基于氣流與激光檢測(cè)技術(shù)的無(wú)創(chuàng)靜脈測(cè)壓新方法的研究
發(fā)布時(shí)間：2018-09-09 15:04
【摘要】：摘要：食管靜脈曲張(EV)是肝硬化病人一種常見的并發(fā)癥,一半左右的肝硬化患者在確診肝硬化時(shí)已有食管靜脈曲張。EV的主要癥狀是破裂出血,并且肝功能等級(jí)越高患者,其EV破裂出血死亡率越高。因此對(duì)于肝硬化患者而言,如何及時(shí)發(fā)現(xiàn)EV出血高危人群,提前預(yù)測(cè)出血傾向并制定合理的治療方案就顯得尤為重要。目前人體食管曲張靜脈壓力測(cè)定存在兩大類技術(shù)且均在內(nèi)鏡下進(jìn)行,即靜脈內(nèi)測(cè)壓和靜脈外測(cè)壓。靜脈內(nèi)測(cè)壓即穿刺測(cè)壓,是公認(rèn)的標(biāo)準(zhǔn)測(cè)壓方法,但該方法存在不能重復(fù)測(cè)壓、穿刺易造成大出血或細(xì)菌感染等缺點(diǎn)。靜脈外測(cè)壓技術(shù)則是當(dāng)前的研究熱點(diǎn)。目前包括兩大類：一是食管曲張靜脈貼壁測(cè)壓的技術(shù),另一種是氣囊測(cè)壓法。但是,這兩類無(wú)創(chuàng)測(cè)壓方法由于受到多種體內(nèi)環(huán)境因素的影響,難以有效減少干擾提高準(zhǔn)確性。因此,為了更好的預(yù)測(cè)EV出血,需要找到一種更安全、準(zhǔn)確、重復(fù)性好的內(nèi)鏡方法用于測(cè)量EV的壓力。 目的：本研究利用光學(xué)原理并結(jié)合自動(dòng)控制技術(shù)、計(jì)算機(jī)實(shí)時(shí)圖像檢測(cè)技術(shù),進(jìn)行氣流結(jié)合激光無(wú)創(chuàng)非接觸測(cè)壓方法的研究�；谠撔聹y(cè)壓方法,研制相應(yīng)的無(wú)創(chuàng)測(cè)壓儀原型,并利用該原型儀器進(jìn)行體外血管實(shí)驗(yàn)及動(dòng)物實(shí)驗(yàn),評(píng)估測(cè)壓新方法的可行性、準(zhǔn)確性和實(shí)用性。 原理：采用小直徑可控氣流壓迫靜脈血管外壁,控制氣流壓力從小到大連續(xù)變化,同時(shí)監(jiān)測(cè)血管外壁的形變；本研究認(rèn)為對(duì)于外凸的薄壁靜脈血管,血管外壁初始形變時(shí)刻的氣流壓力與血管內(nèi)靜壓相等或成線性相關(guān)關(guān)系。 方法： 1.自主設(shè)計(jì)研發(fā)可調(diào)節(jié)氣泵,設(shè)計(jì)調(diào)整氣泵結(jié)構(gòu)以及電路,以實(shí)現(xiàn)氣泵輸出的氣壓脈沖工作頻率和氣壓強(qiáng)度可調(diào),利用可調(diào)節(jié)氣泵可產(chǎn)生出穩(wěn)定、可控制的氣流脈沖(氣壓連續(xù)變化過程不斷往復(fù)進(jìn)行,可完成對(duì)被測(cè)對(duì)象的多次重復(fù)測(cè)量,以提高測(cè)量精度)； 2.對(duì)氣泵產(chǎn)生的氣流、氣流與導(dǎo)管壁摩擦導(dǎo)致的氣壓衰減進(jìn)行實(shí)驗(yàn)研究,試驗(yàn)測(cè)量氣流在管道、血管壁等多個(gè)位置的壓力情況,并分析各個(gè)位置氣流壓力之間的相關(guān)性和函數(shù)關(guān)系,研究氣流路徑上壓力分布是否具有穩(wěn)定性和可計(jì)算的方法； 3.對(duì)激光發(fā)射裝置的構(gòu)建,利用該裝置發(fā)射的激光線,在測(cè)量血管壁上產(chǎn)生能用于無(wú)創(chuàng)測(cè)壓系統(tǒng)捕捉的光學(xué)信號(hào)； 4.自主研發(fā)圖像采集分析系統(tǒng)程序,利用已有的內(nèi)鏡系統(tǒng),連續(xù)采集測(cè)壓靜脈位置的光學(xué)信號(hào)圖像,通過光學(xué)圖像分析程序,快速捕捉血管因氣壓形變引起的光學(xué)信號(hào)圖像改變的情況； 5.構(gòu)建同步體系,對(duì)氣流壓力變化和靜脈管壁變形進(jìn)行同步測(cè)量,實(shí)現(xiàn)儀器捕捉血管形變時(shí)刻,可同時(shí)記錄當(dāng)前氣壓值； 6.進(jìn)行體外血管實(shí)驗(yàn),利用壓力可調(diào)節(jié)的模擬血管儀,使用本研究無(wú)創(chuàng)測(cè)量新方法,用研制的無(wú)創(chuàng)測(cè)壓儀對(duì)仿生血管和離體大隱靜脈血管進(jìn)行實(shí)驗(yàn)測(cè)量,并將測(cè)量數(shù)據(jù)與模擬血管儀數(shù)據(jù)對(duì)比,通過比較分析,驗(yàn)證本研究原理； 7.進(jìn)行動(dòng)物體內(nèi)血管實(shí)驗(yàn),通過將家兔進(jìn)行解剖,對(duì)其下腔靜脈同時(shí)進(jìn)行無(wú)創(chuàng)測(cè)壓和穿刺測(cè)壓,通過分析比較,進(jìn)一步明確無(wú)創(chuàng)測(cè)壓新方法的可行性、準(zhǔn)確性和實(shí)用性。 結(jié)果： 1.根據(jù)無(wú)創(chuàng)測(cè)量新方法的理論構(gòu)想,研制出新型無(wú)創(chuàng)測(cè)壓儀原型。該儀器原型通過主動(dòng)控制氣流連續(xù)變化,以該氣流作為指壓氣流探針壓迫血管,同時(shí)借助激光檢測(cè)技術(shù),同步檢測(cè)血管變形過程；當(dāng)曲張靜脈被主動(dòng)氣流壓陷初始時(shí)刻,記錄氣流壓力；根據(jù)該時(shí)刻氣流壓力數(shù)據(jù)來計(jì)算血管內(nèi)部的壓力。 2.通過體外血管實(shí)驗(yàn)和動(dòng)物體內(nèi)血管實(shí)驗(yàn),結(jié)果表明本研究研制的測(cè)壓儀器與仿生血管的實(shí)際壓力值有良好的相關(guān)性,直線回歸方程式分別為：Y=1.001X+6.036；測(cè)壓儀器與離體大隱靜脈血管的實(shí)際壓力值有良好的相關(guān)性,直線回歸方程式分別為：Y=1.001X+9.703；測(cè)壓儀器與穿刺測(cè)壓儀有良好的相關(guān)性,直線回歸方程為：Y=1.001X+10.820。 結(jié)論：本研究所提出的基于氣流與激光檢測(cè)技術(shù)的無(wú)創(chuàng)測(cè)壓新方法,具有可行性,重復(fù)性好,其測(cè)量準(zhǔn)確度較高,有良好的應(yīng)用價(jià)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.
【學(xué)位授予單位】：中南大學(xué)
【學(xué)位級(jí)別】：博士
【學(xué)位授予年份】：2014
【分類號(hào)】：R575.2
本文編號(hào)：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.
【學(xué)位授予單位】：中南大學(xué)
【學(xué)位級(jí)別】：博士
【學(xué)位授予年份】：2014
【分類號(hào)】：R575.2
【參考文獻(xiàn)】
相關(guān)期刊論文 前1條
1 孔德潤(rùn);許建明;付忠謙;何兵兵;孫斌;張磊;謝岳;;基于計(jì)算機(jī)視覺的無(wú)創(chuàng)性食管曲張靜脈測(cè)壓儀[J];生物醫(yī)學(xué)工程學(xué)雜志;2007年03期
，本文編號(hào)：2232731
本文鏈接：http://sikaile.net/yixuelunwen/xiaohjib/2232731.html
最近更新
教材專著
