CN101721198A - Method for monitoring surgical stress state in general anesthesia process in real time - Google Patents
Method for monitoring surgical stress state in general anesthesia process in real time Download PDFInfo
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Abstract
The invention discloses a method for monitoring a surgical stress state in a general anesthesia process in real time, which belongs to the technical field of medicinal test. The method is performed as the following steps of: (1) acquiring a volume pulse wave signal by a finger photoplethysmography method in real time; (2) detecting the position of a characteristic point of the waveform of a volume pulse wave in real time, and extracting pulse wave characteristic parameters from the volume pulse wave; and (3) firstly performing standardization and then performing weighted linear combination on the pulse wave characteristic parameters to obtain a surgical stress index of the pulse wave. The method has the advantages that: the method is non-invasive, real-time and continuous, integrates a plurality of pulse wave characteristic parameters synchronously for the first time, can reflect a stress state level in a state of general anesthesia more timely, more accurately and more effectively, provides reliable objective evidence for rationally using a narcotic analgesic in clinical general anesthesia, and avoids excessive or deficient narcotic medicament, thereby improving perioperative overall safety.
Description
Technical field
The invention discloses a kind of method of real-time monitoring general anesthesia process Chinese and foreign department stress state, belong to the medical science technical field of measurement and test.
Background technology
Pain is offending subjective feeling and the emotional experience relevant with tissue injury or potential tissue injury.General anesthesia seasonal disease people realizes disappearance, so " pain " under the generalized anesthetic state is called as nociception.Nociception can cause a series of pathophysiological change of body, and serious nociception can cause severe complication even death.Clinically, the narcosis analgesic of capacity (as opioid drug) can effectively suppress the nocuity stress (promptly anti-nocuity stress) under the generalized anesthetic state.But excessive narcosis analgesic also can cause patient to lose stress, causes that circulation suppresses, severe hypotension, and may damage the important organ function.Therefore, how to accomplish not only effectively to suppress nocuity stress under the generalized anesthetic state but also avoid the medicine (narcosis analgesic) of anti-nocuity stress excessive and cause the stress forfeiture, promptly keeping the balance of suitable nocuity stress-anti-nocuity stress, is the main target of desirable general anesthesia and the key of average of operation periods safety.And to the poised state of nocuity stress-anti-nocuity stress accurately, believable, real-time monitoring and assessment be to keep the key of this poised state and prerequisite.
The photoelectricity volume pulsation wave is to beat with heart and the pulsating nature that produces changes the periodic waveform that obtains by the photoplethaysmography method according to the microvascular volumetric blood of periphery.A typical pulse waveform comprises starting point U ripple, characteristic points such as main wave point P ripple, dicrotic notch point V ripple, as shown in Figure 1.
Studies show that what the wave amplitude of volume pulsation wave and dicrotic wave height can reflect body stress degree and the poised state of nocuity stress-anti-nocuity stress.But these observational studies have just been done qualitatively and to have been analyzed, do not adopt in objective, the quantized reflection art stress degree reference value, sign amount that promptly stress degree is analyzed pulse wave characteristic parameters and dependency that stress degree; Also, lack clinical practice not to quantizing with the corresponding pulse wave characteristic parameters of stress state in various degree; In addition, pulse wave wave amplitude, dicrotic wave height and relation that stress degree are just analyzed in existing research isolatedly, and other parameters in the pulse waveform are not carried out comprehensive analysis.
In addition, except above-mentioned two pulse wave parameters, also comprise many measurable in theory parameters, as upstroke slope, pulse frequency variability, dicrotic notch amplitude, dicrotic notch time delay etc., each parameter all includes specific Pathophysiology meaning, and all may have sign stress degree or the ability and the characteristic of the poised state of nocuity stress-anti-nocuity stress.
Clinical sign (the Clinical Signs Stimulus Antinociception that stress mark, CSSA) be that external a kind of surgery of recommending stress the sign amount, it combines indexs such as clinical sign, analgesic blood drug level, operation wound degree, and having preferably, clinical guidance is worth.Can be about the description that clinical sign stress be marked referring to Rantanen M, Yli-Hankala A, Gils M, et al.Novelmultiparameter approach for measurement of nociception at skinincision during general anaesthesia.British Journal of Anaesthesia2006; 96 (3): 367-376.
Summary of the invention
The purpose of this invention is to provide a kind of monitoring method of using the pulse wave surgical stress index to monitor general anesthesia process Chinese and foreign department stress state in real time.
The present invention realizes that technical scheme and key step that above-mentioned purpose is taked are as follows:
The method of the process of monitoring general anesthesia in real time Chinese and foreign department stress state mainly comprises the steps:
(1) adopts the real-time acquired volume pulse wave signal of finger tip photoplethaysmography method;
(2) characteristic point position of the waveform of real-time detection volume pulse wave, and from volume pulsation wave, extract pulse wave characteristic parameters;
(3) to the advanced column criterionization of described pulse wave characteristic parameters, be weighted linear combination again and obtain the pulse wave surgical stress index.
Further, characteristic point of the present invention comprises starting point, main wave point, dicrotic notch point, and described pulse wave characteristic parameters comprises ratio, pulse frequency, the pulse frequency variability of pulse wave upstroke greatest gradient, pulse wave wave amplitude, dicrotic notch height, dicrotic notch height and pulse wave wave amplitude.
Further, the present invention carries out standardization to described pulse wave characteristic parameters and is meant that each pulse wave characteristic parameters is carried out normalize with the method for rectangular histogram conversion to be handled.
Further, weighted linear combination of the present invention obtains the pulse wave surgical stress index and is meant that elder generation stress the sign amount carry out correlation analysis to obtain correlation coefficient to each pulse wave characteristic parameters after the standardization and surgery, back size according to correlation coefficient adopts the weight of each pulse wave characteristic parameters after the settling the standard of the principle of least square, again each pulse wave characteristic parameters after the standardization is carried out linear regression, finally obtain the pulse wave surgical stress index.
Further, surgery of the present invention stress the sign amount be meant that clinical sign stress score value.
Compared with prior art, the invention has the beneficial effects as follows: noinvasive, real-time, continuous, and integrate a plurality of pulse wave characteristic parameters first simultaneously, can more timely, more accurate, more effectively reflect stress state level under the generalized anesthetic state, for rational Application narcosis analgesic in the clinical general anesthesia provides reliable objective basis, avoid anaesthetic excessive or not enough, thereby improve the perioperative overall security.
Description of drawings
Fig. 1. typical pulse waveform with and each characteristic point position mark, wherein, U is that starting point, P are that main wave point, V are that dicrotic notch point, K are pulse wave upstroke greatest gradient point, H
1Be pulse wave wave amplitude, H
2Be the dicrotic notch height.
Fig. 2. the pulse wave signal modulate circuit schematic diagram that uses during the real-time acquired volume pulse waveform of the present invention.
The specific embodiment
The invention will be further described below in conjunction with drawings and Examples.
(1) the real-time collection of pulse wave data.Use the photo-electric pulse transducer to be sandwiched in finger tip, behind photo-electric pulse transducer acquired volume pulse wave signal, be converted into digital pulse ripple signal and be uploaded to PC by the A/D change-over circuit.If the noise of the volume pulsation wave signal of being gathered is excessive, can be earlier through pulse wave signal conditioning circuit (as shown in Figure 2) conditioning carrying out again A/D conversion.
(2) detection of pulse wave characteristic point.Adopt wavelet analysis method and second dervative maximum value process detection volume pulse wave characteristic point position, wherein, as shown in Figure 1, characteristic point comprises starting point, main wave point, dicrotic notch point;
(3) pulse wave characteristic parameters obtains.In volume pulsation wave, between starting point and main wave point, ask first-order difference can obtain the upstroke greatest gradient; The pulse wave wave amplitude that can get by the difference of main wave point and the pairing amplitude of starting point; The dicrotic notch height that can get by the difference of dicrotic notch point and the pairing amplitude of starting point, so can obtain the dicrotic notch height and with the ratio of pulse wave wave amplitude; By the difference of adjacent two main wave point positions is that the difference of time can obtain pulse frequency; And pulse difference at interval can calculate the pulse frequency index of variability one by one;
(4) standardization of pulse wave characteristic parameters.Adopt the method for rectangular histogram conversion that each pulse wave characteristic parameters is carried out the normalize processing, eliminate interindividual variation;
(5) weighted linear combination of pulse wave characteristic parameters.Earlier stress the sign amount carry out correlation analysis to obtain correlation coefficient to each pulse wave characteristic parameters after the standardization and surgery, back size according to correlation coefficient adopts the weight of each pulse wave characteristic parameters after the settling the standard of the principle of least square, again each pulse wave characteristic parameters after the standardization is carried out linear regression, finally obtain the pulse wave surgical stress index, this exponential scope can be set at 0～100, wherein, no surgery stress in the 0 expression general anesthesia, 100 expression stress are extremely violent.Among the present invention, surgery stress sign be measured available clinical sign and stress be represented by score value.
The present invention has obtained the concrete numerical value of pulse wave surgical stress index in real time thus, thereby realizes the real-time monitoring to general anesthesia process Chinese and foreign department stress state.
Claims (5)
1. the method for the process of a monitoring general anesthesia in real time Chinese and foreign department stress state is characterized in that comprising the steps:
(1) adopts the real-time acquired volume pulse wave signal of finger tip photoplethaysmography method;
(2) characteristic point position of the waveform of real-time detection volume pulse wave, and from volume pulsation wave, extract pulse wave characteristic parameters;
(3) to the advanced column criterionization of described pulse wave characteristic parameters, be weighted linear combination again and obtain the pulse wave surgical stress index.
2. the method for a kind of real-time monitoring general anesthesia process Chinese and foreign department stress state according to claim 1, it is characterized in that: described characteristic point comprises starting point, main wave point, dicrotic notch point, and described pulse wave characteristic parameters comprises ratio, pulse frequency, the pulse frequency variability of pulse wave upstroke greatest gradient, pulse wave wave amplitude, dicrotic notch height, dicrotic notch height and pulse wave wave amplitude.
3. the method for a kind of real-time monitoring general anesthesia process Chinese and foreign department stress state according to claim 1 is characterized in that: described pulse wave characteristic parameters is carried out standardization be meant that each pulse wave characteristic parameters is carried out normalize with the method for rectangular histogram conversion to be handled.
4. the method for a kind of real-time monitoring general anesthesia process Chinese and foreign department stress state according to claim 1, it is characterized in that: described weighted linear combination obtains the pulse wave surgical stress index and is meant that elder generation stress the sign amount carry out correlation analysis to obtain correlation coefficient to each pulse wave characteristic parameters after the standardization and surgery, back size according to correlation coefficient adopts the weight of each pulse wave characteristic parameters after the settling the standard of the principle of least square, again each pulse wave characteristic parameters after the standardization is carried out linear regression, finally obtain the pulse wave surgical stress index.
5. the method for a kind of real-time monitoring general anesthesia process Chinese and foreign department stress state according to claim 4 is characterized in that: described surgery stress the sign amount be meant that clinical sign stress score value.
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Cited By (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN104116503A (en) * | 2014-07-16 | 2014-10-29 | 华中科技大学 | Noninvasive continuous blood pressure measuring method and device |
| CN108272441A (en) * | 2018-01-30 | 2018-07-13 | 浙江大学 | Pain index continuous monitoring device |
| CN115633969A (en) * | 2022-11-11 | 2023-01-24 | 重庆玺德尔医疗器械有限公司 | Anesthesia pain nociception evaluation method based on electroencephalogram signal and pulse signal |
-
2009
- 2009-12-29 CN CN200910156606A patent/CN101721198A/en active Pending
Cited By (5)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN104116503A (en) * | 2014-07-16 | 2014-10-29 | 华中科技大学 | Noninvasive continuous blood pressure measuring method and device |
| CN104116503B (en) * | 2014-07-16 | 2016-08-24 | 华中科技大学 | A kind of measurement apparatus of noinvasive continuous blood pressure |
| CN108272441A (en) * | 2018-01-30 | 2018-07-13 | 浙江大学 | Pain index continuous monitoring device |
| CN115633969A (en) * | 2022-11-11 | 2023-01-24 | 重庆玺德尔医疗器械有限公司 | Anesthesia pain nociception evaluation method based on electroencephalogram signal and pulse signal |
| CN115633969B (en) * | 2022-11-11 | 2024-01-05 | 重庆玺德尔医疗器械有限公司 | Anesthesia pain nociception assessment method based on electroencephalogram signals and pulse signals |
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Open date: 20100609 |