JP2017192603A

Movatterモバイル変換

Info

Publication number: JP2017192603A
Application number: JP2016085617A
Authority: JP
Inventors: 田中　仁志; Hitoshi Tanaka; 仁志田中
Original assignee: Takara Belmont Corp
Current assignee: Takara Belmont Corp
Priority date: 2016-04-21
Filing date: 2016-04-21
Publication date: 2017-10-26
Anticipated expiration: 2036-04-21
Also published as: JP6788995B2

Abstract

PROBLEM TO BE SOLVED: To provide an examination table including a lower limb receiving member displaced so as to cause a patient into a proper lithotomy posture.SOLUTION: An examination table 100 for examination of a patient with opened lower limbs includes: a waist receiving member 4 supporting a portion of the patient extending from a waist to hip; and a pair of lower limb receiving members 5 including a base end side 6 adjacent to the waist receiving member 4, supporting the lower limb of the patient, and capable of being displaced between a leg open position with tip sides 7 separated from each other and a leg closed position with the tip sides 7 approaching each other. The lower limb receiving member 5 can be changed into a standing posture with the base end side 6 standing with respect to the tip side 7 as a base shaft and, and in shifting to the standing posture, the tip side 7 moves in a direction approaching the waist receiving member 4.SELECTED DRAWING: Figure 4

Description

Translated fromJapanese

本発明は、産科、婦人科、泌尿器科及び肛門科等の診察又は治療等の処理のために用いる診療台に関する。 The present invention relates to a medical table used for medical examinations or treatments in obstetrics, gynecology, urology, anus, and the like.

上記の診療台では、仰向けの患者を開脚状態にして診察等が行われる。このとき、患者が砕石位であると、医師の診察や治療等の処置をする上で好ましい。例えば、特許文献１では、屈曲した下肢受け部材によって患者の膝部を曲げた状態で固定する診療台が開示されている。この診療台では、患者の姿勢は、閉脚状態で背凭れ部が起立する着座姿勢から、背凭れ部が水平になると同時に下肢受け部材が上方に回動して閉脚状態の外診姿勢となる。その後に、下肢受け部材の移動により患者の両脚が開いて内診姿勢に移行することで患者が砕石位になるよう構成されている。 In the above-mentioned medical table, a patient who is lying on his back is in an open leg state and is examined. At this time, it is preferable for the patient to be in the lithotripsy position for treatment such as medical examination and treatment by a doctor. For example,Patent Document 1 discloses a medical table that fixes a patient's knee in a bent state by a bent leg receiving member. In this medical table, the posture of the patient changes from a sitting posture in which the backrest portion stands in a closed leg state to an outpatient examination posture in a closed leg state while the backrest portion becomes horizontal and the lower limb receiving member rotates upward. Thereafter, both legs of the patient are opened by the movement of the lower limb receiving member, and the patient is placed in a crushed position by shifting to an internal examination posture.

特許文献２には、アクチュエータの駆動により起立する、足裏受け部とふくらはぎ受け部とを有する下肢受け部材を備える産科分娩台の支脚器が開示されている。ふくらはぎ受け部が起立した状態で開脚位置に移行することで患者が砕石位になるよう構成されている。ふくらはぎ受け部は足裏受け部の起立に伴って起立して患者のふくらはぎ部を支持する。このとき、ふくらはぎ受け部が起立するときの基軸は移動しない。 Patent Document 2 discloses a support device for an obstetric delivery table that includes a lower limb receiving member that has a sole receiving part and a calf receiving part that stands by driving of an actuator. It is comprised so that a patient may become a crushed stone position by moving to an open leg position in the state where the calf receiving part stood up. The calf receiving part stands up and supports the patient's calf part as the sole receiving part rises. At this time, the base shaft when the calf receiving portion stands up does not move.

特開平１１−４２２５８号公報Japanese Patent Laid-Open No. 11-42258特開２０１１−１５６０１０号公報JP 2011-156010 A

特許文献１の構成では、診療台が着座姿勢から閉脚状態の外診姿勢を経た後に開脚状態の内診姿勢になる。このため、患者が砕石位になるまでに診療台を大きく姿勢変化させる必要があり、姿勢変化による患者への負荷が大きくなる。また、診療台の姿勢変化が大きいことで診療台の操作性が低くなる。さらに、着座姿勢から外診姿勢へ変更する際に、背凭れ部が座板との角度を保ちながらリクライニングを行うため、診療台（背凭れ部）の最低位置が高くなり、外診が行い難いことがある。
特許文献１の構成では、ふくらはぎ受け部の形状はふくらはぎを快適に受けるために形状が固定されている。また、診療台が水平となる状態では、腰受け部材からふくらはぎ受け部までの距離が外診姿勢の際の診療台の長さによって定められる。そのため、これらの条件を基にして、ふくらはぎ受け部と腰受け部材を配置すると、ふくらはぎ受け部と腰受け部材との間に大きなスペースが発生することとなり、診療台が水平となる状態での患者の快適性に悪影響を及ぼすことがある。In the configuration ofPatent Document 1, the medical examination table becomes an internal examination posture in an open leg state after passing from a sitting posture to an external examination posture in a closed leg state. For this reason, it is necessary to greatly change the posture of the medical table before the patient reaches the lithotripsy position, and the load on the patient due to the posture change increases. In addition, the operability of the medical table becomes low due to the large change in posture of the medical table. In addition, when changing from a sitting posture to an outpatient posture, the reclining portion performs reclining while maintaining an angle with the seat plate, so the minimum position of the examination table (backrest portion) becomes high, making it difficult to go out. Sometimes.
In the configuration ofPatent Document 1, the shape of the calf receiving portion is fixed in order to comfortably receive the calf. Further, in the state where the medical table is horizontal, the distance from the waist receiving member to the calf receiving part is determined by the length of the medical table in the outpatient posture. Therefore, when the calf receiving part and the waist receiving member are arranged based on these conditions, a large space is generated between the calf receiving part and the waist receiving member, and the patient in a state where the medical table is horizontal. May adversely affect comfort.

特許文献２の構成では、ふくらはぎ受け部が起立するときの基軸は移動しないので、平面視においてふくらはぎ受け部の基端側（腰受け部材の側）は、ふくらはぎ受け部の起立が進むにつれて腰受け部材から大きく離れる。このため、患者が不安定な砕石位になることがある。 In the configuration ofPatent Document 2, since the base shaft when the calf receiving part stands up does not move, the base end side (the waist receiving member side) of the calf receiving part in a plan view is the waist support as the calf receiving part rises. A large distance from the member. This can cause the patient to be in an unstable lithotripsy position.

そのため、患者が適正な砕石位になるように下肢受け部材が変位する診療台が求められている。 Therefore, there is a need for a medical table in which the lower limb receiving member is displaced so that the patient is in an appropriate crushed stone position.

本発明に係る診療台の特徴構成は、患者の下肢部を開脚して診療を行う診療台であって、前記患者の腰部から臀部に亘って支持する腰受け部材と、基端側が前記腰受け部材に近接して設けられ前記患者の下肢部を支持し、先端側が離間する開脚位置と前記先端側が近接する閉脚位置とに変位可能な一対の下肢受け部材と、を備え、前記下肢受け部材は、前記先端側を基軸にして前記基端側が起立する起立姿勢に変更可能であるとともに、前記起立姿勢に移行する際に前記先端側が前記腰受け部材に近づく方向に移動する点にある。 A characteristic configuration of a medical table according to the present invention is a medical table that performs medical treatment by opening a lower limb of a patient, and a waist receiving member that supports the patient from the waist to the buttocks, and a proximal end side of the waist A pair of lower limb support members provided close to the receiving member and supporting the lower limbs of the patient and displaceable between an open leg position in which the distal end side is separated and a closed leg position in which the distal end side is adjacent; The member can be changed to a standing posture in which the proximal end side stands up with the distal end side as a base axis, and the distal end side moves in a direction approaching the waist receiving member when shifting to the standing posture.

本構成によれば、下肢受け部材が起立姿勢に移行する際に基軸である先端側が腰受け部材に近づく方向に移動する。これにより、平面視において下肢受け部材の基端側が腰受け部材から離れる距離が小さくなるため、下肢受け部材の基端側によって患者の膝部を水平状態の位置からほぼ真上となる位置に移動させることができる。その結果、下肢受け部材によって患者の膝部が安定的に保持されるので、患者を適正な砕石位にすることができる。また、下肢受け部材が起立姿勢に移行する際に、平面視において下肢受け部材の基端側が腰受け部材から離れる距離が小さくなることで、腰受け部材において患者の腰部から臀部に亘る部位の変位を小さくすることもできる。さらに、下肢受け部材が起立する際に起立用の基軸が腰受け部材に近づくため、下肢受け部材は水平姿勢からの起立角度を大きく変化させ易い。 According to this configuration, when the lower limb receiving member shifts to the standing posture, the distal end side which is the base axis moves in a direction approaching the waist receiving member. As a result, the distance at which the base end side of the lower limb receiving member is separated from the waist receiving member in plan view is reduced, so that the patient's knee is moved from the horizontal position to a position almost directly above by the base end side of the lower limb receiving member. Can be made. As a result, the patient's knee is stably held by the lower limb receiving member, so that the patient can be in an appropriate crushed stone position. In addition, when the lower limb receiving member shifts to the standing posture, the distance from which the proximal end side of the lower limb receiving member is separated from the waist receiving member in a plan view is reduced, so that the portion of the waist receiving member that extends from the patient's waist to the buttocks is displaced. Can be reduced. Furthermore, when the lower limb receiving member stands up, the standing base shaft approaches the waist receiving member, so that the lower limb receiving member can easily change the standing angle from the horizontal posture.

本発明に係る診療台の他の特徴構成は、前記下肢受け部材は、前記起立姿勢に移行する際に前記閉脚位置から前記開脚位置に変位する点にある。 Another characteristic configuration of the medical table according to the present invention is that the lower limb receiving member is displaced from the closed leg position to the open leg position when shifting to the standing posture.

本構成によれば、下肢受け部材の起立姿勢への移行と閉脚位置から前記開脚位置への変位を同時に行うことができるため、患者が砕石位となる診療台の姿勢変更を迅速に行うことができる。 According to this configuration, the transition to the standing posture of the lower limb receiving member and the displacement from the closed leg position to the open leg position can be performed at the same time, so that the posture of the medical table in which the patient is in the crushed position can be quickly changed. Can do.

本発明に係る診療台の他の特徴構成は、前記下肢受け部材は、ふくらはぎ受け部と足載せ部とが一体に構成されている点にある。 Another characteristic configuration of the medical table according to the present invention is that the lower limb receiving member is configured integrally with a calf receiving portion and a footrest portion.

本構成により、ふくらはぎ受け部と足載せ部とが一体として起立姿勢になる。これにより、患者の膝部から足部までを下肢受け部材によって安定的に保持することができる。また、ふくらはぎ受け部と足載せ部とが一体となることで、下肢受け部材の製造コストを低減することができる。 With this configuration, the calf receiving portion and the footrest portion are in an upright posture. Thereby, a patient's knee part can be stably hold | maintained by a leg support member from a leg part. Moreover, the manufacturing cost of the leg support member can be reduced by integrating the calf receiving part and the footrest part.

本発明に係る診療台の他の特徴構成は、前記下肢受け部材は、前記起立姿勢において前記基端側が前記診療台の左右方向の中央側に近接するように構成されている点にある。 Another characteristic configuration of the medical table according to the present invention is that the lower limb receiving member is configured such that, in the standing posture, the proximal end side is close to a central side in the left-right direction of the medical table.

一対の下肢受け部材が開脚位置であり、且つ起立姿勢である状態（以下、起立開脚姿勢と称する。）においては、患者の股部に負荷がかかることがある。そこで、本構成では、下肢受け部材は、起立姿勢において基端側が診療台の左右方向の中央側に近接するように構成されている。こうすると、下肢受け部材が起立開脚姿勢のときに患者の下肢部を診療台の左右中央側に近づけて保持できるため、患者の股部への負荷を低減することができる。 In a state where the pair of lower limb receiving members are in the open leg position and are in the standing posture (hereinafter referred to as standing leg opening posture), a load may be applied to the patient's crotch. Therefore, in this configuration, the lower limb receiving member is configured such that, in the standing posture, the proximal end side is close to the center side in the left-right direction of the medical table. In this way, when the lower limb receiving member is in the standing open leg position, the lower limb portion of the patient can be held close to the left and right central side of the examination table, so that the load on the patient's crotch can be reduced.

本発明に係る診療台の他の特徴構成は、前記下肢受け部材は、前記腰受け部材の側に当該下肢受け部材の下面から延出された延長支持部を設けてある点にある。 Another characteristic configuration of the medical table according to the present invention is that the lower limb receiving member is provided with an extended support portion extending from the lower surface of the lower limb receiving member on the waist receiving member side.

下肢受け部材が起立姿勢のとき、患者の膝部から足部までの領域は下肢受け部材によって支持することができる。しかし、患者の太腿部は、起立姿勢の下肢受け部材からは離間する位置になるため、下肢受け部材では支持されない。そのため、大腿部の位置が不安定になることがある。その点、本構成のように、肢受け部材が、腰受け部材の側に当該下肢受け部材の下面から延出された延長支持部を有すると、この延長支持部によって大腿部の一部を保持することができる。これにより、下肢受け部材によって患者の膝部をより安定的に保持することができる。また、砕石位の姿勢保持に伴う患者の負荷を軽減することができる。 When the lower limb receiving member is in the standing posture, the region from the knee portion to the foot portion of the patient can be supported by the lower limb receiving member. However, the patient's thigh is not supported by the leg support member because the patient's thigh is positioned away from the leg support member in the standing posture. For this reason, the position of the thigh may become unstable. In this regard, as in this configuration, when the limb support member has an extended support portion that extends from the lower surface of the lower limb support member on the side of the waist support member, a part of the thigh is partly extended by this extension support portion. Can be held. Thereby, a patient's knee part can be hold | maintained more stably by the leg support member. In addition, it is possible to reduce the patient's load associated with maintaining the crushed stone posture.

本発明に係る診療台の他の特徴構成は、四節リンク機構と、前記四節リンク機構を駆動するアクチュエータと、を備え、前記下肢受け部材は、位置及び姿勢が前記四節リンク機構によって変更可能に構成されている点にある。 Another characteristic configuration of the medical table according to the present invention includes a four-bar link mechanism and an actuator that drives the four-bar link mechanism, and the position and posture of the lower limb receiving member are changed by the four-bar link mechanism. It is in the point where it is configured.

上述のように、下肢受け部材は、起立姿勢に移行する際に先端側の位置が移動することで、患者の膝部を水平状態の位置からほぼ真上となる位置に移動させることができる。また、下肢受け部材は、起立姿勢に移行しつつ開脚位置に変位したり、反対に起立姿勢から非起立姿勢に移行しつつ閉脚位置に変位したりすることがある。このように下肢受け部材の位置及び姿勢変更は複雑になる。そこで、本構成では、四節リンク機構によって下肢受け部材の位置及び姿勢を変更可能に構成されている。これにより、下肢受け部材の位置及び姿勢を変更する機構を簡易に構成することができる。 As described above, when the lower limb receiving member moves to the standing posture, the position of the distal end side moves, so that the patient's knee can be moved from the position in the horizontal state to a position almost directly above. Further, the lower limb receiving member may be displaced to the open leg position while shifting to the standing posture, or may be displaced to the closed leg position while shifting from the standing posture to the non-standing posture. Thus, changing the position and posture of the lower limb receiving member is complicated. Therefore, in this configuration, the position and posture of the lower limb receiving member can be changed by the four-bar linkage mechanism. Thereby, the mechanism which changes the position and attitude | position of a lower leg receiving member can be comprised easily.

第１実施形態の診療台の水平閉脚姿勢を示す斜視図である。It is a perspective view which shows the horizontal leg posture of the medical table of 1st Embodiment.図１の側面図である。It is a side view of FIG.第１実施形態の診療台の起立閉脚姿勢を示す斜視図である。It is a perspective view which shows the standing closed leg attitude | position of the medical treatment table of 1st Embodiment.図３の側面図である。FIG. 4 is a side view of FIG. 3.第１実施形態の診療台の起立開脚姿勢を示す斜視図である。It is a perspective view which shows the standing open leg attitude | position of the medical treatment table of 1st Embodiment.図５の側面図である。FIG. 6 is a side view of FIG. 5.水平姿勢の下肢受け部材の側面図である。It is a side view of the leg support member of a horizontal posture.起立姿勢の下肢受け部材の側面図である。It is a side view of the leg receiving member of a standing posture.下肢受け部材を水平閉脚状態に変位させる四節リンク機構を示す平面図である。It is a top view which shows the four-bar linkage mechanism which displaces a leg support member in a horizontal closed state.下肢受け部材を起立開脚状態に変位させる四節リンク機構を示す平面図である。It is a top view which shows the four-bar linkage mechanism which displaces a lower limbs receiving member to a standing open leg state.別実施形態の下肢受け部材を水平閉脚状態に変位させる四節リンク機構を示す平面図である。It is a top view which shows the four-bar linkage mechanism which displaces the leg support member of another embodiment to a horizontal closed state.別実施形態の下肢受け部材を起立開脚状態に変位させる四節リンク機構を示す平面図である。It is a top view which shows the four-bar linkage mechanism which displaces the leg support member of another embodiment to a standing open leg state.

以下、診療台の一つの実施形態について、図を参照しながら説明する。 Hereinafter, one embodiment of a medical table will be described with reference to the drawings.

〔第１実施形態〕
図１〜図６に示すように、本実施形態の診療台１００は、床面に設置される基台１と、基台１の上に載置された支持台２とを有し、基台１のボックス内に設けられた昇降用シリンダ（不図示）によって支持台２が上下動する。支持台２には、背凭れ部材３と、腰受け部材４と、一対の下肢受け部材５とが取付けられている。背凭れ部材３は支持台２に対して背凭れ用シリンダ（不図示）によって起伏可能である。腰受け部材４は、患者の腰部から臀部に亘る部位を支持する。下肢受け部材５の下方には支持台２に対して着脱可能な補助台９が設けられている。[First Embodiment]
As shown in FIGS. 1 to 6, a medical table 100 according to this embodiment includes abase 1 installed on a floor surface and asupport base 2 placed on thebase 1. Thesupport base 2 is moved up and down by an elevating cylinder (not shown) provided in one box. Abackrest member 3, awaist support member 4, and a pair of lowerlimb support members 5 are attached to thesupport base 2. Thebackrest member 3 can be raised and lowered by a backrest cylinder (not shown) with respect to thesupport base 2. Thewaist receiving member 4 supports a portion extending from the patient's waist to the buttocks. Below the lowerlimb receiving member 5, anauxiliary base 9 that can be attached to and detached from thesupport base 2 is provided.

下肢受け部材５は、基端側６が腰受け部材４に近接して設けられ、患者の下肢部全体を支持する。下肢受け部材５は、板状に形成されており、患者のふくらはぎ部を載せるふくらはぎ受け部と足部を載せる足載せ部とが一体的に設けられている。下肢受け部材５は、先端側７が離間する開脚位置と先端側７が近接する閉脚位置とに変位可能である。 The lowerlimb receiving member 5 is provided with aproximal side 6 close to thewaist receiving member 4 and supports the entire lower limb of the patient. The lowerlimb receiving member 5 is formed in a plate shape, and a calf receiving part on which a patient's calf part is placed and a foot rest part on which a foot part is placed are integrally provided. The lowerlimb receiving member 5 is displaceable between an open leg position where thedistal end side 7 is separated and a closed leg position where thedistal end side 7 is close.

下肢受け部材５は、下肢受けフレーム５ａ（図９参照）上に載置されており腰受け部材４の下部から延設される回動リンク機構１０を備える。回動リンク機構１０は四節リンク機構によって構成され、下肢受け部材５を開脚位置及び閉脚位置、並びに、水平姿勢及び起立姿勢に変位させる。回動リンク機構１０は、下肢受け部材５の基端側６に位置する第１リンク機構１１と、下肢受け部材５の先端側７に位置する第２リンク機構１２とを備えて構成されている。第１リンク機構１１は第１リンク部１３及び第２リンク部１４を有し、第２リンク機構１２は第３リンク部１５及び第４リンク部１６を有する（図７〜図１０参照）。 The lowerlimb receiving member 5 includes arotation link mechanism 10 that is placed on the lowerlimb receiving frame 5a (see FIG. 9) and extends from the lower portion of thewaist receiving member 4. Therotation link mechanism 10 is constituted by a four-bar link mechanism, and displaces the lowerlimb receiving member 5 into an open leg position and a closed leg position, and a horizontal attitude and a standing attitude. Therotation link mechanism 10 includes afirst link mechanism 11 located on theproximal end side 6 of the lowerlimb receiving member 5 and asecond link mechanism 12 located on thedistal end side 7 of the lowerlimb receiving member 5. . The1st link mechanism 11 has the1st link part 13 and the2nd link part 14, and the2nd link mechanism 12 has the3rd link part 15 and the 4th link part 16 (refer FIGS. 7-10).

支持台２には、第１リンク機構１１を駆動し一対の下肢受け部材５を開脚位置と閉脚位置とに変位させる一対の油圧シリンダ２０（アクチュエータの一例）が設けられている。図７〜図１０においては、一方（左脚側）の下肢受け部材５のみを表している。油圧シリンダ２０のロッド２０ａが第１リンク部１３の基端側に連結されている。第１リンク機構１１の第１リンク部１３及び第２リンク部１４は、回動軸部１３ａ，１４ａが第１支持部２２に軸支され、先端部１３ｂ、１４ｂが第２支持部２３に軸支されている。第３リンク部１５及び第４リンク部１６は、回動軸部１５ａ，１６ａが第２支持部２３に軸支され、先端部１５ｂ、１６ｂが下肢受け部材５の裏面に設けられるブラケット１７に取付けられている。以下の説明では便宜上、下肢受けフレーム５ａを下肢受け部材５として説明する。 Thesupport 2 is provided with a pair of hydraulic cylinders 20 (an example of an actuator) that drives thefirst link mechanism 11 and displaces the pair of lowerlimb receiving members 5 between the open leg position and the closed leg position. 7 to 10, only one (left leg side) lowerlimb receiving member 5 is shown. Therod 20 a of thehydraulic cylinder 20 is connected to the proximal end side of thefirst link portion 13. As for the1st link part 13 and the2nd link part 14 of the1st link mechanism 11, the rotatingshaft parts 13a and 14a are pivotally supported by the1st support part 22, and the front-end | tipparts 13b and 14b are pivoted by the2nd support part 23. It is supported. Thethird link portion 15 and thefourth link portion 16 are attached to abracket 17 whosepivot shaft portions 15 a and 16 a are pivotally supported by thesecond support portion 23 and whosetip portions 15 b and 16 b are provided on the back surface of the lowerlimb receiving member 5. It has been. In the following description, the lowerlimb receiving frame 5a will be described as the lowerlimb receiving member 5 for convenience.

図９に示すように、油圧シリンダ２０の動作によりロッド２０ａが突出すると、第１リンク部１３及び第２リンク部１４の先端側が互いに近接し、一対の下肢受け部材５は閉脚位置に移動する。一方、図１０に示すように、油圧シリンダ２０の動作によりロッド２０ａが引退すると、第１リンク部１３及び第２リンク部１４の先端側が離間し、一対の下肢受け部材５は開脚位置に移動する。 As shown in FIG. 9, when therod 20a protrudes due to the operation of thehydraulic cylinder 20, the distal ends of thefirst link portion 13 and thesecond link portion 14 are close to each other, and the pair of lowerlimb support members 5 move to the closed leg position. On the other hand, as shown in FIG. 10, when therod 20a is retracted by the operation of thehydraulic cylinder 20, the distal ends of thefirst link portion 13 and thesecond link portion 14 are separated from each other, and the pair of lowerlimb support members 5 move to the open leg position. To do.

図７、図８に示すように、下肢受け部材５は、第２リンク機構１２によって先端側７を基軸にして基端側６が起立する起立姿勢に変更可能に構成されている。下肢受け部材５が起立姿勢になることで、下肢受け部材５の基端側を膝部受け部にして患者の膝部を支持することができる。 As shown in FIGS. 7 and 8, the lowerlimb receiving member 5 is configured to be changeable to a standing posture in which theproximal end side 6 stands with thedistal end side 7 as a base axis by thesecond link mechanism 12. When the lowerlimb receiving member 5 is in the standing posture, the proximal end side of the lowerlimb receiving member 5 can be used as a knee receiving portion to support the patient's knee.

第２リンク機構１２の作用によって、さらに、下肢受け部材５は、起立姿勢に移行する際に先端側７が腰受け部材４に近づく方向に移動するよう構成されている（図４参照）。これにより、平面視において下肢受け部材５の基端側６が腰受け部材４から離れる距離が小さくなるため、下肢受け部材５の基端側６によって患者の膝部を水平状態の位置からほぼ真上となる位置に移動させることができる。その結果、下肢受け部材５によって患者の膝部が安定的に保持されるので、患者を適正な砕石位にすることができる。また、平面視において下肢受け部材５の基端側６が腰受け部材４から離れる距離が小さくなることで、腰受け部材４において患者の腰部から臀部に亘る部位の変位を小さくすることもできる。さらに、下肢受け部材５が起立する際に起立用の基軸が腰受け部材４に近づくため、下肢受け部材５は水平姿勢からの起立角度を大きく変化させ易い。 By the action of thesecond link mechanism 12, the lowerlimb receiving member 5 is further configured to move in a direction in which thedistal end side 7 approaches thewaist receiving member 4 when shifting to the standing posture (see FIG. 4). As a result, the distance at which theproximal end side 6 of the lowerlimb receiving member 5 is separated from thewaist receiving member 4 in a plan view is reduced, and theproximal end side 6 of the lowerlimb receiving member 5 allows the patient's knee to be substantially true from the horizontal position. It can be moved to an upper position. As a result, the knee of the patient is stably held by the lowerlimb receiving member 5, so that the patient can be in an appropriate crushed stone position. Further, since the distance that thebase end side 6 of the lowerlimb receiving member 5 is separated from thewaist receiving member 4 in a plan view is reduced, the displacement of the region from the patient's waist to the buttocks in thewaist receiving member 4 can be reduced. Furthermore, when the lowerlimb receiving member 5 stands up, the standing base shaft approaches thewaist receiving member 4, so that the lowerlimb receiving member 5 can easily change the standing angle from the horizontal posture.

以下に第２リンク機構１２について詳しく説明する。第２リンク機構１２は図７〜図１０において具体的な構造が示されている。 Hereinafter, thesecond link mechanism 12 will be described in detail. The specific structure of thesecond link mechanism 12 is shown in FIGS.

第３リンク部１５及び第４リンク部１６の回動軸部１５ａ，１６ａが、第２支持部２３に設けられた取付片２３ａにおいて診療台１００の左右方向に軸支されている。下肢受け部材５の裏面には、下肢受け部材５の長手方向に沿って一対のブラケット１７が設けられている。第３リンク部１５及び第４リンク部１６の先端部１５ｂ，１６ｂは、ブラケット１７の先端側（下肢受け部材５の先端側７）において診療台１００の左右方向に軸支されている。 Therotation shaft portions 15 a and 16 a of thethird link portion 15 and thefourth link portion 16 are pivotally supported in the left-right direction of the medical table 100 on theattachment piece 23 a provided on thesecond support portion 23. A pair ofbrackets 17 are provided on the back surface of the lowerlimb receiving member 5 along the longitudinal direction of the lowerlimb receiving member 5. Thedistal end portions 15 b and 16 b of thethird link portion 15 and thefourth link portion 16 are pivotally supported in the left-right direction of the clinical table 100 on the distal end side of the bracket 17 (thedistal end side 7 of the lower limb receiving member 5).

第２リンク機構１２を駆動するガスシリンダ１８（アクチュエータの一例）が下肢受け部材５の長手方向に設けられている。ガスシリンダ１８は、ロッド１８ａの先端が下肢受け部材５の基端側６に向くよう配置されており、ロッド１８ａとは反対側の端部１８ｂが一対のブラケット１７に間に配設された取付片１７ａに取付けられている。下肢受け部材５の裏面部位と第３リンク部１５及び第４リンク部１６の先端部１５ｂ、１６ｂとの間には、下肢受け部材５の姿勢保持するワイヤー部材１９が複数配設されている。 A gas cylinder 18 (an example of an actuator) that drives thesecond link mechanism 12 is provided in the longitudinal direction of the lowerlimb receiving member 5. Thegas cylinder 18 is disposed such that the tip of therod 18 a faces theproximal end side 6 of the lowerlimb receiving member 5, and anend 18 b opposite to therod 18 a is disposed between the pair ofbrackets 17. It is attached to thepiece 17a. A plurality ofwire members 19 that hold the posture of the lowerlimb receiving member 5 are disposed between the back surface portion of the lowerlimb receiving member 5 and thedistal end portions 15b and 16b of thethird link portion 15 and thefourth link portion 16.

図８に示すように、ガスシリンダ１８のロッド１８ａが伸長動作すると、下肢受け部材５は先端側７の部位を基軸として起立する。下肢受け部材５が起立すると、第３リンク部１５及び第４リンク部１６の先端部１５ｂ，１６ｂがブラケット１７とともに持ち上がるため、第３リンク部１５及び第４リンク部１６が基端側６に向けて回動する。これにより、下肢受け部材５の先端側７が腰受け部材４の側に近接するように移動する（図４参照）。 As shown in FIG. 8, when therod 18 a of thegas cylinder 18 extends, the lowerlimb receiving member 5 stands with thedistal end side 7 as a base axis. When the lowerlimb receiving member 5 stands up, thedistal end portions 15b and 16b of thethird link portion 15 and thefourth link portion 16 are lifted together with thebracket 17, so that thethird link portion 15 and thefourth link portion 16 are directed toward theproximal end side 6. Rotate. Accordingly, thedistal end side 7 of the lowerlimb receiving member 5 moves so as to be close to thewaist receiving member 4 side (see FIG. 4).

患者の太腿部は、起立姿勢の下肢受け部材５からは離間する位置になるため、下肢受け部材５では支持されない。そのため、大腿部の位置が不安定になることがある。そこで、下肢受け部材５は、基端側６に当該下肢受け部材５の下面から延出された延長支持部８が設けられている。延長支持部８を設けることで、起立姿勢の下肢受け部材５の基端側６において患者の膝部に加えて大腿部の一部を保持することができる。これにより、下肢受け部材５によって患者の膝部をより安定的に保持することができる。また、砕石位の姿勢保持に伴う患者の負荷を軽減することができる。 The patient's thigh is not supported by theleg support member 5 because the patient's thigh is in a position separated from theleg support member 5 in the standing posture. For this reason, the position of the thigh may become unstable. Therefore, the lowerlimb receiving member 5 is provided with anextended support portion 8 extending from the lower surface of the lowerlimb receiving member 5 on theproximal end side 6. By providing theextended support portion 8, a part of the thigh in addition to the patient's knee can be held on theproximal end side 6 of the lowerlimb receiving member 5 in the standing posture. Thereby, a patient's knee part can be hold | maintained more stably by theleg support member 5. FIG. In addition, it is possible to reduce the patient's load associated with maintaining the crushed stone posture.

起立開脚姿勢（図５）に下肢受け部材５が変位することで、患者の膝部が下肢受け部材５の基端側６に支持されるようになり、患者を適正な砕石位にすることができる。水平閉脚姿勢（図１）から起立開脚姿勢（図５）に下肢受け部材５を姿勢変更するためには、例えば起立姿勢に移行する際に閉脚位置から開脚位置に変位させる。すなわち、第１リンク機構１１と第２リンク機構１２とを同時に動作させるようにする。このようにすると、患者が砕石位となる診療台の姿勢変更を迅速に行うことができる。 Displacement of the lowerlimb support member 5 in the standing open leg posture (FIG. 5) enables the patient's knee to be supported by theproximal end side 6 of the lowerlimb support member 5, and makes the patient an appropriate crushed stone position. Can do. In order to change the posture of the lowerlimb receiving member 5 from the horizontal closed posture (FIG. 1) to the standing open leg posture (FIG. 5), for example, when shifting to the standing posture, it is displaced from the closed leg position to the open leg position. That is, thefirst link mechanism 11 and thesecond link mechanism 12 are operated simultaneously. In this way, it is possible to quickly change the posture of the medical table where the patient is in the crushed stone position.

なお、下肢受け部材５の姿勢変更は、水平閉脚姿勢（図１）から起立閉脚姿勢（図３）に移行させた後に開脚位置に変位させてもよいし、水平閉脚姿勢（図１）から開脚位置に変位させた後に起立姿勢に移行させてもよい。この場合は、第１リンク機構１１及び第２リンク機構１２の何れか一方を先に動作させ、その後に他方を動作させる。 The posture of the lowerlimb receiving member 5 may be changed from the horizontal closed leg position (FIG. 1) to the standing closed leg position (FIG. 3) and then displaced to the open leg position, or from the horizontal closed leg position (FIG. 1). You may make it transfer to a standing posture after displacing to an open leg position. In this case, one of thefirst link mechanism 11 and thesecond link mechanism 12 is operated first, and then the other is operated.

〔第２実施形態〕
第１実施形態において、一対の下肢受け部材５が起立開脚姿勢（図５）の状態では、患者の股部に対して必要以上に負荷がかかることがある。
そこで、本実施形態では、下肢受け部材５は、水平姿勢（図１１）から移行した起立姿勢（図１２）において基端側６が診療台１００の左右方向の中央側に近接するように構成されている。こうすると、起立開脚姿勢（図１２）の下肢受け部材５において患者の下肢部を診療台１００の左右中央側に近づけて保持できるため、患者の股部への負荷を低減することができる。[Second Embodiment]
In the first embodiment, when the pair of lowerlimb support members 5 are in the standing open leg posture (FIG. 5), a load may be applied more than necessary on the patient's crotch.
Therefore, in the present embodiment, the lowerlimb receiving member 5 is configured such that theproximal end side 6 is close to the center side in the left-right direction of the examination table 100 in the standing posture (FIG. 12) that has shifted from the horizontal posture (FIG. 11). ing. In this way, since the lower limbs of the patient can be held close to the left and right central side of the clinical table 100 in the lowerlimb receiving member 5 in the standing open leg posture (FIG. 12), the load on the patient's crotch can be reduced.

具体的には、図１１に示すように、下肢受け部材５において、ブラケット１７の両端位置に支持板３０を設けている。支持板３０は、下肢受け部材５に対して左右方向に設けられ、診療台１００の左右方向の中央側が先端側７に向けて傾斜している。ブラケット１７は、支持板３０に対して基端側６よりも先端側７が左右方向外側に変位して取付けられている。このブラケット１７に第３リンク部１５及び第４リンク部１６の先端側を軸支し、第３リンク部１５及び第４リンク部１６についても第２支持部２３の取付片２３ａに対して傾いて軸支される。このように、第２リンク機構１２を構成することで、図１２に示すように、下肢受け部材５は起立開脚姿勢において基端側６が診療台１００の左右方向の中央側に近接する姿勢（傾斜姿勢）となる。 Specifically, as shown in FIG. 11,support plates 30 are provided at both end positions of thebracket 17 in the lowerlimb receiving member 5. Thesupport plate 30 is provided in the left-right direction with respect to the lowerlimb receiving member 5, and the center side in the left-right direction of the medical table 100 is inclined toward thedistal end side 7. Thebracket 17 is attached to thesupport plate 30 such that thedistal end side 7 is displaced outward in the left-right direction from theproximal end side 6. Thebrackets 17 are pivotally supported at the distal ends of thethird link portion 15 and thefourth link portion 16, and thethird link portion 15 and thefourth link portion 16 are also inclined with respect to the mountingpiece 23 a of thesecond support portion 23. It is pivotally supported. In this way, by configuring thesecond link mechanism 12, as shown in FIG. 12, the lowerlimb receiving member 5 is in a posture in which theproximal end side 6 is close to the central side in the left-right direction of the treatment table 100 in the standing open leg posture. (Inclined posture).

〔他の実施形態〕
（１）上記の実施形態では、下肢受け部材５が、ふくらはぎ受け部と足載せ部とを有する例を示したが、下肢受け部材５はふくらはぎ受け部のみを有して構成されていてもよい。[Other Embodiments]
(1) In the above embodiment, the lowerlimb receiving member 5 has an example having the calf receiving portion and the footrest portion. However, the lowerlimb receiving member 5 may be configured to have only the calf receiving portion. .

（２）上記の実施形態では、２つの四節リンク機構（リンク機構１１、１２）を用いて下肢受け部材５の位置及び姿勢を変更する例を示した。水平閉脚姿勢（図１）と起立開脚姿勢（図５）との変更のみを行う診療台１００にあっては、１つの四節リンク機構によって下肢受け部材５を変位させてもよい。また、四節リンク機構以外の構成を用いて下肢受け部材５を動作させてもよい。(2) In the above embodiment, an example in which the position and posture of the lowerlimb receiving member 5 are changed using two four-bar linkage mechanisms (linkmechanisms 11 and 12) has been described. In the treatment table 100 that only changes between the horizontal closed posture (FIG. 1) and the standing open leg posture (FIG. 5), the lowerlimb receiving member 5 may be displaced by one four-bar linkage mechanism. Moreover, you may operate theleg support member 5 using structures other than a four-bar linkage mechanism.

（３）上記の実施形態では、下肢受け部材５を姿勢変更させるためのアクチュエータとしてガスシリンダ１８や油圧シリンダ２０を用いる例を示したが、これに限定されない。例えば、ガスシリンダ１８に代えて油圧シリンダを用いてもよく、油圧シリンダ２０に代えてガスシリンダを用いてもよく、電動機とギアとの組み合わせた他のアクチュエータを利用してもよい。(3) In the above-described embodiment, the example in which thegas cylinder 18 and thehydraulic cylinder 20 are used as the actuator for changing the posture of the lowerlimb receiving member 5 is shown, but the present invention is not limited to this. For example, a hydraulic cylinder may be used instead of thegas cylinder 18, a gas cylinder may be used instead of thehydraulic cylinder 20, and another actuator in which an electric motor and a gear are combined may be used.

本発明は、医療施設において用いられる診療台に広く用いることができる。 The present invention can be widely used for a medical table used in a medical facility.

３：背凭れ部材
４：腰受け部材
５：下肢受け部材
６：基端側
７：先端側
８：延長支持部
１１：第１リンク機構
１２：第２リンク機構
１３：第１リンク部
１４：第２リンク部
１５：第３リンク部
１６：第４リンク部
１７：ブラケット
１８：アクチュエータ
１８ａ：ロッド
２０：アクチュエータ
２０ａ：ロッド
２２：第１支持部
２３：第２支持部
１００：診療台3: Backrest member 4: Waist receiving member 5: Lower limb receiving member 6: Base end side 7: Front end side 8: Extension support portion 11: First link mechanism 12: Second link mechanism 13: First link portion 14:First 2 link part 15: 3rd link part 16: 4th link part 17: Bracket 18:Actuator 18a: Rod 20:Actuator 20a: Rod 22: 1st support part 23: 2nd support part 100: Medical table

Claims

Translated fromJapanese

患者の下肢部を開脚して診療を行う診療台であって、
前記患者の腰部から臀部に亘って支持する腰受け部材と、
基端側が前記腰受け部材に近接して設けられ前記患者の下肢部を支持し、先端側が離間する開脚位置と前記先端側が近接する閉脚位置とに変位可能な一対の下肢受け部材と、を備え、
前記下肢受け部材は、前記先端側を基軸にして前記基端側が起立する起立姿勢に変更可能であるとともに、前記起立姿勢に移行する際に前記先端側が前記腰受け部材に近づく方向に移動する診療台。A medical table for performing treatment by opening a leg of a patient,
A waist support member that supports the patient's lower back and hips;
A pair of lower limb support members that are provided close to the waist support member and support the lower limbs of the patient and displaceable between an open leg position where the distal end side is separated and a closed leg position where the distal end side is close; Prepared,
The lower limb receiving member can be changed to a standing posture in which the proximal end stands up with the distal end as a base axis, and the medical treatment in which the distal end moves in a direction approaching the waist receiving member when shifting to the standing posture. Stand.

前記下肢受け部材は、前記起立姿勢に移行する際に前記閉脚位置から前記開脚位置に変位する請求項１に記載の診療台。 The medical table according to claim 1, wherein the lower limb receiving member is displaced from the closed leg position to the open leg position when shifting to the standing posture.

前記下肢受け部材は、ふくらはぎ受け部と足載せ部とが一体に構成されている請求項１又は２に記載の診療台。 The medical table according to claim 1 or 2, wherein the lower limb receiving member includes a calf receiving portion and a footrest portion integrally formed.

前記下肢受け部材は、前記起立姿勢において前記基端側が前記診療台の左右方向の中央側に近接するように構成されている請求項１から３のいずれか一項に記載の診療台。 The medical table according to any one of claims 1 to 3, wherein the lower limb receiving member is configured such that, in the standing posture, the proximal end side is close to a central side in the left-right direction of the medical table.

前記下肢受け部材は、前記基端側に当該下肢受け部材の下面から延出された延長支持部を設けてある請求項１から４のいずれか一項に記載の診療台。 The medical table according to any one of claims 1 to 4, wherein the lower limb receiving member is provided with an extended support portion extending from a lower surface of the lower limb receiving member on the base end side.

四節リンク機構と、前記四節リンク機構を駆動するアクチュエータと、を備え、
前記下肢受け部材は、位置及び姿勢が前記四節リンク機構によって変更可能に構成されている請求項１から５のいずれか一項に記載の診療台。A four-bar linkage mechanism, and an actuator for driving the four-bar linkage mechanism,
The medical table according to any one of claims 1 to 5, wherein the lower limb receiving member is configured such that a position and a posture thereof can be changed by the four-bar linkage mechanism.