JP2001309894A - Equipment for measuring peripheral venous pressure and its method - Google Patents
Equipment for measuring peripheral venous pressure and its methodInfo
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- JP2001309894A JP2001309894A JP2000131925A JP2000131925A JP2001309894A JP 2001309894 A JP2001309894 A JP 2001309894A JP 2000131925 A JP2000131925 A JP 2000131925A JP 2000131925 A JP2000131925 A JP 2000131925A JP 2001309894 A JP2001309894 A JP 2001309894A
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- Prior art keywords
- pressure
- peripheral
- arm band
- peripheral venous
- venous pressure
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Abstract
Description
【０００１】[0001]
【発明の属する技術分野】この発明は、血圧計等に付設
して有用な末梢静脈圧測定装置に関する。BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a peripheral venous pressure measuring device useful for a blood pressure monitor or the like.
【０００２】[0002]
【従来の技術】一般に血圧測定を行う場合は、腕帯で局
部を圧迫して動脈、静脈を閉塞させ、腕帯圧の微速減圧
過程でコロトコフ音を検出するなどして血圧測定を行う
が、測定過程で減圧速度が遅いと、うっ血が生じること
が知られており、うっ血が生じると血圧測定、特に最低
血圧の測定に影響を及ぼすことも知られている。末梢静
脈圧が拡張期血圧（最低血圧）に近いと、その傾向が強
い。したがって、血圧測定において、末梢静脈を知るこ
とは重要なことである。従来、末梢静脈の内圧測定法と
しては、カテーテルを用いた観血的方法がある。2. Description of the Related Art In general, when measuring blood pressure, blood pressure is measured by compressing a local part with an arm band to block an artery or a vein and detecting Korotkoff sound in a process of slowly reducing the arm band pressure. It is known that congestion occurs when the rate of decompression is low during the measurement process, and that congestion affects the measurement of blood pressure, particularly the measurement of diastolic blood pressure. The tendency is strong when the peripheral venous pressure is close to the diastolic blood pressure (diastolic blood pressure). Therefore, in measuring blood pressure, it is important to know the peripheral veins. Conventionally, as an internal pressure measurement method of a peripheral vein, there is an invasive method using a catheter.
【０００３】[0003]
【発明が解決しようとする課題】上記した従来の末梢静
脈の内圧測定法は、観血式であるため、資格保有者が測
定を実施する必要があり、誰もが簡単に実施できるもの
ではない。観血的測定であり、被測定者に対する負担や
リスクがある等の問題点があるため、末梢静脈圧は血圧
測定に重要な影響を与える要素であることが理解されな
がら、ほとんど測定されていない。The above-mentioned conventional method for measuring the internal pressure of the peripheral vein is of the invasive type, so that it is necessary for a qualified person to carry out the measurement, and not everyone can easily carry out the measurement. . Peripheral venous pressure is understood to be an important factor in blood pressure measurement, but it is hardly measured because it is an invasive measurement and there are problems such as burden and risk on the subject .
【０００４】この発明は上記問題点に着目してなされた
ものであって、非観血的に誰もが簡単に測定し得る末梢
静脈圧測定装置を提供することを目的としている。The present invention has been made in view of the above problems, and has as its object to provide a peripheral venous pressure measuring device that can be easily measured by anyone without using blood pressure.
【０００５】[0005]
【課題を解決するための手段】この発明の末梢静脈圧測
定装置は、生体を押圧し、止血するための腕帯と、この
腕帯内を加圧する加圧手段と、腕帯内の圧力を検出する
圧力検出手段と、腕帯内圧と末梢静脈内圧の均衡点を抽
出する圧均衡点抽出手段と、抽出された均衡点から末梢
静脈圧を換算する手段とを備えている。SUMMARY OF THE INVENTION A peripheral venous pressure measuring device according to the present invention comprises: an arm band for pressing a living body to stop bleeding; a pressurizing means for pressurizing the inside of the arm band; The system includes pressure detecting means for detecting, pressure equilibrium point extracting means for extracting an equilibrium point between intra-arm band pressure and peripheral venous pressure, and means for converting peripheral venous pressure from the extracted equilibrium point.
【０００６】例えば、腕帯による圧迫での血管の閉塞状
態から、腕帯圧を微速減圧して行くと、先ず動脈血液が
間欠的に流れ始め、やがて腕帯内圧と末梢静脈内圧が等
しくなると、静脈血液も流れ始める。この静脈血液が流
れ始める点の腕帯内圧と末梢静脈圧とは相関があり、こ
の点の腕帯内圧と末梢静脈内圧の均衡点から末梢静脈圧
が換算される。[0006] For example, when the arm band pressure is reduced at a very low speed from the occlusion state of the blood vessel due to the compression by the arm band, first, the arterial blood starts to flow intermittently, and when the intra-arm band pressure and the peripheral venous pressure eventually become equal, Venous blood also begins to flow. There is a correlation between the intra-arm band pressure and the peripheral venous pressure at the point where the venous blood starts to flow, and the peripheral venous pressure is converted from the equilibrium point of the intra-arm band pressure and the peripheral intra-venous pressure at this point.
【０００７】[0007]
【発明の実施の形態】以下、実施の形態により、この発
明をさらに詳細に説明する。図１は、この発明が実施さ
れる電子血圧計の構成を示すブロック図である。この実
施形態電子血圧計は、腕に巻回し、加圧により動脈を止
血するための腕帯１と、コロトコフ音を検出するＫ音セ
ンサ２と、腕帯１内の圧力を検出する圧力センサ３と、
腕帯１を加圧するための加圧ポンプ４と、排気弁５と、
表示器６と、ブザー７と、操作スイッチ８と、電源回路
９と、ＣＰＵ１０と、末梢静脈センサ１１と、圧力セン
サアンプ１２とを備えている。これらのハード構成は、
末梢静脈圧力センサ１１及び圧力センサのアンプ１２以
外は、従来よりＫ音法の電子血圧計が備えるものであ
り、特に新規なものではない。この実施形態電子血圧計
の特徴は、末梢静脈圧力センサを備えるとともに、ＣＰ
Ｕ１０内の後述する処理にある。DESCRIPTION OF THE PREFERRED EMBODIMENTS Hereinafter, the present invention will be described in more detail with reference to embodiments. FIG. 1 is a block diagram showing a configuration of an electronic sphygmomanometer according to the present invention. The electronic sphygmomanometer according to this embodiment includes an arm band 1 wound around an arm to stop an artery by pressurization, a K sound sensor 2 for detecting Korotkoff sound, and a pressure sensor 3 for detecting a pressure in the arm band 1. When,
A pressurizing pump 4 for pressurizing the arm band 1, an exhaust valve 5,
It includes a display 6, a buzzer 7, an operation switch 8, a power supply circuit 9, a CPU 10, a peripheral vein sensor 11, and a pressure sensor amplifier 12. These hardware configurations are
Except for the peripheral vein pressure sensor 11 and the amplifier 12 of the pressure sensor, the electronic sphygmomanometer of the K-tone method is conventionally provided, and is not particularly novel. The features of the electronic blood pressure monitor of this embodiment include a peripheral vein pressure sensor and a CP.
This is in the process described later in U10.
【０００８】この実施形態の如きＫ音法を採用した電子
血圧計では、一般的には加圧ポンプ４をＯＮして腕帯１
を所定圧まで加圧して、その後、微速減圧過程に入り、
Ｋ音センサ２でコロトコフ音の発生、消滅を検知し、コ
ロトコフ音の発生点の腕帯圧を最高血圧（ＳＹＳ）、コ
ロトコフ音の消滅時点の腕帯圧を最低血圧（ＤＩＡ）と
決定している。In an electronic sphygmomanometer adopting the K sound method as in this embodiment, generally, the pressurizing pump 4 is turned on and the arm band 1 is turned on.
Pressurized to a predetermined pressure, and then enter the slow depressurization process,
The K sound sensor 2 detects the occurrence and disappearance of Korotkoff sound, and determines the arm pressure at the point where the Korotkoff sound is generated as systolic blood pressure (SYS) and the arm pressure at the time of disappearance of Korotkoff sound as diastolic blood pressure (DIA). I have.
【０００９】しかしながら、この血圧測定時の血管の状
況を見ると、図２に示すように、腕帯１が加圧設定値ま
で加圧された状態では、動脈ＢＡ、静脈ＢＶとも閉じた
状態にある。減圧が徐々に進み、やがて腕帯圧が収縮期
血圧よりも低くなると、動脈圧が腕帯圧を上回った期間
のみ動脈が開き、動脈圧が腕帯圧を下回った期間は動脈
が閉じ、Ｋ音が発生する。腕帯圧が収縮期血圧近くの場
合は、まだ静脈ＢＶは閉じたままであり、腕帯装着部よ
り末梢部に送り込まれる血液量が増て行く。これが続く
ことによって、末梢静脈圧は相対的に大となる。そし
て、うっ血が生じる拡張期血圧と末梢静脈圧の差が小に
なり、コロトコフ音も小さくなり、結果としてコロトコ
フ音が早く消滅することになり、拡張期血圧を過大評価
することとなる。However, looking at the condition of the blood vessels at the time of measuring the blood pressure, as shown in FIG. 2, when the arm band 1 is pressurized to the pressurization set value, both the artery BA and the vein BV are closed. is there. When the decompression gradually progresses and the arm band pressure becomes lower than the systolic blood pressure, the artery opens only during the period when the arterial pressure exceeds the arm band pressure, and the artery closes during the period when the arterial pressure falls below the arm band pressure. A sound is generated. When the arm band pressure is close to the systolic blood pressure, the vein BV is still closed, and the amount of blood sent from the arm band wearing part to the peripheral part increases. As this continues, the peripheral venous pressure becomes relatively large. Then, the difference between the diastolic blood pressure at which congestion occurs and the peripheral venous pressure becomes small, and the Korotkoff sound also decreases. As a result, the Korotkoff sound disappears quickly, and the diastolic blood pressure is overestimated.
【００１０】上記のように、うっ血が生じると、従来の
Ｋ音法のみでは誤測定を生じることになる。そこで、こ
の実施形態電子血圧計では末梢静脈圧力センサ１１によ
り、非観血的に末梢静脈圧を測定し、うっ血による血圧
測定への影響を回避するようにしている。末梢静脈圧力
センサ１１としては、例えば図３に示すように、血圧計
本体２０にリード線により接続されたバンド状のストレ
インゲージタイプのセンサ１１ａを手首に装着する。ま
た、図４に示すように、センサ固定具１３により、圧力
センサ１１ａを手首に固定するようにしても良い。この
場合も、圧力センサ１１ａはリード線により、血圧計本
体２０に接続されている。As described above, when congestion occurs, erroneous measurement occurs only with the conventional K-tone method. Therefore, in the electronic sphygmomanometer of the present embodiment, the peripheral venous pressure is non-invasively measured by the peripheral venous pressure sensor 11 so as to avoid the influence of blood stasis on blood pressure measurement. As the peripheral venous pressure sensor 11, for example, as shown in FIG. 3, a band-shaped strain gauge type sensor 11a connected to a sphygmomanometer main body 20 by a lead wire is attached to a wrist. Further, as shown in FIG. 4, the pressure sensor 11a may be fixed to the wrist by the sensor fixture 13. Also in this case, the pressure sensor 11a is connected to the sphygmomanometer main body 20 by a lead wire.
【００１１】この実施形態において、図５の（ａ）に示
すように、腕帯１を加圧目標値まで加圧した後、微速減
圧して行く一方、末梢静脈圧力センサ１１で末梢静脈内
圧（相対圧）を測定する。静脈が閉じている間は腕帯圧
の減少とともに血流が末梢に送られるので末梢静脈内圧
は上昇するが、さらに腕帯圧が下がり、静脈も流れ始め
ると、やがて腕帯圧と静脈内圧が均衡することになり、
末梢静脈圧は最大となり、その後は均衡したまま両者と
も減少して行く。図５の（ａ）に示した均衡区間ＴB で
は、腕帯圧と静脈内圧（相対圧）には相関があり、図５
の（ｂ）に示すように、両者間はｙ＝ａｘ＋ｂで表せ
る。そのため、この式を用い、静脈内圧（相対値）から
腕帯圧（絶対値）を換算する。すなわち、典型的には末
梢静脈内圧と、その時点の腕帯圧が等しくなるので、図
５の（ｃ）に示すように、末梢静脈圧（絶対値）を得る
ことができる。In this embodiment, as shown in FIG. 5A, after the arm band 1 is pressurized to the pressurization target value, the pressure is gradually reduced while the peripheral vein pressure sensor 11 detects the peripheral intravenous pressure ( Relative pressure). While the vein is closed, peripheral venous pressure rises because blood flow is sent to the periphery with a decrease in arm band pressure, but when the arm band pressure further decreases and the vein begins to flow, the arm band pressure and intravenous pressure eventually increase. Will be balanced,
Peripheral venous pressure is at a maximum, and thereafter both decrease in a balanced manner. In FIG. Equilibrium interval T B shown in (a) of 5, the cuff pressure and the venous pressure (relative pressure) are correlated, 5
As shown in (b), the space between the two can be represented by y = ax + b. Therefore, using this equation, the arm band pressure (absolute value) is converted from the intravenous pressure (relative value). That is, typically, the peripheral intravenous pressure is equal to the arm band pressure at that time, so that the peripheral venous pressure (absolute value) can be obtained as shown in FIG.
【００１２】したがって、この実施形態電子血圧計で
は、図６のフロー図に示すように、腕帯圧の微速減圧過
程で末梢静脈圧力センサ１１よりの検出信号、つまり末
梢静脈相対圧力値をＣＰＵ１０に取り込み（ステップＳ
Ｔ１）、末梢静脈圧の最大値を検出し（ステップＳＴ
２）、これに対応する腕帯圧力値を参照して（ステップ
ＳＴ３）、最大静脈圧を決定している（ステップＳＴ
４）。 他の末梢静脈圧測定方法として、図７の（ａ）
に示すように、腕帯圧の微速減圧過程で時間経過ととも
に、末梢静脈圧力センサ１１により、末梢静脈圧（相対
値）を測定し、その末梢静脈圧（相対値）のピーク点を
求め、その時の腕帯圧を末梢静脈圧の最大値とする。つ
まり、この末梢静脈圧の最大値が血圧測定値に影響を与
えるパラメータとなる。Therefore, in the electronic blood pressure monitor of this embodiment, the detection signal from the peripheral vein pressure sensor 11, that is, the peripheral vein relative pressure value is sent to the CPU 10 in the process of reducing the arm band pressure at a very low speed, as shown in the flowchart of FIG. Import (Step S
T1), detecting the maximum value of the peripheral venous pressure (step ST)
2) The maximum venous pressure is determined (step ST3) by referring to the corresponding arm band pressure value (step ST3).
4). As another method for measuring peripheral venous pressure, FIG.
As shown in the figure, the peripheral venous pressure (relative value) is measured by the peripheral venous pressure sensor 11 with the lapse of time in the process of slowly decreasing the arm band pressure, and the peak point of the peripheral venous pressure (relative value) is obtained. The arm band pressure of is the maximum value of the peripheral venous pressure. That is, the maximum value of the peripheral venous pressure is a parameter that affects the measured blood pressure value.
【００１３】また、他の末梢静脈圧測定方法としては、
腕帯中央での血液量に対応する物理量を測定しても良
い。図７の（ｂ）に示すように、腕帯の微速減圧過程
で、それまで閉じていた静脈が開くと、急激に腕帯の中
央部での血液量が大となる。これを例えば図８に示す発
光素子１４ａ、受光素子からなる光電センサ１４で測定
し、血液量増加による増加点Ｐ1 での腕帯圧を末梢静脈
圧とする。ここでも光電センサ１４は血圧計本体２０に
リード線で接続されている。この静脈の血液量に対応す
る物理量としては、図９に示す電極１５ａ、１５ｂ、１
５ｃ、１５ｄによるインピーダンス測定や、ドプラ測定
を用いても良い。これらは減圧測定での静脈内圧の最大
値は腕帯下の静脈が開口し始める時点であることに着目
しているものである。電極１５ａ、１５ｂ、１５ｃ、１
５ｄも血圧計本体２０に接続されている。図７の（ｂ）
に示すＰ1 点の検出方法として、図７の（ｃ）に示すよ
うに、図７の（ｂ）の物理量変化の信号を微分して、そ
の最大点を求めても良い。この場合、具体的には図８、
図９に示すセンサを用いて測定される。[0013] Other methods for measuring peripheral venous pressure include:
A physical quantity corresponding to the blood volume at the center of the arm band may be measured. As shown in FIG. 7 (b), when the closed vein is opened during the slow decompression process of the arm band, the blood volume in the central portion of the arm band rapidly increases. The light-emitting element 14a shown in figure 8, for example, measured by the photoelectric sensor 14 consisting of light receiving elements, the cuff pressure at increasing points P 1 due to the increase blood volume and peripheral venous pressure. Here, the photoelectric sensor 14 is connected to the sphygmomanometer main body 20 by a lead wire. The physical quantities corresponding to the venous blood volume include the electrodes 15a, 15b, 1 shown in FIG.
The impedance measurement by 5c and 15d or the Doppler measurement may be used. They focus on the fact that the maximum value of the intravenous pressure in the decompression measurement is the time when the vein under the arm band starts to open. Electrodes 15a, 15b, 15c, 1
5d is also connected to the sphygmomanometer main body 20. FIG. 7B
As shown in FIG. 7C, as a method of detecting the P 1 point shown in FIG. 7, the maximum point may be obtained by differentiating the physical quantity change signal shown in FIG. 7B. In this case, specifically, FIG.
It is measured using the sensor shown in FIG.
【００１４】さらに他の末梢静脈圧測定方法として、腕
帯の微速加圧過程を利用しても良い。微速加圧過程にお
ける腕帯圧と末梢静脈圧力センサ１１で測定する末梢静
脈圧（相対値）の関係は、図１０の（ａ）に示すよう
に、静脈が閉じるＰ2 点までは相関しているが、Ｐ2 点
以降は腕帯圧が上昇しても末梢静脈圧（相対値）はほと
んど変化しない。したがって、加圧開始から点Ｐ2 まで
の相関のある区間ＴB につき、求めた末梢静脈圧（相対
値）と腕帯圧より、図１０の（ｂ）に示すように、ｙ＝
ａｘ＋ｂで、換算により末梢静脈圧（絶対値）を求め
る。そして、Ｐ2 までの末梢静脈圧特性を腕帯圧に合致
させることで、図１０の（ｃ）の如く、末梢静脈圧（絶
対値）を得ることができる。As still another method for measuring peripheral venous pressure, a process of applying the arm band at a very low speed may be used. Relationship of peripheral venous pressure (relative value) measured in cuff pressure and peripheral venous pressure sensor 11 at very low speed pressurization process, as shown in (a) of FIG. 10, the vein is closed until P 2 points correlated are but peripheral venous pressure (relative value) be P 2 point subsequent to rise cuff pressure is hardly changed. Thus, per period T B correlated from the start pressurization to the point P 2, from the peripheral venous pressure (relative value) and the cuff pressure obtained, as shown in (b) of FIG. 10, y =
The peripheral venous pressure (absolute value) is calculated by ax + b. Then, by matching the cuff pressure peripheral venous pressure characteristics up to P 2, as shown in Figure 10 (c), it is possible to obtain a peripheral venous pressure (absolute value).
【００１５】加圧過程での測定は、減圧過程での測定よ
りもうっ血が起こりにくい（末梢静脈内圧が上昇しにく
い）。末梢静脈内圧の最大値は最高血圧ＳＹＳに対応す
る時点の値、また最低血圧ＤＩＡの時の静脈内圧は、図
１０の（ｃ）において、ＤＩＡ時点の末梢静脈圧（相対
値）から換算式により、末梢静脈圧電（絶対値）に換算
できるので、その差によってうっ血の度合を判断でき
る。In the measurement during the pressurization process, hemostasis is less likely to occur (the peripheral intravenous pressure is less likely to increase) than in the measurement during the decompression process. The maximum value of the peripheral venous pressure is the value at the time corresponding to the systolic blood pressure SYS, and the intravenous pressure at the time of the diastolic blood pressure DIA is calculated from the peripheral venous pressure (relative value) at the DIA in FIG. Since it can be converted into a peripheral vein piezoelectric (absolute value), the degree of congestion can be determined from the difference.
【００１６】加圧過程で測定する場合の他の末梢静脈圧
測定方法として、図１１の（ａ）に示すように、血圧測
定は微速加圧過程で行うが、末梢静脈圧力センサ１１に
よる末梢静脈圧（相対値）の測定は、加圧終了後の微速
減圧の過程でも行い、末梢静脈圧力（相対圧）と腕帯圧
の均衡の取れた時点以降の区間ＴB で相関を取り、図５
と同様にして、換算により図１１の（ｂ）に示す末梢静
脈圧（絶対値）を得ても良い。この場合においても、末
梢静脈圧（相対血）の最大値に対応する腕帯圧が、図１
１の（ｂ）に示すように、最大静脈圧（絶対値）とな
る。これより、末梢静脈圧（絶対値）の全体特性が得ら
れ、加圧過程におけるＤＩＡに対応する末梢静脈圧とＤ
ＩＡとの差値を得、この差値より、再測定の要否を判定
できる。As another method of measuring the peripheral venous pressure when measuring in the pressurizing process, as shown in FIG. 11A, the blood pressure is measured in the very slow pressurizing process. measurement of pressure (relative value) is carried out at slow depressurization of process after completion of pressurization, correlates with peripheral venous pressure (relative pressure) and the balance arm band pressure balanced point after interval T B, FIG. 5
Similarly, the peripheral venous pressure (absolute value) shown in FIG. 11B may be obtained by conversion. Also in this case, the arm band pressure corresponding to the maximum value of the peripheral venous pressure (relative blood) is shown in FIG.
As shown in FIG. 1B, the maximum venous pressure (absolute value) is obtained. From this, the overall characteristics of the peripheral venous pressure (absolute value) are obtained, and the peripheral venous pressure and D corresponding to DIA in the pressurization process are obtained.
A difference value from IA is obtained, and it is possible to determine whether re-measurement is necessary based on the difference value.
【００１７】上記図５の（ａ）で示した微速減圧過程で
の腕帯内圧と静脈内圧（相対圧）間には、図１２の
（ａ）に示すように、圧力伝達ロスがある。この図１２
の（ａ）から均衡時に腕帯圧と末梢静脈圧（相対値）の
関係は相関があり、図１２の（ｂ）で表せるが、ここで
圧力ロス率をＫとし、これを考慮した換算式は、末梢静
脈圧（換算値）＝（１／ａｙ−ｂ／ａ）・（１−ｋ）と
なり、これを図示すると、末梢静脈圧は図１２の（ｃ）
に示すものとなる。As shown in FIG. 12A, there is a pressure transmission loss between the intra-arm band pressure and the intravenous pressure (relative pressure) in the slow speed depressurization process shown in FIG. 5A. This FIG.
From (a) in FIG. 12, the relationship between the arm band pressure and the peripheral venous pressure (relative value) at equilibrium is correlated and can be expressed as (b) in FIG. 12, where the pressure loss rate is K, and a conversion formula taking this into account. Is calculated as follows: peripheral venous pressure (converted value) = (1 / ay−b / a) · (1−k).
It becomes what is shown in.
【００１８】さらに他の末梢静脈圧を測定する方法とし
て、末梢動脈圧を測定し、この末梢動脈圧を用いる方法
がある。末梢動脈圧も末梢静脈圧力上昇の影響を受け、
うっ血の影響を受ける。図１３で示すように、指先に光
電脈波センサ１６を装着し、血管の容積変化を取り込
む。減圧過程における腕帯内圧の変化と、末梢動脈圧の
変化を示すと図１４の（ａ）の通りとなる。この図１４
の（ａ）の末梢動脈圧のピークと、図５の（ａ）、
（ｂ）の末梢静脈圧のピーク点は一致するので、この末
梢動脈圧のピーク点に対応する腕帯圧が末梢静脈圧とな
る。As another method of measuring peripheral venous pressure, there is a method of measuring peripheral arterial pressure and using this peripheral arterial pressure. Peripheral arterial pressure is also affected by increased peripheral venous pressure,
Affected by congestion. As shown in FIG. 13, a photoplethysmographic sensor 16 is attached to a fingertip to capture a change in the volume of a blood vessel. FIG. 14A shows a change in the intra-arm band pressure and a change in the peripheral arterial pressure in the decompression process. This FIG.
(A), the peak of the peripheral arterial pressure, and (a) of FIG.
Since the peak point of the peripheral venous pressure in (b) coincides, the arm band pressure corresponding to the peak point of the peripheral arterial pressure is the peripheral venous pressure.
【００１９】なお、上記実施形態の説明では、末梢静脈
圧センサとして、圧力センサを例にあげたが、これに代
えて末梢静脈光電センサを用いても良い。図１５は、図
１の末梢静脈圧力センサ１１及び圧力センサアンプ１２
に代えて、末梢静脈光電センサ２１、光電センサ駆動回
路２２を採用した電子血圧計の回路ブロック図である。
この電子血圧計の末梢静脈光電センサ２１の発光素子２
１ａと受光素子２１ｂを図１６に示すように、手首の静
脈ＰＶの位置を設け、例えば図７の（ａ）で示した手法
で、末梢静脈圧を測定することができる。In the above description of the embodiment, a pressure sensor is taken as an example of a peripheral vein pressure sensor, but a peripheral vein photoelectric sensor may be used instead. FIG. 15 shows the peripheral venous pressure sensor 11 and the pressure sensor amplifier 12 of FIG.
It is a circuit block diagram of the electronic sphygmomanometer which adopted the peripheral vein photoelectric sensor 21 and the photoelectric sensor drive circuit 22 instead of FIG.
Light-emitting element 2 of peripheral vein photoelectric sensor 21 of this electronic sphygmomanometer
As shown in FIG. 16, the position of the vein PV of the wrist is provided for the light receiving element 1 a and the light receiving element 21 b, and the peripheral venous pressure can be measured by, for example, the method shown in FIG.
【００２０】図１７は、実際に腕帯圧の減圧過程で腕帯
をコロトコフ音、光電センサにより検出した脈波及び腕
帯中央部のドプラによる血液量を計測した波形を示す図
である。また、図１８は図５の（ｂ）、図１９は図５の
（ｃ）の実測例を示す図である。FIG. 17 is a view showing waveforms obtained by measuring the Korotkoff sound of the arm band, the pulse wave detected by the photoelectric sensor and the blood volume by the Doppler at the center of the arm band in the process of actually reducing the arm band pressure. FIG. 18 is a diagram showing an actual measurement example of FIG. 5B and FIG. 19 is a diagram showing an actual measurement example of FIG. 5C.
【００２１】なお、上記実施形態ではＫ音法による自動
血圧測定に末梢静脈圧測定機能を付設する場合を示した
が、この発明の末梢静脈圧測定装置は、腕帯圧を変化さ
せて聴診器によりコロトコフ音を医者が聞いて、血圧を
測定する血圧計やオシロメトリック法採用の電子血圧計
にも適用できる。また、末梢静脈圧のみを測定する場合
にも使用できる。In the above embodiment, the peripheral venous pressure measuring function is added to the automatic blood pressure measurement by the K sound method, but the peripheral venous pressure measuring device of the present invention changes the arm band pressure to change the stethoscope. Therefore, the present invention can be applied to a sphygmomanometer for measuring blood pressure and an electronic sphygmomanometer employing an oscillometric method by listening to a Korotkoff sound by a doctor. It can also be used when measuring only peripheral venous pressure.
【００２２】[0022]
【発明の効果】この発明によれば、末梢静脈圧センサを
備え、腕帯圧変化過程で腕帯による押圧と末梢静脈内圧
との均衡点を求め、この均衡点での末梢静脈圧の相対値
を腕帯圧と対応づけるようにしたので、非観血的に、か
つ簡便に末梢静脈の絶対圧が測定できる。末梢のうっ血
の程度を測定できる。血圧測定中に末梢静脈圧を並行し
て測定することもできるから、血圧計に使用すれば、血
圧の測定値の妥当性を評価できる。という効果が得られ
る。According to the present invention, a peripheral venous pressure sensor is provided, a balance point between the pressing by the arm band and the peripheral venous pressure is obtained in the process of changing the arm band pressure, and the relative value of the peripheral venous pressure at this equilibrium point is obtained. Is made to correspond to the arm band pressure, so that the absolute pressure of the peripheral vein can be measured noninvasively and simply. The degree of peripheral congestion can be measured. Since the peripheral venous pressure can be measured in parallel during the blood pressure measurement, the use of the blood pressure monitor can evaluate the validity of the measured value of the blood pressure. The effect is obtained.
【図１】この発明が実施される血圧計の構成を示すブロ
ック図である。FIG. 1 is a block diagram showing a configuration of a sphygmomanometer according to the present invention.
【図２】同実施形態電子血圧計の採用原理を説明するた
めの測定系模式図である。FIG. 2 is a schematic diagram of a measurement system for explaining a principle of adoption of the electronic sphygmomanometer according to the embodiment.
【図３】同実施形態電子血圧計で使用される末梢静脈圧
力センサの一例を説明する図である。FIG. 3 is a diagram illustrating an example of a peripheral venous pressure sensor used in the electronic blood pressure monitor of the embodiment.
【図４】同実施形態電子血圧計で使用可能な末梢静脈圧
力センサの他の例を説明する図である。FIG. 4 is a diagram illustrating another example of a peripheral vein pressure sensor usable in the electronic blood pressure monitor of the embodiment.
【図５】同実施形態電子血圧計の微速減圧過程での末梢
静脈圧の測定例を説明する図である。FIG. 5 is a diagram illustrating an example of measuring peripheral venous pressure in the slow depressurization process of the electronic blood pressure monitor of the embodiment.
【図６】図５で示す末梢静脈圧の測定処理動作を説明す
るフロー図である。FIG. 6 is a flowchart for explaining a peripheral venous pressure measurement processing operation shown in FIG. 5;
【図７】上記実施形態電子血圧計の微速減圧過程での他
の末梢静脈圧の測定例を説明する図である。FIG. 7 is a view for explaining another example of measurement of peripheral venous pressure in the slow depressurization process of the electronic sphygmomanometer according to the embodiment.
【図８】腕帯の中央部での血液量の変化により、末梢静
脈圧を測定する場合の光電センサの配置を示す図であ
る。FIG. 8 is a diagram showing the arrangement of photoelectric sensors when measuring peripheral venous pressure based on a change in blood volume at the center of the arm band.
【図９】腕帯の中央部での血液量の変化により、末梢静
脈圧を測定する場合に使用する他のセンサ例を説明する
図である。FIG. 9 is a diagram illustrating another example of a sensor used for measuring peripheral venous pressure based on a change in blood volume at the center of a cuff.
【図１０】上記実施形態電子血圧計の微速加圧過程での
他の末梢静脈圧の測定例を説明する図である。FIG. 10 is a diagram illustrating another measurement example of peripheral venous pressure in the process of applying the electronic sphygmomanometer at a very low speed.
【図１１】上記実施形態電子血圧計の微速加圧過程後の
微速減圧過程でのさらに他の末梢静脈圧の測定例を説明
する図である。FIG. 11 is a diagram illustrating still another example of measuring peripheral venous pressure in the slow depressurization process after the slow speed pressurization process of the electronic blood pressure monitor of the embodiment.
【図１２】上記実施形態電子血圧計の微速減圧過程での
他の末梢静脈圧の測定例を説明する図である。FIG. 12 is a diagram for explaining another example of measuring peripheral venous pressure in the slow depressurization process of the electronic sphygmomanometer according to the embodiment.
【図１３】指先の脈波光電センサの配置例を示す図であ
る。FIG. 13 is a diagram showing an example of the arrangement of a pulse wave photoelectric sensor at the fingertip.
【図１４】同脈波光電センサを用いて末梢静脈圧を測定
する例を説明する図である。FIG. 14 is a diagram illustrating an example of measuring peripheral venous pressure using the pulse wave photoelectric sensor.
【図１５】この発明の他の実施形態電子血圧計の構成を
示すブロック図である。FIG. 15 is a block diagram showing a configuration of an electronic blood pressure monitor according to another embodiment of the present invention.
【図１６】同実施形態電子血圧計の末梢静脈光電センサ
を手首に装着する場合を示す図である。FIG. 16 is a diagram showing a case where the peripheral vein photoelectric sensor of the electronic blood pressure monitor of the embodiment is worn on the wrist.
【図１７】実際に図７の（ｃ）を測定した腕帯圧、光電
センサ信号、Ｋ音、末梢静脈流のドプラ波形を示す図で
ある。FIG. 17 is a diagram showing the armband pressure, the photoelectric sensor signal, the K sound, and the Doppler waveform of the peripheral venous flow actually measured in FIG. 7C.
【図１８】図５の（ｂ）に対応する実際の測定例を示す
図である。FIG. 18 is a diagram showing an actual measurement example corresponding to FIG. 5 (b).
【図１９】図５の（ｃ）に対応する実際例を示す図であ
る。FIG. 19 is a diagram showing a practical example corresponding to FIG. 5 (c).
１ 腕帯 ２ Ｋ音センサ ３ 圧力センサ ４ 加圧ポンプ ５ 排気弁 ６ 表示器 ７ ブザー ８ 操作スイッチ ９ 電源回路 １０ ＣＰＵ １１ 末梢圧センサ １２ 圧力センサアンプ DESCRIPTION OF SYMBOLS 1 Arm band 2 K sound sensor 3 Pressure sensor 4 Pressure pump 5 Exhaust valve 6 Display 7 Buzzer 8 Operation switch 9 Power supply circuit 10 CPU 11 Peripheral pressure sensor 12 Pressure sensor amplifier
Claims (11)
の腕帯内を加圧する加圧手段と、腕帯内の圧力を検出す
る圧力検出手段と、腕帯内圧と末梢静脈内圧の均衡点を
抽出する圧均衡点抽出手段と、抽出された均衡点から末
梢静脈圧を換算する手段とを備えたことを特徴とする末
梢静脈圧測定装置。1. An arm band for pressing a living body to stop bleeding, pressurizing means for pressurizing the inside of the arm band, pressure detecting means for detecting pressure in the arm band, intra-arm band pressure and peripheral intravenous pressure. A peripheral equilibrium point extracting means for extracting the equilibrium point, and a means for converting the peripheral venous pressure from the extracted equilibrium point.
減圧過程で、末梢静脈相対圧を検出する手段と、検出さ
れた末梢静脈相対圧の最大点を求める手段とからなり、
末梢静脈相対圧の最大値を圧均衡点とすることを特徴と
する請求項１記載の末梢静脈圧測定装置。2. The pressure equilibrium point extracting means comprises means for detecting a peripheral vein relative pressure in a process of decelerating the intra-arm band pressure, and means for obtaining a maximum point of the detected peripheral vein relative pressure,
The peripheral vein pressure measuring device according to claim 1, wherein the maximum value of the relative pressure of the peripheral veins is set as a pressure equilibrium point.
減圧過程で、末梢静脈相対圧を検出する手段と、検出さ
れた末梢静脈相対圧の最大点を求める手段とからなり、
前記換算手段は、前記末梢静脈相対圧の最大点に対応す
る腕帯圧以降の減圧過程での腕帯圧と末梢静脈相対圧か
ら末梢静脈圧の絶対値を換算することを特徴とする請求
項１記載の末梢静脈圧測定装置。3. The pressure equilibrium point extracting means comprises means for detecting a peripheral vein relative pressure in the process of decelerating the intra-arm band pressure, and means for obtaining a maximum point of the detected peripheral vein relative pressure,
The conversion means converts the absolute value of the peripheral venous pressure from the arm band pressure and the peripheral vein relative pressure in the decompression process after the arm band pressure corresponding to the maximum point of the peripheral vein relative pressure. 2. The peripheral venous pressure measuring device according to 1.
は、腕帯中央部の血液量の検出手段出力をハイパスフィ
ルタを通して得られた信号の最大点を求めるものである
ことを特徴とする請求項１又は請求項３記載の末梢静脈
圧測定装置。4. The method according to claim 1, wherein the means for determining the maximum point of the relative pressure of the peripheral vein determines the maximum point of a signal obtained through a high-pass filter based on the output of the blood volume detecting means at the central part of the arm band. The peripheral venous pressure measuring device according to claim 1 or 3.
速加圧過程で末梢静脈相対圧を検出する手段と、検出さ
れた末梢静脈相対圧が腕帯内圧の増加に相関しない点を
抽出する手段とからなり、前記換算手段は腕帯内圧と末
梢静脈相対圧が相関する区間で腕帯内圧と末梢静脈相対
圧から末梢静脈圧の絶対値を換算することを特徴とする
請求項１記載の末梢静脈圧測定装置。5. The pressure equilibrium point extracting means includes means for detecting peripheral vein relative pressure in the process of applying the intra-arm girdle pressure at a very low speed, and detecting that the detected peripheral vein relative pressure does not correlate with an increase in intra-arm girdle pressure. 2. The extracting means, wherein the converting means converts the absolute value of the peripheral venous pressure from the intra-arm band pressure and the relative peripheral vein pressure in a section where the intra-arm band pressure and the peripheral vein relative pressure are correlated. The peripheral venous pressure measuring device according to the above.
めの腕帯内圧微速加圧後の腕帯内圧微速減圧過程で、末
梢静脈相対圧を検出する手段と、検出された末梢静脈相
対圧の最大点を求める手段とからなり、前記換算手段
は、前記末梢静脈相対圧の最大点に対応する腕帯圧以降
の減圧過程での腕帯圧と末梢静脈相対圧から末梢静脈圧
の絶対値を換算することを特徴とする請求項１記載の末
梢静脈圧測定装置。6. The pressure equilibrium point extracting means includes means for detecting a peripheral vein relative pressure in a process of evacuation of the intra-arm band pressure after the evacuation of the intra-arm band pressure for blood pressure measurement; Means for determining the maximum point of the pressure, the conversion means, the absolute value of the peripheral venous pressure from the arm band pressure and peripheral vein relative pressure in the decompression process after the arm band pressure corresponding to the maximum point of the peripheral vein relative pressure The peripheral venous pressure measuring device according to claim 1, wherein the value is converted.
減圧過程で、末梢動脈圧を検出する手段と、検出された
末梢動脈圧の最大点を求める手段とからなり、末梢静脈
相対圧の最大値を圧均衡点とすることを特徴とする請求
項１記載の末梢静脈圧測定装置。7. The pressure equilibrium point extracting means comprises means for detecting a peripheral arterial pressure in the process of reducing the intra-arm band pressure at a very low speed, and means for obtaining a maximum point of the detected peripheral arterial pressure. The peripheral venous pressure measuring device according to claim 1, wherein a maximum value of the pressure is set as a pressure equilibrium point.
静脈が開いたことを検出する手段であり、開いたことが
検出された時点の腕帯圧が圧力均衡点であることを特徴
とする請求項１記載の末梢静脈圧測定装置。8. The pressure equilibrium point extracting means is means for detecting that a vein has opened at the central part of the arm band, and that the arm band pressure at the time when the opening is detected is a pressure equilibrium point. The peripheral venous pressure measuring device according to claim 1, wherein
血液量に対応する物理量が大きく変化したことを検出す
るものであることを特徴とする請求項１記載の末梢静脈
圧測定装置。9. The means for detecting that a vein has opened,
2. The peripheral venous pressure measurement device according to claim 1, wherein the device detects a large change in a physical quantity corresponding to a blood volume.
圧と末梢静脈相対圧との圧ロスを考慮し、腕帯圧と末梢
静脈相対圧の相関から、末梢静脈圧絶対値を換算するこ
とを特徴とする請求項３又は請求項６記載の末梢静脈圧
測定装置。10. The converting means converts the absolute value of the peripheral venous pressure from the correlation between the arm band pressure and the relative pressure of the peripheral vein in consideration of the pressure loss between the arm band pressure and the relative pressure of the peripheral vein during the decompression process. The peripheral venous pressure measuring device according to claim 3 or 6, wherein:
あるいはその後の減圧過程で、腕帯内圧を検出するとと
もに、末梢静脈圧センサで末梢静脈圧（相対圧）を測定
し、この末梢静脈圧の最大値に対応する腕帯圧から末梢
静脈圧（絶対値）を求めるようにしたことを特徴とする
末梢静脈圧測定方法。11. A blood vessel of a living body is pressurized by an arm band, and in a pressurizing step or a subsequent depressurizing step, a pressure inside the arm band is detected, and a peripheral venous pressure (relative pressure) is measured by a peripheral venous pressure sensor. A method for measuring peripheral venous pressure, wherein a peripheral venous pressure (absolute value) is obtained from an arm band pressure corresponding to the maximum value of the peripheral venous pressure.
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| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
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| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US7488292B2 (en) | 2003-07-07 | 2009-02-10 | Olympus Corporation | Blood vessel detection device |
| JP2010279654A (en) * | 2009-06-08 | 2010-12-16 | Utsunomiya Univ | Specific blood pressure information generator |
| EP2505133A1 (en) * | 2011-03-30 | 2012-10-03 | Nihon Kohden Corporation | Venous pressure measurement apparatus |
| CN103211587A (en) * | 2012-01-23 | 2013-07-24 | 欧姆龙健康医疗事业株式会社 | Blood pressure measurer |
| JP2015160082A (en) * | 2014-02-28 | 2015-09-07 | 国立大学法人広島大学 | Blood pressure measurement apparatus and blood pressure measurement method |
| CN109431473A (en) * | 2018-12-28 | 2019-03-08 | 复旦大学附属中山医院 | Venipuncture system based on pressure field detecting |
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2000
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| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US7488292B2 (en) | 2003-07-07 | 2009-02-10 | Olympus Corporation | Blood vessel detection device |
| JP2010279654A (en) * | 2009-06-08 | 2010-12-16 | Utsunomiya Univ | Specific blood pressure information generator |
| EP2505133A1 (en) * | 2011-03-30 | 2012-10-03 | Nihon Kohden Corporation | Venous pressure measurement apparatus |
| JP2012205822A (en) * | 2011-03-30 | 2012-10-25 | Nippon Koden Corp | Venous pressure measurement apparatus |
| US9743846B2 (en) | 2011-03-30 | 2017-08-29 | Nihon Kohden Corporation | Venous pressure measurement apparatus |
| USRE48076E1 (en) | 2011-03-30 | 2020-07-07 | Nihon Kohden Corporation | Venous pressure measurement apparatus |
| USRE49055E1 (en) | 2011-03-30 | 2022-05-03 | Nihon Kohden Corporation | Venous pressure measurement apparatus |
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| CN103211587B (en) * | 2012-01-23 | 2016-04-06 | 欧姆龙健康医疗事业株式会社 | Blood pressure measurement apparatus |
| JP2015160082A (en) * | 2014-02-28 | 2015-09-07 | 国立大学法人広島大学 | Blood pressure measurement apparatus and blood pressure measurement method |
| CN109431473A (en) * | 2018-12-28 | 2019-03-08 | 复旦大学附属中山医院 | Venipuncture system based on pressure field detecting |
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