无创连续心输出量分析算法研究与软件设计

发布时间：2018-07-13 15:38

【摘要】：心输出量是血流动力学中关键参数之一,对其进行连续监测具有重要意义。目前临床心输出量方法主要以有创为主,微创方法正经受临床验证,但对于普通病人与健康人的心输出量,无创方法具有更好的应用价值。现有无创方法存在操作复杂、费用昂贵、抗干扰气稳定性较差等问题,不具有推广价值,因此,研究一种无创、连续、便携、低成本的心输出量监测仪具有重要意义。论文工作内容主要有：1、提出了一种基于光电容积脉搏波(PPG)信号的无创连续心输出量算法,通过PPG计算出衰减常数RC,根据动脉顺应性与脉搏波传导时间关系,获得外周阻力R来计算心输出量,并将其命名为KC算法。2、根据无创心输出量算法设计了无创心输出量监测软件,用以实时监测心输出量等血流动力学参数,并可用于验证与修正算法。3、进行算法验证,五例临床病人的10段数据进行算法的可行性验证,2段数据进行无创算法验证,在手术中心输出量变化幅度巨大的阶段,无创实验方案的实验结果曲线与Flotrac/Vigileo监测仪实验曲线变化趋势表现出良好的一致性。论文所提出的KC算法不依赖统计学原理,可准确反映心输出量的变化趋势,在反映心输出量变化趋势方面不需要人群统计参数,使所开发的测量仪器系统具有良好的个体适应性。基于光电容积脉搏波测量心输出量的无创监测方法相比于有创法测量其临床适用范围更为广泛,可应用于健康人群和轻度患者的监测,具有应用推广优势。
[Abstract]:Cardiac output is one of the key parameters in hemodynamics. At present, the main clinical cardiac output method is invasive, the minimally invasive method is undergoing clinical verification, but for the normal patients and healthy people, the non-invasive method has a better application value. The existing noninvasive methods have some problems such as complex operation, expensive operation, poor stability of anti-jamming gas, and so on. Therefore, it is of great significance to study a non-invasive, continuous, portable and low-cost cardiac output monitor. The main work of this paper is: 1. A non-invasive continuous cardiac output algorithm based on photovolumic pulse wave (PPG) signal is proposed. The attenuation constant RCis calculated by PPG, and the relationship between arterial compliance and pulse wave conduction time is obtained. The peripheral resistance R is obtained to calculate cardiac output, and it is named KC algorithm. According to the non-invasive cardiac output algorithm, a non-invasive cardiac output monitoring software is designed for real-time monitoring of cardiac output and other hemodynamic parameters. And it can be used to verify and modify the algorithm. 3, to verify the algorithm, to verify the feasibility of the algorithm from 10 segments of five clinical patients and to verify the non-invasive algorithm of 2 segments of data, so that the output of the operation center changes greatly. The experimental results of the non-invasive scheme are in good agreement with the experimental curves of Flotrac-Vigileo monitor. The KC algorithm proposed in this paper does not depend on the principle of statistics and can accurately reflect the change trend of cardiac output. There is no need for population statistical parameters to reflect the changing trend of cardiac output. The developed measuring instrument system has good individual adaptability. Compared with the invasive method, the non-invasive monitoring method based on photovolumic pulse wave can be applied to the monitoring of healthy people and mild patients more widely than that of the invasive method. It has the advantage of application and popularization.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：TH789;R54

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