Summary of the invention
The shortcoming of prior art in view of the above, it is an object of the invention to provide the thorn in a kind of sacral nerve stimulatorSwash state adjustment method, can only stimulate by the stimulus parameter set for solving sacral nerve stimulator in prior art, it is impossible to fromThe dynamic problem adjusted.
For achieving the above object and other relevant purposes, the present invention provides the stimulation state in a kind of sacral nerve stimulator to adjustAdjusting method, described sacral nerve stimulator uses automatic mode to realize the adjustment of stimulation state, specifically includes following steps:
1) obtaining initial impulse parameter and desired stimulation Effect value, initial impulse parameter includes boost pulse amplitude, stimulationPulse width and stimulus frequency, and specify two electrodes as working electrode, it is intended that two electrodes are as measuring electrode；
2) starting described sacral nerve stimulator to start to stimulate, sacral nerve stimulator starts to stimulate according to initial impulse parameter；
3) in stimulating course, after often stimulating N number of pulse, N is preset value, obtains the nerves reaction electricity on described measurement electrodePressure value v and measure interelectrode resistance value r, calculates current nerve according to described nerves reaction magnitude of voltage v and resistance value rReaction effect value nr, computing formula is nr=v/r；Nerves reaction Effect value and the step 1 of gained will be calculated) described in expectation thornSharp Effect value compares, if the nerves reaction Effect value calculating gained is less than desired stimulation Effect value, then adds strong stimulation, asFruit calculates the nerves reaction Effect value of gained and is more than desired stimulation Effect value, then weaken stimulation.
Preferably, in described automatic mode, specifically adjustment to stimulating state also includes: calculate described current neural anti-Answer the difference between Effect value nr and described desired stimulation Effect value, adjust current stimulation ginseng according to the size of described differenceNumber, realizes adding strong stimulation or weakening stimulation with this；Described current stimulus parameter is current boost pulse amplitude, currently stimulatesOne or several combination in pulse width and current stimulus frequency.
Preferably, each stimulus parameter used in described sacral nerve stimulator in the range of: boost pulse amplitude is divided into 100Shelves, gear difference is 0-0.2V；Boost pulse width is divided into 13 grades, and gear difference is 30us；Stimulus frequency scope 44 grades, gear difference is0-30Hz。
Preferably, when described current stimulus parameter is current boost pulse amplitude, current boost pulse amplitude adjustsMethod particularly includes: when described difference be on the occasion of time, current boost pulse amplitude is adjusted upward, when described difference is negative value,Current boost pulse amplitude being adjusted downwards, the gear number adjusted up or down is regulated by the order of magnitude of difference, specificallyFor: when the absolute value of difference is more than 10, adjust 3 grades；When the absolute value of difference is more than 5 less than 10, adjust 2 grades；Difference absoluteWhen value is more than 1 less than 5, adjust 1 grade, when the absolute value of difference is less than 1, do not adjust.
Preferably, when described current stimulus parameter is current boost pulse width, current boost pulse width adjustmentMethod particularly includes: when described difference be on the occasion of time, current boost pulse width is adjusted upward, when described difference is negative value,Being adjusted downwards by current boost pulse width, the gear number adjusted up or down is regulated by the order of magnitude of difference, specificallyFor: when the absolute value of difference is more than 10, adjust 3 grades；When the absolute value of difference is more than 5 less than 10, adjust 2 grades；Difference absoluteWhen value is more than 1 less than 5, adjust 1 grade, when the absolute value of difference is less than 1, do not adjust.
Preferably, when described current stimulus parameter is current stimulus frequency, the concrete grammar that current stimulus frequency adjustsFor: when described difference be on the occasion of time, current stimulus frequency is adjusted upward, when described difference is negative value, will currently stimulate frequencyRate adjusts downwards, and the gear number adjusted up or down is regulated by the order of magnitude of difference, particularly as follows: the absolute value of difference is bigIn 10 time, adjust 3 grades；When the absolute value of difference is more than 5 less than 10, adjust 2 grades；When the absolute value of difference is more than 1 less than 5, adjustWhole 1 grade, when the absolute value of difference is less than 1, do not adjust.
Preferably, described sacral nerve stimulator also includes using fixed model to stimulate, and fixed model refers to: sacral nervesThe constant stimulus parameter that stimulator is sent to sacral nerve stimulator according to external controller persistently stimulates, constant stimulus parameter bagInclude the boost pulse amplitude of setting, boost pulse width and stimulus frequency.
As it has been described above, the stimulation state adjustment method in the sacral nerve stimulator of the present invention, have the advantages that thisThe sacral nerve stimulator of invention has automatic mode and can automatically adjust, and it can be by obtaining the nerves reaction measured on electrodeMagnitude of voltage and the interelectrode resistance value of measurement, calculate current nerves reaction effect by nerves reaction magnitude of voltage and resistance valueValue, and current nerves reaction Effect value is compared with desired stimulation Effect value, regulate in real time according to comparative resultEffect of stimulation, adds strong stimulation or weakens stimulation, therefore, present invention achieves being automatically adjusted of sacral nerve stimulator, to reachPreferably using effect.
Detailed description of the invention
By particular specific embodiment, embodiments of the present invention being described below, those skilled in the art can be by this explanationContent disclosed by book understands other advantages and effect of the present invention easily.
Refer to Fig. 1 to Fig. 3.It should be clear that structure depicted in this specification institute accompanying drawing, ratio, size etc., the most only in order toCoordinating the content disclosed in description, understand for those skilled in the art and read, being not limited to the present invention can be realThe qualifications executed, therefore do not have technical essential meaning, the modification of any structure, the change of proportionate relationship or the tune of sizeWhole, under not affecting effect that the present invention can be generated by and the purpose that can reach, all should still fall in disclosed skillIn the range of art content can contain.Meanwhile, in this specification cited as " on ", D score, "left", "right", " middle " andThe term of " one " etc., is merely convenient to understanding of narration, and is not used to limit the enforceable scope of the present invention, its relativenessIt is altered or modified, is changing under technology contents without essence, when being also considered as the enforceable category of the present invention.
As it is shown in figure 1, the present invention provides the stimulation state adjustment method in a kind of sacral nerve stimulator, the sacrum god of the present inventionHaving two kinds of stimulus modelities through stimulator may select, one is exactly fixed model, stimulates according to fixed model, then sacrumThe constant stimulus parameter being sent to sacral nerve stimulator according to external controller is persistently stimulated by nerve stimulator, constant stimulusParameter includes boost pulse amplitude, boost pulse width and the stimulus frequency set.One is automatic mode, according to automatic moldFormula realizes the adjustment of stimulation state, specifically includes following steps:
1) obtaining initial impulse parameter and desired stimulation Effect value nr0, initial impulse parameter includes boost pulse amplitude, thornSwash pulse width and stimulus frequency, and specify two electrodes as working electrode, it is intended that two electrodes are as measuring electrode；SeeShown in Fig. 3, specifying the first electrode 51 and the 3rd electrode 53 in the present embodiment is working electrode, the second electrode 52 and the 4th electrode 54For measuring electrode；
2) starting sacral nerve stimulator to start to stimulate, sacral nerve stimulator starts to stimulate according to initial impulse parameter；
3) in stimulating course, after often stimulating N number of pulse, N is preset value, obtains the nerves reaction magnitude of voltage measured on electrodeV and measure interelectrode resistance value r, calculates current nerves reaction effect according to nerves reaction magnitude of voltage v and resistance value rValue nr, computing formula is nr=v/r；Nerves reaction Effect value and the step 1 of gained will be calculated) described in desired stimulation Effect valueNr0 compares, if the nerves reaction Effect value calculating gained is less than desired stimulation Effect value, then adds strong stimulation, if meterThe nerves reaction Effect value calculating gained is more than desired stimulation Effect value, then weaken stimulation.
The sacral nerve stimulator of the present invention has automatic mode and can automatically adjust, and it can be measured on electrode by obtainingNerves reaction magnitude of voltage v and measure interelectrode resistance value r, calculated currently by nerves reaction magnitude of voltage v and resistance value rNerves reaction Effect value nr, and current nerves reaction Effect value nr is compared with desired stimulation Effect value nr0, rootRegulate effect of stimulation according to comparative result in real time, add strong stimulation or weaken stimulation, therefore, present invention achieves sacral nerve stimulationBeing automatically adjusted of device, to reach more preferable using effect.
For preferably regulating, above-mentioned N can be the natural number between 15-25, and optimum just carries out one for 20 pulses of stimulationSecondary measurement.
For realize preferably regulation stimulation degree, in above-mentioned automatic mode specifically to stimulate state adjustment also include: meterDifference between current nerves reaction Effect value nr and desired stimulation Effect value nr0, Δ=nr-nr0, big according to differenceLittle adjust current stimulus parameter, realize adding strong stimulation or weakening stimulation with this；Described current stimulus parameter is currentOne or several combination in boost pulse amplitude, current boost pulse width and current stimulus frequency.
Separately below using boost pulse amplitude, boost pulse width (i.e. pulsewidth) and stimulus frequency as current stimulus parameterAdjust.
In the present embodiment each stimulus parameter used in sacral nerve stimulator in the range of: boost pulse amplitude is divided into 100Shelves, gear difference is 0-0.2V；Boost pulse width is divided into 13 grades, and gear difference is 30us；Stimulus frequency scope 44 grades, gear difference is0-30Hz；The division of above-mentioned gear number human body the most preferably adapts and divides.
When current stimulus parameter is current boost pulse amplitude, current boost pulse amplitude adjusts method particularly includes:When difference be on the occasion of time, current boost pulse amplitude is adjusted upward, when described difference is negative value, by current boost pulse widthDegree adjusts downwards, and the gear number adjusted up or down is regulated by the order of magnitude of difference, particularly as follows: the absolute value of difference is bigIn 10 time, adjust 3 grades；When the absolute value of difference is more than 5 less than 10, adjust 2 grades；When the absolute value of difference is more than 1 less than 5, adjustWhole 1 grade, when the absolute value of difference is less than 1, do not adjust.Such as patient selects the initial impulse parameter to be: boost pulse amplitude is906uA, stimulus frequency is 65Hz, and boost pulse width is 240us, and under automatic mode, the practical stimulation pulse amplitude of acquisition is900uA, Δ=6, illustrate that stimulation degree is too strong, and when the absolute value of difference is more than 5 less than 10, then lower 2 grades.
When current stimulus parameter is current boost pulse width, current boost pulse width adjustment method particularly includes:When described difference be on the occasion of time, current boost pulse width is adjusted upward, when described difference is negative value, will currently stimulate arteries and veinsRushing width to adjust downwards, the gear number adjusted up or down is regulated by the order of magnitude of difference, particularly as follows: difference is absoluteWhen value is more than 10, adjust 3 grades；When the absolute value of difference is more than 5 less than 10, adjust 2 grades；The absolute value of difference is more than 1 less than 5Time, adjust 1 grade, when the absolute value of difference is less than 1, do not adjust.
When current stimulus parameter is current stimulus frequency, current stimulus frequency adjusts method particularly includes: when described differenceValue on the occasion of time, current stimulus frequency is adjusted upward, when described difference is negative value, current stimulus frequency is adjusted downwards,The gear number adjusted up or down is regulated by the order of magnitude of difference, during particularly as follows: the absolute value of difference is more than 10, adjusts3 grades；When the absolute value of difference is more than 5 less than 10, adjust 2 grades；When the absolute value of difference is more than 1 less than 5, adjust 1 grade, differenceWhen absolute value is less than 1, do not adjust.
Form is made in the adjustment of above-mentioned stimulus parameter, in order to the more specific adjustment understanding automatic mode, see table 1.
Table 1
The concrete structure of the sacral nerve stimulator of the present invention is: sacral nerve stimulator includes for receiving body outer controller instituteTransmission circuit, single-chip microcomputer, boost pulse generation module and the electrode bundle signaled, electrode bundle includes four electrodes, every electrodeEnd all have the stimulation point for contacting with sacral nerves, according to reality implant situation, chosen position suitable two from whichRoot electrode, exports boost pulse as working electrode；And other two electrodes are as measuring electrode, it is used for measuring nerves reaction electricityPressure signal and tissue impedance, for understanding the automatic adjustment of the actual physiological situation within patient body and stimulus parameter.WorkChoosing of electrode is configured by external controller.
The first circuit of neural voltage between electrode is measured as in figure 2 it is shown, be provided with in above-mentioned boost pulse generation moduleModule and complete to measure the second circuit module of tissue impedance between electrode, two circuit modules are all connected with single-chip microcomputer 1, are used toUnderstand the automatic adjustment of the actual physiological situation within patient body and stimulus parameter；Above-mentioned first circuit module includes and electrodeThe first selectors 2 that bundle 5 is connected, and the amplifier 6 of voltage and amplification and analog-digital converter 4, the first circuit between acquisition electrodeModule is controlled by the single-chip microcomputer 1 in implant stimulator, completes the measurement of neural voltage between electrode in the moment required；Second electricityRoad module includes the second selector 7 being connected with described electrode bundle 5, and the adjustable current source 3 being connected with second selector 7,And above-mentioned first circuit module, second circuit module is controlled by single-chip microcomputer 1, completes tissue impedance between electrode in the moment requiredMeasurement, for understanding automatically adjusting of actual physiological situation patient body within and stimulus parameter.
When measuring interelectrode nerves reaction voltage, as shown in Figure 2, single-chip microcomputer 1 sends control signals to firstSelector 2, connects two electrodes specifying as measuring electrode, then these two voltages measured between electrodes are exaggerated device 6 and adoptCollecting and amplify, the signal after amplification is converted to digital signal by analog-digital converter 4, sends single-chip microcomputer 1 to.
When measuring interelectrode tissue impedance, as shown in Figure 2, single-chip microcomputer 1 sends control signals to the second selectionDevice 7 and adjustable current source 3, to send two measurement electrodes that the electric current determining amplitude flows to specify.Then single-chip microcomputer 1 is sent out againGo out control signal and measure the voltage signal on electrode to first selector 2, amplifier 6, analog-digital converter 4, collection.By this voltageValue, divided by aforementioned currents value, just obtains tissue impedance values.
Single-chip microcomputer 1 calculates nerves reaction Effect value nr, nr=v/r subsequently.This value is characterized under current stimulus parameter, suffers fromThe nerves reaction intensity of person.During controller sends automatic mode setting command in vitro, specify the expectation of nerves reaction intensityValue nr0.If this value is less than expected value, then show that stimulation degree is inadequate, it should add strong stimulation；If this value is more than expected value,Then show that stimulation degree is the strongest, it should weaken stimulation.
In sum, the stimulation state adjustment method in the sacral nerve stimulator of the present invention, it can be measured by acquisitionNerves reaction magnitude of voltage on electrode and the interelectrode resistance value of measurement, calculated by nerves reaction magnitude of voltage and resistance value and work asBefore nerves reaction Effect value, and current nerves reaction Effect value is compared with desired stimulation Effect value, according to thanRelatively result regulates effect of stimulation in real time, adds strong stimulation or weakens stimulation, therefore, present invention achieves sacral nerve stimulatorIt is automatically adjusted, to reach more preferable using effect.So, the present invention effectively overcomes various shortcoming of the prior art and has heightDegree industrial utilization.
The principle of above-described embodiment only illustrative present invention and effect thereof, not for limiting the present invention.Any ripeAbove-described embodiment all can be modified under the spirit and the scope of the present invention or change by the personage knowing this technology.CauseThis, have usually intellectual such as complete with institute under technological thought without departing from disclosed spirit in artAll equivalences become are modified or change, and must be contained by the claim of the present invention.