CN211883777U - Korotkoff sound-based blood pressure measurement and cardiovascular system evaluation system - Google Patents
Korotkoff sound-based blood pressure measurement and cardiovascular system evaluation system Download PDFInfo
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- CN211883777U CN211883777U CN201922206579.8U CN201922206579U CN211883777U CN 211883777 U CN211883777 U CN 211883777U CN 201922206579 U CN201922206579 U CN 201922206579U CN 211883777 U CN211883777 U CN 211883777U
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Abstract
The utility model discloses a blood pressure measurement and cardiovascular system evaluation system based on korotkoff sound, it aims at solving prior art, and blood pressure measurement is not accurate, individual difference influences the big problem of measuring result. The utility model discloses a carry out information detection in radial artery department and combine the technological means of intelligent pressurization and intelligent pressure release, the signal source is stable, has ensured the accurate seizure of korotkoff sound to measuring result's stability and reliability have been improved. And simultaneously, the utility model discloses can combine to detect measurement result calculation according to human basic information and obtain human cardiovascular parameter, input human age, height, sex, weight, information such as arm length, handle through the algorithm, obtain the cardiac function parameter of some lists such as measuring PWV, heartbeat, heart transfusion, blood viscosity, help the state of the cardiovascular system of inspector aassessment self.
Description
Technical Field
The utility model belongs to the technical field of medical science detects, specific theory indicates a blood pressure measurement and cardiovascular system evaluation system based on korotkoff sound.
Background
The blood pressure measuring instrument is mainly used for measuring the blood pressure of a human body and is generally applied to the prevention and treatment of blood pressure abnormity. The accuracy of blood pressure measurements is directly related to prophylactic and therapeutic effects, such as: the blood pressure measurement is inaccurate, and the effective basis is lost for treatment; the measured data are incorrect, and not only can hypertension not be treated, but also wrong medicine taking and wrong treatment can be caused, and even health and life are endangered. Whether the blood pressure can be measured accurately is the key to the accuracy and stability of the blood pressure measuring instrument.
At present, although blood pressure measuring instruments on the market are various in types and brand forest, the existing blood pressure measuring instruments are mainly divided into two categories from the working method and principle of the blood pressure measuring instruments: the method comprises the steps of invasive measurement and non-invasive measurement, wherein the invasive measurement is difficult to implement and not strong in applicability due to complex operation; the non-invasive measurement method effectively avoids the defects of the invasive measurement method, so the existing blood pressure measuring instruments generally adopt the non-invasive measurement method, and the blood pressure measuring instruments applying the non-invasive measurement method are most common in korotkoff sound method blood pressure meters and oscillography electronic blood pressure meters.
Electronic sphygmomanometer by oscillography
The oscillometric process of measuring blood pressure is identical to the Korotkoff sound method in that the cuff is pressurized to block the blood flow of the brachial artery, and then slowly depressurized, during which small pulses of sound and pressure are transmitted from the arm. Oscillometric sphygmomanometers operate by looping the cuff around the limb, increasing the pressure in the cuff until arterial blood flow is blocked, and then slowly decreasing the pressure in the cuff. During the inflation and deflation of the cuff, small pressure changes (fluctuations) occur in the cuff as a result of the arterial blood pressure pulsations, the pulsation waves with increasing and decreasing amplitudes are detected and stored with the corresponding cuff pressure in the measurement system, and the systolic, diastolic and mean arterial pressures are calculated by suitable mathematical methods. The oscillometric blood pressure measuring technology is a measuring method widely adopted in blood pressure automatic measuring instruments at present, the criterion is given by a statistical method through a large number of crowd experiments, and therefore, the oscillometric blood pressure measurement has obvious defects: i.e. there is a large error between the individual measurements. The electronic sphygmomanometer based on the oscillometric method calculates the blood pressure, namely, the average pressure is calculated by using oscillation pulse waves in the process of boosting or reducing the blood pressure, and the measured blood pressure value is finally obtained through a certain mathematical algorithm (the algorithm is not uniform and the individual difference is large). From this, it is known that the "measurement" result of the electronic sphygmomanometer by the oscillometric method is not accurate, and thus has not been accepted by the mainstream medical field. Oscillometric blood pressure measurement has two fatal defects: firstly, the oscillography is easy to interfere, but an intangible wave cannot judge whether the interference is generated; secondly, the universality of the algorithm is unscientific, and the blood pressure of different people can be converted by the same algorithm, which not only is the problem of measurement error, but also can cause misdiagnosis, so that the electronic sphygmomanometer based on the oscillography can not replace the Korotkoff auscultatory method medically.
(II) Korotkoff's sound method sphygmomanometer
A Korotkoff sound method sphygmomanometer is used for measuring based on a Korotkoff sound method (indirect measurement), wherein the process of measuring the blood pressure by the Korotkoff sound method is to pressurize a cuff to block the blood flow of a brachial artery, then slowly reduce the pressure, and in the meantime, sound and small pressure pulses are transmitted from an arm; along with deflation and pressure reduction, the blood flow always rushes open the blood vessel when the external pressure is slightly lower than the internal pressure peak, and a first Korotkoff sound is emitted; the last korotkoff sound appears before the external pressure is slightly higher than the internal pressure, and then it is silent. The Korotkoff sound method for measuring blood pressure has the advantages that: it does not erase personality, but presupposes admission of personality; the Korotkoff's sound method can be used to define blood pressure because it has undoubted certainty that: regardless of any vastly different individual, it does not require modeling, but only the ability to hear the "first" and "last" korotkoff sounds; the nature of the Korotkoff sound method is to "measure" blood pressure rather than "calculate" blood pressure. Therefore, the measurement by the Korotkoff sound method is the currently accepted blood pressure measurement golden standard in the medical field, and the actual application value and the measurement precision of the measurement by the Korotkoff sound method are far higher than those of the measurement by the oscillometric method.
The korotkoff sound sphygmomanometer is mainly divided into a mercury sphygmomanometer and a korotkoff sound electronic sphygmomanometer:
(1) the mercury sphygmomanometer judges systolic and diastolic pressures by auscultation of the first and fifth phases of korotkoff sounds, but generally requires a trained professional and is closely related to the experience and operation of the user, resulting in a very limited range of mercury sphygmomanometers. On the other hand, the mercury sphygmomanometer itself depends on the professional quality of the operator, so that there are artificial subjective errors and objective errors caused by the theoretical defects of the korotkoff sound method, such as: the characteristics of the beginning and the end of the Korotkoff sounds, the pressure errors between the pseudo high pressure, the pseudo low pressure and the pulse beat, sometimes can not give accurate blood pressure measurement values, and sometimes even have larger errors. Meanwhile, the mercury-containing product has great harm to the environment.
(2) The Korotkoff sound electronic sphygmomanometer collects Korotkoff sound signals through an electronic auscultation device for auscultation, but because the Korotkoff sounds are extremely difficult to collect electronically and poor in anti-interference capability, effective Korotkoff sounds and background noises are difficult to separate, and errors of the Korotkoff sounds are derived from professional skill literacy of measuring personnel and whether the measuring process is standardized or not, the Korotkoff sound electronic sphygmomanometer is extremely low in clinical application and is not suitable for conventional family users.
In the prior art, the measurement precision of the Korotkoff sound method still faces the following problems: (1) blood pressure of arrhythmia: the blood pressure of patients with hypertension of early atrial fibrillation and ventricular premature beat is measured by a mercury desktop sphygmomanometer, a barometer sphygmomanometer or an reading-aid sphygmomanometer, but the number of the patients with hypertension is too large, and accurate blood pressure is difficult to measure even if the blood pressure is measured manually. (2) Blood pressure of reflux disorder: the upper arm blood reflux disorder is an unavoidable problem at home and abroad, and is characterized in that the Korotkoff sound volume is reduced suddenly when some people continuously measure the second blood pressure after the first blood pressure measurement during blood pressure measurement, the first sound volume is difficult to find repeatedly, so the measurement fails, and the Korotkoff sound volume is smaller or even difficult to distinguish when the third blood pressure measurement is continuously carried out. (3) Uneven decompression speed affects measurement accuracy: the sphygmomanometer is fast before slow during pressurization and pressure relief, the air pressure does not change at a constant speed, the systolic pressure has a large error, and particularly, the blood pressure level of grade 3 with the pressure of more than 180mmHg is difficult to measure accurately.
In addition, the smart bracelet (watch) released in the market at present also has the function of blood pressure measurement, and the working principle of the smart bracelet (watch) is that the blood pressure measurement value is calculated according to the algorithm through the measured heart rate and pulse wave, but the measurement precision is extremely low, and the smart bracelet (watch) has no application value.
In summary, the prior art cannot meet the urgent need of controlling the blood pressure of a patient at the present stage, and it is desirable to accurately and conveniently measure the blood pressure and to operate stably and reliably.
SUMMERY OF THE UTILITY MODEL
An object of the utility model is to overcome above-mentioned problem, provide one kind and measure accurate convenience, can avoid individual difference influence, be applicable to clinical and domestic measuring blood pressure measurement and cardiovascular evaluation system based on Korotkoff's sound method effectively.
The purpose of the utility model is realized through the following technical scheme:
the utility model provides a blood pressure measurement and cardiovascular system evaluation system based on korotkoff sound, including sleeve area and measurement host computer, the measurement host computer includes:
the central processing module is used for processing signals;
a display screen;
the intelligent pressurizing module is used for inflating and pressurizing the cuff and ensuring that the brachial artery is completely locked;
the intelligent pressure relief module controls the cuff to relieve pressure at a uniform pressure relief speed according to the acquired signal;
a pulse signal acquisition module;
a cuff airbag pressure acquisition module;
the waveform display module displays the waveform of the radial artery pulse wave and the waveform of the brachial artery pulse wave according to the acquired pulse signals;
the cardiovascular parameter calculation module is used for calculating according to the basic information of the human body and the detection measurement result;
and the communication module uploads the detection data to the background.
Further, the intelligent pressurizing module comprises: the device comprises a radial artery fluid pressure vibration sensor, a first four-way valve, an air pump, a pressure sensor, an air storage bag and a closed-loop servo control speed-limiting pressurization flow valve, wherein the air pump, the pressure sensor, the air storage bag and the closed-loop servo control speed-limiting pressurization flow valve are respectively connected with the first four-way valve.
Further, radial artery fluid pressure vibration sensor includes piezoelectric sensor, sealed resonant cavity and silica gel filler layer, the one side on silica gel filler layer does radial artery fluid pressure vibration sensor presses close to the one side that detects the department.
Further, intelligence pressure release module includes: the closed-loop servo control air leakage valve is connected with the brachial artery fluid pressure vibration sensor at the other two ends of the three-way valve respectively; and the other two ends of the second four-way valve are respectively connected with the cuff and the closed-loop servo control speed-limiting pressurized flow valve.
Further, the pulse signal acquisition module comprises the radial artery fluid pressure vibration sensor and the brachial artery fluid pressure vibration sensor; the cuff air bag pressure acquisition module comprises a brachial artery fluid pressure sensor.
Further, closed loop servo control speed limit pressurized flow valve includes that one end is provided with the shell body of proportional valve gas outlet, the other end is provided with the proportional valve air inlet, set up in just possess the proportional valve main part of proportional valve wire in the shell body the proportional valve main part with it has the silica gel layer to fill between the shell body.
Further, the communication module is a 3G module, a 4G module or a 5G module.
Preferably, the cardiovascular parameter calculation module and the waveform display module are integrated with the central processing module.
The implementation method of the blood pressure measurement and cardiovascular system evaluation system based on the Korotkoff sounds comprises the following steps:
(1) opening a speed-limiting pressurizing flow valve controlled by a closed loop servo to intelligently pressurize the cuff, simultaneously acquiring a fluid pressure pulse wave signal of a brachial artery and a fluid pressure pulse wave signal of a radial artery respectively through a brachial artery fluid pressure vibration sensor and a radial artery fluid pressure vibration sensor, acquiring cuff airbag pressure through the brachial artery fluid pressure sensor, and displaying a brachial artery pulse wave, a radial artery pulse wave waveform and a cuff airbag pressure value on a display screen;
(2) acquiring a fluid pressure pulse wave signal of a radial artery through a radial artery fluid pressure vibration sensor, and stopping inflating and pressurizing the cuff air bag when the radial artery fluid pressure pulse wave signal cannot be detected;
(3) closing the closed-loop servo control speed-limiting pressurized flow valve, opening the closed-loop servo control air escape valve, and intelligently and uniformly releasing pressure of the cuff air bag;
(4) in the pressure relief process, when the radial artery fluid pressure vibration sensor detects a fluid pressure pulse wave signal for the first time, the pressure value of the cuff air bag acquired by the brachial artery fluid pressure sensor at the moment is the measured systolic pressure;
(5) judging whether the unloading of the brachial artery blood vessel is finished or not according to the change trend of the pulse wave conduction time PWTT from the brachial artery pulse wave to the radial artery pulse wave;
(6) if the change trend of the pulse wave transmission time PWTT tends to be stable, the unloading of the brachial artery blood vessel is finished, and the measurement is finished; at the critical point when the change trend of the pulse wave transmission time PWTT tends to be stable, the pressure value of the cuff air bag is the measured diastolic pressure;
(7) the closed-loop servo control air escape valve is completely opened and quickly releases air; meanwhile, the detection data is uploaded to the background.
Further, the intelligent pressurization method comprises the following steps: when the machine is started, the air pump inflates the air storage bag through the first four-way valve, and the air storage bag stores high-pressure air; when the detection is started, the air pump and the air storage bag inflate the cuff air bag through the closed-loop servo control speed-limiting pressurized flow valve; the radial artery fluid pressure vibration sensor detects a fluid pressure pulse wave signal at the radial artery in real time, and if the fluid pressure pulse wave signal at the radial artery disappears, the closed-loop servo control speed-limiting pressurized flow valve is closed to complete the gas filling and pressurizing operation of the cuff;
the intelligent pressure relief method comprises the following steps: controlling the opening of a throttle valve of a closed-loop servo control air escape valve, and realizing uniform pressure release of a cuff by adopting a PID algorithm as follows:
s ═ P · (PID parameters). DELTA.P (b)
Wherein S is the opening degree of a throttle valve of the closed-loop servo control air escape valve, delta P is the pressure difference of the cuff air bag between two pulses, the PID parameter is a constant, and P is the current pressure value of the cuff air bag.
Further, the pulse wave conduction velocity PWV on the artery wall is calculated according to the conduction time PWTT from the detected brachial artery pulse wave to the radial artery pulse wave and the conduction time PWTT is equal to L/PWTT, wherein L is the brachial artery fluid pressure vibration sensor and the radial artery fluid.
The design principle of the utility model is as follows: the utility model discloses the people has analyzed the factor that influences the blood pressure accuracy in actual work: (1) a measurement principle; (2) system accuracy and stability; (3) the speed of the exhaust; (4) the width of the cuff; (5) the performance of the sphygmomanometer using the filter; (6) pulse pressure of the patient, etc. The utility model discloses the produced blood pressure signal of standard signal source is found not to receive the influence of human factor, and the signal is stable, and repeatability is good, can get rid of human physiology factor completely to measuring result's influence, fully reflects the blood pressure measuring's condition. Therefore, the utility model discloses an application changes the tradition and relies on the mode of the "listening" of operating personnel professional literacy based on the Korotkoff sound method, adopts the technological means of surveying in disturbing artery department, according to blood flow pressure signal, directly measures the initial point and the finish point of Korotkoff sound, and its detection accuracy is far higher than current electron auscultation mode, has overcome the problem that Korotkoff sound is difficult to detect; simultaneously, combine above-mentioned detection means, the utility model discloses still integrated the aassessment to cardiovascular system, cardiovascular parameter has high reference value to human health.
Different from the traditional blood pressure measurement, the utility model discloses an advantage of the technical means of surveying the pulse signal in radial artery department lies in: (1) the interference is small. The method has the advantages that the interference of an air bag is avoided, the signal quality is greatly improved, the requirements on the quality of the waveform in the detection process are not particularly high, the form amplitude is not required, and only the first pulse wave from the pulse wave of the brachial artery to the radial artery and the delay from the pulse wave of the brachial artery to the pulse wave of the radial artery in a subsequent series need to be detected; (2) the method can be applied to the measurement of PWV value, and is a very valuable index. (3) The cuff structure is not required to be modified, the cuff structure is simple, and a single tube and a single air bag are suitable for a standardized cuff; (4) the highest lock-up pressure can be estimated; (5) making a pulse wave oscillogram and analyzing cardiac functions; (6) pulse waves are detected at the radial artery, pressure action is hardly exerted, and people have no oppression, so that heart rate or arrhythmia continuous monitoring and HRV (heart rate variability) analysis can be carried out; (7) the waveform display with the visual detection process and structure is realized, and whether the measurement is real or effective can be judged very visually. In the detection process, the range of the detection result can be visually observed; in addition, the interaction effect in the detection process is also increased due to the intuitive waveform display; (8) the existing products on the market adopt a cuff and double air bags to detect PWTT, and the defects include that the distance between the two air bags is too close, the PWTT time is too short, and the acquisition error is difficult to control; in addition, the downstream is provided with a compression function of the air bag on the blood vessel, so that the state of the brachial artery blood vessel is not changed in a free state, even if the blood flow is in the blocking state, pulse waves still exist in the two air bags due to the impact of the blood flow on the blood vessel wall, but the amplitude is relatively small, so that the measurement has no avoidable error, and the detection at the radial artery completely overcomes the problem, when the brachial artery is completely blocked, the pulse wave at the radial artery completely disappears, the signal is a clean and flat straight line, the first korotkoff sound is inevitably generated at the place where the first radial pulse wave appears, but the korotkoff sound is easy to be leaked out of the ear, in addition, the detection at the radial artery has almost no pressure to the radial artery blood vessel, and the deformation of the radial artery blood vessel can not be caused, so that the deformation and the state of the upstream brachial artery blood vessel can not be influenced; (9) the accuracy of the principle: when detecting PWTT at radial artery, the first Korotkoff sound will appear at the position of the first pulse wave, but the Korotkoff sound can be easily leaked out. But with the detection technique at the radial artery, this signal will be captured accurately.
Compared with the prior art, the utility model, still have following advantage and beneficial effect:
(1) the utility model discloses a carry out information detection's technological means in radial artery department, the signal source is stable, has ensured the accurate seizure of korotkoff sound to measurement result's stability and reliability have been improved.
(2) The utility model discloses can combine to detect measurement result calculation to obtain human cardiovascular parameter according to human basic information, input human age, height, sex, weight, information such as arm length, handle through the algorithm, obtain this measuring PWV, the heartbeat, the heart is defeated, the blood viscosity etc. and some listed cardiac function parameters assist the state of the cardiovascular system of inspector aassessment self.
(3) If the blood flow does not thoroughly block in the detection, can lead to the testing result to produce very big error promptly, the utility model discloses an intelligence pressurization technological means has ensured that the brachial artery blood flow of people before measuring each time is the thoroughly state of blocking, has guaranteed the testing result.
(4) If gasbag pressure release is inhomogeneous, too fast in the detection, can lead to systolic pressure measuring error great promptly, the utility model discloses an intelligence pressure release technical means realizes at the uniform velocity pressure release, has avoided systolic pressure measuring error effectively.
(5) The utility model discloses a real-time waveform display of display screen and capacitive touch screen's man-machine conversation come the supplementary degree of acceptance of judging measuring result for measurement process and result are visual directly perceived, and have improved blood pressure measurement's interactivity.
Drawings
Fig. 1 is a schematic view showing the brachial artery completely released.
Fig. 2 is a schematic view showing a state in which the brachial artery is just being pushed open by systolic pressure after locking.
Fig. 3 is a schematic view showing a state in which the brachial artery is gradually unloaded.
FIG. 4 is a schematic diagram of capturing Korotkoff sounds using a fluid vibration signal.
Fig. 5 is the structure schematic diagram of the middle intelligent blood pressure measuring device of the utility model.
Fig. 6 is a schematic structural diagram of the radial artery fluid pressure vibration sensor of the present invention.
Fig. 7 is a schematic structural diagram of a servo proportional valve according to the present invention.
Description of reference numerals: 1-pressure sensor, 2-gas storage bag, 3-air pump, 4-first four-way valve, 5-closed loop servo control speed-limiting pressure flow valve, 6-cuff, 7-brachial artery fluid pressure vibration sensor, 8-second four-way valve, 9-closed loop servo control air escape valve, 10-three-way valve, 11-brachial artery fluid pressure sensor, 12-radial artery fluid pressure vibration sensor, 121-piezoelectric sensor, 122-sealed resonant cavity, 123-silica gel filler layer, 124-auxiliary cavity, 125-piezoelectric sensor lead, 51-proportional valve air outlet, 52-proportional valve air inlet, 53-outer shell, 54-proportional valve main body, 55-proportional valve lead and 56-silica gel layer.
Detailed Description
Example 1
The embodiment provides a blood pressure measuring method based on Korotkoff sounds, which is different from the prior art in that a sensor is adopted to detect a pressure pulse signal at a radial artery, the traditional mode of 'hearing' the Korotkoff sounds of human ears is changed into a mode of directly measuring the Korotkoff sounds, and meanwhile, the measuring method is different from a measuring mode of an electronic Korotkoff sound sphygmomanometer, and the measuring method is higher in accuracy. The method comprises the following steps:
after the measured person wears the cuff, the cuff air bag at the brachial artery is inflated and pressurized, meanwhile, the fluid pressure pulse wave signals are detected at the radial artery in real time, and the detected pulse wave signals are processed and displayed on a display screen to form waveforms.
During cuff balloon pressurization, the blood vessels at the brachial artery are gradually squeezed until the brachial artery is completely occluded and blood flow is interrupted, as shown in fig. 1-2. The significance of ensuring that the brachial artery is completely locked is: the error of the detection result is avoided; the prior art means generally adds air and pressurizes to a fixed locking pressure, but the brachial artery can not be completely locked because of the difference of human bodies, especially for the measured person with special constitution such as hypertension. In the embodiment, the brachial artery locking state is judged according to the fluid pressure pulse wave signal, so that the influence of fixed pressurization or human factors is avoided, when the radial artery fluid pressure pulse wave signal completely disappears, the blood flow of the brachial artery is in a completely locked state, and the state can be visually displayed through a detection signal without depending on the working quality of an operator.
After the blood flow of the brachial artery is completely locked, the air filling and the pressurization are stopped, the pressure relief processing is carried out on the cuff air bag, when the pressure relief operation is started, the fluid pressure pulse wave signals of the brachial artery and the fluid pressure pulse wave signals of the radial artery during the heart beating are continuously collected, the real-time oscillogram of the brachial artery pulse waves and the radial artery pulse waves is displayed in real time, meanwhile, the conduction time from the brachial artery fluid vibration pressure pulse waves to the radial artery fluid vibration pressure pulse waves is synchronously collected, and the collected signals are displayed on a display screen after being processed to form waveform display.
As shown in fig. 2, in the pressure relief process, when a fluid pressure pulse wave signal is detected at the radial artery for the first time, it indicates that the brachial artery is just flushed away by systolic pressure, a small femoral blood flow occurs, a first korotkoff sound occurs, and a first amplitude minute pulse wave occurs at the radial artery. The first Korotkoff sound is difficult to hear by the human ear, and the blood flow of the locked brachial artery is judged to break through the locking by detecting the blood flow signal at the radial artery, so that the first Korotkoff sound can be accurately captured. When the first Korotkoff sound appears, the mean value of the pressure value of the cuff air bag and the pressure value of the cuff air bag corresponding to the last beat of the fluid pressure pulse wave is the measured systolic pressure.
As shown in fig. 3, with the continuous pressure relief of the cuff airbag, the brachial artery gradually changes from the locked state to the diastolic state until the blood flow gradually returns to the normal state, which indicates that the brachial artery vessel is unloaded. In the process that the pressure of the air bag is gradually reduced, the extrusion degree of brachial artery blood vessels is gradually reduced, the diameter of the aorta blood vessels is enlarged and gradually returns to the original size, and the time T for transmitting the PWV wave to the radial artery on the aorta at a certain distance is shorter (according to the definition of PWV, for the same individual, the value of PWV is only related to the diameter r of the blood vessel at the same moment and is in a negative correlation relationship, namely the larger the diameter of the blood vessel is, the larger the PWV is). When the pressure of the air bag is continuously reduced after the vessel is completely unloaded, namely the diameter of the brachial artery vessel is enlarged and gradually returns to the original size, the T value is almost unchanged. From the recorded T values, the heart rate per beat is analyzed in the T time series group to find a time series of rises, the starting point of which is the point of unloading of the brachial artery vessel wall, the pressure value of which is the diastolic pressure, i.e. the last acoustic korotkoff sound appears before the external pressure is slightly higher than the internal pressure trough, and then is attributed to silence. In the method, whether the unloading of the brachial artery blood vessel is finished is judged according to the change trend of the pulse wave conduction time PWTT from the brachial artery pulse wave to the radial artery pulse wave, specifically, when the change trend of the pulse wave conduction time PWTT tends to be stable, the unloading of the brachial artery blood vessel is finished, and the pressure value of the cuff air bag is the measured diastolic pressure, so that the measurement is finished.
In order to better realize the embodiment, in the pressure relief process, a PID algorithm is adopted to realize the pressure relief at the uniform pressure relief speed of the cuff airbag: when the pressure difference detected by the cuff between the two pulses is higher than a set value, the air leakage flow is reduced, and when the pressure difference detected by the cuff between the two pulses is lower than the set value, the air leakage flow is improved. Wherein the set value can be adjusted by the skilled person according to the actual measurement requirements or individual differences.
The blood flows through the blood vessels to the periphery under the action of the heart, and a forward pulse wave is formed on the wall of the artery blood vessels. The speed at which this forward wave is conducted on the vessel wall depends to a large extent on the stiffness of the vessel wall. Thus, the stiffness of arterial vessels, particularly large vessels, can be assessed by measuring the Pulse Wave Velocity (PWV) on the arterial wall, which depends mainly on the elasticity of the arterial vessel wall. In this embodiment, the cuff continues to release pressure after the brachial artery vessel is unloaded, and the stiffness of the artery vessel is evaluated by measuring the pulse wave velocity PWV on the artery wall using the formula PWV ═ L/PWTT: wherein, L is the length from a brachial artery detection point to a radial artery detection point, and PWTT is the conduction time from a brachial artery pulse wave to a radial artery pulse wave.
The technical content disclosed in "pulse wave clinical engineering" indicates that the heart function indexes such as heart beat, heart transfusion, blood viscosity and the like of a human body can be accurately estimated according to the pulse wave form, systolic pressure and diastolic pressure collected by measurement and by combining with the basic information (such as height, weight, age, sex and the like) of the human body to perform algorithm analysis, so as to assist a detector in estimating the state of the cardiovascular system of the detector. In the embodiment, the measurement data of the adopted blood pressure measurement method is combined with the basic information of the human body to obtain the relevant parameters of the cardiovascular system.
By adopting the method provided by the embodiment, the measurement process and the result are visual, the measured data information is displayed by the waveform, and the start and end points of the korotkoff sound can be accurately and visually displayed by the brachial artery pulse wave vibration waveform and the radial artery pulse wave vibration waveform, as shown in fig. 4 (wherein, the higher waveform is the brachial artery pulse wave vibration waveform, and the lower waveform is the radial artery pulse wave vibration waveform).
Example 2
As shown in fig. 5 to 7, the present embodiment provides a korotkoff sound-based blood pressure measurement and cardiovascular system evaluation system, which includes a cuff and a measurement host, wherein the cuff in the present embodiment adopts a national standard cuff structure, has a simple structure, is a single-tube single-airbag, and is suitable for a standardized cuff. The measurement host computer includes: the device comprises a central processing module, a display screen, an intelligent pressurizing module, an intelligent pressure relief module, a waveform display module, a pulse signal acquisition module, a cuff airbag pressure acquisition module, a cardiovascular parameter calculation module and a communication module, wherein the power supply can be an external power supply or a battery.
The central processing module is mainly responsible for data processing of each acquired signal, such as: pulse wave shape, systolic pressure, diastolic pressure, etc., and model STM32F103ZET6 is selected.
The intelligent pressurizing module comprises: the device comprises a radial artery fluid pressure vibration sensor, a first four-way valve, an air pump, a pressure sensor, an air storage bag and a closed-loop servo control speed-limiting pressurization flow valve, wherein the air pump, the pressure sensor, the air storage bag and the closed-loop servo control speed-limiting pressurization flow valve are respectively connected with the first four-way valve. The cuff is inflated and pressurized through the intelligent pressurizing module, and the brachial artery is completely locked. The intelligent pressurizing module realizes the intelligent pressurizing operation in the following mode: when the machine is started, the air pump inflates the air storage bag through the first four-way valve, and the air storage bag stores high-pressure air; when the detection is started, the air pump and the air storage bag inflate the cuff air bag through the closed-loop servo control speed-limiting pressurized flow valve; and the radial artery fluid pressure vibration sensor detects a fluid pressure pulse wave signal at the radial artery in real time, and if the fluid pressure pulse wave signal at the radial artery disappears, the closed-loop servo control speed-limiting pressurized flow valve is closed to complete the inflating and pressurizing operation of the cuff. The intelligent pressurizing module avoids the defects that most of existing sphygmomanometers pressurize the cuff air bag to a fixed pressure value, so that people with low systolic pressure add too high pressure and discomfort, and invalid deflation time is additionally increased, but the brachial artery is not completely locked for people with high systolic pressure.
Intelligence pressure release module includes: the closed-loop servo control air escape valve is connected with the brachial artery fluid pressure vibration sensor at the other two ends of the three-way valve respectively; the other two ends of the second four-way valve are respectively connected with the cuff and the closed-loop servo control speed-limiting pressurizing flow valve. The intelligent pressure relief module controls the opening of a throttle valve of the closed-loop servo control air relief valve, and realizes uniform pressure relief of the cuff by adopting a PID algorithm, wherein the PID algorithm is as follows: and S is P (PID parameter) and delta P, wherein S is the throttle opening of the closed-loop servo control air escape valve, delta P is the pressure difference of the cuff air bag between two pulses, the PID parameter is a constant, and P is the current pressure value of the cuff air bag. In the intelligent pressure relief process, the pressure vibration pulse wave at the radial artery is synchronously acquired through the radial artery fluid vibration pressure sensor, the pulse wave of the brachial artery fluid pressure vibration sensor and the pressure value sequence of the brachial artery fluid pressure sensor are recorded at the same time, and the pulse wave and the pressure value sequence are stored and processed by an algorithm. Among the prior art, the mechanical relief valve that many sphygmomanometer adopted causes gasbag high-pressure area to lose heart too fast, makes hypertension crowd's systolic pressure measuring error huge, and gasbag low-pressure area loses heart too slowly again, has prolonged check-out time, has increased human uncomfortable and has felt, and the intelligent pressure release that this embodiment provided has solved the inhomogeneous problem of pressure release speed among the prior art.
The closed-loop servo control speed-limiting pressurizing flow valve and the closed-loop servo control air escape valve applied to intelligent pressurization and intelligent pressure relief both adopt servo proportional valves, as shown in fig. 7, which comprise an external shell, an air inlet and an air outlet which are positioned at two ends of the shell, and a proportional valve (preferably a micro proportional valve) which is positioned inside the shell.
In the embodiment, the intelligent pressurizing module and the intelligent pressure relief module are used for completing pressurizing and pressure relief operations of the cuff air bag, so that the highest suitable locking pressure is ensured when pressurizing is finished, and uniform pressure relief is realized during pressure relief, thereby effectively solving the problems in the prior art and ensuring the measurement accuracy.
The pulse signal acquisition module is composed of a sensor, is mainly used for acquiring pulse signals and comprises a radial artery fluid pressure vibration sensor and a brachial artery fluid pressure vibration sensor; the cuff air bag pressure acquisition module comprises a brachial artery fluid pressure sensor, wherein the radial artery fluid pressure vibration sensor and the brachial artery fluid pressure vibration sensor are also applied to the intelligent pressurization module and the intelligent pressure relief module. As shown in fig. 7, the radial artery fluid pressure vibration sensor includes: piezoelectric sensor, sealed resonance cavity, silica gel filler layer, vice cavity, piezoelectric sensor wire, wherein, biocompatible material is preferred in silica gel filler layer, and its surface is the one side that radial artery fluid pressure vibration sensor is close to the detection department. The resonant cavity is in an arch-like shape, two sides of the cross section of the resonant cavity are vertical, and the upper part of the resonant cavity is arc-shaped. The brachial artery fluid pressure vibration sensor and the brachial artery fluid pressure sensor may be configured as in the radial artery fluid pressure vibration sensor, or may be an existing pressure sensor. The collected signals are processed by a central processing module after being processed by a precision operational amplifier TLC2254, and then are displayed by waveforms.
The waveform display module displays the waveform of the radial artery pulse wave and the waveform of the brachial artery pulse wave according to the acquired pulse signals; and the cardiovascular parameter calculation module is used for calculating according to the basic information of the human body and the detection measurement result. In this embodiment, the waveform display module is an existing module, and the waveform display module and the blood vessel learning parameter calculation module are integrated in the central processing unit.
The communication module can adopt the mature remote transmission module in the market at present, such as: and the communication module is used for uploading detection data to the background and establishing an accurate health big data platform for a measurer.
The display screen displays the pulse waveform signals acquired in real time on the display screen after being processed by the central processing unit, and has the advantages of visualization of the measurement process and interesting man-machine conversation. Meanwhile, the display screen is a touch screen, preferably a capacitive touch screen, and can input the distance L between the brachial artery fluid pressure vibration sensor and the radial artery fluid pressure vibration sensor for detecting the accuracy of the human, and then accurately calculate the PWV of the left upper limb and the right upper limb through the time PWTT of transmission between the detected brachial artery pulse wave and the radial artery pulse wave and through the time PWV ═ L/PWTT. PWV is the only valuable clinical indicator for assessing vascular stiffness. Meanwhile, the radial artery fluid pressure vibration sensor can acquire accurate pulse wave forms of the radial artery, and cardiac function indexes of the human body, such as heart beat, heart transfusion, blood viscosity and the like, can be accurately estimated by inputting corresponding height, weight, age, sex and the like of the human body for algorithm analysis through acquired systolic pressure and diastolic pressure.
The embodiment also provides a measurement use method of the intelligent blood pressure measurement device, which specifically comprises the following steps:
(1) opening a speed-limiting pressurizing flow valve controlled by a closed loop servo to intelligently pressurize the cuff, simultaneously acquiring a fluid pressure pulse wave signal of a brachial artery and a fluid pressure pulse wave signal of a radial artery respectively through a brachial artery fluid pressure vibration sensor and a radial artery fluid pressure vibration sensor, acquiring cuff airbag pressure through the brachial artery fluid pressure sensor, and displaying a brachial artery pulse wave, a radial artery pulse wave waveform and a cuff airbag pressure value on a display screen;
(2) acquiring a fluid pressure pulse wave signal of a radial artery through a radial artery fluid pressure vibration sensor, and stopping inflating and pressurizing the cuff air bag when the radial artery fluid pressure pulse wave signal cannot be detected;
(3) closing the closed-loop servo control speed-limiting pressurized flow valve, opening the closed-loop servo control air escape valve, and intelligently and uniformly releasing pressure of the cuff air bag;
(4) in the pressure relief process, when the radial artery fluid pressure vibration sensor detects a fluid pressure pulse wave signal for the first time, the pressure value of the cuff air bag acquired by the brachial artery fluid pressure sensor at the moment is the measured systolic pressure;
(5) judging whether the unloading of the brachial artery blood vessel is finished or not according to the change trend of the pulse wave conduction time PWTT from the brachial artery pulse wave to the radial artery pulse wave;
(6) if the change trend of the pulse wave transmission time PWTT tends to be stable, the unloading of the brachial artery blood vessel is finished, and the measurement is finished; at the critical point when the change trend of the pulse wave transmission time PWTT tends to be stable, the pressure value of the cuff air bag is the measured diastolic pressure;
(7) the closed-loop servo control air escape valve is completely opened and quickly releases air; meanwhile, the detection data is uploaded to the background.
As described above, the utility model discloses alright fine realization. The above description is only a preferred embodiment of the present invention, and should not be taken as limiting the invention, and any modifications, equivalent replacements, improvements, etc. made within the spirit and principle of the present invention should be included in the protection scope of the present invention.
Claims (9)
1. A blood pressure measurement and cardiovascular system evaluation system based on Korotkoff sounds comprises a cuff and a measurement host, and is characterized in that the measurement host comprises:
the central processing module is used for processing signals;
a display screen;
the intelligent pressurizing module is used for inflating and pressurizing the cuff and ensuring that the brachial artery is completely locked;
the intelligent pressure relief module controls the cuff to relieve pressure at a uniform pressure relief speed according to the acquired signal;
a pulse signal acquisition module;
a cuff airbag pressure acquisition module;
the waveform display module displays the waveform of the radial artery pulse wave and the waveform of the brachial artery pulse wave according to the acquired pulse signals;
the cardiovascular parameter calculation module is used for calculating according to the basic information of the human body and the detection measurement result;
and the communication module uploads the detection data to the background.
2. The korotkoff sound-based blood pressure measurement and cardiovascular system evaluation system of claim 1, wherein the intelligent pressurizing module comprises: the device comprises a radial artery fluid pressure vibration sensor (12), a first four-way valve (4), an air pump (3), a pressure sensor (1), an air storage bag (2) and a closed-loop servo control speed-limiting pressure flow valve (5), wherein the air pump, the pressure sensor (1), the air storage bag and the closed-loop servo control speed-limiting pressure flow valve are respectively connected with the first four-way valve (4).
3. The korotkoff sound-based blood pressure measurement and cardiovascular system evaluation system according to claim 2, wherein the radial artery fluid pressure vibration sensor (12) comprises a piezoelectric sensor (121), a sealed resonant cavity (122) and a silica gel filler layer (123), and one side of the silica gel filler layer (123) is the side of the radial artery fluid pressure vibration sensor (12) close to the detection site.
4. The Korotkoff's sound-based blood pressure measurement and cardiovascular system evaluation system of claim 3, wherein the intelligent pressure relief module comprises: the brachial artery fluid pressure vibration sensor (12), the second four-way valve (8), the brachial artery fluid pressure vibration sensor (7) and the three-way valve (10) which are connected with the second four-way valve (8) are respectively connected with a closed-loop servo control air release valve (9) of the brachial artery fluid pressure sensor (11) at the other two ends of the three-way valve (10); the other two ends of the second four-way valve (8) are respectively connected with the cuff and the closed-loop servo control speed-limiting pressurized flow valve (5).
5. The Korotkoff's sound-based blood pressure measurement and cardiovascular system evaluation system according to claim 4, characterized in that the pulse signal acquisition module comprises the radial artery fluid pressure vibration sensor (12) and the brachial artery fluid pressure vibration sensor (7).
6. The Korotkoff's sound-based blood pressure measurement and cardiovascular system evaluation system of claim 4, wherein the cuff balloon pressure acquisition module comprises a brachial artery fluid pressure sensor (11).
7. The Korotkoff's sound-based blood pressure measurement and cardiovascular system evaluation system according to claim 4, wherein the closed-loop servo-controlled speed-limiting pressurizing flow valve (5) comprises an outer shell (53) provided with a proportional valve outlet (51) at one end and a proportional valve inlet (52) at the other end, a proportional valve main body (54) provided in the outer shell (53) and provided with a proportional valve lead (55), and a silicone layer (56) filled between the proportional valve main body (54) and the outer shell (53).
8. The Korotkoff's sound-based blood pressure measurement and cardiovascular system evaluation system of claim 1, wherein the communication module is a 3G module, a 4G module, or a 5G module.
9. The Korotkoff's sound-based blood pressure measurement and cardiovascular system evaluation system of claim 1, wherein the cardiovascular parameter calculation module and waveform display module are integrated into the central processing module.
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