CN102908134B - Parameter calibration method and parameter calibration system for continuously monitoring cardiac output - Google Patents
Parameter calibration method and parameter calibration system for continuously monitoring cardiac output Download PDFInfo
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Abstract
The invention relates to the technical field of medical detection, and particularly relates to a parameter calibration method and a parameter calibration system for continuously monitoring cardiac output. The method comprises the steps of measuring a pulse wave data signal through a luminescent device; simultaneously connecting a vessel of a target to be measured by a conduit, and measuring the standard cardiac output; calculating the pulse wave data signal to obtain local blood flow; establishing a physiological model according to the mapping relation; after the physiological model is established, withdrawing the conduit connected with the vessel of the target to be measured, and transmitting two paths of optical signals with different wavelength to the vessel of the target to be measured via the luminescent device till a continuous pulse wave data signal is obtained; and adjusting the continuous pulse wave data signal according to the physiological model. According to the invention, the conduit does not need to be retained in the body of the patient for a long time, thereby reducing the operation complexity of the medical personnel, and reducing the pain of the patient and potential harm to the patient.
Description
Technical field
The present invention relates to medical treatment to detect and the technical field of parametric calibration, be specifically related to parameter calibrating method that a kind of cardiac output monitors continuously and system.
Background technology
Cardiac output refers to the total blood volume of side per minute ventricle injection, is heart rate and the product of stroke volume, is the key clinical index of description cardiovascular system state.In clinical, especially in operating room, ICU, heart or vascular interventional treatment, cardiac output or stroke volume can help medical personnel to know the heart body of patient, and the continuous monitoring of kinemic change is contributed to obtaining instant kinemic change, therefore the continuous monitoring of cardiac output or stroke volume and quick response are just seemed particularly important.At present, for a lot of to kinemic method for continuous measuring, according to the difference of the Principles and methods of equipment, and the difference of its mode of operation, existing kinemic measuring method is mainly divided into noinvasive and Wicresoft two class.
Noninvasive measuring method, such as: bioimpedance (ICG), this is a kind of dynamic change according to thoracic cavity electrical impedance, measures the noninvasive method of cardiac function.This method is Modling model between capacity of blood vessel or blood flow change and thorax impedance changes, but changes due to the thorax impedance that body moves, breathes, mechanical ventilation, obesity, edema etc. may cause equally, and therefore accuracy is lower; And for example: sphygmogram method, it is analyzed based on the contour feature of arterial pulse waveform, calculates cardiac output by the model between different wave and cardiac output.Because the pulse wave profile of different patient is different, the pulse wave profile that especially cardiovascular disease causes also is cause the reason of the method measurement difficulty extremely; Therefore noninvasive measuring method, easily by the interference of various factors, most accuracy is lower;
The kinemic method of continuous measurement of Wicresoft, needs the conduit of the connection with pressure transducer to puncture among tremulous pulse, and is stranded in for a long time in body, easily causes damage to patient and operation comparatively complexity.
Summary of the invention
For overcoming above-mentioned defect, the parameter calibrating method that namely object of the present invention is to provide a kind of cardiac output to monitor continuously and system.
The object of the invention is to be achieved through the following technical solutions:
The parameter calibrating method of a kind of kinemic continuous monitoring of the present invention, comprising:
By the optical signal of luminescent device to the blood vessel transmitting two-way different wave length of measured target, receive the two ways of optical signals after described blood vessel; Meanwhile, the blood vessel of the conduit access measured target of pressure transducer will be connected to, measurement standard cardiac output;
This two ways of optical signals is converted to the corresponding signal of telecommunication, and carries out amplification respectively and process obtains two-way pulse wave data signal;
Two-way pulse wave data signal is calculated, obtains the regional blood flow of one-period;
Calculate the mapping relations between standard cardiac output and regional blood flow, and set up physiological models according to these mapping relations;
After setting up physiological models, withdraw from the conduit connected with the blood vessel of measured target, and continue through the optical signal of luminescent device continuous print to the blood vessel transmitting two-way different wave length of measured target, until obtain continuous print pulse wave data signal.
Further, described in calculate mapping relations between standard cardiac output and regional blood flow, and set up physiological models according to these mapping relations and also comprise:
Mapping relations between calculating standard cardiac output and regional blood flow, set up physiological models according to these mapping relations, and store this physiological models;
Judge whether to need again to calculate mapping relations, if desired again calculate, then again enter measurement standard cardiac output and receive the two ways of optical signals after described blood vessel; Again calculate if do not need, then all physiological models be stored are averaged, and upgrade physiological models according to average result.
Further, described in continue through luminescent device continuous print launches optical signal from two-way different wave length to the blood vessel of measured target, comprise until obtain continuous print pulse wave data signal:
The pulse frequency value obtained from continuous print pulse wave data signal, and the continuous print pulse wave data signal after adjustment is calculated, obtain continuous print regional blood flow;
Continuous print regional blood flow is combined with physiological models, calculates continuous print stroke volume;
Utilize continuous print stroke volume and pulse frequency value to calculate, obtain continuous print cardiac output.
Further, comprise after obtaining continuous print cardiac output described in:
Continuous print cardiac output is shown and/or prints and/or store.
Further, comprise after obtaining continuous print cardiac output described in:
Judge continuous print cardiac output whether in preset range, if not in preset range, then labelling is carried out to this continuous print cardiac output.
Further, the optical signal of described two-way different wave length comprises: red signal light and infrared signal.
A kind of kinemic continuous monitor system of the present invention, comprising:
Photosignal sending and receiving module, described photosignal sending and receiving module is attached on the blood vessel of measured target, for being launched the optical signal of two-way different wave length to the blood vessel of measured target by luminescent device, and receive the two ways of optical signals after described blood vessel, this two ways of optical signals is converted to the corresponding signal of telecommunication;
Standard cardiac output measurement module, described standard cardiac output measurement module connects with the blood vessel of measured target, comprise: interconnective standard cardiac output computer, pressure transducer, described pressure transducer gathers standard cardiac output information by conduit, then calculates standard cardiac output by standard cardiac output computer; And after setting up physiological models, withdraw from the conduit connected with the blood vessel of measured target;
Pulse wave signal modular converter, described pulse wave signal modular converter and photosignal sending and receiving model calling, for carrying out signal of telecommunication amplification to two-way respectively and process obtains two-way pulse wave data signal;
Regional blood flow computing module, described regional blood flow computing module is connected with pulse wave signal modular converter, for calculating two-way pulse wave data signal, obtains regional blood flow;
Physiological models creation module, described physiological models creation module is connected with regional blood flow computing module and standard cardiac output measurement module respectively, for according to regional blood flow and standard cardiac output, calculate its mapping relations, and set up physiological models according to these mapping relations;
Pulse frequency value acquisition module, described pulse frequency value acquisition module is connected with pulse wave signal modular converter, for the pulse frequency value obtained from pulse wave data signal;
Stroke volume computing module, described stroke volume computing module is connected with regional blood flow computing module and physiological models creation module, for according to regional blood flow and physiological models, calculates continuous print stroke volume;
Continuous cardiac output computing module, described Continuous cardiac output computing module is connected with stroke volume computing module and pulse frequency value acquisition module, for calculating continuous print stroke volume and pulse frequency value, obtains continuous print cardiac output.
Further, a kind of kinemic continuous monitor system of the present invention also comprises:
Cardiac output display module, described cardiac output display module is connected with Continuous cardiac output computing module, for showing continuous print cardiac output;
Cardiac output print module, described cardiac output print module is connected with Continuous cardiac output computing module, for printing continuous print cardiac output;
Cardiac output memory module, described cardiac output memory module is connected with Continuous cardiac output computing module, for storing continuous print cardiac output;
Alarm module, described alarm module is connected with Continuous cardiac output computing module, for judging Continuous cardiac output whether in preset range, if not in preset range, then carrying out labelling to this continuous print cardiac output and carrying out alarm.
Further, described photosignal sending and receiving module comprises: red signal light receiving-transmitting device and infrared signal receiving-transmitting device.
Method of the present invention is in the process of kinemic continuous monitoring, to the method that the intermediate parameters of observation process is calibrated; It utilizes the conduit be connected with pressure transducer to puncture among tremulous pulse and measures standard cardiac output, and utilize photoelectric sensor to gather regional blood flow, and set up physiological models accurately according to the mapping relations between standard cardiac output and regional blood flow, to realize the calibration of parameter, after calibration completes, the conduit thrust among tremulous pulse can be removed, make the present invention more accurate to kinemic monitoring result; System of the present invention, carries out analyzing to the continuous pulse wave data signal after having calibrated and calculates, to realize kinemic continuous monitoring; And due to the present invention do not need long-term by catheter retention in patient body, because this reducing the operation complexity of medical personnel, and decrease the misery of patient and potential injury.
Accompanying drawing explanation
For ease of illustrating, the present invention is described in detail by following preferred embodiment and accompanying drawing.
Fig. 1 is the workflow diagram of the parameter calibrating method of kinemic continuous monitoring of the present invention;
Fig. 2 is that the parameter calibrating method applying kinemic continuous monitoring of the present invention carries out continuous workflow diagram of monitoring;
Fig. 3 is the structural principle schematic diagram of kinemic continuous monitor system of the present invention.
Detailed description of the invention
In order to make object of the present invention, technical scheme and advantage clearly understand, below in conjunction with drawings and Examples, the present invention is further elaborated.Should be appreciated that specific embodiment described herein only in order to explain the present invention, be not intended to limit the present invention.
Refer to Fig. 1, the parameter calibrating method of a kind of kinemic continuous monitoring of the present invention, comprising:
101. connect photosignal
By the optical signal of luminescent device to the blood vessel transmitting two-way different wave length of measured target, receive the two ways of optical signals after described blood vessel, and this two ways of optical signals is converted to the corresponding signal of telecommunication
i 1 ,
i 2 ;
102. measurement standard cardiac outputs
While receiving the two ways of optical signals after described blood vessel, will the blood vessel of the conduit access measured target of pressure transducer be connected to, measurement standard cardiac output;
103. obtain pulse wave data signal
Respectively the signal of telecommunication to be amplified and process obtains two-way pulse wave data signal;
104. obtain regional blood flow
Two-way pulse wave data signal is calculated, obtains the regional blood flow in a cardiac cycle
q;
105. set up physiological models
Calculate the mapping relations between standard cardiac output and regional blood flow, and set up physiological models according to these mapping relations; This arterial vascular regional blood flow of the process that the present invention relates to
qmapping relations can be used
hdetermine, namely
; And due to regional blood flow
qwith stroke volume
sVbetween there is corresponding relation, therefore, can obtain
i 1 ,
i 2 with
sVbetween mapping relations
j, that is:
, due to
i 1 with
i 2 not only containing the relevant information of pulse wave, also include the information of tremulous pulse saturation simultaneously, and therefore include total hemoglobin concentration and blood vessel diameter etc. information.Calibration factor in model
μ, comprise the regional blood flow in the arteries of specific part
qwith stroke volume
sVbetween percent information, contain simultaneously arteries periodically diastole and shrink time the light path that causes and arteries diameter between percent information.For different patients,
μconcrete numerical value different, therefore, the factor in different patient model
μcan be obtained by the method for calibration.Therefore, by standard cardiac output
cOwith regional blood flow
qcan calculate
μ, to set up physiological models accurately.
106. withdraw from the conduit that connects of blood vessel
After setting up physiological models, withdraw from the conduit connected with the blood vessel of measured target;
107. continue continuous measurement pulse wave data signal
And by the optical signal of luminescent device continuous print to the blood vessel transmitting two-way different wave length of measured target, until obtain continuous print pulse wave data signal.
Refer to Fig. 2, as a kind of extended mode, the parameter calibrating method of kinemic continuous monitoring of the present invention can be utilized to carry out kinemic continuous monitoring, specifically comprise:
201. connect photosignal
By the optical signal of luminescent device to the blood vessel transmitting two-way different wave length of measured target, receive the two ways of optical signals after described blood vessel, and this two ways of optical signals is converted to the corresponding signal of telecommunication; The generation two-way transmission after this blood vessel of the optical signal of two-way different wave length or reflected light signal, blood vessel in the present invention, refers to enough near the tremulous pulse of human aortic, such as: carotid artery, axillary artery or femoral artery etc.Arteries due to these positions is not easy the impact of the factors such as temperature and the change of vasoconstriction or expansion occurs.In the physiological models that the present invention relates to, the arteries chosen is the closer to aorta, and the corresponding relation between its regional blood flow and stroke volume is more stable, and measurement result is more accurate.Because the relevant parameter of physiological models is determined by calibration, therefore the specific part pointed by the present invention, can be not limited to a certain fixed position, and operator can select measuring point according to actual needs, add the motility of operation, make operation more easy.
In an embodiment of the present invention, select carotid artery as the position obtaining blood oxygen pulse ripple signal.This position distance aorta is comparatively near, and the diastole shrinkage degree of blood vessel is more stable.
Wherein, the optical signal of two-way different wave length comprises: red signal light and infrared signal;
202. measurement standard cardiac outputs
While receiving the two ways of optical signals after described blood vessel, will the blood vessel of the conduit access measured target of pressure transducer be connected to, measurement standard cardiac output;
Due to the individual variation of measured target, relevant parameter in the kinemic physiological models of continuous measurement is different, therefore before carrying out continuous measurement cardiac output, need by least one times accurately standard cardiac output measurement result calculate relevant parameter in this physiological models;
And due to the kinemic method of existing measurement varied, therefore the measurement standard cardiac output pointed by the present invention, the kinemic method of a certain particular measurement can be not limited to, operator can select proper calibration method with field condition according to actual needs, add the motility of operation, make operation more easy.
In the present embodiment, the cardiac output measured through lung-heat dilution technology of Wicresoft can be used to carry out measurement standard cardiac output to physiological models, it is one not only simple and safe but also mode accurately.Its method is that volume and the known liquid of temperature are injected right atrium by central venous catheter.After injection mixes with the blood in heart, carry out along with sanguimotor, temperature is diluted and is spread, the change of blood heat is measured by a temperature sensor, the latter is placed on larger body circulation tremulous pulse, such as, and the far-end of a ductus arteriosus in stock or axillary artery.By there is corresponding relation to determine cardiac output accurately between the change of blood flow temperature and cardiac output.The mode of this Wicresoft, because it does not need to be inserted into by conduit in disease human heart, therefore can avoid causing the potential risks such as arrhythmia, thrombosis, angiorrhexis.
203. obtain pulse wave data signal
Respectively the signal of telecommunication to be amplified and process obtains two-way pulse wave data signal;
204. obtain regional blood flow
Two-way pulse wave data signal is calculated, obtains the regional blood flow in a cardiac cycle
q;
205. set up physiological models
Mapping relations between calculating standard cardiac output and regional blood flow, set up physiological models according to these mapping relations, and store this physiological models;
206. judge whether to need again to calculate
Judge whether to need again to calculate mapping relations, if desired again calculate, then again enter measurement standard cardiac output and receive the two ways of optical signals after described blood vessel;
207. upgrade physiological models
If judged result is not for need again to calculate, then all physiological models be stored are averaged, and upgrade physiological models according to average result;
208. withdraw from the conduit that connects of blood vessel
After setting up physiological models, withdraw from the conduit connected with the blood vessel of measured target,
209. continue continuous measurement pulse wave data signal
And by the optical signal of luminescent device continuous print to the blood vessel transmitting two-way different wave length of measured target, until obtain continuous print pulse wave data signal;
The 210. pulse frequency values obtained
The pulse frequency value obtained from continuous print pulse wave data signal
hR,
211. obtain continuous print regional blood flow
Continuous print pulse wave data signal is calculated, obtains the regional blood flow of consecutive periods
q;
212. calculate stroke volume
By continuous print regional blood flow
qbe combined with physiological models, calculate continuous print stroke volume
sV;
213. calculate continuous print cardiac output
Utilize continuous print stroke volume
sVwith pulse frequency value
hRcalculate, obtain continuous print cardiac output
cO, namely
;
214. export continuous print cardiac output
Obtaining continuous print cardiac output
cOafterwards, to continuous print cardiac output
cOcarry out showing and/or printing and/or store;
215. labelling continuous print cardiac outputs
Obtaining continuous print cardiac output
cOafterwards, continuous print cardiac output is judged
cOwhether in preset range, if not in preset range, then to this continuous print cardiac output
cOcarry out labelling.
Please refer to Fig. 3, a kind of kinemic continuous monitor system of the present invention, comprising:
Photosignal sending and receiving module 301, described photosignal sending and receiving module 301 is attached on the blood vessel of measured target, for being launched the optical signal of two-way different wave length to the blood vessel of measured target by luminescent device, and receive the two ways of optical signals after described blood vessel, this two ways of optical signals is converted to the corresponding signal of telecommunication;
Standard cardiac output measurement module 302, described standard cardiac output measurement module 302 connects with the blood vessel of measured target, comprise: interconnective standard cardiac output computer, pressure transducer, described pressure transducer gathers standard cardiac output information by conduit, then calculates standard cardiac output by standard cardiac output computer; And after setting up physiological models, withdraw from the conduit connected with the blood vessel of measured target;
Pulse wave signal modular converter 303, described pulse wave signal modular converter 303 is connected with photosignal sending and receiving module 301, for carrying out signal of telecommunication amplification to two-way respectively and process obtains two-way pulse wave data signal;
Regional blood flow computing module 304, described regional blood flow computing module 304 is connected with pulse wave signal modular converter 303, for calculating two-way pulse wave data signal, obtains regional blood flow;
Physiological models creation module 305, described physiological models creation module 305 is connected with regional blood flow computing module 304 and standard cardiac output measurement module 302 respectively, for according to regional blood flow and standard cardiac output, calculate its mapping relations, and set up physiological models according to these mapping relations;
Pulse frequency value acquisition module 307, described pulse frequency value acquisition module 307 is connected with pulse wave signal modular converter 303, for the pulse frequency value obtained from pulse wave data signal;
Stroke volume computing module 308, described stroke volume computing module 308 is connected with regional blood flow computing module 304 and physiological models creation module 305, for according to regional blood flow and physiological models after adjustment, calculates continuous print stroke volume;
Continuous cardiac output computing module 306, described Continuous cardiac output computing module 306 is connected with stroke volume computing module 308 and pulse frequency value acquisition module 307, for calculating continuous print stroke volume and pulse frequency value, obtains continuous print cardiac output.
Further, a kind of kinemic continuous monitor system of the present invention also comprises:
Cardiac output display module, described cardiac output display module is connected with Continuous cardiac output computing module, for showing continuous print cardiac output;
Cardiac output print module, described cardiac output print module is connected with Continuous cardiac output computing module, for printing continuous print cardiac output;
Cardiac output memory module, described cardiac output memory module is connected with Continuous cardiac output computing module, for storing continuous print cardiac output;
Alarm module, described alarm module is connected with Continuous cardiac output computing module, for judging Continuous cardiac output whether in preset range, if not in preset range, then carrying out labelling to this continuous print cardiac output and carrying out alarm.
Further, described photosignal sending and receiving module comprises: red signal light receiving-transmitting device and infrared signal receiving-transmitting device.
The foregoing is only preferred embodiment of the present invention, not in order to limit the present invention, all any amendments done within the spirit and principles in the present invention, equivalent replacement and improvement etc., all should be included within protection scope of the present invention.
Claims (3)
1. a kinemic continuous monitor system, is characterized in that, comprising:
Photosignal sending and receiving module, described photosignal sending and receiving module is attached on the blood vessel of measured target, for being launched the optical signal of two-way different wave length to the blood vessel of measured target by luminescent device, and receive the two ways of optical signals after described blood vessel, this two ways of optical signals is converted to the corresponding signal of telecommunication;
Standard cardiac output measurement module, described standard cardiac output measurement module connects with the blood vessel of measured target, comprise: interconnective standard cardiac output computer, pressure transducer, described pressure transducer gathers standard cardiac output information by conduit, then calculates standard cardiac output by standard cardiac output computer; And after setting up physiological models, withdraw from the conduit connected with the blood vessel of measured target;
Pulse wave signal modular converter, described pulse wave signal modular converter and photosignal sending and receiving model calling, for carrying out signal of telecommunication amplification to two-way respectively and process obtains two-way pulse wave data signal;
Regional blood flow computing module, described regional blood flow computing module is connected with pulse wave signal modular converter, for calculating two-way pulse wave data signal, obtains regional blood flow;
Physiological models creation module, described physiological models creation module is connected with regional blood flow computing module and standard cardiac output measurement module respectively, for according to regional blood flow and standard cardiac output, calculate its mapping relations, and set up physiological models according to these mapping relations;
Pulse frequency value acquisition module, described pulse frequency value acquisition module is connected with pulse wave signal modular converter, for the pulse frequency value obtained from pulse wave data signal;
Stroke volume computing module, described stroke volume computing module is connected with regional blood flow computing module and physiological models creation module, for according to regional blood flow and physiological models, calculates continuous print stroke volume;
Continuous cardiac output computing module, described Continuous cardiac output computing module is connected with stroke volume computing module and pulse frequency value acquisition module, for calculating continuous print stroke volume and pulse frequency value, obtains continuous print cardiac output.
2. kinemic continuous monitor system according to claim 1, is characterized in that, also comprise:
Cardiac output display module, described cardiac output display module is connected with Continuous cardiac output computing module, for showing continuous print cardiac output;
Cardiac output print module, described cardiac output print module is connected with Continuous cardiac output computing module, for printing continuous print cardiac output;
Cardiac output memory module, described cardiac output memory module is connected with Continuous cardiac output computing module, for storing continuous print cardiac output;
Alarm module, described alarm module is connected with Continuous cardiac output computing module, for judging Continuous cardiac output whether in preset range, if not in preset range, then carrying out labelling to this continuous print cardiac output and carrying out alarm.
3. kinemic continuous monitor system according to claim 2, is characterized in that, described photosignal sending and receiving module comprises: red signal light receiving-transmitting device and infrared signal receiving-transmitting device.
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CN108042106A (en) * | 2017-11-14 | 2018-05-18 | 李明 | Artificial intelligence deviation rectifying method for improving detection precision of human body sign non-invasive detection equipment |
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EP2281504A1 (en) * | 2009-08-04 | 2011-02-09 | Pulsion Medical Systems AG | Apparatus and method for determining a physiological parameter |
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