JP3065633B2 - Shock wave therapy device and thermal therapy device - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION [Object of the Invention] (Field of Industrial Application) The present invention relates to a shock wave therapy apparatus for treating a target treatment object in a living body such as a cancer tissue or a calculus by destroying the focused energy of the shock wave. Things.

Alternatively, the present invention relates to a thermal treatment apparatus for treating cancer tissue or the like by using continuous ultrasonic waves and destroying the cancer tissue or the like with the focused energy of the ultrasonic waves.

(Prior Art) In recent years, various developments regarding a shock wave treatment apparatus that destroys a calculus or the like by irradiating a shock wave have been attempted.
For example, there is one described in Japanese Patent Application No. 62-290158 filed by the present applicant.

Hereinafter, this technique will be described with reference to the drawings. Ninth
As shown in detail in the figure, a shock wave therapy apparatus which shows a schematic configuration of the whole is a shock wave transducer 15 for transmitting a shock wave composed of ultrasonic waves, and a sound field different from a shock wave transmission region formed by the shock wave transducer 15. Ultrasonic transducer for transmitting and receiving ultrasonic waves forming a region
And a pulser for sending a pulse signal to the shockwave transducer 15.
18 and a pulse signal is transmitted to the ultrasonic transducer 16 to excite the ultrasonic transducer 16 to perform a B-mode scan and to receive an echo signal from the ultrasonic transducer 16 based on the B-mode scan. A transmission / reception circuit 19, an output signal of the transmission / reception circuit 19, a signal processing circuit 20 for performing amplitude detection on the input signal and transmitting it as a video signal to a signal conversion system 21. CPU (Central Processing Unit) 22 for controlling and the transmitting and receiving circuit 1 controlled by the CPU 22
9, a signal processing circuit 20, a controller 23 for controlling the transmission / reception timing of pulse signals in the pulsar 18, and the CPU 2
A signal conversion system 21 (for example, a digital scan converter) which is controlled by the transmission / reception circuit 19 and performs signal conversion processing on output signals of the signal processing circuit 20;
Based on the output signal of the fan-shaped sound field area 42 by the ultrasonic transducer 16, a body surface image of the living body, a kidney image, a kidney stone image, etc.
Display means 27 including a TV monitor or the like for displaying a shock wave transmitting area of the shock wave transducer 15, a focus point marker 26, and the like, and a CPU 22 for setting the generation timing of a pulse signal transmitted from the pulsar 18 to the shock wave transducer 15. And a position controller 30 that adjusts the relative position of the ultrasonic transducer 16 with respect to the shock wave transducer 15.

Next, the shock wave applicator 17 will be described in detail with reference to FIG. The shock wave applicator 17 is a shock wave transducer 15 that generates a shock wave (for example, an ultrasonic pulse of strong energy) focused on a focal point 41a in the living body 32.
And the shock wave transmitting surface 15a of the shock wave transducer 15.
A water tank 33 provided on the side and the shock wave transducer
A sound field area 42 including the focal point 41a is formed in a state where the ultrasonic wave transmitting / receiving surface 16a is in contact with the living body surface 32s, which is arranged in the shock wave transmitting area 41 from the shock wave transmitting surface 15a to the focal point 41a. And an ultrasonic transducer 16 for collecting B-mode image (tomographic image) data of the living body 32.

To describe these components in more detail, the shock wave transducer 15 includes a concave vibrator (not shown) having a constant curvature. At the center of the shock wave transducer 15, an ultrasonic transducer 16 is attached via a transducer support driving unit 36 so as to be movable in the direction of arrow B. The transducer support drive unit 36 is configured to arbitrarily move and stop the ultrasonic transducer 16 in the direction of arrow B based on a control signal of the position controller 30 that adjusts the relative positional relationship of the ultrasonic transducer 16 with respect to the shock wave transducer 15 and its mechanism. It has a drive source. For example, a rack member is fixed to a side surface of the ultrasonic transducer 16, and a transducer support drive unit 36 having a motor having a pinion gear meshing with the rack attached to a drive shaft has a rotation angle of the motor controlled by the position controller 30. By being controlled, the relative positional relationship between the shock wave transducer 15 and the ultrasonic transducer 16 is adjusted. By the way, a water tank 33 filled with water as a shock wave transmitting liquid is provided on the shock wave transmitting surface 15a side of the shock wave transducer 15,
The water tank 33 has a cylindrical or conical shape having a bottom surface substantially equal to the outer diameter of the shock wave transducer 15.
A bellows 33a that can expand and contract in the direction of arrow B or within a predetermined angle with respect to that direction is formed on the side surface, and the bottom 37 is a thin film having an acoustic impedance substantially equal to that of water.

In the case of performing a destructive treatment of a renal calculus 39 in the kidney shown by 38 in FIG. 8, for example, using the shock wave treatment apparatus configured as described above, first, the bottom 37 of the water tank 33 of the shock wave applicator 17 is used.
Is brought into close contact with the surface 32s of the living body 32.
9, control the signal processing circuit 20 and the signal conversion system 21 to drive the ultrasonic transducer 16 to display the biological information on the screen of the display means 27.
Display 32 tomographic images. In this case, since the ultrasonic wave transmitting / receiving surface 16a of the ultrasonic transducer 16 directly contacts the living body surface 32s, a clear tomographic image can be obtained by eliminating the influence of the bottom of the water tank, water and the like.

Next, when a kidney image 38 is drawn on this tomographic image, a kidney stone image 39 in the kidney image 38 is searched for. In this case, on the display means 27, based on the signal transmitted and received from the CPU 22 to the signal conversion system 21, the shock wave transmission area 41 and the focal point marker 26 are displayed at the corresponding positions, and displayed in real time. The displayed portion of the tomographic image of the living body 32 changes as the shock wave applicator 17 moves. Then, when the kidney stone image 39 is depicted in the tomographic image, the shock wave applicator is further applied.
17 is finely adjusted so that the renal stone image 39 is focused on the focal point marker 26.
The shock wave applicator 17 is fixed in this state. In this case, since the bellows 33a holds the set posture, the shock wave applicator 17 can be easily fixed.

Next, the operator operates the pulse generation switch 29 to operate the CPU2.
2. A control signal is transmitted to the pulser 18 via the controller 23. As a result, a pulse signal is transmitted to the shock wave transducer 15, and the shock wave transducer 15 directs an ultrasonic pulse (shock wave for destruction of the target treatment object) toward the renal calculus 39 existing at a position corresponding to the position of the focusing point marker 26. To transmit. This ultrasonic pulse becomes a shock wave at the position of the kidney stone 39, and destroys the kidney stone.

By repeating the generation of such an ultrasonic pulse several times as necessary, the entire kidney stone 39 can be destroyed and treated.

Also, in the conventional thermal treatment apparatus, the shock wave transducer 15 and the pulser 18 shown in FIG. 9 are similarly configured as a continuous ultrasonic transducer and a continuous transmission circuit, respectively, which generate continuous ultrasonic waves. The continuous ultrasonic waves from the transducer are focused, and heat is generated at the focal point to destructively treat the target treatment object.

(Problem to be Solved by the Invention) When treating a target treatment in a living body, the target treatment usually moves by breathing, and sometimes the living body itself moves, so the number of times during the treatment is increased. It is considered that performing treatment while confirming the therapeutic effect is a preferable operation method in terms of safety.

However, the conventional shock wave therapy apparatus and thermal therapy apparatus have a problem that the treatment cannot be performed while easily confirming the number of shock wave irradiations or the continuous ultrasonic irradiation time, the state of the living body, and the therapeutic effect.

Therefore, the present invention has been made in view of the above circumstances, and an object of the present invention is to provide a shock wave treatment device and a thermal treatment device that can improve treatment efficiency.

[Structure of the Invention] (Means for Solving the Problems) A shock wave treatment apparatus according to the present invention for achieving the above object includes a shock wave treatment device having a shock wave generation means for generating a shock wave focused on a target treatment object in a living body. In the apparatus, first setting means for setting the total number of irradiations required to end the treatment of the target treatment object, and a first setting means for dividing the total irradiation number set by the first setting means into a plurality of sets. A second setting means for setting an irradiation number smaller than the total irradiation number, and interrupting the irradiation each time the irradiation number set by the second setting means is reached,
And control means for controlling to end the irradiation when the total number of irradiations set by the first setting means is reached.

According to another aspect of the present invention, there is provided a hyperthermia apparatus including a continuous ultrasonic wave generating unit configured to generate continuous ultrasonic waves focused on a target medical object in a living body. Setting means for setting the total number of irradiations necessary to end the treatment of the subject, and an irradiation number smaller than the total number of irradiations for dividing the total number of irradiations set by the first setting means into a plurality of pieces. A second setting means for setting irradiation, and interrupting the irradiation each time the number of irradiations set by the second setting means is reached, and terminating the irradiation when the number of irradiations set by the first setting means is reached. And control means for performing control.

(Operation) According to the present invention, by generating a shock wave or a continuous ultrasonic wave based on the irradiation condition including the number of pauses set by the condition setting means, the progress of the treatment can be monitored for each number of pauses. Continuation of treatment or the like can be appropriately performed while checking, and thus safety can be improved.

(Embodiment) An embodiment of the present invention will be described below in detail with reference to FIGS. The same components as those of the shock wave therapy apparatus described in the section of the related art are denoted by the same reference numerals, and detailed description thereof will be omitted.

FIG. 1 is a schematic overall perspective view of a shock wave therapy apparatus according to one embodiment of the present invention.

First, as a component different from the conventional shock wave treatment device, a shock wave irradiation condition setting device 101 as a signal output means,
There is an irradiation shock wave data output device 102, a display means 103, and an audio output device 104.

This apparatus comprises a holding mechanism HM for tilting and moving the shock wave applicator 17, an imaging unit IU including a display means 103, a shock wave irradiation condition setting device 101, a sound output device 104 and the like, and an irradiation shock wave Data output device 102, CP
A system controller SC provided with U22, etc., a holding mechanism operation panel 18 provided on the outer periphery of the shock wave applicator 17 for operating the holding mechanism HM, and a water for controlling the amount of water in the water tank 33 of the shock wave applicator 17. Controller 34
And a bed T on which a living body (hereinafter also referred to as “patient”) is placed. In the figure, FS indicates a holding mechanism HM.
Is operated by the operator's foot.

FIG. 2 is a block diagram of the apparatus shown in FIG. 1, and FIG. 3 is a plan view showing a setting panel of the shock wave irradiation condition setting apparatus 101.

The shock wave irradiation condition setting device 101 includes shock wave irradiation conditions such as a shock wave irradiation number, a shock wave irradiation rate (hereinafter simply referred to as a “pulse rate”), a shock wave driving voltage, and a pause number (shock wave generation number). Is set by the operator. Here, the number of shock wave irradiations is the total number of irradiations until the treatment is completed, and the pulse rate is the number of irradiations per unit time. For example, if the pulse rate is 2.0 Hz, irradiation is performed twice per second. The number of pauses means a pause of the shock wave treatment. For example, if the number of pauses is 300, the irradiation is stopped at 300 times. Shock wave irradiation condition setting items include the number of irradiations,
There are four: shock wave drive voltage, pulse rate, and number of pauses.

First, the number of shock wave irradiations is set by the push buttons for setting the number of shock wave irradiations, that is, the up button 201 and the down button 202.
Is appropriately pressed. Here is the up button
Each time the button 201 or the down button 202 is pressed once, the number of shock wave irradiation increases or decreases by 100. If, for example, 3000 is set as the number of shock wave irradiations in this way, the number of shock wave irradiations (Maxi
(Mum Shot No.) is displayed on the display unit 206 as 3000 as can be seen from the figure. This number does not change until the setting is changed or canceled. Similarly, the number of pauses is also set by the up button 204 and the down button 205 for setting the number of pauses.
Is appropriately pressed. Also in this case, similarly, the number is increased or decreased in 100 units by the Ab button 204 and the Down button 205. Then, the pause count display section (Pause / Remaining Sh
ot No.) 207 displays, for example, 300. This number is decremented by one each time the shock pulse is emitted. That is, while the shock wave is being irradiated, the number of remaining shots up to the temporary stop is displayed, and at the time of the temporary stop, it returns to the initial set value instantaneously in the order of microseconds. Next, the shock wave drive voltage is set by rotating the shock wave drive voltage setting knob 213 left and right. In this case, the drive voltage (Driving Volt) increases / decreases in units of 1 kV and is set to, for example, 15 kV.
age) is displayed on the display section 211 as 15.0. Similarly, in the case of the pulse rate, the knob 214 is set by rotating the knob left and right. Also in this case, the frequency increases or decreases in units of 0.5 Hz. For example, if the set value is 2 Hz, 002.0 is displayed on the display unit 212. In addition, the number of actually irradiated shock waves is displayed on the display unit 207. That is, it is increased by one each time the shock wave is irradiated. Each time a shock wave is applied, the shoot lamp 20
9 lights up. If the entire apparatus is not in a state capable of irradiating a shock wave, the pulse ready lamp 210 is turned on. The clear button 203 is for canceling the setting.

Next, the irradiation shock wave data output device 102 will be described. In this case, for example, a printer or the like used for a general personal computer or the like may be used, but this outputs, for example, the one shown in FIG. The numbers shown in FIG. 5 through 7 indicate kidney stones as shown in FIG.
39 shows 39 different focusing positions. In this part, the first to 1000th shock wave pulses are recorded in association with the drive voltage. The same applies to the 100th to 20th shots
00th, 2001 to 3000th, 3001
The first to 4000th shots are recorded. Here, the ordinates of ... are respectively set to drive voltages of 0 to 20 kV. However, the scale of the vertical and horizontal axes changes according to the setting conditions.
In addition, the set irradiation conditions and patient information are recorded. The patient information is a part indicated as a patient ID in the figure, and is, for example, a part for recording a patient name, a position and a size of a calculus of the patient, or a symbolized form thereof. This is performed by an appropriate input device, for example, an attached keyboard or the like.

Also, as can be seen from FIG.
For each power generation, the drive voltage is increased from 0 to the maximum drive voltage, that is, the set drive voltage. The 300 shots are the number of pause shots, which means that the shock wave irradiation stops every 300 shots. When stopping temporarily, the position of the focal point may be moved. In such a case,
The drive voltage is controlled by the CPU 22 so as to gradually increase the drive voltage to ensure higher safety. More specifically, if the total number of irradiations is 1000 to 4000, the maximum driving voltage is increased by 1 kV every 4 pulses of the shock wave, and if the total number of irradiations is 4001 to 8000, it is increased by 1 kV every 8 pulses. is there. Such an irradiation method may be set as one of the conditions.

Next, the display means 103 will be described. The display means 103
The display means 27 of the conventional device shown in FIG.
And the cumulative number N of the shock wave irradiation, the pulse rate R, and the drive voltage V are also displayed.

Next, the audio output device 104 will be described. The voice output device 104 includes a voice synthesis memory, a speaker, and the like (not shown). When irradiation of the set number of times of the shock wave is completed, the voice output device 104 outputs a voice based on the voice information stored in the voice synthesis memory from the speaker. To notify the suspension of the shock wave irradiation. That is, the shock wave irradiation condition setting device 101 outputs an end signal to the CPU 22 of the system controller SC when the irradiation of the number of shock waves set by operating the buttons 201 and 202 is completed. The CPU 22 inputs an audio output signal to the audio output device 104 arranged in the imaging unit IU based on the end signal from the shock wave irradiation condition setting device 101. The sound output device 104 outputs sound based on the sound output signal.

The operation of the shock wave therapy apparatus having the above-described elements is as follows. First, the operator operates the holding mechanism operation panel 18 and places the impact applicator 17 on the patient's body surface. Then, the display means 10 after the signal processing in each of the components already described.
3, a tomographic image displayed as the sound field area 42, the shock wave transmission area 41, and the focal point marker 26 are displayed. The operator operates the shock wave applicator 17 while looking at the display means 103 to search for a kidney stone 39, for example. If a kidney stone 39 is found, the operator determines the shock wave irradiation condition according to the position and size of the stone 39 and sets it by the shock irradiation condition setting device 101. If this set value is, for example,
If 3000, pulse rate 2.0 Hz, drive voltage is 15 kV, and the number of pauses is 200, the shock wave irradiation status corresponding to the display image is displayed on the upper left of the display means 103 via the signal conversion system 21 under the control of the CPU 22. (See FIG. 6 (a)). here,
The cumulative number N of the shock wave irradiations corresponds to the number shown on the display unit 207 of the shock wave irradiation condition setting device 101 described above. Since the irradiation has not been performed yet, N =
It is displayed as 0. Shock wave irradiation starts and the display
If the number shown in 207 is, for example, N = 1000, it is displayed as N = 1000, R = 2.0 Hz, V = 15 kV as shown in FIG. 6 (b). Further, the pulse rate R is always a constant value during the treatment, so that R = 2 Hz. The driving voltage V is
Here, V = 15 kV. As described above, the drive voltage of the shock wave to be actually irradiated is such that when the shock wave irradiation is completed (in this case, the irradiation number is 3000), the operator presses an appropriate switch to print out the treatment record.
In this case, for example, the one shown in FIG. 4 is output.

Here, a simple example of the shock wave output control by the CPU 22 will be described with reference to the flowchart of FIG.

First, in step 301, the setting device 101 sets the shock wave irradiation number (m), the shock wave (maximum) drive voltage (W), the pulse rate (R), and the number of pauses (P). Here, n is a numerical value corresponding to the number of irradiation shock waves displayed on the display unit 207 of the setting device 101, and the initial value is 0.
Although the description of the pulse rate is omitted below, it is controlled by the input of a clock whose illustration is omitted. Next, steps 302 to 306 are steps for setting the increased irradiation number of the driving voltage. For example, if m is 3000, 302 → 303
Is set to i = 4. That is, 4
This means that the drive voltage (V) is increased by 1 kV each time a shot is irradiated. (Here, the case of increasing by 1 kV is taken as an example. A determination method of 0.5 kV or W / 10 kV may be used. Similarly, when m = 8000, 302 → 3
Following the steps from 04 to 306, i = 10 is set.

Next, step 307 is a step of waiting for the input of the pulse generation switch 29 described above. In step 308, the cumulative number of irradiations n and m are compared, and n
If m = m, the process proceeds to step 309 to complete the treatment. If n <m, the process proceeds to step 310, where the number q of remaining shots up to the temporary stop is evaluated. If q = 0, the operation is suspended and the CPU is stopped based on the end signal from the setting device 101.
Step 22 is to control the audio output device 104 to output audio from the speaker, and to reset q = P, V = 0, j = 0.
Return to 7. Here, j is a parameter for increasing V, and V is increased by comparing with i described above. If q> 0, the process proceeds to the next step 312.
Hereinafter, steps 312 to 318 are steps for determining a drive voltage, and output a shock wave irradiation command to the controller 23. Also, in response to the parameter rewriting in steps 307 and 320, the numerical value displayed on the setting device 101 changes under the control of the CPU 22.

The shock wave transducer 15 and the pulser 18 of the shock wave treatment apparatus shown in FIG. 2 are a continuous ultrasonic transducer and a continuous oscillation circuit for generating continuous ultrasonic waves, respectively.
The continuous wave from the continuous ultrasonic transducer is focused on, the heat is generated at this focusing point, and the shock wave treatment device shown in FIG. A similar effect is achieved.

In addition, a shock wave irradiation state displayed simultaneously with a display image does not necessarily require a strict response. For example, a response having a time difference of several milliseconds or less can sufficiently exhibit the result.

According to the shock wave therapy apparatus according to the embodiment of the present invention having the above-described configuration, when the generation of the number of times of the pause of the shock wave set by the shock wave irradiation condition setting apparatus is completed, the sound is output from the sound output apparatus. Since the patient and the operator are informed, the patient can relax with this voice, and the operator can proceed to the next operation, so that the treatment can be performed efficiently.

Furthermore, a treatment with high safety can be performed by gradually increasing the drive voltage of the shock wave, and excessive shock wave irradiation to the patient, or unnecessary irradiation can be prevented by setting the number of pauses. .

The present invention is not limited to the above-described embodiment, and can be variously modified and implemented. For example, the shock wave treatment device has been described, but as described in the section of the prior art,
As another irradiation shock wave data output device, instead of printing out the treatment record, it may be output as a monitor, and even if it can be output to the display device 103 already described, a dedicated display device is provided. You may. Further, this may be recorded on an appropriate recording medium, for example, a floppy disk or an optical disk.

Further, the audio output device may output a sound such as a buzzer.

[Effects of the Invention] As described in detail above, according to the present invention, it is possible to appropriately perform treatment or the like while checking the progress of treatment for each number of pauses, thereby improving safety. it can.

[Brief description of the drawings]

1 to 7 are views relating to a shock wave treatment apparatus which is an embodiment of the present invention. FIG. 1 is a schematic overall perspective view of the apparatus, FIG. 2 is an overall block diagram, and FIG. FIG. 4 is a plan view showing a setting panel surface of the irradiation condition setting device, FIG. 4 is a diagram showing an example of a treatment record, FIG. 5 is a diagram showing an example of a focal point movement of shock wave treatment, and FIGS. 6 (a) and (b). FIG. 7 is a view showing a display example of the display means, FIG. 7 is a flowchart showing the operation of the present apparatus,
FIG. 8 is a sectional view showing the structure of the shock wave applicator, and FIG.
FIG. 1 is a block diagram showing the overall configuration of a conventional shock wave therapy apparatus. 15 Shock wave transducer (shock wave generating means) 101 ... Shock wave irradiation condition setting device (signal output means) 104 ... Sound output device

──────────────────────────────────────────────────続 き Continued on the front page (58) Field surveyed (Int. Cl. ⁷ , DB name) A61B 17/22 330 A61B 18/00 A61F 7/00 322

Claims (4)

(57) [Claims] 1. A shock wave treatment apparatus comprising a shock wave generating means for generating a shock wave focused on a target treatment object in a living body, wherein a first irradiation number necessary for terminating treatment of the target treatment object is set. Setting means; second setting means for setting an irradiation number smaller than the total irradiation number for dividing the total irradiation number set by the first setting means into a plurality; Control means for interrupting the irradiation each time the set number of irradiations is reached, and controlling to end the irradiation when the total number of irradiations set by the first setting means is reached; Treatment device. 2. The shock wave therapy apparatus according to claim 1, further comprising a notifying means for notifying that the irradiation has been interrupted by said control means. 3. A thermal treatment apparatus comprising a continuous ultrasonic wave generating means for generating continuous ultrasonic waves focused on a target treatment object in a living body, wherein the total number of irradiations necessary for terminating the treatment of the target treatment object is set. First setting means for setting the number of irradiations smaller than the total number of irradiations for dividing the total number of irradiations set by the first setting means into a plurality of pieces; Control means for interrupting the irradiation each time the number of irradiations set by the setting means is reached, and ending the irradiation when the number of irradiations set by the first setting means is reached. And thermal treatment equipment. 4. The thermal treatment apparatus according to claim 3, further comprising a notifying means for notifying the interruption when the control means interrupts the irradiation.