本文選題：血壓連續(xù)測量 + 脈搏波傳導(dǎo)時間　； 參考：《東北大學(xué)》2012年碩士論文

【摘要】：血壓是反映心血管功能的重要生理參數(shù),是診斷疾病、觀察治療效果和進(jìn)行預(yù)后判斷的重要依據(jù)。相對比于傳統(tǒng)的血壓測量方法,無創(chuàng)連續(xù)血壓測量方法可以擺脫氣囊束縛,實現(xiàn)較長時間內(nèi)血壓情況的實時監(jiān)測。無創(chuàng)連續(xù)血壓測量方法有效地克服了傳統(tǒng)血壓測量方法的缺點,對于特殊情況下血壓的監(jiān)測以及臨床監(jiān)護(hù)具有一定的優(yōu)勢。在臨床醫(yī)學(xué)上,對危重病人和手術(shù)中的重癥患者需要進(jìn)行連續(xù)的血壓監(jiān)護(hù),以便當(dāng)病人出現(xiàn)意外時,醫(yī)護(hù)人員能夠及時采取救護(hù)措施。從以上分析看,連續(xù)血壓測量在臨床診斷中均具有重要意義。 本文的研究基礎(chǔ)為動脈血壓和脈搏波傳播的相關(guān)理論。通過改變體位得到多組變化血壓值,建立了兩種不同的利用脈搏波傳導(dǎo)時間測量血壓的數(shù)學(xué)模型,用袖帶法測量的血壓值與模型估算的血壓值進(jìn)行誤差對比分析。 本文主要完成了以下工作： (1)分析了數(shù)據(jù)采集過程中長時間采集和不同指端采集對脈搏波傳導(dǎo)時間的影響。 (2)對采集到的信號進(jìn)行預(yù)處理,將小波變換,數(shù)字濾波器,平均加權(quán)等去噪方法進(jìn)行比較,確定去噪和去基線的最合適方法。 (3)將預(yù)處理后的ECG和脈搏波信號進(jìn)行特征參數(shù)提取。用墨西哥小帽小波結(jié)合模極大值的方法確定ECG信號的R波,檢測率達(dá)97%以上。使用差分閾值的方法確定脈搏波信號的波峰,檢測率達(dá)98%以上。 (4)建立兩種不同的利用脈搏波傳導(dǎo)時間估算血壓的模型。模型參數(shù)均為2個,模型1中的系數(shù)通過一次標(biāo)定可得。模型2中的兩個系數(shù)是通過多次測量的血壓和脈搏波傳導(dǎo)時間進(jìn)行非線性回歸得到。 (5)設(shè)計實驗,分別標(biāo)定兩個模型,并且利用模型估算血壓與袖帶法得到的測量血壓進(jìn)行比較。結(jié)果兩種模型血壓估算精度均符合AAMI,模型1血壓測量誤差小于3.5±7.15mmHg,模型2血壓測量誤差小于2.58±6.64mmHg。
[Abstract]:Blood pressure is an important physiological parameter reflecting the cardiovascular function. It is an important basis for diagnosing the disease, observing the effect of the treatment and judging the prognosis. Relative to the traditional blood pressure measurement method, the non-invasive continuous blood pressure measurement method can get rid of the bondage of the air bag and realize the real time monitoring of the blood pressure in a long time. It has effectively overcome the shortcomings of the traditional blood pressure measurement methods, and has some advantages for the monitoring of blood pressure in special cases and clinical monitoring. In clinical medicine, continuous blood pressure monitoring is required for critically ill patients and severe patients in the operation. From the above analysis, continuous blood pressure measurement is of great importance in clinical diagnosis.
The basis of this study is the theory of arterial blood pressure and pulse wave propagation. By changing the position of the body to get a number of changes in blood pressure, two different mathematical models for measuring blood pressure using pulse wave conduction time are established. The error of the blood pressure measured by the cuff method is compared with the value of the model estimated by the model.
This article mainly completed the following work:
(1) the effects of long time acquisition and different fingertip collection on pulse wave propagation time were analyzed.
(2) to preprocess the collected signals, compare the denoising methods such as wavelet transform, digital filter and average weighting, and determine the most suitable method for denoising and removing the baseline.
(3) the characteristic parameters of the pre processed ECG and pulse wave signals are extracted. The R wave of the ECG signal is determined by the method of combining the modulus maximum of the Mexico small cap wavelet. The detection rate is over 97%. The peak of the pulse wave signal is determined by the method of differential threshold, and the detection rate is over 98%.
(4) to establish two different models of blood pressure estimation using pulse wave conduction time. The model parameters are all 2, and the coefficients in model 1 can be obtained by one time calibration. The two coefficients in model 2 are obtained by nonlinear regression through multiple measured blood pressure and Mai Bobo conduction time.
(5) the experiment was designed, two models were calibrated respectively, and the blood pressure was compared with the measured blood pressure obtained by the cuff method. Results the accuracy of the blood pressure estimation in the two models were all in accordance with AAMI, the model 1 blood pressure measurement error was less than 3.5 + 7.15mmHg, and the blood pressure measurement error of model 2 was less than 2.58 + 6.64mmHg..

【學(xué)位授予單位】：東北大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2012
【分類號】：R318.04

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