CN101883518B - 用于检测晕厥的装置 - Google Patents
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Abstract
用于检测即将发生的血管迷走性晕厥的装置,其包括多个ECG传感器(12)以及远离心脏定位的远端脉搏传感器(22),所述多个ECG传感器中的一个位于邻近心脏处。处理单元(30)测量脉搏从心脏ECG传感器传播到远端脉搏传感器的脉搏波传导时间。
Description
技术领域
本发明涉及检测血管迷走性晕厥的方法和装置。
背景技术
血管迷走性晕厥是知觉的突然丧失,其病因尚不完全清楚,但是其涉及血压降低从而导致昏倒。对于老年患者来说,因为昏倒可能导致由于倒下引发的伤害,因此这种晕厥很危险。
随着人口老龄化,占很大百分比的七十岁以上人口在未来十年中会在某种程度上受血管迷走性晕厥的困扰。一种统计量显示在十年内将有23%的老年人口受到晕厥的困扰,并且这种事件可能占这类患者急诊就诊的5%以及医院就诊的3%。由此,血管迷走性晕厥的问题广泛分布。
这种晕厥给老年患者带来严重问题,因为这使得他们更难独自生活。
提供一种能对这种晕厥预先发出警报的装置是非常有利的。
在US2007/0070800中提出了一种在先方案,其结合了光电容积描记传感器并从测量得的传感器信号估算出现晕厥的概率。
在WO2002/41771中描述了备选解决方案,其用袖带测量血压。
发明内容
根据本发明,提供一种如权利要求1所述的装置。
通过使用脉搏波传导时间方法可以获得比上面提及的在先方案更可靠的结果。该方法非常简单,从而其可以结合到低功耗装置中,在患者进行其正常生活时可由患者永久地佩戴该装置。
重要的是,所采用的该方法能够预先对即将发生的晕厥发出警报并给患者坐下或躺下的时间以最小化其倒下的风险。在另一方面,本发明涉及如权利要求7所述的方法。
附图说明
为了能更好的理解本发明的具体实施方式,下面将参考附图对其进行描述,其中:
图1示出贴片(patch);
图2示出腕带;
图3示出处理单元;以及
图4示出检测血管迷走性晕厥的方法的各步骤。
这些附图是示意性的并且没有按照比例绘制。在不同的图中,相似的部件使用相同的附图标记。
具体实施方式
参考附图1到附图3,本发明的实施方式包括贴片10、腕带20以及处理单元30。贴片10佩戴在胸部,并且在本实施方式中被结合到服饰中,此处是结合到T恤衫中。
在贴片10中结合有多个传感器。贴片10包括ECG传感器12。
贴片10还包括其它传感器,用于测量行动和姿势的加速度计14。还提供电池17,并且整个贴片应当使用非常低的能耗。贴片的其它特征是任选的并且将在下文中论述。
腕带20包括脉搏传感器22。
脉博传感器22可以是机械压电传感器,例如,通过测量光吸收的变化来检测经过的脉搏波的光学传感器,或者生物阻抗传感器。
提供处理单元30并随身佩戴。处理单元30包括用于捕获患者语音的麦克风32,以及扬声器34。该处理单元还包括处理器36和存储器38,存储器包括用于控制该处理器的代码40。提供无线电收发器42以提供无线电联系,并且特别是在需要的时候与应急服务(emergency service)联系。提供显示器49以输出数据和操作消息。
该处理单元包括电池46,并且其以低功耗运行以实现长电池寿命而不需要过大的电池重量。
存储器48用于在一段时期内记录传感器数据,从而使得对患者的生命体征进行回顾分析成为可能。存储器48可以存储24小时或更长时期的数 据。
在使用中,传感器不断捕获血液动力学参数并将它们传送到处理单元30。这些参数包括ECG和脉搏波传导时间。对该数据进行处理并将其存储在存储器48中。
包括例如ECG数据的数据可以在一段时间内被记录。这允许了在晕厥事件过程中获取数据。这些数据对于护理患者的医学从业者来说可能是有用的,因为如果该医学从业者没有观察到该晕厥,则血管迷走性晕厥的诊断是非常困难的。
用于检测晕厥的现有测试使用复杂的计算机***和连续不断的监测。然而,重要的是该处理需要在低功耗单元上执行。因此,使用复杂的数据处理以执行检查的现有方法并不适用。由于现有的测试并不适用,本发明人设计出一种简单算法,其可以使用具有较低处理能力的低功耗装置实施。
特别是,本发明人将脉搏波传导时间方法和背景(context)数据组合使用。该背景数据包括时间、从加速度计44测量得到的与姿势和行动相关的信息、以及来自患者的记录的语音和噪声。
脉搏波传导时间是重要参数,其通过检测脉搏在贴片10和腕带20之间的传导时间来测量。在贴片10处的脉搏可以从ECG数据中确定,例如在ECG中的R峰。在该腕带处的脉搏可以通过任何方便的脉搏检测技术来测量。
本发明所使用的简单算法如下,如图4所示。首先,使用加速度计来检测姿势的变化(步骤50),并且特别是检测何时患者以立位保持静止(步骤52)。然后,当患者静止站立整整一分钟时,该***测量参考脉搏波传导时间(PAT0),其是ECG脉搏的预定特征和在脉搏传感器处检测到脉搏之间的时间(步骤54)。
然后,***以相同方式持续监测该脉搏波传导时间(步骤56)。计算测量的脉搏波传导时间(PAT)与参考脉搏波传导时间之间的比率PAT/PAT0。当该比率超过预定的界限(步骤58)时,检查背景数据(步骤60)以查看患者是否处于不需要发出警告的位置或状态。具体地,该加速度计数据提供重要的背景数据。如果患者相对静止和保持水平,例如,睡着了,可能就不需要发出警告,当在这种情况下并不需要警告时,警告可以由此被禁 止。
如果该比率超过该界限,并且背景数据并没有指示不需要警告,则发出警告(步骤62)。
应当理解,对代码40进行编制以使得当在处理器36中运行该代码时处理器36会执行该方法的各个步骤。
在一个实施方式中,比率PAT/PAT0的预定界限可以在1.08到1.2的范围内。
该计算很简单并且由此并不会使处理单元30的处理能力过载,同时其仍能为血管迷走性晕厥提供很好的预先警报。
该警报可以通过多种方式实现。在一个实施方式中,由扬声器播放预定的消息。该消息可以是,例如“立刻躺下!将双腿举起”。该消息也可以是意图提供给路过的人或者旁观者的警报消息。
在播放了该警报消息后,本实施方式中的处理器持续监视该患者。对于患者没有从晕厥中足够快的恢复过来的情况,或者对于需要额外的帮助的情况,处理器通过使用该无线电收发器自动呼叫呼叫中心来呼叫应急服务。特别是,如果从加速度计数据中认识到患者已经倒下,则在这种情况下将呼叫应急服务。
在该实施方式中,ECG传感器12可以包括多种电容传感器。它们并不需要与皮肤很好的接触。合适的传感器在WO2007/060609(Philips)中已经披露。这些传感器集成到纺织品中,在此处该贴片用于T恤衫。需要多少传感器就可以使用多少。
因此,备选实施方式可以包括标准ECG配置中的10个传感器,或者更少数量的传感器,例如在被称为EASI导联配置中的5个传感器,其可以由此用于计算导出的ECG。
这些传感器不必须集成到贴片中,而是也可以集成到带子或其它物品中。一些传感器可以集成到不同的可佩戴物品中。在一个特定实施方式中,一定数量的ECG传感器集成到纺织品中以覆盖胸腔,这种纺织品例如是T恤衫。这给ECG传感器提供了方便佩戴的衬底。
加速度计44不必须结合到该贴片中,而是可以结合到纺织品、带子或者甚至所佩戴的处理器30中。
传感器数据的测量和记录并不必须仅包括上面所提到的那些因素。当对附加数据进行记录,其可以用作背景数据以确定是否发出或禁止报警。
贴片10可以包括温度传感器16,其可以用于记录体温波动。在这种情况下,当将该装备用于睡眠问题的夜间诊断时,体温可能是非常相关的考虑因素。
此外,阻抗传感器17可以结合到该贴片中,其在胸腔处注入小电流并由此测量电阻。阻抗心动描记可以用于提供关于胸腔组织组成和心脏的泵浦功能以及机械活动(每博输出量以及心输出)的信息。
该贴片中可以包括麦克风18。这可以用于测量心音和肺音。该麦克风可以是压电麦克风。心音和肺音(包括心脏的瓣膜音)给出关于心和肺功能的附加信息。
加速度计44可以是两轴或者三轴加速度计。
所描述的***对于老年人护理、心脏康复以及血压Holter监测都特别适用。
Claims (6)
1.一种用于检测即将发生的血管迷走性晕厥的装置,其包括:
布置在人体上的多个可佩戴传感器(8),所述可佩戴传感器包括多个ECG传感器(12),所述ECG传感器中的一个是当将所述ECG传感器布置在身体上时布置在心脏附近的心脏传感器;
远端脉搏传感器(22),其布置在所述人体上远离所述心脏处;以及
处理单元(30),布置其用于从所述ECG传感器(12)和所述远端脉搏传感器接收数据,从而确定脉搏从心脏ECG传感器传播到所述远端脉搏传感器的脉搏波传导时间,并且根据所述脉搏波传导时间确定血管迷走性晕厥的存在或出现。
2.如权利要求1所述的装置,其中,所述远端脉搏传感器(22)在腕带(20)上。
3.如权利要求1或2所述的装置,其中,所述心脏传感器是所述多个ECG传感器(12)中的一个。
4.如权利要求3所述的装置,布置其用于将所述脉搏波传导时间确定为在使用所述心脏传感器测量的ECG的预定特征和由所述远端脉搏传感器检测的所述脉搏之间的时间。
5.如权利要求1或2所述的装置,其还包括在其上布置有所述ECG传感器的贴片(10)。
6.如权利要求1或2所述的装置,其中,布置所述处理单元用于通过比较所述脉搏波传导时间和参考脉搏波传导时间的比率并当所述比率超过预定值时确定血管迷走性晕厥的所述存在,来确定血管迷走性晕厥的所述存在。
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Application Number | Priority Date | Filing Date | Title |
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EP07122515 | 2007-12-06 | ||
EP07122515.5 | 2007-12-06 | ||
PCT/IB2008/054958 WO2009072034A1 (en) | 2007-12-06 | 2008-11-26 | Apparatus and method for detection of syncopes |
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CN101883518A CN101883518A (zh) | 2010-11-10 |
CN101883518B true CN101883518B (zh) | 2012-05-30 |
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US (1) | US20100249542A1 (zh) |
EP (1) | EP2217140B1 (zh) |
JP (1) | JP5551606B2 (zh) |
CN (1) | CN101883518B (zh) |
AT (1) | ATE544395T1 (zh) |
BR (1) | BRPI0820715A8 (zh) |
WO (1) | WO2009072034A1 (zh) |
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