CN1409646A - 具有整体传感器的生物面罩 - Google Patents

具有整体传感器的生物面罩 Download PDF

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CN1409646A
CN1409646A CN00817186A CN00817186A CN1409646A CN 1409646 A CN1409646 A CN 1409646A CN 00817186 A CN00817186 A CN 00817186A CN 00817186 A CN00817186 A CN 00817186A CN 1409646 A CN1409646 A CN 1409646A
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face shield
pick
patient
gas delivery
monitoring patient
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CN100512902C (zh
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戴维·伯顿
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Compumedics Sleep Pty Ltd
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Abstract

在监测病人时使用的呼吸面罩(10)，面罩(10)中设有便于应用于病人的传感器(25、26)，使得面罩(10)在病人身上放置所有所需的传感器。面罩(10)包括外围(12)，外围(12)具有其中设有传感器(25)的柔软易弯曲材料，用于接触病人皮肤并形成密封。面罩(10)还具有设置在面罩主体上和相连带子或帽子上的传感器(26)。传感器(25、26)可以用于检测病人的EMG、EEG、EOG、ECG、表面血压、温度、脉搏、血液氧、病人的姿势、病人的活动量、面罩(10)中的声音和气体压力。

Description

具有整体传感器的生物面罩
                        发明背景
发明领域
本发明涉及一种呼吸面罩，该面罩装有在麻醉或换气中使用的用于检测病人睡觉窒息、呼吸失调的传感器。
相关技术描述
在专利5243971中公开了一种用于向发生窒息或其它呼吸失调的病人施加强制压力的面罩。这些面罩形成密封，防止面罩中的空气从面罩和脸部的结合处泄漏。通常还使用用于向病人输送气体的其它类型面罩。
在专利5503146中，通过在连接到面罩的供气中的计量传感器测量已经供给病人的气流，或在专利5131399中，通过缠绕病人胸部的带子测量其呼吸，从而测量供给病人的气流。
有些装置如专利5507716中提供与覆盖病人眼睛的睡眠面罩结合的传感器。但是，没有公开设置在呼吸面罩中以检测或研究病人呼吸失调的传感器。
目前，如果要密切监测病人，则须将多个电极或传感器分别施于病人并用导线与记录装置连接。多个传感器和由此缠结的导线妨碍了这种监测装置的使用。提供有用信息的传感器包括脑电图(EEG)、肌动电流图(EMG)、眼电图(EOG)、心电图(ECG)、脉搏传送时间(PTT)、气流传感器、温度传感器、麦克风、血氧测量计、血压传感器、脉搏传感器、病人移动、姿势、光线、活动传感器、通过聚偏二氟乙烯-(PVD)或压电(Piezo)检测的面罩泄漏、面罩压力、眼移动和其他收集关于病人或其环境数据的元件。
这对于病人和要将一系列不同的装置连接到病人身上以便同时监测多个不同参数的护士来说非常不便。因此希望提供便于测量多个参数的单个装置。
                        发明概述
本发明涉及在呼吸面罩中设置传感器以方便监测病人。面罩具有绕其接触病人面部以在其间形成安全可靠密封的外围的柔软易弯曲密封材料。传感器可以凹入放在表面上的柔软易弯曲密封材料中，以在将面罩放置在使用者面部时接触使用者的面部。传感器的接线可以置于柔软易变形密封材料的内部，在面罩的使用中，该密封材料对导线绝缘以防止其受到损坏。可以将许多传感器组装在面罩内。传感器可以被放在面罩的外围或其它部分，不与皮肤接触。还可以将传感器放置在与面罩相连的带子或帽子中或其他和面罩一起使用的装置上。
由于需要将所有传感器置于面罩中，该面罩易于快速地被戴在病人身上，使连接各传感器的所有接线与面罩成一体并通过单个插头接通，因此更容易和更方便了病人和护理者对病人的睡眠失调、呼吸失调或麻醉的监测。
面罩、与面罩相连的带子或帽子上或内的传感器类型包括但不限于血氧定量法传感器、病人姿势传感器、眼移动传感器、泄漏检测传感器、EEG、EMG、EOG、ECG、PTT、麦克风、脉搏、血压、氧饱和、温度、移动传感器、姿势传感器、光传感器、泄漏检测传感器和气体输送传感器。
输送给面罩的外部气源的接头通过气嘴连接在面罩上。电源接头和数据输出电缆通过插头接入与面罩相连的电缆中。另外，面罩中的电池和面罩中的遥测装置可以向微处理器或计算机提供电力和传送数据。为了便于携带，可以将微处理器安装在面罩上或由病人携带。同样地，气瓶可以连接到面罩上，并由病人携带，以便当病人戴上面罩时，可以移动病人。
生物面罩的独特用途包括能在对接受治疗者实施麻醉气体时采用麻醉程度监测。在对病人实施麻醉气体的同时监测未戴上生物面罩病人的能力提供了对接受治疗者的直接和响应麻醉程度的生物反馈功能。可以采用生物面罩通过应用标准睡眠分阶段指标来判定接受治疗者的睡眠状态，如R&K规则的指标和/或分析EEG信号数量的诊断技术的应用，如双光谱分析(Bispectral Analysis)。本发明独特之处在于能以最低限度侵害接受治疗人的呼吸面罩实施这样的分析。
R&K规则指的是由Rechtschaffen和Anothony Kales于1968年编写的“标准化术语、技术和接受治疗人睡眠阶段的计分系统的手册”，其成为本文的组成部分，这里作为参考。
                                发明目的
本发明的目的在于监测病人。
本发明的目的在于提供需要的有助于治疗病人的数据。
本发明的目的在于提供用于监测戴有呼吸面罩或其结合部件的病人的传感器。
本发明的目的在于根据通过监测病人所获得的数据来调节供给病人的气流。
本发明的目的在于根据由监测病人所获得的数据来诊断病人。
本发明的目的在于方便而迅速地应用检测病人所需的所有传感器。
通过结合附图对本发明所进行的详细说明，可以清楚理解本发明的其它目的、优点和新颖特征。
                       附图简要说明
图1是在呼吸面罩外围上的柔软易弯曲材料内表面上的传感器区域的示意图。
图2是在呼吸面罩外围上的柔软易弯曲材料内的传感器和布线的视图。
图3是在呼吸面罩外围上的柔软易弯曲材料内的传感器和布线的侧视图。
图4是连接到面罩的带子的侧视图，该面罩具有埋入带子和面罩中的传感器。
图5是呼吸面罩外围上的传感器区域的示意图。
图6是呼吸面罩内表面上的传感器的示意图。
图7是具有位于面罩表面上的传感器的面罩的侧视图。
                          优选实施例描述
图1示出了面罩10的内部，该面罩10包括接触病人面部的外围面12。外围面12具有多个区域20。每个区域20具有在凹槽29中的传感器25，用于检测要监测病人的参数或其它数据如气体泄漏。其它传感器26设置在面罩10上，但不与病人的皮肤接触。这些传感器26检测病人数据或相关数据如环境光线、面罩中的气体压力或环境温度。面罩10具有气体接头14和面罩接口连接器16，气体接头14用于连接软管32以向面罩10供应气体，面罩接口连接器16供电缆30插入以提供电力和进行数据传输。
在本发明的一些实施例中，由于传感器如热敏传感器和光敏传感器产生电流，因此传感器25不需要外部电源。
面罩外围面12最好由与病人脸部形成良好密封接触从而防止气体泄漏的柔软易弯曲材料如硅橡胶制成。该材料应该足够柔软而且易弯曲以便适应脸部轮廓。外围面上最好具有供插入传感器25的凹槽29，使得当将面罩向着病人的面部按压时，传感器能与病人的皮肤保持接触。
如图3所示，连接到面罩10的传感器或电极25最好利用橡胶复合物28如硅或其它食品等级类型橡胶，该橡胶复合物28将用于电接触皮肤的碳或其它导电材料嵌入面罩中。如图2所示，凹槽29的空间足以容纳导线27的电接头，导线27埋入外围面12下面的柔软易弯曲材料内。因此防止导线27受损而形成电绝缘。最好将传感器25插入凹槽29内的导线27或印刷电路中。导线27最好位于嵌入面罩中的印刷电路上或是嵌入面罩内的细线，并且将传感器25与面罩接口连接器16相连。
图5显示了位于区域20表面上的导电材料40，如嵌有硅的碳，可以被用在分离区域20中的面罩10外围12的表面上，以便传导来自病人面部的电表面能量。导电材料40最好在接触皮肤时在有潮气的情况下也能被激活以提高其导电性。导电材料40可以应用于所有区域20中接触的所有电极25。另外，电极25可以直接接触病人面部。电极还可以位于面罩10外围12上的柔软易弯曲材料内部。
图4显示了面罩10和用于将面罩在病人身上固定就位的带子35的侧视图。带子35具有与导线27连接的传感器25，导线27将传感器与面罩接口连接器16和用于将数据传递到计算机或其它仪器的电缆30相连。带子35中的传感器25可以是用于测量脑电波的脑电图EEG传感器。带子35可以由其中具有传感器的帽子代替。另外，下巴部带子37可以设有传感器25。
图5显示了围绕面罩10外围的在区域20中所使用传感器25类型的实施例。由围绕面罩10外围12的在区域20中的传感器来检测由病人皮肤电位产生的生理信号。导电电极胶40可以用于改善传感器25和皮肤表面之间的电接触。导电胶40能有助于减小面部和区域20中传感器25产生的电输出之间的阻抗。导电胶40还有助于防止气体泄漏。
下面说明作为面罩传感器布置实施例的传感器及其功能。但是可以有许多其它类型的传感器和传感器的布置。
区域50是由鼻梁上方获得眼移动参考电信号的眼电流图(EOG)。
区域51是检测左眼内部的眼移动电信号的EOG，区域61是为右眼内部的眼移动电信号而设计的。眼移动数据与睡眠程度有关，如快速眼移动REM表示深睡眠状态和做梦。
区域52是为EOG而设计的，用于检测左眼外部的眼移动电信号，区域62是为右眼外部的眼移动电信号而设计的。
区域53是为肌动电流图(EMG)而设计的，用于检测由上左下巴中的肌肉收缩产生的电信号。区域63对应上右下巴。区域54和64分别对应下左下巴和下右下巴。下巴信号的大小与病人的放松状态和随后的睡眠状态成正比。
区域55是上左唇的EMG，显示关于睡眠状态的信息。它与病人的放松和睡眠状态成正比。区域65是上右唇的EMG。
区域56是左鼻内面罩的EMG，其还提供唇移动的信号并与病人的放松和睡眠状态成正比。同样地，区域66是右鼻内面罩的EMG。
区域57和67用于口部左外面罩和口部右外面罩的EMG信号，其还与病人放松和睡眠状态成正比。
区域70是用于气流判定的压力传感器口。
面罩上的麦克风80检测病人呼吸或打鼾声。
图6显示了将两个传感器58和68用于探测病人心电图ECG的实施例。该数据还用于监测病人。病人的心脏功能提供许多关于病人状态的有用数据。脉搏传送时间(PTT)是其将ECG脉搏由心脏传送到传感器如放置在头部、指端或耳朵上的传感器所花费的时间。PTT传感器可以放在面罩中，与面罩相连。PTT测量被用于判定病人唤起和合格血压的变化。
热敏传感器81用于面罩的内表面上，以便检测鼻呼吸。热敏传感器82用于面罩的外表面上，以便检测口的呼吸。对着鼻子或嘴的面罩10表面上的传感器81和82的热敏性表示病人是通过其鼻子还是其嘴进行呼吸的。热敏传感器81、82可以择一地放在面罩10的内部、面罩10的外部或面罩10的材料内部来检测呼吸。热敏传感器81、82可以是热敏电阻材料、热电偶材料或任何其它温度敏感性材料。热敏传感器81、82可以被覆盖在面罩内部上、面罩外部上或面罩中。热敏传感器81、82检测与呼吸量成正比的热量。
检测口呼吸很重要，因为未检测或部分未检测口呼吸影响病人呼吸气体的呼吸监测的完整性并因而有损输送给病人的理想气体。检测口呼吸很重要，它有助于入睡中不正常呼吸的诊断。此外，由口呼吸实现对面罩鼻通气的控制。
压力传感器84测量面罩内部的压力，以便表示面罩内部是否存在正压力以及压力的大小。压力降低表示发生了漏气。
面罩内部的表面反射氧化测定传感器85检测病人脉搏频率和氧饱和度。
与病人接触的面罩10外围12上的表面血压传感器90可以用于监测病人血压。
与病人接触的面罩10外围12上的热敏电阻91可以用于监测病人的温度。
具有位于面罩内表面上的传感器95的病人再循环气体检测系统检测留在面罩10中的由病人呼出的气体量。面罩中的高含量呼出气体表示面罩没有被彻底吹净，同时如果没有送入足够的新鲜气体则会带来麻烦。
面罩软管接头14中的病人回气发生探测器97检测送有新鲜气体的面罩中的呼出气体量。
图7显示了在靠近外围12的面罩内部或外部上的热敏传感器83如热敏电阻或热电偶。这些传感器可以固定在围绕面罩10外围的导热材料92上。另外，导热材料可以处于部分外围上。该热敏材料可以处于面罩10的内表面上、面罩10的外表面上或嵌入面罩材料内。通过热敏传感器83或导热材料92上的热敏传感器83进行的温度变化检测与围绕外围的面罩泄漏相关。热敏性材料可以是面罩中的面罩内部上、面罩外部上或面罩外围上的热敏性材料。该热敏性材料可以是热敏电组、热电偶或任何其它热敏性材料。
面罩10的气体泄漏会引起与导热材料92和传感器83有关的温度变化，并使保健专家实时监测泄漏情况或监测面罩泄漏后的情况。在有些情况下，病人的气体输送是至关重要的，它可以挽救生命，在另一些情况下，泄漏事故可有助于对病人的诊断。以向保健专家报警即通知其输送的气体遭到泄漏的形式来进行救助，这会影响病人处理和病人诊断状态。在其它情况下，气体泄漏检测可以使气体输送系统自动补偿气体泄漏。
面罩10外表面上的光敏电阻86显示病人的环境光线状态。
姿势传感器87显示病人的姿势或活动。例如这些传感器显示病人是否是躺着并且是不动的。这样的传感器可以是穿过开关触头的移动球或水银传感器开关。
身体移动传感器88可以是PVD或压电材料或微型机构，用于检测病人身体移动范围或速度以便判定是醒着还是休息状态。
所有上述传感器可以通过遥测装置而不是电缆30来发送数据。
所有上述收集的数据可以有用于监测病人的各种用途，包括睡眠观察、麻醉或睡眠窒息。
可以将收集的数据转换成一系列数据流以使单根线连接所有传感器。该传感器可以提供数据以调节对病人的气体输送。
可以对信号进行放大和滤波调整用于使信号接近最佳噪声和信号性能的信号源状态。
可以应用对传感器如病人姿势传感器、热传导区域、麦克风或与光有关的电阻的电偏压。
计算机可以处理数据或仅仅存储由面罩中或连接面罩的带子中的监测传感器产生的数据。可以将监测数据用于诊断病人、提供反馈给固定到病人身上的仪器、提高或降低供应给病人的气体或实现其它功能。
生物-反馈应用中的EEG数据控制的实例，在病人具有鼻排气装置如通风装置时对病人的空气输送可以是连续正空气压力(CPAP)、双-正空气压力(BIPAP)、可变正空气压力(VPAP)、睡眠连接的正空气压力(SPAP)，EEG电极提供病人是否入睡的重要信号之一。当认为病人睡着了时，气体仅仅应用于面罩。该功能是比较完善的、对病人舒服度敏感，而且比使用在有些排气系统中的延迟倾斜系统更经济适用。
在使用延迟倾斜的排气装置中，使用者设定系统的时间，向病人分配斜升的气体压力输送，使得气体应用不对使用者产生过多干扰影响和对其入睡产生负面影响。
在应用辅助鼻排气之前，面罩10中的传感器最好能判定病人何时实际上入睡了。过早施加压力可使病人由于附加正压力的不适而不能入睡。
面罩10可以被制成医疗上使用的无菌易处理器械，它通过不需为新病人进行消毒处理的面罩并提供比重复使用面罩更好的消毒处理而降低处理成本。
显然，本发明可以有根据上述教导的许多改进和改变。因此应该明白，可以在附加权利要求的范围内而不是根据上述特别说明来实施本发明。

Claims (31)

1、一种具有在气体输送中监测病人的传感器的面罩，包括：
具有接触病人面部的外围的面罩，
面罩上的至少一个传感器，用于检测至少一个表示病人状态的参数，
面罩中的、连接于所述至少一个传感器以传送数据的导线，
传送来自面罩的数据的元件，
面罩上的软管接头，用于连接软管以将气体输送给面罩。
2、如权利要求1所述的具有在气体输送中监测病人的传感器的面罩，其中传送来自面罩的数据的元件包括将面罩中的导线连接到电缆的面罩接口连接器。
3、如权利要求1所述的具有在气体输送中监测病人的传感器的面罩，包括向面罩供电以操作传感器的元件。
4、如权利要求3所述的具有在气体输送中监测病人的传感器的面罩，其中所述向面罩供电以操作传感器的元件包括面罩接口连接器，所述连接器将电源导线与面罩中的导线连接以将电力传递给传感器，以及
传递来自面罩的数据的元件包括面罩接口连接器，用于将面罩中的导线与电缆连接。
5、如权利要求3所述的具有在气体输送中监测病人的传感器的面罩，其中所述向面罩供电以操作传感器的元件包括电池，该电池连接在面罩中的导线上，用于向传感器传递电力。
传递来自面罩的数据的元件包括遥测装置。
6、如权利要求1所述的具有在气体输送中监测病人的传感器的面罩，其中从以下的组中选择面罩上的传感器，包括EEG、EMG、EOG、ECG、PTT、温度、表面血压、脉搏、血液氧含量、光、呼吸频率、呼吸量、气流量、鼻气流量、口气流量、姿势、活动传感器、面罩泄漏、面罩压力、眼移动、麦克风、气体压力、病人再循环空气检测、病人回气和移动。
7、如权利要求1所述的具有在气体输送中监测病人的传感器的面罩，其中在面罩外围上的至少一个传感器与病人皮肤接触以测量参数。
8、如权利要求7所述的具有在气体输送中监测病人的传感器的面罩，其中面罩外围具有柔软易弯曲材料，用于接触病人的面部。
9、如权利要求8所述的具有在气体输送中监测病人的传感器的面罩，其中所述材料具有至少一个凹槽，凹槽中设有传感器，用于接触病人的皮肤。
10、如权利要求9所述的具有在气体输送中监测病人的传感器的面罩，其中在易弯曲材料中的导线连接至少一个传感器，以同时进行电力和数据连接。
11、如权利要求8所述的具有在气体输送中监测病人的传感器的面罩，其中嵌入橡胶材料的碳在柔软易弯曲材料中的传感器和病人的皮肤之间形成电接触。
12、如权利要求1所述的具有在气体输送中监测病人的传感器的面罩，其中所述面罩具有至少一根连接到面罩上的带子以将面罩固定就位。
13、如权利要求1所述的具有在气体输送中监测病人的传感器的面罩，其中所述面罩具有至少一根连接到面罩上的带子以将面罩固定就位，并且所述带子具有至少一个传感器，该传感器用导线连接到面罩上以监测病人。
14、如权利要求1所述的具有在气体输送中监测病人的传感器的面罩，其中所述面罩具有连接到面罩上的帽子以将面罩固定就位。
15、如权利要求1所述的具有在气体输送中监测病人的传感器的面罩，其中所述面罩具有帽子，至少一个传感器连接到所述帽子上，所述传感器连接在与面罩中的导线相连的帽子上，以监测病人。
16、如权利要求13所述的具有在气体输送中监测病人的传感器的面罩，其中所述带子包括下巴部带子。
17、如权利要求1所述的具有在气体输送中监测病人的传感器的面罩，其中在下巴部带子中的至少一个传感器用于测量下巴EMG。
18、如权利要求13所述的具有在气体输送中监测病人的传感器的面罩，其中所述带子包括具有测量EEG的传感器的头部带子。
19、如权利要求15所述的具有在气体输送中监测病人的传感器的面罩，其中所述帽子包括测量EEG的传感器。
20、如权利要求13所述的具有在气体输送中监测病人的传感器的面罩，其中所述带子包括耳部带子，该耳部带子具有应用于病人耳部的氧饱和传感器。
21、如权利要求1所述的具有在气体输送中监测病人的传感器的面罩，其中在部分面罩上的热敏传感器检测该部分面罩上的温度变化。
22、如权利要求21所述的具有在气体输送中监测病人的传感器的面罩，其中所述面罩具有导热性材料，所述热敏传感器与其热耦合。
23、如权利要求1所述的具有在气体输送中监测病人的传感器的面罩，其中靠近病人鼻子的面罩上的热敏性材料检测鼻呼吸探测的温度变化。
24、如权利要求1所述的具有在气体输送中监测病人的传感器的面罩，其中靠近病人嘴部的面罩上的热敏性材料检测口呼吸探测的温度变化。
25、如权利要求1所述的具有在气体输送中监测病人的传感器的面罩，其中靠近面罩外围的面罩上的热敏性材料检测泄漏探测的温度变化。
26、如权利要求21所述的具有在气体输送中监测病人的传感器的面罩，其中热敏性材料包括热敏电阻。
27、如权利要求21所述的具有在气体输送中监测病人的传感器的面罩，其中热敏性材料包括热电偶。
28、如权利要求21所述的具有在气体输送中监测病人的传感器的面罩，其中热敏性材料包括面罩上的涂层。
29、如权利要求21所述的具有在气体输送中监测病人的传感器的面罩，其中面罩的热敏性材料部分包括面罩的内表面部分。
30、如权利要求21所述的具有在气体输送中监测病人的传感器的面罩，其中面罩的热敏性材料部分包括面罩的外表面部分。
31、如权利要求21所述的具有在气体输送中监测病人的传感器的面罩，其中面罩的热敏性材料部分包括面罩材料内的部分。
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CN110585546A (zh) * 2019-08-23 2019-12-20 山东大学 具有舌下神经与膈肌刺激功能的呼吸面罩及通气治疗设备
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CN110464944B (zh) * 2019-08-26 2022-04-19 深圳创达云睿智能科技有限公司 一种呼吸机的控制方法、装置及呼吸机
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EP1237613A1 (en) 2002-09-11
ATE404236T1 (de) 2008-08-15
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US20100147304A1 (en) 2010-06-17
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US8281787B2 (en) 2012-10-09
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AU765937B2 (en) 2003-10-02
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US20040163648A1 (en) 2004-08-26
KR100489139B1 (ko) 2005-05-17
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