本文選題：近紅外光譜技術(shù) + 休克��； 參考：《電子科技大學(xué)》2016年碩士論文

【摘要】：休克是指一些原因(如大出血、創(chuàng)傷等)引起的急性血液循環(huán)障礙,微循環(huán)灌流嚴(yán)重不足,以至重要生命器官機(jī)能代謝紊亂和結(jié)構(gòu)損傷的復(fù)雜全身性嚴(yán)重病理過程,是臨床各科嚴(yán)重疾病中最常見的并發(fā)癥。本課題應(yīng)用近紅外光譜術(shù),研發(fā)出一種休克多部位綜合無創(chuàng)光學(xué)監(jiān)護(hù)儀,同時(shí)進(jìn)行了相關(guān)臨床試驗(yàn)。本文首先介紹了國(guó)內(nèi)外關(guān)于休克監(jiān)護(hù)現(xiàn)狀,發(fā)現(xiàn)目前還沒有可以連續(xù)、實(shí)時(shí)、無創(chuàng)監(jiān)護(hù)休克狀態(tài)的監(jiān)護(hù)儀,結(jié)合近紅外光譜術(shù)近年來在血氧檢測(cè)方向的研究,提出設(shè)計(jì)一種可對(duì)休克病人進(jìn)行連續(xù)、實(shí)時(shí)、無創(chuàng)監(jiān)測(cè)的技術(shù)方案。接著研究了血氧檢測(cè)理論中最為經(jīng)典的脈搏血氧飽和度算法,但是應(yīng)用于休克病人監(jiān)護(hù)是無效的。于是提出了兩種不受外周循環(huán)不暢和外周灌注不足影響的血氧參數(shù)算法,一種是組織血氧飽和度相對(duì)量算法,一種是組織血氧飽和度絕對(duì)量算法。接著,根據(jù)初步計(jì)劃的需求對(duì)想要監(jiān)測(cè)的人體部位進(jìn)行了蒙特卡洛光學(xué)仿真,以頸部區(qū)域?yàn)槔o出了最佳的光源探測(cè)器距離參數(shù),為監(jiān)護(hù)儀的探頭設(shè)計(jì)提供了設(shè)計(jì)參數(shù)。然后對(duì)儀器元器件進(jìn)行調(diào)研,最終確定了光源、探測(cè)器、主控制器、模數(shù)轉(zhuǎn)換器、光源驅(qū)動(dòng)器等元件的選型并用Altium Designer 14設(shè)計(jì)了探頭和主控的電路。又在Qt平臺(tái)下結(jié)合Qwt第三方繪圖庫,編寫儀器的上位機(jī)程序,實(shí)現(xiàn)了數(shù)據(jù)的實(shí)時(shí)顯示與存儲(chǔ)。在儀器研發(fā)完畢的時(shí)候,用實(shí)驗(yàn)驗(yàn)證了儀器的主要性能指標(biāo),如系統(tǒng)響應(yīng)一致性、背光干擾、暗噪聲、靈敏性等。最后在上海新華醫(yī)院進(jìn)行預(yù)臨床試驗(yàn),通過制定的監(jiān)測(cè)方案,監(jiān)測(cè)了處于休克邊緣的病人,經(jīng)過數(shù)據(jù)處理分析發(fā)現(xiàn)該儀器確實(shí)可以對(duì)休克嚴(yán)重程度進(jìn)行預(yù)警,同時(shí)發(fā)現(xiàn)中央頸靜脈區(qū)域的血氧參數(shù)更能有效監(jiān)測(cè)病人病情的發(fā)展趨勢(shì)。在預(yù)臨床試驗(yàn)過程中發(fā)現(xiàn)了中央靜脈血管充盈度受人體體位變化的影響,為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.
【學(xué)位授予單位】：電子科技大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R318.6

【參考文獻(xiàn)】

相關(guān)博士學(xué)位論文 前1條

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本文編號(hào)：2066832