CN105411560B - The adaptive biological feedback system of anal intestine, its pressure catheter and its System Utilization Procedure - Google Patents
The adaptive biological feedback system of anal intestine, its pressure catheter and its System Utilization Procedure Download PDFInfo
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- CN105411560B CN105411560B CN201410487174.5A CN201410487174A CN105411560B CN 105411560 B CN105411560 B CN 105411560B CN 201410487174 A CN201410487174 A CN 201410487174A CN 105411560 B CN105411560 B CN 105411560B
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Abstract
The invention discloses the adaptive biological feedback system of anal intestine, its pressure catheter and its System Utilization Procedures.Wherein pressure catheter includes the multiple sensor connectors and intraluminal catheter positioned at head；Multiple conduit apopores are provided on the intraluminal catheter, intraluminal catheter is internally provided with a plurality of water route；Each conduit apopore is connected by a water route with a sensor connector respectively.The pressure catheter of the present invention, to Anorectal manometry, can directly reflect anorectal movement by pressoreceptor, while can be that adaptive reponse system quantitative is analyzed, and be conducive to patient and more clearly understand that the defecation of oneself acts and adjusts and correct in time.
Description
Technical field
The present invention relates to a kind of adaptive biological feedback system of anal intestine for chronic functional constipation, its pressure catheter and
Its System Utilization Procedure.
Background technology
Constipation is a kind of common symptom of digestive tract, and with speeding for current people's rhythm of life, living standard is continuously improved,
Constipation number is also being continuously increased, and its incidence gradually increases, and especially constipation by outlet obstruction is to cause functional consitipation
Most important reason and a kind of common disease, it has also become influence modern life quality an important factor for one of.The disease is sent out
Sick rate is high, is felt not to the utmost with difficult defecation, defecation, is tenesmus, be hard and dry or not dry also difficult discharge is primary symptom, treatment is rather
It is intractable.Although constipation seldom directly results in hospital or dead, due to the long-term difficult defecation of patients with chronic constipation, many patients are not
Drug defecation must not depended on.This not only has side effects of pharmaceutical drugs, must bear affliction for a long time, greatly affected the work of patient
And life.
Biofeedback therapy is a kind of emerging biobehavioral therapy, and principle is to utilize biofeedback mechanism, is answered
It is pocessed, amplified with special equipment acquisition patient's own physiological action message, vision or audible signal known to people are aobvious
Show, patient is allowed to adjust physiological activity according to the own physiological action message that it is observed.It utilizes modern physiological scientific instrument, leads to
Itself feedback of remarkable body physiological or pathological information, the coordination of the Pelvic floor tension of relaxation spasm, adjustment Pelvic floor defecation are made
With elimination pathologic process keeps patient physically and mentally healthy.Emerging biofeedback therapy have simplicity, Noninvasive, it is without side-effects,
It easily endures, the advantages that medical expense is low, treat-and-release.
Although biofeedback therapy at home and abroad has been carried out the research of many decades and as functional abnormal defecation
Effective therapy, but be applied to clinical bio-feedback therapeutic apparatus at present and have the following problems：
1) training objective value is fixed, and cannot adjust training objective, patient according to the base case of patient and status quo of training
It is easy fatigue or loses the confidence, compliance is poor, influences to train effect；
2) feedback information is in the form of a single, and picture is stiff, cannot vivo react the training result of patient；
3) only have qualitative analysis, no quantitative display, feedback training result that cannot be intuitively；
4) electromyography signal used can only reflect anorectal movement indirectly.
Invention content
The first purpose of the invention is to provide the pressure measurement for the adaptive reponse system of anal intestine in a kind of merging enteric cavity
Conduit.
Realize that the technical solution of first purpose of the invention is a kind of pressure catheter of the adaptive reponse system of anal intestine, it is described
Pressure catheter includes the multiple sensor connectors and intraluminal catheter positioned at head；Multiple conduits are provided on the intraluminal catheter to go out
Water hole, intraluminal catheter are internally provided with a plurality of water route；Each conduit apopore passes through a water route and a sensor connector respectively
It is connected.
Second object of the present invention be to provide it is a kind of it is effective, quantitative analysis, dramatic anal intestine is adaptively anti-
Feedback system.
Realize that the technical solution of second purpose of the invention is a kind of adaptive reponse system of anal intestine, including pressure catheter,
Automatic constant pressure controller, multi-channel amplifier, water tank, pressure sensor, main frame and display；The pressure catheter is adopted
The structure described in claim 1, and connect one by one with multiple pressure sensors by sensor connector；The automatic constant pressure control
Device controls water tank and water is injected pressure catheter via multiple pressure sensors at constant pressure；The water inlet end of the pressure sensor is set
There is inlet valve；The multi-channel amplifier is electrically connected with each pressure sensor and its inlet valve, and voltage-controlled with automatic constant
Device communication connection processed；The multi-channel amplifier and display are electrically connected with main frame.
The multi-channel amplifier includes usb circuit, sensor signal amplifying circuit, water valve control circuit and first
Serial communication circuit；The sensor signal amplifying circuit, water valve control circuit and first serial communicating circuit are and USB interface
The two-way electrical connection of circuit；The usb circuit with main frame is two-way is electrically connected；The sensor signal amplifying circuit with
Pressure sensor is electrically connected；The water valve control circuit is electrically connected with the inlet valve of pressure sensor；The first serial is logical
Circuit is interrogated to connect with automatic constant pressure controller communication.
The automatic constant pressure controller includes the of second serial communicating circuit, air pump and air accumulator and multi-channel amplifier
The communication connection of one serial communication circuit, and be electrically connected with air pump；The air pump, air accumulator are sequentially communicated, and the air pump makes
Air accumulator maintains constant pressure.
The adaptive reponse system of anal intestine further includes computer-aided equipment；The computer-aided equipment and main frame
Electrical connection.
Third purpose of the present invention, which is to provide, a kind of can give quantitative analysis, the adaptive reponse system of incremental anal intestine
Application method.
Realize that the technical solution of third purpose of the present invention is the application method of the adaptive reponse system of anal intestine, including with
Lower step：
Step 1：The intraluminal catheter of pressure catheter is placed in patient anus, by sensor connector and pressure sensor one
One connection, opens the adaptive reponse system of anal intestine；Patient does defecation action, obtains the abdominal pressure value P of patient1, sphincter pressure
Force value S1With single toilet training time T1；Specifically, be spaced 20 seconds sampling three times defecation when abdominal pressure value, sphincter
Pressure value and single toilet training time calculate the abdominal pressure average value of defecation, sphincter pressure average value and single three times
Toilet training average time does defecation action as patient, obtains the abdominal pressure value P of patient1, sphincter pressure value S1And list
Secondary toilet training time T1And it preserves.
Step 2：Carry out adaptive training：Frequency of training is set, patient arranges in each training according to the prompt of system
Just it acts, to the abdominal pressure value of the patient obtained every time, sphincter pressure value and single toilet training time and this time training
Required value be compared, score ratio as system, when frequency of training reaches the frequency of training of setting, terminate.
The specific method of the step 2 is：
A, setting frequency of training N, 10≤N≤35, N is natural number；
B, abdominal pressure training standard value M is chosen according to patient age, gender, male's M values are 30mmHg, and women M values are
25mmHg；It is 50mmHg (male) or 40mmHg (women) that sphincters contract, which presses training standard value L,；The single toilet training time marks
Quasi- value is 12s；
C, by the abdominal pressure value P of step 11, sphincter pressure value S1With single toilet training time T1It is trained with abdominal pressure
Standard value M, sphincters contract pressure training standard value L and single motion training time standard value K are compared, to determine that system is wanted
Abdominal pressure value reference point P, sphincter pressure reference point S when patient being asked to be trained next time and single toilet training time ginseng
According to value T；
D, joined according to abdominal pressure value reference point P, the sphincter pressure reference point S of step C and single toilet training time
According to value T, patient continues to train, and patient abdomen pressure value, sphincter pressure value and the single defecation in this time training are instructed
The white silk time is recorded as new P1、S1And T1；, by it and abdominal pressure value reference point P, sphincter pressure reference point S and single defecation
Training time, reference point T was compared, abdominal pressure scoring C1=P1/P；Sphincter pressure scoring C2=S1/S；It is scored according to two,
Determine abdominal pressure value reference point P, sphincter pressure reference point S and the single defecation when system requirements patient is trained next time
Training time reference point T；It is so recycled, until frequency of training reaches the frequency of training N of setting, training terminates.
In C steps in the step 2, abdominal pressure value reference when system requirements patient is trained next time is determined
The specific method of value P, sphincter pressure reference point S and single toilet training time reference point T is：
If P1>M, then P=M；If P1<M judges P1With the comparison result of M/2, if P1<M/2, then P=M/2, if P1>
M/2, then P=P1；
If T1>12, then T=12；If T1<12, judge T1With 10 comparison result, if T1<10, then T=10, if T1>
10, then T=T1；
If S1>10, then S=10；If S1<10, judge S1With 0 comparison result, if S1<0, then S=10, if S1>0,
Then S=S1。
In D steps in step 2, determine abdominal pressure value reference point P when system requirements patient is trained next time,
The specific method of sphincter pressure reference point S and single toilet training time reference point T is：
If C1>0.75, then P=P × 1.2, T=T × 1.2；If C1<0.75, judge C1With 0.5 comparison result, if
C1<0.5, then P=P1, T=T1；If C1>0.5, then P=P × 0.8, T=T × 0.8；
If C2>0.75, then S=S1×0.75；If C2<0.75, judge C2With 0.5 comparison result, if C2<0.5, then
S=S1；If C2>0.5, then S=S × 1.2.
The adaptive reponse system of anal intestine is by display with the side of word and/or figure and/or video and/or voice
Formula feedback training process.
After using above-mentioned technical proposal, the present invention has advantageous effect below：
(1) pressure catheter of the invention can directly reflect anorectal by pressoreceptor to Anorectal manometry
Movement, while can be that adaptive reponse system quantitative is analyzed, be conducive to patient and more clearly understand that the defecation of oneself is dynamic
Make and adjusts and correct in time.
(2) method of the invention is shown in defecation process by Anorectal manometry on the display screen of system in real time
Pressure change allows patient intuitively to see whether muscle coordination closes when oneself defecation from display screen by multimedia
It is suitable, and then adjustment and the action of training defecation and process under physician guidance, it is different to reach the functional defecation for the treatment of by easy stages
Normal purpose.
(3) training objective that the present invention can be according to the basic condition of patient and the setting of each training result next time, instruction
It is flexible to practice method, it is incremental.
(4) present invention includes the form feedback training of figure, sound, word as a result, picture is lively, directly by multimedia
It sees, should be readily appreciated that.
(5) treatment through the invention, can enhance patient treatment confidence, improve treatment acceptance and training it is comfortable
Degree improves curative compliance, can especially be obviously improved the clinical symptoms of functional consitipation or Patients with Fecal Incontinence, improve
Clinical cure rate.
Description of the drawings
In order that the present invention can be more clearly and readily understood, right below according to specific embodiment and in conjunction with attached drawing
The present invention is described in further detail, wherein
Fig. 1 is the structural schematic diagram of the pressure catheter of the present invention.
Fig. 2 is the structure diagram of the reponse system of the present invention.
Fig. 3 is the electric circuit diagram of the reponse system of the present invention.
Fig. 4 is the line map of sensor of the invention signal amplification circuit.
Attached figure label is：
Pressure catheter 1, sensor connector 11, intraluminal catheter 12, conduit apopore 12-1, automatic constant pressure controller 2, second
Serial communication circuit 21, air pump 22, air accumulator 23, multi-channel amplifier 3, usb circuit 31, sensor signal amplifying circuit
32, water valve control circuit 33, first serial communicating circuit 34, water tank 4, pressure sensor 5, main frame 6, display 7, meter
Calculation machine ancillary equipment 8.
Specific implementation mode
(embodiment 1)
See Fig. 1, a kind of pressure catheter of the adaptive reponse system of anal intestine of the present embodiment, it is characterised in that：Pressure catheter 1
Include the multiple sensor connectors 11 and intraluminal catheter 12 positioned at head；Multiple conduit apopores are provided on intraluminal catheter 12
12-1, intraluminal catheter 12 are internally provided with a plurality of water route；Each conduit apopore 12-1 passes through a water route and a sensing respectively
Device connector 11 is connected.Pressure catheter 1 can at most support 24 sensor connectors 11, each sensor connector 11 is used for passing
Defeated test point pressure value.
See Fig. 2, the adaptive reponse system of anal intestine include pressure catheter 1, automatic constant pressure controller 2, multi-channel amplifier 3,
Water tank 4, pressure sensor 5, main frame 6, display 7 and computer-aided equipment 8；Pressure catheter 1 uses claim 1
Structure, and connect one by one with multiple pressure sensors 5 by sensor connector 11；Automatic constant pressure controller 2 controls water tank 4 in perseverance
Water is injected pressure catheter 1 by pressure via multiple pressure sensors 5；The water inlet end of pressure sensor 5 is equipped with inlet valve 51；It is more
Channel amplifier 3 is electrically connected with each pressure sensor 5 and its inlet valve 51, and is communicated and connected with automatic constant pressure controller 2；
Multi-channel amplifier 3 and display 7 are electrically connected with main frame 6.Computer-aided equipment 8 is electrically connected with main frame 6
It connects.Computer-aided equipment 8 can be printer, sound equipment etc..
See that Fig. 3, system use 220VAC mains-supplieds, the power supply state of whole system is controlled by power switch, by 12V
Switching Power Supply is depressured, and low-voltage DC is provided to multi-channel amplifier 3 and automatic constant pressure controller 2；Multi-channel amplifier 3
Including usb circuit 31, sensor signal amplifying circuit 32, water valve control circuit 33 and first serial communicating circuit 34；It passes
Sensor signal amplifying circuit 32, water valve control circuit 33 and first serial communicating circuit 34 with 31 two-way electricity of usb circuit
Connection；Usb circuit 31 with main frame 6 is two-way is electrically connected；Sensor signal amplifying circuit 32 and 5 electricity of pressure sensor
Connection；Water valve control circuit 33 is electrically connected with the inlet valve 51 of pressure sensor 5；First serial communicating circuit 34 and automatic constant
The communication connection of pressure controller 2.Automatic constant pressure controller 2 includes second serial communicating circuit 21, air pump 22 and air accumulator 23；Second
Serial communication circuit 21 and the communication of first serial communicating circuit 34 of multi-channel amplifier 3 connect, and are electrically connected with air pump 22；Gas
Pump 22, air accumulator 23, water tank 4 are sequentially communicated, and air pump 22 makes air accumulator 23 and water tank 4 maintain constant pressure.
See that Fig. 4, pressure sensor are connect by J1 interfaces with amplifier；Amplifier is by TLC274I four high guaily unit integrated circuits
Match corresponding resistance capacitance composition；Pressure sensor signal by amplification is connected by output interface OUTAD and rear class MCU
It connects.
Pressure catheter 1 is placed in patient's inner body, and each conduit apopore 12-1 is hindered by patient's body portion on pressure catheter 1, from
And pressure change occurs for each pressure sensor 5 for connecting pressure catheter 1, and simulated pressure signal is transmitted to sensor signal and is put
Big circuit 32, sensor signal amplifying circuit 32 send digital signal to main frame 6 by processing such as analog-to-digital conversions,
Processed data are passed through display 7 and computer-aided equipment 8 by main frame 6 according to adaptive biofeedback algorithm
The equipment of sound equipment etc sends patient to.
Each pressure sensing point 11 on pressure catheter 1 is placed in patient's inner body abdomen or sphincter respectively first.P1、
T1, S1 indicate respective abdominal pressure value, sphincter pressure value, the single training time value that current training patient is reached, P, T, S
Indicate the reference point that system requirements patient is trained next time.Abdominal pressure is instructed after C1, C2 respectively often carry out a toilet training
Practice scoring and sphincter training scoring.The adaptive reponse system of anal intestine is by display 7 with word and/or figure and/or video
And/or the mode feedback training process of voice.
Step 1：The intraluminal catheter 12 of pressure catheter 1 is placed in patient anus, by sensor connector 11 and pressure sensing
Device 5 connects one by one, opens the adaptive reponse system of anal intestine；Patient does defecation action, is spaced abdomen when sampling defecation three times for 20 seconds
Portion's pressure value, sphincter pressure value and single toilet training time calculate the abdominal pressure average value of defecation, sphincter pressure three times
Power average value and single toilet training average time, defecation action is done as patient, obtains the abdominal pressure value P of patient1, include about
Flesh pressure value S1With single toilet training time T1And it preserves.
Step 2：Carry out adaptive training：Frequency of training is set, patient arranges in each training according to the prompt of system
Just it acts, to the abdominal pressure value of the patient obtained every time, sphincter pressure value and single toilet training time and this time training
Required value be compared, using ratio as system score.
The specific method of step 2 is：
A, setting frequency of training N, 10≤N≤35, N is natural number；
B, abdominal pressure training standard value M is chosen according to patient age, gender, male's M values are 30mmHg, and women M values are
25mmHg；It is 10mmHg that sphincters contract, which presses training standard value,；Single toilet training time standard value is 12s；
C, by the abdominal pressure value P of step 11, sphincter pressure value S1With single toilet training time T1It is trained with abdominal pressure
Standard value M, sphincters contract pressure training standard value L and single motion training time standard value K are compared, to determine that system is wanted
Abdominal pressure value reference point P, sphincter pressure reference point S when patient being asked to be trained next time and single toilet training time ginseng
According to value T；
Determine abdominal pressure value reference point P, sphincter pressure reference point S when system requirements patient is trained next time and
The single toilet training time specific method of reference point T is：
If P1>M, then P=M；If P1<M judges P1With the comparison result of M/2, if P1<M/2, then P=M/2, if P1>
M/2, then P=P1；
If T1>12, then T=12；If T1<12, judge T1With 10 comparison result, if T1<10, then T=10, if T1>
10, then T=T1；
If S1>10, then S=10；If S1<10, judge S1With 0 comparison result, if S1<0, then S=10, if S1>0,
Then S=S1。
D, joined according to abdominal pressure value reference point P, the sphincter pressure reference point S of step C and single toilet training time
According to value T, patient continues to train, and patient abdomen pressure value, sphincter pressure value and the single defecation in this time training are instructed
The white silk time is recorded as new P1、S1And T1；, by it and abdominal pressure value reference point P, sphincter pressure reference point S and single defecation
Training time, reference point T was compared, abdominal pressure scoring C1=P1/P；Sphincter pressure scoring C2=S1/S；It is scored according to two,
Determine abdominal pressure value reference point P, sphincter pressure reference point S and the single defecation when system requirements patient is trained next time
Training time reference point T；It is so recycled, until frequency of training reaches the frequency of training N of setting, training terminates.
Determine abdominal pressure value reference point P, sphincter pressure reference point S when system requirements patient is trained next time and
The single toilet training time specific method of reference point T is：
If C1>0.75, then P=P × 1.2, T=T × 1.2；If C1<0.75, judge C1With 0.5 comparison result, if
C1<0.5, then P=P1, T=T1；If C1>0.5, then P=P × 0.8, T=T × 0.8；
If C2>0.75, then S=S1×0.75；If C2<0.75, judge C2With 0.5 comparison result, if C2<0.5, then
S=S1；If C2>0.5, then S=S × 1.2.
(application examples)
Patient takes lateral position, and the intraluminal catheter 12 of pressure catheter 1 is inserted into anal canal and is fixed at maximum pressure.Advise trouble
Person does defecation action, multimedia display anal orifice and rectal intestine pressure, and detection abdomen is exerted oneself and the harmony of sphincter relaxation and in doctor
Pressure curve is set not rise or fall when allowing patient to try defecation under guidance, Pelvic floor is loosened in therefrom study, corrects defecation action,
Repetition training anal canal pressure when defecation declines.Treatment about needs 45min every time, carries out 20-35 toilet training, weekly treatment
2-3 times.10 times as a treatment course.
42 clinical diagnosises are that Treatment of Outlet Obstruction Type Constipation patient enters group, are randomly assigned, by the adaptive biofeedback of surrounding
Treatment or fixed type biological feedback treating, as a result show：1. compared with fixed type biological feedback treating, adaptive biofeedback
Treatment can be relieved the constipation symptom of patient, including increase times of defecation (P weekly<0.01) defecation time (P, is reduced<
0.0001), alleviate the defecation degree (P that exerts oneself<0.0001), abdominal distension (P<0.001), stool feels (P not to the utmost<0.01) and stool is urgent
Feel (p=0.0008)；2. compared with fixed type biological feedback treating, adaptive biofeedback therapy significantly reduces clinical medicine use
It measures (P=0.006)；3. using after adaptive biofeedback therapy, anus rectal motility is significantly improved, including reduces contradiction
Shrink (P<0.0001) rectal pressure (P=0.07), is improved, rectal and anal sphincter reflexes are reduced, is controlled with fixed type biological feedback
Treatment is compared, and contradiction contraction ratio is substantially reduced (P<0.0001)；4. adaptive biofeedback therapy reduces expansion rectum and causes
Awareness of defecation threshold value, especially just feel (P<0.03) and distress feels (P<0.04), hence it is evident that be better than fixed type biological feedback treating (P<
0.05).Therefore, adaptive biofeedback therapy can be obviously improved the clinical symptoms of Treatment of Outlet Obstruction Type Constipation, improve clinical cure
Rate improves anus rectal motility, especially contradiction contraction and rectal sensation, and therapeutic effect is fed back better than fixed type biological.
Particular embodiments described above has carried out further in detail the purpose of the present invention, technical solution and advantageous effect
It describes in detail bright, it should be understood that the above is only a specific embodiment of the present invention, is not intended to restrict the invention, it is all
Within the spirit and principles in the present invention, any modification, equivalent substitution, improvement and etc. done should be included in the guarantor of the present invention
Within the scope of shield.
Claims (2)
1. a kind of adaptive reponse system of anal intestine, it is characterised in that：Including pressure catheter (1), automatic constant pressure controller (2), more
Channel amplifier (3), water tank (4), pressure sensor (5), main frame (6) and display (7)；The pressure catheter (1)
Include the multiple sensor connectors (11) and intraluminal catheter (12) positioned at head；It is provided with multiple lead on the intraluminal catheter (12)
Pipe apopore (12-1), intraluminal catheter (12) are internally provided with a plurality of water route；Each conduit apopore (12-1) passes through one respectively
Water route is connected with a sensor connector (11), and is connect one by one with multiple pressure sensors (5) by sensor connector (11)；
Water is injected pressure catheter by automatic constant pressure controller (2) the control water tank (4) via multiple pressure sensors (5) at constant pressure
(1)；The water inlet end of the pressure sensor (5) is equipped with inlet valve (51)；The multi-channel amplifier (3) passes with each pressure
Sensor (5) and its inlet valve (51) electrical connection, and communicate and connect with automatic constant pressure controller (2)；The multi-channel amplifier
(3) it is electrically connected with main frame (6) with display (7)；The automatic constant pressure controller (2) includes second serial communication electricity
Road (21), air pump (22) and air accumulator (23)；First string of the second serial communicating circuit (21) and multi-channel amplifier (3)
Mouth communicating circuit (34) communicates connection, and is electrically connected with air pump (22)；The air pump (22), air accumulator (23), water tank (4) are successively
Connection, and the air pump (22) makes air accumulator (23) and water tank (4) maintain constant pressure；Multi-channel amplifier (3) packet
Include usb circuit (31), sensor signal amplifying circuit (32), water valve control circuit (33) and first serial communicating circuit
(34)；The sensor signal amplifying circuit (32), water valve control circuit (33) and first serial communicating circuit (34) are and USB
Interface circuit (31) two-way electrical connection；The usb circuit (31) with main frame (6) is two-way is electrically connected；The sensing
Device signal amplification circuit (32) is electrically connected with pressure sensor (5)；The water valve control circuit (33) and pressure sensor (5)
Inlet valve (51) is electrically connected；The first serial communicating circuit (34) connects with automatic constant pressure controller (2) communication.
2. the adaptive reponse system of a kind of anal intestine according to claim 1, it is characterised in that：Further include that area of computer aided is set
Standby (8)；The computer-aided equipment (8) is electrically connected with main frame (6).
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| CN105938024A (en) * | 2016-05-30 | 2016-09-14 | 赵飞 | Antiskid type anus temperature measurement apparatus |
| CN112137777B (en) * | 2019-06-26 | 2021-11-16 | 上海交通大学 | External control system of artificial anal sphincter device |
| CN110314345A (en) * | 2019-06-28 | 2019-10-11 | 宁波迈达医疗仪器有限公司 | A kind of biofeedback therapy |
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| CN204105998U (en) * | 2014-09-23 | 2015-01-21 | 宁波迈达医疗仪器有限公司 | Anorectal self adaptation biological feedback system and pressure catheter thereof |
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