CN2756256Y - Implanted type diaphragm pace-maker - Google Patents

Abstract

The utility model discloses an implanted type diaphragm pacemaker. The utility model comprises a heart rate / oxygen saturation of the blood/chest impedance detecting circuit, a microprocessor, a display and key circuit, a stimulating pulse processing output circuit, a transmitting circuit, a receiving circuit and a diaphragm pacing electrode, wherein all the function circuits of the utility model are connected to corresponding interfaces of the microprocessor, and pulse width modulation signals on the microprocessor are processed by the stimulating pulse processing output circuit, pass through the high frequency carrier waves of the transmitting circuit, are transmitted to the receiving circuit and then are demodulated by the receiving circuit into pulse voltage which is transferred to the diaphragm pacing electrode. Collected physiological signals and the principle of self-adaptive control are used to realize the automatic control of output signals. The electrode is implanted to directly stimulate phrenic nerves; thereby, accurate positioning is carried out, and the pulse waveform, the pulse amplitude and the pulse interval of generated respiration stimulating signals can be arbitrarily adjusted. Balanced bidirectional stimulating pulses are used; thereby, charges injected into the nerves when the diaphragm nerves are stimulated can be balanced and the problem that the direct simulation of the phrenic nerves easily leads to the damage or the fatigue of the phrenic nerves is solved.

Description

The implanted diaphragm pacemaker

Technical field

This utility model relates to a kind of diaphragm pacemaker, especially relates to a kind of diaphragm pacemaker of human implantable.

Background technology

Diaphragm pacing device has abroad begun one's study a long time ago, 1967 Green (Glenn) invented diaphragm pacemaker in the implant into body, it is incomplete to be mainly used in the chronic ventilatory function of treatment, the electrode of this diaphragm pacemaker is imbedded phrenic nerves place, the Intradermal left and right sides under the neck, press the automatically one-sided or bilateral of respiratory rhythm and transmit the electric pulse stimulation phrenic nerves by electromagnetic coupled, and reach the purpose of improving respiratory function from external.But the pacing parameter of this kind implanted diaphragm pacemaker needs manual adjustment, can not change automatically according to the variation of physiological parameter, may cause permanent lesion to phrenic nerves when implanting, and the part is easily infected.For overcoming the shortcoming of above-mentioned implanted diaphragm pacemaker, developed external diaphragm muscle pacemaker, at present, existing multiple external diaphragm pacing device is used clinically, and there are many diaphragm pacing devices to apply for patent, as China Patent No. is a kind of external diaphragm pacemaker that discloses of 87208778.6, and this external diaphragm pacemaker is formed two passages by shell, hand switch, permutator and chip.It is by manual control or automatic signal, under the control of trigger impulse envelope circuit, power amplification circuit is exported two-way boost pulse through the skin electricity and to bilateral sternocleidomastoid lower edge 1/2 to 1/3 place, and its characteristics are the output parameter of each circuit of strict control, make it can reach the purpose of treatment.Another China Patent No. is a kind of improved external diaphragm pacemaker that discloses of 89220851.1, it is characterized in that adopting the crystal oscillator clock after frequency division, control and amplification, to produce the train of pulse of therapeutical effect, by placing the conductive rubber therapeutic electrode at 1/2 to 1/3 place under the chest lock mamillary process muscle outer edge, stimulate patient's bilateral phrenic nerves motor point, cause the diaphram motion.Owing to adopted the crystal oscillator clock, had high accuracy and stability; Simultaneously, adopt pulse amplifier other agitators before replacing, stable output signal, load capacity are strong.Also have a China Patent No. 03226172.1 for disclosing a kind of automatic control diaphragm pacing device, it mainly is made up of a respiration energy converting device and corresponding monitoring of respiration circuit, control circuit, diaphragm pacing circuit, diaphragm pacing electrode and warning circuit.Wherein respiration energy converting device and corresponding monitoring of respiration circuit are used to monitor patient's breath signal, and when ending to surpass setting-up time, patient's breath signal produces particular burst by control circuit triggering diaphragm pacing circuit immediately, the pacing signal of this train of pulse acts on the patient by the diaphragm pacing electrode, cause patient's diaphram action and produce breathing, thereby can in time recover to breathe, avoid the patient to damage human body, even die because of being choked to death because of anoxia.

But above-mentioned external diaphragm pacing device is difficult to accurate location because of its electrode adheres to body surface, causes pace-making radio ernergy, parameter area and the weak effect opposite sex all bigger, and easily causes diaphragmatic fatigue.Also stimulate simultaneously cervical plexus, brachial plexus nerve and regional area muscle group, disturb the actual effect of ventilation therapy.Because stimulus intensity is big, return patient and cause extremely discomfort, add that curative effect difference is big, long-term steadiness therapeutic effect remains to be inquired into, and therefore external formula diaphragm pacemaker is difficult to obtain promote.

The utility model content

The purpose of this utility model is to provide the implanted diaphragm pacemaker that a kind of energy satisfies directly to stimulate phrenic nerves and do not cause injury of phrenic nerve or fatigue.

The purpose of this utility model can realize by following technical measures: comprise heart rate/blood oxygen saturation/breast impedance detection circuit, microprocessor, show and key circuit, boost pulse is handled output circuit, radiating circuit, receiving circuit and diaphragm pacing electrode, the signal output port of testing circuit inserts the detection signal input interface on the microprocessor, demonstration and key circuit are connected to corresponding interface on the microprocessor, pulse-width signal outfan on the microprocessor connects the input that boost pulse is handled output circuit, the output stimulation pulse signal that boost pulse is handled output circuit is transmitted into receiving circuit behind the radiating circuit high frequency carrier, receiving circuit is demodulated to pulse voltage and is transported to the diaphragm pacing electrode.

Described boost pulse is handled output circuit and is comprised two-stage low-pass filter circuit, amplifying circuit, voltage follower circuit and current output circuit, the pulse-width signal of input is amplified by the filtering of two-stage low-pass filter circuit, amplifying circuit, through the pulse of voltage follower circuit output voltage, through the pulse of current output circuit output current.

The pulse amplitude adjustable extent of described output current is 0～5mA, the adjustable extent of output voltage is-and 5V～+ 5V.

Described output stimulation pulse signal is the two-way boost pulse of balance, and promptly negative-going pulse is followed a direct impulse,

The amplitude of just asking pulse is 1/2 of a negative-going pulse, and 2 times of negative-going pulses that width is.

Utilize the physiological signal of collection and the principle of Self Adaptive Control, realized the automatic control of output signal.Electrode is implanted in employing directly stimulates phrenic nerves, the location accurately, pace-making radio ernergy, parameter area and the weak effect opposite sex are all less, and the impulse waveform of the respiratory irritation signal that sends, pulse amplitude, pulse spacing can regulate arbitrarily, and satisfying directly stimulates phrenic nerves and do not cause injury of phrenic nerve or tired requirement.Adopt the two-way boost pulse of balance in addition, can balance inject neural electric charge during to diaphragm nerve stimulation, solved direct stimulation phrenic nerves and caused injury of phrenic nerve or tired problem easily.

Description of drawings

Fig. 1 is a theory diagram of the present utility model;

Fig. 2 is the circuit diagram of this utility model specific embodiment.

The specific embodiment

As shown in Figure 1, comprise heart rate/blood oxygen saturation/breast impedance detection circuit, microprocessor, demonstration and key circuit, boost pulse processing output circuit, radiating circuit, receiving circuit, diaphragm pacing electrode, microprocessor is according to detected heart rate, blood oxygen saturation and breast impedance, control breathing frequency, respiratory intensity and inspiratory duration, produce pulse-stimulating signal, after boost pulse is handled the output circuit processing, pass through transmission antennas transmit through the 2MHz high frequency carrier by radiating circuit.Implant subcutaneous wireless reception circuit and accept high-frequency carrier signal, and be demodulated to pulse voltage and be transported to the diaphragm pacing electrode, stimulate phrenic nerves to cause the contraction of diaphram; Implanted diaphragm pacing electrode adopts bipolar electrode, is made with the precious metal material platinum by cardiac pacing.Owing to utilize heart rate, blood oxygen saturation and breast impedance to control pacing frequency, therefore can satisfy the needs of under different conditions, regulating respiration parameter automatically, thereby reach the purpose of simulation autonomous respiration.

As shown in Figure 2, microprocessor adopts 16 single-chip microcomputer MSP430F413 of super low-power consumption FLASH type, and the catching of the intervalometer TimerA in the single-chip microcomputer/comparing unit is as pulsewidth modulation (PWM) output.TimerA selects to increase count mode, is output as PWM reset/set pattern, promptly resets set when timer value equals CCR0 when timer value equals CCR1.Waveform to needed various amplitudes is sampled (sample frequency is fSMCLK/CCR0), obtains several arrays, and sampled result is carried out linear transformation, and to make its maximum be CCR0.In TimerA when work, be sent to CCR1 to first value of array earlier, finish a count cycle after, in interrupt handling routine, next value in the array is delivered to CCR1, use up up to this array, just finish and export a boost pulse; Dynamically revise the boost pulse that the CCR1 value can obtain different amplitudes and waveform.

Parameter controlling section adopts man-machine dialog interface, form by two buttons and one 128 * 64 dot matrix lcd, by they can regulate inspiratory duration (0.1～4.9s), pulse amplitude (0～5mA), the pulse spacing (1～130ms).In an inspiratory cycle, the amplitude of pulse and interval are pressed setting means and are changed, thereby can satisfy the clinical needs under the different situations.

Boost pulse is handled output circuit and is made up of two-stage low-pass filter circuit, amplifying circuit, voltage follower circuit and current output circuit, amplifier IC1A, IC1B form the two-stage low-pass filter circuit, amplifier IC2B forms amplifying circuit, amplifier IC1C forms voltage follower circuit, and amplifier IC1D forms the constant-current source current output circuit; The model of above-mentioned amplifier is TL064.Amplify again through the two-stage low-pass filtering from the pulse-width signal of single-chip microcomputer P12 foot output and to be divided into voltage output and electric current is exported.Galvanism mainly produces the output boost pulse of certain constant current, and the pulse amplitude adjustable extent of output current is set between 0～5mA.Voltage stimulates the main boost pulse that produces certain constant voltage, because pacing electrode directly acts on phrenic nerves, so the adjustable extent of output voltage is also less, for-5～+ 5V between.The output stimulation pulse signal is the two-way boost pulse of balance, and promptly negative-going pulse is followed a direct impulse, and the amplitude of direct impulse is 1/2 of a negative-going pulse, and 2 times of negative-going pulses that width is.

Overall Power Consumption is low, and power pack adopts 9 volts of aneroid battery as main power, can obtain 3 volts of power supplies of single-chip microcomputer and liquid crystal by the DC-DC conversion of MAX653, and the amplifier power supply is ± 6 volts, is obtained by two MAX7660.

After the start, produce stimulation output automatically according to initial stimulus parameter, initial parameter is set at: the breathing cycle expiratory duration is 1.8 seconds, and inspiratory duration is 1.2 seconds; The initial value of pulse amplitude and final value are 500 microamperes; The initial value in pulse spacing and final value are 40 milliseconds.Can be by selecting and confirming that two buttons carry out the adjustment of parameter in conjunction with the liquid crystal menu.Be in course of adjustment, stimulate and to carry out work, the parameter by new settings is set after finishing immediately carries out by the parameter of original setting.

TimerA is as PWM, and the pulsewidth of boost pulse is fixed as 150 μ s, and this is to realize by the number (6) of controlling the PWM ripple.The amplitude of boost pulse is to realize by the dutycycle (CCR1/CCR0) of controlling the PWM ripple.Basic timer control impuls interval and air-breathing, expiratory duration.

Claims (4)

1, a kind of implanted diaphragm pacemaker, it is characterized in that: comprise heart rate/blood oxygen saturation/breast impedance detection circuit, microprocessor, show and key circuit, boost pulse is handled output circuit, radiating circuit, receiving circuit, the diaphragm pacing electrode, the signal output port of testing circuit inserts the detection signal input interface on the microprocessor, demonstration and key circuit are connected to corresponding interface on the microprocessor, pulse-width signal outfan on the microprocessor connects the input that boost pulse is handled output circuit, the output stimulation pulse signal that boost pulse is handled output circuit is transmitted into receiving circuit behind the radiating circuit high frequency carrier, receiving circuit is demodulated to pulse voltage and is transported to the diaphragm pacing electrode.

2, implanted diaphragm pacemaker according to claim 1, it is characterized in that: described boost pulse is handled output circuit and is comprised two-stage low-pass filter circuit, amplifying circuit, voltage follower circuit and current output circuit, the pulse-width signal of input is amplified by the filtering of two-stage low-pass filter circuit, amplifying circuit, through the pulse of voltage follower circuit output voltage, through the pulse of current output circuit output current.

3, implanted diaphragm pacemaker according to claim 1 is characterized in that: the pulse amplitude adjustable extent of described output current is 0～5mA, the adjustable extent of output voltage is-and 5V～+ 5V.

4, implanted diaphragm pacemaker according to claim 1, it is characterized in that: described output stimulation pulse signal is the two-way boost pulse of balance, be that negative-going pulse is followed a direct impulse, the amplitude of direct impulse is 1/2 of a negative-going pulse, and 2 times of negative-going pulses that width is.

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