WO2006114055A1

WO2006114055A1 - Health and rehabilitation therapy system for blood vessel

Info

Publication number: WO2006114055A1
Application number: PCT/CN2006/000788
Authority: WO
Inventors: Zhensheng Zheng
Original assignee: The First Affiliated Hospital, Sun Yat-Sen University
Priority date: 2005-04-25
Filing date: 2006-04-25
Publication date: 2006-11-02
Also published as: CN2792415Y

Abstract

A health and rehabilitation therapy system for blood vessel, in which a main machine (1) of an external counterpulsation apparatus is electrically connected with a blood flow velocity detecting apparaturs (7) and is provided with a control module (4). The control module (4) is use for cooperating with the blood flow velocity detecting apparaturs (7) so as to confirm the optimal parameters for counterpulsation.

Description

Vascular health rehabilitation system

[Technical Field]

The invention relates to the field of medical instruments, in particular to a vascular health rehabilitation treatment system. 【Background technique】

Recent vascular medical research in more than a decade has confirmed that increasing blood flow velocity (reflecting blood flow shear stress) can mobilize the self-repairing function of vascular endothelial cells, thereby preventing the occurrence and development of atherosclerosis. As for how to increase blood flow velocity and blood flow shear stress, it has never been noticed in the past.

A counterpulsation device can be used to increase blood flow velocity. The principle of the counterpulsation device is to use the ECG trigger to drive the opening and closing of the charging and exhausting solenoid valves to achieve the pressure and evacuation of the air sputum, thereby achieving the purpose of treating various diseases by counterpulsation. Therefore, an effective counterpulsation requires accurate inflation immediately at the beginning of the diastolic phase of the heart, allowing the diastolic blood pressure to rise immediately, pouring more blood into the heart muscle, the brain, and all organs; Empty, the body's lower body pressure is relieved, the blood vessels open to meet the heart's ejection, due to the opening of the blood vessels, the systolic blood pressure drops, the heart ejection resistance decreases, the myocardial pressure can be reduced, and the oxygen consumption can be reduced accordingly.

The above-mentioned counterpulsation process improves the blood flow velocity, but it has been proved that: how to accurately inflate the pressure, depressurize the blood pressure, when to start the pressure discharge, and how much counter pressure to apply, etc. The parameters constitute the key factors affecting the counter-stroke effect.

The counterpulsation parameters of the existing counterpulsation device are generally set by the operator according to the device indication: subjective factors such as electrocardiogram, exhaust gas mark, and air source pressure. According to the finger vein pattern appearing during the counterpulsation, the charging and exhausting time and the source pressure are adjusted to the satisfaction according to the principle of the counterpulsation. This kind of operation is undoubtedly not scientific enough.

The applicant had admitted 30 patients with coronary heart disease who were voluntarily tested under different counterpulsation pressures. The diastolic phase-incremental wave (hereinafter referred to as DA wave) was calculated and the dv/dt slope was calculated. The counterpulsation pressure increased, and the dv/dt of their DA wave increased gradually (see Figure 4). Among them, 14 cases showed that the dv/dt growth was flat when the counterpulsation pressure increased to 0.35kg/cm ² or more, and another 15 cases were The counterpulsation pressure is increased to 0.4 kg/cm ² to maintain the dv/dt to a peak.

This result indicates that if the blood flow shear stress is increased as the target of treatment, the pressure required for the counterpulsation, about half of the patients do not need 0.4kg/cm ² . Similarly, the applicant has also confirmed the charge time limit, exhaust time limit, and charge. The parameters such as gas time and exhaust time have been studied accordingly. It is unscientific to adjust a series of parameters based on the operator's experience. It is not scientific enough to improve blood flow velocity and shear stress. Counter-effect. Therefore, it is necessary to test each patient to determine a specific set of counterpulsation parameters.

It can be seen that the existing counterpulsation device, because the counterpulsation parameter is set by the operator, has subjective judgment factors, whether it is the best counterpulsation state of the patient, and there is no realistic objective index, and can only judge that the subjectively set parameter is valid. The counterpulsation state, not necessarily the best counterpulsation state. Because of the individual patient differences, the optimal state of the counterpulsation parameters of different patients will be different. Only by detecting the blood flow velocity, the optimal counterpulsation parameters can be finally determined.

[Summary of the Invention]

The main object of the present invention is to provide a vascular health rehabilitation system capable of effectively improving blood flow velocity by setting an optimal counterpulsation parameter and having a good protective effect on vascular endothelial cells, thereby preventing and treating cardiovascular and cerebrovascular diseases.

The object of the present invention is achieved by the following technical solution: The vascular health rehabilitation treatment system comprises a counterpulsation device having a host, the counterpulsation device main body is electrically connected with the blood flow velocity detecting device, and the counterpulsation device main body is provided with a control module , used to determine the best counterpulsation parameters of the counterpulsation in conjunction with the blood flow velocity detecting device.

The control module completes the following steps:

Step 1: Initialize each counter-attack parameter with a reasonable value;

Step 2: driving the blood flow velocity detecting device to detect and feed back the blood flow velocity of the human body to the control module;

Step 3: Further determine the optimal counterpulsation parameters based on the measured blood flow velocity.

The optimal counterpulsation parameters include an inflation time limit, an exhaust time limit, an inflation time, an exhaust time, and a counter pressure.

Specifically, step 3 further includes the following steps:

Step 3.1: Determine the corresponding counter-pulsation before and after the peak of the T. band formed by the repolarization after ventricular electrical excitation. The time corresponding to the highest rise of the D wave is the optimal inflation time;

Step 3.2: Firstly, determine the time corresponding to the decrease of the contraction S wave corresponding to the peak of the P wave caused by atrial excitability to the lowest position, or set the optimal exhaust time, or continue to exhaust the signal from the P wavefront. After moving, the time corresponding to the ratio of the corresponding D wave and S wave area reaching the maximum is the optimal exhaust time;

Step 3.3: From a certain time point, measure the S wave formed by the pulsation of the systole during the systolic period and the counterpulsation D wave formed by the lower limb compression during the diastolic phase, and calculate the S wave and the D wave. The area to be measured at least twice, taking the mean value and then calculating the time ratio when the ratio of the S wave to the D wave area is maximum is the optimal inflation time limit;

Step 3.4: Detect the internal pressure of the thigh in a certain period of time, and determine the optimal exhaust time limit when the pressure drop in the capsule is 1 - 2 mm Hg;

Step 3.5: Firstly, the blood flow velocity detecting device is used to detect the diastolic counterpulsation rising steepness dv/dt of the patient under different counterpulsation pressures, and the dv/dt values measured under different counterpulsing pressures are recorded, the different dv The curve of the /dt value on the plane coordinate increases linearly and then an inflection point occurs, which is used as the optimal counterpulsation pressure.

In step 3.5, the value is taken at least twice under the same counterpulsation pressure, and the average value is the final ascending steepness dv/dt.

In addition, in the above step 3, the determination between the respective counterpulsation parameters should be kept as follows: First, the initial counterpulsation pressure is kept constant, and then the optimal inflation time, the optimal exhaust time, the optimal inflation time limit, and the most Good exhaust time limit; secondly, the optimal counter-pressure is further determined in the case where the optimal values of the inflation time, the exhaust time, the inflation time limit, and the exhaust time limit have been determined.

The blood flow velocity detecting device may be a volumetric pulse wave detecting device or a Doppler non-invasive blood flow detecting device.

Compared with the prior art, the invention has the advantages of: non-invasive blood flow detecting device, capable of detecting the blood flow velocity before counterpulsation and counterpulsation for each patient in a targeted manner, scientifically determining a group of energy The best counterpulsation parameters for increasing blood flow velocity (reflecting blood flow shear stress) act on the patient, thereby providing a good protective effect on vascular endothelial cells, thereby achieving the purpose of preventing and treating cardiovascular and cerebrovascular diseases.

[Description of the Drawings]

Figure 1 is a schematic diagram of the principle of the present invention;

2 is a schematic diagram of the principle of a Doppler non-invasive blood flow detecting device;

Figure 3 is a schematic diagram showing the principle of a volume pulse wave detecting device;

Figure 4 shows the diastolic increase in pulse wave in 30 patients with coronary heart disease who underwent counterpulsation under different counterpulsation pressures. The dv/dt slope plot calculated after the wave.

5 is a schematic flow chart of each calculation unit of the special software of the present invention, wherein a is an inflation time calculation unit; b is an exhaust time calculation unit; c is a counter-pulse pressure calculation unit; d is an inflation time limit calculation unit; e is an exhaust Time limit calculation unit.

【detailed description】

The present invention will be further described below in conjunction with the accompanying drawings and embodiments:

Referring to FIG. 1 , the vascular health rehabilitation system of the present invention includes a counterpulsation device, and the counterpulsation device includes a host 1, a control display 2, a power source 3, a gas source 5, a gas distribution valve 6, and a gas source pressure control module 4, The main unit 1 of the beat device is equipped with a control module, and the display screen 2 is used to display information, which is convenient for the user to monitor the operation process. The power supply 3 is electrically connected to the control display screen 2, the counterpulsation device host 1 and the air source 5, respectively, and the control display screen 2, the air distribution valve 6, and the air source pressure control module 4 are electrically connected to the counterpulsation device host 1, respectively. The air source 5 is electrically connected to the air source pressure control module 4, and the air source 5 and the gas distribution wall 6 are connected through the gas transmission pipe 8, and the host device 1 of the counterpulsation device is electrically connected with blood flow velocity detection. The blood flow velocity detecting device 7 may be a Doppler non-invasive blood flow detecting device or a volumetric pulse wave detecting device or a combination of both for the user to select according to needs. The Doppler non-invasive blood flow detecting device or the volumetric pulse wave detecting device is directly electrically connected to the counterpulsing device host 1, respectively.

Referring to Fig. 2, the multi-Puller non-invasive blood flow detecting device is a well-known technique, which adopts a Doppler blood flow measuring method, and can accurately and non-invasively detect blood flow velocity during counterpulsation. The working principle is as follows: It is composed of a pulse ultrasonic wave source 71, a pulse delay calibration system 72, a receiver 73, and a direction and flow rate post-processor 74. The pulse delay calibration system 72 is for adjusting the opening time of the reception so that the blood flow signal in the blood vessel 70 of the distance d can be clearly received. The direction of blood flow in the blood vessel 70 is related to the polarity of the received signal; when d is set, the direction and magnitude of the blood flow can be obtained by post-processing according to the received echo signal through the direction and flow rate after the processor 74 performs post-processing.

Referring to FIG. 3, the volumetric pulse wave detecting device is also a well-known technique, which is a photoelectric sensor. When the wavelength of the light source 77 matches the characteristics of the photosensitive member 78, and at the same time it is a near-infrared monochromatic light having better penetration in the tissue, it is ten times stronger than the penetration in the blood flow. This phenomenon is used to produce a finger volume pulse wave detecting device. In use, the light source 77 and the photosensitive element 78 are respectively placed on both sides of the fingertip to be tested. At this time, the photosensitive member 78 receives a change in light intensity, which is blood flow in the tissue when the pulse fluctuates. The change in light rate, which is the change in blood flow volume in the tissue. There is a linear relationship between volumetric flow rate and flow rate, so volumetric detection can indirectly detect blood flow velocity.

When the present invention is used, the operator selects the Doppler non-invasive blood flow detecting device or the volumetric pulse wave detecting device as the blood flow velocity detecting device 7 to perform blood flow velocity detection on the patient as needed, and the acquired data is obtained by the counterpulsation device host 1 The control module processes and obtains the optimal counterpulsation parameters, and then cooperatively controls the air source 5 and the air distribution valve 6 through the air source pressure control module 4 to act on the patient, thereby implementing appropriate counterpulsation pressure on different patients. Features.

The control module completes the following steps:

Step 1: Initialize each counter-attack parameter with a reasonable value;

Step 2: driving the blood flow velocity detecting device to detect and feed back the blood flow velocity of the human body to the control mode.

The optimal counterpulsation parameters include an inflation time limit, an exhaust time limit, an inflation time, an exhaust time, and a counterpulsation pressure.

In step 3, the following steps are also included:

Step 3.1: As shown in Figure 5a, first move the T-band peak formed by the repolarization of the ventricular electrical excitation to the position of 10 sec seconds forward, and every 10 milliseconds, for 3 consecutive times, calculate whether the D wave rises, if any, Find the highest value and assign it to the intermediate variable A, and record the time at this time. If the D wave value drops during the advancement process, you can stop the forward movement and then move backward from the T wave peak. No greater than A value, if any, assigned to A, if less than A, stop moving backward. The time corresponding to the finally obtained A value is determined as the optimal inflation time;

Step 3.2: As shown in Figure 5b, first move forward from the peak of the P wave caused by atrial excitation, move every 10 milliseconds to take 3 waves and take the mean value, and calculate whether the S wave is the shrinking wave. If so, find Out of it to the lowest. If the shrinkage wave does not fall back and rise during the forward movement, the forward movement can be stopped and the backward movement can be stopped. Until it is found that the contraction wave energy drops to the lowest, the best exhaust time, or can continue to move the P wave back and forth, and find the maximum sum of the D wave area and the S wave area is the optimal exhaust time;

Step 3.3: As shown in Fig. 5d, from 80 亳 seconds, the inflation time calculation unit measures the S wave formed by the pulsation of the systole and the inverse of the lower body pressure during the diastolic phase at regular intervals such as 20 milliseconds. The D wave is calculated, and the area formed by the S wave and the D wave is calculated. Up to 400 milliseconds, the measurement is performed three times in succession, and the time limit in which the area ratio of the S wave plus the D wave is the largest is the optimal inflation time limit; Step 3.4: As shown in Fig. 5e, the internal pressure of the thigh is detected every 20 milliseconds from 120 milliseconds, and the optimal exhaust time is determined when the internal pressure drops to 1-2 mmHg;

Step 3.5: As shown in Fig. 5c, the optimal counterpulsation pressure is firstly determined by using the blood flow velocity detecting device to detect the diastolic counterpulsation rising steepness dv/dt of the patient under different counterpulsation pressures, and recording different counterpulsations. The dv/dt value measured under pressure, the curve of the different dv/dt values on the plane coordinate increases linearly and then an inflection point occurs, and the inflection point is used as the optimal counterpulsation pressure.

The specific process for determining the optimal counterpulsation pressure is further explained below:

a. The initial counter-pulsation pressure is automatically set by the control module, such as 0.02 MPa. After the pressure is stabilized, the control module calculates the rising branch steepness dv/dt of the diastolic wave by the received signal measured by the blood flow velocity detecting device. , that is, the rising slope, and the ten slope values are successively averaged and stored;

b. The program automatically adjusts the pressure and raises it to 0.025MPa, 0.03Mpa, 0.035Mpa, 0.04Mpa, 0.045Mpa, etc., and processes it as described in a.

c. The control module expresses the dv/dt values obtained in a and b on the plane coordinates to form a trend graph (see Figure 4).

d. The curve of the trend graph has an ascending segment, and an inflection point occurs after its linear rise, and then enters a slow phase, which is used by the present invention as the optimal counterpulsation pressure.

e. The patient is treated according to the best counterpulsation pressure measured by d.

It should be noted that, in determining the optimal counterpulsation parameter, the whole process is automatically completed by the program of the control module, and the calculation work of the staff is completed.

In summary, the present invention has the following beneficial effects:

1. Targeted blood flow velocity detection in each patient during counterpulsation or counterpulsation, and determine a set of optimal counterpulsation parameters that can improve blood flow shear stress on the patient, thus acting on vascular endothelial cells Good protection, and thus achieve the purpose of prevention and treatment of cardiovascular and cerebrovascular diseases.

2, non-invasive blood flow testing equipment can provide a reliable basis for the choice of counterpulsation parameters, and can be carried out in a targeted and individualized manner, which is automatically performed by the device itself, without operator intervention. Therefore, the performance of the counterpulsation device is significantly improved, and the operation is prevented from being caused by improper operation. The low counter-pulsation effect or excessive counter-pulsation pressure brings discomfort to the patient and improves the quality of medical diagnosis.

3. The invention adopts a modular design, has a simple structure and is easy to implement, and is convenient for upgrading and upgrading the existing counter-pulsation device, and has low cost and obvious effect.

Claims

Claim

A vascular health rehabilitation treatment system, comprising a counterpulsation device having a host, wherein the counterpulsation device host is electrically connected to the blood flow velocity detecting device, and the counterpulsation device host is provided with a control module for using the blood The flow velocity detecting device cooperates with the optimal counterpulsation parameter for determining the counterpulsation.

2. The vascular health rehabilitation system according to claim 1, wherein: said control module performs the following steps:

Step 1: Initialize each counter-attack parameter with a reasonable value;

Step 2: Drive the blood flow velocity detecting device to detect and feed back the human blood flow velocity to the control module; Step 3: further determine the optimal counterpulsation parameter based on the measured blood flow velocity.

The vascular health rehabilitation system according to claim 2, wherein: said optimal counterpulsation parameters include an inflation time limit, an exhaust time limit, an inflation time, an exhaust time, and a counterpulsation pressure.

4. The vascular health rehabilitation system according to claim 3, wherein the step 3 further comprises the following steps:

Step 3.1: Determine the corresponding inversion of the T-band peak before and after the repolarization of the ventricular electrical excitation. The time corresponding to the highest D wave rise is the optimal inflation time;

Step 3.2: Firstly, determine the time corresponding to the decrease of the contraction S wave corresponding to the peak of the P wave caused by atrial excitation to the lowest position, or continue to move the exhaust signal from the P wave back and forth to find the corresponding The time corresponding to the ratio of the D wave and the S wave area reaching the maximum is the optimal exhaust time;

Step 3.3: From a certain time point, measure the S wave formed by the pulsation of the systole during the systolic period and the counterpulsation D wave formed by the lower limb compression during the diastolic phase, and calculate the S wave and the D wave. The area is measured at least twice, and the mean time is taken to calculate the time limit when the ratio of the S wave to the D wave area is maximum is the optimal inflation time limit;

Step 3.4: Detect the internal pressure of the thigh in a certain time, and determine the optimal exhaust time limit when the internal pressure drops to 1-2 mm Hg;

Step 3.5: Firstly, the blood flow velocity detecting device is used to detect the diastolic phase of the patient under different counterpulsation pressures. The anti-pulse wave rises steepness dv/dt, and records the dv/dt value measured under different counterpulsation pressures. The curve of the different dv/dt values on the plane coordinates increases substantially linearly. At the inflection point, the inflection point is used as the optimal counterpulsation pressure.

5. The vascular health rehabilitation system according to claim 4, wherein in step 3.5, the value is at least twice or more under the same counterpulsation pressure, and the average value is the final ascending steepness dv/dt.

6. The vascular health rehabilitation treatment system according to claim 4, wherein the determination between the respective counterpulsation parameters is maintained in the following order: first, maintaining the initial counterpulsation pressure constant, and then determining the optimal inflation time, the best Exhaust time, optimal inflation time limit and optimal exhaust time limit; secondly, the optimal counter-pressure is further determined under the condition that the optimal values of inflation time, exhaust time, inflation time limit and exhaust time limit have been determined.

The vascular health rehabilitation treatment system according to any one of claims 1 to 6, wherein the blood flow velocity detecting means is a volume pulse wave detecting means.

The vascular health rehabilitation system according to any one of claims 1 to 6, wherein the blood flow velocity detecting device is a Doppler non-invasive blood flow detecting device.