CN117815559B - Self-adaptive heart surgery defibrillator - Google Patents
Self-adaptive heart surgery defibrillator Download PDFInfo
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Abstract
The invention discloses a self-adaptive cardiac surgical defibrillator, which relates to the technical field of cardiac resuscitation and comprises a defibrillation polar plate and a self-adaptive system, wherein a scanning unit and an adjusting switch are arranged on the defibrillation polar plate, the adjusting switch is used for adjusting a defibrillation mode, the scanning unit is used for scanning physical data of a patient and generating a defibrillation region, the self-adaptive system comprises a voltage module and a distance module, the self-adaptive system is internally provided with a self-adaptive model which is used for acquiring electrocardiogram data and blood oxygen data for training, and adaptively adjusting defibrillation voltage for defibrillation according to the electrocardiogram data and the blood oxygen data, the distance unit is internally provided with a distance adjusting strategy, the distance adjusting strategy comprises the steps of setting polar plate distance, determining a main region and a sub-region according to the defibrillation region, acquiring the position of the main region and adaptively adjusting the position of the sub-region, and the defibrillation polar plate distance between the defibrillation polar plate in the main region and the defibrillation polar plate in the sub-region is set so as to keep a safe distance between the two defibrillation polar plates.
Description
Technical Field
The invention relates to the technical field of cardiac resuscitation, in particular to an adaptive cardiac surgical defibrillator.
Background
Cardiac arrest is a life-threatening medical condition in which the patient's heart fails to provide blood flow to support life, where cardiac resuscitation is preferred, and in severe cases defibrillation is performed using a defibrillator to deliver high voltage pulses to the heart to promote the heart's return to normal rhythmic and contractile function. Because the defibrillator is used for promoting heart to resume rhythm by means of electric shock, the defibrillator is often used in hospitals, wherein the most used defibrillator is an ALS defibrillator, physical sign information of a patient is displayed in a screen through an external power supply and detected, and medical staff defibrillates the patient through a defibrillation polar plate. At present, in order to facilitate the cardiac resuscitation in emergency, a portable AED is provided, the AED is connected with two electrode plates through a machine body, the AED is attached to a specific position of a chest of a patient through the electrode plates, and whether electric shock is needed or not is prompted according to electrocardiographic information of the patient by self analysis, so that the patient is defibrillated.
The prior art chinese patent publication CN107106856B discloses a defibrillator and a method of using the defibrillator employing an ECG analysis algorithm capable of detecting arrhythmia in the presence of noise artifacts caused by cardiopulmonary resuscitation (CPR) compressions. The apparatus and method provide both a continuous mode of operation and a scheduled mode of operation for staggered periods of CPR and electrotherapy in a manner that improves the effectiveness of rescue, resulting in more CPR "hands-on" time, better treatment of defibrillation, and a shortened transition time between CPR and electrotherapy.
The prior art discloses a mode of conducting defibrillation by analyzing and guiding electrocardiographic data, but since the placement positions of two defibrillation plates also affect the defibrillation effect in actual use of the defibrillator, particularly in defibrillation, the distance between the two defibrillation plates needs to be kept at least 10CM, and the apex and the bottom of the heart can be defibrillated, in case of wrong use, rapid accurate defibrillation for restoring heart rhythm can not be achieved in emergency rescue, meanwhile, the voltage selection in defibrillation is also an important factor for determining whether damage is caused to the heart of a patient after defibrillation, heart damage is easily caused when the voltage is too high, and defibrillation effect is easily not achieved when the voltage is too low.
Disclosure of Invention
Aiming at the defects existing in the prior art, the invention aims to provide an adaptive cardiac surgical defibrillator which is provided with an adaptive defibrillation voltage and a defibrillation polar plate position according to the body state and electrocardiogram data of a patient so as to achieve the effect of rapidly defibrillation and recovering heart rhythm.
In order to achieve the above purpose, the present invention provides the following technical solutions:
An adaptive cardiac surgical defibrillator comprising:
The defibrillation electrode plate is provided with a scanning unit and an adjusting switch, the adjusting switch is used for adjusting a defibrillation mode, and the scanning unit is used for scanning body state data of a patient and generating a defibrillation region according to the body state data;
The self-adaptive system comprises a voltage module and a distance module;
The voltage module is internally provided with an adaptive model, and the adaptive model is used for acquiring electrocardiogram data and blood oxygen data for training and adaptively adjusting defibrillation voltage for defibrillation according to the electrocardiogram data and the blood oxygen data;
The distance module is internally provided with a distance adjusting strategy, the distance adjusting strategy comprises the steps of setting the distance between the electrode plates, determining a main area and a sub-area according to the defibrillation area, acquiring the position of the main area and adaptively adjusting the position of the sub-area, and keeping the distance between the defibrillation electrode plates in the main area and the defibrillation electrode plates in the sub-area so as to keep the safe distance between the two defibrillation electrode plates.
As a further improvement of the present invention, the defibrillation pad is provided with a transmitter for outputting a defibrillation region to the chest of the patient and forming a region marker, the transmitter including a projector provided at a front end portion of the defibrillation pad for projecting the region marker and a compensator provided along a peripheral array of the defibrillation pad for compensating for projecting the region marker when the defibrillation pad contacts the chest of the patient.
As a further improvement of the present invention, the scanning unit is configured with a scanning strategy, the scanning strategy comprising:
Before defibrillation, the defibrillation polar plate is taken to face the chest of the patient, the chest of the patient is scanned, a chest image is obtained, recognition logic is configured, a plurality of morphological features in the chest image are recognized according to the recognition logic, the morphological features are extracted and combined to form morphological data, and the recognition logic determines a defibrillation region according to the morphological data.
As a further improvement of the present invention, a tracking strategy is further configured in the scanning unit, and the tracking strategy includes:
Acquiring a defibrillation region and a chest image, recording the position of the determined defibrillation region in the chest image, tracking the position of a defibrillation polar plate, and generating a tracking signal when the position of the defibrillation polar plate is recognized to be changed from the position of the chest of a scanned patient;
According to the tracking signal, if the moving direction of the defibrillation polar plate is not the defibrillation direction, acquiring the position of the transmitter, and adjusting the transmitting angle of the transmitter so as to ensure that the position of a region mark formed on the chest of the patient is unchanged, wherein the defibrillation direction represents the moving direction of the defibrillation polar plate towards the defibrillation region;
If the moving direction of the defibrillation polar plate is the defibrillation direction, a switching signal is generated, the projector is closed according to the switching signal, and the compensator is started to compensate the formed area mark, so that the position of the defibrillation mark is kept unchanged during defibrillation movement.
As a further refinement of the invention, the specific manner in which the identification logic determines the defibrillation region from the posture data comprises:
Identifying shoulder features, chest features, sternum features and nipple features, wherein the shoulder features represent end point positions of the shoulder, the chest features represent positions, where the last rib far away from the shoulder is connected with the sternum, the sternum features represent sternum position features along the throat towards the chest, corresponding shoulder marks, chest marks and nipple marks are formed for the shoulder features, the chest features and the nipple features, standard domains are constructed, when the standard domains are constructed, the shoulder marks, the nipple marks and the chest marks on one side of displacement are sequentially connected, and nipple marks and the shoulder marks on the other side are connected, a closed polygonal area is formed, and the sternum features are fitted in the standard domains and the sternum marks are formed.
As a further refinement of the invention, the recognition logic further comprises:
when the defibrillation region is divided according to the standard domain, the nipple mark deviating from the heart position is taken as the center, the defibrillation region is formed according to the shape of the nipple mark fitting defibrillation polar plate, meanwhile, the midpoint position of the sternum mark is identified, the midpoint of the sternum mark and the shoulder mark on the same side with the heart position are connected to form a mark line I, the chest on one side of the heart position is divided into a discarding region and a measuring region according to the mark line I, the discarding region represents the standard domain range of the mark line I on one side of the head of a patient, and the measuring region represents the standard domain range of the mark line I on one side of the abdomen of the patient;
Identifying the position of the nipple mark, correcting a mark line I if the nipple mark is positioned in a discarding area, taking a connecting line of the nipple mark and a shoulder mark as the mark line I, setting a standard vertical line, taking the nipple mark as a starting point as a standard vertical line which faces to a measuring and calculating area and is vertical to the mark line I, taking an end point of the standard vertical line away from the mark line I as a center, and fitting the shape of a defibrillation polar plate to form a defibrillation area;
If the nipple mark is positioned in the measuring and calculating area, constructing a vertical line perpendicular to the first mark line by taking the nipple mark on the same side of the heart as a starting point, fitting a second mark line parallel to the first mark line at the nipple mark position of the constructed vertical line, mirroring the vertical line by taking the second mark line as a mirror axis to form a mirror vertical line, and fitting the shape of the defibrillation polar plate by taking one end of the mirror vertical line away from the second mark line as the center to form a defibrillation area, thereby forming the defibrillation area for guiding the defibrillation polar plate to defibrillate.
As a further improvement of the present invention, the specific content of the distance adjustment strategy for determining the distance between the main area and the sub-area includes:
The method comprises the steps of obtaining residual voltages of the body surfaces of the defibrillation electrode plates after primary defibrillation, comparing the values of the residual voltages obtained by the two defibrillation electrode plates, taking a defibrillation region where the defibrillation electrode plate with a small residual voltage value is located as a main region, and taking a defibrillation region where the defibrillation electrode plate with a large residual voltage is located as a sub-region;
Configuring a residual threshold and a correction threshold, wherein the residual threshold represents the minimum value of the residual voltage, the correction threshold represents the minimum moving distance value of the correction defibrillation region, and the acquired residual voltage is compared with the residual threshold;
If the residual voltage is greater than the residual threshold value, generating a correction signal and correcting the position of the defibrillation region;
and if the residual voltage is smaller than the residual threshold value, the position of the original defibrillation region is maintained.
As a further improvement of the present invention, the correction of the defibrillation region further includes:
Identifying that the main area is positioned on the same side of the heart or on the opposite side of the heart, if the main area is positioned on the opposite side of the heart, mirroring the position of the heart to the side where the main area is positioned by taking the sternum mark as a mirror image axis, identifying the offset distance between the central position of the main area and the heart tip of the heart or the mirror image heart, wherein the offset distance comprises a transverse distance and a longitudinal distance, the transverse distance represents the distance value between the center of the main area and the centrifugal tip along the direction perpendicular to the sternum mark, the longitudinal distance represents the distance value between the center of the main area and the centrifugal tip along the direction parallel to the sternum mark, performing difference processing on the transverse distance and the longitudinal distance, setting the correction direction to be along the direction parallel to the sternum mark when the difference is positive, setting the correction direction to be along the direction perpendicular to the sternum mark when the difference is negative, and correcting the moving distance of the main area by using a correction threshold.
As a further improvement of the present invention, the distance adjustment strategy further comprises:
Acquiring centers corresponding to the main area and the sub-area, constructing a distance triangle, and constructing right-angle edges by taking the central connecting line of the center of the main area and the sub-area as a bevel edge and respectively taking the center of the main area as a perpendicular sternum mark and the sub-area as a parallel sternum mark;
And configuring a defibrillation included angle, wherein the defibrillation included angle represents an included angle between a hypotenuse and a right-angle side constructed by the center of the main area, determining the center of the subarea according to the center position of the main area, the pole plate distance and the defibrillation included angle, and fitting the corrected center position of the subarea to the subarea for placing the defibrillation pole plate.
As a further improvement of the present invention, constructing the adaptive model and adaptively adjusting the defibrillation voltage comprises the steps of:
S1: acquiring electrocardiogram and blood oxygen data of a patient through a monitoring device;
s2: preprocessing the acquired electrocardiogram and blood oxygen data and enhancing data signals to obtain physical sign data;
S3: extracting heart rate, ST segment variation and blood oxygen saturation characteristics from the preprocessed physical sign data;
S4: constructing a training set with known defibrillation voltages and based on the features extracted by the patient;
S5: training the training set to establish a neural network model for adaptively adjusting defibrillation voltage when the monitoring device acquires sign data of the patient;
S6: verifying the trained neural network model by using an independent test data set to evaluate the performance and accuracy of the neural network model;
S7: the trained neural network model is deployed into a defibrillator to achieve adaptive adjustment of defibrillation voltages.
The invention has the beneficial effects that:
1. The method comprises the steps that a scanning unit and an adjusting switch are arranged on a defibrillation polar plate, different defibrillation modes are adjusted according to different crowds of a patient, the different defibrillation modes are fed back to the scanning unit to scan the patient, a defibrillation region is correspondingly generated, a defibrillation region forming region mark is reflected on the chest of the patient under the action of a transmitter, and the position of the defibrillation polar plate is guided.
2. The CNN convolutional neural network model is constructed, training analysis is carried out on the acquired electrocardiogram data and blood oxygen data, and defibrillation voltage is output, so that the effect of self-adaptively adjusting the defibrillation voltage according to the acquired electrocardiogram data and blood oxygen data is realized, a main area and a subarea are determined according to a distance adjusting strategy after defibrillation is carried out once, whether the defibrillation area needs to be corrected is determined by comparing the residual voltage of the body surface with the residual threshold value, and the position of the subarea is adjusted in a self-adaptive mode after the main area is corrected, and the effect of self-adaptively adjusting the positions of the two defibrillation electrode plates for defibrillation is achieved, and the safe distance between the two defibrillation electrode plates is kept.
Drawings
FIG. 1 is a system flow diagram for maintaining zone markers;
fig. 2 is a flow chart of a system for determining a defibrillation region;
FIG. 3 is a system flow diagram for determining a main region and a sub-region;
FIG. 4 is a system flow diagram of a correction master area;
FIG. 5 is a system flow diagram of a correction sub-region;
FIG. 6 is a schematic diagram of building a standard region;
fig. 7 is a schematic diagram of the overall structure of the defibrillator;
fig. 8 is a schematic structural view of a defibrillation pad;
fig. 9 is a schematic diagram of a configuration of an on-board transmitter embodying a defibrillation shock;
Fig. 10 is a diagram of a defibrillation region pattern projected by a projector;
fig. 11 is a diagram of a defibrillation region pattern generated by the compensator compensation.
Description of the drawings: 1. a defibrillator; 2. defibrillation electrode plates; 3. an adjusting switch; 4. a transmitter; 41. a projector; 42. and a compensator.
Detailed Description
In order to make the objects, technical solutions and advantages of the embodiments of the present invention more clear, the technical solutions of the embodiments of the present invention will be clearly and completely described below with reference to the accompanying drawings of the embodiments of the present invention. It will be apparent that the described embodiments are some, but not all, embodiments of the invention. All other embodiments, which can be made by a person skilled in the art without creative efforts, based on the described embodiments of the present invention fall within the protection scope of the present invention.
Unless defined otherwise, technical or scientific terms used herein should be given the ordinary meaning as understood by one of ordinary skill in the art to which this invention belongs. The terms "first," "second," and the like, as used herein, do not denote any order, quantity, or importance, but rather are used to distinguish one element from another. The word "comprising" or "comprises", and the like, means that elements or items preceding the word are included in the element or item listed after the word and equivalents thereof, but does not exclude other elements or items. The terms "connected" or "connected," and the like, are not limited to physical or mechanical connections, but may include electrical connections, whether direct or indirect. "upper", "lower", "left", "right", etc. are used merely to indicate relative positional relationships, which may also be changed when the absolute position of the object to be described is changed.
In order to keep the following description of the embodiments of the present invention clear and concise, the detailed description of known functions and known components thereof have been omitted.
Referring to fig. 1 to 11, in a specific embodiment of an adaptive cardiac surgical defibrillator 1 according to the present invention, the adaptive cardiac surgical defibrillator includes a defibrillation electrode 2 and an adaptive system, a scanning unit and an adjusting switch 3 are disposed on the defibrillation electrode 2, the adjusting switch 3 is used for adjusting a defibrillation mode, and because different people need to be subjected to a defibrillation adjusting mode according to different people, especially different constitutions between adults and children, so as to perform safe defibrillation, the adjusting switch 3 is also used for adjusting the scanning unit when corresponding to different defibrillation modes, the scanning unit is used for scanning physical data of a patient, generating a defibrillation region according to the physical data, and guiding a medical staff to place the defibrillator 1 in the defibrillation region according to the defibrillation region. The self-adaptive system comprises a voltage module and a distance module, wherein the voltage module is internally provided with a self-adaptive model, the self-adaptive model is used for acquiring electrocardiogram data and blood oxygen data to train and adaptively adjusting defibrillation voltage for defibrillation according to the electrocardiogram, the blood oxygen data and body surface voltage to achieve the effect of quickly and adaptively adjusting the defibrillation voltage, auxiliary medical staff is not required to manually adjust after defibrillation is finished, the distance module is internally provided with a distance adjusting strategy, the distance adjusting strategy comprises the steps of setting plate distance, determining a main area and a subarea according to a defibrillation area, acquiring the position of the main area and adaptively adjusting the position of the subarea, and keeping the plate distance between a defibrillation plate 2 in the main area and the defibrillation plate 2 in the subarea so as to obtain the safe distance between the two defibrillation plates 2 when safe defibrillation is kept.
The defibrillation polar plate 2 is provided with a transmitter 4, the transmitter 4 is used for outputting a defibrillation region to the chest of a patient and forming a region mark, so that a medical staff can conveniently know the position of the defibrillation region on the chest according to the region mark, a scanning strategy is configured in a scanning unit, and the scanning strategy comprises:
Before defibrillation, the defibrillation polar plate 2 is taken to face the chest of a patient, the chest of the patient is scanned, a chest image is obtained, recognition logic is configured, a plurality of morphological features in the chest image are recognized according to the recognition logic, the morphological features are extracted and combined to form morphological data, and the recognition logic determines a defibrillation region according to the morphological data.
The transmitter 4 includes a projector 41 and a compensator 42, the projector 41 is disposed at the front end of the defibrillation pad 2, the projector 41 is used for projecting an area marker, the compensator 42 is disposed along the peripheral array of the defibrillation pad 2, the compensator 42 is used for compensating the projection forming area marker when the defibrillation pad 2 contacts with the chest of the patient for defibrillation, so that before defibrillation and during defibrillation, whether the defibrillation pad 2 is located in the defibrillation area can be identified by the area marker for accurate defibrillation, and a tracking strategy is further configured in the scanning unit, wherein the tracking strategy includes:
Acquiring a defibrillation region and a chest image, recording the determined position of the defibrillation region in the chest image, tracking the position of the defibrillation polar plate 2, generating a tracking signal when the position of the defibrillation polar plate 2 is recognized to be changed with the position of the chest of a scanned patient, acquiring the position of the transmitter 4 according to the tracking signal if the moving direction of the defibrillation polar plate 2 is not the defibrillation direction, and adjusting the transmitting angle of the transmitter 4, wherein the defibrillation direction represents the moving direction of the defibrillation polar plate 2 towards the defibrillation region so as to fix the position of a region mark formed on the chest of the patient;
if the moving direction of the defibrillation electrode plate 2 is the defibrillation direction, the distance between the defibrillation electrode plate 2 and the defibrillation region is shortened due to the movement towards the defibrillation region, and the size of the image is enlarged or reduced along with the change of the distance in the projected imaging mode, so that when the moving direction of the defibrillation electrode plate 2 is recognized as the defibrillation direction, a switching signal is generated, the projector 41 is closed and the compensator 42 is started according to the switching signal to compensate the formation region mark, so that the position of the defibrillation mark is kept unchanged during the defibrillation movement, the judgment of the defibrillation position according to the experience of medical staff is not needed during the defibrillation, and the universality of the use of the defibrillator 1 is improved.
Specific ways in which the identification logic determines the defibrillation region from the posture data include:
Identifying shoulder features, chest features, sternum features and nipple features, wherein the shoulder features represent end point positions of the shoulder, the chest features represent positions, where the last rib far away from the shoulder is connected with the sternum, the sternum features represent sternum position features along the throat towards the chest, corresponding shoulder marks, chest marks and nipple marks are formed for the shoulder features, the chest features and the nipple features, standard domains are constructed, when the standard domains are constructed, the shoulder marks, the nipple marks, the chest marks and the nipple marks on one side are sequentially connected, and the nipple marks and the shoulder marks on the other side are connected, so that a closed polygonal area is formed, and the sternum features are fitted in the standard domains and the sternum marks are formed.
When the defibrillation region is divided according to the standard domain, the nipple mark deviating from the heart position is taken as the center, the defibrillation region is formed according to the shape of the nipple mark fitting defibrillation polar plate 2, meanwhile, the midpoint position of the sternum mark is identified, the midpoint of the sternum mark and the shoulder mark on the same side with the heart position are connected to form a mark line I, the chest on one side of the heart position is divided into a discarding region and a measuring region according to the mark line I, the discarding region represents the standard domain range of the mark line I on one side of the head of a patient, and the measuring region represents the standard domain range of the mark line I on one side of the abdomen of the patient.
Identifying the position of the nipple mark, correcting a mark line I if the nipple mark is positioned in a discarding area, taking a connecting line of the nipple mark and a shoulder mark as the mark line I, setting a standard vertical line, taking the nipple mark as a starting point as a standard vertical line which faces to a measuring and calculating area and is vertical to the mark line I, taking an end point of the standard vertical line away from the mark line I as a center, and fitting the shape of a defibrillation polar plate 2 to form a defibrillation area;
If the nipple mark is positioned in the measuring and calculating area, constructing a vertical line perpendicular to the first mark line by taking the nipple mark on the same side of the heart as a starting point, fitting a second mark line parallel to the first mark line at the nipple mark position of the constructed vertical line, mirroring the vertical line by taking the second mark line as a mirror axis to form a mirror vertical line, and fitting the shape of the defibrillation polar plate 2 by taking one end of the mirror vertical line away from the second mark line as the center to form a defibrillation area, thereby forming the defibrillation area for guiding the defibrillation polar plate 2 to defibrillate.
The method for constructing the self-adaptive model and self-adaptively adjusting the defibrillation voltage comprises the following steps:
S1: acquiring electrocardiogram and blood oxygen data of a patient through a monitoring device;
s2: preprocessing the acquired electrocardiogram and blood oxygen data and enhancing data signals to obtain physical sign data;
S3: extracting heart rate, ST segment variation and blood oxygen saturation characteristics from the preprocessed physical sign data;
S4: constructing a training set with known defibrillation voltages and based on the features extracted by the patient;
S5: training the training set to establish a neural network model for adaptively adjusting defibrillation voltage when the monitoring device acquires sign data of the patient;
S6: verifying the trained neural network model by using an independent test data set to evaluate the performance and accuracy of the neural network model;
S7: the trained neural network model is deployed into a defibrillator to achieve adaptive adjustment of defibrillation voltages.
The specific steps of the pretreatment in the step S2 include:
S21: carrying out noise reduction treatment on electrocardiogram and blood oxygen data;
S22: carrying out signal enhancement on electrocardiogram and blood oxygen data by adopting a wavelet transformation mode;
s23: carrying out data calibration on the enhanced electrocardiogram and blood oxygen data by adopting a calibration algorithm;
S24: data alignment is carried out on electrocardiogram and blood oxygen data;
s25: and extracting features from the processed data and obtaining sign data.
Step S22, the original signal isThe coefficient obtained after wavelet transformation is/>Where j represents the scale and k represents the position, the wavelet transform is formulated as:
Wherein, Is a wavelet function with a summation range of the whole original signal/>According to the wavelet transform result, processing by thresholding according to the magnitude of wavelet coefficient, setting the coefficient with smaller magnitude to zero, thereby removing noise component, and obtaining final wavelet coefficient/>, using soft thresholding：
Wherein, T is a threshold value,Is/>Is a symbol of (c).
In step S23, because the electrocardiogram signal and the blood oxygen data will deviate due to the interference of external factors in the acquisition process, the calibration algorithm is used to estimate and compensate the baseline drift to eliminate the deviation caused by the interference factors, so as to calibrate the data, and the expression form of the calibration algorithm is as follows:
Wherein, Is a calibrated signal,/>Is the original signal,/>Is a coefficient of the filter,/>Is the calibrated signal at the previous time.
In step S24, due to the time difference between the collection of the electrocardiographic data and the blood oxygen data, the electrocardiographic data and the blood oxygen data are aligned to the same time axis, so as to obtain the best time axis alignment effect, so that the electrocardiographic data and the blood oxygen data on the same time axis can be conveniently used, and the electrocardiographic data and the blood oxygen data are aligned in time axis by adopting an alignment algorithm, wherein the alignment algorithm specifically comprises:
s241: determining a unified time axis range, selecting the minimum value and the maximum value of the electrocardiographic data and blood oxygen data time sequences as the unified time axis range, and setting time intervals;
S242: for the time point t on each unified time axis, two time points t 1 and t 2 of the electrocardiogram data closest to t are found and satisfy Performing linear interpolation calculation, and setting electrocardiographic data corresponding to t 1 as/>The electrocardiographic data corresponding to t 2 is/>The electrocardiographic data at time t is calculated by interpolation as:
s243: let t 1 correspond to blood oxygen data as Blood oxygen data corresponding to t 2 is/>Then the blood oxygen data at time t is calculated by interpolation as:
the method enables the electrocardiographic data and the blood oxygen data to be aligned on a unified time axis through an interpolation calculation method, so that subsequent processing and analysis are convenient.
The training of the neural network model in step S5 includes the following steps:
the CNN convolutional neural network model is selected, the sign data in the training set are normalized, the size of the sign data is adjusted and input into the CNN model, a softmax activation function is used as an activation function of an output layer, and the specific expression of the activation function is as follows:
Wherein, Representing the value of the ith feature in the input vector after the softmax function,/>Representing the original score of the ith feature in the input vector, N representing the dimension of the input vector, e representing the base of the natural logarithm.
The method comprises the steps that 70% of physical sign data is used as a training set, 10% of physical sign data is used as a verification set, 20% of physical sign data is used as a test set, a neural network model comprises a neural network of L layers, wherein the first layer is an input layer, the last layer is an output layer, one neuron of the output layer is used for defibrillation, a loss function is defined as a mean square error and is used as a loss function, and the specific expression of the loss function is as follows:
Where m represents the number of training samples, Representing the desired output value,/>Representing the output value of the model prediction.
According to a back propagation algorithm, calculating the gradient of a loss function for each parameter, and calculating the weight parameter W and the bias parameter b of the defibrillation voltage by adopting a chain rule, wherein the concrete expression form is as follows:
Where J is the loss function, W is the weight matrix of the model, b is the bias term of the model, And/>The partial derivatives of the loss function pair W and b, respectively.
According to the updating rule of the gradient descent method, the expression form of the weight and the bias parameter of the updated defibrillation voltage is as follows:
Wherein, Is learning rate,/>The symbolic representation updating operation, through training and parameter updating of the back propagation algorithm, the neural network model can automatically adjust defibrillation voltage, and the predicted result output by the neural network model is enabled to be more approximate to the expected result.
The specific content of the distance between the main area and the subarea determined by the distance adjusting strategy comprises the following steps:
The method comprises the steps of obtaining residual voltages of the body surfaces of the defibrillation polar plates 2 after defibrillation once, comparing the values of the residual voltages obtained by the two defibrillation polar plates 2, taking a defibrillation region where the defibrillation polar plate 2 with a small residual voltage value is located as a main region, taking the defibrillation region where the defibrillation polar plate 2 with a large residual voltage is located as a sub-region, and taking one side with a smaller residual voltage value after defibrillation as a main region because the defibrillation voltage is transmitted to and leads to muscle contraction of a patient through the body surfaces when defibrillation is carried out, wherein the smaller the residual voltage after defibrillation voltage transmission is used for representing higher conduction efficiency, the higher the probability of further representing defibrillation effectiveness is.
Configuring a residual threshold and a correction threshold, wherein the residual threshold represents the minimum value of the residual voltage, the correction threshold represents the minimum moving distance value of the correction defibrillation region, and the acquired residual voltage is compared with the residual threshold;
If the residual voltage is greater than the residual threshold value, generating a correction signal and correcting the position of the defibrillation region;
and if the residual voltage is smaller than the residual threshold value, the position of the original defibrillation region is maintained.
When correcting the defibrillation region:
Identifying that the main area is positioned on the same side of the heart or on the opposite side of the heart, if the main area is positioned on the opposite side of the heart, mirroring the position of the heart to the side where the main area is positioned by taking the sternum mark as a mirror image axis, identifying the offset distance between the central position of the main area and the heart tip of the heart or the mirror image heart, wherein the offset distance comprises a transverse distance and a longitudinal distance, the transverse distance represents the distance value between the center of the main area and the centrifugal tip along the direction perpendicular to the sternum mark, the longitudinal distance represents the distance value between the center of the main area and the centrifugal tip along the direction parallel to the sternum mark, performing difference processing on the transverse distance and the longitudinal distance, setting the correction direction to be along the direction parallel to the sternum mark when the difference is positive, setting the correction direction to be along the direction perpendicular to the sternum mark when the difference is negative, and correcting the moving distance of the main area by using a correction threshold.
Obtaining centers corresponding to the main area and the subarea, constructing a distance triangle, taking a central connecting line of the center of the main area and the subarea as a bevel edge, respectively constructing a right-angle side by taking the center of the main area as a perpendicular sternal marker and taking the subarea as a parallel sternal marker, configuring a defibrillation angle, characterizing the angle between the bevel edge and the right-angle side constructed by the center of the main area, determining the center of the subarea according to the center position of the main area, the polar plate distance and the defibrillation angle, fitting the subarea for placing the defibrillation polar plate 2 at the center position of the corrected subarea, thereby achieving the effects of dividing the main area and the subarea according to the identification residual voltage, judging whether the defibrillation area needs to be corrected according to the comparison of the residual voltage and the residual threshold value, correcting the main area through the correction threshold value when the defibrillation area is corrected, and adjusting the position of the subarea through a self-adaptive adjustment mode, thereby achieving the effects of correcting the position of the defibrillation polar plate 2 and keeping a safe distance between the two defibrillation polar plates 2.
Working principle and effect:
By arranging the scanning unit and the adjusting switch 3 on the defibrillation polar plate 2, different defibrillation modes are adjusted according to different crowds of a patient, the defibrillation areas are correspondingly generated after the patient is scanned by feeding back to the scanning unit, and the defibrillation area forming area marks are reflected on the chest of the patient under the action of the transmitter 4, so that the position of the defibrillation polar plate 2 is guided.
The acquired electrocardiogram data and blood oxygen data are subjected to training analysis by constructing a CNN convolutional neural network model, and defibrillation voltage is output, so that the effect of self-adaptively adjusting the defibrillation voltage according to the acquired electrocardiogram data and blood oxygen data is realized, a main area and a subarea are determined according to a distance adjusting strategy after defibrillation is performed once, whether the defibrillation area needs to be corrected is determined by comparing the residual voltage of the body surface with the residual threshold value, and the position of the subarea is adaptively adjusted after the main area is corrected, and the effect of self-adaptively adjusting the defibrillation positions of the two defibrillation electrode plates 2 and keeping the safe distance between the two defibrillation electrode plates 2 is achieved.
Furthermore, although exemplary embodiments have been described in the present disclosure, the scope thereof includes any and all embodiments having equivalent elements, modifications, omissions, combinations (e.g., of the various embodiments across), adaptations or alterations as would be appreciated by those in the art. The elements in the claims are to be construed broadly based on the language employed in the claims and are not limited to examples described in the present specification or during the practice of the application, which examples are to be construed as non-exclusive. It is intended, therefore, that the specification and examples be considered as exemplary only, with a true scope and spirit being indicated by the following claims and their full scope of equivalents.
The above description is intended to be illustrative and not restrictive. For example, the above-described examples (or one or more aspects thereof) may be used in combination with each other. For example, other embodiments may be used by those of ordinary skill in the art upon reading the above description. In addition, in the above detailed description, various features may be grouped together to streamline the invention. This is not to be interpreted as an intention that the disclosed features not being claimed are essential to any claim. Rather, inventive subject matter may lie in less than all features of a particular disclosed embodiment. Thus, the following claims are hereby incorporated into the detailed description as examples or embodiments, with each claim standing on its own as a separate embodiment, and it is contemplated that these embodiments may be combined with one another in various combinations or permutations. The scope of the invention should be determined with reference to the appended claims, along with the full scope of equivalents to which such claims are entitled.
The above embodiments are only exemplary embodiments of the present invention and are not intended to limit the present invention, the scope of which is defined by the claims. Various modifications and equivalent arrangements of this invention will occur to those skilled in the art, and are intended to be within the spirit and scope of the invention.
Claims (10)
1. An adaptive cardiac surgical defibrillator (1), comprising:
The device comprises a defibrillation polar plate (2), wherein a scanning unit and an adjusting switch (3) are arranged on the defibrillation polar plate (2), the adjusting switch (3) is used for adjusting a defibrillation mode, and the scanning unit is used for scanning physical state data of a patient and generating a defibrillation region according to the physical state data;
The self-adaptive system comprises a voltage module and a distance module;
The voltage module is internally provided with an adaptive model, and the adaptive model is used for acquiring electrocardiogram data and blood oxygen data for training and adaptively adjusting defibrillation voltage for defibrillation according to the electrocardiogram data and the blood oxygen data;
The distance module is internally provided with a distance adjusting strategy, the distance adjusting strategy comprises the steps of setting the distance between the polar plates, determining a main area and a sub-area according to the defibrillation area, acquiring the position of the main area and adaptively adjusting the position of the sub-area, wherein the main area represents the defibrillation area where the defibrillation polar plate (2) with small residual voltage value on the body surface after defibrillation is located, the sub-area represents the defibrillation area where the defibrillation polar plate (2) with large residual voltage value on the body surface after defibrillation is located, and the distance between the defibrillation polar plate (2) in the main area and the defibrillation polar plate (2) in the sub-area is kept, so that the safety distance between the two defibrillation polar plates (2) is kept.
2. An adaptive cardiac surgical defibrillator (1) according to claim 1, wherein: be provided with transmitter (4) on defibrillation polar plate (2), transmitter (4) are used for exporting the defibrillation region to on the patient's thorax and form regional mark, transmitter (4) are including projector (41) and compensator (42), projector (41) set up in the front end of defibrillation polar plate (2), projector (41) are used for projecting regional mark, compensator (42) are along the peripheral array setting of defibrillation polar plate (2), compensator (42) are used for compensating when defibrillation polar plate (2) and patient's thorax contact defibrillation and throw and form regional mark.
3. An adaptive cardiac surgical defibrillator (1) according to claim 2, wherein: a scanning strategy is configured in the scanning unit, and the scanning strategy comprises the following steps:
Before defibrillation, the defibrillation polar plate (2) is taken to face the chest of a patient, the chest of the patient is scanned, a chest image is obtained, recognition logic is configured, a plurality of morphological features in the chest image are recognized according to the recognition logic, the morphological features are extracted and combined to form morphological data, and the recognition logic determines a defibrillation region according to the morphological data.
4. An adaptive cardiac surgical defibrillator (1) according to claim 3, wherein: the scanning unit is also configured with a tracking strategy, and the tracking strategy comprises:
Acquiring a defibrillation region and a chest image, recording the position of the determined defibrillation region in the chest image, tracking the position of a defibrillation polar plate (2), and generating a tracking signal when the positions of the defibrillation polar plate (2) and the chest of a scanned patient are recognized to change;
According to the tracking signal, if the moving direction of the defibrillation polar plate (2) is not the defibrillation direction, acquiring the position of the transmitter (4), and adjusting the transmitting angle of the transmitter (4) so as to ensure that the position of a region mark formed on the chest of a patient is unchanged, wherein the defibrillation direction represents the moving direction of the defibrillation polar plate (2) towards the defibrillation region;
If the moving direction of the defibrillation polar plate (2) is the defibrillation direction, a switching signal is generated, the projector (41) is turned off according to the switching signal, and the compensator (42) is started to compensate the formation area mark, so that the position of the defibrillation mark is kept unchanged during defibrillation movement.
5. An adaptive cardiac surgical defibrillator (1) according to claim 4, wherein: the specific manner in which the identification logic determines the defibrillation region from the posture data includes:
Identifying shoulder features, chest features, sternum features and nipple features, wherein the shoulder features represent end point positions of the shoulder, the chest features represent positions, where the last rib far away from the shoulder is connected with the sternum, the sternum features represent sternum position features along the throat towards the chest, corresponding shoulder marks, chest marks and nipple marks are formed for the shoulder features, the chest features and the nipple features, standard domains are constructed, when the standard domains are constructed, the shoulder marks, the nipple marks and the chest marks on one side of displacement are sequentially connected, and nipple marks and the shoulder marks on the other side are connected, a closed polygonal area is formed, and the sternum features are fitted in the standard domains and the sternum marks are formed.
6. An adaptive cardiac surgical defibrillator (1) according to claim 5, wherein: the recognition logic further includes:
When the defibrillation region is divided according to the standard domain, the nipple mark deviating from the heart position is taken as the center, the defibrillation region is formed according to the shape of the nipple mark fitting defibrillation polar plate (2), meanwhile, the midpoint position of the sternum mark is identified, the midpoint of the sternum mark and the shoulder mark on the same side with the heart position are connected to form a mark line I, the chest on one side of the heart position is divided into a discarding region and a measuring region according to the mark line I, the discarding region represents the standard domain range of the mark line I towards one side of the head of a patient, and the measuring region represents the standard domain range of the mark line I towards one side of the abdomen of the patient;
Identifying the position of the nipple mark, correcting a mark line I if the nipple mark is positioned in a discarding area, taking a connecting line of the nipple mark and a shoulder mark as the mark line I, setting a standard vertical line, taking the nipple mark as a starting point as a standard vertical line which faces to a measuring and calculating area and is vertical to the mark line I, taking an end point of the standard vertical line away from the mark line I as a center, and fitting the shape of a defibrillation polar plate (2) to form a defibrillation area;
If the nipple mark is positioned in the measuring and calculating area, constructing a vertical line perpendicular to the first mark line by taking the nipple mark on the same side of the heart as a starting point, fitting a second mark line parallel to the first mark line by taking the nipple mark position of the constructed vertical line as a mirror axis mirror image vertical line to form a mirror image vertical line, and fitting the shape of the defibrillation polar plate (2) by taking one end of the mirror image vertical line far away from the second mark line as the center to form a defibrillation area, thereby forming the defibrillation area for guiding the defibrillation polar plate (2) to defibrillate.
7. An adaptive cardiac surgical defibrillator (1) according to claim 6, wherein: the specific content of the distance between the main area and the subarea determined by the distance adjusting strategy comprises the following steps:
The method comprises the steps of obtaining residual voltages of the body surfaces of the defibrillation electrode plates (2) after primary defibrillation, comparing the values of the residual voltages obtained by the two defibrillation electrode plates (2), taking a defibrillation region where the defibrillation electrode plate (2) with a small residual voltage value is located as a main region, and taking a defibrillation region where the defibrillation electrode plate (2) with a large residual voltage is located as a sub-region;
Configuring a residual threshold and a correction threshold, wherein the residual threshold represents the minimum value of the residual voltage, the correction threshold represents the minimum moving distance value of the correction defibrillation region, and the acquired residual voltage is compared with the residual threshold;
If the residual voltage is greater than the residual threshold value, generating a correction signal and correcting the position of the defibrillation region;
and if the residual voltage is smaller than the residual threshold value, the position of the original defibrillation region is maintained.
8. An adaptive cardiac surgical defibrillator (1) according to claim 7, wherein: the correction of the defibrillation region further includes:
Identifying that the main area is positioned on the same side of the heart or on the opposite side of the heart, if the main area is positioned on the opposite side of the heart, mirroring the position of the heart to the side where the main area is positioned by taking the sternum mark as a mirror image axis, identifying the offset distance between the central position of the main area and the heart tip of the heart or the mirror image heart, wherein the offset distance comprises a transverse distance and a longitudinal distance, the transverse distance represents the distance value between the center of the main area and the centrifugal tip along the direction perpendicular to the sternum mark, the longitudinal distance represents the distance value between the center of the main area and the centrifugal tip along the direction parallel to the sternum mark, performing difference processing on the transverse distance and the longitudinal distance, setting the correction direction to be along the direction parallel to the sternum mark when the difference is positive, setting the correction direction to be along the direction perpendicular to the sternum mark when the difference is negative, and correcting the moving distance of the main area by using a correction threshold.
9. An adaptive cardiac surgical defibrillator (1) according to claim 8, wherein: the roll adjustment strategy further comprises:
Acquiring centers corresponding to the main area and the sub-area, constructing a distance triangle, and constructing right-angle edges by taking the central connecting line of the center of the main area and the sub-area as a bevel edge and respectively taking the center of the main area as a perpendicular sternum mark and the sub-area as a parallel sternum mark;
and configuring a defibrillation included angle, wherein the defibrillation included angle represents an included angle between a hypotenuse and a right-angle side constructed by the center of the main area, determining the center of the subarea according to the center position of the main area, the pole plate distance and the defibrillation included angle, and fitting the corrected center position of the subarea to be used for placing the defibrillation pole plate (2).
10. An adaptive cardiac surgical defibrillator (1) according to any one of claims 1 to 9, wherein: the construction of the adaptive model and the adaptive adjustment of the defibrillation voltage comprise the following steps:
S1: acquiring electrocardiogram and blood oxygen data of a patient through a monitoring device;
s2: preprocessing the acquired electrocardiogram and blood oxygen data and enhancing data signals to obtain physical sign data;
S3: extracting heart rate, ST segment variation and blood oxygen saturation characteristics from the preprocessed physical sign data;
S4: constructing a training set with known defibrillation voltages and based on the features extracted by the patient;
S5: training the training set to establish a neural network model for adaptively adjusting defibrillation voltage when the monitoring device acquires sign data of the patient;
S6: verifying the trained neural network model by using an independent test data set to evaluate the performance and accuracy of the neural network model;
S7: the trained neural network model is deployed into a defibrillator to achieve adaptive adjustment of defibrillation voltages.
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