KR100948826B1 - Method for measuring abdominal pressure indirectly using surface electromyographic signals - Google Patents
Method for measuring abdominal pressure indirectly using surface electromyographic signals Download PDFInfo
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/20—Measuring for diagnostic purposes; Identification of persons for measuring urological functions restricted to the evaluation of the urinary system
- A61B5/202—Assessing bladder functions, e.g. incontinence assessment
- A61B5/205—Determining bladder or urethral pressure
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/03—Detecting, measuring or recording fluid pressure within the body other than blood pressure, e.g. cerebral pressure; Measuring pressure in body tissues or organs
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
- A61B5/316—Modalities, i.e. specific diagnostic methods
- A61B5/389—Electromyography [EMG]
- A61B5/391—Electromyography [EMG] of genito-urinary organs
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/68—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient
- A61B5/6846—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive
- A61B5/6847—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive mounted on an invasive device
- A61B5/6852—Catheters
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/68—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient
- A61B5/6846—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive
- A61B5/6867—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive specially adapted to be attached or implanted in a specific body part
- A61B5/6873—Intestine
Abstract
본 발명은 요류동태 검사 시 비침습적이고 간접적으로 복압을 측정하기 위한 방법에 관한 것으로서, 보다 구체적으로는 복압 상승 운동 시 복부에서 발생하는 표면 근전도 신호를 수집하여 비침습적으로 복압을 추정하기 위한 방법에 관한 것이다. 본 발명은, 피검자가 복압 상승 운동을 수행하는 제 1단계와; 상기 복압 상승 운동 시 복압과 생체 신호를 수집하는 제 2단계와; 상기 수집된 생체 신호를 실효값으로 변환하고 필터링하여 스무딩 된 신호로 변환하는 제 3단계와; 상기 변환된 생체 신호와 상기 수집된 복압 신호 간의 관계식을 계산하는 제 4단계와; 이후에 피검사자의 복압을 측정하고자 경우, 피검자의 생체 신호를 수집하고, 수집된 생체 신호를 실효값으로 변환하고 필터링하여 스무딩 된 신호로 변환한 후, 상기 계산된 관계식을 이용하여 변환된 생체 신호를 복압으로 변환하여 피검자의 복압을 측정하는 제 5단계를 포함하여 이루어진다. 본 발명은 기존 카테터 삽입을 이용한 복압 측정법에서의 여러 가지 문제점을 해결할 수 있으며, 환자와 의사에게 편의성을 제공할 수 있다는 이점을 가진다.The present invention relates to a method for non-invasive and indirectly measured abdominal pressure during urine dynamics test, and more specifically to a method for non-invasive estimation of abdominal pressure by collecting surface EMG signals generated in the abdomen during the abdominal pressure lifting exercise It is about. The present invention includes a first step in which a subject performs an abdominal pressure lifting exercise; A second step of collecting abdominal pressure and bio signals during the abdominal pressure lifting exercise; Converting the collected biosignal into an effective value and filtering the converted biosignal into a smoothed signal; A fourth step of calculating a relation between the converted biosignal and the collected stress signal; Then, in order to measure the subject's abdominal pressure, the biosignal of the subject is collected, the collected biosignal is converted into an effective value, filtered, and converted into a smoothed signal, and then the converted biosignal is converted using the calculated relational expression. And converting to abdominal pressure to measure abdominal pressure of the subject. The present invention can solve various problems in the conventional abdominal pressure measurement method using the catheter insertion, has the advantage that can provide convenience to the patient and doctor.
요류동태 검사, 복압, 근전도, 회귀모델링, 직장내압, 배뇨압, 방광내압 Urinary dynamics test, abdominal pressure, EMG, regression modeling, rectal pressure, urination pressure, bladder pressure
Description
본 발명은 요류동태 검사 시 비침습적이고 간접적으로 복압을 측정하기 위한 방법에 관한 것이다. 구체적으로 본 발명은 피검자가 다양한 복부 운동으로 인한 복압 변화 시 복부에서 발생되는 표면 근전도 신호를 수집하여 간접적으로 복압을 추정하기 위한 방법에 관한 것이다.The present invention relates to a method for non-invasive and indirectly measuring abdominal pressure during urodynamic testing. More specifically, the present invention relates to a method for estimating abdominal pressure indirectly by collecting surface EMG signals generated in the abdomen when abdominal pressure changes due to various abdominal exercises.
요류동태 검사는 하부요로 질환을 가진 환자들을 대상으로 실시되며, 방광의 축뇨와 배뇨 시 방광 배뇨근의 압력(배뇨압)을 지속적으로 관찰하면서 방광의 비정상적 반사유무를 알아내고, 배뇨근의 근 긴장도와 수축력을 측정한다. 이 중 배뇨압(Pdet)은 아래의 식 (1)과 같이 방광내압(Pves)과 복압(Pabd)의 차에 의해 계산되므로, 요류동태 검사 시 방광내압과 복압은 반드시 동시에 측정해야 한다. Urinary kinetic tests are performed in patients with lower urinary tract diseases.They monitor for bladder urination and urinary bladder pressure (urinary pressure) during urination to detect abnormal reflexes of the bladder. Measure Among these, urinary pressure (P det ) is calculated by the difference between the internal pressure of bladder (P ves ) and abdominal pressure (P abd ), as shown in Equation (1) below. .
Pdet = Pves - Pabd (1)P det = P ves -P abd (1)
방광내압은 축뇨와 배뇨로 인해 방광 내부에 발생하는 압력을 의미하며, 방광 내부에 이중도관 요도 카테터 (double lumen Foley catheter)나 마이크로 팁 카 테터를 삽입하여 측정한다. 복압은 방광 주변을 둘러싼 내부 장기나 외부로부터 방광벽에 가해지는 압력을 의미하며, 이는 발살바법, 기침, 보행, 자세변화 등에 의해 변하게 된다. Bladder internal pressure refers to the pressure generated inside the bladder due to urination and urination, and is measured by inserting a double lumen foley catheter or micro tip catheter into the bladder. Abdominal pressure refers to the pressure exerted on the bladder wall from the internal organs or the outside surrounding the bladder, which is changed by the foot saliva method, coughing, walking, and posture change.
복압은 카테터를 삽입하여 직장내압, 하대정맥 및 대퇴 정맥압 등을 측정함으로써 간접적으로 추정할 수 있다. 이 중 항문 카테터를 이용한 직장내압(Prect) 측정법은 장치가 간단하고 측정 결과가 비교적 정확하여, 실제 의료 현장에서는 직장내압 측정법이 표준 방법(gold standard)으로 사용되고 있다. 하지만 직장내압 측정법에 사용되는 카테터법은 카테터 도관에 공기방울이 있거나 피검자의 움직임으로 인해 카테터 팁이 주변 장기와 접촉할 경우 큰 오차를 발생시킬 수 있으며, 검사 도중 배뇨나 배변으로 인해 외부로 빠질 수 있고, 피검자의 활동에 제약을 준다는 단점이 있다.Abdominal pressure can be indirectly estimated by measuring the rectal pressure, inferior vena cava, and femoral vein pressure by catheterization. To the work of the internal pressure (P rect) Measurement Using Anal catheter device is simple and relatively accurate measurements, in the actual medical field, the work pressure measurement is used as a standard method (gold standard). However, the catheter method used in intraocular pressure measurement can cause a large error when the catheter tip contacts the surrounding organs due to air bubbles in the catheter catheter or the subject's movement, and may fall out due to urination or defecation during the test. The disadvantage is that it limits the activity of the subject.
본 발명의 목적은 기존에 복압 측정을 위한 표준 방법으로 사용되던 직장내압 측정법에서 카테터 사용으로 인한 문제점을 해결하기 위해, 복부에서의 표면 근전도 신호를 수집하여 비침습적으로 복압을 측정할 수 있는 방법을 제공하는 것이다.An object of the present invention is to collect a non-invasive surface EMG signal in the abdomen to solve the problems caused by the use of the catheter in the rectal pressure measurement method that was previously used as a standard method for measuring abdominal pressure non-invasive To provide.
본 발명의 적절한 실시 형태에 따르면, 복부의 표면 근전도와 직장내압 신호를 측정하여 잡음을 제거하고 증폭하는 단계; 근전도의 실효값(root mean square)을 계산하고 이동평균 필터를 이용하여 신호를 스무딩(smoothing)하는 단계; 회귀 모델링 방법을 이용하여 상기 근전도와 직장내압 간의 회귀방정식을 계산하는 단계; 상기 계산된 회귀방정식을 이용하여 근전도 신호를 복압으로 변환하는 단계로 구성된다.According to a preferred embodiment of the present invention, measuring the surface EMG and rectal pressure signal of the abdomen to remove noise and amplify; Calculating a root mean square of the EMG and smoothing the signal using a moving average filter; Calculating a regression equation between the EMG and intrarectal pressure using a regression modeling method; And converting the EMG signal into abdominal pressure using the calculated regression equation.
본 발명에 따른 표면 근전도를 이용한 복압측정 방법은 기존에 카테터 삽입으로 인해 발생하는 환자의 고통을 줄일 수 있으며 카테터 사용으로 인해 발생할 수 있는 여러 가지 문제점을 해결할 수 있다는 이점을 가진다.The abdominal pressure measuring method using the surface electromyography according to the present invention can reduce the pain of the patient caused by the conventional catheter insertion and can solve various problems caused by the catheter use.
아래에서 본 발명은 도면을 참조하고 그리고 본 발명의 범위를 제한하지 않는 실시 예를 이용하여 상세하게 설명된다.The invention is described in detail below with reference to the drawings and using embodiments which do not limit the scope of the invention.
도 1은 기존의 항문 카테터를 이용한 복압 측정방법을 도시한 것이다.1 illustrates a method for measuring abdominal pressure using a conventional anal catheter.
기존에는 방광(10)에 방광내압 측정 카테터(20)를 삽입하여 방광 내부의 뇨에 의해 방광벽에 가해지는 압력인 방광내압(Pves)을 측정하고, 직장(30) 내부에 직장내압 측정 카테터(40)를 삽입하여 복압(Pabd)을 측정하여, 두 신호 간의 차이를 계산함으로써 배뇨압(Pdet)의 변화를 관찰하였다.Conventionally, a bladder
도 2는 본 발명을 위한, 복압 상승 시 복부에서 측정된 표면 근전도 신호와 직장내압 신호를 이용하여 두 신호 간의 관계식을 구하는 과정을 도시한 것이다.Figure 2 shows a process for obtaining a relationship between the two signals using the surface EMG signal and rectal pressure signal measured in the abdomen when the abdominal pressure rise for the present invention.
먼저, 피검자의 직장에 항문 카테터를 삽입하고, 복부의 복직근에 표면 근전도 전극을 부착한다.First, an anal catheter is inserted into the rectum of a subject and a surface EMG electrode is attached to the abdominal muscles of the abdomen.
그 다음, 피검자에게 힘을 완전히 뺀 상태에서 서서히 복부에 힘을 가하여 최대 수축 시(maximum voluntary contraction, MVC)까지 힘을 주도록 하여 서서히 복압을 상승시키며, 동시에 항문 카테터와 표면 전극을 이용하여 직장내압(Prect)과 복부에서의 근전도 신호(EMG)를 수집한다.Then, the subject is gradually depressed and the abdominal force is gradually applied to the patient until the maximum contraction (maximum voluntary contraction (MVC)), and the abdominal pressure is gradually increased.At the same time, using the anal catheter and the surface electrode, the rectal pressure ( P rect ) and the EMG signal from the abdomen.
상기 수집된 근전도 신호는 실효값(RMS)으로 변환되며, 이동 평균 필터를 이용하여 스무딩 되며, 이 후 회귀 모델링 기법을 이용하여 상기 스무딩 된 근전도 신호와 직장내압 신호 간의 n차의 관계식(an, ..., a0)을 계산한다.The collected EMG signals are converted into RMS values and smoothed using a moving average filter, and then, using a regression modeling technique, n-th relationship between the smoothed EMG signals and the rectal pressure signal (a n , ... , a 0 )
본 발명에서는 직장내압 측정법을 이용하여 복압 신호를 측정하는 것으로 하였으나, 그 외 하대 정맥압 및 대퇴 정맥압 등 복압 상승과 관련된 다양한 생체 신 호가 사용될 수 있음은 당업자에게 있어서 자명할 것이다.In the present invention, the abdominal pressure signal is measured using the rectal pressure measurement method, but it will be apparent to those skilled in the art that various biological signals related to the abdominal pressure increase such as inferior vena cava and femoral vein pressure may be used.
또한 본 발명에서는 근전도 신호를 수집하기 위하여 복부의 복직근에 표면 전극을 부착하는 것으로 하였으나, 그 외 기침, 척추 굴곡 운동, 보행 등 여러 복압 상승 운동 시 근육의 활성도가 가장 높을 것으로 예상되는 다양한 근육으로부터 측정된 근전도 신호가 사용될 수 있음은 당업자에게 있어서 자명할 것이다.In addition, in the present invention, the surface electrode is attached to the abdominal abdominal muscle in order to collect the EMG signal, but it is measured from various muscles that are expected to have the highest muscle activity during various abdominal pressure lifting exercises such as coughing, spinal flexion, and walking. It will be apparent to those skilled in the art that the EMG signal can be used.
또한 본 발명에서는 복압을 상승시키기 위해 피검자가 힘을 완전히 뺀 상태에서 최대 수축시까지 복부에 힘을 주는 운동을 하였으나, 기침, 척추 굴곡 운동, 발살바법 등 복압 상승과 관련된 다양한 운동이 적용될 수 있음은 당업자에게 있어서 자명할 것이다.In addition, in the present invention, in order to increase the abdominal pressure, the subject exercised the abdominal force until the maximum contraction in the state of completely deducted, but various movements related to the abdominal pressure increase such as cough, spine flexion, foot salva method can be applied. Will be apparent to those skilled in the art.
또한, 본 발명에서는 실효값 변환과 이동 평균 필터링 과정을 통해 근전도 신호를 완만하게 변환하였으나, 저역 통과 필터 등의 신호 필터링 기법, AM(amplitude modulation) 등의 신호 변조 기법, autoregressive 등의 신호 모델링 기법 등 다양한 신호처리 방법이 적용될 수 있음은 당업자에게 있어서 자명할 것이다.In addition, in the present invention, the EMG signal is smoothly converted through an effective value conversion and a moving average filtering process, but a signal filtering technique such as a low pass filter, a signal modulation technique such as AM (amplitude modulation), a signal modeling technique such as autoregressive, etc. It will be apparent to those skilled in the art that various signal processing methods may be applied.
또한, 본 발명에서는 회귀 모델링 기법을 이용하여 근전도와 직장내압 간의 관계식을 도출하는 것으로 하였으나, 그 외 두 신호 간의 관계식을 도출할 수 있는 다양한 분석 기법이 적용될 수 있음은 당업자에게 있어서 자명할 것이다.In addition, in the present invention, the relationship between EMG and rectal pressure is derived using a regression modeling technique, but it will be apparent to those skilled in the art that various analysis techniques for deriving a relationship between two signals can be applied.
도 3은 상기 도출된 관계식을 이용하여 근전도 신호를 복압 신호로 변환하기 위한 과정을 도시한 것이다.3 illustrates a process for converting an EMG signal into a suppressed signal using the derived relational expression.
먼저, 상기 과정에서 직장내압 측정을 위해 사용된 항문 카테터를 제거한 후, 요류동태 검사를 하면서 복부에서의 표면 근전도 신호를 수집한다.First, after removing the anal catheter used for rectal pressure measurement in the process, the surface EMG signal in the abdomen is collected while performing the urodynamic examination.
상기 수집된 근전도 신호는 실시간으로 필터링과 증폭 과정을 거친 후 실효값으로 변환하여 스무딩 한다.The collected EMG signals are filtered and amplified in real time, and then converted into smooth values.
상기 스무딩 된 근전도 신호(EMG)는 기 도출된 관계식(an, ..., a0)을 이용하여 복압 신호 (P'abd)로 변환하며, 최종 추정된 복압 신호와 근전도 신호의 계산식 (2)는 다음과 같다.The smoothed EMG signal (EMG) is converted into a pressure signal (P ' abd ) by using the derived relation equation (a n , ... , a 0 ), and the calculated equation of the final estimated pressure signal and EMG signal (2 ) Is as follows.
P'abd = an*EMGn + an -1*EMGn -1 + ... + a0 (2)P ' abd = a n * EMG n + a n -1 * EMG n -1 + ... + a 0 (2)
도 1은 기존의 카테터를 이용한 복압 측정 방법을 도시한 것이다.1 illustrates a method for measuring abdominal pressure using a conventional catheter.
도 2는 복부 근전도를 이용하여 복압을 추정하기 위해 회귀방정식을 산출하는 과정을 도시한 것이다.2 illustrates a process of calculating a regression equation for estimating abdominal pressure using abdominal electromyography.
도 3은 기 산출된 회귀방정식을 이용하여 복부 근전도 신호를 복압으로 변환하기 위한 과정을 도시한 것이다.3 illustrates a process for converting an abdominal EMG signal into abdominal pressure using a pre-calculated regression equation.
10: 방광 20: 방광내압 측정 카테터 10: bladder 20: bladder pressure measuring catheter
30: 직장 40: 직장내압 측정 카테터30: Rectal 40: Rectal pressure catheter
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