JPS63315042A - Extracoporeal type treatment apparatus - Google Patents

Abstract

PURPOSE:To control the observation angular position of an observation apparatus and the energy emitting angular position of a treatment energy generator to efficient desired angular positions, by providing a guide means for guiding at least one of the treatment energy generator and the observation apparatus toward the desired position on the surface of a human body. CONSTITUTION:In an extracorporeal type treatment apparatus 1, the apparatus main body 2 is allowed to approach the human body 11 laid down on a usual bed 15 so as to lie on its belly and an operating bed 7 is regulated front and back as well as up and down and a guide arm 10 is arranged along the outer peripheral surface of the trunk of the human body 11, and an observation apparatus 5 and a treatment energy generator 6 are allowed to approach the surface of the human body or brought into contact therewith to make it possible to perform the detection of a calculus and the destructing operation thereof. When lithodialysis is performed, a support shaft 9 is revolved to incline the guide arm 10 to the surface of the human body and the treatment energy generator 6 can be arranged at an angular position most efficient in crushing. That is, an angular position emitting shock wave energy can be selected so as to avoid the lungs.

Description

[Detailed Description of the Invention] [Industrial Field of Application] This invention is an extracorporeal treatment device, in particular, an observation device that detects a treatment target such as a stone formed inside the body, and a treatment device that detects a treatment target such as a stone generated inside the body. This invention relates to an extracorporeal treatment device that focuses shock wave energy to crush and treat stones, etc.

[Conventional technology]

Stones formed in the gallbladder, kidneys, etc. are detected using observation equipment such as X-rays and ultrasound, and therapeutic shock wave energy is generated outside the body using high-pressure electrical discharge and ultrasonic vibration. A stone destruction device as an extracorporeal treatment device that focuses the energy and crushes the stone has already been disclosed in Japanese Patent Laid-Open No. 61-31140 and Japanese Patent Laid-Open No. 61-457.
It is well known as disclosed in Japanese Patent Application Laid-open No. 47, Japanese Patent Application Laid-Open No. 145131/1980, and the like.

Most of these types of devices include a special bed on which the patient lies supine, an observation device to detect the location of affected areas such as stones, and shock wave energy generated outside the body that directs the shock wave energy to the affected area. It consists of a therapeutic energy generator that focuses on the stone at the location.

The above-mentioned special bed is made up of two holding stands: one supporting the upper part from the shoulders to the head and the other holding stand supporting the lower part from the waist to the feet, and the area from the chest to the lower abdomen is unsupported. The observation device and the therapeutic energy generating device are movably arranged in such a space that the human body is sandwiched therebetween. The observation device is composed of a well-known X-ray device and an ultrasonic diagnostic device, and is designed to generate X-rays and ultrasonic waves to detect the location of an affected area such as a stone, and to store the location.

The therapeutic energy generation device is composed of a discharge type shock wave generation device that generates shock wave energy by high-pressure discharge and an ultrasonic type shock wave generation device that generates shock wave energy using an ultrasonic vibrator such as a piezoelectric element. Shock wave energy is focused on the affected area to crush stones, etc.

[Problems to be Solved by the Invention] By the way, in this type of conventional treatment device, the patient is placed in a supine position on a special bed, and the observation device and treatment energy generating device are brought close to and in contact with the human body. Since various treatment operations are performed, the patient's body position is limited, the degree of freedom in treatment is low, and the space for the observation device and treatment energy generating device is limited. In other words, an X-ray observation device simply sandwiches the human body and transmits the X-rays, while an ultrasound observation device simply moves its ultrasonic transducer along the body surface to determine the radiation angle and angle of the ultrasonic wave. It did not have a function to efficiently and finely adjust the transmission angle of X-rays. Furthermore, in the treatment energy generating device, for example, in the case of gallstones, the shock wave generator is installed at an angle that avoids the lungs, and there is no function that allows the energy emission angle to be adjusted to an efficient angle. Its only function was to guide it along the body surface.

Generally, when treating gallstones, the human body is placed in the supine position, and when treating kidney stones, the body is placed in the supine or prone position, and the treatment position is restricted by a special bed, etc. I don't like it.

Additionally, in hospitals that already have X-ray and ultrasound diagnostic equipment, it is uneconomical to purchase a new external treatment device with a dedicated bed, and patients can freely sit in either the supine or prone position. It has been desired to develop an external treatment device that can perform treatment using an ordinary bed.

Therefore, the purpose of the present invention is to improve the degree of freedom in treatment attitude and improve economic efficiency, and to provide a method that can be expected to improve the degree of freedom of treatment and improve economic efficiency. An object of the present invention is to provide an extracorporeal treatment device that can efficiently adjust the observation angular position of a J device and the energy emission angular position of a therapeutic energy generation device to desired angular positions.

[Means and effects for solving the problems] In order to achieve the above object, the present invention includes an observation device that generates X-rays, ultrasonic waves, etc. to observe the location of affected areas such as stones in the body, and an observation device that generates X-rays, ultrasonic waves, etc. A therapeutic energy generating device that focuses the generated therapeutic shock wave energy toward the affected area position; The apparatus is characterized by comprising a guide means for guiding the apparatus toward the position.

[Example] The present invention will be explained below with reference to illustrated embodiments.

Although the extracorporeal treatment device described below is configured as a stone crushing device, it goes without saying that the extracorporeal treatment device according to the present invention is not limited to stone destruction.

FIG. 1 shows the configuration of an extracorporeal treatment device according to a first embodiment of the present invention, and this extracorporeal treatment device 1 includes:
The movable device body 2 is equipped with an operating keyboard 3 and a monitor display 4, as well as an observation device 5.
and an operating head 7 for guiding the therapeutic energy generating device 6 to a desired angular position.

The operating head 7 is attached to the protruding tip of a rotating shaft 8 that is vertically supported on the device body 2, and is moved up and down by the lifting and lowering of the rotating shaft 8.
It moves back and forth relative to 1. This head 7 is provided with a support shaft 9 that projects horizontally toward the front, and a guide arm 10 is provided at the tip of the support shaft 9.
is attached to the arm 10, and a viewing filtration device 5 is attached to the same arm 10.
is attached to the movable table 5a, and the therapeutic energy generating device 6 is attached so as to be slidable along the arm 10 by the movable table 6a. The guide arm 10 is formed in a partial arc shape, that is, in the present embodiment, a semicircular arc shape, and extends along the outer surface of approximately half of the torso circumference of the human body 11 to the apnotherapy device 5 and the therapeutic energy generation device. 6 can be moved. Further, the support shaft 9 is rotatable around the coaxial central axis, and therefore the guide arm 10 is rotated 3606 times around an extension of the central axis of the support shaft 9.

The observation device 5 attached to the movable table 5a has, for example, an ultrasonic transducer that performs sector scanning, and emits ultrasonic waves into the human body 11 to detect stones in the kidney 12 or the like in the body.
The kidney stone 13 discovered by this device 5 has its position displayed on the screen of the monitor display 4 such as a CRT.

The therapeutic energy generating device 6 attached to the movable table 6a has a high-pressure discharge type shock wave energy generating source, and the generated shock wave energy is transferred to a pouch called Voretex filled with a shock wave propagating medium such as water. It is composed of a shock wave generator that focuses on a kidney stone 13 in the human body 11 through a water bag 14 made of (trade name) and crushes the stone 13.

In the extracorporeal treatment device 1 of this embodiment configured as described above, the human body 1 is placed in a supine position on an ordinary bed 15.
1, the operating bed 7 is adjusted back and forth and up and down, the guide arm 10 is placed along the outer surface of the torso of the human body 11, and the observation device 5 and therapeutic energy generation device 6 are Stone detection and stone destruction operations can be easily performed by bringing the device close to or in contact with the surface of the human body. When carrying out this stone crushing treatment, as shown in FIG.
can be placed at the angular position for the most efficient grinding. That is, it is possible to select an angular position at which the shock wave energy is emitted while avoiding the lungs and the like.

Furthermore, when the human body 11 is laid down on the bed 15 in a prone position as shown in FIG. Accordingly, the observation device 5 and the therapeutic energy generating device 6 are brought close to or in contact with the outer surface of the human body 11 from below to perform treatment.

Next, FIG. 4 is a schematic diagram of the main parts of an extracorporeal treatment apparatus showing a second embodiment of the present invention. The treatment device of the second embodiment is different from the first embodiment in that the treatment energy generating device 6 of the first embodiment shown in FIGS. This is different from the example.

That is, this therapeutic ultrasonic energy generation device 16 is
Mounting plate 1 consisting of a reflective shade generally formed into an elliptical spherical surface
A large number of ultrasonic transducers 18 made of piezoelectric elements are arranged and fixed in a mosaic shape on the inner surface of the body 7, and the shock wave generation surface on the front side is placed facing the human body 11, so that the shock wave generation A pouch 19 made of Voretex (trade name) or the like having liquid injection and pressure control means is disposed between the human body 11 and the pouch 19 is filled with a shock wave propagation liquid such as water. . Also, the mounting plate 17
An ultrasonic DI device 2o that performs linear scanning or sector scanning is attached to the center of the image forming apparatus.

The ultrasonic energy generating device 16 configured as described above is movably attached to the guide arm 10 by a moving table 16a. The rest of the structure is the same as that of the apparatus of the first embodiment. Even if configured as in this second embodiment, the same functions and effects as in the first embodiment can be achieved.

Moreover, FIG. 5 shows an example in which the guide arm 10 in the first embodiment is replaced with a C-ring shaped guide arm 21. Is it visible on the C-ring shaped guide arm 21 like this? If the I-1 device 5 and the therapeutic energy generating device 6 are each movably attached, when the treatment position is changed, the observation device 5 and the therapeutic energy generating device 6 can be moved along the guide arm 21, making it easy to operate. becomes easy.

Furthermore, if configured as the extracorporeal treatment device of the present invention, C.
An X-ray device having a shaped guide arm can be easily combined and used as an observation device. That is, as shown in FIG. 6, an X-ray projector 22, a photomultiplier tube, etc.
An X-ray device 2 is attached to a C-shaped guide arm 24 with an image intensifier 23, which is a radiation passive body, facing each other.
5 is placed near one side of the human body 11 on the bed 15, and the extracorporeal treatment device 1 having the treatment energy generating device 6 or 16 attached to the guide arm 10 is placed on the other side. Stone 1 is detected by X-ray observation device 25 with human body 11 in between.
3 is detected, and then the extracorporeal treatment device 1 is operated to crush the stone 13.

Furthermore, when the external treatment device of the present invention and an endoscope are used together, a shelf 26 is provided in the main body 2 of the external treatment device as shown in FIG. Light source device 27
By arranging related equipment and tools such as the 3D and treatment tools 28, it becomes easy to use and extremely convenient.

[Effects of the Invention] As described above, according to the present invention, any treatment position can be supported, and the observation angular position and the therapeutic shock wave energy emission angular position can be finely adjusted to the most efficient position. It is possible to provide an extracorporeal treatment device that can perform Further, since it can be easily used in combination with other equipment such as an X-ray device, it is possible to improve flexibility and economical efficiency.

[Brief explanation of the drawing]

FIG. 1 is a side view of an extracorporeal treatment device showing a first embodiment of the present invention, and FIGS. 2 and 3 are rear views of essential parts showing the operating mode of the extracorporeal treatment device shown in FIG. 1, respectively. and a side view; FIG. 4 is a schematic configuration diagram of the main parts of an extracorporeal treatment device showing a second embodiment of the present invention; FIG. 5 is a side view showing another example of the guide arm; FIG. 6 is a FIG. 7 is a side view showing a case where the extracorporeal treatment device and the X-ray device of the present invention are used in combination. FIG. 7 is a side view showing another example of the device main body in the extracorporeal treatment device.

Claims (1)

[Claims] An observation device that generates X-rays, ultrasonic waves, etc. to observe the location of an affected area such as a stone in the body, and focuses therapeutic shock wave energy generated outside the body toward the affected location. It is characterized by comprising a therapeutic energy generating device, and a guide means that is displaced around the human body surface and guides at least one of the therapeutic energy generating device and the observation device toward a desired position on the human body surface. Extracorporeal treatment device.