CN85200905U - Microcomputerized enhanced external counter-pulsation for treatment of coronary heart diseases - Google Patents

Abstract

Disclosed is a microcomputerized enhanced external counter-pulsation for the treatment of coronary heart disease. The utility model is characterized in having the gas bag of a buttocks and lower abdomen, a charging and exhausting gas sequence processing device and a monitor device are controlled by a miniature single-board computer to make the gas bag sequentially charged and exhausted gases, the corresponding limb and buttocks of a human body are put pressure by the declined pressure from a far-end to a near-end, has the function of storing a signal, and has the advantages of freezing curve display on a screen and delaying control automatically, etc. The utility model is small size and easy operation, the concave-convex surface of the counter-pulsation bed is designed according to the normal physiological curvature of a human body, and noise reduction covers are arranged above and below the bed.

Description

Microcomputerized enhanced external counter-pulsation for treatment of coronary heart diseases

Relate to the improvement of physical therapy appliance.

Before this utility model is made, abroad in report (The Ameriean Tournal of CARDIOLOGY U.S. cardiovascular magazine 32(10): 656-661 in 1973,1973) external counterpulsation apparatus is an extremity sequential-type counterpulsation device, this device is to be wrapped in extremity with air bag, the sequential extremity that stress on of back near-earth far away earlier, device adopts high-pressure air source (1000～1750mmHg), by the open time of control electromagnetic valve, inject specified air and go into air bag, use the vacuum pump pumpback, make the air bag emptying, therefore must use huge air compressor and vacuum pump (taking up an area of 24 square chi), and 10 cover pressure monitoring devices, guaranteeing that air bag does not produce excess pressure, thereby volume is big, noise height (82 decibels), involve great expense, operate cumbersomely, clinical use can not be provided.

The extremity sequential-type counterpulsation device of existing domestic general use has been abandoned high-pressure air source and vacuum pump, adopt the low pressure and mass flow oil-free diaphragm pump, the pump housing takes up an area of 2 squares of Foot, noise is reduced in below 62 decibels, because pipeline is thicker, inflationtime is fixed (100 milliseconds), air accumulator pressure is 270～300mmHg, gasbag pressure is stabilized in the expectation level, need not pressure monitoring device, air bag is light, and is simple to operate, diastolic pressure improves 32%, and the ratio of ear arteries and veins diastolic wave amplitude and contraction wave amplitude (D/S) equals 1.32 ± 0.19.But from the clinical data prompting, obtain the good anti-effect of fighting, promote side Zhi Xunhuan to set up, must make diastolic pressure be promoted to enough height, therefore this

The counter-pulsation device diastolic pressure improves not remarkable; And fill the ECG simulator wave filter in the exhaust processor, R ripple detector, R-R integrator are analog circuit, and it is relatively poor therefore to fill aerofluxus control timing accuracy, and the model rate is little, does not have automatic time delay control function; Device volume is bigger; Noise is higher; The anti-bed of fighting is a horizontal, and patient posture is uncomfortable, and clinical efficacy is undesirable.

The purpose of this utility model is to overcome the shortcoming of said apparatus, makes diastolic pressure be promoted to enough height, and device volume is dwindled, and noise reduces, thereby improves clinical therapeutic efficacy.

The method of solution task is on the basis of extremity air bag, adds with buttocks air bag and hypogastric region air bag; Adopt micro veneer machine, ADC, DAC, enumerator, LED to constitute the control system of counterpulsation device, sequential blood processor of aerofluxus and monitor are filled in control; The anti-bed of fighting is pressed human body normal physiological bending design male and fomale(M﹠F), head of a bed liftable, the upper and lower silencer cover that is provided with of bed.

Microcomputerized and enhanced external counter pulsation device of the present utility model, be to trigger a mechanical system by the electrocardiogram signal, stress on the position (extremity, buttocks and hypogastric region) that human body can pressurize at diastole, wherein blood is driven return trunk and head, aortic diastolic pressure (also being perfusion pressure coronarius) thereby raising, thereby the increase coronary flow improves blood supply of cardiac muscle; At paradoxical expansion, the pressure of pressurized portion is removed rapidly, and intravascular pressure descends, and systolic arterial pressure decreases, thereby the resistance (afterload) that faces when making heart contraction alleviates myocardial oxygen consumption thereby minimizing.

The advantage that this utility model had is: 1. increase hypogastric region, buttocks air bag; Pressurizeed to near-end by centrifugal dirty far-end, gasbag pressure is successively decreased gradually by far-end to near-end sequentially, thereby has further improved the anti-ripple that flows of relaxing period, and list is significantly improved with sequential counter the fighting of extremity.2. using miniature computer (single board computer system) is controlled in real time

System makes and fills the aerofluxus time started energy accurate tracking electrocardio ripple R-R variation of interval, and error is less than 10ms; And can carry out digital filtering, reduce by 50 weeks and disturb; Automatically detect the R ripple or produce the simulation timing signal; Can realize signal dynamics or static the demonstration, and show heart rate and fill the aerofluxus time started with three bit digital respectively; Counter fighting produced timing alarm in one hour.3. noise isolation is good, and noise meets national armarium standard less than 58 decibels during counter fighting.4. the anti-bed of fighting is pressed human body normal physiological bending design male and fomale(M﹠F), and patient posture is comfortable, and patient can free fetch bit.5. with the large pipeline ventilation, gas in trend atmosphere emptying capsule is without negative pressure pump.6. volume is little, and is easy and simple to handle, and cost is low.

The concrete feature of this device provides with accompanying drawing, and is described further:

Fig. 1, microcomputerized and enhanced external counter pulsation device system block diagram.

Fig. 2, an anti-sketch map of fighting

Fig. 3, buttocks airbag structure sketch map

Fig. 4, microcomputer enhanced external counterpulsation circuit system block diagram

Shown in Figure 1 be that ecg-r wave with ear pulse wave amplifier (7) ecg amplifier (8) is a signal, the automatic control delay circuit by single board computer (1) triggers inflation electromagnetic valve (3) V in the air chest (2) sequentially ₁, V ₂, V ₃, V ₄, make it open sequentially, allow in the air reservoir (4) barotropic gas with time rating by (3) and pipeline thereof, pipeline passes the anti-bed of fighting, and successively enters corresponding four groups of air bags (5), B ₁(calf bladder), B ₂(thigh air bag), B ₃(buttocks air bag), B ₄(upper limb air bag), 2 every group in air bag is positioned over left and right sides limbs and buttocks respectively, and air bag is inflated sequentially, stresses on the corresponding limbs and the buttocks of human body by far-end to near-end, and pressure successively decreases gradually.After the inflation action is finished, the evacuation time that set up by the operator (1), promptly the appropriate time before the next R ripple of electrocardiogram triggers

(2) whole air bleeding valves (6) V in ₅, V ₆, V ₇, V ₈, it is opened simultaneously, so the gas that stresses in whole air bags of human body is discharged to atmosphere, finish the aerofluxus action.Treat that next cardiac cycle begins, this device carries out work with same order again.Barotropic gas in the air chest is supplied with by pipeline by air pump (9), and this air pump is a low pressure high flow capacity oil-free diaphragm pump.

Fig. 2, an anti-last silencer cover (1) of fighting, an anti-following silencer cover (2) of fighting, pipe perforation (3) connect air bag

Fig. 3, air bag have overcoat (1) to be made by artificial leather or canvas or leather etc. outward, and air bag (2) is made by rubber.

Fig. 4, CPU(1), EPROM(2), RAM(3), CTC(4), ADC(5), PIO(6), LED(7), enumerator (8), DAC(9), DAC ₂(10), timing warner (11).

Electrocardio ripple (12), ear or refer to pulse wave (13) and preset constant (14) and after (5) become digital signal, send into (1), (1) by (4) regularly and after under (2) internal memory instruction control the electrocardio ripple being carried out digital filtering, digital signal is deposited in (3), and from the electrocardio ripple, detect the QRS ripple, obtain beginning inflationtime and beginning evacuation time respectively by formula (1) and formula (2), deliver to by the A mouth of (6) then and fill sequential processor of aerofluxus (20) and power amplifier (21), promote electromagnetic valve group (22), control the aerofluxus of filling of air bag.The heart rate that calculates by (1) and fill the aerofluxus time started and deliver to (7) and go to show.The X-axis deflection system (17), (1) that produces X-axis scanning sawtooth waveforms and send to display monitor central monitoring system by (1) control (8) and through (10) taken out signal from (3) and delivered to (9) through the B mouth of (6) and become Y-axis analog deflection signal, drive the Y-axis deflection system (18) of display monitor central monitoring system then, under the effect of functional switch (23), can carry out dynamic or static (freezing) demonstration, also changing scanning speed, the counter one hour regularly newspaper of fighting

Alert signal is delivered to (11) by (1), uses flashing light and audible alarm then.

By (1) send to blanking signal (

), by (6) send to synchronizing signal (

), blanking and synchronizing signal add that X, Y-axis deflection system, power supply, high tension generator, CRT constitute monitor (19) jointly.

Sequential blood processor (20) is made up of three grades or multi-stage inflatable sequential circuit and exhaust circuit, and corresponding every grade of circuit all has a power amplifier (21).

In order to save internal memory and raising speed, equation (1):

Be by formula T fill=0.4 $\sqrt{\mathrm{TR-R}}$ Simplify (tracking error is less than 10ms).

Equation (2) is: T row=TR-R-T fills-C row.

TR-R in the above-mentioned formula represents that ECG R wave interval, T fill the time of expression R ripple to the inflation beginning, C ₁' and C ₁" be built-in inflation constant, C fills and is external inflation constant, and C row is external aerofluxus constant.

Clinical data proves: during counter fighting, inflate by far-end of limb to near-end sequentially and to stress on limbs and buttocks, the calf bladder internal pressure is 250～300mmHg, the thigh intracapsular pressure is 220～270mmHg, the buttocks intracapsular pressure is 160～250mmHg, shank and thigh, when distance was 40～60 milliseconds when thigh and buttocks air bag were sequential, diastolic pressure can obviously improve D/S(ear arteries and veins diastolic wave amplitude/contraction wave amplitude)=1.9 ± 0.5.It is 90.3% that the anti-obvious effective rate of fighting the back symptom of coronary heart disease, angina pectoris patient increases; In addition cerebral ischemia diseases (as cerebral infarction, apoplexy sequela etc.), retinal ischemic disease (thromboembolism etc.), renal ischaemia and peripheral angiopathy etc. all there is remarkable result.

Claims (13)

1, external counterpulsation apparatus, it comprises a display monitor central monitoring system, ear pulse wave amplifier, ecg amplifier, one is carried out regularly and sequential control device filling aerofluxus, connects several groups of electromagnetic valves in air pump and the air chest by pipeline, connects anti-bed and the extremity air bag of fighting again; Of the present utility model being characterised in that has a hypogastric region buttocks air bag, constitutes the control system and the anti-bed of fighting of counterpulsation device by micro veneer machine, ADC, DAC, enumerator, LED.

2, according to claim 1, its feature is to electrocardio ripple, ear pulse wave and preset constant and send into CPU after ADC becomes digital signal, and CPU is by CT _CRegularly, and under the instruction control of EPROM internal memory, the electrocardio ripple carried out digital filtering after, deposit digital signal in RAM, and from the electrocardio ripple, detect the QRS ripple.

(1) formula of pressing:

(2) formula:

T _Row=T _R-R-T _Fill-C _Row

Obtain beginning inflationtime and beginning evacuation time respectively, deliver to by PIO then and fill the aerofluxus sequential circuit.

3, according to claim 1 or 2, it is characterized in that CPU control computer, and through DAC ₂Produce X-axis scanning sawtooth waveforms, and send to the X-axis deflection system of display monitor central monitoring system, take out signal by CPU from RAM simultaneously, send to Y-axis through PIO and DAC and simulate deflection system, and send to blanking signal by CPU, PIO sends to synchronizing signal.

4, the hypogastric region buttocks air bag of an external counterpulsation apparatus is characterized in that according to capsule cover that can closely wrap up buttocks of buttocks configuration design, in its interlayer, about an air bag (Fig. 3) is respectively arranged.

5, according to claim 4, when it is characterized by each air bag and shakeouing, area is not less than 300 square centimeters.

6, according to claim 4, it is characterized by the intrinsic pressure 160～250mmHg of being of air bag, than shank, force down in the thigh air bag.

7, the anti-bed of fighting of the special use of an external counterpulsation apparatus, it is characterized by the head of a bed can lifting, and bed is gone to bed and is had silencer cover.

8, according to claim 7, the anti-bed of fighting can be pressed human body normal physiological bending design male and fomale(M﹠F).

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