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WO2015021779A1 - 超声扫描设备、呼吸机、医疗系统和相关方法 - Google Patents

超声扫描设备、呼吸机、医疗系统和相关方法 Download PDF

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Publication number
WO2015021779A1
WO2015021779A1 PCT/CN2014/074414 CN2014074414W WO2015021779A1 WO 2015021779 A1 WO2015021779 A1 WO 2015021779A1 CN 2014074414 W CN2014074414 W CN 2014074414W WO 2015021779 A1 WO2015021779 A1 WO 2015021779A1
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WO
WIPO (PCT)
Prior art keywords
ventilator
ultrasonic scanning
ultrasonic
enable signal
unit
Prior art date
Application number
PCT/CN2014/074414
Other languages
English (en)
French (fr)
Inventor
李勇
刘硕
宋海波
左云霞
刘进
Original Assignee
深圳迈瑞生物医疗电子股份有限公司
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Priority claimed from CN201310350186.9A external-priority patent/CN104367339B/zh
Application filed by 深圳迈瑞生物医疗电子股份有限公司 filed Critical 深圳迈瑞生物医疗电子股份有限公司
Publication of WO2015021779A1 publication Critical patent/WO2015021779A1/zh
Priority to US15/016,832 priority Critical patent/US10449313B2/en
Priority to US16/456,568 priority patent/US11260188B2/en

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/0057—Pumps therefor
    • A61M16/0066—Blowers or centrifugal pumps
    • A61M16/0069—Blowers or centrifugal pumps the speed thereof being controlled by respiratory parameters, e.g. by inhalation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/06—Measuring blood flow
    • A61B8/065—Measuring blood flow to determine blood output from the heart
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/08—Detecting organic movements or changes, e.g. tumours, cysts, swellings
    • A61B8/0883—Detecting organic movements or changes, e.g. tumours, cysts, swellings for diagnosis of the heart
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/52—Devices using data or image processing specially adapted for diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/5215—Devices using data or image processing specially adapted for diagnosis using ultrasonic, sonic or infrasonic waves involving processing of medical diagnostic data
    • A61B8/5223—Devices using data or image processing specially adapted for diagnosis using ultrasonic, sonic or infrasonic waves involving processing of medical diagnostic data for extracting a diagnostic or physiological parameter from medical diagnostic data
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/54—Control of the diagnostic device
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/54—Control of the diagnostic device
    • A61B8/543—Control of the diagnostic device involving acquisition triggered by a physiological signal
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/021—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes operated by electrical means
    • G—PHYSICS
    • G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H50/00—ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics
    • G16H50/30—ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics for calculating health indices; for individual health risk assessment
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/06—Measuring blood flow
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/44—Constructional features of the ultrasonic, sonic or infrasonic diagnostic device
    • A61B8/4416—Constructional features of the ultrasonic, sonic or infrasonic diagnostic device related to combined acquisition of different diagnostic modalities, e.g. combination of ultrasound and X-ray acquisitions
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/46—Ultrasonic, sonic or infrasonic diagnostic devices with special arrangements for interfacing with the operator or the patient
    • A61B8/461—Displaying means of special interest
    • A61B8/463—Displaying means of special interest characterised by displaying multiple images or images and diagnostic data on one display
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/56—Details of data transmission or power supply
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/10—Preparation of respiratory gases or vapours
    • A61M16/1045—Devices for humidifying or heating the inspired gas by using recovered moisture or heat from the expired gas
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/10—Preparation of respiratory gases or vapours
    • A61M16/105—Filters
    • A61M16/1055—Filters bacterial
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/10—Preparation of respiratory gases or vapours
    • A61M16/14—Preparation of respiratory gases or vapours by mixing different fluids, one of them being in a liquid phase
    • A61M16/16—Devices to humidify the respiration air
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M2205/00—General characteristics of the apparatus
    • A61M2205/05—General characteristics of the apparatus combined with other kinds of therapy
    • A61M2205/058—General characteristics of the apparatus combined with other kinds of therapy with ultrasound therapy
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M2205/00—General characteristics of the apparatus
    • A61M2205/33—Controlling, regulating or measuring
    • A61M2205/3375—Acoustical, e.g. ultrasonic, measuring means

Definitions

  • the present application relates to medical devices, and more particularly to an ultrasound scanning device, a ventilator, a medical system including the ultrasound scanning device and a ventilator, and related methods.
  • Ultrasound scanning equipment can detect the movement and structural information of tissues and organs by applying ultrasonic echo, which is a convenient and non-invasive choice for cardiac monitoring. It is widely used in intensive care units (Intensive). Care Unit, ICU) The monitoring of departments, operating rooms, and running patients. It can be used to continuously monitor real-time parameters of the user's heart tissue movement for a long time, such as ejection fraction, ventricular volume, blood flow rate and other hemodynamic parameters. During use, it is necessary to ensure that the ultrasound scanning device scans the same heart section every time and obtains consistent and consistent diagnostic parameters for the same heart section.
  • ICU intensive care unit
  • a ventilator When the patient is in a state of complete coma, general anesthesia, etc. without spontaneous breathing, a ventilator is required to breathe the patient. Respiratory support is one of the most critical means of saving the lives of critically ill patients. Therefore, the ventilator has become an indispensable device in clinical treatment. It is becoming more and more widely used in the fields of first aid, anesthesia, ICU and respiratory therapy.
  • the ventilator can replace, control or change the normal physiological breathing of the person, increase the lung ventilation, improve the respiratory function, reduce the respiratory power consumption, and save the heart reserve capacity.
  • An ultrasonic scanning device comprising: an ultrasonic scanning unit; an ultrasonic controller for controlling the operation of the ultrasonic scanning unit and detecting an operating state of the ultrasonic scanning unit, when detecting that the ultrasonic scanning unit changes from a working state to a non- a first enable signal is generated when the working state is detected, and a second enable signal is generated when detecting that the ultrasonic scanning unit is switched from the non-working state to the working state; and the output terminal is configured to enable the first enable signal or The second enable signal is delivered to the ventilator.
  • a ventilator corresponding to the above ultrasonic scanning device comprising: a pneumatic unit for generating a respiratory airflow; an enabling input for receiving a first enable signal or a second enable signal from the ultrasonic scanning device; and breathing control And triggering the operation of the pneumatic unit according to the first enable signal, or triggering the pneumatic unit to stop according to the second enable signal.
  • a method of controlling a ventilator comprising a pneumatic unit for generating a respiratory airflow
  • the control method comprising: receiving a first enable signal or a second enable signal from an ultrasonic scanning device, the first The enable signal is generated when the ultrasonic controller of the ultrasonic scanning device detects that the ultrasonic scanning unit transitions from the working state to the non-working state, and the second enabling signal is detected by the ultrasonic controller from the ultrasonic scanning unit Generating when the non-working state transitions to the working state; triggering the pneumatic unit to operate according to the first enable signal, or triggering the pneumatic unit to stop working according to the second enable signal.
  • a first medical device comprising: the ultrasonic scanning device and the ventilator, the enable output of the ultrasonic scanning device being coupled to an enable input of the ventilator.
  • An ultrasonic scanning device includes: an ultrasonic scanning unit; a periodic input end for receiving a ventilation cycle signal from the ventilator; an ultrasonic controller configured to analyze the ventilation cycle signal, and generate an ultrasonic scanning time sequence according to the analysis result;
  • the ultrasound scanning unit performs an ultrasound scan according to the ultrasound scan time series.
  • a ventilator corresponding to the ultrasonic scanning device described above comprising: a pneumatic unit for generating a respiratory airflow; and a periodic output for transmitting a ventilation cycle signal of the pneumatic unit to the ultrasonic scanning device.
  • a scanning method of an ultrasonic scanning device comprising: receiving a ventilation cycle signal from a ventilator; analyzing the ventilation cycle signal, and generating an ultrasound scan time sequence according to the analysis result; performing an ultrasound scan according to the ultrasound scan time series.
  • a second medical device comprising: the ultrasonic scanning device and the ventilator, the periodic input of the ultrasonic scanning device being coupled to a periodic output of the ventilator.
  • a medical system comprising: a first medical device, a second medical device, and a medical processor, the medical processor triggering operation of the first medical device or the second medical device according to an input selection instruction, the selecting The instructions include an instruction to select the first medical device to operate and an instruction to select the second medical device to operate.
  • the enable signal of the ultrasonic scanning device is supplied to the ventilator to provide a reference for the operation of the subsequent ventilator, so that it is possible to determine whether it is necessary to provide mechanical ventilation during the ultrasound scan as needed.
  • Figure 1 and Figure 2 are schematic diagrams showing changes in the cut surface of the same ventricle short-axis section under mechanical ventilation interference
  • Figure 3 is a schematic diagram of a pressure curve of a common ventilation mode
  • FIG. 4 is a schematic structural view of a medical device according to an embodiment
  • FIG. 5 is a schematic flow chart of a method for controlling a ventilator according to an embodiment
  • FIG. 6 is a schematic diagram showing the working flow of the medical device shown in FIG. 4;
  • FIG. 7 is a schematic structural view of a medical device according to an embodiment
  • FIG. 8 is a schematic view showing a pressure curve of the ventilator in the controlled ventilation mode in the medical device shown in FIG. 7;
  • FIG. 9 is a schematic flow chart of a scanning method of an ultrasonic scanning device according to an embodiment.
  • Fig. 10 is a schematic structural view of a medical system according to an embodiment.
  • the inspiratory action (mainly the movement of the diaphragm) produces a negative chest pressure
  • the passive expansion of the lung occurs with alveolar and airway negative pressure, thereby forming a pressure difference between the airway mouth and the alveoli to complete the inhalation; after inhalation is completed
  • the thoracic and pulmonary elastic retraction produces an opposite pressure difference to complete the exhalation. Therefore, the normal breathing is due to the body's "active negative pressure difference" between the alveoli and the airway mouth through the breathing action to complete the inhalation.
  • the thoracic and pulmonary elastic retraction after inhalation produces a passive positive pressure difference between the alveolar and airway mouth and exhales. To meet the needs of physiological ventilation.
  • the ventilator ventilation is driven by external mechanical force to make a positive pressure difference between the airway mouth and the alveoli to achieve "inhalation", while exhalation is the passive activation of the thoracic and pulmonary elastic retraction after removal of the external mechanical drive pressure. Breathing out of the pressure, that is, there is a "passive positive pressure difference" in the breathing cycle to complete the breathing.
  • the positive pressure difference leads to an increase in lung capacity, pushing the lung tissue towards the heart, chest wall and diaphragm.
  • the pressure curve of the common ventilation mode includes control ventilation, auxiliary ventilation, positive end expiratory pressure, auxiliary/control ventilation, (synchronous) intermittent command ventilation/continuous positive airway pressure, and the like.
  • volume control ventilation Volume Control Ventilation, VCV
  • Pressure Control Ventilation Pressure Control Ventilation
  • PCV Pressure Control Ventilation
  • Intermittent command - capacity control ventilation mode Synchronized Intermittent Mandatory Ventilation of Volume Control, SIMV-VC) or Synchronized Intermittent Mandatory Ventilation of Pressure Control, SIMV-PC
  • Intermittent command control ventilation mode to enhance coordination between human and machine; for patients with strong spontaneous breathing ability, you can choose pressure support (Pressure) Support, PS) ventilation mode, that is, only to give patients ventilation support.
  • PS Pressure Support
  • the present application proposes a scheme for eliminating mechanical ventilation interference of the ventilator during the ultrasonic scanning process, which eliminates the interference caused by mechanical ventilation caused by mechanical ventilation during data acquisition, and avoids the complexity of data processing in the later stage.
  • the stability and accuracy of the ultrasound scan results were also determined.
  • a medical device 40 of an embodiment includes a ventilator 41 and an ultrasound scanning device 42.
  • the ventilator 41 can be coupled to one or more suitable gas sources (not shown), which can be external or internal drive sources.
  • the gas is regulated in the pneumatic unit 411 as a breathing gas that is used to generate a flow of breathing gas. It may also include a valve for controlling the pressure or flow of the breathing gas.
  • the breathing gas is then directed to the user via a connection mechanism such as an inspiratory tube, a breathing mask, and an expiratory tube.
  • the pneumatic unit 411 is controlled by a breathing controller 413 that can provide control of commonly used ventilation modes, such as switching of ventilation modes, and the like.
  • the ventilator 41 may also include other standard components such as a humidifier, a dehumidifier, a bacteria filter, humidity, and a heat exchanger.
  • the ventilator 41 described above controls the function of the operation of the ventilator based on the signal of the ultrasonic scanning device 42. Specifically, the ventilator 41 receives a first enable signal or a second enable signal (described below) from the ultrasonic scanning device 42 via the enable input 412 such that the breath controller 413 is enabled according to the first received
  • the signal triggers the pneumatic unit 411 to operate or triggers the pneumatic unit 411 to stop operating based on the received second enable signal.
  • the enable input terminal 412 and the breathing controller 413 may be added ports, control components, or newly added definitions of the existing blank ports, or may be present without affecting the operation of the original functions. There are multiplexing of ports and control components.
  • the ultrasonic scanning unit 421 is configured to transmit and receive ultrasonic waves to the portion to be detected, so that the ultrasonic scanning device 42 performs scanning detection on the human organs.
  • the signal processing unit 424 processes the ultrasonic echo signals obtained by the ultrasonic scanning unit 421 and converts them into images and corresponding physiological parameters such as blood flow rate, ventricular volume, ejection fraction and the like.
  • the display unit 425 is configured to display an image obtained by the signal processing unit and corresponding physiological parameters.
  • the ultrasound scanning unit 421, the signal processing unit 424, and the display unit 425 can be implemented using respective functional modules in a conventional ultrasound scanning device.
  • the ultrasonic scanning device 42 further includes an enable output 422 and an ultrasonic controller 423.
  • the ultrasonic controller 423 controls the ultrasonic scanning unit 421 to operate and detects the operating state of the ultrasonic scanning unit 421, and generates a first enable signal when detecting that the ultrasonic scanning unit 421 transitions from the active state to the non-operating state, when the ultrasonic scanning unit is detected from A second enable signal is generated when the non-working state is converted to the active state.
  • the enable output 422 transmits the first enable signal or the second enable signal, for example, to the ventilator 41.
  • the breathing controller controls the pneumatic unit to stop mechanical ventilation when the ultrasonic controller
  • the enable output 422 outputs the first enable signal to the ventilator 41
  • the breath controller 413 controls the pneumatic unit 411 to resume mechanical ventilation.
  • the enable output 422 and the ultrasonic controller 423 may be ports or control components added to the original ultrasonic device, or newly added definitions of the existing blank ports, or may be performed without affecting the operation of the original functions. Reuse of existing ports and control components.
  • the enable input 422 of the ventilator 41 and the enable output of the ultrasonic scanning device 42 are electrically coupled, and the electrical path can be in various ways.
  • the most direct way is conductive connection, which can be wired or wireless.
  • the enable input 412 of the ventilator 41 and the enable output 422 of the ultrasonic scanning device 42 can have different forms. For example, both are female sockets, and the two sockets are inserted into each other by means of wires having plugs at both ends.
  • the enable input 412 of the ventilator 41 is a wire with a plug at one end, the other end of the wire is connected to the breathing controller 413 of the ventilator 41, and the enable output 422 of the ultrasonic scanning device 42 is a socket through
  • the plug-in wire insertion socket enables interconnection of the ventilator and the ultrasonic scanning device 42.
  • the enable output 422 of the ultrasonic scanning device 42 and the enable input 412 of the ventilator 41 are wires with a plug at one end, and the other end of the wire is connected to the ultrasonic controller 423 of the ultrasonic scanning device 42, and the ventilator 41
  • the enable input 412 is a socket through which the ventilator 41 and the ultrasonic scanning device 42 are interconnected by inserting the leaded lead into the socket.
  • the enable output 422 of the ultrasonic scanning device 42 can actively deliver the first enable signal or the second enable signal to the ventilator. 41. It is also possible to passively transmit an enable signal to the ventilator 41, which can be set according to specific needs.
  • the ventilator has a fixed upper limit, which is referred to as a ventilator stop upper limit.
  • the ultrasonic controller 423 detects that the ultrasonic scanning unit 421 continues to scan for the ventilator stop upper limit, the ultrasonic controller 423 controls the ultrasonic scanning unit 421 to stop scanning. And outputting the first enable signal to the ventilator 41, and the breathing controller 413 controls the pneumatic unit 411 to resume mechanical ventilation.
  • the ventilator 41 it is also possible to set the ventilator 41 to suspend the ventilation after the pause time exceeds the preset value. This preset value may be an appropriate value within the upper limit of the ventilator 41.
  • Step S501 receiving a first enable signal or a second enable signal from the ultrasonic scanning device, wherein the first enable signal is an ultrasonic controller of the ultrasonic scanning device, when detecting that the ultrasonic scanning unit changes from the working state to the non-working state
  • the ultrasonic controller that generates the second enable signal for the ultrasonic scanning device is generated when detecting that the ultrasonic scanning unit transitions from the non-working state to the working state.
  • the first enable signal may also be generated when the ultrasonic controller detects that the ultrasonic scan unit continues to scan for the ventilator stop upper limit.
  • the ventilator 41 communicates with the ultrasonic scanning device 42 via the enable output 422 and the enable input 412 to communicate, the communication connection of which is described above with respect to the description of the medical device. From the perspective of the ultrasonic scanning device 42, when the ultrasonic controller 423 detects that the scanning unit is in the scanning state, the second output signal is output to the ventilator through the enable output terminal 422, and the ultrasonic controller 423 detects the scanning unit scan. At the end, the first enable signal is output to the ventilator 41 via the enable output 412.
  • Step S503 triggering the operation of the pneumatic unit according to the first enable signal, or triggering the pneumatic unit to stop according to the second enable signal.
  • the breath controller 413 controls the pneumatic unit 411 to resume mechanical ventilation when the ventilator 41 is enabled.
  • the breath controller 413 controls the pneumatic unit 411 to stop mechanical ventilation.
  • the ultrasonic controller 423 is required to generate the first enable signal when the ultrasonic scanning unit 421 continues the scanning time to reach the upper limit of the ventilator 41, but on the ventilator 41 side, it may be The ventilation is resumed after the ventilator 41 pauses for more than a predetermined value.
  • This preset value may be a suitable value within the upper limit of the ventilator 41.
  • the workflow of using the medical device of the present embodiment is as shown in FIG. 6, which is performed by inputting an enable signal of the ultrasonic scanning device 42 to the ventilator, and when the ultrasonic scanning device is in a scanning state, the ventilator is suspended.
  • Mechanical ventilation ensures that the heart is in the same position for each scan of the ultrasound scanning device.
  • the medical device 70 includes a ventilator 71 and an ultrasound scanning device 72.
  • ventilator 71 can be coupled to one or more suitable gas sources (not shown), which can be external or internal drive sources.
  • the gas is regulated in the pneumatic unit 711 as a breathing gas, the pneumatic unit 711 is used to generate a flow of breathing gas, and may include a valve for controlling the pressure or flow of the breathing gas.
  • the breathing gas is then directed to the user via a connection mechanism such as an inspiratory tube, a breathing mask, and an expiratory tube.
  • the ventilator 71 can also include other standard components such as a humidifier, a dehumidifier, a bacteria filter, humidity, and a heat exchanger.
  • the ventilator 71 delivers the venting cycle signal of the pneumatic unit 711 to the ultrasonic scanning device 72 via the periodic output 712.
  • the periodic output 712 can be a port added to the original ventilator, or a new definition of an existing blank port, or a reuse of an existing port and a control component without affecting the operation of the original function.
  • FIG. 8 is a schematic diagram of a pressure curve when the ventilator 71 is in the controlled ventilation mode.
  • the horizontal axis is the time axis, and it can be seen that the mechanical ventilation period of the pneumatic unit 711 is T1.
  • the periodic signal may refer to a periodic signal of a fixed period, or may be a periodic signal of a periodic change, and may be regarded as a ventilation cycle signal as long as it is a control signal capable of controlling ventilation of the ventilator.
  • the ultrasonic scanning unit 721 is configured to transmit and receive ultrasonic waves to the portion to be detected, so that the ultrasonic scanning device 72 performs scanning detection on the human body; and the signal processing unit 724 scans the ultrasonic waves.
  • the ultrasonic echo signal obtained by unit 721 is processed and converted into an image and corresponding physiological parameters, such as blood flow rate, ventricular volume, ejection fraction and other cardiac physiological parameters; display unit 725 is used to display the image obtained by the signal processing unit. And corresponding physiological parameters.
  • the ultrasound scanning unit 721, the signal processing unit, and the display unit can be implemented using respective functional modules in a conventional ultrasound scanning device.
  • the ultrasonic scanning device 72 of the present embodiment further includes a periodic input terminal 722 and an ultrasonic controller 723.
  • the cycle input end 722 is configured to receive a ventilation cycle signal from the ventilator 71;
  • the ultrasound controller 723 is configured to parse the ventilation cycle signal, generate an ultrasound scan time series according to the analysis result, and control the ultrasound scan unit to generate the ultrasound scan time sequence according to the Perform an ultrasound scan.
  • the periodic input end 722 and the ultrasonic controller 723 may be added ports and control components on the original ultrasonic scanning device, or may be newly added to the existing blank port, or may be affected without affecting the operation of the original function. Reuse of existing ports and control components.
  • the scanning period of the ultrasonic scanning unit 721 should be synchronized with the ventilation period signal, and the starting point of each scanning of the ultrasonic scanning unit 721 always falls.
  • the starting point of each periodic signal of the ventilator is added to the position of the first predetermined time value, and the end point of each scanning also always falls at the starting point of each period of the venting period signal plus the position of the second predetermined time value.
  • the first predetermined time value may be 0 or other positive value.
  • the second predetermined time value plus the starting point of the ventilation cycle still falls within the cycle, that is, each The start and end points of the secondary scan are located in the same ventilation cycle signal.
  • the ventilator 71 outputs a periodic signal of mechanical ventilation to the ultrasonic scanning device, and the periodic signal can be understood as a time series, that is, the ventilation cycle signal contains period information T1.
  • the ultrasound controller 723 outputs a scan time series of ultrasound, that is, an ultrasound scan time period T2, according to the input ventilation cycle signal.
  • the time period T2 falls within a fixed period of time T1, for example, T2 may be from the beginning of T1 to the beginning of T1 plus 2 seconds, or from the beginning of T1 plus 3 seconds to T1. Add 5 seconds to wait.
  • the ultrasound scanning unit performs an ultrasound scan as required according to the time series generated by the ultrasound controller.
  • T2 only falls in the same position of each segment T1, not necessarily the beginning to the end of the ventilator stopping the supply of air.
  • the ultrasound device and the ventilator need to communicate according to a pre-agreed protocol
  • the ventilator encapsulates the ventilation cycle signal according to the protocol and transmits, and the ultrasound scanning device receives according to the protocol. And parsing the ventilation cycle signal of the package.
  • the specific communication protocol can be implemented by referring to related technologies of common device communication, which is not limited herein.
  • the enable input of ventilator 71 and the enable output of ultrasonic scanning device 72 are electrically coupled.
  • the electrical path can be in various ways, the most direct way being an electrically conductive connection.
  • the enabling input of the ventilator 71 and the enabling output of the ultrasonic scanning device 72 may have different forms, for example, both of which are concave sockets, and the two sockets are respectively inserted into the sockets through the wires having the plugs at both ends,
  • the enable input of the ventilator 71 is a wire with a plug at one end, the other end of the wire is connected to the breathing controller of the ventilator
  • the enable output of the ultrasonic scanning device 72 is a socket through which the plug is inserted The wire is inserted into the socket to interconnect the ventilator and the ultrasound scanning device.
  • the enable output of the ultrasonic scanning device 72 and the enable input of the ventilator 71 are wires with a plug at one end, and the other end of the wire is connected to the ultrasonic controller of the ultrasonic scanning device 72, and the ventilator 71
  • the input end is a socket, and the interconnection of the ventilator and the ultrasonic scanning device is realized by inserting the lead wire with the plug into the socket.
  • the enable input of the ultrasonic scanning device 72 can actively deliver the first enable signal or the second enable signal to the ventilator 71, or It is passive to send the enable signal to the ventilator, and can be set according to specific needs.
  • the scanning method of the ultrasonic scanning device of an embodiment includes the following steps:
  • Step S901 receiving a ventilation cycle signal from the ventilator.
  • the communication connection between the ventilator and the ultrasonic scanning device refers to the description of the medical device in Embodiment 2.
  • the ultrasonic device and the ventilator need to communicate according to a pre-agreed protocol.
  • the ventilator encapsulates the ventilation cycle signal and sends it according to the protocol.
  • the specific communication protocol can be implemented by referring to related technologies of common device communication, which is not limited herein.
  • Step S903 analyzing the ventilation cycle signal, and generating an ultrasound scan time series according to the analysis result.
  • the ultrasonic scanning device receives and parses the ventilation cycle signal encapsulated by the ventilator according to a predetermined agreement according to the protocol, and generates an ultrasonic scanning time sequence according to the analysis result.
  • the scanning period of the ultrasonic scanning unit should be synchronized with the ventilation period signal, that is, the starting point of each scanning of the ultrasonic scanning unit is always Falling at the starting point of each periodic signal of the ventilator plus the position of the first predetermined time value, the end point of each scan also always falls at the starting point of each cycle of the ventilation cycle signal plus the second predetermined time value Position
  • the first predetermined time value may be 0 or other positive value
  • the second predetermined time value plus the starting point of the cycle also always falls within the ventilation cycle, ie each The start and end points of the secondary scan are located in the same ventilation cycle signal, thereby ensuring that each T2 shown in Fig. 8 falls at a fixed position of each
  • step S905 the ultrasonic scanning unit performs ultrasonic scanning according to the ultrasonic scanning time series.
  • the medical device of the embodiment synchronizes the scanning interval of the ultrasonic scanning device with the mechanical ventilation of the ventilator by inputting the mechanical ventilation cycle signal of the ventilator to the ultrasonic scanning device, thereby ensuring that each time the ultrasound scanning device scans, the heart Is in the same position.
  • a medical system 100 includes a medical processor 103, a ventilator 101, and an ultrasonic scanning device 102, wherein the ventilator 101 has the functions of the ventilators mentioned in Embodiments 1 and 2.
  • the ultrasonic scanning device 102 has the functions of the ultrasonic scanning device mentioned in Embodiments 1 and 2, that is, the medical system 100 provides the first medical device of the "ultrasound scanning device control ventilator" of Embodiment 1 and provides "the embodiment 2"
  • the second medical device of the ventilator controls the ultrasonic scanning device
  • the medical processor 103 is configured to select the first medical device or the second medical device to perform work according to the selection instruction input by the user, that is, the selecting the instruction comprises selecting the first medical device The instructions for the work and the instructions for selecting the second medical device to work.
  • the medical system 100 of the present embodiment provides a user interaction interface, such as providing a window for display selection for selection, or providing a selection button for selection.
  • the selection button or the selection window is a representation of the selection instruction, which can also be other ways.
  • two ports are provided in the ventilator 101, one port for supporting the enable input and the other port for supporting the periodic output, and the ultrasonic scanning device 102 is also provided with two ports, one for supporting the enable output.
  • the other is for supporting the period input, when the connection enable input and the enable output are, indicating that the user selects the first medical device of the "ultrasound scanning device control ventilator" provided in Embodiment 1, and similarly, when connecting The cycle input and the cycle output indicate that the user has selected the first medical device of the "ventilator-controlled ultrasound scanning device” provided in Embodiment 2.
  • the scanning interval of the ultrasonic scanning device 102 is synchronized with the mechanical ventilation period of the ventilator 101 by inputting a signal of the ventilator 101 to the ultrasonic scanning device 102.
  • the ventilator 101 suspends mechanical ventilation when the ultrasonic scanning device 102 is in a scanning state; in either case, the ultrasonic scanning device is secured For each scan of 102, the heart is in the same position. At the source of the data, the interference caused by mechanical ventilation caused by cardiac motion is eliminated, the complexity of post-processing data is avoided, and the stability and accuracy of the scan monitoring results are determined.

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Abstract

一种超声扫描设备、呼吸机、医疗系统和相关方法。超声扫描设备（42）包括：超声扫描单元（421）；超声控制器（423），用于控制所述超声扫描单元（421）工作并检测超声扫描单元（421）的工作状态，当检测到所述超声扫描单元（421）从工作状态转变为非工作状态时生成第一使能信号，当检测到所述超声扫描单元（421）从非工作状态转变为工作状态时生成第二使能信号；使能输出端（422），用于将所述第一使能信号或第二使能信号输送到呼吸机以控制呼吸机（41）的运行。通过将超声扫描设备（42）的使能信号输送给呼吸机（41），为后续呼吸机的工作运转提供参考，从而可以根据需要确定是否需要在进行超声扫描时提供机械通气。

Description

超声扫描设备、呼吸机、医疗系统和相关方法
【技术领域】
本申请涉及医疗器械，尤其涉及一种超声扫描设备、呼吸机、包含该超声扫描设备和呼吸机的医疗系统以及相关方法。
【背景技术】
超声扫描设备因其可应用超声波回声来检测组织器官的运动及结构信息，成为心动监测的一种便利无创的选择，广泛应用于重症加强护理病房（Intensive Care Unit, ICU）科室、手术室、运转病人的监测等场合。其可用于长时间连续监测用户心脏组织运动的实时参数，如射血分数、心室容积、血液流速等血流动力学参数。在使用过程中，需要保证超声扫描设备每次都是扫描同样的心脏切面，针对同样的心脏切面得到稳定一致的诊断参数。
当病人处于完全昏迷、全麻等没有自主呼吸状态下，需要使用呼吸机对病人进行呼吸通气。呼吸支持是挽救急、危重患者生命最关键的手段之一。因而，呼吸机在临床救治中已成为不可缺少的器械。它在急救、麻醉、ICU和呼吸治疗领域中正愈来愈广泛应用。呼吸机能代替、控制或改变人的正常生理呼吸，增加肺通气量，改善呼吸功能，减轻呼吸功耗，节约心脏储备能力。
然而，在实际临床应用中，由于机械通气使病人肺容量增加，肺组织推向心脏，导致心脏位置的变化。而常规超声扫描设备对心脏的扫描区域是固定的。一旦心脏位置发生变化，相当于超声扫描设备在不同时刻扫描了心脏的不同区域，甚至可能扫描到心脏以外的区域，从而干扰超声扫描设备的图像采集，影响超声扫描设备输出的扫描结果的稳定性和准确性。如图1和图2所示为心室短轴切面示意图，图1和图2中的白色直线段表示同一参考位置，容易看出，心脏由于呼吸机供气而左右摆动，使得扫描线扫描的切面相应发生变化。所以，扫描线得到的数据并非基于同一切面，使超声扫描结果失去了意义。因此，在现有临床条件下，通常是由医生通过肉眼观察控制超声扫描设备的扫描，扫描结果的稳定性和准确性都欠佳。
【发明内容】
基于此，有必要提供一种能确保超声扫描结果具有较好的稳定性和准确性的超声扫描设备、呼吸机、包含该超声扫描设备和呼吸机的医疗系统以及相关方法。
一种超声扫描设备，包括：超声扫描单元；超声控制器，用于控制所述超声扫描单元工作并检测所述超声扫描单元的工作状态，当检测到所述超声扫描单元从工作状态转变为非工作状态时生成第一使能信号，当检测到所述超声扫描单元从非工作状态转换为工作状态时生成第二使能信号；使能输出端，用于将所述第一使能信号或所述第二使能信号输送到呼吸机。
一种上述超声扫描设备相对应的呼吸机，包括：用于产生呼吸气流的气动单元；使能输入端，用于接收来自超声扫描设备的第一使能信号或第二使能信号；呼吸控制器，用于根据所述第一使能信号触发所述气动单元工作，或者根据所述第二使能信号触发所述气动单元停止工作。
一种呼吸机的控制方法，所述呼吸机包括用于产生呼吸气流的气动单元，所述控制方法包括：接收来自超声扫描设备的第一使能信号或第二使能信号，所述第一使能信号在所述超声扫描设备的超声控制器在检测到超声扫描单元从工作状态转变为非工作状态时生成，所述第二使能信号在所述超声控制器在检测到超声扫描单元从非工作状态转变为工作状态时生成；根据所述第一使能信号触发所述气动单元工作，或者根据所述第二使能信号触发所述气动单元停止工作。
一种第一医疗装置，包括：上述超声扫描设备和呼吸机，所述超声扫描设备的所述使能输出端与所述呼吸机的使能输入端相连。
一种超声扫描设备，包括：超声扫描单元；周期输入端，用于接收来自呼吸机的通气周期信号；超声控制器，用于解析所述通气周期信号，并根据解析结果生成超声扫描时间序列；所述超声扫描单元根据所述超声扫描时间序列进行超声扫描。
一种与上述超声扫描设备相对应的呼吸机，包括：用于产生呼吸气流的气动单元；周期输出端，用于将所述气动单元的通气周期信号输送到超声扫描设备。
一种超声扫描设备的扫描方法，包括：接收来自呼吸机的通气周期信号；解析所述通气周期信号，并根据解析结果生成超声扫描时间序列；根据所述超声扫描时间序列进行超声扫描。
一种第二医疗装置，包括：上述超声扫描设备和呼吸机，所述超声扫描设备的所述周期输入端与所述呼吸机的周期输出端相连。
一种医疗系统，包括：第一医疗装置、第二医疗装置以及医疗处理器，所述医疗处理器根据输入的选择指令触发所述第一医疗装置或所述第二医疗装置工作，所述选择指令包括选择所述第一医疗装置工作的指令和选择所述第二医疗装置工作的指令。
在上述装置中，将超声扫描设备的使能信号输送给呼吸机，为后续呼吸机的工作运转提供参考，从而可根据需要确定是否需要在进行超声扫描时提供机械通气。
【附图说明】
为了更清楚地说明本发明实施例，下面将对实施例中所需要使用的附图作简单地介绍，显而易见地，下面描述中的附图仅仅是本发明的一些实施例，对于本领域普通技术人员来讲，在不付出创造性劳动的前提下，还可以根据这些附图获得其他的附图。
图1和图2分别为同一心室短轴切面在机械通气干扰下切面发生变化的示意图；
图3为常用通气模式的压力曲线示意图；
图4为一实施方式的医疗装置的结构示意图；
图5为一实施方式的呼吸机的控制方法的流程示意图；
图6为图4所示医疗装置的工作流程示意图；
图7为一实施方式的医疗装置的结构示意图；
图8为图7所示医疗装置中呼吸机处于控制通气模式时的压力曲线示意图；
图9为一实施方式的超声扫描设备的扫描方法的流程示意图；及
图10为一实施方式的医疗系统的结构示意图。
【具体实施方式】
以下说明提供了用于完全理解各个实施例以及用于本领域的技术人员实施的特定细节。然而，本领域的技术人员应该理解，无需这样的细节亦可实践本发明。在一些实例中，为了避免不必要地混淆对实施例的描述，没有详细示出或描述公知的结构和功能。
除非上下文清楚地要求，否则，贯穿本说明和权利要求，用语“包括”、“包含”等应以包含性的意义来解释而不是排他性或穷尽性的意义，即，其含义为“包括，但不限于”。在本详细描述部分中，使用单数或复数的用语也分别包括复数或单数。此外，在用于本申请中时，用语“在此”、“以上”、“以下”及类似意义的用语指的是作为整体的本申请而不是本申请任何特定部分。
自主呼吸时，吸气动作（主要是膈肌的运动）产生胸腔负压，肺被动扩张出现肺泡和气道负压，从而构成了气道口和肺泡之间的压力差而完成吸气；吸气完成后胸廓及肺弹性回缩，产生相反的压力差完成呼气。因此，正常呼吸是由于机体通过呼吸动作产生肺泡与气道口“主动性负压力差”而完成吸气，吸气后的胸廓及肺弹性回缩产生肺泡与气道口被动性正压力差而呼气，以满足生理通气的需要。而呼吸机通气是由体外机械驱动使气道口和肺泡产生正压力差以实现“吸气”，而呼气是在撤去体外机械驱动压后胸廓及肺弹性回缩产生肺泡与气道口被动性正压力差而呼气，即呼吸周期均存在“被动性正压力差”而完成呼吸。正压力差带来肺容量增加，使得肺组织推向心脏、胸壁和膈肌。如图3所示，为常用通气模式的压力曲线，包括控制通气、辅助通气、呼气末正压、辅助/控制通气、（同步）间歇指令通气/连续气道正压等。对于完全没有自主呼吸能力的病人，需要选择容量控制通气（Volume Control Ventilation，VCV）或者压力控制通气（Pressure Control Ventilation，PCV）这样完全机控的通气模式，此时呼吸机工作周期为虚线框内所示曲线，即此时病人呼吸周期完全由呼吸机决定；对于有一定自主呼吸能力的病人，可以选择同步间歇指令—容量控制通气模式（Synchronized Intermittent Mandatory Ventilation of Volume Control，SIMV-VC）或者同步间歇指令-压力控制通气模式（Synchronized Intermittent Mandatory Ventilation of Pressure Control，SIMV-PC）这样的间歇指令控制通气模式，以增强人机之间的协调性；对于自主呼吸能力较强的病人，可以选择压力支持（Pressure Support，PS）通气模式，即仅仅给予病人通气支持即可。经分析验证可知，在完全被动呼吸情况下，呼吸机机械通气都使病人心脏位置发生改变，而且心脏位移周期与机械通气周期同步。
基于上述分析，本申请提出了一种在超声扫描过程中排除呼吸机机械通气干扰的方案，该方案在数据采集时就排除了机械通气导致心脏运动造成的干扰，避免了后期数据处理复杂性，同时确定了超声扫描结果的稳定性和准确性。下面通过具体实施方式结合附图对本申请作进一步详细说明。
如图4所示，一实施方式的医疗装置40，包括呼吸机41和超声扫描设备42。
呼吸机41可以连接到一个或多个合适的气体源（未示出），该气体源可以是外部或内部驱动源。气体在气动单元411内调节成呼吸气体，该气动单元用于产生呼吸气流。其还可包括用于控制呼吸气体的压力或流量的阀。呼吸气体然后通过吸气管、呼吸面罩、呼气管等连接机构引导到用户。气动单元411受控于呼吸控制器413，呼吸控制器413可提供对常用的通气模式的控制，例如通气模式的切换等。呼吸机41还可以包括其它标准部件，例如加湿器、减湿器、滤菌器、湿度和热交换器等。
上述呼吸机41根据超声扫描设备42的信号来控制呼吸机的工作的功能。具体地，呼吸机41通过使能输入端412接收来自超声扫描设备42的第一使能信号或第二使能信号（下文中给出描述），从而呼吸控制器413根据接收的第一使能信号触发气动单元411工作，或者根据接收的第二使能信号触发气动单元411停止工作。使能输入端412以及呼吸控制器413可以是在原有呼吸机上增设的端口、控制部件，或者是对已有的空白端口的新增定义，也可以在不影响原有功能运行的情况下对现有端口和控制部件的复用。
在超声扫描设备42中，超声扫描单元421用于向待检测部位发射和接收超声波，使超声扫描设备42对人体脏器进行扫描探测。信号处理单元424则是对超声扫描单元421得到的超声回波信号进行处理，将其转换为图像及对应的生理参数，例如血液流速、心室容积、射血分数等心动生理参数。显示单元425则用于显示信号处理单元得到的图像及对应生理参数。超声扫描单元421、信号处理单元424和显示单元425可以采用常规的超声扫描设备中的相应功能模块实现。
进一步地，在本实施方式中，超声扫描设备42还包括使能输出端422以及超声控制器423。超声控制器423控制超声扫描单元421工作并检测超声扫描单元421的工作状态，当检测到超声扫描单元421从工作状态转变为非工作状态时生成第一使能信号，当检测到超声扫描单元从非工作状态转换为工作状态时生成第二使能信号。使能输出端422则是将第一使能信号或第二使能信号传输出去，如输送到呼吸机41。也就是说，当超声控制器423检测到扫描单元421处于扫描状态时，通过使能输出端422输出第二使能信号到呼吸机41，呼吸控制器控制气动单元停止机械通气，当超声控制器423检测到扫描单元扫描结束时，通过使能输出端422输出第一使能信号到呼吸机41，呼吸控制器413控制气动单元411恢复机械通气。使能输出端422以及超声控制器423可以是在原有超声设备上增设的端口、控制部件，或者是对已有的空白端口的新增定义，也可以在不影响原有功能运行的情况下对现有端口和控制部件的复用。
呼吸机41的使能输入端422和超声扫描设备42的使能输出端之间电连接，其电通路可以有各种方式。最直接的方式是导电连接，可以是有线连接，也可以是无线耦合等方式。呼吸机41的使能输入端412和超声扫描设备42的使能输出端422可以有不同形式。例如，二者均为凹形插口，通过两端具有插头的导线分别相配合地插入两个插口。或者，呼吸机41的使能输入端412为一端带有插头的导线，导线的另一端与呼吸机41的呼吸控制器413相连，而超声扫描设备42的使能输出端422为插口，通过将该带有插头的导线插入插口实现呼吸机和超声扫描设备42的互连。或者，超声扫描设备42的使能输出端422和呼吸机41的使能输入端412为一端带有插头的导线，导线的另一端与超声扫描设备42的超声控制器423相连，而呼吸机41的使能输入端412为插口，通过将该带有插头的导线插入插口实现呼吸机41和超声扫描设备42的互连。具体地，在使用过程中，将呼吸机41和超声扫描设备42互连后，超声扫描设备42的使能输出端422可以主动地将第一使能信号或第二使能信号输送给呼吸机41，也可以是被动地将使能信号输送到呼吸机41，可视具体需求做出相应改变来设定。
通常呼吸机的停止时间有一固定上限，这里称为呼吸机停止上限，当超声控制器423检测到超声扫描单元421持续扫描时间达到呼吸机停止上限时，超声控制器423控制超声扫描单元421停止扫描，并输出第一使能信号到呼吸机41，呼吸控制器413控制气动单元411恢复机械通气。当然也可以设定呼吸机41暂停时间超过预设值后就恢复通气，这个预设值可以是呼吸机41停止上限以内的合适的值。
一实施方式的呼吸机的控制方法，如图5所示，该方法包括如下步骤：
步骤S501，接收来自超声扫描设备的第一使能信号或第二使能信号，其中第一使能信号为超声扫描设备的超声控制器在检测到超声扫描单元从工作状态转变为非工作状态时生成，第二使能信号为超声扫描设备的超声控制器在检测到超声扫描单元从非工作状态转变为工作状态时生成。此外，由于呼吸机的停止时间通常有一固定上限，即呼吸机停止上限，因此，第一使能信号还可以是生成于当超声控制器检测到超声扫描单元持续扫描时间达到呼吸机停止上限时。
呼吸机41与超声扫描设备42之间通过使能输出端422和使能输入端412建立连接以通信，其通信连接方式参考前述对医疗装置的描述。从超声扫描设备42的角度来看，当超声控制器423检测到扫描单元处于扫描状态时，通过使能输出端422输出第二使能信号给呼吸机，当超声控制器423检测到扫描单元扫描结束时，通过使能输出端412输出第一使能信号到呼吸机41。
步骤S503，根据第一使能信号触发气动单元工作，或者根据第二使能信号触发气动单元停止工作。
从呼吸机41的角度来看，当呼吸机41的使能输入端412接收到的是第一使能信号时，呼吸控制器413控制气动单元411恢复机械通气，当呼吸机41的使能输入端412接收到的是第二使能信号时，呼吸控制器413控制气动单元411停止机械通气。
虽然从超声扫描设备42的角度而言，需要超声控制器423在超声扫描单元421持续扫描时间达到呼吸机41停止上限时生成第一使能信号，但是，在呼吸机41侧，也可以是设定呼吸机41暂停时间超过一预设值后就恢复通气，这个预设值可以是呼吸机41停止上限以内的合适的值。
具体上述方法各步骤的实现可参考前述对医疗装置的描述，在此不作重述。
在一实施方式中，使用本实施例的医疗装置的工作流程如图6所示，其通过将超声扫描设备42的使能信号输入到呼吸机，当超声扫描设备处于扫描状态时，呼吸机暂停机械通气，从而可保证超声扫描设备的每次扫描时，心脏都是处于相同的位置。
实施例2：
如图7所示，在一实施方式中，医疗装置70包括呼吸机71和超声扫描设备72。
类似实施例1，呼吸机71可以连接到一个或多个合适的气体源（未示出），该气体源可以是外部或内部驱动源。气体在气动单元711内调节成呼吸气体，该气动单元711用于产生呼吸气流，可包括用于控制呼吸气体的压力或流量的阀。呼吸气体然后通过吸气管、呼吸面罩、呼气管等连接机构引导到用户。呼吸机还71可以包括其它标准部件，例如加湿器、减湿器、滤菌器、湿度和热交换器等。
呼吸机71通过周期输出端712将气动单元711的通气周期信号输送到超声扫描设备72。周期输出端712可以是在原有呼吸机上增设的端口，或者是对已有的空白端口的新增定义，也可以在不影响原有功能运行的情况下对现有端口和控制部件的复用。如图8为呼吸机71处于控制通气模式时的压力曲线示意图。其中横轴为时间轴，可以看出气动单元711的机械通气周期为T1。这里，周期信号可以指固定周期的周期信号，也可以是周期变化的周期信号，只要是可以控制呼吸机通气的控制信号，都可以看作通气周期信号。
同样类似实施例1，在超声扫描设备72中，超声扫描单元721用于向待检测部位发射和接收超声波，使超声扫描设备72对人体脏器进行扫描探测；信号处理单元724则是对超声扫描单元721得到的超声回波信号进行处理，将其转换为图像及对应的生理参数，例如血液流速、心室容积、射血分数等心动生理参数；显示单元725则用于显示信号处理单元得到的图像及对应生理参数。超声扫描单元721、信号处理单元和显示单元可以采用常规的超声扫描设备中的相应功能模块实现。
除了超声扫描单元721、信号处理单元724和显示单元725外，本实施例的超声扫描设备72还包括周期输入端722以及超声控制器723。周期输入端722用于接收来自呼吸机71的通气周期信号；超声控制器723用于解析该通气周期信号，根据解析结果生成超声扫描时间序列，并控制超声扫描单元根据该生成的超声扫描时间序列进行超声扫描。周期输入端722和超声控制器723可以是在原有超声扫描设备上增设的端口和控制部件，或者是对已有的空白端口的新增定义，也可以在不影响原有功能运行的情况下对现有端口和控制部件的复用。
为能更好地排除呼吸机机械通气干扰，在所生成的超声扫描时间序列中，超声扫描单元721的扫描周期应与通气周期信号同步，超声扫描单元721的每次扫描的起始点始终落在呼吸机的每一个周期信号的起始点加上第一预定时间值的位置，每次扫描的结束点也始终落在通气周期信号的每一个周期的起始点加上第二预定时间值的位置。其中第一预定时间值可以是0也可以是其它的正数数值，对于每一个通气周期来说，第二预定时间值加上该通气周期的起始点的结果仍落在该周期内，即每次扫描的起始点和结束点位于同一个通气周期信号内。也就是说，结合图8所示，呼吸机71输出机械通气的周期信号给超声扫描设备，该周期信号可以理解为时间序列，即通气周期信号包含有周期信息T1。超声控制器723根据输入的通气周期信号输出超声的扫描时间序列，即超声扫描时间段T2。该时间段T2落在T1的固定时间段内，例如T2可以是从T1的起始处至T1的起始加上2秒处，或者是从T1的起始加上3秒处至T1的起始加上5秒处等。最终，超声扫描单元根据超声控制器生成的时间序列，按照需求进行超声扫描。此外T2只是落在每一段T1的相同位置，不一定是呼吸机停止供气的开始端到结束端。
应理解，为能实现超声扫描设备和呼吸机的通信，超声设备与呼吸机需要按照事先约定的协议进行通信，呼吸机根据协议规定封装通气周期信号并发送，而超声扫描设备则根据协议规定接收并解析该封装的通气周期信号。具体通信协议可参考常用的设备通信的相关技术实现，在此不做限定。
与上述实施方式相类似，呼吸机71的使能输入端和超声扫描设备72的使能输出端之间电连接。其电通路可以有各种方式，最直接的方式是导电连接。呼吸机71的使能输入端和超声扫描设备72的使能输出端可以有不同形式，例如，二者均为凹形插口，通过两端具有插头的导线分别相配合地插入两个插口，又如，呼吸机71的使能输入端为一端带有插头的导线，导线的另一端与呼吸机的呼吸控制器相连，而超声扫描设备72的使能输出端为插口，通过将该带有插头的导线插入插口实现呼吸机和超声扫描设备的互连。再如，超声扫描设备72的使能输出端和呼吸机71的使能输入端为一端带有插头的导线，导线的另一端与超声扫描设备72的超声控制器相连，而呼吸机71的使能输入端为插口，通过将该带有插头的导线插入插口实现呼吸机和超声扫描设备的互连。在使用过程中，将呼吸机71和超声扫描设备72互连后，超声扫描设备72的使能输入端可以主动地将第一使能信号或第二使能信号输送给呼吸机71，也可以是被动地将使能信号输送到呼吸机，可视具体需求做出相应改变来设定。
基于本实施例的医疗装置，一实施方式的超声扫描设备的扫描方法，如图9所示，该方法包括以下步骤：
步骤S901，接收来自呼吸机的通气周期信号。
呼吸机和超声扫描设备之间的通信连接参考实施例2中对医疗装置的描述，当然，为能实现超声扫描设备和呼吸机的通信，超声设备与呼吸机需要按照事先约定的协议进行通信，呼吸机根据协议规定封装通气周期信号并发送。具体通信协议可参考常用的设备通信的相关技术实现，在此不做限定。
步骤S903，解析通气周期信号，并根据解析结果生成超声扫描时间序列。
超声扫描设备根据协议规定接收并解析呼吸机按照事先约定的协议封装好的通气周期信号，根据解析结果生成超声扫描时间序列。为能更好地排除呼吸机机械通气干扰，在所生成的超声扫描时间序列中，超声扫描单元的扫描周期应与通气周期信号同步，也就是说，超声扫描单元的每次扫描的起始点始终落在呼吸机的每一个周期信号的起始点加上第一预定时间值的位置，每次扫描的结束点也始终落在通气周期信号的每一个周期的起始点加上第二预定时间值的位置，该第一预定时间值可以是0也可以是其它的正数数值，而对于每一个通气周期，第二预定时间值加上该周期的起始点也始终落在该通气周期内，即每次扫描的起始点和结束点位于同一个通气周期信号内，从而可保证如图8所示的每个T2落在每个T1的固定位置。
步骤S905，超声扫描单元根据超声扫描时间序列进行超声扫描。
具体上述方法各步骤的实现可参考本实施例前述对医疗装置的描述，在此不作重述。
本实施例的医疗装置通过将呼吸机的机械通气周期信号输入到超声扫描设备，使超声扫描设备的扫描间隔与呼吸机的机械通气同步，从而可保证超声扫描设备的每次扫描时，心脏都是处于相同的位置。
如图10所示，在一实施方式中，一种医疗系统100包括医疗处理器103、呼吸机101和超声扫描设备102，其中呼吸机101具有实施例1和2中提及的呼吸机的功能，超声扫描设备102具有实施例1和2中提及的超声扫描设备的功能，即医疗系统100提供实施例1的“超声扫描设备控制呼吸机”的第一医疗装置以及提供实施例2的“呼吸机控制超声扫描设备”的第二医疗装置，医疗处理器103用于根据用户输入的选择指令选择第一医疗装置或第二医疗装置进行工作，也就是说，选择指令包括选择第一医疗装置工作的指令和选择第二医疗装置工作的指令。
可以理解，本实施例的医疗系统100提供用户交互接口，例如提供显示选择的窗口供进行选择，或者是提供选择按钮供选择。当然，选择按钮或是选择窗口是选择指令的表现方式，其也可以是其它方式。例如在呼吸机101设置两个端口，一个端口用于支持使能输入端，另一个端口用于支持周期输出端，同时超声扫描设备102上也设置两个端口，一个用于支持使能输出端，另一个用于支持周期输入端，当连接使能输入端和使能输出端，表示用户选择了实施例1提供的“超声扫描设备控制呼吸机”的第一医疗装置，同样地，当连接周期输入端和周期输出端，表示用户选择了实施例2提供的“呼吸机控制超声扫描设备”的第一医疗装置。
本一实施方式中，通过将呼吸机101的信号输入到超声扫描设备102，使超声扫描设备102的扫描间隔与呼吸机101的机械通气周期同步。在另一实施方式中，通过将超声扫描设备102的扫描信号输入到呼吸机101，当超声扫描设备102处于扫描状态时，呼吸机101暂停机械通气；不论哪种方式，都保证了超声扫描设备102的每次扫描，心脏都是处于相同的位置。在数据源头上，就排除了机械通气导致心脏运动造成的干扰，避免了后期数据处理复杂性，同时确定了扫描监测结果的稳定性和准确性。
本领域技术人员可以理解，上述实施方式中各种方法的全部或部分步骤可以通过程序来指令相关硬件完成，该程序可以存储于一计算机可读存储介质中，存储介质可以包括：只读存储器、随机存储器、磁盘或光盘等。
以上所述实施例仅表达了本发明的几种实施方式，其描述较为具体和详细，但并不能因此而理解为对本发明专利范围的限制。应当指出的是，对于本领域的普通技术人员来说，在不脱离本发明构思的前提下，还可以做出若干变形和改进，这些都属于本发明的保护范围。因此，本发明专利的保护范围应以所附权利要求为准。

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  1. 一种超声扫描设备，其特征在于，包括：
    超声扫描单元；
    超声控制器，用于控制所述超声扫描单元工作并检测所述超声扫描单元的工作状态，当检测到所述超声扫描单元从工作状态转变为非工作状态时生成第一使能信号，当检测到所述超声扫描单元从非工作状态转换为工作状态时生成第二使能信号；
    使能输出端，用于将所述第一使能信号或所述第二使能信号输送到呼吸机以控制呼吸机的运行。
  2. 根据权利要求1所述的超声扫描设备，其特征在于，所述超声控制器还用于当检测到所述超声扫描单元持续工作时间达到所述呼吸机停止上限时，控制所述超声扫描单元从工作状态转变为非工作状态，生成所述第一使能信号。
  3. 一种呼吸机，其特征在于，包括：
    气动单元，用于产生呼吸气流；
    使能输入端，用于接收来自超声扫描设备的第一使能信号或第二使能信号，所述第一使能信号或所述第二使能信号根据超声扫描设备的工作状态获得；
    呼吸控制器，用于根据所述第一使能信号触发所述气动单元工作，或者根据所述第二使能信号触发所述气动单元停止工作。
  4. 根据权利要求3所述的呼吸机，其特征在于，所述呼吸控制器还用于在所述气动单元停止工作超过预设时间阈值时，触发所述气动单元恢复工作，所述预设时间阈值小于或等于呼吸机停止上限。
  5. 一种呼吸机的控制方法，所述呼吸机包括用于产生呼吸气流的气动单元，其特征在于，所述控制方法包括：
    接收来自超声扫描设备的第一使能信号或第二使能信号，所述第一使能信号在所述超声扫描设备的超声控制器在检测到超声扫描单元从工作状态转变为非工作状态时生成，所述第二使能信号在所述超声控制器在检测到超声扫描单元从非工作状态转变为工作状态时生成；
    根据所述第一使能信号触发所述气动单元工作，或者根据所述第二使能信号触发所述气动单元停止工作。
  6. 一种第一医疗装置，其特征在于，包括：如权利要求1或2所述的超声扫描设备和如权利要求3或4所述的呼吸机，所述超声扫描设备的所述使能输出端与所述呼吸机的使能输入端相连。
  7. 一种超声扫描设备，其特征在于，包括：
    超声扫描单元；
    周期输入端，用于接收来自呼吸机的通气周期信号；
    超声控制器，用于解析所述通气周期信号，并根据解析结果生成超声扫描时间序列；
    所述超声扫描单元根据所述超声扫描时间序列进行超声扫描。
  8. 如权利要求7所述的超声扫描设备，其特征在于，在所述超声扫描时间序列中，所述超声扫描单元的每次扫描的起始点始终落在所述通气周期信号的每一个周期的起始点加上第一预定时间值的位置，每次扫描的结束点也始终落在所述通气周期信号的每一个周期的起始点加上第二预定时间值的位置，所述每次扫描的起始点和结束点位于同一个通气周期信号内。
  9. 根据权利要求7所述的超声扫描设备，其特征在于，所述超声控制器用于根据与呼吸机事先约定的协议解析所述通气周期信号。
  10. 一种呼吸机，其特征在于，包括：
    气动单元，用于产生呼吸气流；
    周期输出端，用于将所述气动单元的通气周期信号输送到超声扫描设备。
  11. 一种超声扫描设备的扫描方法，其特征在于，包括：
    接收来自呼吸机的通气周期信号；
    解析所述通气周期信号，并根据解析结果生成超声扫描时间序列；
    根据所述超声扫描时间序列进行超声扫描。
  12. 一种第二医疗装置，其特征在于，包括：如权利要求7-9任一项所述的超声扫描设备和如权利要求10所述的呼吸机，所述超声扫描设备的所述周期输入端与所述呼吸机的周期输出端相连。
  13. 一种医疗系统，其特征在于，包括：如权利要求6所述的第一医疗装置、如权利要求12所述的第二医疗装置、以及医疗处理器，所述医疗处理器根据输入的选择指令触发所述第一医疗装置或所述第二医疗装置工作，所述选择指令包括选择所述第一医疗装置工作的指令和选择所述第二医疗装置工作的指令。
PCT/CN2014/074414 2013-08-12 2014-03-31 超声扫描设备、呼吸机、医疗系统和相关方法 WO2015021779A1 (zh)

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