CN1358075A - 脉冲血氧计探头移离检测系统 - Google Patents
脉冲血氧计探头移离检测系统 Download PDFInfo
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- A61B5/68—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/145—Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissue
- A61B5/1455—Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissue using optical sensors, e.g. spectral photometrical oximeters
- A61B5/14551—Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissue using optical sensors, e.g. spectral photometrical oximeters for measuring blood gases
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Abstract
本发明提出脉冲血氧计探头的许多改进,从而可以检测探头何时移离病人和/或防止出现移离状态。当探头局部或完全移离病人时便发探头移离状态,但此时在脉冲血氧计工作范围内仍可检测到交流信号。一方面本发明提供电触头,该触头在正确固定探头时接触病人皮肤。另一方面,本发明提供许多格栅,这些格栅配置在传感器光检测器的前方,以滤除不来源于检测器前方位置的倾斜光。因此,如果发光器和光检测器未正确准直,则在脉冲血氧计的有效操作范围内不能产生信号。按照本发明的方法,如果脉冲血氧计已确定探头未正确固定于病人,则该脉冲血氧计将发声报警或显示出警告。
Description
发明领域
本发明涉及可以固定在病人手指、脚指或附属部分的光学探头。本发明尤其涉及探头移离(dislodged)病人时进行识别的装置和方法。
相关技术说明
血氧测量法用于测量血液中的含氧状态。在临床上例如在关键的护理和手术中早期检测到低血氧是极为重要的,因为在几分钟时间内不能充分输送氧便会造成脑损伤和死亡。脉冲血氧测量法是广受欢迎的非侵入方法,用于测量动脉血的氧气饱和程度,是氧气供给的指示器。脉冲血气测量系统一般由固定在病人身上的探头、监示器和连接探头和监示器的电缆组成。脉冲血氧测量探头常规具有红光和红外光发射二极管发光器和光二极管检测器。该探头通常固定在病人手指或脚指上,或很年轻病人的脚上。对于手指探头可以作成使得发光器发射的光穿过手指甲、动脉、血管、毛细血管、组织和骨头。光二极管放在发光二极管对面,使其可以检测发光二极管发射的透过手指细胞组织的透射光。
通过分析动脉血液对探头发射的两种光波长的差致吸收,脉冲血氧测量监示器(脉冲血氧计)可以测定氧的饱和度。脉冲血氧仪可交替地触发探头的发光二极管,并读出电光二极管检测器产生的总电流。该电流正比于受检光的强度。脉冲血氧仪计算受检红光强度和红外光强度之比,然后根据所得到的比值用经验法确定动脉血液中氧的饱和程度。脉冲血氧计包括用于控制探头、处理探头信号以及显示病人氧气饱和度和脉冲率的线路。在转让给本发明受让人的美国专利5632 272中公开了一种脉冲血氧计。
发明概要
本发明提供许多可以加在脉冲血氧计探头上的改进,由此可以检测何时探头移离(probe-off)病人和/或可以防止发生探头移离状态。当光学探头局部地或完全地移离病人时便发生探头移离状态,但此时在脉冲血液计的工作区域内仍能继续检测AC信号。
一方面,本发明提供许多电触头,在正确固定探头时该触头接触病人皮肤。脉冲血氧计可通过触头检验连接性,从而确定是否正确固定探头。如果探头没有正确固定,则脉冲血氧计确定为发生探头移离状态,而使血氧计测量到看起来探头仍固定好的交流信号。
另一方面,本发明提供了许多格栅,放在探头光检测器的前方,以滤除不从检测器前方位置射出的倾斜光线。如果探头移离,则发光器不可能还保持在光检测器的前方。如果发光器和光检测器没有正确地对准,则在脉冲血氧计的有效工作范围内光检测器将不产生信号。这种格删可以防止倾斜一定角度的光达到光检测器,防止产生可能由脉冲血氧计解释为生理信号的假信号。因此脉冲血氧计可以确定:当光检测器不产生有效信号时探头便移离。另外,因为倾斜光不能达到光检测器而产生表观有效信号,所以可以避免发生探头移离状态。
附图简要说明
下面说明附图,在所有附图中,相同的参考编号代表相应的部件。
图1是脉冲血氧计系统一个实施例的示意图;
图2A~B示出光学探头以及固定在成年病人指尖上的光学探头;
图3A是本发明一个实施例的脉冲血氧计系统的示意图,该系统中装有接触病人皮肤的电触头;
图3B是透视图,示出装有接触病人皮肤的电触头的光学探头;
图3C是脉冲血氧计系统一个实施例的示意图,该系统装有接触病人皮肤的电触头;
图3D是脉冲血氧计系统优选实施例的示意图,该系统装有许多接触病皮肤的电触头;
图3E是一般化的示意图,示出在脉冲血氧计探头上装有另一实施例电触头的脉冲血氧计;
图3F是透视图,示出装有图3E实施例的光学探头;
图3G是脉冲血氧计系统一般化示意图,该系统装有本发明另一
实施例的传感器;
图3H是透视图,示出装有图3G接触传感器的光学探头;
图4示出未固定的探头;
图5A示出一种探头,其中在检测器组件的前方配置许多格栅;
图5B示出正确固定的探头,其中在检测器组件的前方放置许多格栅;
图5C是探头优选实施例的顶视平面图,该探头中在检测器组件的前面配置许多格栅;
图6是用于检测探头移离的方法的流程图。
优选实施例的详细说明
为计算末稍动脉氧饱和度Sp2O2,血液测量法依靠氧化血红素HbO2和去氧化血红素Hb的不同光吸收。可在探头的红光波长和红外光波长处测量这种有差别的吸收。另外,脉冲血氧测量法依赖动脉血的脉动特性来区分血红素吸收和周围组织中其它组分的吸收。由于在末稍组织部位流入和流出动脉的血液其体积变化,所以在收缩期和舒张期之间的光吸收是变化的。组织部位可能包括皮肤、肌肉、骨头、静脉血、脂肪、色素等,其中每一个均吸收光。血氧饱和度测量是基于受检红光信号和红外光信号的随时变化部分或交流部分与随时间不变部分或直流部分之比。AC/DC比可归一化信号,可解释通过受测组织的光程长度中发生变化的原因。
图1中重新示意示出转让给本发明受让人并作为参考文献包含在本文中的美国专利5 758 644(简称为’644专利)所公开一个实施例的脉冲血氧计系统100。该系统100包括脉冲血氧计140,该血氧计通过连接件142连接于探头110。探头110包括第一LED(发光二极管)112、第二LED 114和光检测器116。第一和第二LED 112和114背对背连接,共用电线118。光检测器116具有自己的电连接线122。LED 112、114及光检测器116中各个的输出均连接于共同的接地线130。两个LED 112和114最好作成可以产生不同的光波长,这些光穿过病人肌肉,由光检测器116检测。血氧计140可选择LED,使其可通过将正电压或负电压加在连线118上而被驱动。编码电阻器132的电阻可由脉冲血氧计140测量,以确定探头110的具体特性。编码电阻器132与第一LED 112或第二LED 114并联。电阻器可用来指示第一和第二LED 112、114的工作波长,或指示探头的类型。为读出编码电阻器132的电阻,脉冲血氧计140驱动第一LED 112/编码电阻器132联合电路,驱动电流低到LED只流过无意义的电流。在此电流强度下,所有电流基本上都流过编码电阻132,因此脉冲血氧计140可以根据欧姆定律确定电阻器的电阻。使编码电阻器132与LED 112、114中的一个LED并联可以省去将脉冲血氧计140连接于探头110的附加导线的增加费用。
在转让给本申请受让人的并作为参考文献本文中引用的美国专利5 782 757公开一种与脉冲血氧测量系统联用的一次性探头的一个实施例。图2A~B示出光学探头202以及该光学探头202在成年病人指尖上的固定。一次性光学探头202被设计可成舒适地贴在病人指尖上。如图2A所示,探头202包括中央部分204、一对伸出中部分204的粘接片205、位于粘接片205之间的连接部分210以及一对从中央部分伸出的较小的粘接条215,该粘接条位于光学探头202的与连接片210相对的端部。探头202还包括带有许多发光器(例如发光二极管)的发射孔220以及检测器孔230,前者配置在中央部分204内,靠近连接部分210,后者使得光可以通到检测器组件235。图2A用虚线示出成年人手指尖250,例示出在使用中将探头202固定在手指尖250上时指尖250所放的位置。虽然在图2A~2B中未具体示出,但探头202通常用多层材料构成。
图2B例示出固定在指尖250上的探头202。如图2B所示,探头202可折叠到与指尖的所述端部贴合。粘接片205向下折叠(以图2B作例)绕在指尖250上,而粘接条215则向上折叠(以图2B作例)绕在指尖250的外周上,以提供支承。如图2B所示,当绕指尖250折叠探头202时,装在探头上的发光器便与检测器组件235间隔开,并对着该组件,使得发光器发出的光可以穿过发射孔220,然后通过手指,经检测器孔230入射在检测器组件235上。
图2B示出接收连接部分260,该部分与连接器210上的触头252接触,以便在光学探头202和脉冲血氧计140之间提供电连接。一当光学探头牢固固定于指尖250和连接器210在光学探头和数字处理电路之间形成电连接时,信号便由检测器235检测,并经连接器26传送到处理电路。
当光学探头局部或完全移离病人时便发生探头移离状态,但在脉冲血氧计工作范围内仍可继续检测AC信号。这种探头移离事故是很严重的,因为当探头事实上未正确固定于病人身上时脉冲血氧计仍能显示正常的饱和度,很可能造成未看到饱和度降低的事件。不能检测探头移离状态是探头检测器直接接收发光器的光而没接收透过人体组织的透射光造成的结果。
如图3A所示,本发明一个方面涉及一种光学探头202,这种探头上装有许多在正确固定探头时可接触病人皮肤的电触头341和342。为检测探头的移离状态,脉冲血氧计140的探头移离检测组件138周期性将电压加在触头341和342之间,或使其间流过电流。非零电流表示病人皮肤344已接通触头341和342之间的电路,并且探头202已正确固定。如果探头移离,则病人皮肤不再接触触头341和342,造成断路。
图3B示出光学探头202的一个优选实施例,该探头含有本发明的一个实施例。本实施例将第一电触头341和第二电触头342装在探头202中央部分204的表面306上。电触头341和342配置的位置使得在正确固定探头202时可确保触头接触病人的皮肤或肌肉部分。在例示实施例中,触头341和342靠近检测孔203。在另一实施例中,触头位于检测孔203的相对两侧。光学探头202还具有发射孔220,LED发射的至少两波长的光穿过该孔。
如图3C示意图所示,图1的脉冲血氧计系统100被改型为含有本发明的第一方面,方法是将附加导线342从连接器142接到探头202。附加导线连接于触头341,而第二触头342连接到共用地线130。
图3D示意示出本发明的另一实施例。触头341和342串联在编码电阻器132的电路内。当病人皮肤344接触触头341和342时,经编码电阻器132的电路将闭合;当病人皮肤344不接触触头341和342时,经编码电阻器132和电路将断开。皮肤344在触头341和342之间具有确定电阻,这将影响编码电阻器的测量电阻值。当触头341和342与编码电阻器132串联时,触头341和342之间的电阻在脉冲血氧计140测量编码电阻器132的电阻时便要加在编码电阻器132的电阻上。然而,如果选择编码电阻器132的电阻值,使其远大于触头341和342之间病人皮肤344的电阻,则皮肤344的电阻在测量编码电阻器132的电阻时实际上可以忽略。或者,编码电阻器的合格的电阻可以表示为一个范围,该范围包括电路中可能加上的皮肤的电阻。在此种结构中,脉冲血氧计140的探头移离检测组件138可以证明光学探头202是正确固定的,同时可以检查编码电阻器132的电阻。断路表示探头已移离,而测到编码电阻器132的有效电阻则表明探头202是正确固定的。如果探头移离,则脉冲血氧计140可使警铃发声或显示警告信息,或用两种方式报警。
脉冲血氧计140操作在最高灵敏度时特别容出现探头移离差错,此时从发光器直接检测到的光中即使引发相当小的变化,这种变化也具有足够强度而可处理为生理信号。在探头移离状态下,稍为改变发光器和检测器之间的直线光路也能引发检测器的交流信号。例如病人的稍为运动如呼吸的胸部运动也可能引起探头移离的交流信号。另一个例子是,探头构件的“蠕动”例如折叠的探头在移离后逐渐回到原来不折叠形状也可能引起探头脱开的交流信号。
图3E和3F示出本发明的一般化实施例,该实施例的特征与图3A和3B中所述特征相同,只是电触头341和342由接触传感器343取代。电触头341和342在涉及皮肤时是接触传感器343的特殊情况,接触传感器343还包括压电传感器、导电接触传感器,或其它可以检测组织体接触的其它任何接触传感器。
图3G和3H示出图3A和3B电接触型接触传感器的再一实施例。图3G示出示意形式,具有脉冲血氧计140及探头移离检测组件。图3H是透视图,示出具有光发射器和至少一个检测器的光学脉冲血氧计探头。然而在此实施例中,电触头341A和电触头342配置成彼此相对。电触头341A靠近发射孔220,使其接触靠近发光器220的那部分组织体。电触头342靠近检测孔203。同样可以配置其它的接触传感器,一个靠近发射孔220,而另一个靠近检测孔203。
在一个实施例中电触头341、342、341A是金属的。在另一实施例中,这些触头包括导电粘接剂或凝胶型触头。
图4示出已经松开的探头202。示出探头202处于局部未折叠形状,形成从发射孔220到检测组件235的倾斜路径。当病人活动时或当探头202松开时,沿倾斜光路410传播的光线可产生能够由脉冲血氧计140解释为生理信号的交流信号。
如图5A的横截面图所示,按照本发明的第二方面,在检测孔203内的检测组件235的前方配置许多格栅502。该格栅502阻挡沿倾斜路径410传播的光线(即不起源于检测组件235前方的光线)。如图5B所示,如果正确固定探头,则发射孔220便正好位于检测组件235的前方,光线将沿直接路径510直接射过格栅。
图5C是平面图,示出本发明这方面的优选实施例。检测孔203形成在塑料片上,该片上具有可使格栅502横过检测器孔203固定就位的槽口506。在此方面的优选实施例中,格栅可用市售的“3M LightControl Film”膜制作。
本方面的格栅502还对血氧计140提供一种单独的或改进的方法,在此种方法中通过监测光检测器116产生的信号便可确定何时探头发生移离。如果探头202未正确固定,则发射孔可能移离其位于检测组件235正上方的正确位置,这样形成的任何倾斜光可由格栅502挡住。由于没有光射到检测器组件235,所以检测器不产生信号。脉冲血氧计140的探头移离检测器138可以检测到信号的消失并发声报警。格栅502还有利地阻挡倾斜光,这种倾斜光可能产生由脉冲血氧计140解释为生理信号的假信号,因此格栅502可以减小或消除可能发生的探头移离。可以单独使用格栅或与本文所述的触头联用。
图6示出方法的一个实施例600,利用该方法,血氧计140可以检测探头移离或探头移离状态。在程序步604,探头移离检测器138检查皮肤触头341和342之间的连接性。如果在程序步608查出触头341和342之间是连接的,则血氧计通过控制进入步骤612。另一方面,如果在步骤608查出不存在连接性,则血氧计140通过控制进到程序步620。在程序步620血氧计140发声报警,提醒必须注意的情况。在程序步612血氧计140检查光检测器产生的有效交流信号。如果在步骤616查出信号是有效的,则血氧计140通过控制回到步骤604,再开始循环。另一方面,如果在程序步616查出交流信号是无效的,则血氧计在程度步620发声报警。因此,脉冲血氧计可检查和检测探头的移离和探头移离状态。
尽管已说明和在附图中例示出本发明的某些优选实施例,但应当明白,这些实施例只是例示性的,不对本发明的广泛性有任何限制。另外,还应当明白,本发明不限于所说明和所示的具体结构和配置,因为可以进行各种改变或变型而不超出的所申请保护的本发明精神和范围。本发明的范围不受上述详细说明的限制,而只受所附权利要求书的限制。
Claims (13)
1.一种光学探头,用于非侵害测定介体的特性,包括:
—探头表示,该表面成形为在正确固定探头时可以接触介体的表面;
—发射光辐射的发光器;
—检测器,检测由发光器发射的并由介体衰减的光辐射;
—接触检测器,位于至少一个探头表面上,可响应该介质和上述探头表面之间的接触。
2.如权利要求1所述的光学探头,其特征在于,上述接触检测器包括至少两个电触头。
3.如权利要求2所述的光学探头,其特征在于,上述电触头配置在上述发光器的发射孔和上述检测器的检测孔的附近。
4.如权利要求2所述的光学探头,还包括连接于上述光学探头的血氧测量系统,上述血氧测量系统具有探头移离检测组件,上述探头移离检测组件可响应除了跨越该至少两个电触头的开路状态之外的状态,以确定光学探头固定于介体。
5.如权利要求2所述的光学探头,其特征在于,上述探头移离检测组件可响应跨越至少两个电触头的开路状态,以确定探头未固定导电介体。
6.一种脉冲血氧测定探头,包括:
—可弯曲的探头主体,该主体作成在探头正确固定于病人身上时可接触病人肢体相对的表面皮肤;
—发光二极管,装在探头主体上,其中发光二极管作成可使光透过病人的肌肉;
—光检测器,装在探头主体内,其中光检测器还作成可以检测由发光二极管发射的透过病人细胞组织的光;
至少一个格栅,配置在光检测器的前方,其中格栅被作成可以滤除不来自光检测器前方位置的光。
7.一种脉冲血氧测定探头,包括:
—探头表面,该表面成形为在正确固定探头时可接触病人细胞组织的表面;
—发光二极管;
—光检测器,作成为可以检测由发光二极管发射的并由人体组织衰减的光;
一个在探头表面上的接触检测器,该接触检测器被成形为在探头正确接触人体细胞组织时可接触人体细胞组织,上述接触检测器作成可连接于血氧计。
8.如权利要求7所述的脉冲血氧测定探头,其特征在于,上述接触检测器包括至少两个电触头。
9.如权利要求8所述的采用脉冲血氧测定探头的脉冲血氧计,还包括探头移离检测组件,该组件可响应跨越上述两个探头表面上的至少两个电触头的开路状态而指示脉冲血氧测量探头没有正确定位在病人细胞组织上。
10.如权利要求7所述的采用脉冲血氧测定探头的脉冲血氧计,还包括探头移离检测组件,该组件可响应上述接触检测器,以确定上述探头是否正确固定在病人细胞组织上。
11.一种验证光学探头正确固定在病人身上的方法,该方法包括:
提供光学探头,该光学探头具有至少两个触头,该触头成形为在正确固定探头时可接触病人皮肤;
将电压施加在触头之间;
根据触头之间的电流确定触头是否接触病人皮肤。
12.一种检测脉冲血氧测定探头未正确固定于组织部位的方法,该方法包括:
提供脉冲血氧测定探头,该探头具有发光器、光检测器和至少两个触头,该光检测器成形为在正确固定探头时可以检测发光器发射的光,该触头作成为在正确固定探头时可以接触病人皮肤;
使发光器发射光;
检查触头之间的连接性;
检查光检测器信号的有效性;
根据连接性检查和信号有效性检查确定是否正确固定脉冲血氧测定探头。
13.一种脉冲血氧测定系统,包括:
一个脉冲血氧测定基本单元;
一个光学探头,作成为可以固定在病人的肢体上;
定位于上述光学探头上的至少两个电触头,该电触头作成为在探头正确固定于病人时可以接触病人皮肤;
探头移离检测组件,该组件作成为可以检查电触头之间的合格的连接,因此,探头移离检测器可以确定探头是否正确固定于病人。
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JP2003502089A (ja) | 2003-01-21 |
CA2382319A1 (en) | 2003-05-09 |
US20030139656A1 (en) | 2003-07-24 |
EP1199977A2 (en) | 2002-05-02 |
WO2000078209A3 (en) | 2001-04-19 |
US6771994B2 (en) | 2004-08-03 |
WO2000078209A2 (en) | 2000-12-28 |
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