JPH0647005A - At-home medical examination system using electric stethoscope - Google Patents

Abstract

PURPOSE:To provide the at-home medical examination system using an electric stethoscope for executing a medical examination by converting the cardiac sound and the respiratory organ sound of a patient measured at home to electric signals and sending them to a hospital, and sending its prescription to the home, based on a doctor's diagnosis. CONSTITUTION:The system consists of an electric stethoscope 1 having a probe in which a microphone for generating a signal by measuring the body sound is contained, a terminal equipment 2 for processing a signal of the electric stethoscope, a pair of MODEMs 3, 7 for transferring the signal through a telephone circuit, and a host computer 8 for deciding the kind of a disease and the condition of the disease by comparing auscultated data sent from the electric stethoscope with fundamental data of the body sound and generating an instructing signal of its prescription, etc. Also, this system consists of a hospital side display device 9 for displaying decision data of the prescription, etc., based on its instructing signal, and a home side display device 4 for displaying its prescription by a prescription signal generated, based on its prescription, after the doctor's prescription is inputted to the host computer.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a home medical care system using an electric stethoscope, and more specifically, it converts the heart sounds and respiratory sounds of a viewer measured at home into electric signals and sends them to a hospital. The present invention relates to a home medical care system using an electric stethoscope that sends a prescription to a home for medical treatment based on a doctor's diagnosis.

[0002]

2. Description of the Related Art In conventional medical care, a nurse usually visits or is hospitalized at a hospital or clinic, receives a medical examination directly from a doctor, and is treated according to the doctor's prescription.

Generally, in the case of a person who has a mild latent disease which does not require hospitalization, the person usually returns to a normal state by proper treatment after the onset of the disease, and by first aid before receiving medical treatment from a doctor. Can relieve symptoms. Also,
In the case of an emergency, or in the case of a person living in a remote area, it is desirable to take appropriate first-aid measures under the guidance of a doctor while staying at home until the ambulance arrives.

Taking asthma as an example, asthma means sudden spastic dyspnea, which is a recurrent disease. There are two types of asthma, bronchial asthma and cardiac asthma.Bronchial asthma is a disease of the respiratory tract itself caused by allergy and airway hypersensitivity. The cause is heart failure caused by a disease. Both of them are common from night to early morning, but bronchial asthma develops especially at dawn, and cardiovascular asthma develops once in bed and often awakens suddenly because of suffocation. In cardiac asthma, blood is concentrated in the lungs when sleeping in the supine position, and it is thought that seizures are more likely to occur due to pulmonary congestion, and the symptoms are alleviated when sitting. Differentiation is important because the treatments for both are quite different. Bronchodilators are mainly used for bronchial asthma, and diuretics and digitalis preparations are used for cardiac asthma.

When a person has such a latent disease, he or she usually sees a doctor once and often has medicines necessary for treatment. In that case, if the doctor prescribes the type and dosage of the drug according to the symptoms,
It is quite possible to treat at home. However, at present, when an asthma attack occurs, there is no other way but to call the doctor in person to explain the symptoms and ask for instructions, or carry the doctor to an emergency hospital or call an ambulance. Moreover, it is expected that even if the symptoms are explained to the doctor by telephone, they will not be conveyed objectively and accurately, so that the doctor may not be able to grasp the symptoms and may not be able to give an appropriate first aid instruction.

[0006]

In view of the above situation, the present invention is to solve the problems such as asthma attack which can be diagnosed by an electric stethoscope which is relatively easy to operate. Immediately at home, the results of measuring body sounds such as heart sounds and respiratory sounds with a stethoscope are transmitted to the doctor as they are, the doctor objectively grasps the symptoms based on the auscultation data, and the prescription is instantaneously given. The point is to provide a home medical care system that uses an electric stethoscope that can be transmitted to the home for emergency treatment.

[0007]

In order to solve the above-mentioned problems, the present invention is a high-performance device which is mounted at a proper place on the body and measures body sounds such as heart sounds and respiratory sounds to generate electrical acoustic signals. An electric stethoscope having a probe with a built-in sensitivity microphone;
A terminal device that digitally processes the acoustic signal of the electric stethoscope, a home-side modem connected to the terminal device, and a hospital side that transmits the signal between the home-side modem and a communication network such as a telephone line. Modem, connected to the hospital-side modem, auscultation data sent from the electric stethoscope, and determine the type of disease, symptoms in comparison with the basic data of body sounds in various diseases that have been input in advance, A host computer that generates an instruction signal such as a prescription, a hospital-side display device that displays judgment data such as a prescription based on the instruction signal output from the host computer, and a doctor's prescription is input to the host computer. After that, when a prescription signal generated based on the prescription is input to the terminal device via the both modems, a home-side display device that displays the prescription is displayed. To constitute a home care system an electric stethoscope using that.

Further, a hospital-side voice converter for converting auscultation data input to the host computer into audible sound, and a home-side storage device capable of reading and reading auscultation data output from the terminal device are provided. More preferably, a hospital-side storage device capable of reading and reading auscultation data input to the host computer is provided.

[0009]

The home medical care system using the electric stethoscope according to the present invention having the above-mentioned contents is provided by attaching a probe of the electric stethoscope provided at home to a proper place on the body, so that the body sounds such as heart sounds and respiratory sounds. Sound is measured with a high-sensitivity microphone built into the probe, and the acoustic signal is input to a terminal device and digitally processed to form auscultation data. This auscultation data is transmitted from a home modem to a communication network such as a telephone line or a dedicated line. Use it to transmit to the hospital modem. The auscultation data input to the host computer from the modem on the hospital side, and the basic body sounds of a healthy person and those having various diseases, which are input and stored in advance in the internal memory or the external memory of the host computer. The data is arithmetically processed, the kind of the disease and the symptom are judged by comparing the both data, an instruction signal including a prescription suitable for it and personal data is generated, and the hospital side display device is based on the instruction signal. Display reference data such as prescription. Then, after seeing the reference data displayed on this display device, the doctor makes a diagnosis and determines the optimum prescription, and then inputs the prescription to the host computer, the prescription signal generated based on that prescription is sent to the hospital modem. Is transmitted to the home modem, and the prescription is displayed on the home display device via the terminal device. Looking at the prescription displayed on this display device, the viewer himself or his / her family gives first aid such as medication.

Further, by providing the hospital side audio converter for converting the auscultation data input to the host computer into audible sound, the doctor can directly auscultate the body sounds such as the heart sounds and respiratory sounds of the viewer. This is possible, and the same direct auscultation diagnosis as in the past can be performed.

By providing a home-side storage device capable of reading and reading auscultation data output from the terminal device, the auscultation data can be temporarily stored when a communication network such as a telephone line is congested and the host computer cannot be connected. The auscultation data can be stored and reproduced and transmitted when the communication network can be connected.

Furthermore, by providing a hospital-side storage device capable of reading and reading auscultation data input to the host computer, it becomes possible to trace symptoms and
It enables detailed analysis of auscultation data.

[0013]

The present invention will be described in more detail with reference to the embodiments shown in the accompanying drawings. The greatest feature of the present invention resides in the system configuration using the electric stethoscope 1 which is easy to handle and has high sensitivity. FIG. 1 shows a typical embodiment of the system configuration.

First, at home, the electric stethoscope 1 for measuring at least body sounds such as heart sounds and respiratory sounds, and a terminal device 2 including a microcomputer for digitally processing acoustic signals generated by the electric stethoscope 1. A home-side modem 3 for transmitting auscultation data processed by the terminal device 2 to the hospital using a communication network such as a telephone line or a dedicated line;
A home-side display device 4 that is connected to the terminal device 2 and displays a prescription transmitted from the hospital side is provided. Further, the electric stethoscope 1 is connected to a voice converter 5 for converting an acoustic signal into an audible sound so that the acoustic signal can be heard directly at home, and the terminal device 2 is connected to a telephone line or the like. When the communication network is too busy to connect to the hospital side, the auscultation data is read and temporarily stored, and when the communication network becomes connectable, the stored auscultation data is reproduced and the terminal device 2 The home-side storage device 6 is connected so that the data can be read out and sent to the home-side modem 3. The home storage device 6 is preferably equipped with a portable storage medium such as a floppy disk, a magnetic tape or an audio cassette tape. That is, with the auscultation data stored in this storage medium, it is possible to directly bring it to the hospital, mail it, or the like.

Next, at the hospital, at least the hospital-side modem 7 that receives the auscultation data sent from the home-side modem 3, and the auscultation data sent from the home connected to the hospital-side modem 7. , The basic data of the body sounds of a healthy person and the body sounds of persons with various diseases, which are pre-stored in the built-in memory or the external memory, are arithmetically processed, and the types and symptoms of the diseases are compared by comparing the two data. A host computer 8 for determining and generating an instruction signal including a prescription and personal data suitable for the determination, and a hospital-side display for displaying reference data such as prescription based on the instruction signal output from the host computer 8. A device 9 is provided. Further, by providing the hospital side audio converter 10 for converting the auscultation data input to the host computer 8 into audible sound, the doctor can directly auscultate the body sounds such as the heart sounds and respiratory sounds of the viewer. Therefore, the judgment of the host computer 8 can be confirmed, and the diagnosis by direct auscultation similar to the conventional one can be performed. Furthermore, by providing the hospital-side storage device 11 capable of reading and reading the auscultation data input to the host computer 8, it becomes possible to trace the symptoms and analyze the auscultation data in detail. Although not shown, a fast Fourier transform (FFT) device or the like is appropriately provided so that the auscultation data can be frequency-decomposed to perform more objective diagnosis. Further, when the storage medium of the home-side storage device 6 is sent to the hospital by mail or the like, the auscultation data can be input to the host computer 8 by an appropriate reading device.

Next, an auscultation method using a generally-used stethoscope will be briefly described. The auscultation method using a stethoscope has been widely used for a long time as a simple diagnosis of lung and heart diseases. In this auscultation method, a cone-shaped head is pressed against the skin, and minute vibrations transmitted from the inside of the body and reaching the skin are collected as sounds, which are collected via a flexible tube made of rubber or polymer material. It is transmitted to a pair of branch pipes made of metal, and a doctor inserts the mounting parts provided at the tips of the branch pipes into both ears and hears the above-mentioned body sounds, and compared with normal sounds accumulated empirically It is a method of determining the presence or absence of. Since such auscultation method is very simple and has a lot of clinical experience, it seems that it is an established diagnosis method at first glance, but its judgment is not objective. In addition, from the viewpoint of frequency characteristics that are regarded as important in today's audio equipment, in all conventional stethoscopes, the head and tube resonance points are below 1 kHz, which is the frequency distribution region of heart sounds and lung sounds, and are strict. It cannot be said that it is an acoustic transducer with good characteristics in a sense. That is, a high frequency region such as a heart sound is lost. Moreover, since the conventional stethoscope is used by pressing the head strongly against the skin, the vibration of the skin is suppressed and the original sound cannot be collected in principle.

The electric stethoscope 1 according to the present invention will be described in detail below. In this embodiment, as the electric stethoscope 1,
An electric stethoscope for skin that presses against the skin to measure heart sounds and respiratory sounds through the skin, and an electric stethoscope for esophagus that inserts into the esophagus and directly measures respiratory sounds generated from the lungs and bronchi Is shown. Both have the same structure except that the structure of the probe 12 is different. Hereinafter, the probe of the electric stethoscope 1 for skin will be referred to as 12a, and the probe of the electric stethoscope 1 for esophagus will be referred to as 12b.

FIG. 2 shows the probe 12a.
In the present embodiment, a ring-shaped fixing plate 14 is fixed in the middle of a cylindrical case 13 having one end open and the other end closed, and a ring-shaped fixing plate 14 is formed at the center of the fixing plate 14. A cylindrical portion 1 formed at one end of a bellows 16a as a hollow vibration transmitter 16 having soft elasticity in the mounting hole 15 provided.
7 is inserted and fixed, and a receiving surface 18 formed at the other end of the bellows 16a is set to project from the open end 19 of the case 13 by a predetermined length L, and the front cylindrical portion 17 has a high-sensitivity microphone. 20 bellows on the receiving side 16
It is fixed so as to face the internal space 21 of a. A signal line 22 from the microphone 20 is guided into a pipe-shaped handle 23 fixed to the upper side surface of the case 13 in an inclined state through a through hole 24 opened in the side surface of the case 13 and led out from an end portion of the handle 23. I am letting you. However, in the present invention, the shape of the case 13 and the case 1
The mounting structure of the vibration transmitter 16 and the microphone 20 in the inside of the structure 3 is not limited to the above-mentioned embodiment, and an appropriate structure is adopted.

Further, FIG. 3 shows another embodiment (second embodiment) in which a hollow balloon 16b is used as the vibration transmitting body 16. This balloon 1
6b has a cylindrical portion 17 integrally formed at one end of the spherical portion in the same manner as described above, and the cylindrical portion 17 is fitted and fixed in the mounting hole 15 of the fixing plate 14, and the microphone 20 is inserted inside the cylindrical portion 17. It is inserted and fixed, and the spherical surface protruding from the open end 19 of the case 13 at the other end of the balloon 16b serves as the vibration receiving surface 18 similarly to the above. The other configurations are similar to those of the first embodiment described above, and thus the same configurations are denoted by the same reference numerals and the description thereof is omitted.

4 and 5 show an embodiment of the probe 12b of an electric stethoscope for an esophagus. In this embodiment, a flexible material such as silicone rubber is formed into a cylindrical shape, and both ends are formed. A small number of small holes 26, ... Are provided around one end of the open tube 25 to form a vibration-receiving portion 27, and one end of the vibration-receiving portion 27 is closed in a hemispherical shape to form a thin soft elastic silicone rubber or the like. And a high-sensitivity microphone 29 inside the distal end portion of the tube 25, which is the proximal end side of the vibration receiving portion 27, with the receiving side facing the distal end. The microphone 29 and the vibration receiving film 28 form an airtight space 30. Further, the other end of the tube 25 is closed by a cap 31, and the signal line 32 of the microphone 29 passes through the tube 25 and is led out through the cap 31.
It is connected to the amplifier 2. However, in the present invention, the shape of the vibration-receiving portion 27 at the tip of the tube 25 and the airtight mounting structure of the vibration-receiving film 28 covering the vibration-receiving portion 27 are not limited to those in the above-described embodiment, and an appropriate structure is adopted. . For example, it is possible to integrally form the tube 25 and the vibration-receiving film 28 by forming the tip 25 of the tube 25 to be thin and closing it. Further, the vibration receiving film 28 is not limited to the hemispherical shape, and a shape having a flat end face may be adopted. In addition to the structure of the vibration receiving portion 27 having the small holes 26, a slit-like groove is formed and the thickness of the tube 25 is made sufficiently thin so that the vibration of the vibration receiving film 28 is prevented from leaking into the airtight space 30. If it can be transmitted inside, small hole 26
Can be omitted.

FIG. 6 shows the relationship between the electric stethoscope 1 and other devices. The electric stethoscope 1 comprises a probe 12a or a probe 12b and an amplifier (AMP) 33 for the probe 12a or the probe 12a. The probe 12b is connectable to the amplifier 33, and the amplifier 33 includes a headphone 34 and a digital audio converter 5 as the audio converter 5.
An audio tape recorder (DAT) 35 is connected. Then, the body sound is measured by the microphone 20 built in the probe 12a or the microphone 29 built in the probe 12b and is output as an electric acoustic signal, and this acoustic signal is converted into a predetermined voltage and current by the amplifier 33. The amplified sound can be converted into an audible sound by the headphones 34 and can be heard, and can be recorded and stored in the digital audio tape recorder 35 and can also be reproduced. Here, the amplifier 33
Can be integrated with the terminal device 2. still,
In that case, the digital audio tape recorder 35 may be the same as the home-side storage device 6. And
The output of the amplifier 33 is input as auscultation data to the terminal device 2 through an interface such as an A / D converter.

Although the headphones 34 are shown in the present embodiment as the voice converter 5, any earphones, speakers or the like which can convert the output signal of the amplifier 33 into voice can be adopted. . In addition, the amplifier 33
It is also possible to transmit a signal between the audio converter 5 and the voice converter 5 by wireless communication.

Therefore, in the case of measuring body sounds such as heart sounds and respiratory sounds from the surface of the skin using the electric stethoscope 1 according to the present invention, as shown in FIG. 7, the open end of the probe 12a is used. When the 19 side is lightly pressed against the skin 36, first, the vibration receiving surface 18 of the bellows 16a comes into contact with the skin 36, and the bellows 16a is compressed by a substantially protruding length L, so that the case 13
The open end 19 of the is lightly contacted with the skin 36. When set in this state, the contact pressure of the vibration receiving surface 18 on the skin 36 is always constant, and measurement with good reproducibility is possible. Then, the body sound generated inside the body 36
When the skin 36 is transmitted, the skin 36 vibrates, and the vibration vibrates the vibration receiving surface 18 of the bellows 16a. Then, the pressure in the internal space 21 of the bellows 16a slightly fluctuates, propagates to the receiving side of the microphone 20 as a longitudinal wave, is converted into an electric acoustic signal by the microphone 20, and the acoustic signal is predetermined by the amplifier 33. Is amplified to the output of. Then, the output signal is sent to the voice converter 5 and converted into an audible sound. At the same time, the output signal of the amplifier 33 can be sent to the digital audio tape recorder 35 for recording and storage.

On the other hand, when the respiratory sound is measured in the esophagus using the electric stethoscope 1 according to the present invention, the probe 12b is inserted to a predetermined depth in the esophagus 37 as shown in FIG. Then, the vibration-receiving membrane 28 vibrates due to the respiratory sound generated from the bronchus or lungs propagating in the esophagus 37, and when the vibration of the vibration-receiving membrane 28 causes a slight change in the pressure of the airtight space 30, a longitudinal wave is generated. Is propagated to the reception side of the microphone 29, converted into an electric acoustic signal by the microphone 29, and the acoustic signal is amplified to a predetermined output by the amplifier 33. Others are the same as above.

As described above, the auscultation data transmitted from the terminal device 2 installed in the home to the host computer 8 via both the modems 3 and 7 is frequency-decomposed by a fast Fourier transformer or the like, and then its frequency spectrum is obtained. The host computer 8 analyzes the characteristics of the above, and those characteristics, those of a healthy person who has been pre-entered in the built-in memory or the external memory, heart disease and lung cancer, polybes, tuberculosis, asthma or bronchitis, etc. Comparing a large number of collected and standardized basic data for each human case, determine the type of disease and symptoms, and output a prescription suitable for it, including personal data, as an instruction signal, Based on the instruction signal, it is displayed on the hospital-side display device 9 as reference data in the doctor's diagnosis. Further, the auscultation data can be converted into an audible sound by the hospital side audio converter 10 via an interface such as a D / A converter so that a doctor can directly auscultate. In this way, the auscultation data and basic data are stored in the host computer 8
By making a comparison with, it is possible to make an objective diagnosis. Then, the doctor looks at the reference data such as the prescription displayed on the display device 9, makes a final diagnosis, and inputs the optimum prescription for the viewer into the host computer 8, and based on the prescription. The generated prescription signal is transmitted from the hospital modem 7 to the home modem 3, and the prescription is displayed on the home display device 4 via the terminal device 2. Looking at the prescription displayed on the display device 4, the viewer himself or his / her family gives first aid such as medication.

[0026]

As described above, according to the home care system using the electric stethoscope of the present invention, the body such as heart sounds and respiratory sounds can be prepared by using the electric stethoscope which is easy to handle at home and has high sensitivity. By measuring the sound and operating the terminal device, the auscultation data is transmitted to the host computer on the hospital side using a communication network such as a telephone line or a dedicated line, processed there, and displayed on the display device. Look at the results,
The doctor makes a final diagnosis of the type and symptom of the disease and inputs the prescription to the host computer, and the prescription is displayed on the home-side display device. First-aid measures such as medication can be taken as instructed. Therefore, particularly in the case of suddenly developing diseases such as asthma attacks, quick first aid can be performed based on the doctor's prescription without going to the hospital, and the symptoms can be reduced and the patient can return to a normal state. . In addition, by utilizing the system of the present invention, it is possible to receive regular medical examinations while staying at home, which has the remarkable effect of facilitating home care especially for bedridden elderly people.

If a hospital-side audio converter for converting auscultation data input to the host computer into audible sound is provided, the doctor can directly auscultate the body sounds such as the heart sounds and respiratory sounds of the viewer. With a home-side storage device that can perform direct auscultation diagnosis similar to the conventional method and can read and read auscultation data output from a terminal device, a communication network such as a telephone line cannot be connected to a host computer. In some cases, the auscultation data can be temporarily stored, the auscultation data can be reproduced and transmitted when the communication network can be connected, and the auscultation data input to the host computer can be read and read. If a side memory device is provided, the symptoms can be tracked and the auscultation data can be analyzed in detail.

[Brief description of drawings]

FIG. 1 is a block diagram of a home care system using an electric stethoscope of the present invention.

FIG. 2 is a simplified cross-sectional view showing a first embodiment of a probe used in an electric stethoscope for skin.

FIG. 3 is a schematic sectional view showing a second embodiment of the same.

FIG. 4 is a simplified cross-sectional view showing an embodiment of a probe used in an electric stethoscope for an esophagus.

FIG. 5 is a perspective view of the same.

FIG. 6 is a block diagram showing the concept of an electric stethoscope.

FIG. 7 is a simplified cross-sectional view of a state in which the probe of the electric stethoscope for skin is in contact with the skin.

FIG. 8 is a simplified cross-sectional view showing a use state in which a probe of an electric stethoscope for an esophagus is inserted into the esophagus.

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 1 Electric stethoscope 2 Terminal device 3 Home side modem 4 Home side display device 5 Home side voice converter 6 Home side storage device 7 Hospital side modem 8 Host computer 9 Hospital side display device 10 Hospital side voice converter 11 Hospital side storage device 12, 12a, 12b probe 13 case 16 vibration transmitter 16a bellows 16b balloon 18 receiving surface 20 microphone 25 tube 28 receiving membrane 29 microphone 33 amplifier 34 headphone 35 digital audio tape recorder 36 skin 37 esophagus

Claims (4)

[Claims] 1. An electric stethoscope having a probe, which is mounted in a proper place on a body and has a built-in high-sensitivity microphone for measuring body sounds such as heart sounds and respiratory sounds to generate an electric acoustic signal, and the electric stethoscope. A terminal device for digitally processing the acoustic signal of the container, a home-side modem connected to the terminal device, and a hospital-side modem for transmitting a signal between the home-side modem and a communication network such as a telephone line, The type and condition of the disease is judged by comparing the auscultation data sent from the electric stethoscope and the basic data of the body sounds of various diseases which are input in advance, which are connected to the modem on the hospital side, the prescription thereof, etc. A host computer that generates an instruction signal of the above; a hospital-side display device that displays determination data such as prescription based on the instruction signal output from the host computer; After the doctor's prescription is entered in
An electric stethoscope characterized by comprising a home-side display device for displaying a prescription when a prescription signal generated based on the prescription is inputted to the terminal device via the both modems Home care system. 2. The home care system using an electric stethoscope according to claim 1, further comprising a hospital-side voice converter that converts auscultation data input to the host computer into audible sound. 3. The home medical care system using an electric stethoscope according to claim 1, further comprising a home-side storage device capable of reading and reading auscultation data output from the terminal device. 4. The home care system using the electric stethoscope according to claim 1, further comprising a hospital-side storage device capable of reading and reading auscultation data input to the host computer.