本文選題：異步除顫　切入點(diǎn)：同步除顫　出處：《深圳大學(xué)》2017年碩士論文

【摘要】：心室顫動(Ventricular Fibrillation,室顫)是一種嚴(yán)重危及患者生命安全的惡性心律失常。心源性猝死(sudden cardiacdeath,SCD)是心血管疾病的主要死亡原因,占心血管病死亡總數(shù)的50%以上。而造成SCD的主要原因是,在各類心血管病變的基礎(chǔ)上發(fā)生的一時性功能障礙和電生理改變,并引發(fā)惡性室性心動過速(ventricular tachycardia,室速)、室顫等。由于SCD發(fā)病急、進(jìn)展快、病情兇險,且80%發(fā)生在醫(yī)院外,且其中80%又發(fā)生在睡眠中,造成搶救困難,常常使患者的突然死亡,給家庭和社會造成重大損失,是嚴(yán)重威脅人民健康和生命的惡性疾病。目前室顫是成人心搏驟停最常見的心律失常類型,在院前突發(fā)的SCD中室顫占30-40%。有文獻(xiàn)報(bào)道院前猝死的存活者中大部分是以室顫為初始心搏驟停的節(jié)律,能否成功復(fù)蘇與電除顫的應(yīng)用率密切相關(guān)。因此,早期電除顫成為心肺復(fù)蘇中終止室顫的唯一有效手段,每延遲除顫1分鐘,搶救成功率就下降7-10%。心房顫動(atrialFibrillation,房顫)是心房發(fā)生病變在體表心電圖上的表現(xiàn),此時心房已不能正常的完成舒張與收縮。房顫是一種慢性的心律失常,初始可能為短暫性房顫,但如果不及時進(jìn)行診治,會發(fā)展為永久性房顫,引起中風(fēng)等惡性疾病。本系統(tǒng)主要研究室顫和房顫檢測的算法,并應(yīng)用此算法在異步除顫模式下正確定位室顫,在同步除顫模式下正確定位房顫,并根據(jù)QRS波檢測環(huán)節(jié)及時定位出的QRS波位置,及時進(jìn)行除顫,挽救患者生命。在對大量心電數(shù)據(jù)研究的基礎(chǔ)上,最終采用以Lempel-Ziv復(fù)雜度為主的計(jì)算方法進(jìn)行室顫檢測,先以斜率方法及時定位QRS波的位置,再以RR間期不規(guī)則度的計(jì)算方法進(jìn)行房顫檢測,實(shí)現(xiàn)系統(tǒng)的異步除顫和同步除顫。本系統(tǒng)采用公共開源標(biāo)準(zhǔn)數(shù)據(jù)庫MIT和CU進(jìn)行準(zhǔn)確性評測,評測結(jié)果表明系統(tǒng)性能較好,抗干擾能力強(qiáng),能夠?qū)崿F(xiàn)正確定位室顫和房顫。同時由于系統(tǒng)的計(jì)算量適中,實(shí)現(xiàn)后,系統(tǒng)可移植到除顫監(jiān)護(hù)儀和自動體外除顫器(Automatic External Defibrillator,AED)等設(shè)備,特別適用于一般的小型嵌入式除顫類設(shè)備中。
[Abstract]:Ventricular fibrillation (VF) is a kind of malignant arrhythmia which seriously endangers the life of patients. Sudden cardiac death (SCDs) is the main cause of death of cardiovascular diseases, accounting for more than 50% of the total death of cardiovascular diseases. On the basis of all kinds of cardiovascular diseases, transient dysfunction and electrophysiological changes occurred, and caused malignant ventricular tachycardia, ventricular tachycardia, ventricular tachycardia, ventricular tachycardia, ventricular fibrillation and so on. Among them, 80% occurred in sleep, causing rescue difficulties, often causing sudden death of patients, causing great losses to families and society. Ventricular fibrillation is the most common type of arrhythmia in adults with sudden cardiac arrest. Ventricular fibrillation (VF) accounts for 30-40% of the sudden SCD before hospital. It has been reported that most of the survivors of sudden death before hospital use ventricular fibrillation as the rhythm of initial cardiac arrest. The successful resuscitation is closely related to the rate of defibrillation. Early electrical defibrillation has become the only effective way to terminate ventricular fibrillation in cardiopulmonary resuscitation. Every minute of defibrillation, the success rate of rescue is reduced by 7-100.Atrial fibrillation is the manifestation of atrial lesion on the surface electrocardiogram. Atrial fibrillation, a chronic arrhythmia, may initially be transient atrial fibrillation, but if not treated in time, it can develop into permanent atrial fibrillation. This system mainly studies the detection algorithm of ventricular fibrillation and atrial fibrillation, and uses this algorithm to correctly locate ventricular fibrillation in asynchronous defibrillation mode and atrial fibrillation in synchronous defibrillation mode. According to the position of QRS wave located in time by QRS wave detection, defibrillation can be carried out in time to save patient's life. On the basis of studying a large number of ECG data, the method of calculating the complexity of Lempel-Ziv is used to detect ventricular fibrillation. First, the position of QRS wave is located in time by slope method, and then the atrial fibrillation is detected by calculating the irregular degree of RR interval to realize the asynchronous defibrillation and synchronous defibrillation of the system. The system adopts MIT and CU to evaluate the accuracy of the system. The evaluation results show that the system has good performance, strong anti-interference ability, and can realize the correct positioning of ventricular fibrillation and atrial fibrillation. Because of the moderate calculation of the system, the system can be transplanted to defibrillation monitor and automatic External defibrillator AED. etc. It is especially suitable for small embedded defibrillators.
【學(xué)位授予單位】：深圳大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：TN911.7;R541.75

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本文編號：1692157