基于气流与激光检测技术的无创静脉测压新方法的研究
发布时间：2018-09-09 15:04
【摘要】：摘要：食管静脉曲张(EV)是肝硬化病人一种常见的并发症,一半左右的肝硬化患者在确诊肝硬化时已有食管静脉曲张。EV的主要症状是破裂出血,并且肝功能等级越高患者,其EV破裂出血死亡率越高。因此对于肝硬化患者而言,如何及时发现EV出血高危人群,提前预测出血倾向并制定合理的治疗方案就显得尤为重要。目前人体食管曲张静脉压力测定存在两大类技术且均在内镜下进行,即静脉内测压和静脉外测压。静脉内测压即穿刺测压,是公认的标准测压方法,但该方法存在不能重复测压、穿刺易造成大出血或细菌感染等缺点。静脉外测压技术则是当前的研究热点。目前包括两大类：一是食管曲张静脉贴壁测压的技术,另一种是气囊测压法。但是,这两类无创测压方法由于受到多种体内环境因素的影响,难以有效减少干扰提高准确性。因此,为了更好的预测EV出血,需要找到一种更安全、准确、重复性好的内镜方法用于测量EV的压力。 目的：本研究利用光学原理并结合自动控制技术、计算机实时图像检测技术,进行气流结合激光无创非接触测压方法的研究。基于该新测压方法,研制相应的无创测压仪原型,并利用该原型仪器进行体外血管实验及动物实验,评估测压新方法的可行性、准确性和实用性。 原理：采用小直径可控气流压迫静脉血管外壁,控制气流压力从小到大连续变化,同时监测血管外壁的形变；本研究认为对于外凸的薄壁静脉血管,血管外壁初始形变时刻的气流压力与血管内静压相等或成线性相关关系。 方法： 1.自主设计研发可调节气泵,设计调整气泵结构以及电路,以实现气泵输出的气压脉冲工作频率和气压强度可调,利用可调节气泵可产生出稳定、可控制的气流脉冲(气压连续变化过程不断往复进行,可完成对被测对象的多次重复测量,以提高测量精度)； 2.对气泵产生的气流、气流与导管壁摩擦导致的气压衰减进行实验研究,试验测量气流在管道、血管壁等多个位置的压力情况,并分析各个位置气流压力之间的相关性和函数关系,研究气流路径上压力分布是否具有稳定性和可计算的方法； 3.对激光发射装置的构建,利用该装置发射的激光线,在测量血管壁上产生能用于无创测压系统捕捉的光学信号； 4.自主研发图像采集分析系统程序,利用已有的内镜系统,连续采集测压静脉位置的光学信号图像,通过光学图像分析程序,快速捕捉血管因气压形变引起的光学信号图像改变的情况； 5.构建同步体系,对气流压力变化和静脉管壁变形进行同步测量,实现仪器捕捉血管形变时刻,可同时记录当前气压值； 6.进行体外血管实验,利用压力可调节的模拟血管仪,使用本研究无创测量新方法,用研制的无创测压仪对仿生血管和离体大隐静脉血管进行实验测量,并将测量数据与模拟血管仪数据对比,通过比较分析,验证本研究原理； 7.进行动物体内血管实验,通过将家兔进行解剖,对其下腔静脉同时进行无创测压和穿刺测压,通过分析比较,进一步明确无创测压新方法的可行性、准确性和实用性。 结果： 1.根据无创测量新方法的理论构想,研制出新型无创测压仪原型。该仪器原型通过主动控制气流连续变化,以该气流作为指压气流探针压迫血管,同时借助激光检测技术,同步检测血管变形过程；当曲张静脉被主动气流压陷初始时刻,记录气流压力；根据该时刻气流压力数据来计算血管内部的压力。 2.通过体外血管实验和动物体内血管实验,结果表明本研究研制的测压仪器与仿生血管的实际压力值有良好的相关性,直线回归方程式分别为：Y=1.001X+6.036；测压仪器与离体大隐静脉血管的实际压力值有良好的相关性,直线回归方程式分别为：Y=1.001X+9.703；测压仪器与穿刺测压仪有良好的相关性,直线回归方程为：Y=1.001X+10.820。 结论：本研究所提出的基于气流与激光检测技术的无创测压新方法,具有可行性,重复性好,其测量准确度较高,有良好的应用价值。
[Abstract]:Abstract: Esophageal varices (EV) is a common complication in cirrhotic patients.About half of the cirrhotic patients have esophageal varices at the time of diagnosis of cirrhosis.The main symptom of EV is rupture bleeding.The higher the grade of liver function, the higher the mortality of EV rupture bleeding.Therefore, for patients with cirrhosis, how to promptly occur. It is very important to predict the bleeding tendency in advance and make a reasonable treatment plan for the high risk group of EV bleeding.There are two kinds of techniques for measuring the pressure of esophageal varices under endoscopy, i.e. intravenous pressure measurement and Extravenous pressure measurement. Extravenous manometry is the focus of current research. At present, there are two kinds of non-invasive manometry: one is the technique of esophageal varices adhering to the wall, the other is the balloon manometry. However, these two kinds of non-invasive manometry are affected by many internal environmental factors. Therefore, in order to predict EV bleeding better, it is necessary to find a safer, accurate and reproducible endoscopic method for measuring EV pressure.
AIM: To study the method of non-invasive and non-invasive pressure measurement by combining optical principle with automatic control technology and computer real-time image detection technology. The feasibility, accuracy and practicability of the new method.
Principle: Small diameter controlled airflow was used to compress the external wall of the vein to control the continuous change of airflow pressure from small to large, and to monitor the deformation of the external wall of the vein.
Method:
1. Self-design and development of adjustable air pump, design and adjust the structure and circuit of the air pump to achieve the output of air pump pressure pulse frequency and pressure intensity can be adjusted, using adjustable air pump can produce a stable and controllable air pulse (continuous change of air pressure process is carried out repeatedly, can complete the repeated measurement of the object under test. To improve the accuracy of measurement.
2. The air pressure attenuation caused by the friction between the air flow and the duct wall is studied experimentally. The pressure of the air flow in the pipeline and the wall of the blood vessel is measured experimentally. The correlation and functional relationship between the air pressure in each position are analyzed, and whether the pressure distribution on the air flow path is stable and calculable are studied. Law;
3. For the construction of the laser launcher, the optical signal captured by the noninvasive pressure measuring system can be generated on the measuring vessel wall by the laser ray emitted by the laser launcher.
4. Self-developed image acquisition and analysis system program, using the existing endoscopy system, continuous acquisition of pressure vein position of optical signal images, through optical image analysis program, quickly capture vascular pressure deformation caused by optical signal image changes;
5. Construct a synchronous system to measure the changes of air pressure and vein wall deformation synchronously, so that the instrument can capture the time of vessel deformation and record the current pressure simultaneously.
6. The blood vessel experiment in vitro was carried out. The new method of noninvasive measurement was used to measure the bionic blood vessel and the great saphenous vein blood vessel in vitro. The measured data were compared with the data of the simulated blood vessel instrument. The principle of this study was verified by comparison and analysis.
7. The experiment of blood vessel in vivo was carried out. The rabbits were dissected and the inferior vena cava was simultaneously measured by noninvasive manometry and puncture manometry. The feasibility, accuracy and practicability of the new method were further clarified through analysis and comparison.
Result:
1. According to the theoretical conception of the new noninvasive measurement method, a new type of noninvasive manometer prototype was developed. The prototype controlled the continuous change of air flow actively, compressed the blood vessel with the air flow as the finger pressure probe, and simultaneously detected the deformation process of blood vessel with the help of laser detection technology. Record the flow pressure; calculate the pressure inside the blood vessel according to the data of the air pressure at that time.
2. Through in vitro and in vivo blood vessel experiments, the results show that the pressure measuring instrument developed in this study has a good correlation with the actual pressure of the bionic blood vessel. The linear regression equation is Y=1.001X+6.036, and the pressure measuring instrument has a good correlation with the actual pressure of the isolated great saphenous vein. Formula Y = 1.001X + 9.703; piezometer and piezometer have good correlation, linear regression equation is: Y = 1.001X + 10.820.
Conclusion: The new noninvasive pressure measurement method based on gas flow and laser detection technology is feasible, reproducible, accurate and has good application value.
【学位授予单位】：中南大学
【学位级别】：博士
【学位授予年份】：2014
【分类号】：R575.2
本文编号：2232731
[Abstract]:Abstract: Esophageal varices (EV) is a common complication in cirrhotic patients.About half of the cirrhotic patients have esophageal varices at the time of diagnosis of cirrhosis.The main symptom of EV is rupture bleeding.The higher the grade of liver function, the higher the mortality of EV rupture bleeding.Therefore, for patients with cirrhosis, how to promptly occur. It is very important to predict the bleeding tendency in advance and make a reasonable treatment plan for the high risk group of EV bleeding.There are two kinds of techniques for measuring the pressure of esophageal varices under endoscopy, i.e. intravenous pressure measurement and Extravenous pressure measurement. Extravenous manometry is the focus of current research. At present, there are two kinds of non-invasive manometry: one is the technique of esophageal varices adhering to the wall, the other is the balloon manometry. However, these two kinds of non-invasive manometry are affected by many internal environmental factors. Therefore, in order to predict EV bleeding better, it is necessary to find a safer, accurate and reproducible endoscopic method for measuring EV pressure.
AIM: To study the method of non-invasive and non-invasive pressure measurement by combining optical principle with automatic control technology and computer real-time image detection technology. The feasibility, accuracy and practicability of the new method.
Principle: Small diameter controlled airflow was used to compress the external wall of the vein to control the continuous change of airflow pressure from small to large, and to monitor the deformation of the external wall of the vein.
Method:
1. Self-design and development of adjustable air pump, design and adjust the structure and circuit of the air pump to achieve the output of air pump pressure pulse frequency and pressure intensity can be adjusted, using adjustable air pump can produce a stable and controllable air pulse (continuous change of air pressure process is carried out repeatedly, can complete the repeated measurement of the object under test. To improve the accuracy of measurement.
2. The air pressure attenuation caused by the friction between the air flow and the duct wall is studied experimentally. The pressure of the air flow in the pipeline and the wall of the blood vessel is measured experimentally. The correlation and functional relationship between the air pressure in each position are analyzed, and whether the pressure distribution on the air flow path is stable and calculable are studied. Law;
3. For the construction of the laser launcher, the optical signal captured by the noninvasive pressure measuring system can be generated on the measuring vessel wall by the laser ray emitted by the laser launcher.
4. Self-developed image acquisition and analysis system program, using the existing endoscopy system, continuous acquisition of pressure vein position of optical signal images, through optical image analysis program, quickly capture vascular pressure deformation caused by optical signal image changes;
5. Construct a synchronous system to measure the changes of air pressure and vein wall deformation synchronously, so that the instrument can capture the time of vessel deformation and record the current pressure simultaneously.
6. The blood vessel experiment in vitro was carried out. The new method of noninvasive measurement was used to measure the bionic blood vessel and the great saphenous vein blood vessel in vitro. The measured data were compared with the data of the simulated blood vessel instrument. The principle of this study was verified by comparison and analysis.
7. The experiment of blood vessel in vivo was carried out. The rabbits were dissected and the inferior vena cava was simultaneously measured by noninvasive manometry and puncture manometry. The feasibility, accuracy and practicability of the new method were further clarified through analysis and comparison.
Result:
1. According to the theoretical conception of the new noninvasive measurement method, a new type of noninvasive manometer prototype was developed. The prototype controlled the continuous change of air flow actively, compressed the blood vessel with the air flow as the finger pressure probe, and simultaneously detected the deformation process of blood vessel with the help of laser detection technology. Record the flow pressure; calculate the pressure inside the blood vessel according to the data of the air pressure at that time.
2. Through in vitro and in vivo blood vessel experiments, the results show that the pressure measuring instrument developed in this study has a good correlation with the actual pressure of the bionic blood vessel. The linear regression equation is Y=1.001X+6.036, and the pressure measuring instrument has a good correlation with the actual pressure of the isolated great saphenous vein. Formula Y = 1.001X + 9.703; piezometer and piezometer have good correlation, linear regression equation is: Y = 1.001X + 10.820.
Conclusion: The new noninvasive pressure measurement method based on gas flow and laser detection technology is feasible, reproducible, accurate and has good application value.
【学位授予单位】：中南大学
【学位级别】：博士
【学位授予年份】：2014
【分类号】：R575.2
【参考文献】
相关期刊论文 前1条
1 孔德润;许建明;付忠谦;何兵兵;孙斌;张磊;谢岳;;基于计算机视觉的无创性食管曲张静脉测压仪[J];生物医学工程学杂志;2007年03期
，本文编号：2232731
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