CN114042295B

CN114042295B - Recovery device after thoracotomy

Info

Publication number: CN114042295B
Application number: CN202111398987.3A
Authority: CN
Inventors: 刘罡; 李延军; 杜德禄
Original assignee: Xinxiang Central Hospital
Current assignee: Xinxiang Central Hospital
Priority date: 2021-11-24
Filing date: 2021-11-24
Publication date: 2022-11-25
Anticipated expiration: 2041-11-24
Also published as: CN114042295A

Abstract

The invention relates to a rehabilitation device after an open-chest operation, which is formed by connecting a rigid protective strip and a connecting unit which can be greatly extended but can be only shortened in a small amplitude or cannot be shortened.

Description

Recovery device after thoracotomy

Technical Field

The invention relates to the field of medical instruments, in particular to the field of rehabilitation equipment after thoracotomy.

Background

In the chest opening operation, the sternum is sawed off and then sutured again, so the whole chest cavity environment is different from that of normal people, and the sternum cannot bear large external force in the recovery process, otherwise, the wound at the sutured part collapses, and even new injury is caused. Moreover, the patient's breathing is impaired due to changes in chest conditions (e.g., loss of negative pressure environment). The common symptoms include that the chest is not dared to breathe widely due to the pain of the chest, the tissues of the lung such as the bronchus and the like are compressed, so that the lung is in a state that the gas can not be completely eliminated for a long time, the recovery of the lung function is influenced, and the serious lung complications can be caused.

For this reason, in clinical practice, a patient is often worn with a chest band after thoracotomy to fix the chest cavity. However, the common elastic chest strap can only protect the chest from external force to a certain extent, and the chest strap is made of soft material, so that the chest strap still can damage the chest when the external force is large. And if the elastic chest strap is too tight, the breathing recovery of the patient is affected, so that the patient feels more difficult to breathe; if the looseness is too loose, the protection effect cannot be achieved. The degree of tightness is controlled by the patient and family members in daily life, and is difficult to be accurate.

To solve these problems, it has been proposed in the prior art to form the chest band from both a rigid material and an elastic material. However, due to the presence of the elastic material, when an external force is applied, the force is reduced, but the chest cavity is still damaged. And due to the existence of elastic materials, the problem of tightness of wearing still exists, and the difficulty is higher because the patient needs to adjust by himself.

In addition, in clinical practice, in order to make patients quickly recover, patients are recommended to do breathing training. The wearing of the chest strap not only does not help the respiratory training, but also makes the respiratory training more difficult due to the resistance of the chest strap. Because the breathing training needs special equipment, some patients are inconvenient to move, and the convenience of carrying out special breathing training is influenced. Meanwhile, the patient has respiratory disorder, so that the pain of the respiratory training system is great, and the enthusiasm of training is influenced.

For this reason, a chest strap is needed that can provide stronger protection to the chest of a patient undergoing a thoracotomy, does not affect the smooth degree of respiration of the patient, and can also provide support for the respiratory training of the patient.

Disclosure of Invention

In order to solve the above problems and the problems mentioned in the following embodiments, the present invention proposes the following solutions:

a rehabilitation device after thoracotomy comprises a plurality of protective strips, wherein the protective strips are connected through a connecting unit, so that a chest belt main body is spliced; the guard bar is made of rigid material;

the connecting unit comprises an accommodating body and a connecting body; the accommodating body is connected with the protection strips, and the connecting belt connected with the body is connected with the adjacent protection strips; the connecting belt is rigid;

the accommodating body is provided with an accommodating cavity for accommodating the connecting body; the fine adjustment hand wheel is arranged at the upper part of the accommodating body and can roll along the length direction of the accommodating body, so that the height of the accommodating cavity is adjusted, and the connecting body is pressed to deform; the sliding cavity in the middle of the connecting body is of a cavity structure, and the sliding cavity deforms along with the deformation of the accommodating cavity when the accommodating cavity deforms, so that the sliding range of the sliding unit is changed, and the adjustable range of the distance between the adjacent protection pieces is adjusted;

the connecting body internally comprises a sliding cavity, the section of the sliding cavity is formed by splicing two isosceles trapezoids with overlapped bottoms, and the tops of the two trapezoids are respectively positioned at two sides of the sliding cavity; a sliding unit is accommodated in the sliding cavity and connected with a connecting belt, and the diameter of the sliding unit is slightly smaller than the length of the bottom side of the trapezoid of the section of the sliding cavity; when the sliding unit slides in the sliding cavity, the distance between two adjacent protection sheets can be changed; the top angle of the trapezoid close to the inner side of the section of the sliding cavity is larger than that of the trapezoid close to the outer side, and the top lengths of the two trapezoids are the same, so that the outward sliding range of the sliding unit is larger than the inward sliding range;

the top surface of the accommodating cavity of the accommodating body is provided with a light source, the bottom surface is provided with a photoelectric sensor, the photoelectric sensor is used for emitting light rays through the light source after the connecting body is inserted into the accommodating cavity, and the light rays are received by the photoelectric sensor after passing through the transparent connecting body; when the opaque sliding unit slides in the sliding cavity, the position of the sliding unit in the sliding cavity can be known according to the position of light received by the sensor, and therefore the expansion length of the distance between two adjacent protection sheets can be known.

The sliding unit is in the shape of a sphere or a cylinder.

The front part of the rehabilitation device is provided with a shoulder belt, and the back part of the rehabilitation device is also provided with a shoulder belt which can be buckled with the shoulder belt at the front part.

The protection strip is made of hard plastics.

The plastic is PVC, PP or PE.

The rehabilitation device is provided with a respiratory training device which is detachably arranged.

The device also comprises a processor, and the processor prompts whether the rehabilitation device is suitable or not by comparing the respiratory signal acquired by the respiratory training device with the thoracic signal acquired by the photoelectric sensor.

The device also comprises a processor which is used for evaluating the breathing training according to the breathing signal collected by the breathing training device and the thoracic signal obtained by the photoelectric sensor.

A processor for use in a rehabilitation device prompts, based on a respiratory signal and a thoracic signal, the fit of the device, the completeness of the patient's respiratory function, and the effectiveness of respiratory training.

A processor for use in a rehabilitation device for implementing a dedicated resistance breathing training mode.

Invention and technical effects

1. Through the combination and the concrete structural design of foxing and linkage unit, had hard material's protectiveness concurrently and freely breathed smooth and easy nature for whole chest area can enough freely expand, avoids receiving external force to collapse simultaneously.

2. Through the cooperation of the connecting unit and the breathing training unit, particularly the design of the specific structures such as a fine adjustment hand wheel, a sliding element and a sensor, the chest belt with a proper size can be objectively prompted. The size selection and adjustment of the chest strap have objective basis, and are not only dependent on the feeling of the patient, but also more suitable for the patient who can not express consciousness.

3. Through the cooperation of pectoral girdle and breathing training unit, can freely carry out the training of breathing at any time more, and more be fit for the patient of postoperative respiratory disorder, avoid fear psychology, increase training enthusiasm.

4. The processor is used for distributing and controlling the chest belt and the breathing training unit and comprehensively processing signals of the chest belt and the breathing training unit, so that objective adjustment of the size of the chest belt and accurate assistance of breathing training are realized.

The present invention includes, but is not limited to, the above, and the technical contents described in the embodiments are specifically subject to the scope of the present invention.

Drawings

The accompanying drawings, which are included to provide a further understanding of the invention and are incorporated in and constitute a part of this application, illustrate embodiment(s) of the invention and together with the description serve to explain the principle of the invention. In the drawings:

FIG. 1 is a schematic view of a connection unit

FIG. 2 is a front view of a chest band

Figure 3 is a rear schematic view of the chest band.

Detailed Description

Chest belt structure

The front part of the chest belt comprises a plurality of protective strips 1 which are connected through a connecting unit 2, so that the chest belt body is spliced. The chest strap body is provided with shoulder straps 4. The chest strap back part 3 is also provided with shoulder straps 4 which can be buckled with the shoulder straps in the front part.

The guard strip is rigid, but for ease of wearing, rigid plastics such as PVC, PP, PE, etc. may be preferred. The connecting unit can be extended as required (for example, during breathing) to realize chest expansion; but the front part of the chest strap can not be shortened or deformed when being subjected to external force, so that the front part of the chest strap is prevented from collapsing, and the thoracic cavity is prevented from being damaged. The protection strips and the connecting units with different sizes and models can be selected according to the body types of patients.

In general, in order to protect the thoracic cavity, a plurality of protection bars connected by a connection unit extend from the right front of the thoracic cavity to the lateral side of the thoracic cavity. Of course, the back surface can also be made of a flexible material, since hard materials can affect comfort when lying down.

In addition, the guard bar may also be curved in a vertical direction to conform to the surface curve of the human body. An air cushion layer is arranged on the inner side of the guard strip. The air cushion is provided with a plurality of holes corresponding to the holes of the protective strip, thereby meeting the requirement of ventilation and avoiding skin complications caused by wearing the chest strap. The air cushion comprises an air inlet, and the thickness of the air cushion can be changed by inflating or blowing from the outside, so that the chest belt is more attached. Therefore, the belt can further adapt to people with different body types, so that the chest belt can better play a protective role, and the obstruction to breathing is avoided, which is also one of the contributions of the invention. Of course, flexible materials may be used instead of the air cushion.

It will be appreciated that the side straps are slightly shorter or form an arcuate channel in the chest band for receiving a person's arms. Although not shown precisely, it will be appreciated that the entire chest band is similar in style to a garment for ease of wear.

The chest strap further comprises a portable breathing training device (not shown in the figure), which is detachably arranged on a certain protective strip and used for completing breathing training of a patient at any time and any place, collecting breathing signals in the breathing training process and sending the breathing signals to the processor. The specific structure of the breathing training device can be a hydraulic type structure, a piston type structure, an elastic resistance type structure and other structures common in the prior art, but the breathing training device is suitable for being used as a training device with small volume and light weight in order to improve convenience.

Connection unit structure

The connection unit comprises a containing body 2-1 and a connecting body 2-4. The containing body is provided with a containing cavity 2-3 for containing the connecting body 2-4. The fine adjustment hand wheel 2-2 is arranged on the upper part of the containing body and can roll along the length direction of the containing body. The contact of fine setting hand wheel holds the chamber roof to hold the configuration that the chamber roof increases gradually from inside to outside (by in to the direction of bluff piece, the direction of keeping away from the bluff piece is outside) thickness, thereby hold chamber roof downstream when fine setting hand wheel slides from inside to outside, produce decurrent pressure, take place deformation for oppressing the connection body. The inner side of the top wall of the accommodating cavity is provided with a clamping groove for accommodating the protrusion of the connecting body to form clamping locking. Preferably, the projection comprises a ramp to facilitate sliding in.

The connecting body comprises 2-5 sliding cavities inside, the cross sections of the sliding cavities are formed by splicing two isosceles trapezoids with overlapped bottoms, and the tops of the two trapezoids are respectively positioned on two sides of the sliding cavities. The sliding cavity is internally provided with sliding units 2-6 which are connected with connecting belts 2-7. The sliding unit can be in a shape of a sphere, a cylinder and the like which are convenient to slide. The sliding unit slides outwards in the sliding cavity, so that the distance between the two guard sheets connected by the connecting unit is increased. When the sliding unit slides inwards in the sliding cavity, the distance between the two protective sheets is reduced. This movement is usually due to external forces and therefore needs to be limited to avoid damage to the chest. Therefore, the top angle of the trapezoid close to the inner side of the section of the sliding cavity is larger than that of the trapezoid close to the outer side, and the top lengths of the two trapezoids are the same. The diameter of the sliding unit is slightly smaller than the length of the bottom side of the trapezoid of the section of the sliding cavity. Thus, when the sliding unit slides inwards, although the sliding unit can slide with small amplitude, the size of the sliding cavity is rapidly reduced, so that the sliding unit is limited to further slide inwards, namely, the reduction of the distance between the two protective sheets is avoided; when the sliding unit slides towards the outside, the size of the sliding cavity is slowly reduced, so that the sliding unit can slide towards the outside greatly, but finally, the sliding cavity is limited in size, namely, the distance between the protective sheets is increased but is also within a certain range. Therefore, the sliding unit can slide inwards in a smaller range and slide outwards in a larger range, namely the chest belt formed by the protective sheets can be freely expanded outwards but can be contracted inwards in a small range, so that the smoothness of breathing is ensured, and meanwhile, the chest belt can be sufficiently protected when being subjected to external force.

The connecting band is the rigidity, avoids taking place deformation and causes thorax damage. Meanwhile, the connecting belt can be in an arc shape with different degrees so as to adapt to the shape of the chest of the patient. And selecting a proper connecting belt when in use. Preferably, the interface tape may be of a configuration that expands only outwardly and does not contract or collapse inwardly, and may be slightly elastic.

The containing body is fixedly connected with the protection sheet, and the connecting belt connected with the containing body can be connected with the protection sheet in a micro-rotating mode.

The top surface of the accommodating cavity of the accommodating body is provided with a linear light source, the bottom surface of the accommodating cavity is provided with a linear array photoelectric sensor, the linear array photoelectric sensor is used for emitting light through the light source after the connecting body is inserted into the accommodating cavity, and the light is received by the sensor after passing through the transparent connecting body. Therefore, when the opaque sliding unit slides in the sliding cavity, the position of the sliding unit in the sliding cavity can be obtained according to the position of the light received by the sensor, and the expansion length of the distance between two adjacent protection sheets can be obtained accordingly. The distance expansion lengths of every two protective sheets are added up to form the chest expansion length caused by breathing.

Guard bar spacing adjustment

When different patients or the same patient are in different states, and the protective strip interval needs to be adjusted, the connecting bodies of different models can be selected according to the needs. The connecting body has the same structure in each model, and the only difference is the size of two trapezoidal top angles of the cross section of the sliding cavity.

It will be appreciated that different types of connector bodies may be selected if it is desired to adjust the limits of extension and contraction of the bead spacing. The adjustment of the maximum and minimum distance of the guard bar is realized by selecting the connecting bodies with different sizes of the two trapezoidal top angles of the cross section of the sliding cavity.

In addition to the adjustment of the spacing of the guard bars prior to wearing as described above, fine adjustment of the spacing may be required in some cases after wearing is completed. At this point, the fine adjustment hand wheel may be slid. When the hand wheel slided to the outside, owing to hold chamber roof upside (with the one side of hand wheel contact) for from inside to outside tilt up gradually to make the hand wheel to the pressure that holds the chamber roof bigger and bigger, thereby hold the chamber roof and buckle downwards, thereby the oppression connection body. Because the sliding cavity in the middle of the connecting body is of a cavity structure, the top wall of the sliding cavity bends downwards under the compression of the top wall, so that the distance that the sliding unit can slide left and right is reduced. Thereby the adjustable range of the guard plate spacing becomes smaller.

Application method

1. Measuring the chest circumference of the patient, selecting the protective sheets with corresponding sizes and numbers and the connecting units with corresponding specifications according to the database, and assembling the protective sheets into the chest strap.

2. The patient breathes through breathing trainer, and breathing trainer gathers patient's exhalation and inhaled gas volume signal to convert it into electrical signal K (t) and export to the treater.

3. The photoelectric sensor on the chest strap collects the space change signals between the protective sheets of the chest strap of the patient and sends the signals to the processor.

4. The processor adds the signals of the multiple photosensors to obtain a thoracic volume (or length) signal L (t), referred to as a thoracic signal.

5. The processor aligns K (t) with L (t) in time sequence, calculates the variation quantity DeltaK and DeltaL of K (t) and L (t) caused by expiration and inspiration in one respiratory cycle, and compares the magnitudes of the two:

(1) If the absolute value of delta K-delta L is less than or equal to A, the lung volume change caused by breathing is basically equivalent to the actual change of the chest cavity, and the chest belt is considered to be selected appropriately. At the moment, the user is prompted to wear the glasses normally through voice or display.

(2) If the < I > delta K- < delta L > is less than or equal to A, the chest strap is not suitable in size, and the chest strap size cannot be changed synchronously due to the change of the chest cavity along with respiration.

At this time, the hand wheel is finely adjusted to make the sliding range of the sliding unit in the sliding cavity smaller, and after Δ L' is obtained by the same method as above, the following judgment is made:

if | < delta > L' - < delta > L | is less than or equal to B, namely under the condition that the slidable range of the sliding unit is reduced, the change signal of the chest volume obtained according to the photoelectric sensor is almost unchanged, the sliding unit does not slide to the head outwards in the two processes, the chest belt size is indicated to be large, at the moment, the user is prompted to have the oversize chest belt size through voice or display, and the database is searched according to the difference value to give a model selection suggestion of each accessory of the chest belt.

If | Δ L' - Δl | > B, that is, in the case where the slidable range of the slide unit becomes small, the variation signal of the chest volume obtained from the photosensor largely varies, it indicates that the slide unit has slid to the outside to the head in the previous process, and this time has slid to the outside to the head as well. However, since the sliding range is reduced, the two signals are limited to the sliding range and are greatly changed. The chest belt size is relatively small, the user is prompted to be overlarge through voice or display, and the database is searched according to the difference value to give a suggestion of selecting the type of each accessory of the chest belt.

Wherein A and B are threshold values. It is understood that the threshold value can be obtained by calibration before the product is shipped.

Therefore, more objective wearing data can be obtained without blind adjustment according to the dictation of the patient. Independent of the accuracy of the patient's dictation, and for patients with unclear consciousness or incorrect expression, a suitable chest strap can be worn.

Used in cooperation with respiratory training

Cough training

Cough training is a common training modality after chest opening surgery. The common way is to inhale air from a big mouth and hold the breath, open the mouth, contract the abdomen and cough forcefully while opening the glottis, and cough for 2-3 times continuously. Thus being beneficial to the discharge of the effusion in the lung and the recovery of the function of the lung.

However, a severe cough can cause a severe change in the chest volume, thereby causing pain to the wound. Patients are often afraid of this pain and are reluctant to train coughing.

Therefore, before cough training is carried out, the fine adjustment hand wheel on the accommodating body is adjusted to slide outwards, so that the changeable size range of the chest strap is reduced. Therefore, when a patient coughs, the chest cavity can be pressed, the chest cavity is prevented from being changed excessively, and pain is reduced.

Resistance-resisting deep breathing training

The breathing exercise device on the chest strap is adjusted to a resistance mode and the appropriate resistance is selected based on the course of the disease.

The fine adjustment hand wheel is adjusted, so that the sliding range of the sliding element is expanded, the extension range of the chest strap is increased, and deep breathing training obstacles and discomfort caused by the obstacles due to the comfort of the chest strap are avoided.

Deeply sucking a breath, slowly blowing air to a blowing-up port of a breathing training device on the chest strap, and at the moment, recording an air blowing quantity signal M (t) by a sensor and sending the air blowing quantity signal M (t) to a processor;

meanwhile, the photoelectric sensor on the chest strap synchronously acquires a chest volume signal N (t) and sends the chest volume signal N (t) to the processor.

The processor evaluates the synchronous relevance between the N (t) and the M (t), if the synchronous relevance of the two signals is better, the processor judges that the current recovery is better, and can continue the treatment scheme; if the synchronous correlation of the two signals is poor, the recovery of the respiratory system is judged to be improved, and the treatment scheme can be adjusted according to the situation.

Thus, the respiratory training is carried out in a portable manner, and the monitoring of the state of illness is realized.

When resistance training is carried out, the breathing capacity of a patient is poorer than that of a normal person after a chest opening operation, so that the patient is burdened by conventional constant-resistance breathing training, and particularly, the patient needs larger strength in the latter half of breathing, and is easy to feel afraid. Therefore, according to the application scene, the resistance generation curve is optimized, the burden of a patient in the respiratory training process is relieved, and the lung function can be fully exercised. The specific curve is as follows:

wherein

The parameter is an empirical coefficient, and can be calibrated when leaving a factory or in use; t is time; p is the maximum time the user blows.

In making the resistance settings as above, the processor evaluates each at

And

and (3) synchronous correlation between N (t) and M (t) in two time periods, distinguishing synchronous correlation difference in the two time periods, contrasting a standard database, indicating the current patient respiratory state, and giving a training suggestion.

Through clinical observation, the breathing training mode can effectively improve the training effect and shorten the ward observation time and the rehabilitation time.

It is to be understood that the present invention includes, in addition to the above, conventional structures and conventional methods, which are well known and will not be described in detail. It is not intended that such structures and methods be present in the present invention.

It will be appreciated by those skilled in the art that while a number of exemplary embodiments of the invention have been shown and described in detail herein, many other variations or modifications can be made, which are consistent with the principles of this invention, and which are directly determined or derived from the disclosure herein, without departing from the spirit and scope of the invention. Accordingly, the scope of the invention should be understood and interpreted to cover all such other variations or modifications.

Claims

1. The utility model provides a recovery device after open chest surgery which characterized in that: the chest strap comprises a plurality of protective strips, wherein the protective strips are connected through a connecting unit, so that the chest strap main body is spliced; the guard bar is made of rigid material;

the connecting unit comprises an accommodating body and a connecting body; the accommodating body is connected with the protection strips, and the connecting belt for connecting the accommodating body is connected with the adjacent protection strips; the connecting belt is rigid;

the containing body is provided with a containing cavity for containing the connecting body; the fine adjustment hand wheel is arranged at the upper part of the accommodating body and can roll along the length direction of the accommodating body, so that the height of the accommodating cavity is adjusted, and the connecting body is pressed to deform; the sliding cavity in the middle of the connecting body is of a cavity structure, and the sliding cavity deforms along with the deformation of the accommodating cavity when the accommodating cavity deforms, so that the sliding range of the sliding unit is changed, and the adjustable range of the distance between the adjacent protection pieces is adjusted;

the top surface of the accommodating cavity of the accommodating body is provided with a light source, the bottom surface of the accommodating cavity is provided with a photoelectric sensor, the photoelectric sensor is used for emitting light rays through the light source after the connecting body is inserted into the accommodating cavity, and the light rays are received by the photoelectric sensor after passing through the transparent connecting body; when the opaque sliding unit slides in the sliding cavity, the position of the sliding unit in the sliding cavity can be known according to the position of light received by the sensor, and therefore the expansion length of the distance between two adjacent protection sheets can be known.

2. The rehabilitation device of claim 1, wherein: the sliding unit is in a spherical or cylindrical shape.

3. The rehabilitation device of claim 1, wherein: the front part of the rehabilitation device is provided with a shoulder belt, and the back part of the rehabilitation device is also provided with a shoulder belt which can be buckled with the shoulder belt at the front part.

4. The rehabilitation device of claim 1, wherein: the protection strip is made of hard plastics.

5. The rehabilitation device of claim 4, wherein: the plastic is PVC, PP or PE.

6. The rehabilitation device of claim 1, wherein: the rehabilitation device is provided with a respiratory training device which is detachably arranged.

7. The rehabilitation device of claim 6, wherein: the device also comprises a processor, and the processor prompts whether the rehabilitation device is suitable or not by comparing the respiratory signal acquired by the respiratory training device with the thoracic signal acquired by the photoelectric sensor.

8. The rehabilitation device of claim 6, wherein: the device also comprises a processor which is used for evaluating the breathing training according to the breathing signal collected by the breathing training device and the thoracic signal obtained by the photoelectric sensor.