基于氣流與激光檢測技術的無創(chuàng)靜脈測壓新方法的研究
發(fā)布時間：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,并且肝功能等級越高患者,其EV破裂出血死亡率越高。因此對于肝硬化患者而言,如何及時發(fā)現(xiàn)EV出血高危人群,提前預測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定存在兩大類技術且均在內(nèi)鏡下進行,即靜脈內(nèi)測壓和靜脈外測壓。靜脈內(nèi)測壓即穿刺測壓,是公認的標準測壓方法,但該方法存在不能重復測壓、穿刺易造成大出血或細菌感染等缺點。靜脈外測壓技術則是當前的研究熱點。目前包括兩大類：一是食管曲張靜脈貼壁測壓的技術,另一種是氣囊測壓法。但是,這兩類無創(chuàng)測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確性。因此,為了更好的預測EV出血,需要找到一種更安全、準確、重復性好的內(nèi)鏡方法用于測量EV的壓力。 目的：本研究利用光學原理并結合自動控制技術、計算機實時圖像檢測技術,進行氣流結合激光無創(chuàng)非接觸測壓方法的研究�；谠撔聹y壓方法,研制相應的無創(chuàng)測壓儀原型,并利用該原型儀器進行體外血管實驗及動物實驗,評估測壓新方法的可行性、準確性和實用性。 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,同時監(jiān)測血管外壁的形變；本研究認為對于外凸的薄壁靜脈血管,血管外壁初始形變時刻的氣流壓力與血管內(nèi)靜壓相等或成線性相關關系。 方法： 1.自主設計研發(fā)可調(diào)節(jié)氣泵,設計調(diào)整氣泵結構以及電路,以實現(xiàn)氣泵輸出的氣壓脈沖工作頻率和氣壓強度可調(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)變化過程不斷往復進行,可完成對被測對象的多次重復測量,以提高測量精度)； 2.對氣泵產(chǎn)生的氣流、氣流與導管壁摩擦導致的氣壓衰減進行實驗研究,試驗測量氣流在管道、血管壁等多個位置的壓力情況,并分析各個位置氣流壓力之間的相關性和函數(shù)關系,研究氣流路徑上壓力分布是否具有穩(wěn)定性和可計算的方法； 3.對激光發(fā)射裝置的構建,利用該裝置發(fā)射的激光線,在測量血管壁上產(chǎn)生能用于無創(chuàng)測壓系統(tǒng)捕捉的光學信號； 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)采集測壓靜脈位置的光學信號圖像,通過光學圖像分析程序,快速捕捉血管因氣壓形變引起的光學信號圖像改變的情況； 5.構建同步體系,對氣流壓力變化和靜脈管壁變形進行同步測量,實現(xiàn)儀器捕捉血管形變時刻,可同時記錄當前氣壓值； 6.進行體外血管實驗,利用壓力可調(diào)節(jié)的模擬血管儀,使用本研究無創(chuàng)測量新方法,用研制的無創(chuàng)測壓儀對仿生血管和離體大隱靜脈血管進行實驗測量,并將測量數(shù)據(jù)與模擬血管儀數(shù)據(jù)對比,通過比較分析,驗證本研究原理； 7.進行動物體內(nèi)血管實驗,通過將家兔進行解剖,對其下腔靜脈同時進行無創(chuàng)測壓和穿刺測壓,通過分析比較,進一步明確無創(chuàng)測壓新方法的可行性、準確性和實用性。 結果： 1.根據(jù)無創(chuàng)測量新方法的理論構想,研制出新型無創(chuàng)測壓儀原型。該儀器原型通過主動控制氣流連續(xù)變化,以該氣流作為指壓氣流探針壓迫血管,同時借助激光檢測技術,同步檢測血管變形過程；當曲張靜脈被主動氣流壓陷初始時刻,記錄氣流壓力；根據(jù)該時刻氣流壓力數(shù)據(jù)來計算血管內(nèi)部的壓力。 2.通過體外血管實驗和動物體內(nèi)血管實驗,結果表明本研究研制的測壓儀器與仿生血管的實際壓力值有良好的相關性,直線回歸方程式分別為：Y=1.001X+6.036；測壓儀器與離體大隱靜脈血管的實際壓力值有良好的相關性,直線回歸方程式分別為：Y=1.001X+9.703；測壓儀器與穿刺測壓儀有良好的相關性,直線回歸方程為：Y=1.001X+10.820。 結論：本研究所提出的基于氣流與激光檢測技術的無創(chuàng)測壓新方法,具有可行性,重復性好,其測量準確度較高,有良好的應用價值。
[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.
【學位授予單位】：中南大學
【學位級別】：博士
【學位授予年份】：2014
【分類號】：R575.2
本文編號：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.
【學位授予單位】：中南大學
【學位級別】：博士
【學位授予年份】：2014
【分類號】：R575.2
【參考文獻】
相關期刊論文 前1條
1 孔德潤;許建明;付忠謙;何兵兵;孫斌;張磊;謝岳;;基于計算機視覺的無創(chuàng)性食管曲張靜脈測壓儀[J];生物醫(yī)學工程學雜志;2007年03期
，本文編號：2232731
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