JP2003111748A - Swallowing sound obtaining device - Google Patents
Swallowing sound obtaining deviceInfo
- Publication number
- JP2003111748A JP2003111748A JP2001308206A JP2001308206A JP2003111748A JP 2003111748 A JP2003111748 A JP 2003111748A JP 2001308206 A JP2001308206 A JP 2001308206A JP 2001308206 A JP2001308206 A JP 2001308206A JP 2003111748 A JP2003111748 A JP 2003111748A
- Authority
- JP
- Japan
- Prior art keywords
- swallowing
- sound collecting
- swallowing sound
- control circuit
- patient
- Prior art date
- Legal status (The legal status 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 status listed.)
- Pending
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Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B7/00—Instruments for auscultation
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/42—Detecting, measuring or recording for evaluating the gastrointestinal, the endocrine or the exocrine systems
- A61B5/4205—Evaluating swallowing
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- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Medical Informatics (AREA)
- Molecular Biology (AREA)
- Surgery (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Measurement Of The Respiration, Hearing Ability, Form, And Blood Characteristics Of Living Organisms (AREA)
Abstract
Description
【０００１】[0001]
【発明の属する技術分野】本発明は、嚥下（飲み込み）
障害者の診断装置に関し、特に、嚥下障害等の症状の診
断において、嚥下音を採取し、採取された嚥下音を視覚
的・聴覚的に出力する嚥下音採取装置に関する。更に、
嚥下音を採取すると同時に治療やリハビリテーションを
行うための装置を有する嚥下音採取装置に関する。TECHNICAL FIELD The present invention relates to swallowing.
More particularly, the present invention relates to a swallowing sound collecting device that collects swallowing sounds and visually and auditorily outputs the collected swallowing sounds in the diagnosis of symptoms such as dysphagia. Furthermore,
The present invention relates to a swallowing sound collecting apparatus having a device for collecting a swallowing sound and simultaneously performing treatment and rehabilitation.
【０００２】[0002]
【従来の技術】従来、嚥下音は、医者又は看護婦等が聴
診器により聴かれ、その音により嚥下障害の有無の判断
に利用されていた。また、嚥下障害の診断やリハビリテ
ーション効果の診断には、ビデオレントゲンも用いられ
ている。しかし、施設や技術スタッフの不足、造影剤の
選択、撮影のタイミング、患者の負担等、種々の問題が
あり、十分な検査が行えないため、結果的に嚥下障害者
又は嚥下障害の可能性のある者の多くは、誤嚥の可能性
がありながらも放置され、自宅で食事を取らざるを得な
い状況となっている。誤嚥は、一歩間違えると死に直結
する問題であり、嚥下障害者を放置するのは非常に危険
なことである。また、ビデオレントゲンは、Ｘ線による
被爆の問題もあるため、頻繁に使用することができな
い。更に、嚥下障害の治療においては、リハビリテーシ
ョン装置又は訓練器なるものは存在せず、氷や手を用い
たマッサージによって刺激を与えることにより感覚の維
持を行う程度であるのが治療の現状である。2. Description of the Related Art Conventionally, a doctor or a nurse hears a swallowing sound with a stethoscope and uses the sound to judge the presence or absence of dysphagia. Video X-rays are also used to diagnose dysphagia and rehabilitation effects. However, there are various problems such as lack of facilities and technical staff, selection of contrast agents, timing of imaging, burden on patients, etc., and sufficient examination cannot be performed, resulting in the possibility of dysphagia or dysphagia. Many people are left alone despite the possibility of aspiration, and are forced to eat at home. Aspiration is a problem that leads to death if you make a mistake in one step, and it is extremely dangerous to leave a person with dysphagia. In addition, video X-rays cannot be used frequently because of the problem of exposure to X-rays. Furthermore, in the treatment of dysphagia, there is no rehabilitation device or trainer, and the current state of treatment is to maintain the sensation by stimulating with massage using ice or hands.
【０００３】[0003]
【発明が解決しようとする課題】しかしながら、高齢化
が進む中で、退行性変化を基盤とする疾患が増加してお
り、嚥下障害も例外ではなく、嚥下障害者又は嚥下障害
の可能性のある老人は数多く存在するものと考えられ
る。健常とみられる老人の１／３が嚥下障害予備軍では
ないかとも予測される。特別養護老人ホームでは、嚥下
の介助を３０％の者が必要としており、今後の高齢化社
会においては、更に嚥下障害者が増えることが予想され
る。このような現状において、病院はもとより、本人や
訪問看護婦、在宅ヘルパー等が、簡単に嚥下状態を把握
でき、適切に嚥下障害を診断し、患者の嚥下訓練・リハ
ビリテーションにも利用可能な装置が望まれていた。However, as the population ages, the number of diseases based on degenerative changes is increasing, and dysphagia is no exception, and there is a possibility of dysphagia or dysphagia. Many old people are thought to exist. It is also predicted that 1/3 of the healthy elderly may be dysphagia reserves. In nursing homes for the elderly, 30% of people need assistance in swallowing, and it is expected that the number of people with dysphagia will increase in the future aging society. Under these circumstances, not only hospitals, but also patients, visiting nurses, home helpers, etc. can easily grasp the swallowing state, appropriately diagnose dysphagia, and have a device that can be used for swallowing training and rehabilitation of patients. Was wanted.
【０００４】本発明は、斯かる実情に鑑み、医師等だけ
でなく、患者本人でも簡単に嚥下状態を把握でき、しか
も嚥下訓練・リハビリテーションにも応用可能な嚥下音
採取装置を提供しようとするものである。In view of the above situation, the present invention aims to provide a swallowing sound collecting device which can be easily grasped by not only a doctor but also a patient himself / herself and can be applied to swallowing training / rehabilitation. Is.
【０００５】[0005]
【課題を解決するための手段】上述した本発明の目的を
達成するために、本発明による嚥下音採取装置は、患者
の嚥下時の嚥下音を採取するマイク部を含む、患者の嚥
下時の情報を採取する生体情報入力部と、前記生体情報
入力部が接続され、前記生体情報入力部により採取され
た情報を電気信号又は数値情報に変換する制御回路部
と、前記制御回路部に接続され、前記制御回路部により
変換された電気信号又は数値情報を視覚的及び／又は聴
覚的に出力する出力部とからなる。In order to achieve the above-mentioned object of the present invention, a swallowing sound collecting apparatus according to the present invention includes a microphone portion for collecting swallowing sound of a patient during swallowing. A biometric information input unit for collecting information, the biometric information input unit is connected, a control circuit unit for converting the information collected by the biometric information input unit into an electrical signal or numerical information, and connected to the control circuit unit. And an output unit for visually and / or audibly outputting the electric signal or numerical information converted by the control circuit unit.
【０００６】更に、前記制御回路部に接続され、前記制
御回路部により変換された電気信号又は数値情報を記録
する、磁気ディスク装置、光磁気ディスク装置、磁気テ
ープ装置の少なくとも何れか一つを含む記録装置を有す
ることも可能である。Further, at least one of a magnetic disk device, a magneto-optical disk device, and a magnetic tape device, which is connected to the control circuit unit and records the electric signal or numerical information converted by the control circuit unit, is included. It is also possible to have a recording device.
【０００７】更に、前記制御回路部に接続され、前記電
気信号又は数値情報に基づき前記患者の治療を行うため
の、低周波治療器等の治療装置を有しても良い。Further, a treatment device such as a low frequency treatment device for treating the patient based on the electric signal or the numerical information may be provided, which is connected to the control circuit unit.
【０００８】更に、前記制御回路部に接続され、嚥下開
始の合図を送るための信号発生装置を有し、該信号発生
装置から信号が発せられた時間に基づき、患者の嚥下開
始までの反応速度、嚥下開始の正確な時間を測定しても
良い。Further, it has a signal generator connected to the control circuit unit for sending a signal to start swallowing, and based on the time when the signal is emitted from the signal generator, the reaction speed until the patient starts swallowing. Alternatively, the exact time to start swallowing may be measured.
【０００９】なお、信号発生装置は、患者に嚥下を開始
させる合図として、光、音等の信号を発生する装置や患
者が嚥下を開始する合図として、前記制御回路部へ開始
信号を送るためのトリガスイッチであれば良い。The signal generator sends a start signal to the control circuit section as a signal for instructing the patient to start swallowing, as a signal for generating signals such as light and sound, and as a signal for the patient to start swallowing. Any trigger switch will do.
【００１０】制御回路部は、前記電気信号又は数値情報
から、前記嚥下音に対応する嚥下の状態を求め、前記出
力部は、更に、前記制御回路部により求められた前記嚥
下の状態を表示しても良い。The control circuit section obtains the swallowing state corresponding to the swallowing sound from the electric signal or the numerical information, and the output section further displays the swallowing state obtained by the control circuit section. May be.
【００１１】生体情報入力部には、更に、患者の嚥下時
の筋電情報を採取する筋電計、患者の嚥下時の呼吸情報
を採取する呼吸センサ、患者の嚥下時の噛み圧情報及び
／又は吸込圧情報を採取する圧力センサ、患者の嚥下時
のインピーダンス情報を採取する生体インピーダンス測
定装置、患者の嚥下時の透過像情報を採取するビデオレ
ントゲン、患者の嚥下時の磁気共鳴映像を採取するＭＲ
Ｉ装置、患者の嚥下時の外観情報を採取するビデオカメ
ラ等を含めることが可能である。The biometric information input unit further includes an electromyographic device for collecting myoelectric information during swallowing of the patient, a respiratory sensor for collecting respiratory information during swallowing of the patient, biting pressure information during swallowing of the patient, and / or Alternatively, a pressure sensor that collects suction pressure information, a bioimpedance measuring device that collects impedance information when the patient swallows, a video roentgen that collects transmission image information when the patient swallows, and a magnetic resonance image when the patient swallows MR
It is possible to include an I device, a video camera for collecting appearance information of the patient when swallowing, and the like.
【００１２】上記手段によれば、患者自らも簡単に嚥下
状態が視覚的・聴覚的に把握できるので、飲み込みを意
識的に行えるようになり、嚥下訓練等にも効率的に利用
できるという作用が得られる。また、嚥下時の状態をマ
イク以外に種々のセンサで計測することで、より正確に
把握できるようになる。According to the above means, the patient himself / herself can easily visually and audibly grasp the swallowing state, so that he / she can swallow consciously and can be efficiently used for swallowing training. can get. Further, by measuring the state during swallowing with various sensors other than the microphone, it becomes possible to more accurately grasp the state.
【００１３】[0013]
【発明の実施の形態】以下、本発明の実施の形態を図示
例と共に説明する。BEST MODE FOR CARRYING OUT THE INVENTION Embodiments of the present invention will be described below with reference to the drawings.
【００１４】図１は、本発明の嚥下音採取装置の第１実
施例のブロック図である。図示のように、制御回路部１
を中心に、生体情報入力部２及び出力部３がそれぞれ接
続されている。生体情報入力部２は、嚥下音を採取する
ためのマイク部４を有するものであり、マイク部４は、
例えば図２に示すように、患者の咽の外側表面に貼付さ
れ、嚥下時の音である嚥下音を採取する。なお、嚥下音
が採取できれば、センサは貼付することに限定されず、
吸引固定するものや喉の近傍に近接して設けるもの等、
種々適用可能である。そして、採取された嚥下音は、制
御回路部１により所定の電気信号又は数値情報に変換さ
れて出力部３へ出力される。出力部３は、具体的にはス
ピーカやモニタ等であり、視覚的・聴覚的に嚥下音を示
すものである。これにより、嚥下音採取装置を使用する
患者本人だけでなく、看護婦、在宅ヘルパー等にも嚥下
状態が容易に把握できるようになる。継続して本発明に
よる嚥下音採取装置を利用すれば、この出力部３からの
音や波形等を確認するだけで、嚥下の状態が良くなって
いるか悪くなっているかの判断が可能となる。FIG. 1 is a block diagram of a first embodiment of the swallowing sound collecting apparatus of the present invention. As shown, the control circuit unit 1
The biometric information input unit 2 and the output unit 3 are connected to each other. The biological information input unit 2 has a microphone unit 4 for collecting swallowing sound, and the microphone unit 4 is
For example, as shown in FIG. 2, a swallowing sound, which is a sound at the time of swallowing, is attached to the outer surface of the throat of a patient and is collected. If the swallowing sound can be collected, the sensor is not limited to being attached,
Those that are fixed by suction, those that are installed near the throat, etc.
Various applications are possible. Then, the collected swallowing sound is converted into a predetermined electric signal or numerical information by the control circuit unit 1 and output to the output unit 3. The output unit 3 is specifically a speaker, a monitor, or the like, and visually or audibly indicates a swallowing sound. As a result, not only the patient himself / herself who uses the swallowing sound collecting apparatus but also the nurse, the home helper, etc. can easily understand the swallowing state. If the swallowing sound collecting apparatus according to the present invention is continuously used, it is possible to judge whether the swallowing condition is good or bad only by confirming the sound, the waveform and the like from the output unit 3.
【００１５】出力部３のモニタには、マイク部４により
採取された嚥下音を制御回路部１で電気信号に変換した
波形情報が表示される。図３に、ＦＦＴ解析等により電
気信号に変換された嚥下音の波形情報を示す。図３
（ａ）は、健常者の嚥下音を示す波形情報であり、図３
（ｂ）は、嚥下障害者の嚥下音を示す波形情報である。
なお、横軸が時間であり、縦軸は音の強さ（ｄＢ）を示
している。図から分かるように、健常者の波形情報に比
べて、嚥下障害者の波形情報は、その振幅が狭い。この
ことから、嚥下する力が弱く、きちんと嚥下できていな
いという状態が見て取れる。従って、このような波形情
報を視覚的に出力部３のモニタに表示することにより、
嚥下障害の有無を視覚的に判断可能となる。なお、図３
において、水等の液体、プリン等を飲み込んだ時に現れ
るのが、左側の最初の振幅部分である。そして、その数
秒後に空嚥下と呼ばれる嚥下音が発生し、それが右側に
示される振幅部分に現れている。嚥下障害者は、この空
嚥下がなかったり健常者に比べて空嚥下が現れるまでの
時間が長かったりするので、この点に着目しても嚥下障
害の診断が可能となる。On the monitor of the output section 3, waveform information obtained by converting the swallowing sound collected by the microphone section 4 into an electric signal by the control circuit section 1 is displayed. FIG. 3 shows waveform information of the swallowing sound converted into an electric signal by FFT analysis or the like. Figure 3
FIG. 3A is waveform information indicating a swallowing sound of a healthy person, and FIG.
(B) is waveform information showing a swallowing sound of a person with dysphagia.
The horizontal axis represents time and the vertical axis represents sound intensity (dB). As can be seen from the figure, the waveform information of the swallowing person has a narrower amplitude than the waveform information of the healthy person. From this, it can be seen that the ability to swallow is weak and that swallowing is not being performed properly. Therefore, by visually displaying such waveform information on the monitor of the output unit 3,
It becomes possible to visually judge the presence or absence of dysphagia. Note that FIG.
In, the first amplitude part on the left side appears when a liquid such as water or pudding is swallowed. Then, a few seconds later, a swallowing sound called empty swallowing is generated, which appears in the amplitude part shown on the right side. A swallowing person does not have this empty swallowing or takes a longer time until the empty swallowing appears than in a healthy person. Therefore, it is possible to diagnose the swallowing disorder by paying attention to this point.
【００１６】また、波形情報をもとに、例えば健常者の
場合は「１０」、嚥下に異常が見られたら「４」等と、
嚥下音を点数化することで、より判別しやすいようにす
ることも勿論可能である。更に、嚥下音とそのときの咽
の動きというのは、関連があることが分かっているの
で、採取した嚥下音に対応する嚥下の状態を例えば図４
に示すように模式的にリアルタイムに出力部３に表示す
ることで、食塊がどこを通過しているか等、きちんと嚥
下が行えているかが、医師だけではなく患者自身にも視
覚的に判断可能となる。従って、簡単に嚥下状態を把握
できるので、医師による患者への嚥下訓練・リハビリテ
ーション指導における活用や、リハビリテーションの効
果が有効に現れているか否かの患者自身による確認も容
易となる。更に、嚥下の状態に対応した治療やリハビリ
テーションの指示を出力部３に表示することも可能であ
る。Further, based on the waveform information, for example, "10" for a healthy person, "4" for an abnormal swallowing, etc.
Of course, it is possible to make the discrimination easier by scoring the swallowing sound. Furthermore, since it is known that the swallowing sound and the movement of the throat at that time are related to each other, the swallowing state corresponding to the collected swallowing sound is shown in FIG.
It is possible to visually judge not only to the doctor but also to the patient himself by properly displaying on the output unit 3 in real time as shown in Fig. 4, whether the bolus is passing, etc. Becomes Therefore, since the swallowing state can be easily grasped, it becomes easy for the doctor to utilize the swallowing training / rehabilitation instruction to the patient and to confirm whether or not the effect of the rehabilitation is effectively exhibited by the patient. Furthermore, it is possible to display on the output unit 3 instructions for treatment and rehabilitation corresponding to the swallowing state.
【００１７】次に、図５に嚥下音採取装置の第２実施例
のブロック図を示す。図中、図１と同一の符号を付した
部分は同一物を表わしており、基本的な構成は図１に示
すものと同様であるので、重複説明は省略する。本実施
例は、第１実施例の制御回路部１に、記録装置５を接続
したものである。記録装置５には、具体的にはフロッピ
ー（登録商標）ディスクやハードディスク等の磁気ディ
スク装置、ＭＤやＭＯ、ＤＶＤ等の光磁気ディスク装
置、更にはカセットテープ等の磁気テープ装置等種々の
記憶媒体が使用可能であり、その他、パーソナルコンピ
ュータを用いても良い。採取された嚥下音は、制御回路
部１で電気信号・数値情報等に変換され、記録装置５に
逐次記録される。本発明による嚥下音採取装置は、持ち
運び可能なコンパクトな装置とすることも可能であり、
病院内だけでなく自宅で使用することもできるが、この
場合でも、嚥下情報が逐次記録されるので、後日、病院
等へ記録装置５により記録されたデータを持ち込むこと
で医師等による詳細解析が可能となる。また、食事中の
嚥下音を連続的に採取することで、日常生活での判断指
標とすることが可能となる。この蓄積された記録の推移
から、嚥下障害の状態推移が分かるので、治療・リハビ
リテーション等を行っている場合には、その効果が有効
に現れているか否かも確認することができる。Next, FIG. 5 shows a block diagram of a second embodiment of the swallowing sound collecting apparatus. In the figure, the parts denoted by the same reference numerals as those in FIG. 1 represent the same things, and the basic structure is the same as that shown in FIG. In this embodiment, the recording device 5 is connected to the control circuit unit 1 of the first embodiment. The recording device 5 specifically includes various storage media such as magnetic disk devices such as floppy (registered trademark) disks and hard disks, magneto-optical disk devices such as MD, MO, and DVD, and magnetic tape devices such as cassette tapes. Can be used, and a personal computer may also be used. The collected swallowing sound is converted into electric signals, numerical information, etc. by the control circuit unit 1 and sequentially recorded in the recording device 5. The swallowing sound collecting device according to the present invention may be a portable and compact device,
It can be used not only in the hospital but also at home, but even in this case, the swallowing information is sequentially recorded. Therefore, by bringing the data recorded by the recording device 5 to a hospital or the like at a later date, detailed analysis by a doctor or the like can be performed. It will be possible. In addition, by continuously collecting the swallowing sound during meals, it becomes possible to use it as a judgment index in daily life. Since changes in the status of the dysphagia can be known from the changes in the accumulated records, it is possible to confirm whether or not the effects are effectively exhibited when the treatment or rehabilitation is performed.
【００１８】更に、本発明の嚥下音採取装置の生体情報
入力部２には、マイク部４の他に以下に説明するセンサ
等を追加することが可能である。例えば、嚥下時の喉の
筋電情報を得るための筋電計や、呼吸情報を得るための
呼吸センサ、噛み圧情報や吸込圧情報を得るための圧力
センサ、インピーダンス情報を得るための生体インピー
ダンス測定装置等が使用可能である。Further, the biological information input unit 2 of the swallowing sound collecting apparatus according to the present invention may be provided with a sensor described below in addition to the microphone unit 4. For example, an electromyographic device to obtain myoelectric information of the throat during swallowing, a respiratory sensor to obtain respiratory information, a pressure sensor to obtain biting pressure information and suction pressure information, and a bioimpedance to obtain impedance information. A measuring device or the like can be used.
【００１９】上記の生体情報入力部にマイクの他にセン
サを追加した例を説明するために、図６に嚥下音採取装
置の第３実施例のブロック図を示す。図中、図１と同一
の符号を付した部分は同一物を表わしており、基本的な
構成は図１に示すものと同様であるので、重複説明は省
略する。例えば図示すように、本発明の嚥下音採取装置
の生体情報入力部２に筋電計６を追加した場合、筋電計
６のセンサ部は、マイク部４と同様に、例えば図２に示
すように患者の喉の外側表面に貼付される。しかしなが
ら、本発明はこれに限定されず、顎の底部等に貼付して
もよい。この筋電計により、マイク部４による嚥下音採
取と同時に嚥下時の筋電情報を採取する。このように、
嚥下音採取と同時に筋電計による筋肉の収縮等の測定を
行うことで、より正確な嚥下状態を診断することが可能
となる。即ち、口、咽の筋肉の動き、咽を食塊が通過す
る状況等が詳細に分かり、各挙動のずれ、様子がより具
体的に分かるようになる。In order to explain an example in which a sensor is added to the biological information input section in addition to the microphone, FIG. 6 shows a block diagram of a third embodiment of the swallowing sound collecting apparatus. In the figure, the parts denoted by the same reference numerals as those in FIG. 1 represent the same things, and the basic structure is the same as that shown in FIG. For example, as shown in the figure, when the electromyographic meter 6 is added to the biological information input section 2 of the swallowing sound collecting apparatus of the present invention, the sensor section of the electromyographic meter 6 is, for example, as shown in FIG. Affixed to the outer surface of the patient's throat. However, the present invention is not limited to this, and may be attached to the bottom of the chin or the like. With this electromyography, the swallowing sound is collected by the microphone unit 4 and the myoelectric information during swallowing is collected at the same time. in this way,
A more accurate swallowing condition can be diagnosed by measuring the contraction of the muscle with the electromyography at the same time as collecting the swallowing sound. That is, the movements of the muscles of the mouth and pharynx, the situation in which the food bolus passes through the pharynx, and the like can be understood in detail, and the deviation and behavior of each behavior can be understood more specifically.
【００２０】図７に、採取された嚥下音の波形情報とそ
れに対応する筋電図を示す。図７（ａ）は、健常者の嚥
下音を示す波形情報及び筋電図であり、上段が嚥下音
を、下段が筋電図を示し、図７（ｂ）は、嚥下障害者の
嚥下音を示す波形情報及び筋電図であり、同じく上段が
嚥下音を、下段が筋電図を示している。図から分かるよ
うに、嚥下障害が無い場合は、筋肉が動いてそれに対応
するように嚥下音が発せられるが、嚥下障害者は、うま
く飲み込めないため、筋肉がいつまでも動きつづけてい
ることが分かる。従って、このような波形情報を視覚的
に出力部３に表示することにより、嚥下障害の診断も容
易となる。更に、リアルタイムに嚥下時の波形が表示さ
れるので、患者も意識的に嚥下を行え、リハビリテーシ
ョン等の訓練にも寄与する。このように、嚥下音だけで
なく、筋電情報も採取することでより正確に嚥下状態の
診断が可能となる。FIG. 7 shows the waveform information of the swallowed sound collected and the electromyogram corresponding thereto. FIG. 7A is waveform information and an electromyogram showing a swallowing sound of a healthy person, the upper stage shows a swallowing sound, the lower stage shows an electromyogram, and FIG. 7B is a swallowing sound of a swallowing person. Is a waveform information and an electromyogram, and similarly, the upper stage shows a swallowing sound and the lower stage shows an electromyogram. As can be seen from the figure, when there is no dysphagia, the muscles move and a swallowing sound is emitted to correspond to the dysphagia, but it can be seen that the person with dysphagia cannot swallow well, so the muscles continue to move forever. Therefore, visually displaying such waveform information on the output unit 3 facilitates diagnosis of dysphagia. Furthermore, since the waveform during swallowing is displayed in real time, the patient can consciously swallow, which also contributes to training such as rehabilitation. Thus, by collecting not only the swallowing sound but also myoelectric information, the swallowing state can be more accurately diagnosed.
【００２１】更に、生体情報入力部２に呼吸センサを追
加すれば、嚥下時の呼吸状態を測定することが可能とな
る。嚥下障害のない健常者では、嚥下時には通常無呼吸
となる。嚥下時に息の漏れがあれば、誤嚥や咽せを起こ
す可能性が高いことになるため、嚥下障害が有るか無い
かの判断を行うことが可能となる。Furthermore, if a breathing sensor is added to the biological information input section 2, it becomes possible to measure the breathing state during swallowing. A healthy person without dysphagia usually becomes apnea during swallowing. If there is a leak of breath during swallowing, there is a high possibility that aspiration or throat will occur, so it is possible to determine whether or not there is a dysphagia.
【００２２】圧力センサを追加すれば、摂食、嚥下と重
要な関係にある、噛む力や息を吸う力等を測定すること
が可能となり、嚥下障害の検査に利用することが可能な
データを収集することができる。By adding a pressure sensor, it becomes possible to measure the force of biting, the force of inhaling, etc., which have important relationships with eating and swallowing, and the data that can be used for the examination of dysphagia can be obtained. Can be collected.
【００２３】生体インピーダンス測定装置を追加する
と、食塊等の喉を通るものの動きを電気信号として取り
出すことが可能となり、より詳細に嚥下状態を把握する
ことが可能となる。When a bioimpedance measuring device is added, it becomes possible to extract the movement of something that passes through the throat, such as a food bolus, as an electric signal, and it becomes possible to grasp the swallowing state in more detail.
【００２４】その他、ビデオレントゲンやＭＲＩ装置、
ビデオカメラ等を生体情報入力部２に追加し、嚥下時の
喉の透過像や磁気共鳴画像による断面図、外観状態を撮
影することで、更により詳しく患者の嚥下時の状態を把
握することが可能となる。In addition, video X-ray and MRI equipment,
By adding a video camera or the like to the biological information input unit 2 and capturing a cross-sectional view and an appearance state of the throat transmission image or magnetic resonance image during swallowing, it is possible to grasp the patient's swallowing state in more detail. It will be possible.
【００２５】これらの呼吸センサや圧力センサ等により
得られた情報も、同時に出力部３に表示させることで、
より総合的に嚥下状態を診断可能となる。なお、生体情
報入力部２へ追加するセンサは、上述のセンサをそれぞ
れ一つづつ追加するものであっても、複数を組み合わせ
るものであっても構わない。更に、本発明の生体情報入
力部２へ追加するセンサはこれらのセンサに限定され
ず、嚥下状態を把握できるセンサであれば、種々適応可
能である。By displaying the information obtained by these respiration sensors and pressure sensors on the output unit 3 at the same time,
The swallowing state can be diagnosed more comprehensively. The sensors to be added to the biometric information input unit 2 may be the above-mentioned sensors one by one or a combination of plural sensors. Furthermore, the sensor added to the biological information input unit 2 of the present invention is not limited to these sensors, and various kinds of sensors can be applied as long as the sensor can grasp the swallowing state.
【００２６】次に、図８に本発明の嚥下音採取装置の第
４実施例のブロック図を示す。図中、図１と同一の符号
を付した部分は同一物を表わしており、基本的な構成は
図１に示すものと同様であるので、重複説明は省略す
る。本実施例では、採取した嚥下音に基づき治療やリハ
ビリテーションを行うための治療装置７が、制御回路部
１に接続されている。治療装置には、例えば低周波治療
器等が挙げられる。低周波治療器を咽、顎等に付け、嚥
下障害の状態に合わせて適切な治療を行うことで、嚥下
タイミングの調整、筋萎縮・筋力低下防止、筋力アップ
等が図れる。嚥下音採取と同時に治療を行えるので、嚥
下音発生時に的確に所望の筋肉を動かすようにすること
も可能となり、誤嚥も減るため、例えば、特別養護老人
ホームにおける嚥下の介助等にも利用可能である。治療
装置７には、上記低周波治療器の他に、冷・温灸やバイ
ブレータ等が使用可能であり、冷温刺激により嚥下反応
を良くしたり、振動により血行を良くしたりすることが
可能となる。なお、記録装置５や筋電計６等、これまで
説明した種々のものを本実施例に組み合わせ得ることは
勿論である。例えば記録装置５を本実施例に追加するこ
とで、記録装置５により記録された過去のデータと、最
新のデータを比較し、適切な治療やリハビリテーション
を行うことも可能となる。Next, FIG. 8 shows a block diagram of a fourth embodiment of the swallowing sound collecting apparatus of the present invention. In the figure, the parts denoted by the same reference numerals as those in FIG. 1 represent the same things, and the basic structure is the same as that shown in FIG. In the present embodiment, a treatment device 7 for performing treatment and rehabilitation based on the collected swallowing sound is connected to the control circuit unit 1. Examples of the treatment device include a low frequency treatment device. By attaching a low-frequency treatment device to the throat, jaw, etc. and performing appropriate treatment according to the condition of dysphagia, adjustment of swallowing timing, prevention of muscle atrophy / muscular weakness, enhancement of muscle strength, etc. can be achieved. Since treatment can be performed at the same time as swallowing sound collection, it is possible to move the desired muscles accurately when swallowing sound occurs, and since aspiration can be reduced, it can be used, for example, to assist swallowing in nursing homes for the elderly. Is. In addition to the above low-frequency therapy device, cold / hot moxibustion, a vibrator, or the like can be used as the treatment device 7, and it becomes possible to improve swallowing reaction by cold temperature stimulation or improve blood circulation by vibration. . It is needless to say that the various devices described so far, such as the recording device 5 and the electromyographic device 6, can be combined with this embodiment. For example, by adding the recording device 5 to the present embodiment, it is possible to compare the past data recorded by the recording device 5 with the latest data and perform appropriate treatment and rehabilitation.
【００２７】更に、図９に本発明の嚥下音採取装置の第
５実施例のブロック図を示す。図中、図１と同一の符号
を付した部分は同一物を表わしており、基本的な構成は
図１に示すものと同様であるので、重複説明は省略す
る。図９に示すように、制御回路部１に、光や音等の信
号を発生させるための信号発生装置８を接続する。信号
発生装置８とは、例えばランプ等で光を発生させるもの
やブザー等で音を発生させるものである。患者は、信号
発生装置８から発生した光等を合図に嚥下を開始するよ
うにする。このような合図に基づき患者が嚥下を開始す
るため、嚥下開始の正確な時間、嚥下開始までの反応速
度が測定可能となる。また、信号発生装置８は、患者が
嚥下を開始する合図として制御回路部１へ開始信号を送
るためのトリガスイッチ等であっても良い。このよう
に、制御回路部１に嚥下開始の正確な時間を与えること
で、生体情報入力部２により採取された情報をより正確
に解析可能となる。また、患者が嚥下しようと考えてか
ら実際に嚥下が開始されるまでの時間を計測することが
できるため、嚥下が遅れていないか等の診断も可能とな
る。なお、記録装置５や筋電計６等、又は治療装置７
等、これまで説明した種々のものを本実施例に組み合わ
せ得ることは勿論である。Further, FIG. 9 shows a block diagram of a fifth embodiment of the swallowing sound collecting apparatus of the present invention. In the figure, the parts denoted by the same reference numerals as those in FIG. 1 represent the same things, and the basic structure is the same as that shown in FIG. As shown in FIG. 9, a signal generator 8 for generating a signal such as light or sound is connected to the control circuit unit 1. The signal generator 8 is, for example, a device that emits light using a lamp or the like or a device that emits sound using a buzzer or the like. The patient uses the light or the like generated from the signal generator 8 as a signal to start swallowing. Since the patient starts swallowing based on such a signal, it is possible to measure the exact time of the start of swallowing and the reaction rate until the start of swallowing. Further, the signal generator 8 may be a trigger switch or the like for sending a start signal to the control circuit unit 1 as a signal for the patient to start swallowing. In this way, by giving the control circuit unit 1 an accurate time to start swallowing, the information collected by the biological information input unit 2 can be analyzed more accurately. In addition, since it is possible to measure the time from when the patient thinks about swallowing until when the swallowing actually starts, it is possible to diagnose whether or not the swallowing is delayed. The recording device 5, the electromyography device 6 or the like, or the treatment device 7
Needless to say, the various components described so far can be combined with this embodiment.
【００２８】なお、本発明の嚥下音採取装置は、上述の
図示例にのみ限定されるものではなく、本発明の要旨を
逸脱しない範囲内において種々変更を加え得ることは勿
論である。The swallowing sound collecting apparatus of the present invention is not limited to the above-mentioned illustrated example, and various changes can be made without departing from the scope of the present invention.
【００２９】[0029]
【発明の効果】以上、説明したように本発明の嚥下音採
取装置によれば、医師等だけでなく、患者本人でも簡単
に視覚的・聴覚的に嚥下状態を把握でき、しかも嚥下訓
練、リハビリテーション等にも応用可能であるという優
れた効果を奏し得る。As described above, according to the swallowing sound collecting apparatus of the present invention, not only the doctor but also the patient himself / herself can easily and visually grasp the swallowing state, and further swallowing training and rehabilitation. It is possible to obtain an excellent effect that it can be applied to the above.
【図１】図１は、本発明の嚥下音採取装置の第１実施例
のブロック図である。FIG. 1 is a block diagram of a first embodiment of a swallowing sound collecting apparatus according to the present invention.
【図２】図２は、マイク部が患者の咽の外側表面に貼付
される状態を示す図である。FIG. 2 is a diagram showing a state in which a microphone part is attached to the outer surface of the throat of a patient.
【図３】図３は、嚥下音の波形情報を示す図であり、
（ａ）は、健常者の嚥下音の波形情報であり、（ｂ）
は、嚥下障害者の嚥下音の波形情報である。FIG. 3 is a diagram showing waveform information of swallowing sound,
(A) is waveform information of a swallowing sound of a healthy person, (b)
Is waveform information of the swallowing sound of a person with dysphagia.
【図４】図４は、表示装置に表示されるものの表示例で
ある。FIG. 4 is a display example of what is displayed on the display device.
【図５】図５は、本発明の嚥下音採取装置の第２実施例
のブロック図である。FIG. 5 is a block diagram of a second embodiment of the swallowing sound collecting apparatus of the present invention.
【図６】図６は、本発明の嚥下音採取装置の第３実施例
のブロック図である。FIG. 6 is a block diagram of a third embodiment of the swallowing sound collecting apparatus of the present invention.
【図７】図７は、嚥下音の波形情報及び筋電図を示す図
であり、（ａ）は、健常者の嚥下音の波形情報及び筋電
図であり、（ｂ）は、嚥下障害者の嚥下音の波形情報及
び筋電図である。FIG. 7 is a diagram showing waveform information and electromyogram of swallowing sound, (a) is waveform information and electromyogram of swallowing sound of a healthy person, and (b) is swallowing disorder. It is the waveform information and the electromyogram of the swallowing sound of the person.
【図８】図８は、本発明の嚥下音採取装置の第４実施例
のブロック図である。FIG. 8 is a block diagram of a fourth embodiment of the swallowing sound sampling apparatus of the invention.
【図９】図９は、本発明の嚥下音採取装置の第５実施例
のブロック図である。FIG. 9 is a block diagram of a fifth embodiment of the swallowing sound collecting apparatus of the invention.
１ 制御回路部 ２ 生体情報入力部 ３ 出力部 ４ マイク部 ５ 記録装置 ６ 筋電計 ７ 治療装置 ８ 信号発生装置 1 control circuit 2 Biometric information input section 3 Output section 4 Microphone section 5 recording device 6 EMG 7 treatment device 8 signal generator
───────────────────────────────────────────────────── フロントページの続き (72)発明者 宮武 俊明 長崎県佐世保市新行江町800番地 株式会 社日本理工医学研究所内 (72)発明者 古川 悦子 長崎県佐世保市新行江町800番地 株式会 社日本理工医学研究所内 (72)発明者 岳村 英之 長崎県佐世保市新行江町800番地 株式会 社日本理工医学研究所内 (72)発明者 樋渡 信一 長崎県佐世保市新行江町800番地 株式会 社日本理工医学研究所内 (72)発明者 綾木 政光 長崎県佐世保市新行江町800番地 株式会 社日本理工医学研究所内 (72)発明者 鶴▲崎▼ 春華 長崎県佐世保市新行江町800番地 株式会 社日本理工医学研究所内 (72)発明者 三根 勤 長崎県佐世保市新行江町800番地 株式会 社日本理工医学研究所内 ─────────────────────────────────────────────────── ─── Continued front page (72) Inventor Toshiaki Miyatake Nagasaki Prefecture Sasebo City Shingyoe Town 800 Stock Association Company Japan Institute of Science and Technology (72) Inventor Etsuko Furukawa Nagasaki Prefecture Sasebo City Shingyoe Town 800 Stock Association Company Japan Institute of Science and Technology (72) Inventor Hideyuki Takemura Nagasaki Prefecture Sasebo City Shingyoe Town 800 Stock Association Company Japan Institute of Science and Technology (72) Inventor Shinichi Hiwatari Nagasaki Prefecture Sasebo City Shingyoe Town 800 Stock Association Company Japan Institute of Science and Technology (72) Inventor Masamitsu Ayaki Nagasaki Prefecture Sasebo City Shingyoe Town 800 Stock Association Company Japan Institute of Science and Technology (72) Inventor Tsuru ▲ Saki ▼ Haruka Nagasaki Prefecture Sasebo City Shingyoe Town 800 Stock Association Company Japan Institute of Science and Technology (72) Inventor Tsutomu Mine Nagasaki Prefecture Sasebo City Shingyoe Town 800 Stock Association Company Japan Institute of Science and Technology
Claims (16)
を採取する嚥下音採取装置であって、該装置は、 患者の嚥下時の嚥下音を採取するマイク部を含む、患者
の嚥下時の情報を採取する生体情報入力部と、 前記生体情報入力部が接続され、前記生体情報入力部に
より採取された情報を電気信号又は数値情報に変換する
制御回路部と、 前記制御回路部に接続され、前記制御回路部により変換
された電気信号又は数値情報を視覚的及び／又は聴覚的
に出力する出力部と、 からなることを特徴とする嚥下音採取装置。1. A swallowing sound collecting apparatus for collecting swallowing sound in diagnosing a symptom such as dysphagia, wherein the apparatus includes a microphone unit for collecting swallowing sound of a patient during swallowing. A biometric information input unit that collects information, the biometric information input unit is connected, a control circuit unit that converts the information collected by the biometric information input unit into an electrical signal or numerical information, and is connected to the control circuit unit. A swallowing sound collecting device, comprising: an output unit that visually and / or audibly outputs the electrical signal or numerical information converted by the control circuit unit.
て、該装置は、更に、前記制御回路部に接続され、前記
制御回路部により変換された電気信号又は数値情報を記
録する記録装置を有することを特徴とする嚥下音採取装
置。2. The swallowing sound collecting apparatus according to claim 1, wherein the apparatus is further connected to the control circuit unit and records an electric signal or numerical information converted by the control circuit unit. A swallowing sound collecting apparatus comprising a device.
て、前記記録装置は、磁気ディスク装置、光磁気ディス
ク装置、磁気テープ装置の少なくとも何れか一つを含む
ことを特徴とする嚥下音採取装置。3. The swallowing sound collecting apparatus according to claim 2, wherein the recording device includes at least one of a magnetic disk device, a magneto-optical disk device, and a magnetic tape device. Sound sampling device.
嚥下音採取装置であって、該装置は、更に、前記制御回
路部に接続され、前記電気信号又は数値情報に基づき前
記患者の治療を行うための、治療装置を有することを特
徴とする嚥下音採取装置。4. The swallowing sound collecting apparatus according to claim 1, wherein the apparatus is further connected to the control circuit unit, and the patient is based on the electric signal or numerical information. An apparatus for collecting swallowing sound, comprising a treatment device for performing the treatment of 1.
て、前記治療装置は、低周波治療器を含むことを特徴と
する嚥下音採取装置。5. The swallowing sound collecting apparatus according to claim 4, wherein the treatment device includes a low-frequency treatment device.
嚥下音採取装置であって、該装置は、更に、前記制御回
路部に接続され、嚥下開始の合図を送るための信号発生
装置を有し、該信号発生装置から信号が発せられた時間
に基づき、患者の嚥下開始までの反応速度、嚥下開始の
正確な時間を測定することを特徴とする嚥下音採取装
置。6. The swallowing sound collecting device according to claim 1, wherein the device is further connected to the control circuit unit and generates a signal for sending a signal to start swallowing. A swallowing sound collecting apparatus, comprising a device, and measuring a reaction speed of a patient until the start of swallowing, and an accurate time of the start of swallowing, based on the time when a signal is emitted from the signal generating device.
て、前記信号発生装置は、患者に嚥下を開始させる合図
として、光、音等の信号を発生する装置を含むことを特
徴とする嚥下音採取装置。7. The swallowing sound collecting device according to claim 6, wherein the signal generating device includes a device that generates a signal such as light or sound as a signal for instructing the patient to start swallowing. Swallowing sound collecting device.
て、前記信号発生装置は、患者が嚥下を開始する合図と
して、前記制御回路部へ開始信号を送るためのトリガス
イッチを含むことを特徴とする嚥下音採取装置。8. The swallowing sound collecting apparatus according to claim 6, wherein the signal generating device includes a trigger switch for sending a start signal to the control circuit unit as a signal that the patient starts swallowing. A swallowing sound collecting device.
嚥下音採取装置であって、前記制御回路部は、前記電気
信号又は数値情報から、前記嚥下音に対応する嚥下の状
態を求め、前記出力部は、更に、前記制御回路部により
求められた前記嚥下の状態を表示することを特徴とする
嚥下音採取装置。9. The swallowing sound collecting apparatus according to claim 1, wherein the control circuit unit determines a swallowing state corresponding to the swallowing sound from the electrical signal or the numerical information. The swallowing sound collecting apparatus, wherein the output unit further displays the swallowing state obtained by the control circuit unit.
の嚥下音採取装置であって、前記生体情報入力部は、更
に、患者の嚥下時の筋電情報を採取する筋電計を含むこ
とを特徴とする嚥下音採取装置。10. The swallowing sound collecting apparatus according to claim 1, wherein the biological information input unit further includes an electromyographic meter that collects myoelectric information during swallowing of the patient. A swallowing sound collecting device comprising:
の嚥下音採取装置であって、前記生体情報入力部は、更
に、患者の嚥下時の呼吸情報を採取する呼吸センサを含
むことを特徴とする嚥下音採取装置。11. The swallowing sound collecting apparatus according to claim 1, wherein the biological information input unit further includes a respiratory sensor that collects respiratory information during swallowing of a patient. A swallowing sound collecting device.
の嚥下音採取装置であって、前記生体情報入力部は、更
に、患者の嚥下時の噛み圧情報及び／又は吸込圧情報を
採取する圧力センサを含むことを特徴とする嚥下音採取
装置。12. The swallowing sound collecting apparatus according to claim 1, wherein the biological information input unit further includes bite pressure information and / or suction pressure information during swallowing of the patient. A swallowing sound collecting device comprising a pressure sensor for collecting.
の嚥下音採取装置であって、前記生体情報入力部は、更
に、患者の嚥下時のインピーダンス情報を採取する生体
インピーダンス測定装置を含むことを特徴とする嚥下音
採取装置。13. The swallowing sound collecting apparatus according to claim 1, wherein the biometric information input unit further includes a bioimpedance measuring apparatus that collects impedance information of a patient during swallowing. A swallowing sound collecting device comprising:
の嚥下音採取装置であって、前記生体情報入力部は、更
に、患者の嚥下時の透過像情報を採取するビデオレント
ゲンを含むことを特徴とする嚥下音採取装置。14. The swallowing sound collecting apparatus according to claim 1, wherein the biological information input unit further includes a video roentgen for collecting transmission image information of the patient during swallowing. A swallowing sound collecting device characterized by the above.
の嚥下音採取装置であって、前記生体情報入力部は、更
に、患者の嚥下時の磁気共鳴映像を採取するＭＲＩ装置
を含むことを特徴とする嚥下音採取装置。15. The swallowing sound collecting apparatus according to claim 1, wherein the biological information input unit further includes an MRI apparatus that collects a magnetic resonance image of the patient during swallowing. A swallowing sound collecting device characterized by the above.
の嚥下音採取装置であって、前記生体情報入力部は、更
に、患者の嚥下時の外観情報を採取するビデオカメラを
含むことを特徴とする嚥下音採取装置。16. The swallowing sound collecting apparatus according to claim 1, wherein the biological information input unit further includes a video camera that collects appearance information of the patient during swallowing. A swallowing sound collecting device.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| JP2001308206A JP2003111748A (en) | 2001-10-04 | 2001-10-04 | Swallowing sound obtaining device |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| JP2001308206A JP2003111748A (en) | 2001-10-04 | 2001-10-04 | Swallowing sound obtaining device |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| JP2003111748A true JP2003111748A (en) | 2003-04-15 |
Family
ID=19127550
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| JP2001308206A Pending JP2003111748A (en) | 2001-10-04 | 2001-10-04 | Swallowing sound obtaining device |
Country Status (1)
| Country | Link |
|---|---|
| JP (1) | JP2003111748A (en) |
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