shaped member having translucency and low thermal conductivity may be arranged between the first blood flow sensor 12 and the first measured portion. This makes it possible to reduce the possibility that the first blood flow sensor 12 adheres to the measured portion during cooling.
- the first unit to be measured can be arbitrarily set, and is typically set at a position where it is desired to confirm that the blood flow is reduced by the cooling treatment.
- the first measured portion may be set as the base of the finger or the tip of the finger in order to confirm that the blood flow is reduced.
- the first blood flow sensor 12 may be placed in contact with the skin surface of the first measured portion.
- the first blood flow sensor 12 may be arranged on the palm when the cooling target portion is a hand, and on the sole of the foot when the cooling target portion is a foot. By arranging it on the palm or the sole of the foot, the contacted surface with which the first blood flow sensor 12 comes into contact is soft, so that the adhesion of the first blood flow sensor 12 is improved. Further, since the palm side or the sole side is a part where the peripheral blood vessel distribution is developed, it is relatively easy to acquire blood flow data by the first blood flow sensor 12 as compared with the back side of the hand or the back side of the foot. Is.
- the first blood flow sensor 12 may be arranged on the side surface of the hand or toe. By arranging the first blood flow sensor 12 on the side surface of the finger, blood flow data can be acquired by the first blood flow sensor 12 even when the Pelche element 11 is arranged on both sides of the hand or foot. .. Further, since the artery passes near the skin on the side surface of the finger, it is relatively easy to acquire blood flow data by the first blood flow sensor 12.
- the first blood flow sensor 12 may be arranged on the same surface as the nail on the finger or toe (the surface on the instep side of the hand or foot), or on the back of the hand or the back of the foot.
- the Pelche element 11 can be arranged on the entire surface of the palm or the sole side. Since the palm or the sole side is softer than the back of the hand or the back of the foot, the cooling area becomes large when the palm or the sole of the foot is brought into contact with the Pelche element 11, and the cooling can be performed efficiently.
- a plurality of first blood flow sensors 12 may be arranged for one cooling target site (for example, right hand, left hand, right foot, or left foot).
- the first blood flow sensor 12 is fixed to each of the five fingers.
- the position and number of the first blood flow sensor 12 in one cooling target site is not limited to the example shown in FIG.
- the second blood flow sensor 13 is a sensor that is arranged at a position (second measured portion) different from that of the first blood flow sensor 12 in the subject and can acquire blood flow data in the second measured portion. ..
- the second blood flow sensor 13 may be a sensor having the same configuration as the first blood flow sensor 12.
- the blood flow data acquired by the second blood flow sensor 13 is referred to as a second blood flow data.
- the second blood flow obtained from the second blood flow data can be used as a reference value for the first blood flow.
- the problem with blood flow sensors is that it may be difficult to judge by absolute value in principle.
- the change in the first blood flow due to cooling can be specified as the change in the relative value with respect to the second blood flow, and a judgment criterion such as an absolute threshold value can be provided. can. That is, by providing the second blood flow sensor 13, it is possible to more accurately grasp the change in blood flow rate due to cooling. As a result, more appropriate temperature control can be performed.
- the second measured unit can be set arbitrarily. As described above, in order to perform the identification using the relative value, the second measured part is separated from the first measured part, and is closer to the heart of the subject than the first measured part. Can be set.
- the second measured portion may be the wrist or upper arm of the subject.
- the second blood flow sensor 13 may be placed in contact with the skin surface of the second measured portion and may be fixed to the second measured portion by a sensor fastener (not shown).
- the altitude detection sensor 17 is a sensor capable of acquiring altitude data regarding the altitude of the cooling target portion. In the measurement of blood flow, a change in the positional relationship between the measured part (the part to be cooled) and the heart may affect the measurement result. By providing the altitude detection sensor 17, it is possible to grasp that the positional relationship between the measured portion and the heart has changed.
- the altitude detection sensor 17 for example, an acceleration sensor and / or a barometric pressure sensor can be used. That is, the altitude data acquired by the altitude detection sensor 17 is, for example, acceleration information obtained from the acceleration sensor and / or barometric pressure information obtained from the barometric pressure sensor.
- the altitude detection sensor 17 can transmit altitude data to the altitude management unit 207, which will be described later. Either an acceleration sensor or a barometric pressure sensor may be used as the altitude detection sensor 17, but by using the acceleration sensor and the barometric pressure sensor in combination, the altitude management unit 207 calculates the displacement of the altitude more accurately. Can be done.
- the altitude detection sensor 17 can be attached to, for example, the temperature control device 1.
- the altitude detection sensor 17 may be detachably attached to the outer surface of the exterior body 15.
- the mounting position of the altitude detection sensor 17 is not limited to the example of FIG.
- the attachment position of the altitude detection sensor 17 may be any position as long as it can move in conjunction with the cooling target portion when the cooling target portion moves with the movement of the body.
- the cooling target portion is a hand
- the altitude detection sensor 17 is fixed to a part of the hand, a wrist, or the like by a sensor fastener (not shown) which may have the same configuration as the sensor fastener 120. May be done.
- the external terminal 600 is a terminal capable of notifying the user to confirm based on the information from the cooling device 500.
- the user means a person who operates the cooling device 500, and is, for example, a doctor or a nurse who performs cooling treatment on the subject. It is difficult for the user to constantly monitor the cooling by the cooling device 500 while the cooling treatment is performed by the cooling device 500.
- the external terminal 600 is connected to the control device 2 in a wired or wireless manner so as to be able to communicate with the control device 2, and displays, sounds, vibrates, and displays information from the cooling device 500 to a user at a remote location (for example, a nurse station). It can be notified by lighting a lamp or the like. By providing the external terminal 600, it is possible to control the temperature of the cooling therapy while reducing human resources.
- the control device 2 includes a control unit 20, a storage unit 21, a display unit 22, and an operation unit 23.
- the control unit 20 includes a determination unit 201, a temperature control unit 202, a calculation unit 203, a display control unit 204, a cooling protocol execution unit 205, a notification control unit 206, and an altitude control unit 207.
- the control unit 20 is composed of a CPU (Central Processing Unit) or the like, and can execute, for example, a program stored in the storage unit 21 to perform general control on each unit of the cooling device 500.
- the storage unit 21 is composed of a non-volatile storage medium such as a hard disk or a flash memory, and can store various information supplied from the control unit 20. Further, the information stored in the storage unit 21 can be appropriately read out by the control unit 20.
- the display unit 22 is a kind of display, and various information can be displayed on the display surface based on the instruction of the display control unit 204.
- the operation unit 23 is a component that accepts a user's input operation, and may be composed of a switch, a button, a touch screen, and the like.
- the determination unit 201 can determine whether or not the first blood flow amount obtained from the first blood flow data acquired by the first blood flow sensor 12 is within an appropriate range.
- the above-mentioned appropriate range is an appropriate range of blood flow rate arbitrarily defined according to the cooling target site.
- the determination unit 201 is a representative calculated based on a plurality of first blood flow data acquired from the plurality of first blood flow sensors 12. It may be determined whether or not the first blood flow is within an appropriate range.
- the calculation of the representative first blood flow rate obtained from the plurality of first blood flow data may be performed by the calculation unit 203 described later.
- the representative first blood flow may be, for example, the average value of a plurality of first blood flows obtained from the plurality of first blood flow data, or may be the median value of the plurality of first blood flows. ..
- the determination unit 201 may determine whether or not the information (first numerical value data) that correlates with the first blood flow amount obtained from the first blood flow data is within the specified appropriate range.
- the appropriate range may be preset according to the type of information indicated by the first numerical data.
- the temperature control unit 202 can control the Pelche element 11 based on the determination result of the determination unit 201. More specifically, the temperature control unit 202 can control the voltage applied to the Pelche element 11 based on the determination result of the determination unit 201.
- the calculation unit 203 can calculate the amount of change in blood flow at the cooling target site based on the first blood flow data and the second blood flow data. For example, the calculation unit 203 can calculate the blood flow change amount based on the first blood flow amount obtained from the first blood flow data and the second blood flow amount obtained from the second blood flow data. Alternatively, the calculation unit 203 may calculate the blood flow change amount based on the first numerical data and the information obtained from the second blood flow data and correlating with the second blood flow (second numerical data). good. Further, the calculation unit 203 may calculate the blood flow change amount based on the first blood flow amount and the first blood flow amount before the start of the cooling process.
- control unit 20 may include a calculation unit 203 that calculates the blood flow change amount at the cooling target site based on the first blood flow amount and the first blood flow amount before the start of the cooling process.
- a calculation unit 203 that calculates the blood flow change amount at the cooling target site based on the first blood flow amount and the first blood flow amount before the start of the cooling process.
- the display control unit 204 controls the information display on the display unit 22.
- the display control unit 204 outputs the temperature data received from the temperature sensor 14 to the display unit 22, so that the temperature data can be displayed on the display unit 22.
- the cooling protocol execution unit 205 can control the voltage applied to the Pelche element 11 according to a preset cooling protocol.
- the notification control unit 206 can drive the external terminal 600 according to the information supplied from the control unit 20 to notify the user of the information.
- the altitude management unit 207 receives altitude data from the altitude detection sensor 17, and calculates the altitude displacement of the cooling target portion from the altitude data based on the start of cooling.
- the altitude management unit 207 controls display of altitude warning information indicating that the displacement of the cooling target portion exceeds a predetermined value when the displacement of the cooling target portion with respect to the start of cooling becomes a predetermined value or more. It may be transmitted to unit 204. By outputting the altitude warning information to the display unit 22, the display control unit 204 can display the display unit 22 that there is a displacement of a predetermined value or more.
- the altitude management unit 207 may transmit altitude warning information to the temperature control unit 202 informing that the displacement exceeds the predetermined displacement amount when the displacement exceeds the predetermined displacement amount.
- the temperature control unit 202 may suspend the control flow of the voltage applied to the Pelche element 11. In other words, when the temperature control unit 202 receives the altitude warning information, the temperature control unit 202 keeps maintaining the voltage applied to the Pelche element 11 when the altitude warning information is received, and the control unit 20 performs the next processing. You do not have to do.
- the altitude control unit 207 may transmit the altitude warning release information to the temperature control unit 202 when the displacement of the height of the cooling target portion returns from the altitude detection sensor 17 to a predetermined displacement amount or less.
- the temperature control unit 202 may restart the control flow of the voltage applied to the Pelche element 11.
- the altitude management unit 207 may correct the first blood flow rate by using the calculated altitude displacement. For example, the altitude management unit 207 calculates the corrected first blood flow rate using the following equation (1).
- Corrected first blood flow first blood flow x (1 + ⁇ x altitude displacement) (1)
- ⁇ is an arbitrary correction coefficient.
- the determination unit 201 may determine whether or not the first blood flow is within an appropriate range by using the corrected first blood flow that can be acquired from the altitude control unit 207 as the first blood flow.
- FIG. 5 is a flowchart showing an example of the flow of the cooling process by the cooling device 500 according to the first embodiment.
- the determination unit 201 acquires the first blood flow from the first blood flow sensor 12, and the acquired first blood flow is the upper limit value in the appropriate range. It is determined whether or not it is higher than (S1).
- the upper limit of the appropriate range can be set arbitrarily. For example, the value of the blood flow rate determined to be able to reduce the amount of drug exposure to the cooling target site can be used as the upper limit value of the appropriate range.
- the temperature control unit 202 controls the voltage applied to the Pelche element 11 to increase the cooling intensity. (S2).
- the determination unit 201 determines that the first blood flow rate is not higher than the upper limit value of the appropriate range (or less than the upper limit value) (S1: YES)
- the cooling intensity is maintained and the process proceeds to the next determination (S3). ..
- the determination unit 201 acquires the first blood flow rate from the first blood flow sensor 12 again, and determines whether or not the acquired first blood flow rate is higher than the upper limit value of the appropriate range (S3).
- the temperature control unit 202 controls the voltage applied to the Pelche element 11 to increase the cooling intensity. (Return to the process of S2).
- the determination unit 201 determines that the first blood flow rate is not higher than the upper limit value of the appropriate range (S3: NO)
- the cooling intensity is maintained and the process proceeds to the next determination (S7).
- the control unit 20 determines whether or not a predetermined time has elapsed from the start of the cooling process (S7).
- the predetermined time is, for example, a time that can be arbitrarily set based on the time required for administration of the anticancer drug.
- the predetermined time may be stored in the storage unit 21, for example, as cooling required time information. Further, the predetermined time may be input by the user from the operation unit 23.
- the control unit 20 determines that the predetermined time has elapsed (S7: YES)
- the control unit 20 ends the cooling process.
- the control unit 20 determines that the predetermined time has not elapsed (S7: NO)
- the control unit 20 returns to the process of S3.
- the temperature can be controlled so that the blood flow rate in the first measured unit does not become higher than the upper limit of the appropriate range of the blood flow rate. This makes it possible to reduce the amount of drug exposure at the site to be cooled and facilitate the management of cooling therapy that prevents the occurrence of CIPN.
- FIG. 6 is a flowchart showing an example of the flow of the cooling process by the cooling device 500 according to the first embodiment.
- the cooling process 2 is different from the cooling process 1 in that the control is performed in consideration of the lower limit value of the appropriate range.
- the processes assigned the same step number carry out the same process.
- the determination unit 201 performs the same process as the cooling process 1 described above from step S1 to step S3.
- step S3 when the determination unit 201 determines that the first blood flow rate is higher than the upper limit value of the appropriate range (S3: NO), the determination unit 201 then determines that the first blood flow rate is the lower limit value of the appropriate range. It is determined whether or not it is less than (S4).
- the lower limit of the appropriate range can be set arbitrarily. For example, the value of the minimum blood flow rate for reducing the possibility of causing frostbite in the cooling target site can be used as the lower limit value of the appropriate range.
- step S4 when the determination unit 201 determines that the first blood flow is less than the lower limit of the appropriate range (S4: YES), the temperature control unit 202 controls the voltage applied to the Pelche element 11 to control the voltage. Decrease the cooling intensity (S5).
- the determination unit 201 determines that the first blood flow rate is not less than the lower limit value (more than or equal to the lower limit value) in the appropriate range (S4: NO), the cooling intensity is maintained and the process proceeds to the next determination (S6).
- the determination unit 201 acquires the first blood flow rate from the first blood flow sensor 12 again, and determines whether or not the acquired first blood flow rate is less than the lower limit of the appropriate range (S6).
- the temperature control unit 202 controls the voltage applied to the Pelche element 11 to lower the cooling intensity. (Return to the process of S5).
- the determination unit 201 determines that the first blood flow rate does not exceed the lower limit of the appropriate range (S6: NO)
- the cooling intensity is maintained and the process proceeds to the next determination (S7).
- control unit 20 determines that a predetermined time has elapsed from the start of the cooling process (S7: YES)
- the control unit 20 ends the cooling process.
- the control unit 20 determines that the predetermined time has not elapsed (S7: NO)
- the control unit 20 returns to the process of S1.
- the temperature can be controlled so that the blood flow rate in the first measured unit is within an appropriate range of the blood flow rate. This makes it possible to facilitate the management of cooling therapy that can reduce the amount of drug exposure at the site to be cooled and reduce the possibility of frostbite at the site to be cooled.
- the notification control unit 206 may notify that the series of cooling processes is completed via the external terminal 600. Further, when an error occurs in the cooling device 500, the notification control unit 206 may notify the cooling device 500 that an error has occurred via the external terminal 600.
- the control unit 20 may include a cooling protocol execution unit 205 that controls the voltage applied to the Pelche element 11 according to a preset cooling protocol.
- the cooling protocol can be created by the user depending on the type of drug to be administered, the time of administration of the drug, and the like.
- the cooling protocol may be stored in the storage unit 21 in advance. Further, the user may input the information necessary for creating the cooling protocol via the operation unit 23 and store it in the storage unit as the cooling protocol. Further, the cooling protocol may be stored in a cloud server (not shown) that can be connected to the control unit 20 via a communication network.
- the cooling protocol execution unit 205 may acquire the cooling protocol from the storage unit 21 or the cloud server.
- the cooling protocol execution unit 205 is at least one of cooling for an arbitrary predetermined time before and after drug administration, cooling for an arbitrary predetermined time considering the drug administration time, and heating after cooling for a predetermined time according to the cooling protocol. Can be executed.
- cooling protocol execution unit 205 By providing the cooling protocol execution unit 205, it is possible to execute a cooling treatment based on a desired cooling protocol in consideration of the type of the drug to be administered, the administration time of the drug, and the like.
- the cooling device 500 can measure the blood flow rate in the first measured portion more accurately.
- the cooling device 500 by appropriately cooling and controlling the blood flow while measuring the blood flow, it is possible to reduce the amount of drug exposure to the periphery of the extremities and reduce the possibility of frostbite due to supercooling.
- FIG. 7 is a cross-sectional view of an exemplary temperature control device 1HA as a modification of the temperature control device 1H.
- the cross-sectional view shown in FIG. 7 is a cross-sectional view when the temperature control device 1HA is cut in a plane perpendicular to the palm and perpendicular to the extension direction of the middle finger.
- the temperature control device 1HA has a point that the first blood flow sensor 12 is arranged in the exterior body 15HA, a point that the pressure bag 19 is provided as at least a part of the pressure mechanism, and a point that the switch 18 is provided.
- it is different from the above-mentioned temperature control device 1H.
- the same reference numerals are added to the members having the same functions as the members described in the above embodiment, and the description thereof will not be repeated. The same applies to other modifications.
- the first blood flow sensor 12 may be arranged in the exterior body 15HA. At this time, the first blood flow sensor 12 may be supported by the sensor support portion 121A so that the position of the first blood flow sensor 12 does not shift in the exterior body 15HA.
- the pressurizing mechanism pressurizes the measured portion against the first blood flow sensor 12 in a state where the first blood flow sensor 12 and the measured portion are in contact with each other, and / or the first blood flow sensor 12. Can be configured to pressurize the device under test.
- the pressurizing mechanism may include a pressurizing bag 19 that can be expanded by a fluid that can be supplied from the outside.
- the pressure bag 19 may be arranged between the Pelche element 11 and the hand H of the cooling target portion.
- the first blood flow sensor 12 may be arranged at a position opposite to the pressure bag 19 with the hand H sandwiched between them.
- the pressurizing mechanism may include a supply means capable of supplying the fluid to the pressurizing bag 19 and a discharging means capable of discharging the fluid from the pressurizing bag 19.
- the fluid is not particularly limited, but a gas such as air or a liquid such as water can be used.
- the supply means is, for example, a pump when the fluid in the pressure bag 19 is a liquid, and a valve, for example, when the fluid in the pressure bag 19 is a gas.
- the control unit 20 may include a pressurizing mechanism control unit (not shown).
- the pressurizing mechanism control unit can start supplying the fluid to the pressurizing bag 19 by controlling the supply means, for example, when it is determined that the cooling target portion has been inserted to the specified position. The determination of insertion at the specified position will be described later. Further, the pressurizing mechanism control unit can keep the internal pressure of the pressurizing bag 19 during the cooling treatment constant by controlling the supply means and / or the discharging means.
- FIG. 8 is a cross-sectional view of the temperature control device 1HA.
- the cross-sectional view shown in FIG. 8 is an enlarged cross-sectional view of a fingertip portion when the temperature control device 1HA is cut in a plane perpendicular to the palm and parallel to the extending direction of the middle finger.
- FIG. 8 shows an example in which the Pelche element 11 is arranged on both sides (palm side and back side) of the hand (measured portion).
- the Pelche element 11 arranged on the back side of the hand is arranged on the side opposite to the first blood flow sensor 12 with the hand sandwiched between them. Further, the Pelche element 11 arranged on the palm side is arranged at a position separated from the first blood flow sensor 12 also arranged on the palm side.
- the temperature control device 1HA may be provided with a switch 18 on the inner wall of the tip end portion of the exterior body 15.
- the control unit 20 may include an alignment determination unit (not shown). For example, when the switch 18 is pressed by the cooling coping portion, the alignment determination unit may determine that the cooling target portion has been inserted to the specified position.
- the control unit 20 follows the flowchart shown in FIG. 5 or FIG. 6 after the supply of the fluid to the pressure bag 19 by the pressure mechanism control unit is started. Cooling process 1 or cooling process 2 may be started.
- the pressurizing mechanism control unit can reduce the internal pressure of the pressurizing bag 19 by controlling the supply means and / or the discharge means.
- the temperature control device 1HA is provided with a pressurizing mechanism, the first blood flow sensor 12 can be pressed against the first measured portion with a constant contact pressure. This makes it possible to obtain a more accurate first blood flow.
- FIG. 9 is a plan view of an exemplary temperature control device 1HB as a modification of the temperature control device 1H.
- the plan view shown in FIG. 9 is a plan view when the temperature control device 1HB having the right hand of the subject as the cooling target portion is viewed from the back side of the hand.
- FIG. 10 is a cross-sectional view of the temperature control device 1HB.
- the cross-sectional view shown in FIG. 10 is an enlarged view of a fingertip portion in the cross-sectional view taken along the line XX of FIG.
- FIG. 11 is an enlarged view showing the configuration of the fingertip portion of the temperature control device 1HB.
- the temperature control device 1HB is provided with an exterior body 15HB, and the Pelche element 11 can be fixed inside the exterior body 15HB as shown in FIG.
- the first blood flow sensor 12 is the inner surface of the outer body 15HB, and can be fixed to a position facing the pad of each finger when the hand H is inserted into the outer body 15HB by any adhesive means.
- the exterior 15HB may include an altitude detection sensor 17, a heat sink 112, and / or a fan 113.
- the exterior body 15HB is an example of a configuration in which the cooling target portion is the right hand and the first measured portion is set as the fingertip.
- the exterior body 15HB has a glove-shaped shape having five branched structures.
- the glove-shaped exterior body 15HB has, for example, a stretchable bellows structure 152 at a portion corresponding to the base of each finger. Since the exterior body 15HB has the bellows structure 152, the length of each finger of the exterior body 15HB can be adjusted according to the size of the hand H.
- the exterior body 15HB can be formed by using, for example, a batting cloth or a urethane material.
- the material of the exterior body 15HB does not have to be a single material, and there are parts that need to be deformed by an external force, such as a bellows structure 152 part or a part where a band 120B described later is arranged, and other parts. It may be constructed using another material.
- the exterior body 15HB is provided with a band 120B as a sensor fastener at a position overlapping with the first blood flow sensor 12 in the plan view of the plan view shown in FIG.
- At least a part of the band 120B may be fixed (bonded) to the exterior body 15HB by any means.
- the band 120B can adjust the fixed length.
- the band 120B may be a band provided with a hook-and-loop fastener such as a magic tape (registered trademark).
- the band 120B is formed by bonding the first surface 1200 constituting one surface fastener and the other surface fastener provided on at least a part of the second surface 1201 at an arbitrary position.
- the fixed length may be adjusted.
- the band 120B can fix the first blood flow sensor 12 to the first measured portion by adjusting the fixed length. Further, by using the band 120B, the first blood flow sensor 12 can be fixed to the first measured portion with a substantially constant contact pressure.
- FIG. 12 is a plan view of an exemplary temperature control device 1HC as a modification of the temperature control device 1H.
- the plan view shown in FIG. 12 is a plan view of the temperature control device 1HC whose right hand of the subject is the cooling target portion when viewed from the back side of the hand.
- the temperature control device 1HC according to the modification 3 includes an exterior body 15HC, and the Pelche element 11 can be fixed inside the exterior body 15HC. As shown in FIG. 12, the first blood flow sensor 12 may be fixed to the first measured portion by the sensor fastener 120.
- the exterior body 15HC has a glove-shaped shape having five branched structures.
- the exterior body 15HC includes a main body portion 150 that covers parts other than the palm, the back of the hand, and the tips of each finger, and a wing portion 151.
- the wing portion 151 has a shape in which at least a part of the fingertip portion of the main body portion 150 is extended.
- Reference numeral 1201 in FIG. 12 indicates a state in which the fingertips of the exterior body 15HC are open.
- the exterior body 15HC can open the fingertips as shown by reference numeral 1201 in FIG. Further, by joining one joining means 151X provided at the tip of the wing portion 151 and the other joining means 151Y provided on the main body portion 150 side shown by reference numeral 1201 in FIG. 12, the fingertip is attached to the exterior body 15HC. Can be housed inside.
- Reference numeral 1202 in FIG. 12 indicates the exterior body 15HC when the wing portion 151 is closed.
- the hand H is first inserted into the exterior body 15HC with the fingertips open, and the first blood flow sensor 12 is fixed to the fingertips by the sensor fastener 120, and then the wings are used. Section 151 may be closed.
- the first blood flow sensor 12 By inserting the first blood flow sensor 12 into the exterior body 15HC after fixing it to the fingertip with the sensor fastener 120, it is possible to reduce the possibility that the fixed position of the first blood flow sensor 12 shifts. Further, since the first measured portion can be easily opened, the fixed state of the first blood flow sensor 12 can be easily confirmed.
- the pressurizing device 500A of the present disclosure is a device that can be used to perform compression treatment as a therapeutic preventive strategy for CIPN.
- the pressurizing device 500A of the present disclosure is a device that presses the target site or the upstream side (closer to the heart) of the target site or the target site in order to perform the compression process.
- FIG. 13 is a schematic view showing an outline of the pressurizing device 500A according to the second embodiment.
- FIG. 14 is a cross-sectional view taken along the line XIV-XIV of FIG.
- FIG. 15 is a functional block diagram showing an example of the configuration of the pressurization management system 700A.
- FIG. 16 is a flowchart showing an example of the flow of blood flow management processing by the pressurizing device 500A.
- the pressurization management system 700A includes a pressurizing device 500A and an external terminal 600 that performs notification based on information from the pressurizing device 500A.
- the pressurizing device 500A is an example of the blood flow control device according to the present disclosure.
- the pressurization management system 700A is an example of the blood flow management system according to the present disclosure.
- the pressurizing device 500A includes at least one pressure adjusting mechanism 1A and a control device 2A.
- the pressure adjusting mechanism 1A includes, for example, a pressurizing means 11A for adjusting the blood flow of a target site according to blood flow data, a blood flow sensor 12A, and an altitude detection sensor 17.
- the pressurizing means 11A is an example of the blood flow regulating means according to the present disclosure.
- the pressure adjusting mechanism 1A can be applied to each target site.
- FIG. 13 shows, as an example, the pressure adjusting mechanism 1A in which the subject's right hand is the target portion. Although only one pressure adjusting mechanism 1A is shown in FIG. 13, a plurality of pressure adjusting mechanisms may be connected to the control device 2A. For example, when the target site is both hands, the two pressure adjusting mechanisms 1A may be connected to the control device 2A. When the target sites are both hands and feet, four pressure adjusting mechanisms 1A may be connected to the control device 2A.
- the configuration of the pressure adjusting mechanism 1A will be described in detail, but the configuration of the other pressure adjusting mechanism 1A whose target portion is other than the right hand is also the same by appropriately changing the configuration or shape of the pressurizing means 11A. Can be easily understood by those skilled in the art.
- the pressurizing means 11A includes, for example, an elastic glove 110A (cover) and a compression band 111.
- the pressurizing means 11A does not necessarily have to include both the elastic gloves 110A and the compression band 111.
- the pressurizing means 11A may be realized only by the elastic gloves 110A, or may be realized only by the compression band 111.
- the elastic glove 110A is an example of the covering body according to the present disclosure.
- the covering body according to the present disclosure is a member that can cover and press the target portion.
- the covering reduces blood flow at the target site by compressing the target site.
- the covering body according to the present disclosure may be configured so as to be capable of measurement by the blood flow sensor 12A when the blood flow sensor 12A is attached to the target site via the covering body.
- the elastic glove 110A may be, for example, a commercially available latex glove.
- the degree of compression by the elastic gloves 110A may be changed by increasing or decreasing the number of gloves, or may be changed by changing the size of the gloves. If the target site is the foot, the covering may be elastic socks.
- the compression band 111 is a member that is composed of a band-shaped or cylindrical outer band and can be attached to a part of a living body.
- the compression zone 111 is located upstream of the target site and reduces blood flow to the target site by compression.
- FIG. 13 shows an example in which the compression band 111 is attached to the wrist, the compression band 111 may be attached to the upper arm portion. Alternatively, a plurality of compression zones 111 may be attached between the target site and the heart. The degree of compression by the compression band 111 may be changed by changing the tightness of the compression band 111.
- the compression band 111 may be the pressure module 111A.
- the pressurizing module 111A may include, for example, a pressurizing bag capable of expanding or contracting depending on the applied voltage.
- the compression band 111 may be connected to the control device 2A by the connection cable 106. Thereby, the control device 2A can control the degree of compression by the pressurizing module 111A.
- the blood flow sensor 12A is a sensor capable of acquiring blood flow data in the measured portion of the target site.
- the blood flow sensor 12A may be connected to the control device 2A by the connection cable 105.
- the blood flow sensor 12A may be an optical sensor that measures the flow rate of the fluid in the measured portion.
- the flow rate of the fluid measured by the optical sensor is an example of the blood flow data according to the present disclosure, and is referred to as a primary blood flow rate.
- the blood flow sensor 12A may include a light emitting element, a light receiving element, and a flow rate calculation unit. That is, the blood flow sensor 12A may be a flow rate calculation device using the Doppler effect of light, which is described in detail in the first embodiment.
- the light emitting element is an element capable of emitting light to the measured portion.
- the light receiving element is an element capable of receiving scattered scattered light among the light emitted to the measured portion.
- the flow rate calculation unit calculates the flow rate of the fluid in the measured unit based on the frequency component of the scattered light.
- the flow rate calculation device as the blood flow sensor 12A can output the flow rate of the fluid in the measured unit to the control device 2A as the primary blood flow rate.
- the function of the flow rate calculation unit may be provided by, for example, the control unit 20A of the control device 2A.
- the blood flow sensor 12A may be attached to the inside of the holding tool 121B which can hold the fingertip, for example.
- the blood flow sensor 12A may be arranged in direct contact with the measured portion of the target site.
- the elastic glove 110A has a hole corresponding to the measured portion, so that the blood flow sensor 12A can be placed in direct contact with the measured portion. In this case, the processing in the control unit 20A can be simplified.
- the blood flow sensor 12A may be indirectly contacted with the measured portion of the target portion via the elastic glove 110A and arranged. By arranging the blood flow sensor 12A in contact with the measured portion even indirectly, the blood flow data can be measured with high accuracy.
- the altitude detection sensor 17 may be detachably attached to the outer surface of the elastic glove 110A.
- the mounting position of the altitude detection sensor 17 is not limited to the example of FIG.
- the attachment position of the altitude detection sensor 17 may be any position as long as it can move in conjunction with the target portion when the target portion moves with the movement of the body.
- the altitude detection sensor 17 may be fixed to the outer surface of the holding tool 121B.
- it may be fixed to a part of the hand, a wrist, or the like by a holding tool (not shown) which may have the same configuration as the holding tool 121B.
- the altitude detection sensor 17 may be connected to the control device by a connection cable 107.
- connection between the compression band 111, the blood flow sensor 12A and the altitude detection sensor 17, and the control device 2A may be wired or wireless.
- the external terminal 600 can notify the user to confirm based on the information from the pressurizing device 500A.
- the control device 2A includes a control unit 20A, a storage unit 21, a display unit 22, and an operation unit 23.
- the control unit 20A includes a display control unit 204, a notification control unit 206, an altitude control unit 207, a calculation unit 208, a pressurization control unit 209, and a determination unit 201.
- the storage unit 21 may store data necessary for correcting the primary blood flow using a correction value related to the light transmitted through the elastic glove 110A.
- the storage unit 21 may store data on the attenuation rate of light by the elastic gloves 110A as the correction value.
- the light attenuation rate by the elastic glove 110A is a rate at which the light transmitted and received by the blood flow sensor 12A is attenuated by passing through the elastic glove 110A.
- the light attenuation rate of the elastic glove 110A can be specified, for example, as follows. First, the following (i) and (ii) are measured. (I) The flow rate of the fluid in the measured portion measured by the user without wearing the elastic gloves 110A (state of bare hands). (Ii) The flow rate of the fluid in the measured portion measured through a sheet made of the same material as the elastic glove 110A.
- the light attenuation rate by the elastic glove 110A can be specified.
- the model number of the elastic glove 110A and the light attenuation rate may be stored in association with each other in the storage unit 21.
- the calculation unit 208 which will be described later, can acquire the light attenuation rate of the elastic glove 110A to be used as an appropriate correction value by inputting the model number of the glove used by the user.
- the calculation unit 208 calculates the blood flow of the measured unit by correcting the primary blood flow using the correction value for the light transmitted through the elastic glove 110A. For example, the calculation unit 208 may calculate the blood flow rate of the measured unit by dividing the primary blood flow rate by the light attenuation rate of the elastic glove 110A. Since the pressurizing device 500A has the calculation unit 208, the blood flow rate of the measurement unit can be calculated more accurately even when the measurement is performed through the elastic glove 110A.
- the calculation unit 208 may be provided by the blood flow sensor 12A.
- the display control unit 204 may display data related to blood flow data on the display unit 22.
- the display control unit 204 may cause the display unit 22 to display the blood flow rate of the measured unit calculated by the calculation unit 208.
- the user can adjust the degree of pressure on the hand and adjust the blood flow rate, for example, by increasing or decreasing the number of elastic gloves 110A.
- the blood flow rate at the target site may be adjusted by adjusting the tightness of the compression band 111.
- the blood flow rate at the target site may be adjusted by changing the positional relationship between the target site and the heart, more specifically, by changing the height of the target site (hand or foot) with respect to the heart. ..
- the pressurizing control unit 209 is connected to the control device 2A among the pressurizing means 11A and controls the pressurizing means 11A that can be controlled.
- the pressurization control unit 209 controls the operation of the pressurizing bag 111 of the compression band 111 including the pressurizing bag capable of expanding or contracting.
- the determination unit 201 can determine whether or not the blood flow amount obtained from the blood flow data acquired by the blood flow sensor 12A is within an appropriate range.
- the above-mentioned appropriate range is an appropriate range of blood flow rate arbitrarily defined according to the target site.
- the pressurizing device 500A (blood flow management device) according to the present embodiment manages the blood flow at the target site.
- the pressurizing device 500A is arranged in direct or indirect contact with the measured portion at the target site, and has a blood flow sensor 12A capable of acquiring blood flow data, which is data related to blood flow, and a target according to the blood flow data.
- a pressurizing means 11A (blood flow regulating means) for regulating the blood flow of the site is provided.
- the degree of compression at the target site can be grasped from the blood flow data. Further, by arranging the blood flow sensor 12A in direct or indirect contact with the measured portion, the blood flow data can be measured with high accuracy and the blood flow can be adjusted.
- the target portion is a hand or a foot
- the pressurizing means 11A is provided with an elastic glove 110A (cover) that presses the hand or the foot
- the blood flow sensor 12A is elastic. It is in contact with the target site via the glove 110A.
- blood flow can be reduced by using elastic gloves 110A. Further, since the blood flow sensor 12A is in contact with the target portion via the elastic glove 110A, the blood flow data can be measured with high accuracy.
- FIG. 16 is a flowchart showing an example of the flow of the pressurizing process by the pressurizing device 500A according to the second embodiment.
- This flowchart is a flowchart of a case where the pressurizing means 11A includes a pressurizing module 111A including a pressurizing bag capable of expanding or contracting as a compression band 111.
- the calculation unit 208 acquires the primary blood flow rate from the blood flow sensor 12A (S11).
- the calculation unit 208 corrects the primary blood flow acquired in S11 by using the correction value regarding the light transmitted through the elastic glove 110A (S12).
- the calculation unit 208 divides the blood flow volume acquired in S11 by the data of the light attenuation rate by the elastic glove 110A stored in the storage unit 21 to obtain the blood flow rate at the measured site of the hand H. calculate.
- This makes it possible to calculate the blood flow rate of the measured portion with the same accuracy as when the blood flow sensor 12A is placed in direct contact with the measurement even through the elastic glove 110A.
- the possibility that the calculation accuracy of the blood flow of the measured portion is lowered can be significantly reduced. can.
- the determination unit 201 determines whether or not the blood flow amount calculated in S12 is higher than the upper limit value of the appropriate range (S13).
- the pressurization control unit 209 controls the voltage applied to the pressurization module 111A. Increase the compression strength (pressurize) (S14).
- the determination unit 201 determines that the blood flow amount calculated in S12 is not higher than the upper limit value of the appropriate range (S13: NO), the pressurization intensity is maintained and the process proceeds to the next determination (S15).
- the determination unit 201 again determines whether or not the blood flow calculated by the same flow as in S11 to S12 is higher than the upper limit of the appropriate range (S15).
- the pressurization control unit 209 controls the voltage applied to the compression band 111 to increase the pressurization intensity. (Return to the process of S14).
- the determination unit 201 determines that the blood flow volume is not higher than the upper limit value of the appropriate range (S15: NO)
- the pressurization intensity is maintained and the process proceeds to the next determination (S16).
- control unit 20A determines whether or not a predetermined time has elapsed from the start of the pressurization process (S16).
- the control unit 20A determines that the predetermined time has elapsed (S16: YES)
- the control unit 20A ends the pressurization process.
- the control unit 20A determines that the predetermined time has not elapsed (S16: NO)
- the control unit 20A returns to the process of S15.
- pressurization control can be performed so that the blood flow rate in the measured unit does not become higher than the threshold value. This can reduce drug exposure at the target site and facilitate the management of pressure therapy to prevent the development of CIPN.
- the pressurizing means 11A includes a pressurizing module 111A, and the control unit 20A controls the pressurizing module 111A based on the blood flow amount calculated by the calculation unit 208. Can be.
- the blood flow volume at the target site can be controlled by controlling the pressurizing module 111A.
- a pressurizing management system 700B including a pressurizing device 500B and a pressurizing device 500B as a modification of the pressurizing device 500A according to the second embodiment will be described with reference to FIG.
- the same reference numerals are added to the members having the same functions as the members described in the above-described embodiment, and the description thereof will not be repeated.
- FIG. 17 is a functional block diagram showing a modified example of the configuration of the pressurization management system 700B according to the second embodiment.
- the pressurization management system 700B includes a pressurizing device 500B and an external terminal 600 that performs notification based on information from the pressurizing device 500B.
- the pressurizing device 500B is an example of the blood flow control device according to the present disclosure.
- the pressurization management system 700B is an example of the blood flow management system according to the present disclosure.
- the pressurizing device 500B includes at least one pressure adjusting mechanism 1B and a control device 2B.
- the pressure adjusting mechanism 1B includes a blood flow sensor 12B in place of the blood flow sensor 12A provided in the pressure adjusting mechanism 1A.
- the blood flow sensor 12B may include a light emitting element, a light receiving element, and a power spectrum generating unit. That is, the blood flow sensor 12B may be a flow rate calculation device using the Doppler effect of light, which is described in detail in the first embodiment.
- the light emitting element is an element capable of emitting light to the measured portion.
- the light receiving element is an element capable of receiving scattered scattered light among the light emitted to the measured portion.
- the power spectrum generation unit derives a power spectrum showing the relationship between power and frequency based on the frequency component of the scattered light.
- the flow rate calculation device as the blood flow sensor 12A can output the power spectrum in the measured unit to the control device 2A.
- the power spectrum output by the flow rate calculator is an example of blood flow data according to the present disclosure.
- the power spectrum pulsates in response to the pulsation of blood flow.
- the control device 2B includes a control unit 20B, a storage unit 21, a display unit 22, and an operation unit 23.
- the control unit 20B includes a compression degree management unit 210 in place of the calculation unit 208 included in the control unit 20A.
- the compression degree management unit 210 generates compression degree information indicating the degree of compression in the measured unit from the power spectrum.
- the compression degree information indicates, for example, information indicating an area value corresponding to the integrated value of the power spectrum at each time point, information indicating the degree of pulsation of the power spectrum, and the sum of the distances from the origin to the power spectrum at each frequency. It may be any of the information. Further, the compression degree information is information obtained by converting the information indicating the area value, the information indicating the degree of pulsation, or the information indicating the total distance from the origin into an index that makes it easy for the user to recognize the degree of compression. There may be.
- the determination unit 201 can determine whether or not the compression degree information generated by the compression degree management unit 210 is within an appropriate range.
- the appropriate range is an appropriate range of information indicating the degree of compression, which is arbitrarily defined by the type of information indicating the degree of compression. If the compression degree information is higher than the appropriate range, it indicates that the target site is compressed too much.
- the display control unit 204 may display data related to blood flow data on the display unit 22.
- the display control unit 204 may cause the display unit 22 to display the compression degree information generated by the compression degree management unit 210.
- the display control unit 204 may display the power spectrum acquired from the blood flow sensor 12B on the display unit 22 in real time.
- the user can adjust the degree of pressure on the hand and adjust the blood flow rate, for example, by increasing or decreasing the number of elastic gloves 110A.
- the blood flow rate at the target site may be adjusted by adjusting the tightness of the compression band 111.
- the blood flow rate at the target site may be adjusted by changing the positional relationship between the target site and the heart, more specifically, by changing the height of the target site (hand or foot) with respect to the heart. ..
- the storage unit 21 may store in advance the reference data required for generating the compression degree information.
- the pressurizing device 500B may further include a compression degree management unit 210.
- the blood flow sensor 12B has a power and frequency based on a light emitting element capable of emitting light to a measured portion, a light receiving element capable of receiving scattered scattered light among the light, and a frequency component of the scattered light. It is provided with a power spectrum generation unit for deriving a power spectrum showing a relationship with the above.
- the compression degree management unit 210 generates compression degree information indicating the degree of compression in the measured unit from the power spectrum.
- FIG. 18 is a flowchart showing an example of the flow of the pressurizing process of the pressurizing device 500B according to the second embodiment.
- This flowchart is a flowchart of a case where the pressurizing means 11A includes a pressurizing module 111A including a pressurizing bag capable of expanding or contracting as a compression band 111.
- the compression degree management unit 210 acquires a power spectrum from the blood flow sensor 12B (S21). Next, the compression degree management unit 210 generates compression degree information indicating the degree of compression in the measured unit from the power spectrum acquired in S21 (S22).
- the determination unit 201 determines whether or not the compression degree information generated in S22 is higher than the upper limit value of the appropriate range (S23).
- the pressurization control unit 209 controls the voltage applied to the compression band 111. Increase the compression strength (S24).
- the determination unit 201 determines that the compression degree information generated in S22 is not higher than the upper limit value of the appropriate range (S23: NO)
- the pressurization strength is maintained and the process proceeds to the next determination (S25).
- the determination unit 201 again determines whether or not the compression degree information generated by the same flow as in S21 to S22 is higher than the upper limit value in the appropriate range (S25).
- the pressurization control unit 209 controls the voltage applied to the compression band 111. Increase the pressurization strength (return to the processing of S24).
- the determination unit 201 determines that the compression degree information generated in S25 is not higher than the upper limit value of the appropriate range (S25: NO)
- the pressurization strength is maintained and the process proceeds to the next determination (S26).
- control unit 20B determines whether or not a predetermined time has elapsed from the start of the pressurization process (S26).
- the control unit 20B determines that the predetermined time has elapsed (S26: YES)
- the control unit 20B ends the pressurization process.
- the control unit 20B determines that the predetermined time has not elapsed (S26: NO)
- the control unit 20B returns to the process of S25.
- pressurization management can be performed so that the compression degree information does not become higher than the upper limit value of the appropriate range. This can reduce drug exposure at the target site and facilitate the management of pressure therapy to prevent the development of CIPN.
- the pressurizing means 11A includes a pressurizing module 111A, and the control unit 20B is a pressurizing module based on the compression degree information generated by the compression degree management unit 210. 111A can be controlled.
- the blood flow volume at the target site can be controlled by controlling the pressurizing module 111A.
- FIG. 19 is a diagram showing a power spectrum measured by the blood flow sensor 12B in a state where the hand is not pressed.
- FIG. 20 is a diagram showing a power spectrum measured by the blood flow sensor 12B while the hand is being pressed.
- the vertical axis in FIGS. 19 and 20 indicates power.
- the horizontal axis in FIGS. 19 and 20 indicates the frequency.
- Reference numeral G1 in FIG. 19 indicates a power spectrum in the state of bare hands.
- Reference numeral G2 in FIG. 19 indicates a power spectrum in a state where a finger cot (for example, a part of the elastic glove 110A) is worn on the hand.
- the finger cot has the effect of attenuating light, but does not have the effect of pressing the target portion.
- Reference numeral G3 in FIG. 20 indicates a power spectrum in a state where a finger cot is attached to the hand, similarly to the reference numeral G2.
- Reference numeral G4 in FIG. 20 indicates a power spectrum in a state where the finger cot is attached to the hand and the hand is pressed.
- the power spectrum indicated by the reference numeral G1 and the power spectrum indicated by the reference numeral G2 have substantially the same shape.
- the value of the power at each frequency is substantially the same as the value indicated by the reference numerals G1 and the reference numeral G2. That is, it can be seen that the influence on the shape of the power spectrum is very low even through a member such as a finger cot that attenuates light.
- the reason why it is not easily affected by the attenuation of the power spectrum light is considered to be that the blood flow sensor 12B calculates the value of the power spectrum from the primary moment (value corresponding to the flow rate) of the power spectrum.
- the above-mentioned blood flow sensor 12A takes into account the intensity of light when calculating the flow rate of the fluid from the frequency component of the received scattered light, but the power spectrum output by the blood flow sensor 12B contains frequency information. Since it is mainly a reflection, it is not easily affected by the light intensity. Therefore, even if the measurement is performed through the covering body, it is not necessary to correct using the correction value related to light.
- the power value at each frequency indicated by the reference numeral G3 is larger than the power value at each frequency indicated by the reference numeral G4. That is, it can be seen that the shape of the power spectrum changes depending on the degree of compression. That is, it can be seen that by using the power spectrum, it is possible to generate compression degree information indicating the degree of compression in the measured portion.
- Cooling device blood flow control device
- 500B Pressurizing device blood flow control device
- External terminal 700 Cooling control system (blood flow control system) 700A, 700B Pressurization management system (blood flow management system) 1, 1H, 1HA, 1HB, 1HC temperature control device 2, 2A, 2B control device 11 Pelche element (heat transfer module, blood flow control means) 12 1st blood flow sensor 12A, 12B Blood flow sensor 120 Sensor fastener 13 2nd blood flow sensor 14 Temperature sensor 15, 15H, 15HB, 15HC Exterior 16 Cushion material 17 Advanced detection sensor 19 Pressurized bag 20, 20A, 20B Control unit 110A Elastic gloves (cover, blood flow control means) 111 Compression zone (blood flow control means) 111A Pressurization module (blood flow regulation means) 201 Judgment unit 202 Temperature control unit 203 Calculation unit 204 Display control unit 205 Cooling protocol execution unit 206 Notification control unit 207 Advanced control unit 208 Calculation unit 209 Pressurization control unit 210 Pressure degree control unit
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Abstract
Description
本開示の一実施形態について、詳細に説明する。
本開示の冷却装置500は、CIPNに対する治療予防戦略としての冷却処置を行うために用いられ得る装置である。換言すると、本開示の冷却装置500は、上記冷却処置を行うために冷却が必要とされる冷却対象部位を冷却する冷却装置500である。冷却対象部位は、本開示に係る対象部位の一例である。
実際に得られる出力値は離散的であることから、積分(式1)に相当する演算として下記の式(2)に基づいて計算を行う。
上記式(1)および式(2)において、Qは流量相当値、fは周波数、Pはパワーを示している。また、aおよびbは、演算に用いる周波数fの下限および上限を示している。
次に、制御装置2について、図4を用いて説明する。制御装置2は、制御部20と、記憶部21と、表示部22と、操作部23とを備えている。制御部20は、判定部201と、温度管理部202と、算出部203と、表示制御部204と、冷却プロトコル実行部205と、報知制御部206と、高度管理部207とを備える。
上記式(1)において、βは任意の補正係数である。判定部201は、第1血流量として、高度管理部207から取得し得る補正第1血流量を用いて、第1血流量が適正範囲内であるか否かを判定してもよい。
次に、制御部20による、冷却処理の一例について、図5を用いて説明する。図5は、実施形態1に係る冷却装置500による冷却処理の流れの一例を示すフローチャートである。
次に、制御部20による、冷却処理の別の一例について、図6を用いて説明する。図6は、実施形態1に係る冷却装置500による冷却処理の流れの一例を示すフローチャートである。冷却処理2は、適正範囲の下限値についても考慮した制御をしている点において冷却処理1と異なる。冷却処理1と、冷却処理2において、同一のステップ番号を付してある処理は、同様の処理を実施している。
報知制御部206は、一連の冷却処理が終了した場合、外部端末600を介して一連の冷却処理が終了したことを報知してもよい。また、報知制御部206は、冷却装置500に何らかのエラーが生じた場合、外部端末600を介して冷却装置500にエラーが生じたことを報知してもよい。
制御部20は、予め設定された冷却プロトコルに従ってペルチェ素子11に印加する電圧を制御する冷却プロトコル実行部205を備えていてもよい。冷却プロトコルは、投与される薬剤種類、薬剤の投与時間などに応じてユーザによって作成され得る。冷却プロトコルは、予め記憶部21に保管されていてもよい。また、操作部23を介してユーザが冷却プロトコルの作成に必要な情報を入力し、記憶部に冷却プロトコルとして保管されてもよい。さらに、冷却プロトコルは、制御部20と通信ネットワークを介して接続され得るクラウドサーバ(図示せず)内に保管されていてもよい。冷却プロトコル実行部205は、記憶部21またはクラウドサーバから、冷却プロトコルを取得し得る。冷却プロトコル実行部205は、冷却プロトコルに従い、薬剤投与前後における任意の所定時間の冷却、薬剤投与時間を考慮した任意の所定時間の冷却、および所定時間の冷却後の加温のうち、少なくとも1つを実行し得る。
変形例1では、実施形態1に係る温度調節装置1Hの変形例について、図7および図8を用いて説明する。
変形例2では、実施形態1に係る温度調節装置1Hの別の変形例について、図9~図11を用いて説明する。
変形例3では、実施形態1に係る温度調節装置1Hのさらに別の変形例について、図12を用いて説明する。
本開示の他の実施形態について、以下に説明する。説明の便宜上、上記実施形態にて説明した部材と同じ機能を有する部材については、同じ符号を付記し、その説明を繰り返さない。
本開示の加圧装置500Aは、CIPNに対する治療予防戦略としての圧迫処置を行うために用いられ得る装置である。換言すると、本開示の加圧装置500Aは、上記圧迫処理を行うために、対象部位または対象部位よりも上流(心臓に近い側)を圧迫する装置である。
次に、制御装置2Aについて、図15を用いて説明する。制御装置2Aは、制御部20Aと、記憶部21と、表示部22と、操作部23とを備えている。制御部20Aは、表示制御部204と、報知制御部206と、高度管理部207と、計算部208と、加圧管理部209と、判定部201と、を備える。
次に、制御部20Aによる、加圧処理の一例について、図16を用いて説明する。図16は、実施形態2に係る加圧装置500Aによる加圧処理の流れの一例を示すフローチャートである。本フローチャートは、加圧手段11Aが、圧迫帯111として、膨張または収縮が可能な加圧袋を備える加圧モジュール111Aを備えている場合についてのフローチャートである。
実施形態2に係る加圧装置500Aの変形例としての加圧装置500Bおよび加圧装置500Bを備える加圧管理システム700Bについて、図17を用いて説明する。説明の便宜上、上記実施形態にて説明した部材と同じ機能を有する部材については、同じ符号を付記し、その説明を繰り返さない。
次に、制御部20Bによる、加圧処理の一例について、図18を用いて説明する。図18は、実施形態2に係る加圧装置500Bの加圧処理の流れの一例を示すフローチャートである。本フローチャートは、加圧手段11Aが、圧迫帯111として、膨張または収縮が可能な加圧袋を備える加圧モジュール111Aを備えている場合についてのフローチャートである。
500A、500B 加圧装置(血流管理装置)
600 外部端末
700 冷却管理システム(血流管理システム)
700A、700B 加圧管理システム(血流管理システム)
1、1H、1HA、1HB、1HC 温度調節装置
2、2A、2B 制御装置
11 ペルチェ素子(伝熱モジュール、血流調節手段)
12 第1血流センサ
12A、12B 血流センサ
120 センサ留め具
13 第2血流センサ
14 温度センサ
15、15H、15HB、15HC 外装体
16 クッション材
17 高度検出センサ
19 加圧袋
20、20A、20B 制御部
110A 弾性手袋(被覆体、血流調節手段)
111 圧迫帯(血流調節手段)
111A 加圧モジュール(血流調節手段)
201 判定部
202 温度管理部
203 算出部
204 表示制御部
205 冷却プロトコル実行部
206 報知制御部
207 高度管理部
208 計算部
209 加圧管理部
210 圧迫度管理部
Claims (12)
- 対象部位における被測定部に直接または間接的に接触して配置され、血流に関するデータである血流データを取得可能な血流センサと、
前記血流データに応じて前記対象部位の血流を調節する血流調節手段と、を備える、血流管理装置。 - 前記対象部位は手または足であり、
前記血流調節手段は前記手または足を圧迫する被覆体を備えており、
前記血流センサは、前記被覆体を介して前記対象部位に接触している、請求項1に記載の血流管理装置。 - 計算部をさらに備え、
前記血流センサは、前記被測定部における流体の流量を測定する光学式センサであり、
前記計算部は、前記流量を、前記被覆体を透過する光に関する補正値を用いて補正することにより、前記被測定部の血流量を算出する、請求項2に記載の血流管理装置。 - 前記光学式センサは、
前記被測定部に対して光を出射可能な発光素子と、
前記光のうち散乱した散乱光を受光可能な受光素子と、
前記散乱光の周波数成分に基づいて、前記被測定部における流体の流量を算出する流量計算部と、を備える、請求項3に記載の血流管理装置。 - 制御部をさらに備え、
前記血流調節手段は、加圧モジュールを備えており、
前記制御部は、前記血流量に基づいて、前記加圧モジュールを制御する、請求項3または4に記載の血流管理装置。 - 圧迫度管理部をさらに備え、
前記血流センサは、
前記被測定部に対して光を出射可能な発光素子と、
前記光のうち散乱した散乱光を受光可能な受光素子と、
前記散乱光の周波数成分に基づいて、パワーと周波数との関係を示すパワースペクトルを導出する、パワースペクトル生成部と、を備え
前記圧迫度管理部は、前記パワースペクトルから、前記被測定部における圧迫の程度を示す圧迫度情報を生成する、請求項2に記載の血流管理装置。 - 制御部をさらに備え、
前記血流調節手段は、加圧モジュールを備えており、
前記制御部は、前記圧迫度情報に基づいて、前記加圧モジュールを制御する、請求項6に記載の血流管理装置。 - 前記被測定部の高度に関する高度データを取得可能な高度検出センサと、
前記高度データから、前記対象部位の高度の変位を算出する高度管理部と、を備える、請求項1から7のいずれか1項に記載の血流管理装置。 - 前記血流調節手段は、少なくとも1つの伝熱モジュールであり、
前記対象部位における被測定部に接触して配置され、第1血流データを取得可能な少なくとも1つの第1血流センサと、
前記伝熱モジュールを制御する制御部と、を備え、
前記制御部は、
前記第1血流データに基づいて前記伝熱モジュールを制御する温度管理部を備える、請求項1に記載の血流管理装置。 - 前記第1血流センサと異なる位置に配置され、第2血流データを取得可能な少なくとも1つの第2血流センサをさらに備え、
前記制御部は、前記第1血流データと、前記第2血流データとに基づいて、前記対象部位における血流変化量を算出する算出部を備える、請求項9に記載の血流管理装置。 - 前記対象部位の高度に関する高度データを取得可能な高度検出センサと、
前記高度データから、冷却開始時を基準とした前記対象部位の高度の変位を算出する高度管理部と、を備える、請求項9または10に記載の血流管理装置。 - 請求項1から11のいずれか1項に記載の血流管理装置と、前記血流管理装置からの情報に基づき報知を行う外部端末とを備える、血流管理システム。
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JP2015533523A (ja) * | 2012-08-13 | 2015-11-26 | モア リサーチ アプリケ−ションズ リミテッド | 橈骨動脈装置 |
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