CN1929779A - 基于信号质量度量而选择用于脉冲血氧计的整体平均权数 - Google Patents

基于信号质量度量而选择用于脉冲血氧计的整体平均权数 Download PDF

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CN1929779A
CN1929779A CNA2005800073872A CN200580007387A CN1929779A CN 1929779 A CN1929779 A CN 1929779A CN A2005800073872 A CNA2005800073872 A CN A2005800073872A CN 200580007387 A CN200580007387 A CN 200580007387A CN 1929779 A CN1929779 A CN 1929779A
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克拉克·R·小贝克
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Nellcor Puritan Bennett LLC
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/145—Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissue
    • A61B5/1455—Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissue using optical sensors, e.g. spectral photometrical oximeters
    • A61B5/14551—Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissue using optical sensors, e.g. spectral photometrical oximeters for measuring blood gases
    • A61B5/14552—Details of sensors specially adapted therefor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/02—Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/72—Signal processing specially adapted for physiological signals or for diagnostic purposes
    • A61B5/7203—Signal processing specially adapted for physiological signals or for diagnostic purposes for noise prevention, reduction or removal
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/72—Signal processing specially adapted for physiological signals or for diagnostic purposes
    • A61B5/7221—Determining signal validity, reliability or quality

Abstract

本发明揭示一种用于在脉冲血氧计中整体平均信号的方法和系统，其包括：从灌血组织部分中接收对应于两种不同光波长的第一和第二电磁辐射信号，获得所述电磁信号的信号质量的评估，使用所述信号质量的评估来选择用于一整体平均器的权数，和使用所述整体平均器来整体平均所述电磁信号。

Description

基于信号质量度量而选择用于脉冲血氧计的整体平均权数
技术领域
本发明一般涉及血氧计，且更具体而言，涉及用于整体平均信号的整体平均权数的选择，所述整体平均信号包括来自脉冲血氧计的经检测波形。
背景技术
脉冲血氧计通常用于测量各种血液特征，包括患者的动脉血液中血红蛋白的血氧饱和度和脉冲率。这些特征的测量已通过使用非侵入性传感器来完成，所述非侵入性传感器使光通过患者体内灌血组织部分，并光电地感测光在这些组织中的吸收和散射。接着利用所属领域中已知的各种算法，将所吸收和散射的光的量用于估算组织中血液成分的量。脉冲血氧定量法中的“脉冲”来自心搏周期组织中动脉血液的时变量。从感测到的光学测量处理的信号是熟悉的体积描记波形，所述波形与穿过患者体内灌血组织部分的光能的周期性衰减相对应。
整体平均(是时间平均方案)涉及加权因子的使用。在脉冲血氧计中，整体平均用于计算新样本和来自早先一个脉冲周期的先前经整体平均样本的加权平均值。针对整体平均而选择和/或使用的权数对整体平均处理具有重要影响。可均一地选择这些权数，或这些权数可基于被整体平均的信号的特征。例如，Conlon美国专利第4,690,126号揭示一种整体平均，其中向不同的脉冲分配不同的权数，且复合的平均脉冲波形用于计算氧饱和度。用于调节整体平均权数的Conlon的信号度量基于运动伪影程度的测量、低灌注程度的测量(例如，低于阈值的脉冲幅值)和脉冲率。
然而，需要提供更灵活和更稳健的方法来用于选择用于整体平均信号的整体平均权数，这些信号包括来自脉冲血氧计的经检测波形。
发明内容
本发明针对用于整体平均与来自脉冲血氧计的经检测波形相对应的信号的整体平均权数的选择。整体平均权数的选择是基于一个或一个以上各种信号质量度量或指示的，或基于其组合的。在一个实施例中，本发明提供整体平均脉冲血氧计中的信号的方法。所述方法包括：从灌血组织部分中接收对应于两种不同光波长的第一和第二电磁辐射信号；获得电磁信号的信号质量的评估；利用信号质量评估来选择用于整体平均器的权数；和利用整体平均器来整体平均电磁信号。
一方面，整体平均权数的选择涉及各种信号质量指示的评估和使用，其中选择权数包括形成以下信号质量参数中的一者或一者以上的组合，即：信号的心律失常程度的测量值、第一与第二电磁辐射信号之间的类似性或相关性的程度的测量值、通过获得信号的当前脉冲幅值与长期平均脉冲幅值的比值而得到的运动伪影的程度的测量值、信号的当前脉冲幅值与先前脉冲幅值的比值，和信号的当前脉冲周期与平均脉冲周期的比值。
为了进一步理解本发明的性质和优点，可参考结合附图所说明的以下实施方式。
附图说明
图1是示范性血氧计的方框图。
图2是根据本发明的一个实施例的脉冲血氧计的信号处理架构的方框图。
具体实施方式
根据本发明的实施例的方法和系统针对用于整体平均与来自脉冲血氧计的经检侧波形相对应的信号的整体平均权数的选择。整体平均权数的选择是基于一个或一个以上的各种信号质量度量或指示，或基于其组合的。本发明的实施例特别可用于在脉冲血氧计监视器和脉冲血氧传感器中对动脉血液中血红蛋白的氧饱和度和脉冲或心率进行测量，且将参考这些测量对这些实施例进行解释。然而，应意识到，本发明的实施例同样可用于任何一般的患者监视器和相关的患者传感器，诸如ECG、血压等，且因而可用于非血氧定量装置或脉冲血氧装置。
典型的脉冲血氧计测量两个生理参数，动脉血血红蛋白的氧饱和度百分比(SpO2或sat)和脉冲率。可利用各种技术估算氧饱和度。在一项常见技术中，调节和处理由光电检测器产生的光电流以确定红光对红外(IR)信号的调制比的比(比率比)。已观察到这个调制比与动脉氧饱和度密切相关。通过在对一组患者、健康的志愿者或动物体内测得的动脉氧饱和度(SaO2)的范围内测量调制比，可凭经验校准脉冲血氧计和传感器。所观察到的相关性将基于患者调制比的测量值而反过来用于估算血液的氧饱和度(SpO2)。在1998年12月29日申请的题为“METHOD AND APPARATUS FORESTIMATING PHYSIOLOGICAL PARAMETERS USING MODEL-BASED ADAPTIVEFILTERING”的美国专利第5,853,364号中和1990年3月27日申请的题为“METHODAND APPARATUS FOR DETECTING OPTICAL PULSES”的美国专利第4,911,167号中描述了利用调制比来估算氧饱和度，其全文以引用的方式并入本文中以用于所有目的。1997年7月8日申请的题为“MEDICAL SENSOR WITH MODULATED ENCODINGSCHEME”的美国专利第5,645,059号中描述了氧饱和度与调制比之间的关系，其全文以引用的方式并入本文中以用于所有目的。大多数脉冲血氧计提取具有第一确定饱和度或脉冲率的体积描记信号，所述第一确定饱和度或脉冲率均对干扰敏感。
图1是可经配置以实施本发明的实施例的脉冲血氧计的一个实施例的方框图。本发明的实施例可实施为由微处理器122执行的数据处理算法，如下文所述。来自光源110的光传输至灌血组织112中，且散射并被光电检测器114检测到。含有光源和光电检测器的传感器100还可含有编码器116，其提供指示光源110的波长的信号，以允许血氧计选择合适的校准系数来计算氧饱和度。编码器116例如可以是电阻器。
传感器100连接到脉冲血氧计120。血氧计包括连接到内部总线124的微处理器122。RAM存储器126和显示器128也连接到总线。时间处理单元(TPU)130向光驱动电路132提供计时控制信号，所述光驱动电路132控制光源110进行照明的时间，且如果使用多个光源，那么将有多路计时用于不同光源。TPU130还控制来自光电检测器114且通过放大器133和开关电路134的信号的门控接通。视多个光源中在照明的那一光源而定(如果使用多个光源)，在适当的时间对这些信号进行取样。所接收的信号通过放大器136、低通滤波器138和模拟到数字转换器140。数字数据接着被存储在队列串行模块(QSM)142中，用于稍后当QSM142装满时下载到RAM126。在一个实施例中，可具有独立放大器、滤波器和A/D转换器的多个并联路径，以用于所接收的多个光波长或波谱。
基于对应于由光电检测器114接收的光的所接收信号的值，微处理器122将使用各种算法计算氧饱和度。这些算法需要靠经验确定的、对应于(例如)所使用的光的波长的系数。这些系数被存储在ROM146中。在两波长系统中，通过由特定传感器100中对应于特定光源的编码器116指示的值来确定针对任何波谱对而选择的特定系数组。在一个实施例中，可分配多个电阻器值来选择不同组系数。在另一实施例中，使用相同的电阻器以自适用于近红光源或远红光源成对的红外光源的系数中选择。可使用来自控制输入端154的控制输入来选择在近红光源与远红光源之间进行的选择。控制输入端154可以是(例如)脉冲血氧计上的开关、键盘或提供来自远程主机计算机的指令的端口。此外，任何数目的方法或算法可用于确定患者的脉冲率、氧饱和度或任何其他所需的生理参数。
上文陈述的示范性脉冲血氧计的简要描述充当一个基础，来描述用于调节整体平均器的整体平均权数的方法，其将在下文结合图2加以描述。
本发明的实施例可实施为较大的信号处理系统的一部分，所述信号处理系统用于处理用于操作脉冲血氧计的光信号。图2中展示此类信号处理系统，其是根据本发明的一个实施例的脉冲血氧计的信号处理架构的方框图200。根据本发明的实施例的信号处理架构200可实施为由脉冲血氧计的处理器来执行的软件算法。除了计算氧饱和度和脉冲率之外，系统200测量用于确定滤波器加权系数的各种信号度量。信号度量是指示脉冲是否可能是体积描记器或是噪音的东西。信号度量可以与(例如)频率(是否在人体心率的范围内)、形状(形状是否像心脉)、上升时间等相关。图2中所示的系统计算氧饱和度和脉冲率。系统200还用于检测静脉脉动和传感器偏离和丢失脉冲的情况，这些会在下文单独描述。
I.氧饱和度计算
区块202表示信号调节区块的操作。通过以下步骤来于该区块中接收和调节数字化红光和IR信号或波形：(1)进行第一次求导来除去基线位移，(2)用固定系数进行低通滤波，和(3)除以DC值来保留比值。信号调节子系统的功能在于突出人体体积描记器中出现的较高频率，且在于衰减常集中运动伪影的低频率。信号调节子系统基于初始化期间所识别的硬件特征来选择其滤波器系数(宽带或窄带)。输入至区块202的输入是数字化的红光和IR信号，且其输出是经预处理的红光和IR信号。
区块204表示脉冲识别和鉴定区块的操作。将低通滤波的数字化红光和IR信号提供给这个区块来识别脉冲，且将其鉴定为可能的动脉脉冲。此操作可使用预训练神经网络来完成，且主要对IR信号执行。通过检查脉冲的幅值、形状和频率来识别脉冲。输入至这个区块的输入是来自区块208的平均脉冲周期。这个功能使用脉冲率改变前面的鉴定。区块204的输出指示心律失常的程度和个体的脉冲质量。输入至区块204的输入是：(1)经预处理的红光和IR信号；(2)平均脉冲周期；和(3)来自低通滤波器的低通波形。来自区块204的输出包括：(1)心律失常程度；(2)脉冲幅值变化；(3)个体的脉冲质量；(4)脉冲蜂鸣通知；和(5)合格的脉冲周期和龄期。
区块206用于计算信号质量度量。这个区块(区块206)确定脉冲形状(例如，导数偏斜度)、脉冲幅值和变率、比率比的变率和相对于脉冲率的频率组成。输入至区块206的输入包括：(1)原始的数字化红光和IR信号；(2)心律失常程度、个体脉冲质量、脉冲幅值变化；(3)经预处理的红光和IR信号；和(4)平均脉冲周期。来自区块206的输出包括：(1)低通和整体平均滤波器权数；(2)传感器偏离检测器的度量；(3)标准化的经预处理的波形；和(4)调制百分比。
区块208计算平均脉冲周期。这个区块(区块208)根据所接收的脉冲计算平均的脉冲周期。输入至区块208的输入包括：合格的脉冲周期和龄期。来自区块208的输出包括平均脉冲周期。
区块210表示低通滤波器和整体平均子系统的功能。区块210低通滤波并整体平均由区块206处理的标准化的和经预处理的波形。由信号度量区块206确定低通滤波器的权数。使用同样由信号度量区块206确定的整体平均滤波器权数来同样地整体平均信号(即，接近脉冲率和其谐波的相关频率以外的频率被衰减)。如果信号被标记为降级，那么就分配较小的权数。如果信号被标记为心律失常，那么就分配较大的权数，因为在心律失常期间不适合进行整体平均。红光和IR波形被单独处理，但使用相同的滤波权数。滤波经延迟(例如约1秒)以允许首先计算信号度量。
滤波器连续使用可变的权数。如果样本没有被整体平均，那么在经加权的平均值中将先前过滤的样本的权数设置为零，且仍通过算法处理新的样本。这个区块跟踪信号的龄期和/或滤波的累计量(即处理中响应时间和延迟的和)。如果一段时间内没有检测到良好的脉冲，那么将标记结果过旧。输入至区块210的输入包括：(1)标准化的经预处理的红光和IR信号；(2)平均脉冲周期；(3)低通滤波器权数和整体平均滤波器权数；(4)ECG触发器(如果可用)；和(5)针对过零触发器的IR基波。来自区块210的输出包括：(1)经滤波的红光和IR信号和(2)龄期。
区块212表示估算经滤波的波形的比率比方差和计算平均权数的操作。由比率比方差控制滤波器的可变加权。此可变权数滤波的效应是当伪影增加时比率比改变较慢，且当伪影减少时改变较快。子系统具有两个响应模式，包括快速模式和正常模式。举例而言，快速模式中的滤波以3秒的龄期度量为目标，且在正常模式中目标龄期可以是5秒。在快速模式中，当前值的最小加权夹持于较高水平。换句话说，如果存在噪音，那么就将低权数分配给最新的比率比计算，且如果没有噪音，那么就分配高权数。输入至区块212的输入包括：(1)经滤波的红光和IR信号和龄期；(2)校准系数；和(3)响应模式(例如，用户速度设置)。来自区块212的输出包括比率比计算的平均权数。平均权数用作输入至区块214的输入，连同经滤波的IR和红光波形一起来计算经平均的比率比和龄期。
区块216表示计算氧饱和度的操作。利用具有校准系数和经平均的比率比的算法来计算饱和度。输入至区块116的输入包括：(1)经平均的比率比；和(2)校准系数。来自区块216的输出是氧饱和度值。
II.脉冲率计算
区块218低通滤波并整体平均由区块202调节的信号，以用于脉冲率识别。由信号度量区块206确定低通滤波器的权数。同样整体平均信号(即，接近脉冲率和其谐波的相关频率以外的频率被衰减)，且同样通过信号度量模块206确定整体平均滤波器权数。如果信号被标记为降级，那么将分配较小的权数。如果信号被标记为心律失常，那么就分配较大的权数，因为心律失常期间不适合进行整体平均。单独处理红和IR波形。滤波经延迟(例如，约1秒)以允许首先计算信号度量。
滤波器连续使用可变的权数。如果样本未经整体平均，那么在加权的平均值中将先前经滤波的样本的权数设置为零，且仍通过算法处理新的样本。这个区块(区块218)跟踪信号的龄期和/或滤波的累计量(处理中响应时间和延迟的和)。将标记结果过旧(如果一段时间内没有检测到良好的脉冲)。输入至区块218的输入包括：(1)经预处理的红光和IR信号；(2)平均脉冲周期；(3)低通滤波器权数和整体平均滤波器权数；(4)ECG触发器(如果可用)；和(5)针对过零触发器的IR基波。来自区块218的输出包括：(1)经滤波的红光和IR信号和(2)龄期。
区块220或经滤波的脉冲识别和鉴定区块自经滤波的波形计算脉冲周期，且仅当区块204认为脉冲不合格时才使用其结果。输入至区块220的输入包括：(1)经滤波的红光和IR信号和龄期；(2)平均脉冲周期；(3)硬件ID或噪音基准；(4)和用于检测IR和红光能量的传感器的种类或类型。来自区块220的输出包括合格的脉冲周期和龄期。
区块222或平均脉冲周期和计算脉冲率区块计算脉冲率和平均脉冲周期。这个区块(区块222)接收合格的脉冲周期和龄期作为输入，且提供以下内容作为输出：(1)平均脉冲周期和(2)脉冲率。
III.静脉脉动
区块224或检测静脉脉动区块从区块202接收作为输入的经预处理的红光和IR信号和龄期，和脉冲率，且提供静脉脉动的指示作为输出。区块224还使用单齿梳状滤波器在时域中提供输入到整体平均滤波器(例如区块210和218)的IR基波波形。输入至区块224的输入包括：(1)经滤波的红光和IR信号和龄期和(2)脉冲率。来自区块224的输出包括：静脉脉动指示和IR基波。在一个实施例中，区块224测量IR红光Lissajous图的“开度”以确定是否应设置标记(例如，Venous_Pulsation)。输出标记(例如，Venous_Pulsation)周期性地(例如，每秒)更新。此外，IR基波波形输出到整体平均滤波器。
IV.传感器偏离
区块226或检测传感器偏离和脉冲幅值损耗区块使用预训练神经网络来确定传感器是否偏离(例如)患者体内灌血组织的表面。输入至神经网络的输入是在最后几秒内鉴定IR和红光值的性质的若干方面的度量。当信号状态既不指示脉冲存在，也不指示传感器并非位于监视点时(即，脉冲存在、断开连接、脉冲丢失、传感器可能偏离和传感器偏离)，系统200的诸多子系统将忽略样本。输入至区块226的输入包括：(1)信号质量度量；和(2)血氧计LED亮度、放大器增益；和(3)指示血氧计硬件配置的ID。来自区块226的输出包括一信号状态，其包括传感器偏离指示。
在上述架构200中，可利用来自信号处理架构的若干部分的信息得到区块226的功能：脉冲丢失和脉冲搜索指示。另外，如果没有连接有效的传感器，或如果信号处理架构检测到传感器偏离或脉冲幅值损耗，那么信号处理架构将不使用所接收的IR和红光波形来计算氧饱和度或脉冲率。
根据本发明的脉冲血氧计信号处理架构的实施例的简要描述(上文所陈述的)充当一个基础，用于针对整体平均权数的选择的方法和装置，所述整体平均权数用于整体平均与自脉冲血氧计检测所得的波形相对应的信号，如一般由上文区块210和218所指示的。
整体平均权数
如上文所述，整体平均权数的选择是基于一个或一个以上各种信号质量度量或指标，或基于其组合。具体而言，在一个实施例中，用于调节整体平均权数的度量包括心律失常程度的测量。这个度量用于在患者表现为心律失常时减少整体平均程度，因为整体平均对于具有高度可变频率组成的信号来说运作不佳。用于调节整体平均权数的另一度量包括比率比的可变率程度的测量(例如，IR与红光波形之间缺少类似性或相关性)。这个度量对移动或其他噪音源的存在比较敏感。这个度量不同于其他现有技术(诸如Conlon)中已知的度量，Conlon教示一在大概来自相同波长的当前与先前脉冲波形之间比较类似性的度量，而不是不同波长下两个同时存在的波形之间的类似性。用于调节整体平均权数的另一度量包括当前脉冲幅值与长期平均脉冲幅值的比值。长期平均脉冲幅值是指当所有脉冲都合格时响应时间可能为一分钟的平均值，且如果大多数脉冲不合格的话，那么响应时间会有数倍长。这个度量经设计来捕获运动伪影程度，这类似于Conlon度量，然而，这个度量是模拟度量，而Conlon度量只具有几个离散状态(例如，无伪影、低度伪影、高度伪影)。用于调节整体平均权数的另一度量包括当前脉冲幅值与先前脉冲幅值的比值。这个度量用于当大的运动伪影开始或停止时快速改变整体平均权数。用于调节整体平均权数的另一度量包括针对单个脉冲的总信号质量度量的测量，这个度量自身是若干其他度量(包括上文所述的度量)的组合。这个度量用于在运动伪影减退且假设输入波形的质量优于经重度整体平均的波形时快速减少整体滤波。用于调节整体平均权数的另一度量包括当前脉冲周期与平均脉冲周期的比值。这个度量用于在心脏停跳一拍的情况下(有时候会在很多人身上发生)减少整体滤波。
当子系统(210和/或218)被通知脉冲识别和鉴定子系统(204)已完成潜在脉冲的估算时，子系统更新例如由整体平均子系统使用的整体平均权数。针对将输出用于计算饱和度和脉冲率的两个整体平均的例子来计算单独的权数。这些权数部分基于由脉冲识别和鉴定子系统(其输入波形尚未经整体平均)的例子提供的度量。
对于Sat_Ensemble_Averaging_Filter_Weight的等式如下：
x＝max(Short_RoR_Variance，Pulse_Qual_RoR_Variance/1.5)*
max(Long_Term_Pulse_Amp_Ratio，1.0)
RoR_Variance_Based_Filt_Wt＝0.5*0.05/max(0.05，x)
Arr_Prob＝(Period_Var-0.1*Short_RoR_Variance-0.09)/(0.25-0.09)；Arr_Min_Filt_Wt_For_Sat＝0.05+0.5*bound(Arr_Prob，0，1.0)Sat_Ensemble_Averaging_Filter_Weight＝max(RoR_Variance_Based_Filt_Wt，
Arr_Min_Filt_Wt_For_Sat)*(1.0+Pulse_Qual_Score)
Sat_Ensemble Averaging_Filter_Weight＝min(Sat_Ensemble_Averaging_Filter_Weight，1.0)，
其中bound(a，b，c)表示min(max(a，b)，c)
上述等式在比率比方差的较低值时得到默认权数0.5。Short_RoR_Variance和Pulse_Qual_RoR_Variance是在一段时间间隔内计算出的(例如三秒的间隔)。Pulse_Qual RoR_Variance的间隔以常包括最新近样本的最新近脉冲的合格或否决而结束。用较高的比率比方差且用通常指示运动伪影的Long_Term_Pulse_Amp_Ratio的较高值来减少权数。Arr_Min_Filt_Wt_For_Sat主要基于量化心律失常程度的Period_Var将最小值赋予整体平均权数(范围为0.05-0.55)。这样做是因为整体平均对具有不相似周期的脉冲不够有效。如果最新近的脉冲接收到良好的Pulse_Qual_Score，那么这可使Sat_Ensemble_Averaging_Filter_Weight的最大值从0.5增加到1.0。
对于Rate_Ensemble_Averaging_Filter_Weight的等式如下：
Arr_Prob＝(Period_Var-0.07)/(0.20-0.07)
Arr_Min_Filt_Wt_For_Rate＝0.05+0.5*bound(Arr_Prob，0，1.0)
x＝max(RoR_Variance_Based_Filt_Wt，Arr_Min_Filt_Wt_For_Rate)*(1.0+Pulse_Qual_Score)
如果Short_Term_Pulse_Amp_Ratio*Long_Term_Pulse_Amp_Ratio＜1.0
x＝x/Short_Term_Pulse_Amp_Ratio
如果Avg_Period＞0
x＝x*bound(Pulse_Qual_Score*Qualified_Pulse_Period/Avg_Period，1.0，3.0)
则Rate_Ensemble_Averaging_Filter_Weight＝min(x，1.0)
这些等式与Sat_Ensemble_Averaging_Filter_Weight等式的不同之处如下：
a)用于计算Arr_Prob的阈值稍低，因为需要在脉冲鉴定之前，心律失常脉冲不会因整体平均而混淆。
b)Short_Term_Pulse_Amp_Ratio的较小值通常指示运动伪影已减退，这意味着可快速增加整体平均权数。根据经验可发现这对脉冲鉴定有利，而并非对比率比滤波和饱和度计算有利。
c)如果在具有或没有先前的心律失常的情况下心脏跳过一拍，那么所得的长于平均值的Qualified_Pulse_Period将增加整体平均权数，从而不会使跳过的一拍和随后的脉冲鉴定混淆。
一方面，将已如上文所述而确定的整体平均权数用于两个单独的整体平均器来处理检测到的波形，以用于计算氧饱和度和脉冲率。用于计算氧饱和度的整体平均器对已标准化的信号操作，而用于脉冲率计算的整体平均器对未标准化的信号操作。在转让给本文受让人的题为“Pulse Oxiemter with Separate Ensemble Averaging for Oxygen Saturationand Heart Rate”的代理人案号为TTC-009103-022700US的共同待决的专利申请案中(描述对氧饱和度和心率进行单独的整体平均的脉冲血氧计，该案全文以引用的方式并入本文以用于所有目的。在此专利申请案中，可改变通过两个整体平均器为所述两条路径选择的度量，以最优化氧饱和度或脉冲率计算的整体平均。例如，与计算氧饱和度相比，当用以计算脉冲率时，将较低的阈值用于检测心律失常脉冲的度量。同样，当运动伪影已减退时，用于短期脉冲幅值的度量会较小，且这将在脉冲率计算中提供比在氧饱和度计算中更大的权数。
定义：
数据输入
Avg_Period—由脉冲率计算子系统报告的平均脉冲周期。
Long_Term_Pulse_Amp_Ratio—与之前的脉冲幅值相比量化最新脉冲幅值。由脉冲识别和鉴定子系统提供。实质上大于1.0的值通常指示运动伪影，且得到较低的Ensemble_Averaging_Filter_Weights。
Period_Var—来自脉冲识别和鉴定子系统的周期变率度量。用于测定心律失常的范围。例如，值0.10将指示连续脉冲周期之间的平均差是Avg_Period的10％。
Pulse_Qual_RoR_Variance—来自脉冲识别和鉴定子系统的RoR_Variance度量。
Pulse_Qual_Score—由脉冲鉴定神经网络在脉冲识别和鉴定子系统中计算所得的得分。零是极差，且1.0是优秀。
Qualified_Pulse_Period—由脉冲识别和鉴定子系统鉴定的最新近的脉冲周期。
Short_Term_Pulse_Amp_Ratio—与先前的脉冲幅值相比量化最后脉冲幅值。
输出
Frequency_Ratio-Mean_IR_Frequency_Content与脉冲率的比值。
LPF_RoR_Variance—量化比率比的变率。根据LPF_Scaled_Waveforms在9秒窗口中计算。
Rate_LPF_Weight—预处理脉冲鉴定和脉冲率计算中所用的波形的整体平均子系统的例子将使用的低通滤波器权数。
RoR_Variance—量化比率比的变率。根据Scaled_Waveforms在9秒窗口中计算。例如，值0.10将指示样本到样本的比率比值与平均比率比的值平均相差平均比率比的值的10％。
Sat_Ensemble_Averaging_Filter_Weight—预处理脉冲鉴定和脉冲率计算中所用的波形的整体平均子系统的例子将使用的整体平均权数。
Sat_LPF_Weight—预处理脉冲鉴定和脉冲率计算中所用的波形的整体平均子系统的例子将使用的低通滤波器权数。
Scaled_Waveforms—IR和红光Pre_Processed_Waveforms的缩放型式。
Short_RoR_Variance—量化比率比的变率。根据Scaled_Waveforms在3秒窗口中计算。
内部变量
Arr_Prob—将限制整体平均量的心律失常的可能性。基于Period_Var，采用特定用于两个Ensemble_Averaging_Filter_Weights中的每一者的阈值。
Arr_Min_Filt_Wt_For_Rate，Arr_Min_Filt_Wt_For_Sat—对于两个Ensemble_Averaging_Filter_Weights的最小值，基于其各自的Arr_Prob值。
LPF_Scaled_Waveforms-Scaled_Waveform的低通滤波型式，用于计算LPF_RoR_Variance。
Mean_IR_Frequency_Content-IR输入波形的平均频率组成的估算。用于计算Frequency_Ratio度量。
RoR_Variance_Based_Filt_Wt—基于RoR_Variance度量和Long_Term_Pulse_Amp_Ratio的Ensemble_Averaging_Filter_Weights的分量。
因此，所属领域中的技术人员将了解，在不脱离本发明的本质特征的情况下，关于整体平均权数的选择的本发明可以其他特定形式来实施。例如，尽管在时域中描述这些实施例，但基于频率的方法可同等地相关于本发明的实施例。因此，前文揭示内容意图用于说明，而并非限制以上权利要求书中所陈述的本发明范畴。

Claims (18)

1.一种用于在一脉冲血氧计中整体平均信号的方法，其包含：
从一灌血组织部分接收对应于两种不同光波长的第一和第二电磁辐射信号；
获得所述电磁信号的信号质量的一评估；
使用信号质量的所述评估来选择用于一整体平均器的权数；和
使用所述整体平均器来整体平均所述电磁信号。
2.根据权利要求1所述的方法，其中所述获得所述信号质量的一评估包含获得所述信号的心律失常程度的一测量值。
3.根据权利要求2所述的方法，其中所述获得所述信号质量的一评估进一步包含获得所述第一与第二电磁辐射信号之间的类似性或相关性的程度的一测量值。
4.根据权利要求1所述的方法，其中所述获得所述信号质量的一评估包含获得所述信号中存在的运动伪影的程度的一测量值。
5.根据权利要求4所述的方法，其中所述获得运动伪影的程度的一测量值包含获得所述信号的一当前脉冲幅值与长期平均脉冲幅值的一比值。
6.根据权利要求1所述的方法，其中所述获得所述信号质量的一评估包含获得所述信号的一当前脉冲幅值与先前脉冲幅值的一比值。
7.根据权利要求1所述的方法，其中所述获得所述信号质量的一评估包含获得一单个脉冲的总信号质量度量的程度的一测量值，所述度量自身为若干其他度量的一组合。
8.根据权利要求1所述的方法，其中所述获得所述信号质量的一评估包含获得所述信号的一当前脉冲周期与一平均脉冲周期的一比值。
9.根据权利要求1所述的方法，其中所述选择权数包含形成一个或一个以上参数的一组合，所述参数选自由以下项目组成的群组：所述信号的心律失常程度的一测量值、所述第一与第二电磁辐射信号之间的类似性或相关性的程度的一测量值、通过获得所述信号的一当前脉冲幅值与长期平均脉冲幅值的一比值而得到的运动伪影的程度的一测量值、所述信号的一当前脉冲幅值与先前脉冲幅值的一比值，和所述信号的一当前脉冲周期与一平均脉冲周期的一比值。
10.一种用于在一脉冲血氧计中整体平均信号的装置，其包含：
接收构件，其用于从一灌血组织部分接收对应于两个不同光波长的第一和第二电磁辐射信号；
获得构件，其用于获得所述电磁信号的信号质量的一评估；
选择构件，其用于使用信号质量的所述评估来选择用于一整体平均器的权数；和一整体平均器，其用于使用所述权数来整体平均所述电磁信号。
11.根据权利要求10所述的装置，其中所述用于获得所述信号质量的一评估的构件经配置以用于获得所述信号的心律失常程度的一测量值。
12.根据权利要求11所述的装置，其中所述用于获得所述信号质量的一评估的构件进一步经配置以用于获得所述第一与第二电磁辐射信号之间的类似性或相关性的程度的一测量值。
13.根据权利要求10所述的装置，其中所述用于获得所述信号质量的一评估的构件经配置以用于获得所述信号中存在的运动伪影的程度的一测量值。
14.根据权利要求10所述的装置，其中所述用于获得所述信号质量的一评估的构件经配置以用于获得所述信号的一当前脉冲幅值与长期平均脉冲幅值的一比值。
15.根据权利要求10所述的装置，其中所述用于获得所述信号质量的一评估的构件经配置以用于获得所述信号的一当前脉冲幅值与先前脉冲幅值的一比值。
16.根据权利要求10所述的装置，其中所述用于获得所述信号质量的一评估的构件经配置以用于获得一单个脉冲的总信号质量度量的程度的一测量值，所述度量自身为若干其他度量的一组合。
17.根据权利要求10所述的装置，其中所述用于获得所述信号质量的一评估的构件经配置以用于获得所述信号的一当前脉冲周期与一平均脉冲周期的一比值。
18.根据权利要求10所述的装置，其中所述用于选择权数的构件经配置以用于形成一个或一个以上参数的一组合，所述参数选自由以下项目组成的群组：所述信号的心律失常程度的一测量值、所述第一与第二电磁辐射信号之间的类似性或相关性的程度的一测量值、通过获得所述信号的一当前脉冲幅值与长期平均脉冲幅值的一比值而得到的运动伪影的程度的一测量值、所述信号的一当前脉冲幅值与先前脉冲幅值的一比值，和所述信号的一当前脉冲周期与一平均脉冲周期的一比值。
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US20110092785A1 (en) 2011-04-21
US8560036B2 (en) 2013-10-15
EP1729631A1 (en) 2006-12-13
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US20090082651A1 (en) 2009-03-26
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US7194293B2 (en) 2007-03-20
US20070208242A1 (en) 2007-09-06
US7890154B2 (en) 2011-02-15
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US20050197549A1 (en) 2005-09-08
US20140031652A1 (en) 2014-01-30
US9211090B2 (en) 2015-12-15
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US7474907B2 (en) 2009-01-06
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