CN1320411A - Non-wound method and device for measuring blood pressure - Google Patents

Abstract

A method and device for measuring blood pressure without wound is disclosed. Said method includes fixing the included angle between palm and wrist and the included angle between wrist and forearm to the most proper angles to measure blood pressure of arteria radialis, arranging at least one pressurizing bag and a pulse sensor array on the skin at arteria radialis, and pressurizing the arteria radialis while detecting its pulse signals. Its advantages are no influence of human body moving, and high correctness.

Description

No wound is measured the method and apparatus of blood pressure

The present invention relates to measure the method and apparatus of blood pressure, relate in particular to the method and apparatus of the no wound continuous measurement human body artery blood pressure of a kind of method and apparatus of no wound discontinuous measurement human body artery blood pressure of so-called volume vibratory drilling method and a kind of so-called cubage compensation method.

Volume vibratory drilling method (also claim " volume oscillographic method ") has been utilized when the blood vessel external pressure equals blood vessel in mean pressure and be higher than in the blood vessel systolic pressure, and its blood vessel is in best state (this state is called as " idling ") of suitable flexibility and the principle that is crushed respectively.Because all (peak of the blood pressure in each cardiac cycle is called systolic pressure to the blood pressure in the arteries do cyclically-varying along with heartbeat constantly, minimum is called diastolic pressure, meansigma methods is called mean pressure), and the diameter of blood vessel (volume) forms pulse in the cyclically-varying with endarterial blood pressure.Obviously, when the blood vessel external pressure equals mean pressure in the blood vessel, the amplitude maximum of pulse when promptly blood vessel is in along flexible best state, and be higher than systolic pressure in the blood vessel, asphygmia when promptly blood vessel is crushed when the blood vessel external pressure.When utilizing the volume vibratory drilling method to measure arteriotony, generally at first on the skin surface above the tested tremulous pulse, fix an air bag (or liquid capsule) and a photoelectric sensor that is used to detect arterial pulse that is used for tremulous pulse is carried out external pressurized, make the boosting or reducing pressure of gasbag pressure is done once linear with the speed of about 3mmHg/ second in a lower limit is lower than the scope that mean pressure, the upper limit be higher than systolic pressure or ladder then, measure the oscillation amplitude change of the pulse in the whole gasbag pressure change procedure simultaneously.If can guarantee that gasbag pressure is delivered to the tremulous pulse outer surface in the soft tissue below the air bag center unattenuatedly, and photoelectric sensor also only detects the pulse of the tremulous pulse be arranged in this part soft tissue, and then the gasbag pressure when pulse amplitude maximum point and end point is with the mean pressure and the systolic pressure that equal respectively in the tremulous pulse.Thereby utilize pressure transducer to measure the gasbag pressure value in these two moment, do not measure mean pressure and systolic pressure in the tremulous pulse with can having wound; In addition, mean pressure and systolic pressure that utilization records can also be according to empirical equations, and promptly diastolic pressure=(3 * mean pressure-systolic pressure)/2 calculate diastolic pressure.Because each air bag pressurization or decompression process all need the regular hour, and each process can only be measured pressure value one time, so the blood pressure measurement that utilizes this method to be interrupted.This method is compared with auscultation (also claiming Ke Shi sound method), Palpation, rubescent method and the ultrasonic Doppler method of traditional no wound discontinuous measurement blood pressure, have respectively and can measure mean pressure, the measurement error of avoiding subjective judgment ability difference to cause, and the device structure and use advantages such as simple.In addition, it be widely used in now clinically comparing with the pressure vibration method (also claiming oscillographic method) of family, also have and can accurately measure rather than according to the advantage of statistical data reckoning systolic pressure.

Cubage compensation method (also claim " blood vessel no-load method ") has been when then having utilized the blood vessel external pressure all to equate with blood pressure in the blood vessel at any time, the principle on the diameter when blood vessel diameter will be no longer fixed on its idling with blood pressure waveform variation (promptly no longer beating) in the blood vessel by embedding.This method generally also comprises the air bag (or liquid capsule) and the photoelectric sensor that is used to detect arterial pulse that are used for tremulous pulse is carried out external pressurized, also has a feedback control system that is used for detected arterial pulse is gone to control gasbag pressure in addition.When utilizing cubage compensation method continuous blood pressure measuring, at first the same with the volume vibratory drilling method, in certain scope, change gasbag pressure, measure of the variation of the amplitude of pulse simultaneously with gasbag pressure.When gasbag pressure equal endarterial mean pressure that is make arteries be in the most softish state, when the pulse amplitude presents maximum, connect feedback control system detected arterial pulse signal is amplified and phase compensation, and the pressure that goes further to control air bag with it changes according to pulse wave on the basis of mean pressure.In case make the pressure waveform be added in tested arterial blood tube wall outside not only in shape but also all identical on amplitude with the periodically variable waveform of this endarterial blood pressure, that is when making inside and outside both sides stressed of tested arterial blood tube wall all reach dynamic equilibrium at any time, the blood vessel diameter of tested tremulous pulse will no longer change with blood pressure waveform in the blood vessel and on the diameter when being fixed on its idling by embedding, promptly the pulse amplitude is close to zero.At this moment need only the force value of measuring air bag with pressure transducer continuously, can realize the measurement of successive blood pressure waveform and pressure value.Because no wound, this method is compared with traditional direct manometry of intra-arterial intubate that the wound continuous blood pressure measuring is arranged, have no pain, can not cause bleeding, complication or sequela such as infection, thrombosis, thromboembolism and nerve injury, and operation is by advantages such as simplifications greatly.In addition, it is compared with the tensammetry (also claiming the counter-force method) that occurs in recent years, also has the calibration of need not, and measurement result is not subject to advantages such as the moving interferential influence of patient body.

Above-mentioned two kinds of methods are not used in the upper arm that is generally used for measuring blood pressure at present, measure the finger arteriotony on the finger and generally be used in.This mainly is because the brachial artery position at upper arm position is darker, not only is difficult for carrying out the photoelectricity pulse detection, and must carry out full week or could oppress brachial artery fully near the pressurization in full week upper arm.Because this compressing is arranged, frequently use volume vibratory drilling method discontinuous measurement blood pressure for a long time or continue for a long time and use volume vibratory drilling method continuous blood pressure measuring, can make that all the whole forearm in its downstream and the blood circulation and the nervous function of hand are seriously influenced; And finger artery position table is shallow, is convenient to realize the photoelectricity pulse detection, and the air bag pressurization is also less to the influence of blood circulation and nervous function when measuring simultaneously.But a large amount of clinical experiment results has shown that these two kinds of methods are used to point also exists another great problem, promptly because the finger tremulous pulse belongs to the peripheral arteriole big to resistance of blood flow, whether just often used its blood pressure what is called " systemic blood pressure " (i.e. the aortic blood pressure of close heart) with generally judging patient's blood pressure clinically compared, even under normal circumstances also will hang down about 10mmHg, if this difference can reach tens of mmHg under the arteriosclerosis situation.The more important thing is because big than in the large artery trunks blood vessel wall of the smooth muscle composition in the small artery blood vessel wall, and these vascular smooth muscle compositions very easily are subjected to the influence of various factors (such as cold, anesthesia etc.) to produce contraction or diastole, cause that blood pressure fluctuates widely in the small artery, to such an extent as to can not be used to reflect patient's systemic blood pressure with the pressure value that the finger tremulous pulse records at all in many occasions.Especially ought run into patient's the very poor occasion of circulatory function, the finger tremulous pulse causes intra-arterial to lose blood because of vascular smooth muscle extremely shrinks sometimes, to such an extent as to can't measure blood pressure on finger.

In order correctly to reflect the systemic blood pressure of human body, can not influence the blood flow circulation in downstream, tested position again, in recent years, someone has proposed a kind of measuring point these two kinds of methods and has changed to wrist portion, thereby and the pressurized air bag that traditional complete all pressurised airbag change a small size into is only oppressed the scheme of the radicular arteries in wrist two radicular arterieses (scratching tremulous pulse and ulnar artery).This is based on 2 considerations: the diameter that the first is scratched tremulous pulse or ulnar artery is much larger than the finger tremulous pulse, and the smooth muscle composition in their blood vessel wall is less than in the finger tremulous pulse, so their blood pressure than finger tremulous pulse and temporo tremulous pulse more near the human body systemic blood pressure, also be much smaller by the influence of various factors.Even and, generally also can measure pulse scratching on tremulous pulse or the ulnar artery, and the situation that blood pressure measurement can't carry out can not occur in the very poor occasion of patient's circulatory function.Particularly, be convenient to reasons such as operation owing to the These characteristics of wrist tremulous pulse and in wrist portion, the tremulous pulse of scratching at wrist position has the direct pressure measurement of wound to be applied to operation and critical illness monitoring by countries in the world as the most frequently used blood pressure measuring method for many years always, to such an extent as to the pressure value of wrist tremulous pulse is the most reliable by the conduct of clinical worker custom, the criterion of human body systemic blood pressure the most accurately.Thereby wrist portion is changed in the measuring point of these two kinds of methods have high clinical use value.Its two be normal person's tremulous pulse bigger and vein at the wrist place all more than two, wherein two radicular arterieses (scratching tremulous pulse and ulnar artery) are interconnected by two archs of aorta in that palm is inner, several veins also are interconnected by dorsal venous rete of hand at the back of hands.Being interconnected between these blood vessels guaranteed both just to make certain radicular arteries of wrist portion or/and the part vein is blocked for a long time, but another radicular arteries and other most veins are when still can blood flow unimpeded, and the blood circulation of hand can not be affected basically yet.Thereby, on scratching a radicular arteries in tremulous pulse and the ulnar artery, wrist can utilize these two kinds of methods to carry out frequent or successive blood pressure measurement for a long time.

Yet, though relevant research shows, at the radius end near the radial artery the highest raised points of palmar, utilize volume vibratory drilling method and cubage compensation method, can record mean pressure, systolic pressure or blood pressure waveform respectively exactly, but these researchs also find, accurately measure these pressure values in wrist portion and be actually unusual difficulty.It is very responsive for the position of photoelectric sensor mainly to show as the blood pressure measurement precision, even if at the highest raised points place of radius end towards palmar, only differ 2 each other, on the diverse location of 3mm, the pressure value that records will be very different.In addition, its certainty of measurement also is subjected to the influence of some external factor: the one, when wrist portion is that turning cylinder rotates with the major axis of forearm, or when the hands root is done to palmar side or dorsal side crooked with respect to wrist, the pressure value that records is changed a lot.The 2nd, along with the air bag pressurization, except gasbag ektexine can outwards move along the wrist radial direction, air bag integral body also can take place along the circumferential direction to wrist palmar central part and along long axis direction moving to the hands root.These move the volume that all can change air bag, and the mobile displacement that also can cause photoelectric sensor of circumferencial direction and long axis direction.Wherein the displacement meeting of photoelectric sensor all impacts the certainty of measurement of volume vibratory drilling method and cubage compensation method, and the change of bag volume then influences the precision of cubage compensation method especially, even destroys the stability of its feedback control system.In addition, it is fixed loosening also can to occur air bag for a long time after the continuous measurement, and this also obviously influences the precision of cubage compensation method and the stability of feedback control system.On the other hand, these researchs are also found, because the fixedly bandage of air bag also can produce bigger pressure to other position of wrist, so after carrying out the long-time continuous measurement, the blood flow circulation and the nervous function that are positioned at the hand in air bag downstream still can be subjected to bigger influence.Particularly, the long-time lasting compressing of air bag can cause the pain at balloon tamponade position.

The method and apparatus that the purpose of this invention is to provide a kind of Wound-less continuous blood pressure measuring, it can utilize influence ground that volume vibratory drilling method and cubage compensation method principle be subjected to the said external factor very simply and not wrist portion correctly measure be interrupted and successive radial artery or/and the ulnar artery blood pressure can also eliminate long-time continuous simultaneously and measure the blood flow circulation of hand and the influence of neuro-machine.

For achieving the above object, the solution that the present invention adopts is:

1. be positioned on the angle of the most suitable measurement radial artery blood pressure to the angle of major general's hands root, in addition, preferably also the corner of wrist portion with respect to forearm be positioned on the angle of the most suitable measurement radial artery blood pressure with respect to wrist portion.The cooperation of these two angles location can guarantee to reduce the tendon and the neural position of radial artery both sides, make radial artery be in one with its below the nearest position of radius, help air bag and oppress radial artery effectively.When frequently long-time or METHOD FOR CONTINUOUS DETERMINATION blood pressure, for guaranteeing the wrist measurement and positioning, the present invention also can adopt the fixing holder of a wrist to fix the rotation of wrist portion and the bending of hands root, so that body occurs when moving the measured, pressurised airbag and pulse transducer mutually and the tendon of wrist inside, nerve and radius remain constant with respect to the position of scratching tremulous pulse;

2. in order to find the exact position that most accurately to measure the radial artery blood pressure at an easy rate, a pulse transducer array is set in the pressurization centre of area that is positioned at the radial artery pressurization utricule of radius end on FANGPI table on the highest raised points of palmar.Utricule is being added when decompression, measuring radial artery ripple signal the whole utricule pressure change procedure from a plurality of positions of wrist portion by the pulsation sensor array, and deliver to the optimum pulse signal selecting circuit.Because the pulse signal amplitude that records from the near pick off of radial artery is big, and pulse signal mean pressure and contraction that the position that pressure transmits records are forced down, in order to find the radial artery upward pressure to transmit best point, in the amplitude that this optimum pulse signal selecting circuit is parallel to amplitude maximum point in all row pulse signals that all biographies sensors that radial artery arranges record in the array and the string pulse signal that is in a ratio of maximum of other row, select one the tunnel and in utricule pressure process, have the amplitude maximum point, and after being higher than the pairing pressure of amplitude maximum point, utricule pressure has that amplitude begins to disappear basically and amplitude begins constant substantially point, and the pairing air bag pressure of its amplitude maximum point and basic end point is in a ratio of minimum pulse signal as the optimum pulse signal with other road, uses it for volume vibratory drilling method or cubage compensation method and measures the radial artery blood pressure.For the selected exact position that can most accurately measure the radial artery blood pressure of the utricule centrally aligned that pressure is transmitted degree of depth maximum, after selecting the optimum pulse signal, demonstrate which position that the pick off that records this optimum pulse signal is positioned at sensor array with mode the most intuitively, the fixed position of regulating air bag then makes the pick off that records this optimum pulse signal be positioned at the center of sensor array.In addition, when carrying out long-time blood pressure measurement, in order to prevent to cause the skew of measuring position because of measured's body is moving, should check automatically regularly whether best sensing station is positioned at the center of array, if find that off-center is excessive, should send warning signal so that readjust the fixed position of pressurization utricule;

3. little angle of rotation that the hands root is rotated to the little finger side adopts the fixedly bandage of the bigger air bag of diameter to be adjacent to the hands wrist at this position so that make the hands root lobe of big thumb below be unlikely to hinder towards the highest raised points of palmar away from the radius end;

4. in order to prevent that the air bag integral body that air bag when pressurization take place from moving to the hands root along the wrist long axis direction, help the firm of air bag bandage, should eliminate part that hands root and wrist portion join with poor, simultaneously the complicated shape that caves in to dorsal flexion owing to the hands root of this part be replenished into the face of cylinder of a rule near the diameter of forearm part;

5. in order to reduce utricule when pressurization pressure, make the fixture of utricule and the fixture and the wrist portion of wrist that big as far as possible contact area be arranged to the wrist portion other parts;

6. for fear of because long-time continuing oppressed pain and the numbness that a place causes, can on radial artery and ulnar artery, respectively establish a pressurization utricule respectively, thereby on two radicular arterieses, alternately carry out blood pressure measurement.Owing on ulnar artery, be difficult to survey accurate blood pressure, can utilize the radial artery blood pressure measurement that the ulnar artery blood pressure measurement is calibrated.The poor Di of the mean pressure of the radial artery of promptly obtaining the while or recording in succession and the pairing utricule pressure of ulnar artery pulse amplitude maximum point that records, obtain in the process of dip stick arterial pressure the ulnar artery pulse amplitude when utricule pressure equals the systolic pressure of radial artery and the ratio Pi of its peak swing simultaneously.Like this, again during the dip stick arteriotony, the pairing utricule pressure of ulnar artery pulse amplitude maximum point that at every turn will newly record deducts Di, draws current mean pressure in the back; Simultaneously, in somatocyst pressure is lower than the scope of current mean pressure, find in the ulnar artery pulse amplitude and the pairing utricule pressure of the point of the proportional Pi of its peak swing, draw current systolic pressure.In order to prevent that tested wrist from having excessive rotation to change Di and Pi, measure in the blood pressure process long-time, should use the same method termly automatically and redeterminate Di and Pi.

Brief description of drawings

Fig. 1 is the general diagram of first embodiment of the present invention;

Fig. 2 is the sketch map of the whole wrist sniffer among the embodiment shown in Figure 1;

Fig. 3 be Fig. 2 the wrist sniffer with the vertical direction of wrist on, the cross-sectional view done along the center of the external pressurized air bag in the wrist sniffer;

Fig. 4 is the profile of being done along the A-A hatching on the wrist sniffer of Fig. 3, reflect pulse transducer structure in the pressurised airbag;

Fig. 5 is the sketch map that utilizes three angles that the fixing holder of wrist in the wrist sniffer of Fig. 2 is fixed into wrist portion and hands root;

Fig. 6 is the sketch map of the method for examples measure mean pressure shown in Figure 1 and systolic pressure;

Fig. 7 is the general diagram of second kind of embodiment of the present invention;

Fig. 8 is the sketch map of the method for second kind of examples measure blood pressure waveform;

Fig. 9 is the general diagram of the third embodiment of the present invention.

Figure 10 be the 4th kind of embodiment of the present invention the wrist sniffer with the vertical direction of wrist on, the cross-sectional view done along the center of the external pressurized air bag in the wrist sniffer.

Implement mode of the present invention:

Embodiment 1

Embodiments of the invention 1 are a kind ofly to utilize the volume vibratory drilling method not have the method for wound discontinuous measurement blood pressure in wrist portion.

At first, the measurement and positioning method of present embodiment as shown in Figure 5, is fixed on the angle of hands root 17 with respect to wrist portion 18 on the angle of the most suitable measurement radial artery blood pressure, makes them be preferably formed as 100～175 ° angle; And further the corner of wrist portion 18 with respect to forearm 19 is fixed on the angle of the most suitable measurement radial artery blood pressure, this corner is preferably 30～100 °.The cooperation of these two angles location can guarantee to reduce the tendon and the neural position of radial artery both sides, make radial artery be in one with its below the nearest position of radius, help air bag and oppress radial artery effectively.

When frequently long-time or METHOD FOR CONTINUOUS DETERMINATION blood pressure, for guaranteeing the wrist measurement and positioning, as shown in Figure 2, the present invention also can adopt the fixing holder 6 of a wrist to fix the rotation of wrist portion 18 and the bending of hands root 17, so that body occurs when moving the measured, tendon, nerve and the radius of pressurised airbag 5 and pulse transducer array and wrist inside remain constant with respect to the position of scratching tremulous pulse;

After being positioned by said method, the no wound of present embodiment is measured the method for blood pressure, as Fig. 1 and shown in Figure 6, includes following steps:

A, at wrist portion radius 7 ends an arterial pulse sensor array 4 and one pressurization utricule 3 is set on the skin surface at the highest raised points place of palmar at least, and keeps sensor array and utricule invariant position with respect to this point;

B, this moment control pressurization utricule 3 pressure change in lower limit is lower than the scope that the possible mean pressure of measured, the upper limit be higher than the possible systolic pressure of measured.When utricule 3 pressure changed, only utricule 3 only took place towards wrist near the face of wrist one sides and does not produce circumferential tensile distortion, and the displacement of any direction does not take place simultaneously;

C, when utricule 3 pressure change, measure radial artery ripple signal the whole pressure change procedure from a plurality of positions of wrist portion by pulse transducer array 4, and deliver to optimum pulse signal selecting circuit 28; Because the pulse signal amplitude that records from the near pick off of radial artery is big, and pulse signal mean pressure and contraction that the position that pressure transmits records are forced down, in order above radial artery 7, to find pressure to transmit best point, the amplitude that is parallel to amplitude maximum point in all row pulse signals that all biographies sensors that radial artery arranges record in the array is in a ratio of in the string pulse signal of maximum with other row, select one the tunnel and in utricule pressure process, have the amplitude maximum point, and have after utricule pressure is higher than the pairing pressure of amplitude maximum point that amplitude begins to disappear basically and amplitude begins constant substantially point (as shown in Figure 6), and its amplitude maximum point and the basic pairing utricule pressure of end point and other road be in a ratio of minimum pulse signal as the optimum pulse signal.

D, the optimum pulse signal of selecting is used to not have wound ground measures the radial artery blood pressure.In the present embodiment, the optimum pulse signal of selecting is used for the volume vibratory drilling method and does not have wound measurement mean pressure and systolic pressure.

In the present embodiment, arterial pulse sensor array 4 preferably is positioned at the centre of area of pressurization utricule 3, when the pick off that makes pressure transmit the optimum pulse signal that best position records was positioned at sensor array 4 centers, the centre of area that pressure transmits the pressurization utricule 3 of degree of depth maximum just in time can be aimed at this pressure and transmit best position.

Which after selecting the optimum pulse signal, demonstrate on the position that the pick off that records the optimum pulse signal is positioned at sensor array with mode the most intuitively.When fixing utricule 3, show the position of regulating utricule 3 according to this, make best sensing station as far as possible just in time be positioned at the center of sensor array 4, the centre of area that pressure transmits the utricule of degree of depth maximum is positioned on the position that pressure transmits;

Present embodiment can check automatically whether best sensing station is positioned at the center of array 4, when off-center is excessive, sends warning signal when being applied to long-time blood pressure measurement, readjust the fixed position of pressurization utricule 3.

In the present embodiment arterial pulse sensor array 4 is fixed on the medial surface towards the wall of wrist of utricule, do not oppress the wrist surface equably, can directly survey pulse signals again from radial artery 7 so that do not influence the utricule medial wall.

When measuring the radial artery blood pressure, preferably also the corner that the centrage of hands root 17 rotates to the little finger side with respect to the centrage of wrist portion 18 palmar surfaces fixedly should be 10～40 °, make the hands root lobe 20 of thumb below not hinder the fixedly bandage of utricule 3 to be adjacent to wrist, shown in Fig. 5 b.

Utricule 3 integral body that take place when preventing utricule 3 pressurization along the wrist long axis direction to the hands root move and help utricule fixedly bandage firmly, it is poor with the diameter near forearm 19 parts with wrist portion 18 joining parts that present embodiment is eliminated hands root 17, simultaneously the complicated shape that caves in to dorsal flexion owing to hands root 17 of this part replenished into the face of cylinder of a rule.

The fixture 5 of utricule 3 and the fixture of wrist 6 have big as far as possible contact area with wrist portion, the pressure of 5 pairs of wrist portion 18 other parts of utricule fixture when pressurizeing to reduce utricule 3 as far as possible.

As shown in Figure 1, for realizing the present embodiment method, the device that present embodiment adopted comprises three parts, and wherein first is a wrist sniffer 0 that is used for wrist radial artery 7 is carried out pulse detection and external pressurized; Second portion is that a radial pulse signal that is used for that wrist sniffer 0 is recorded carries out the pulse signal blood processor 1 that optimum pulse is selected; Thereby third part is one to be used to supply with air bag 3 pressure and to measure gasbag pressure and the voltage supply-measuring system 2 of radial pulse measurement radial artery blood pressure.

At first first's wrist sniffer 0 is described.As shown in Figures 2 and 3, be that the tremulous pulse 7 of scratching to wrist portion carries out that pulse wave detects and external pressurized at present embodiment, thereby realize scratching the blood pressure measurement of tremulous pulse.This wrist sniffer 0 comprises scratches tremulous pulse pressurised airbag 3, arterial pulse pick off 4, and the fixing holder 6 of inflatable bag fixing band 5 and wrist is totally four parts.

As shown in Figures 2 and 3, the tremulous pulse pressurised airbag 3 of scratching in the present embodiment is flat round balloons.For the pressure that guarantees this air bag can pass to the degree of depth of scratching tremulous pulse 7 places fully, on the one hand, the fixed position of this air bag 3 should make its center can aim at the radial artery 7 of radius 8 ends towards the highest raised points place of palmar; On the other hand, the diameter of this air bag 3 should be big fully, but excessively can be urged to another root ulnar artery 9 and other vein blood vessels simultaneously, so this diameter is chosen as 1/3～3/5 (for example generally can be selected in about 30mm for being grown up) of wrist diameter.In addition, in order to guarantee that this air bag 3 produces circumferential tension force and influences scratching effective compressing of tremulous pulse 7 in being unlikely to because of the wall of expansion at it after the inflation, the wall 10 towards inboard (wrist) of this air bag 3 adopt light-permeables, have certain elastic thin film 10 and make, and make it have the shape of protruding to wrist one side, and the wall and the wall toward the outer side along circumference one circle of this air bag 3 adopt the material with certain degree of hardness to make.

Scratching arterial pulse pick off 4 is reflective photoelectric sensor arrays.As shown in Figure 3, the inside of wrist portion has complicated nonuniformity structure.Only with regard near the radial artery 7, except there is radius 8 below of radial artery 7, also contain several hardness are quite high, the pressure transmission in the soft tissue played inhibition tendon 11 and neuropeptide 11 2 in the middle of the soft tissue of radial artery both sides.According to mechanics principle, can most effectively gasbag pressure be delivered to radial artery 7, thereby the position of accurately measuring the radial artery blood pressure is that radial artery 7 is nearest from epidermis and radius 8, and from the tendon 11 and neuropeptide 11 2 point farthest of both sides.But Fig. 1 (is seen in the wrist inside in reality, Fig. 3), the degree of depth, position and these tendons 11 of radial artery 7 itself and the shape of radius 8, position be different and different along with axial location all, particularly radius 8 also is irregular towards the transverse shape of the radius termination at the highest protruding point place of palmar, and varies with each individual.Obviously to find the above-mentioned optimum that can accurately measure the radial artery blood pressure must adopt sensor array 4 to carry out analyzing comparison after the meticulous multimetering.For the ease of this pick off 4 is fixed on the wrist with above-mentioned air bag 3, and does not influence air bag medial wall 10 and oppress the wrist surface equably, this sensor array 4 is by the inside of the above-mentioned air bag 3 of interior plant.As shown in Figure 4, in the present embodiment, this sensor array 4 is made of 10 infrarede emitting diodes 13 and 15 phototriodes 14.Wherein, 15 phototriodes 14 are formed a rectangular array.This array is 3 row on the direction that the traveling with radial artery 7 parallels, and whenever classifies 5 row as.Be equipped with the gap between row and row and row and the row.In addition, be equipped with the gap between 10 4 limits of infrarede emitting diode 13 apart from the phototriode matrix, be arranged around matrix around.These light emitting diodes 13 and phototriode 14 are fixed on the inner surface of the medial wall 10 made from semitransparent thin film of above-mentioned air bag 3.In the time of fixedly, should make the sensitive surface of the light-emitting area of light emitting diode 13 and phototriode 14, and make the center of midpoint alignment thin film medial wall 10 of phototriode array towards the inner surface of thin film medial wall 10.In addition, in order to prevent that light and extraneous light that light emitting diode 13 sends from directly being received by phototriode 14, between light emitting diode 13 and the phototriode array and the overall optical electric transducer around all post the good shading thin slice 15 of one deck extensibility (as black sponge sheet).Detecting with this photoelectric sensor when scratching the pulse of tremulous pulse 7, the infrared light that 10 light emitting diodes 13 wherein send sees through the medial wall 10 that makes with semitransparent thin film of air bag 3 and injects wrist inside from different orientation.Can cause the intensity variation that reflexes in the phototriode 14 owing to scratch tremulous pulse 7 with the capacity of blood vessel variation that cyclically-varying produced of blood pressure wherein, and then the output current of phototriode 14 is changed, 15 phototriodes 14 just can convert the volume-variation of scratching tremulous pulse 7 from 15 positions to 15 the tunnel and scratch arterial pulse signal output thus.

Inflatable bag fixing band 5 be used in keep pulse transducer 4 pressurised airbag 3 be fixed on the above-mentioned wrist location.In fact, for simplified structure, present embodiment has been made one to air bag 3 and bandage 5, promptly adopt the bandage that certain thickness and hardness are arranged, on the position corresponding to air bag of the face of wrist, process a diameter flat round pool identical at it with air bag 3 diameters, then the edge of above-mentioned air bag medial wall 10 made from thin film be bonded in bandage 4 pit on the edge of wrist, this cavity with certain degree of hardness constitutes above-mentioned air bag 3 on this air bag medial wall 10 made from thin film and the bandage 5 thereby utilize.Gasbag ektexine is along the moving of wrist radial direction when preventing air bag 3 inflation, and this bandage 5 should be made by non-telescoping basically material, and the fixing of its two ends also should adopt the device with non-telescoping property.In the present embodiment, the two ends of this bandage 5 are utilized velcro 16 and are fixed in the fixing holder 6 of wrist.Simultaneously, air bag 3 integral body moving along the circumferential direction when preventing airbag aeration, this bandage 5 (at least in the part from radius 8 dorsal parts to the ulna palmar that with the air bag is the center) on the whole all should have certain rigidity.This is owing to the along the circumferential direction mobile reason of air bag 3 integral body is that wrist is ellipse on the transverse section, and the air bag 3 that radial artery 7 is pressurizeed is pressurized air bags, and it just in time is in the part of joining of the arc of two different curvature.This must cause when air bag pressurizes, and the circumferential component in the pulling force in the bandage 5 of fixation balloon produces circumferentially air bag 3 and moves in air bag both sides imbalance.But thisly can be accompanied by the variation of the shape of bandage 5 mobile the time, thereby make that bandage 5 is not yielding can to stop this moving.In addition, the material of this bandage 5 also should have certain elasticity, and when being subjected to long-time continuous compressing back diameter and diminishing, its rebound performance can also make it to be fastened on air bag 3 on the wrist can not become flexible with convenient wrist.On the other hand, for only guarantee by air bag 3 fully compressing tested scratch tremulous pulse 7, and reduce the pressure of 5 pairs of other parts of wrist of bandage as much as possible, effective contact area of this bandage 5 and wrist should be big as much as possible, should adopt big as far as possible bandage width (for general adult more preferably greater than 50mm) for this reason, and make bandage 5 all have the concaveconvex shape that matches in the profile of wrist portion and hands root with wrist portion 18 and hands root 17 contacted parts.

The fixing holder 6 of wrist is to have a supporting plate that the hard material of certain intensity is made, and its length and width should guarantee to cover whole palm dorsal part, wrist dorsal part and near the dorsal part of the forearm of elbow joint.Should fixing holder 6 have three effects: first effect is to be used to hands root 17 is separately fixed on the angle of the most suitable measurement radial artery blood pressure with respect to the angle of wrist portion 18 and wrist portion 18 corner with respect to forearm 19, limit the rotation of wrist portion 18 and the bending of hands root 17 simultaneously, so that when moving to make the measured body occur as much as possible, the tendon 11 of pressurised airbag 3 and pulse transducer 4 and wrist inside, neuropeptide 11 2 and radius 8 remain constant with respect to the position of scratching tremulous pulse 7.Shown in Fig. 5 (a) and Fig. 5 (c), the shape of the fixing holder 6 of wrist should make the dorsal surface of the root 17 of going smoothly and the dorsal surface of wrist portion 18 form 100～175 ° angle, and makes the palmar surface of wrist portion 18 form 30～100 ° inside corner with respect to the palmar surface of the close elbow joint part 19 of forearm.Guarantee that these two angles can reduce the position of the tendon 11 and the neuropeptide 11 2 of radial artery 7 both sides, and make radial artery 7 be in a position nearest, help air bag 3 and oppress radial artery 7 effectively with the radius 8 of its below.In addition, shown in Fig. 5 (b), the centrage that the shape of fixing holder 6 also should make hands root 17 forms 10～40 ° the corner that rotates to the little finger side with respect to the centrage of wrist portion 18 palmar surfaces, adopts the fixedly bandage 5 of the bigger air bag of diameter to be adjacent to wrist at this position so that the hands root lobe 20 of big thumb below is unlikely to hinder towards the highest raised points of palmar away from the radius end.Second effect of the fixing holder 6 of wrist is help air bag bandage 5 firm.The reason that the air bag integral body that takes place when considering air bag 3 pressurization moves to hands root 17 along the wrist long axis direction be since wrist portion 18 near the diameter at forearm 19 places greater than diameter near hands root 17 places, cause when air bag 3 pressurization, on its lateral wall, can producing towards hands root 17 component caused, thereby should shown in Fig. 5 (a), strengthen the thickness of this supporting plate 6 in hands root 17 dorsal surfaces and wrist portion 18 dorsal surface joints, poor to eliminate this part with diameter near forearm 19 parts.In addition, the thickening of this part can also strengthen the fixedly intensity during hands root 17 of this supporting plate, simultaneously the complicated shape that caves in to dorsal flexion owing to the hands root of hands root 17 and wrist portion 18 joining parts is replenished into the face of cylinder of a rule, be convenient to air bag bandage 5 fixing of broad.The 3rd effect of the fixing holder 6 of wrist is the pressure that disperses 5 pairs of wrist dorsal parts of air bag bandage.Thereby the medial surface that should guarantee it can be well with the convex-concave shape kissing of wrist portion 18 dorsal parts and, (therefore, in order to adapt to the wrist of difformity, thickness, it is standby to do several fixedly holders respectively), and for avoiding fixing holder 6 measured of causing really up to the mark uncomfortable, can be at the thin soft cushioning 21 of the sticking one deck of the medial surface of fixing holder 6.In addition, being fixed with the little bandage 22 that several ends are provided with velcro in the fixing holder 6 of this wrist is used for measured's hands root 17, wrist portion 18 and forearm 19 are tied up in the fixing holder of this wrist.

The no wound of present embodiment is interrupted the operation principle of scratching the arteriotony measurement:

As shown in Figure 1,15 tunnel outputs of the pulse transducer array 4 of this wrist sniffer 0 are connected with 15 inputs of 15 passage pulse signal amplification filtering circuit 23 in the pulse signal blood processor 1 respectively, simultaneously scratch in this wrist sniffer 0 tremulous pulse pressurised airbag 3 airway and voltage supply-measuring system 2 in the pressure output end of voltage/pneumatic pressure converter 24 and the pressure input of pressure transducer 25 be connected.The outfan of pressure transducer 25 is received pressure signal amplifying circuit 26.Fixedly during the wrist sniffer, at first measured's hands root 17, wrist portion 18 and forearm 19 is fixed in the fixing holder 6 of wrist in the wrist sniffer 0, then the centrally aligned radius end of the air bag in the wrist sniffer 03 behind the radial artery 7 at the highest raised points place of palmar, inflatable bag fixing band 4 is wrapped in wrist portion 18, and fixedly the two ends of bandage utilize the fixing holder 6 of velcro 16 and wrist to be fixed together.

When blood pressure continuous measurement begins, the voltage of service voltage/pneumatic pressure converter 24 is automatically regulated in gasbag pressure initialization circuit 27 beginnings in voltage supply-measuring system 2, make the air bag 3 in the wrist sniffer 0 begin to carry out external pressurized to scratching tremulous pulse 7, simultaneously the pulse transducer array 4 in the wrist sniffer 0 goes out to scratch arterial pulse signal from 15 position probing, delivers to pulse signal blood processor 1 and deliver to wherein optimum pulse signal selecting circuit 28 again after amplification filtering.Because the position difference, the amplitude and the envelope shape that go out to scratch arterial pulse signal from 15 position probing all are different mutually, and may go out to scratch arterial pulse in some position probing and can not find maximum point and end point.Obviously, the row that other row of the amplitude ratio of the pulse signal that records when the amplitude maximum point are big are near from tremulous pulse; Mean pressure that records and systolic pressure are positioned at pressure than other capable low row and transmit well, promptly can accurately measure the position of blood pressure.Thereby in the row of the amplitude maximum of amplitude maximum point, select one the tunnel and in utricule pressure process, have the amplitude maximum point and have after utricule pressure is higher than the pairing pressure of amplitude maximum point that amplitude begins to disappear basically and amplitude begins constant substantially point, and its amplitude maximum point and the basic pairing utricule pressure of end point and other road be in a ratio of a road minimum pulse signal as the optimum pulse signal.

The optimum pulse signal that is selected is sent to amplitude maximum point vanishing Point Detection Method circuit 29.According to volume vibration ratio juris (Fig. 6), point out current gasbag pressure for these two and promptly equal endarterial mean pressure and systolic pressure respectively.So when testing circuit 29 detects amplitude maximum point and end point, provide control signal, make the force value output circuit gasbag pressure value in 30 those two moment of output, promptly measured mean pressure and systolic pressure.Can also calculate diastolic pressure by diastolic pressure calculating section 31 according to diastolic pressure=(3 * mean pressure-systolic pressure)/2 more then.

On the other hand, for the ease of the location, the optimum pulse signal that is selected is also sent to carries out best sensing station demonstration.This demonstration can record the optimum pulse signal transducer and be positioned on which position of sensor array demonstrating with mode (used sensor array for example draws) the most intuitively on the blood pressure measurement display.When fixation balloon 3, should show the fixed position of regulating air bag 3 according to this, make best sensing station just in time be positioned at the center of array as far as possible.In the present embodiment, also be provided with a pulse transducer position warning circuit 38, if tested wrist has bigger rotation (though the fixing holder 6 of wrist can be played the effect of restriction wrist portion 18 with respect to the rotation of forearm 19 during fixation balloon or in the long-time blood pressure measurement process, but in fact wrist portion can also be done certain rotation) best sensing station occurs and depart from the center of array when excessive, this warning circuit 38 can warning reminding retighten air bag 3.Select owing to all carry out the optimum pulse signal in each the measurement, therefore can guarantee all to measure blood pressure at every turn in optimum.

This embodiment need to be specially adapted to long-time measurement blood pressure, but the patient's of blood pressure relatively milder (recovery after for example postoperative recovery, the treatment etc.) clinical or domestic monitoring.

Embodiment 2

Being one as second embodiment of the present invention utilizes the cubage compensation method not have the method and apparatus of wound continuous measurement radial artery blood pressure in wrist portion.As shown in Figure 7, the measurement and positioning of present embodiment and measuring method are identical with embodiment 1, and its main distinction is that the optimum pulse signal that will select is used for the cubage compensation method and does not have the wound continuous measurement and scratch the arteriotony waveform.Because the cubage compensation method is a kind of prior art, its work process is described in detail in the explanation of back.

The device of present embodiment sees also Fig. 7, and wrist sniffer 0 wherein and pulse signal blood processor 1 all can adopt the identical device with embodiment 1; In addition, the fixing means of fixing holder of wrist and air bag is identical with embodiment 1 also, in this explanation no longer repeatedly.In the present embodiment, the main distinction of comparing with embodiment 1 is that the outfan of the optimum pulse signal selecting circuit 28 in voltage supply-measuring system 32 is not spent the force value that controlled pressure value output circuit 30 is read air bag 3, but is used for controlling the variation of the pressure in the air bag 3 by the feedback control system that has connected into a closed loop with the control signal input of voltage/pneumatic pressure converter 24.

Utilizing this method and apparatus to carry out before continuous blood pressure measures, in order to find and write down the tested volume of tremulous pulse 7 when the idling of scratching, voltage supply-measuring system 32 is at first received " open loop " position to duty switch 33.As shown in Figure 8, under this operate in open loop state state, also the same with the volume vibratory drilling method, gasbag pressure initialization circuit 27 in voltage supply-measuring system is automatically regulated the voltage of service voltage/pneumatic pressure converter 24, make the air bag 3 in the wrist sniffer 0 begin to carry out external pressurized to scratching tremulous pulse 7, simultaneously the pulse transducer array 4 in the wrist sniffer 0 goes out to scratch the pulse signal of tremulous pulse 7 from 15 position probing, delivers to optimum pulse signal selecting circuit 28 after amplification filtering.The optimum pulse signal that is selected is delivered to amplitude maximum point testing circuit 34.When the amplitude maximum point is detected, promptly identify radial artery 7 and be in that this blood vessel idling is volumetrical when beating with the cyclically-varying of endarterial blood pressure up and down, system can make gasbag pressure initialization circuit 27 stop its pressure of air bag 3 is regulated, and the meansigma methods (direct current composition) that makes a no-load volume memory circuit 35 write down at this moment to scratch the arterial pulse waveform is scratched the idling volume V o of tremulous pulse as the measured.

Then, voltage supply-measuring system 32 is automatically received " closed loop " position to duty switch 33, the pulse sensor near the pulse of tremulous pulse 7 this idling volume of scratching subtract each other by a comparison circuit 36 with the no-load volume V o that write down by no-load volume memory circuit 35, and increase the gain of servo amplifying circuit 37 gradually, poor (promptly the scratching the composition of beating in the arterial pulse waveform) that obtain amplified and certain phase compensation, and remove to control air bag 3 with its driving voltage/pneumatic pressure converter 24 and further apply its waveform pressure the same with the intra-arterial blood pressure waveform from the outside to scratching tremulous pulse 7.Shown in the part of the closed loop state among Fig. 8 (for the sake of clarity, each waveform of closed loop state is unfolded on time shaft) beginning, this will make that scratching the arterial pulse amplitude begins to diminish.Obviously, when the gain of servo amplifying circuit 37 be adjusted to air bag 3 is added in scratch tremulous pulse 7 outsides pressure not only in shape at waveform, and it is also fully identical on the amplitude of waveform with the blood pressure waveform of scratching tremulous pulse inside, when promptly making the inside and outside both sides scratch tremulous pulse 7 blood vessel wall stressed reach dynamic equilibrium, shown in the part of the closed loop state back among Fig. 8, the blood vessel wall of scratching tremulous pulse 7 will no longer be beaten with the cyclically-varying of blood pressure in the blood vessel, and its capacity of blood vessel will be fixed on its idling volume V by complete embedding.So under closed-loop working state, as long as make system in the gain that increases servo amplifying circuit 37 gradually, the time point that finds the pulse amplitude of scratching tremulous pulse 7 finally to go to zero, just can affirm the pressure that begins thus in the pressurised airbag 3 at any time all with scratch tremulous pulse 7 in blood pressure equate, at this moment use the pressure transducer 25 continuous measurement pressurised airbag 3 interior pressure that link to each other with pressurised airbag 3 can realize scratching the no wound continuous measurement of arteriotony waveform.

This embodiment is specially adapted to need measure blood pressure for a long time, and the sharply patient's of (for example anaesthetize, operation, emergency case) clinical monitoring of blood pressure.

Embodiment 3

Embodiments of the invention 3 are one not only can be interrupted pressure value to the wrist radial artery and measure, but also can carry out the method and apparatus of continuous blood pressure waveform measurement, as shown in Figure 9.The measurement and positioning method of present embodiment is all identical with embodiment 1 with the optimum pulse system of selection.Its main distinction is that the optimum pulse signal that will select alternately is used for the volume vibratory drilling method and does not have wound and measure mean pressure and systolic pressure and be used for the cubage compensation method and do not have the wound continuous measurement and scratch the arteriotony waveform.

The device of present embodiment also comprises a wrist sniffer and a voltage supply-measuring system.The major part of wrist sniffer and voltage supply-measuring system all with two embodiment in front in identical, different is to measure in order both to be interrupted pressure value, can carry out the continuous blood pressure waveform measurement again, as shown in Figure 9, must with optimum pulse signal selecting circuit among first embodiment later based on the volume vibratory drilling method voltage supply-measuring system (be the part 29 that is used to control the force value of reading air bag among Fig. 1,30,31) with second embodiment in the later voltage supply-measuring system of optimum pulse signal selecting circuit based on the cubage compensation method (be the feedback control system 34 that is used to control the variation of gasbag pressure among Fig. 7,35,36,37) functional select switch 39 by " discontinuous measurement-continuous measurement " is switched.Because this switching is very simple, does not repeat them here.

For blood pressure sometimes gently, rapid patient sometimes, adopt present embodiment freely selecting to measure at interval to carry out long blood pressure monitoring in infinitely-great scope from zero according to patient's the state of an illness in clinical or family.

Embodiment 4

Embodiments of the invention 4 be scratch alternately be interrupted on 9 liang of radicular arterieses of tremulous pulse 7 and ulnar artery or/and successive blood pressure measurement.Its measurement and positioning method and optimum pulse system of selection are same as the previously described embodiments, its main difference be on radial artery 7 and ulnar artery 9 respectively each press put a pressurization utricule 3 and 3 that is provided with pulse transducer ', on two radicular arterieses, alternately carry out blood pressure measurement.

In the present embodiment, institute's pulse transducer that is provided with adopts as the identical sensor array 4 of above-mentioned embodiment in the radial artery pressurization utricule 3.But at ulnar artery pressurization utricule 3 ' interior pulse transducer can be photoelectric sensor parallel with one another only, is preferably in the interior circumferential array along wrist of the pressurization scope of ulnar artery 9 pressurization utricules photoelectric sensor parallel with one another more than 2.In the present embodiment, when ulnar artery 9 is carried out blood pressure measurement, must utilize radial artery 7 blood pressure measurement the ulnar artery blood pressure measurement to be calibrated as standard.Promptly obtain the mean pressure of the radial artery 7 that records and the poor Di of the pairing utricule pressure of ulnar artery 9 pulse amplitude maximum points that records, obtain in the process of dip stick arterial pressure the ulnar artery 9 pulse amplitudes when utricule 3 pressure equal the systolic pressure of radial artery 7 and the ratio Pi of its peak swing simultaneously.Like this, again during the dip stick arteriotony, the pairing utricule pressure of ulnar artery 9 pulse amplitude maximum points that at every turn will newly record deducts Di, draws current mean pressure in the back; Simultaneously, in somatocyst pressure is lower than the scope of current mean pressure, find in the ulnar artery pulse amplitude and the pairing utricule pressure of the point of the proportional Pi of its peak swing, draw current systolic pressure.

When utilizing radial artery 7 blood pressure measurement that ulnar artery 9 blood pressure measurement are calibrated, can utilize the volume vibratory drilling method to measure a blood pressure at radial artery 7 and ulnar artery 9 simultaneously two pressurization utricule 3 and 3 ' connections.Perhaps, when the blood pressure measurement of utilizing radial artery 7 is calibrated the blood pressure measurement of ulnar artery 9, also radial artery 7 blood pressure measurements and ulnar artery 9 blood pressure measurements separately successively can be carried out in succession.Adopt the method for present embodiment to carry out to redeterminate Di and Pi according to above-mentioned calibration steps termly automatically in the long-time continuous blood pressure process;

For realizing the present embodiment method, the device that present embodiment adopted also comprise one basically with first embodiment in identical wrist sniffer 0, just as shown in figure 10, on air bag bandage 5 offside of original radial artery pressurised airbag 3 be provided with again one be used for to ulnar artery pressurization air bag 3 ', its inside also is provided with a pulse transducer and is used for the detection ruler arterial pulse.In addition, it has any voltage supply-measuring device that adopts in the middle of two separate three above-mentioned embodiment, thereby utilizes switching device shifter alternately to radial artery with ulnar artery is that be interrupted or successive blood pressure measurement.

In the present embodiment, radial artery pressurised airbag and radial pulse pick off wherein also all should adopt with first embodiment in identical structure so that measure the radial artery blood pressure equally exactly; Identical structure among ulnar artery pressurised airbag 3 ' can adopt and first embodiment, but the ulnar artery pulse transducer not necessarily will adopt and resembles complicated photosensor arrays the radial pulse pick off.This is because as shown in Figure 3, because ulnar artery 9 positions are darker, and exist tendon 11 between the skin table of it and its top, make gasbag pressure be difficult for being delivered to fully ulnar artery 9, therefore all be difficult to measure exactly the pressure value of ulnar artery in any position of wrist outside.Generally, in common gasbag pressure scope, on ulnar artery, can detect the maximum point of pulse amplitude, but can not detect end point, and the gasbag pressure of its maximum point correspondence always is higher than the mean pressure in the tremulous pulse.But for the ease of finding ulnar artery, the circumferential array of upper edge, about position wrist that is preferably in ulnar artery photoelectric sensor parallel with one another more than 2.Obviously, when adopting photoelectric sensor parallel with one another, the amplification filtering circuit that is used for the ulnar artery pulse signal is 1 passage of needs only also, and can omit optimum pulse selection circuit.

Because for same tested wrist, radial artery blood pressure and ulnar artery blood pressure are substantially the same; And if tested wrist does not have big rotation, the pressure of ulnar artery air bag 3 ' interior and actual transfer also are constant to the difference of the pressure of ulnar artery 9 basically, so in the present embodiment, when ulnar artery being carried out blood pressure measurement, should utilize the radial artery blood pressure measurement to calibrate as standard at every turn.Can be during calibration with two pressurization utricule 3 and 3 ' connections, utilize the volume vibratory drilling method to measure a blood pressure at radial artery and ulnar artery simultaneously, obtain the mean pressure of the radial artery that records and the poor Di of the pairing utricule pressure of ulnar artery pulse amplitude maximum point that records then, obtain in the process of dip stick arterial pressure the ulnar artery pulse amplitude when utricule pressure equals the systolic pressure of radial artery and the ratio Pi of its peak swing simultaneously.Like this, again during the dip stick arteriotony, the pairing utricule pressure of ulnar artery pulse amplitude maximum point that at every turn will newly record deducts Di, draws current mean pressure in the back; Simultaneously, in somatocyst pressure is lower than the scope of current mean pressure, find in the ulnar artery pulse amplitude and the pairing utricule pressure of the point of the proportional Pi of its peak swing, draw current systolic pressure., to measure in the blood pressure process because tested wrist has excessive rotation to change Di and Pi in order preventing, should to redeterminate Di and Pi with the method when measuring beginning termly automatically in long-time continuous.

In the present embodiment, in order to simplify circuit, also can with radial artery and ulnar artery are carried out in two separate voltage supply-measuring devices of blood pressure measurement except pulse signal amplification filtering, optimum pulse signal select and pulse amplitude detecting part shared one of other parts.Certainly also can a shared fully voltage supply-measuring device with being used for that radial artery 7 and ulnar artery 9 are carried out the voltage supply-measuring device of blood pressure measurement, and when a certain radicular arteries in radial artery 7 and the ulnar artery 9 is carried out blood pressure measurement, by a switching device shifter voltage supply-measuring device alternately is connected with tested eparterial utricule pipeline and pulse signal outfan.After but simplifying like this, owing to can not obtain the blood pressure measurement of two radicular arterieses respectively simultaneously with a blood pressure measurement again, so when utilizing the radial artery blood pressure measurement that the ulnar artery blood pressure measurement is calibrated, must separate priority to the blood pressure measurement of radial artery and blood pressure measurement and carry out in succession to ulnar artery.Its calibration steps and above-mentioned similar, the radial artery blood pressure measurement that just is used for as standard is not to record in the ulnar artery blood pressure measurement, but the result of a blood pressure measurement adjacent with the ulnar artery blood pressure measurement.

Can avoid long-time pain and the numbness that cause in compressing one place that continue owing to be used alternatingly two radicular arterieses, this method can make the time of frequent or continuous blood pressure measuring unrestrictedly be prolonged.

Embodiment 5

The method that present embodiment adopted is same as the previously described embodiments.

The device of present embodiment 5 is that the pressure transducer in the voltage supply-measuring system in the foregoing description, voltage/pneumatic pressure converter even whole voltage supply-measuring system and wrist sniffer are made of one.Can reduce line and pipeline when measuring like this, the clinical practice of being more convenient for; And, for for utilizing cubage compensation method continuous blood pressure measuring, do the speed of pressurize feedback control greatly like this, thereby further improve the certainty of measurement of blood pressure waveform.

Embodiment 6

Embodiments of the invention 6 are that the surveying record device with the above-mentioned described any no wound wrist blood pressure measuring device of 5 embodiment and other physiological parameter (for example electrocardio, breathing, body temperature etc.) is made of one, and constitute the multi-parameter life sign monitor.

Embodiment 7

Embodiments of the invention 7 are the described any no wound wrist blood pressure measuring device of 6 above-mentioned embodiment is connected with data recording equipment (for example tape recorder, integrated circuit memory etc.) or is made of one and miniaturization, constitute the long-time monitoring of blood pressure device of the portable usefulness of going out.

Embodiment 8

Embodiments of the invention 8 are that the described any no wound wrist blood pressure measuring device of 7 above-mentioned embodiment is connected with wired or wireless communication device (for example radio transmitter, telephone or radio telephone etc.), and formation can transmit the remote blood pressure monitor network of measurement result and acquisition medical treatment guidance to medical institutions.Embodiment 9

The measurement and positioning method of present embodiment, optimum pulse system of selection and measuring method and enforcement are just 1 identical.But the device of embodiment 9 is the simplification of carrying out on the basis of embodiment 1 to be improved, and in the present embodiment, has omitted the fixing holder 6 of wrist wherein.For realizing correct measurement of the present invention location, during measurement, the measured is according to the instructions for use of this device, oneself keep wrist portion 18 and hands root 17 motionless, and make wrist portion 18 remain on the angle of the most suitable above-mentioned measurement radial artery blood pressure with respect to the corner of forearm and hands root angle with respect to wrist portion, show the inflatable bag fixing band that correctly has been fastened according to the optimum pulse sensing station then, measure mean pressure, systolic pressure and the diastolic pressure of radial artery with this.Can make according to present embodiment and to be convenient to family's current check blood pressure or to observe the hypertension therapeutic effect and check UP the wrist sphygomanometer of simple type of usefulness of outpatient service.

The foregoing description only is used to illustrate the present invention, but not is used to limit the present invention.The present invention can also have multiple enforcement and improved plan.For example, in four above-mentioned embodiment, we have utilized the volume vibratory drilling method of discontinuous measurement arteriotony and the cubage compensation method of continuous measurement arteriotony.Wherein all adopt tested tremulous pulse to get the pulse amplitude and whether reach maximum as judging whether tested arteries is in the criterion of idling, and employing control air pressure is controlled the external pressure that tested tremulous pulse is applied and adopt photoelectric sensor to detect arterial pulse.In fact, can adopt other criterion, the idling of tested tremulous pulse is judged in the variation of for example variation of the shape of pulse wave or baseline height, artificial stack is got on pulse wave small vibration wave amplitude, the variation of blood flow rate etc.; Also can adopt control hydraulic pressure to control external pressure that tested tremulous pulse is applied and adopt other to can be used in the pick off that detects arterial pulse and detect arterial pulse.

Claims (57)

1, a kind of measurement and positioning method of not having wound measurement blood pressure, at least adopt an arterial pulse pick off to be pressed on and detect the radial pulse signal on the skin surface at wrist portion radial artery place, it is characterized in that being fixed on the angle of the most suitable measurement radial artery blood pressure to the angle of major general's hands root with respect to wrist portion; This angle can reduce the position of tendon and make radial artery approach radius.

2, no wound according to claim 1 is measured the measurement and positioning method of blood pressure, and when it is characterized in that measuring the radial artery blood pressure, the dorsal surface of described hands root and the dorsal surface of wrist portion are preferably formed as 100～175 ° angle;

3, no wound according to claim 1 is measured the measurement and positioning method of blood pressure, when it is characterized in that measuring the radial artery blood pressure, the corner of wrist portion with respect to forearm is fixed on the angle of the most suitable measurement radial artery blood pressure; This angle can make radial artery further approach radius.

4, no wound according to claim 3 is measured the measurement and positioning method of blood pressure, when it is characterized in that measuring the radial artery blood pressure, described wrist portion is that the palmar surface of wrist portion is preferably 30～100 ° with respect to the inside corner that the palmar surface of the close elbow joint part of forearm forms with respect to the corner of forearm

5. a no wound that adopts measurement and positioning method as claimed in claim 1 is measured the method for blood pressure, includes following steps:

A, at wrist portion radius end an arterial pulse sensor array and one pressurization utricule is set on the skin surface at the highest raised points place of palmar at least, and keeps arterial pulse sensor array and pressurized capsule bulk phase invariant position for this point;

B, this moment control pressurization utricule pressure change in lower limit is lower than the scope that the possible mean pressure of measured, the upper limit be higher than the possible systolic pressure of measured;

C, when utricule pressure changes, measure radial artery the whole pressure change procedure signal of fighting from a plurality of positions of wrist portion by the pulse transducer array, and deliver to the optimum pulse signal selecting circuit; Because the pulse signal amplitude that records from the near pick off of radial artery is big, and pulse signal mean pressure and contraction that the position that pressure transmits records are forced down, in order above radial artery, to find pressure to transmit best point, amplitude when being parallel to amplitude maximum point all row pulse signals that all biographies sensors that radial artery arranges record in array is in a ratio of in the string pulse signal of maximum with other row, select one the tunnel and in utricule pressure process, have the amplitude maximum point, and have after utricule pressure is higher than the pairing pressure of amplitude maximum point that amplitude begins to disappear basically and amplitude begins constant substantially point, and its amplitude maximum point and the basic pairing utricule pressure of end point and other road be in a ratio of minimum pulse signal as the optimum pulse signal;

D, the optimum pulse signal of selecting is used to not have wound ground measures the radial artery blood pressure.

6, a kind of method that wound is measured blood pressure of not having according to claim 5, it is characterized in that the arterial pulse sensor array preferably is positioned at the pressurization centre of area of pressurization utricule, make that when the pick off that records the optimum pulse signal is positioned at the sensor array center pressure transmits the centre of area of the pressurization utricule of degree of depth maximum just in time can aim at the best position of the pairing pressure transmission of this pick off.

7, a kind of method that wound is measured blood pressure of not having according to claim 6, it is characterized in that selecting the optimum pulse signal after, demonstrate on which position that the pick off that records the optimum pulse signal is positioned at sensor array with mode the most intuitively; When fixing utricule, show the fixed position of regulating utricule according to this, make best sensing station just in time be positioned at the center of array;

8, a kind of method that wound is measured blood pressure of not having according to claim 7, it is characterized in that when carrying out long-time blood pressure measurement, can check automatically whether best sensing station is positioned at the center of array, when off-center is excessive, send the caution signals that to readjust pressurization utricule fixed position.

9, a kind of method that wound is measured blood pressure of not having according to claim 5 is characterized in that preferably the arterial pulse sensor array being fixed on the medial surface towards the wall of wrist of utricule, makes it not influence the utricule medial wall and oppresses the wrist surface equably.

10, a kind of method that wound is measured blood pressure of not having according to claim 5, when it is characterized in that measuring the radial artery blood pressure, preferably also the hands root slightly should be rotated to the little finger side, make the centrage of hands root form 10～40 ° corner with respect to the centrage of wrist portion palmar surface, the hands root lobe of thumb below does not hinder the fixedly bandage of utricule to be adjacent to wrist.

11, a kind of method that wound is measured blood pressure of not having according to claim 5, it is characterized in that eliminating part that hands root and wrist portion join with poor near the diameter of forearm part, simultaneously the complicated shape that caves in to dorsal flexion owing to the hands root of this part is replenished into the face of cylinder of a rule, the utricule integral body that takes place when preventing the utricule pressurization moves to the hands root along the wrist long axis direction, is convenient to the firm of utricule.

12, a kind of method that wound is measured blood pressure of not having according to claim 5, it is characterized in that making the fixture of utricule and the fixture and the wrist portion of wrist that big as far as possible contact area is arranged, the utricule fixture is to the pressure of wrist portion other parts when reducing the utricule pressurization as far as possible.

13, a kind of method that wound is measured blood pressure of not having according to claim 5 is characterized in that the optimum pulse signal that will select is used for the volume vibratory drilling method and does not have wound measurement mean pressure and systolic pressure.

14, a kind of method that wound is measured blood pressure of not having according to claim 5 is characterized in that the optimum pulse signal that will select is used for the cubage compensation method and does not have the wound continuous measurement and scratch the arteriotony waveform.

15, a kind of method that wound is measured blood pressure of not having according to claim 5 is characterized in that the optimum pulse signal that will select alternately is used for the volume vibratory drilling method and does not have wound and measure mean pressure, systolic pressure and be used for the cubage compensation method and do not have the wound continuous measurement and scratch the arteriotony waveform.

16, a kind of method that wound is measured blood pressure of not having according to claim 5 is characterized in that respectively being provided with respectively simultaneously a pulse transducer and pressurization utricule on radial artery and ulnar artery, alternately carries out blood pressure measurement on two radicular arterieses.

17, a kind of method that wound is measured blood pressure of not having according to claim 16, it is characterized in that the ulnar artery pulse transducer also can be photoelectric sensor parallel with one another, the interior edge of pressurization scope that is preferably in ulnar artery pressurization utricule is perpendicular to arranging photoelectric sensor parallel with one another more than 2 on the direction of ulnar artery.

18, a kind of method that wound is measured blood pressure of not having according to claim 16 when it is characterized in that ulnar artery carried out blood pressure measurement, can utilize the radial artery blood pressure measurement as standard the ulnar artery blood pressure measurement to be calibrated.

19, a kind of method that wound is measured blood pressure of not having according to claim 16, when it is characterized in that utilizing the radial artery blood pressure measurement that the ulnar artery blood pressure measurement is calibrated, obtain the mean pressure of the radial artery that records and the poor Di of the pairing utricule pressure of ulnar artery pulse amplitude maximum point that records, obtain in the process of dip stick arterial pressure the ulnar artery pulse amplitude when utricule pressure equals the systolic pressure of radial artery and the ratio Pi of its peak swing simultaneously.Like this, again during the dip stick arteriotony, the pairing utricule pressure of ulnar artery pulse amplitude maximum point that at every turn will newly record deducts Di, draws current mean pressure in the back; Simultaneously, in somatocyst pressure is lower than the scope of current mean pressure, find in the ulnar artery pulse amplitude and the pairing utricule pressure of the point of the proportional Pi of its peak swing, draw current systolic pressure.

20, a kind of method that wound is measured blood pressure of not having according to claim 19, when it is characterized in that utilizing the radial artery blood pressure measurement that the ulnar artery blood pressure measurement is calibrated, two pressurization utricules can be communicated with, utilize the volume vibratory drilling method to measure a blood pressure at radial artery and ulnar artery simultaneously.

21, a kind of method that wound is measured blood pressure of not having according to claim 19, when it is characterized in that utilizing the radial artery blood pressure measurement that the ulnar artery blood pressure measurement is calibrated, radial artery blood pressure measurement and ulnar artery blood pressure measurement are separately successively carried out in succession.

22, according to claim 16 or 18 or 19 described a kind of methods that wound is measured blood pressure of not having, it is characterized in that in long-time continuous blood pressure process, should redeterminate Di and Pi automatically termly;

23, a kind of method that wound is measured blood pressure of not having according to claim 5, it is characterized in that adopting other criterion, the variation of for example variation of the shape of pulse wave or baseline height, artificial stack is got on pulse wave small vibration wave amplitude, the variation of blood flow rate wait the idling of judging tested tremulous pulse; Also can adopt control hydraulic pressure to control external pressure that tested tremulous pulse is applied and adopt other to can be used in the pick off that detects arterial pulse and detect arterial pulse.

24, a kind of wrist sniffer that does not have wound measurement blood pressure, at least include a pressurization utricule on the skin table that is fixed in the radicular arteries top in wrist radial artery and the ulnar artery by a fixture, it is characterized in that on the pressurized portion of radial artery pressurization utricule, being provided with an arterial pulse sensor array at least.

25, no wound according to claim 24 is measured the wrist sniffer of blood pressure, its feature in described pressurization utricule adversary wrist to add pressure surface the best rounded, its diameter should be 1/3～3/5 of wrist diameter; The adopting towards the medial wall of wrist of this pressurization utricule has certain elastic thin film makes, and makes it have the shape of protruding to the wrist direction, and this utricule is made along the material that the wall that makes a circle in week and the employing of wall toward the outer side have certain degree of hardness.

26, no wound according to claim 24 is measured the wrist sniffer of blood pressure, it is characterized in that the pulse transducer the best in the described pulse transducer array is the reflective photoelectric sensor that is made of luminescent device and photoelectric device; Its optimum structure is that core is that several photoelectric devices are mutually near the rectangular array that is arranged in, on every side around arranging luminescent device; Being hidden with light screening material except the part towards the sensitive surface of the medial surface of the wall of pressing close to skin of photoelectric device.

27, no wound according to claim 26 is measured the wrist sniffer of blood pressure, it is characterized in that described photodevice matrix be parallel to radial artery and perpendicular to the direction of radial artery on have 2 photoelectric devices respectively at least, wherein each photoelectric device is exported one road radial pulse signal respectively.

28, no wound according to claim 26 is measured the wrist sniffer of blood pressure, it is characterized in that described pulse transducer array the best is arranged at the medial surface of the wall of pressing close to skin of pressurization utricule inside, the sensitive surface of photoelectric device and the light-emitting area of photoelectric device be towards the medial surface of the wall of pressing close to skin, the centre of area of the described medial surface of centrally aligned of this photodevice matrix.

29, no wound according to claim 28 is measured the wrist sniffer of blood pressure, it is characterized in that the thin film towards the medial wall of wrist of this pressurization utricule has light-permeable in the part of sensor array column distribution at least.

30, no wound according to claim 24 is measured the wrist sniffer of blood pressure, it is characterized in that described utricule fixture the best is a bandage, this bandage employing has higher hardness and certain elastic material is made near the wrist diameter but in the ring-type corresponding to wrist dorsal part opening; It should adopt non-telescoping device to be connected at the two ends of opening part.

31, no wound according to claim 30 is measured the wrist sniffer of blood pressure, it is characterized in that the diameter of the width of described fixedly bandage more preferably greater than wrist, and contacted of bandage and wrist portion should have the concaveconvex shape that matches with wrist portion.

32, no wound according to claim 30 is measured the wrist sniffer of blood pressure, its feature can be made of one with fixing bandage in described pressurization utricule, promptly adopt and have certain thickness bandage, the position corresponding to the pressurization utricule on the face of wrist at bandage processes a flattened round pit identical with the utricule diameter, and the edge towards wrist of the pit on the edge that described employing is had a medial wall that certain elastic thin film makes and the bandage seals and combines.

33, no wound according to claim 24 is measured the wrist sniffer of blood pressure, it is characterized in that described fixture the best also should set up the fixing holder of wrist.The fixing holder of described wrist is the supporting plate of being made by the hard material of certain intensity, its length and width should guarantee to cover whole palm dorsal part, wrist dorsal part and near the dorsal part of the forearm of elbow joint, and its shape should form 100 °～175 ° angle with the back side of hands root and the dorsal surface of wrist portion, and with the palmar surface of wrist portion with respect to the close elbow joint of forearm palmar side partly form 30 °～100 ° to inside lock, and preferably also the centrage of hands root is formed 10～40 ° corner with respect to the centrage of wrist portion palmar surface towards the little finger side.

34, the wrist sniffer of noinvasive blood trouble pressure according to claim 33, it is characterized in that the thickness of the fixing holder of described wrist in hands root dorsal surface and wrist portion dorsal surface joint is strengthened, eliminate that this part is poor with the diameter near forearm part, and the complicated shape that caves in to dorsal flexion owing to the hands root of hands root and wrist portion joining part is replenished into the face of cylinder of a rule.

35, the wrist sniffer of noinvasive blood trouble pressure according to claim 33 is characterized in that the medial surface of the fixing holder of described wrist and the convex-concave shape of wrist portion back surface match.

36, the wrist sniffer of noinvasive blood trouble pressure according to claim 33, but it is characterized in that the fixing holder of described wrist is provided with the fixture of fixing arm and hands.

37, no wound according to claim 24 is measured the wrist sniffer of blood pressure, it is characterized in that described arterial pulse pick off and pressurization utricule can be by each fix one respectively on the radial artery of wrist portion and the skin table above the ulnar artery, make two pressurization utricules and arterial pulse pick off alternately to radial artery with ulnar artery pressurizes respectively and pulse signal detects by switching device shifter.

38, according to the described a kind of wrist sniffer that wound is measured blood pressure that do not have of claim 37, it is characterized in that described ulnar artery pulse transducer preferably more than two on perpendicular to the direction of ulnar artery mutually near the photoelectric device of arranging, thereby and with these photoelectric devices one road ulnar artery pulse signal of exporting parallel with one another.

39, a kind of wrist sniffer that wound is measured blood pressure that do not have according to claim 24, it is characterized in that the pressurization utricule will connect when this wrist sniffer was used to measure blood pressure pressure transducer also with utricule fixedly bandage be made of one.

40, a kind of employing as the pulse signal blood processor of the no wound measurement blood pressure of any wrist sniffer of claim 24 to the claim 39, it is characterized in that including at least an above-mentioned wrist sniffer, this wrist sniffer is provided with a radial pulse sensor array at least, the multichannel pulse signal that described pulse transducer array is exported is connected to an optimum pulse signal selecting by after amplification and filtering.

41, measure the pulse signal blood processor of blood pressure according to the described no wound of claim 40, it is characterized in that described optimum pulse selecting arrangement is that amplitude when being parallel to amplitude maximum point all row pulse signals that all biographies sensors that radial artery arranges record in the pulse transducer array is in a ratio of in the string pulse signal of maximum with other row, select one the tunnel and in utricule pressure process, have the amplitude maximum point, and have after utricule pressure is higher than the pairing pressure of amplitude maximum point that amplitude begins to disappear basically and amplitude begins constant substantially point, and its amplitude maximum point and the pairing utricule of basic end point press with other road be in a ratio of minimum pulse signal as the optimum pulse signal.

42, measure the pulse signal blood processor of blood pressures according to claim 40 or 41 described no wounds, it is characterized in that when described optimum pulse signal is selected go out after, the display device of an optimum pulse sensing station of control, this device are adopted intuitively, and mode shows the particular location of pulse transducer in the middle of the pulse transducer array that records the optimum pulse signal.

43, measure the pulse signal blood processor of blood pressures according to claim 40 or 41 described no wounds, it is characterized in that being provided with a pulse transducer position caution device, when the pulse transducer that records the optimum pulse signal departs from the center of pulse transducer array, can send warning signal.

44,, it is characterized in that described optimum pulse selecting arrangement, the display device of optimum pulse sensing station and pulse transducer position caution device can be made of one with the wrist sniffer according to the described noinvasive blood trouble of claim 40 pressure measuring device.

45, a kind of noinvasive blood trouble pressure measuring device that adopts as any described pulse signal blood processor of claim in the claim 40 to 44, it is characterized in that including at least an above-mentioned wrist sniffer, this wrist sniffer is provided with a radial artery pressurization utricule and a radial pulse sensor array at least, the multichannel pulse signal of this pulse transducer array output is selected the optimum pulse signal of one road radial artery through the optimum pulse selecting arrangement, described radial artery pressurization utricule is connected with the pressure output end of the voltage/pressure converter of a voltage supply-measuring device and the pressure input of pressure transducer, and the radial artery optimum pulse signal of optimum pulse selecting arrangement output is connected with the signal input part of the pulse amplitude detecting device of this voltage supply-measuring device.

46,, it is characterized in that described voltage supply-measuring device can measure mean pressure, systolic pressure and the diastolic pressure of radial artery discontinuously based on the volume vibratory drilling method according to the described noinvasive blood trouble of claim 45 pressure measuring device.

47,, it is characterized in that described voltage supply-measuring device can measure the blood pressure waveform of radial artery continuously based on the cubage compensation method according to the described noinvasive blood trouble of claim 45 pressure measuring device.

48,, it is characterized in that to utilize switching device shifter to make alternately mean pressure, systolic pressure and diastolic pressure or the blood pressure waveform to measure radial artery respectively of described voltage supply-measuring device based on volume vibratory drilling method and cubage compensation method according to the described noinvasive blood trouble of claim 45 pressure measuring device.

49, according to described any one noinvasive blood trouble pressure measuring device of claim 45 to 48, it is characterized in that described wrist sniffer has two separate arterial pulse pick offs and two separate pressurization utricules, and two separate voltage supply-measuring devices, alternately use them to radial artery with ulnar artery is that be interrupted or successive blood pressure measurement by switching device shifter.

50, according to the described noinvasive blood trouble of claim 49 pressure measuring device, it is characterized in that described ulnar artery pulse transducer adopts several mutually and the photoelectric device that connects, one road ulnar artery pulse signal of their output through amplification with filtering after can be directly be connected with the signal input part of the pulse amplitude detecting device of the voltage supply-measuring device that is used for the dip stick arteriotony.

51, according to the described noinvasive blood trouble of claim 49 pressure measuring device, it is characterized in that can with radial artery and ulnar artery are carried out in two separate voltage supply-measuring devices of blood pressure measurement except pulse signal amplification filtering, optimum pulse signal select and pulse amplitude detecting part shared one of other parts.

52, according to described any one noinvasive blood trouble pressure measuring device of claim 49 to 51, it is characterized in that being used for that radial artery and ulnar artery are carried out the voltage supply-measuring device of blood pressure measurement can a shared fully voltage supply-measuring device, and when a certain radicular arteries in radial artery and the ulnar artery is carried out blood pressure measurement, by a switching device shifter above-mentioned voltage supply-measuring device alternately is connected with tested eparterial pressurization utricule pipeline and pulse signal outfan.

53, according to claim 49 or 50 described noinvasive blood trouble pressure measuring devices, it is characterized in that preferably being provided with a device that utilizes the radial artery blood pressure measurement that the ulnar artery blood pressure measurement is calibrated.

54,, it is characterized in that described optimum pulse selecting arrangement, best sensing station display device, sensing station caution device and voltage supply-measuring device can be made of one with the wrist sniffer according to the described noinvasive blood trouble of claim 49 pressure measuring device.

55, according to claim 49 or 54 described noinvasive blood trouble pressure measuring devices, it is characterized in that and described noinvasive blood trouble pressure measuring device and blood pressure measurement recording equipment can be made of one.

56, according to claim 49 or 54 or 55 described noinvasive blood trouble pressure measuring devices, it is characterized in that and the surveying record device of described noinvasive blood trouble pressure measuring device and other physiological parameter can be made of one.

57,, it is characterized in that and described noinvasive blood trouble pressure measuring device can be connected with communication device according to any one noinvasive blood trouble pressure measuring device described in claim 49 or 54 to 56.

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