休克多部位综合无创光学监护仪

发布时间：2018-06-25 16:54

本文选题：近红外光谱技术 + 休克　；参考：《电子科技大学》2016年硕士论文

【摘要】：休克是指一些原因(如大出血、创伤等)引起的急性血液循环障碍,微循环灌流严重不足,以至重要生命器官机能代谢紊乱和结构损伤的复杂全身性严重病理过程,是临床各科严重疾病中最常见的并发症。本课题应用近红外光谱术,研发出一种休克多部位综合无创光学监护仪,同时进行了相关临床试验。本文首先介绍了国内外关于休克监护现状,发现目前还没有可以连续、实时、无创监护休克状态的监护仪,结合近红外光谱术近年来在血氧检测方向的研究,提出设计一种可对休克病人进行连续、实时、无创监测的技术方案。接着研究了血氧检测理论中最为经典的脉搏血氧饱和度算法,但是应用于休克病人监护是无效的。于是提出了两种不受外周循环不畅和外周灌注不足影响的血氧参数算法,一种是组织血氧饱和度相对量算法,一种是组织血氧饱和度绝对量算法。接着,根据初步计划的需求对想要监测的人体部位进行了蒙特卡洛光学仿真,以颈部区域为例给出了最佳的光源探测器距离参数,为监护仪的探头设计提供了设计参数。然后对仪器元器件进行调研,最终确定了光源、探测器、主控制器、模数转换器、光源驱动器等元件的选型并用Altium Designer 14设计了探头和主控的电路。又在Qt平台下结合Qwt第三方绘图库,编写仪器的上位机程序,实现了数据的实时显示与存储。在仪器研发完毕的时候,用实验验证了仪器的主要性能指标,如系统响应一致性、背光干扰、暗噪声、灵敏性等。最后在上海新华医院进行预临床试验,通过制定的监测方案,监测了处于休克边缘的病人,经过数据处理分析发现该仪器确实可以对休克严重程度进行预警,同时发现中央颈静脉区域的血氧参数更能有效监测病人病情的发展趋势。在预临床试验过程中发现了中央静脉血管充盈度受人体体位变化的影响,为下一步研究提供了新思路。
[Abstract]:Shock refers to the acute circulatory disturbance caused by some causes (such as massive hemorrhage, trauma, etc.), the severe insufficiency of microcirculation perfusion, and the complicated and severe pathological process of dysfunction and structural damage of vital organs. It is the most common complication of serious diseases in various clinical departments. A multi-site comprehensive non-invasive optical monitor for shock was developed by near-infrared spectroscopy and related clinical trials were carried out. This paper first introduces the current situation of shock monitoring at home and abroad, and finds that there is no continuous, real-time, non-invasive monitor for monitoring shock state at present, combined with the research of near infrared spectroscopy (NIR) in the direction of blood oxygen detection in recent years. To design a continuous, real-time and non-invasive monitoring scheme for shock patients. Then, the most classical pulse oxygen saturation algorithm in the theory of blood oxygen detection is studied, but it is ineffective to be used in monitoring shock patients. Two algorithms of blood oxygen parameters, one is the relative amount of tissue oxygen saturation, the other is the absolute amount of tissue oxygen saturation, which is not affected by the peripheral circulation and the peripheral perfusion insufficiency. Then the Monte Carlo optical simulation is carried out on the human body to be monitored according to the requirements of the preliminary plan. The optimum distance parameter of the detector is given by taking the neck region as an example, which provides the design parameters for the probe design of the monitor. Then the instrument components were investigated, and the type selection of light source, detector, main controller, A / D converter, light source driver and so on were determined. The probe and the main control circuit were designed by Altium designer 14. In QT platform combined with Qwt third party drawing library, the upper computer program of the instrument is written to realize the real-time display and storage of the data. At the end of the instrument development, the main performance indexes of the instrument are verified by experiments, such as system response consistency, backlight interference, dark noise, sensitivity and so on. Finally, a pre-clinical trial was conducted in Shanghai Xinhua Hospital. Through a monitoring program, patients on the edge of shock were monitored. After data processing and analysis, it was found that the instrument could indeed warn the severity of shock. At the same time, it was found that the blood oxygen parameters in the central jugular region were more effective in monitoring the development trend of the patient's condition. In the course of preclinical trial, it was found that the central vein filling degree was affected by the change of human body posture, which provided a new way for further study.
【学位授予单位】：电子科技大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R318.6

【参考文献】