CN113229853B

CN113229853B - Method for monitoring aspiration of airway

Info

Publication number: CN113229853B
Application number: CN202110708294.3A
Authority: CN
Inventors: 颜慰安; 钱苏荣; 侯莹
Original assignee: Suzhou Municipal Hospital
Current assignee: Suzhou Municipal Hospital
Priority date: 2021-06-25
Filing date: 2021-06-25
Publication date: 2022-07-19
Anticipated expiration: 2041-06-25
Also published as: CN113229853A

Abstract

The invention discloses a method for monitoring aspiration of an airway, which comprises the following steps: continuously ultrasonically probing a throat region containing airway tissues to obtain airway ultrasonic image data; generating an airway ultrasonic image according to the airway ultrasonic image data; carrying out foreign matter identification on the air passage ultrasonic image by using a foreign matter identification model, and if foreign matters in an air passage are identified, sending a first alarm; the foreign matter identification model is generated by training a deep neural network model according to foreign matter training data, and the foreign matter training data are a certain number of air passage ultrasonic sample images marked with reflux. The invention provides a method for monitoring airway aspiration, which can monitor airway aspiration caused by esophageal reflux in real time.

Description

Method for monitoring aspiration of airway

Technical Field

The invention relates to a method for monitoring aspiration of an airway.

Background

Food aspiration into the air intake can cause repeated pulmonary infections and have a higher risk of suffocation death or secondary ischemic-hypoxic encephalopathy. The complications with extremely high risk are easy to occur in the diseases of abnormal structures and functions of oral cavity, pharynx and esophagus caused by cerebrovascular accident, brain trauma, brain tumor operation, cervical vertebra disease operation and the like. 50% -70% of stroke patients are at risk of swallowing disorders and aspiration, which is also a major cause of death for such patients. The main reasons for food aspiration into the airway are two: firstly, when eating, food can not successfully eat the esophagus because of the abnormal neuromuscular control capability of the oral cavity and the pharyngeal part, but can enter the airway through the glottis; secondly, food that has entered the stomach flows back into the airway due to the weak control of the upper esophageal sphincter.

At present, the aspiration is mainly avoided through the training of oral cavity and pharyngeal strength actively participated by a patient clinically, and the method of indwelling a nasogastric tube and percutaneous gastrostomy is adopted for the patient with poor curative effect or insufficient treatment matching capability, so that the feeding channel is changed, and the aspiration is avoided. However, even if we can artificially change the food intake passage to avoid food from leaking into the air intake passage at the pharynx to the maximum, we still have difficulty in avoiding food that has entered the stomach from flowing back into the air intake passage. In the case of conscious patients, the regurgitated food can be actively swallowed back into the esophagus when gastric reflux occurs, but in the case of unconscious patients with insufficient consciousness, either a small amount of "reflux" or a large amount of "vomiting" may present acute or chronic life threat.

Disclosure of Invention

The invention aims to provide a method for monitoring airway aspiration, which can monitor airway aspiration caused by esophageal reflux in real time.

In order to achieve the purpose, the technical scheme of the invention is to design a method for monitoring aspiration of an airway, which comprises the following steps:

continuously ultrasonically probing a throat region containing airway tissues to obtain airway ultrasonic image data;

generating an airway ultrasonic image according to the airway ultrasonic image data;

carrying out foreign matter identification on the air passage ultrasonic image by using a foreign matter identification model, and if a foreign matter in an air passage is identified, sending a first alarm;

the foreign matter identification model is generated by training a deep neural network model according to foreign matter training data, and the foreign matter training data are a certain number of air passage ultrasonic sample images marked with reflux.

Preferably, the method further comprises:

continuously ultrasonically probing a laryngeal area containing esophageal tissues to obtain esophageal ultrasonic image data;

generating continuous esophagus ultrasonic images according to the esophagus ultrasonic image data;

carrying out reflux identification on the esophagus ultrasonic image by using a reflux identification model, and if the reflux in the esophagus area is identified, sending a second alarm;

the reflux object identification model is generated by training a deep neural network model according to reflux object training data, and the reflux object training data are a certain number of esophagus ultrasonic sample images marked with reflux objects.

Preferably, the method for identifying the esophageal reflux based on the continuous esophageal ultrasound images comprises: based on the mark of the vertical section of the esophagus on one frame of the esophagus ultrasonic image, the mark is automatically synchronized on a plurality of frames of the esophagus ultrasonic images, and the positions of the synchronized marks on different frames of the esophagus ultrasonic images can be shifted along with the change of time; identifying the regurgitant based on the shifted marker position.

Preferably, the method further comprises the following steps: displaying an airway ultrasound image and displaying a first alert indication on the airway ultrasound image indicating a foreign object within the airway region;

an esophageal ultrasound image is displayed and a second alarm indication indicating regurgitant within the esophageal region is displayed on the esophageal ultrasound image.

Preferably, the acquiring a real-time ultrasound image of the larynx includes:

an ultrasound unit wearable at a laryngeal position for continuous ultrasound probing of an airway and esophagus of a laryngeal region, the ultrasound unit comprising: at least one receiving transducer adapted to continuously detect reflected ultrasonic waves, the reflected ultrasonic waves comprising generated ultrasonic waves originating at least in part from being directed toward the airway and generated ultrasonic waves originating at least in part from being directed toward the esophagus and being collectively oriented such that at least one transmitting transducer generates the ultrasonic waves at an angle of incidence of between about 20 degrees and about 70 degrees relative to a surface of the larynx.

Preferably, the frequency of the ultrasonic wave is a frequency between about 6MHz to about 115 MHz.

The invention has the advantages and beneficial effects that: the method for monitoring the aspiration of the air passage is provided, and non-invasive, convenient to carry and continuous real-time monitoring on the aspiration of the air passage caused by the backflow of the esophagus is provided; the image is used for direct evaluation, so that the limitation of indirect judgment of backflow through the pH value of food is broken through, and false positive after test after acidic food is eaten is avoided; the esophagus backflow and the aspiration of the respiratory airway can be simultaneously evaluated, so that the causal relationship between the esophagus backflow and the respiratory airway can be determined, and the accurate treatment can be facilitated.

Detailed Description

The following examples are provided to further illustrate embodiments of the present invention. The following examples are only for illustrating the technical solutions of the present invention more clearly, and the protection scope of the present invention is not limited thereby.

The invention provides a method for monitoring aspiration of an airway, which comprises the following steps:

continuously ultrasonically probing a throat region containing airway tissues to generate an airway ultrasonic image, wherein the airway ultrasonic image is an airway Doppler frequency shift image, a Doppler frequency shift signal in the airway ultrasonic image data is extracted by using a Doppler effect, and the Doppler frequency shift image is generated by processing the airway Doppler frequency shift signal by using a fast Fourier transform technology;

carrying out foreign matter identification on the air passage ultrasonic image by using a foreign matter identification model, and if foreign matters in an air passage are identified, sending a first alarm;

the foreign matter identification model is generated by training a deep neural network model according to foreign matter training data, and the foreign matter training data are a certain number of air passage ultrasonic sample images marked with reflux;

the method further comprises detecting an esophageal reflux object:

The airway recognition model and the esophagus recognition model respectively comprise a feature extraction network, a detection network and a segmentation network; wherein, the split network can adopt a full convolution network. The feature extraction network is respectively connected with the detection network and the segmentation network, and the detection network is connected with the segmentation network. The feature extraction network is mainly used for extracting features of input data to obtain high-level semantic features so as to improve the effect of feature extraction. Based on the method, the detection network and the segmentation network respectively process the received high-level semantic features, and realize the interaction of the information data of the detection network and the segmentation network in the processing process. The segmentation network adjusts the segmentation processing process by adopting the detection frame information of the detection network in the detection processing process, can reduce the identification range during the segmentation processing, and further can realize faster and more accurate segmentation identification.

The method for identifying the backflow object in the esophagus based on the continuous esophagus ultrasonic images comprises the following steps:

based on the mark of the vertical section of the esophagus on one frame of the esophagus ultrasonic image, the mark is automatically synchronized on a plurality of frames of the esophagus ultrasonic images, and the positions of the synchronized marks on different frames of the esophagus ultrasonic images can shift along with the change of time;

and identifying the reflux object based on the shifted mark position, and then sending out a second alarm.

The method further comprises the following steps:

displaying an airway ultrasonic image, and overlaying and displaying a first alarm indicator for indicating foreign matters in an airway region on the airway ultrasonic image;

the esophageal ultrasound image is displayed and a second alarm indicator for indicating regurgitant flow within the esophageal region is displayed superimposed on the esophageal ultrasound image.

The above-mentioned real-time ultrasound image of the larynx includes:

an ultrasound unit wearable at a laryngeal position for continuous ultrasound probing of the airway and esophagus of the laryngeal region, the ultrasound unit comprising: at least one receiving transducer adapted to continuously detect reflected ultrasonic waves, the reflected ultrasonic waves comprising generated ultrasonic waves originating at least in part from being directed toward the airway and generated ultrasonic waves originating at least in part from being directed toward the esophagus and being collectively oriented such that at least one transmitting transducer generates the ultrasonic waves at an angle of incidence of between about 20 degrees and about 70 degrees relative to a surface of the larynx.

The frequency of the ultrasonic wave is a frequency between about 6MHz to about 115 MHz.

The foregoing is only a preferred embodiment of the present invention, and it should be noted that, for those skilled in the art, various modifications and decorations can be made without departing from the technical principle of the present invention, and these modifications and decorations should also be regarded as the protection scope of the present invention.

Claims

1. A method of monitoring airway aspiration, comprising: continuously ultrasonically probing a throat region containing airway tissues to generate an airway ultrasonic image, identifying foreign matters in the airway ultrasonic image by using a foreign matter identification model, and sending a first alarm if the foreign matters in the airway are identified, wherein the foreign matter identification model is generated by training a deep neural network model according to foreign matter training data, and the foreign matter training data are a certain number of airway ultrasonic sample images marked with the foreign matters;

continuously ultrasonically probing a laryngeal area containing esophageal tissues to generate continuous esophageal ultrasonic images, performing reflux identification on the esophageal ultrasonic images by using a reflux identification model, and sending a second alarm if the reflux in the esophageal area is identified, wherein the reflux identification model is generated by training a deep neural network model according to reflux training data, and the reflux training data are a certain number of esophageal ultrasonic sample images marked with the reflux;

displaying an airway ultrasonic image, and overlaying and displaying a first alarm indicator for indicating foreign matters in the airway region on the airway ultrasonic image, displaying an esophagus ultrasonic image, and overlaying and displaying a second alarm indicator for indicating reflux in the esophagus region on the esophagus ultrasonic image;

acquiring a real-time ultrasound image of the larynx includes: an ultrasound unit wearable at a laryngeal position for continuous ultrasound probing of an airway and esophagus of a laryngeal region, the ultrasound unit comprising: at least one receiving transducer adapted to continuously detect reflected ultrasonic waves comprising generated ultrasonic waves originating at least in part from being directed toward the airway and generated ultrasonic waves originating at least in part from being directed toward the esophagus and collectively oriented such that at least one transmitting transducer generates the ultrasonic waves at an angle of incidence of between about 20 degrees and about 70 degrees relative to a surface of the larynx;