基于脈搏波傳導時間變異性的低血壓預測研究
發(fā)布時間：2019-04-02 02:32
【摘要】：擇期剖宮產(chǎn)麻醉后低血壓極大威脅著母嬰的安全,實現(xiàn)麻醉前的低血壓風險預測具有重要的臨床意義。與常用的心率變異性研究相比,脈搏波信號蘊含豐富的血管特性信息,可以更為直接準確地反映血壓的調節(jié)機制,因此論文圍繞脈搏波傳導時間變異性(Pulse Transit Time Variability, PTTV)對剖宮產(chǎn)麻醉后低血壓的風險評估進行了深入研究。 論文的主要內容包括： 基于脈搏波傳導時間與血壓的關系,提出了應用脈搏波傳導時間變異性進行低血壓預測的分析方法。研究了心電及脈搏波信號的特征點檢測方法、適合短時程序列分析的自回歸(Auto Regressive, AR)模型的頻域分析方法。 提出了相對心率頻率(Relative Frequency of Heart Rate, RFHR)與相對心動周期(Relative Cardiac Cycle, RCC)兩個新概念,進行了基于相對心率頻率的功率譜分析。將谷點位置作為頻段劃分依據(jù),聚集范圍分別為0.2559±0.0096、0.4213+0.01、0.6006±0.0116和0.7706+0.01817,離散程度小,具有很高的一致性,其中0.1-0.26譜段、0.26-0.42譜段及0.42-0.6譜段包含的譜峰分別對應于五倍心動周期調節(jié)、三倍心動周期調節(jié)和兩倍心動周期調節(jié),物理含義清晰,解決了頻譜峰谷位置的聚類問題。 基于相對心率頻率的功率譜分析方法,對69例臨床數(shù)據(jù)術前一天、手術當天擴容前、擴容后至麻醉前三個階段的數(shù)據(jù)進行統(tǒng)計學分析,結果表明,參數(shù)RCC5/RCC3(五倍心動周期調節(jié)頻段與三倍心動周期調節(jié)頻段的能量比值)的判別閾值設置為0.7057時,預測敏感度達80%,特異性達79.7%,在擴容后對重度低血壓具有潛在的預測能力,對擇期剖宮產(chǎn)麻醉后低血壓的風險預測具有一定臨床指導意義。
[Abstract]:Hypotension after elective cesarean section greatly threatens the safety of mothers and infants. It is of great clinical significance to predict the risk of hypotension before anesthesia. Compared with common heart rate variability (HRV) studies, pulse wave signals contain abundant information of blood vessel characteristics and can reflect the regulation mechanism of blood pressure more directly and accurately. Therefore, the thesis focuses on the pulse wave conduction time variability (Pulse Transit Time Variability,). PTTV) studied the risk assessment of hypotension after cesarean section anesthesia. The main contents of this paper are as follows: based on the relationship between pulse wave conduction time and blood pressure, a method for predicting hypotension using pulse wave conduction time variability is proposed. The characteristic point detection method of ECG and pulse wave signal is studied, and the frequency domain analysis method of autoregressive (Auto Regressive, AR) model is suitable for short-time program analysis. Two new concepts of relative heart rate frequency (Relative Frequency of Heart Rate, RFHR) and relative cardiac period (Relative Cardiac Cycle, RCC) are proposed, and the power spectrum analysis based on relative heart rate frequency is carried out. Taking the valley position as the basis for frequency band division, the aggregation ranges are 0.2559 鹵0.0096, 0.4213 0.01, 0.6006 鹵0.0116 and 0.7706 0.01817, respectively. 0.26 and 0.42, respectively, correspond to five-fold, three-fold, and two-fold cardiac period regulation, respectively. The physical meaning of the peak is clear. The clustering problem of peak and valley position of spectrum is solved. Based on the power spectrum analysis method of relative heart rate frequency, the data of 69 cases of clinical data were analyzed statistically one day before operation, and after volume expansion to three stages before anaesthesia. When the discriminant threshold of the parameter RCC5/RCC3 (the energy ratio between the five-fold and triple-cycle regulation bands) is set to 0.7057, the sensitivity and specificity of the prediction are 80% and 79.7%, respectively, when the threshold value is set to 0.7057. It has the potential to predict severe hypotension after expansion, and has some clinical significance in predicting the risk of hypotension after elective cesarean section anesthesia.
【學位授予單位】：浙江大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：TN911.7
本文編號：2452149
[Abstract]:Hypotension after elective cesarean section greatly threatens the safety of mothers and infants. It is of great clinical significance to predict the risk of hypotension before anesthesia. Compared with common heart rate variability (HRV) studies, pulse wave signals contain abundant information of blood vessel characteristics and can reflect the regulation mechanism of blood pressure more directly and accurately. Therefore, the thesis focuses on the pulse wave conduction time variability (Pulse Transit Time Variability,). PTTV) studied the risk assessment of hypotension after cesarean section anesthesia. The main contents of this paper are as follows: based on the relationship between pulse wave conduction time and blood pressure, a method for predicting hypotension using pulse wave conduction time variability is proposed. The characteristic point detection method of ECG and pulse wave signal is studied, and the frequency domain analysis method of autoregressive (Auto Regressive, AR) model is suitable for short-time program analysis. Two new concepts of relative heart rate frequency (Relative Frequency of Heart Rate, RFHR) and relative cardiac period (Relative Cardiac Cycle, RCC) are proposed, and the power spectrum analysis based on relative heart rate frequency is carried out. Taking the valley position as the basis for frequency band division, the aggregation ranges are 0.2559 鹵0.0096, 0.4213 0.01, 0.6006 鹵0.0116 and 0.7706 0.01817, respectively. 0.26 and 0.42, respectively, correspond to five-fold, three-fold, and two-fold cardiac period regulation, respectively. The physical meaning of the peak is clear. The clustering problem of peak and valley position of spectrum is solved. Based on the power spectrum analysis method of relative heart rate frequency, the data of 69 cases of clinical data were analyzed statistically one day before operation, and after volume expansion to three stages before anaesthesia. When the discriminant threshold of the parameter RCC5/RCC3 (the energy ratio between the five-fold and triple-cycle regulation bands) is set to 0.7057, the sensitivity and specificity of the prediction are 80% and 79.7%, respectively, when the threshold value is set to 0.7057. It has the potential to predict severe hypotension after expansion, and has some clinical significance in predicting the risk of hypotension after elective cesarean section anesthesia.
【學位授予單位】：浙江大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：TN911.7
【參考文獻】
相關期刊論文 前10條
1 劉曉紅;范紫香;陳小珍;任從才;;腰-硬聯(lián)合麻醉下剖宮產(chǎn)術低血壓的相關因素分析與護理[J];中國醫(yī)藥導刊;2007年03期
2 李向軍,陳裕泉;QRS波群時頻檢測方法的新進展[J];國外醫(yī)學.生物醫(yī)學工程分冊;2005年05期
3 孔諳,白凈,席葆樹,祖佩貞,張菊鵬;心血管系統(tǒng)參數(shù)變化對脈搏波波形影響的數(shù)字仿真研究[J];航天醫(yī)學與醫(yī)學工程;1999年04期
4 支冬棟;衛(wèi)紅凱;杜斌;;現(xiàn)代譜估計法中幾種不同模型參數(shù)估計法的比較[J];艦船電子對抗;2009年01期
5 武艷華;黃純;邢耀廣;顧蘇;潘華;;基于AR模型的間諧波檢測算法的研究[J];繼電器;2006年02期
6 黃紹強;;預防剖宮產(chǎn)脊麻后低血壓的研究進展[J];臨床麻醉學雜志;2009年01期
7 陳良;劉建寧;;變換體位引起的血壓改變預測剖宮產(chǎn)腰麻仰臥位低血壓綜合征的發(fā)生[J];臨床麻醉學雜志;2011年07期
8 李雙蓮;;護理干預對剖宮產(chǎn)產(chǎn)婦仰臥位低血壓綜合征的影響[J];護理研究;2012年18期
9 宋寧;關華;;經(jīng)典功率譜估計及其仿真[J];現(xiàn)代電子技術;2008年11期
10 馮成才;閔紅星;;綜合措施防治剖宮產(chǎn)術中低血壓的臨床觀察[J];寧夏醫(yī)科大學學報;2009年05期
相關博士學位論文 前1條
1 王選;基于光電容積脈搏波形態(tài)的傷害感受指數(shù)的研究[D];浙江大學;2012年
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