CN111568407A - Method for judging shock development stage of patient based on laser speckle blood flow instrument - Google Patents
Method for judging shock development stage of patient based on laser speckle blood flow instrument Download PDFInfo
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- 230000035939 shock Effects 0.000 title claims abstract description 84
- 230000017531 blood circulation Effects 0.000 title claims abstract description 38
- 238000000034 method Methods 0.000 title claims abstract description 20
- 238000011161 development Methods 0.000 title claims abstract description 18
- 230000004089 microcirculation Effects 0.000 claims abstract description 45
- 230000010412 perfusion Effects 0.000 claims abstract description 20
- 238000012544 monitoring process Methods 0.000 claims abstract description 12
- 230000008081 blood perfusion Effects 0.000 claims description 16
- 238000011282 treatment Methods 0.000 description 11
- 230000036772 blood pressure Effects 0.000 description 6
- 238000004393 prognosis Methods 0.000 description 6
- 238000003745 diagnosis Methods 0.000 description 4
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- 230000008602 contraction Effects 0.000 description 2
- 230000007423 decrease Effects 0.000 description 2
- 210000000056 organ Anatomy 0.000 description 2
- 230000009885 systemic effect Effects 0.000 description 2
- 208000034486 Multi-organ failure Diseases 0.000 description 1
- 208000010718 Multiple Organ Failure Diseases 0.000 description 1
- 208000037273 Pathologic Processes Diseases 0.000 description 1
- 239000008280 blood Substances 0.000 description 1
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- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/02—Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
- A61B5/026—Measuring blood flow
- A61B5/0261—Measuring blood flow using optical means, e.g. infrared light
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/68—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient
- A61B5/6801—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be attached to or worn on the body surface
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Abstract
The invention provides a method for judging the shock development stage of a patient based on a laser speckle blood flow instrument, which comprises the following steps of 1, obtaining a laser speckle image by using the laser speckle blood flow instrument, calculating a speckle contrast ratio K of a selected area of the patient through the laser speckle image, 2, selecting a fixed area of the same fingertip of the patient, continuously recording the change condition of the speckle contrast ratio K in the fixed area within monitoring time, obtaining the microcirculation blood flow perfusion volume of the patient, 3, calculating the microcirculation blood flow perfusion volume ratio α of the fingertip to a finger root1And the shock is used as an auxiliary index for judging the shock, and whether the shock occurs or not is judged through the auxiliary index; step 4, continuously monitoring the perfusion volume of the microcirculation blood flow, and when shock occurs, comparing the speckle contrast ratio K with the average speckle contrast ratio K of the patient when the vital signs are normal0A comparison is made to determine the stage of shock of the patient.
Description
Technical Field
The invention belongs to the field of medical treatment, and particularly relates to a method for judging the shock development stage of a patient based on a laser speckle blood flow meter.
Background
Shock is a pathological process of systemic organ dysfunction caused by systemic microcirculation disturbance, which may lead to multiple organ failure and ultimately death if not cured in time. Microcirculation is the final link, and is also the most important link, for the exchange of nutrients in the blood with metabolites in the cells. According to research, microcirculation change often occurs before organ function change when shock occurs, and the change cannot be responded by blood flow dynamics parameters such as blood pressure, heart rate and the like. Therefore, the understanding of the patient microcirculation change is of great significance to the treatment and the evaluation of prognosis of shock.
Shock is divided into three phases: a microcirculation contraction period (a first shock period, the decline trend of microcirculation blood flow perfusion is obvious), a microcirculation expansion period (a second shock period, the perfusion amount is more than the loss amount, and the decline trend of the blood flow perfusion is slow), and a microcirculation failure period (a refractory period or a DIC period, blood flow is stopped, no perfusion is carried out, and tissues and organs are seriously anoxic and finally damaged). The first two stages can be corrected by different treatment means, but after the third stage, the shock is irreversible and difficult to cure.
At present, indexes (blood pressure and shock index) for clinically judging the shock degree of a patient are later than the change of the perfusion amount of microcirculation blood flow, are influenced by the pathogenesis, treatment means and the self condition of the patient, and can not timely and accurately transmit information of the shock occurrence and development stage, so that the treatment is delayed. Therefore, the observation of the microcirculation blood perfusion condition of the shock patient can reflect the shock state of the current patient in real time and take corresponding treatment measures in time.
The existing blood flow monitoring instrument realizes long-time real-time monitoring of microcirculation blood flow perfusion amount and has higher resolution and precision. Although the blood flow monitor is already applied to blood flow monitoring of patients suffering from clinical shock, the perfusion volume of microcirculation blood flow in three stages of shock is not clearly divided, and clinicians can still judge the shock condition of the patients only by means of blood pressure values and shock indexes.
Disclosure of Invention
The present invention is made to solve the above problems, and an object of the present invention is to provide a method for determining the stage of shock development in a patient based on a laser speckle blood flow meter.
The invention provides a method for judging the shock development stage of a patient based on a laser speckle blood flow instrument, which is characterized by comprising the following steps: step 1, obtaining a laser speckle image by using a laser speckle blood flow instrument, and calculating a speckle contrast ratio K of a selected area of a patient through the laser speckle image, wherein the formula is as follows:
step 2, selecting a fixed area of the same fingertip of the patient, continuously recording the change condition of the speckle contrast ratio K in the fixed area within the monitoring time, and obtaining the microcirculation blood perfusion volume of the patient;
step 3, calculating α ratio of microcirculation blood perfusion volume of finger tip and finger root1And the shock is used as an auxiliary index for judging the shock, and whether the shock occurs or not is judged through the auxiliary index;
step 4, continuously monitoring the perfusion volume of the microcirculation blood flow, and when shock occurs, comparing the speckle contrast ratio K with the average speckle contrast ratio K of the patient when the vital signs are normal0Comparing and judging the shock stage of the patient, wherein in the formula (1), sigmaIIs the standard deviation of the light intensity within the selected region,
is the average of the light intensity within the selected area.
The method for judging the shock development stage of the patient based on the laser speckle blood flow instrument provided by the invention can also have the following characteristics: wherein, in the step 2, the relation between the microcirculation blood perfusion volume and the speckle contrast ratio is shown in a formula (2) and a formula (3),
in the formula (2) and the formula (3), K is a speckle contrast ratio, x is a microcirculation perfusion amount, T is an exposure time of the CCD camera, and taucThe autocorrelation decay time of the laser speckle image is β, the correlation constant of the laser speckle rheometer.
The method for determining the shock development stage of the patient based on the laser speckle blood flow meter can also be characterized in that α in the healthy population in step 31The distribution interval of (A) is not less than 1.4 and not more than α1α for shock patients of less than or equal to 2.21The distribution interval of (1.00) is more than α1≤1.4。
The method for judging the shock development stage of the patient based on the laser speckle blood flow instrument provided by the invention can also have the following characteristics: in step 4, the speckle contrast ratio value K and the average speckle contrast ratio value K of the patient when the vital sign is normal0For comparison, as shown in formula (4) to formula (6),
K＝K0×(1.18～1.48) (4)，
K＝K0×(1.48～1.82) (5)，
K＞K0×(1.82) (6)，
when K and K0When equation (4) is satisfied, the patient is in first stage of shock when K and K are present0When equation (5) is satisfied, the patient is in second stage of shock when K and K are present0When equation (6) is satisfied, the patient is in third phase of shock.
Action and Effect of the invention
According to the method for judging the shock development stage of the patient based on the laser speckle blood flow meter, the ratio of the microcirculation blood flow perfusion amount of the fingertips and the fingerroots is used as a shock index to judge whether the patient is in shock or not, and the diagnosis, treatment and prognosis of the patient can be assisted by a doctor through the combination of the shock index, a blood pressure value and the shock index. Because the speckle contrast ratio of the fingertip of the patient is measured in real time and is compared with the average speckle contrast ratio when the vital signs of the patient are normal, the shock stage of the patient can be judged quickly, and the microcirculation blood perfusion amount can be observed through the conversion between the speckle contrast ratio and the microcirculation blood perfusion amount, the occurrence and development changes of shock can be found early, timely and accurately, and the method has important significance for guiding treatment and evaluating prognosis.
Drawings
Fig. 1 is a flow chart of a method for determining the stage of shock development in a patient based on a laser speckle-based blood flow meter in an embodiment of the invention.
Detailed Description
In order to make the technical means and functions of the present invention easy to understand, the present invention is specifically described below with reference to the embodiments and the accompanying drawings.
Fig. 1 is a flow chart of a method for determining the stage of shock development in a patient based on a laser speckle-based blood flow meter in an embodiment of the invention.
As shown in fig. 1, the method for determining the shock development stage of a patient based on a laser speckle blood flow meter of the present embodiment includes the following steps:
step 1, obtaining a laser speckle image by using a laser speckle blood flow instrument, and calculating a speckle contrast ratio K of a selected area of a patient through the laser speckle image, wherein the formula is as follows:
in the formula (1), σIIs the standard deviation of the light intensity within the selected region,
is the average of the light intensity within the selected area.
And 2, selecting a fixed area of the same fingertip of the patient, continuously recording the change condition of the speckle contrast ratio K in the fixed area within the monitoring time, and obtaining the microcirculation blood perfusion volume of the patient.
In the embodiment, for a shock patient, the dynamic range of the speckle contrast ratio K of the fingertip is about 0.19-0.4, the metering precision is four digits after the decimal point, and the larger K is, the smaller the microcirculation blood perfusion amount is.
In step 2, the relation between the microcirculation blood perfusion and the speckle contrast ratio is shown in formula (2) and formula (3),
in the formula (2) and the formula (3), K is a speckle contrast ratio, x is a microcirculation perfusion amount, T is an exposure time of the CCD camera, and taucThe autocorrelation decay time of the laser speckle image is β, the correlation constant of the laser speckle rheometer.
Step 3, calculating α ratio of microcirculation blood perfusion volume of finger tip and finger root1And the shock is used as an auxiliary index for judging the shock, and whether the shock occurs or not is judged through the auxiliary index.
α in healthy people in step 31The distribution interval of (A) is not less than 1.4 and not more than α1α for shock patients of less than or equal to 2.21The distribution interval of (1.00) is more than α1≤1.4。
In this embodiment, the average of the ratio of the perfusion volume of the patient's fingertip to the finger root microcirculation during the monitoring process is about α1＝1.24
Step 4, continuously monitoring the perfusion volume of the microcirculation blood flow, and when shock occurs, comparing the speckle contrast ratio K with the average speckle contrast ratio K when the vital signs of the patient are normal0A comparison is made to determine the stage of shock of the patient.
In this embodiment, the average speckle contrast value K when the patient's vital signs are normal0＝0.16。
In step 4, the speckle contrast ratio K and the average speckle contrast ratio K when the vital signs of the patient are normal0For comparison, as shown in formula (4) to formula (6),
K＝K0×(1.18～1.48) (4)，
K＝K0×(1.48～1.82) (5)，
K＞K0×(1.82) (6)，
in this example, when 0.189 < K < 0.237, the patient is considered to be in shock stage one (microcirculatory contractility); when K is more than 0.237 and less than or equal to 0.291, the patient is considered to be in the second stage of shock (microcirculation expansion stage); when K > 0.291, the patient is considered to be in stage three of shock (microcirculation failure).
And the relation between the speckle contrast ratio and the microcirculation blood flow perfusion can obtain that when 209.0 x is more than or equal to 131.5, the patient is in the first stage of shock (microcirculation contraction stage); when 131.5> x ≧ 85.9, the patient is in second stage of shock (microcirculation expansion phase); when x <85.9, the patient is in third stage of shock (microcirculation failure stage).
The change result of the microcirculation blood perfusion amount obtained by calculation is combined with the shock diagnosis indexes (blood pressure value and shock index) used in clinic, so as to assist doctors in diagnosis, treatment and prognosis.
Effects and effects of the embodiments
According to the method for judging the shock development stage of the patient based on the laser speckle blood flow meter, the ratio of the microcirculation blood flow perfusion amount of the fingertips and the fingerroots is used as a shock index to judge whether the patient is in shock or not, and the diagnosis, treatment and prognosis of the patient can be assisted by combining the shock index with a blood pressure value and a shock index. Because the speckle contrast ratio of the fingertip of the patient is measured in real time and is compared with the average speckle contrast ratio when the vital signs of the patient are normal, the shock stage of the patient can be judged quickly, and the microcirculation blood perfusion amount can be observed through the conversion between the speckle contrast ratio and the microcirculation blood perfusion amount, the occurrence and development changes of shock can be found early, timely and accurately, and the method has important significance for guiding treatment and evaluating prognosis.
The above embodiments are preferred examples of the present invention, and are not intended to limit the scope of the present invention.
Claims (4)
1. A method for judging the shock development stage of a patient based on a laser speckle blood flow instrument is characterized by comprising the following steps:
step 1, obtaining a laser speckle image by using a laser speckle blood flow instrument, and calculating a speckle contrast ratio K of a selected area of a patient according to the laser speckle image, wherein the formula is as follows:
step 2, selecting a fixed area of the same fingertip of the patient, continuously recording the change condition of the speckle contrast value K in the fixed area within the monitoring time, and obtaining the microcirculation blood perfusion volume of the patient;
step 3, calculating α ratio of microcirculation blood perfusion volume of finger tip and finger root1And the shock is used as an auxiliary index for judging the shock, and whether the shock occurs or not is judged through the auxiliary index;
step 4, continuously monitoring the perfusion volume of the microcirculation blood flow, and when shock occurs, comparing the speckle contrast ratio K with the average speckle contrast ratio K of the patient when the vital signs are normal0A comparison is made to determine the stage of shock of the patient,
wherein, in the formula (1), σIIs the standard deviation of the light intensity within the selected region,
the average value of the light intensity in the selected area is obtained.
2. The method of determining the stage of shock progression using a laser speckle rheometer as claimed in claim 1, wherein:
wherein, in the step 2, the relation between the microcirculation blood perfusion volume and the speckle contrast ratio is shown in a formula (2) and a formula (3),
in the formula (2) and the formula (3), K is a speckle contrast ratio, x is a microcirculation perfusion amount, T is an exposure time of the CCD camera, and taucβ is the correlation constant of the laser speckle rheometer for the autocorrelation decay time of the laser speckle image.
3. The method of determining the stage of shock progression using a laser speckle rheometer as claimed in claim 1, wherein:
wherein in the step 3, α is contained in healthy people1The distribution interval of (A) is not less than 1.4 and not more than α1α for shock patients of less than or equal to 2.21The distribution interval of (1.00) is more than α1≤1.4。
4. The method of determining the stage of shock progression using a laser speckle rheometer as claimed in claim 1, wherein:
in step 4, the speckle contrast ratio K is equal to the average speckle contrast ratio K when the vital signs of the patient are normal0For comparison, as shown in formula (4) to formula (6),
K＝K0×(1.18～1.48) (4)，
K＝K0×(1.48～1.82) (5)，
K＞K0×(1.82) (6)，
when K and K0When equation (4) is satisfied, the patient is in first stage of shock when K and K are present0When equation (5) is satisfied, the patient is in second stage of shock when K and K are present0When equation (6) is satisfied, the patient is in third phase of shock.
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Citations (5)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN104287713A (en) * | 2013-06-13 | 2015-01-21 | 上海理工大学 | Quick laser speckle blood flow imaging method |
| CN204618222U (en) * | 2015-04-08 | 2015-09-09 | 上海医疗器械高等专科学校 | A kind of portable laser speckle blood flowmeter |
| US20160220129A1 (en) * | 2015-02-04 | 2016-08-04 | General Electric Company | Systems and methods for quantitative microcirculation state monitoring |
| CN207721808U (en) * | 2017-06-28 | 2018-08-14 | 上海健康医学院 | A kind of speckle signals intensifier of laser speckle blood flowmeter |
| CN110301908A (en) * | 2019-05-20 | 2019-10-08 | 南京航空航天大学 | A kind of blood flow velocity monitoring method for contrasting algorithm based on micro- blood flow imaging |
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Patent Citations (5)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN104287713A (en) * | 2013-06-13 | 2015-01-21 | 上海理工大学 | Quick laser speckle blood flow imaging method |
| US20160220129A1 (en) * | 2015-02-04 | 2016-08-04 | General Electric Company | Systems and methods for quantitative microcirculation state monitoring |
| CN204618222U (en) * | 2015-04-08 | 2015-09-09 | 上海医疗器械高等专科学校 | A kind of portable laser speckle blood flowmeter |
| CN207721808U (en) * | 2017-06-28 | 2018-08-14 | 上海健康医学院 | A kind of speckle signals intensifier of laser speckle blood flowmeter |
| CN110301908A (en) * | 2019-05-20 | 2019-10-08 | 南京航空航天大学 | A kind of blood flow velocity monitoring method for contrasting algorithm based on micro- blood flow imaging |
Non-Patent Citations (1)
| Title |
|---|
| 孔平等: "激光散斑血流成像技术研究新进展" * |
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