WO2013086961A1 - 一种气体监测装置、方法及医疗设备 - Google Patents

一种气体监测装置、方法及医疗设备 Download PDF

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Publication number
WO2013086961A1
WO2013086961A1 PCT/CN2012/086293 CN2012086293W WO2013086961A1 WO 2013086961 A1 WO2013086961 A1 WO 2013086961A1 CN 2012086293 W CN2012086293 W CN 2012086293W WO 2013086961 A1 WO2013086961 A1 WO 2013086961A1
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gas
gas concentration
correction
airway
monitoring module
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English (en)
French (fr)
Inventor
刘中华
蒋良军
涂有强
岑建
官方勇
黄光齐
伊斯莱尔松伊尔瓦·希格恩
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Shenzhen Mindray Bio Medical Electronics Co Ltd
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Shenzhen Mindray Bio Medical Electronics Co Ltd
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Priority to US14/305,856 priority Critical patent/US20140296729A1/en
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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
    • A61B5/08—Measuring devices for evaluating the respiratory organs
    • A61B5/087—Measuring breath flow
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/08—Measuring devices for evaluating the respiratory organs
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/08—Measuring devices for evaluating the respiratory organs
    • A61B5/082—Evaluation by breath analysis, e.g. determination of the chemical composition of exhaled breath
    • 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
    • A61B5/7271—Specific aspects of physiological measurement analysis
    • A61B5/7278—Artificial waveform generation or derivation, e.g. synthesizing signals from measured signals
    • G—PHYSICS
    • G01—MEASURING; TESTING
    • G01N—INVESTIGATING OR ANALYSING MATERIALS BY DETERMINING THEIR CHEMICAL OR PHYSICAL PROPERTIES
    • G01N33/00—Investigating or analysing materials by specific methods not covered by groups G01N1/00 - G01N31/00
    • G01N33/48—Biological material, e.g. blood, urine; Haemocytometers
    • G01N33/483—Physical analysis of biological material
    • G01N33/497—Physical analysis of biological material of gaseous biological material, e.g. breath
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. ventilators; Tracheal tubes
    • A61M16/0003—Accessories therefor, e.g. sensors, vibrators, negative pressure
    • A61M2016/0027—Accessories therefor, e.g. sensors, vibrators, negative pressure pressure meter
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. ventilators; Tracheal tubes
    • A61M16/0003—Accessories therefor, e.g. sensors, vibrators, negative pressure
    • A61M2016/003—Accessories therefor, e.g. sensors, vibrators, negative pressure with a flowmeter
    • A61M2016/0033—Accessories therefor, e.g. sensors, vibrators, negative pressure with a flowmeter electrical
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. ventilators; Tracheal tubes
    • A61M16/10—Preparation of respiratory gases or vapours
    • A61M16/1005—Preparation of respiratory gases or vapours with O2 features or with parameter measurement
    • A61M2016/102—Measuring a parameter of the content of the delivered gas
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M2230/00—Measuring parameters of the user
    • A61M2230/40—Respiratory characteristics
    • A61M2230/43—Composition of exhalation

Definitions

  • the present invention relates to a gas monitoring device, and more particularly to a device for gas monitoring of an airway during an anesthesia of a patient.
  • Gas monitoring mainly includes two categories, gas concentration monitoring and airway respiratory mechanics monitoring.
  • the measurement principle of gas concentration monitoring is generally based on non-dispersive infrared spectroscopy (NDIR), that is, according to the absorption characteristics of the infrared light of a certain band of the measured gas, the infrared light of a specific band is selected to pass through the gas sample, and the absorption of the band is monitored.
  • NDIR non-dispersive infrared spectroscopy
  • the type of gas monitoring is related to the selection and number of infrared bands.
  • the measurement principle of respiratory mechanics monitoring is to obtain the three basic parameters of airway pressure, airway flow and time by measuring the pressure of gas at several points in the airway, and then obtain the ratio of tidal volume and inspiratory exhalation time by calculation (I: E Parameters, such as PEEP Pressure, are used to measure airway ventilation in patients.
  • gas concentration monitoring is an independent monitoring module for analyzing gas components and/or detecting gas concentration, gas.
  • the respiratory mechanics monitoring is also an independent monitoring module, which is used to obtain three basic parameters of airway pressure, airway flow and time, and then obtain the ratio of tidal volume and inspiratory exhalation time by calculation (I: E). Rate), exhalation end forward pressure (PEEP) Pressure) and other parameters. The results are then each output for medical reference. During the monitoring process, changes in the measurement environment will have different effects on the calculation results, which will reduce the accuracy of the calculation results.
  • the invention provides a gas monitoring device, a method and a medical device, which improve the accuracy of gas concentration monitoring or airway respiratory mechanics monitoring results.
  • a gas monitoring apparatus comprising:
  • a gas concentration monitoring module for extracting gas in the airway of the patient and detecting the gas, and outputting the gas component and the measured gas concentration
  • a correction module connected to the output end of the gas concentration monitoring module for acquiring a gas component and a measured gas concentration output by the gas concentration monitoring module, wherein the correction module is configured to determine the first according to the gas composition and the measured gas concentration Correcting the value and outputting the first correction value;
  • a respiratory mechanics monitoring module for detecting a respiratory mechanical parameter in the airway of the patient, coupled to the output of the correction module for receiving a first correction value from the correction module, the respiratory mechanics monitoring module being configured to follow the first correction value
  • the predetermined first correction scheme corrects the respiratory mechanics parameters and outputs the final respiratory mechanics parameters.
  • a gas monitoring apparatus comprising:
  • a respiratory mechanics monitoring module for detecting a pressure related amount in a patient's airway and calculating a respiratory mechanical parameter in the airway of the patient
  • a correction module coupled to the respiratory mechanics monitoring module for acquiring a pressure related amount in the airway of the patient detected by the respiratory mechanics monitoring module, the correction module being configured to determine a second correction value according to the pressure correlation amount, and outputting the second Correction value;
  • a gas concentration monitoring module configured to extract gas in the airway of the patient and detect the gas, and output a measured gas concentration
  • the gas concentration monitoring module is configured to perform the gas concentration according to the second correction according to a predetermined second correction scheme. Corrected and output the final gas concentration.
  • a gas monitoring method comprising:
  • Determining a first correction value according to the gas composition and the measured gas concentration acquiring the detected pressure related amount in the airway of the patient, determining a second correction value according to the pressure correlation amount, and outputting the second correction value;
  • the invention also provides a medical device comprising the gas monitoring device described above.
  • the invention uses the parameters obtained in the gas concentration monitoring process to correct the airway respiratory mechanics parameters, thereby reducing the influence of gas type, gas density, viscosity and other factors on the airway respiratory mechanical characteristics, and improving the accuracy of the respiratory mechanics measurement results.
  • the invention uses the parameters obtained during the monitoring of respiratory mechanics to correct the gas concentration, thereby reducing the influence of the airway concentration on the gas concentration, thereby providing the accuracy of the gas concentration measurement result.
  • Figure 1 is a block diagram showing an embodiment of the present invention
  • Figure 3 is a flow chart for correcting gas concentration in an embodiment of the present invention.
  • the respiratory mechanics parameters are affected by the type of gas. There are different gas types in the airway. When the gas composition in the airway changes, the gas density and viscosity in the airway change. Changes can also bring errors to the measurement results of respiratory mechanics parameters. For example, due to factors such as gas density and viscosity, the airway respiratory mechanical properties of the subject have changed. If no correction is made, erroneous measurement results will be obtained.
  • the gas concentration monitoring module and the respiratory mechanics monitoring module are used to measure the airway of the patient, and the parameters detected by the gas concentration monitoring module are used to correct the detection result of the respiratory mechanics monitoring module, or the breathing may be performed.
  • the parameters detected by the mechanical monitoring module are used to correct the detection results of the gas concentration monitoring module.
  • the gas monitoring device includes a gas concentration monitoring module 10 , a respiratory mechanics monitoring module 20 , and a correction module 30 .
  • the correction module 30 is respectively connected to the gas concentration monitoring module 10 and the respiratory mechanics monitoring module 20.
  • the correction module 30 obtains the gas composition and the gas concentration from the gas concentration monitoring module 10, and determines the correction value according to the gas composition and the gas concentration, so that the respiratory mechanics monitoring module 20 Correct the detection result according to the correction value.
  • the correction module 30 obtains a parameter characterizing the airway state from the respiratory mechanics monitoring module 20, and determines a correction value according to the parameter, so that the gas concentration monitoring module 10 corrects the detection result according to the correction value.
  • the gas concentration monitoring module 10 is configured to extract gas from the airway of the patient and detect the gas to obtain a gas composition and/or a measured gas concentration.
  • the respiratory mechanics monitoring module 20 is configured to detect a pressure-related amount in the airway of the patient, that is, a pressure sensor placed in the airway of the patient, and measure the pressure of the gas at several points in the airway to obtain a pressure-related amount.
  • the pressure related quantity includes at least one of three parameters of airway pressure, airway flow and time.
  • the detected pressure related quantity includes three basic parameters of airway pressure, airway flow and time, and then according to the airway.
  • the respiratory mechanics parameters are obtained by calculation of pressure, airway flow and time.
  • the respiratory mechanics parameters include, for example, tidal volume and inspiratory expiratory time ratio (I:E). Rate), exhalation end forward pressure (PEEP) Pressure) parameters such as ventilation can be used to assess ventilation in the patient's airway.
  • the correction module 30 is connected to the gas concentration monitoring module 10 and the respiratory mechanics monitoring module 20 respectively.
  • the correction module 30 is configured to acquire the gas component and the measured gas concentration output by the gas concentration monitoring module 10, and on the other hand, the correction module 30 To obtain the pressure related amount in the airway of the patient detected by the respiratory mechanics monitoring module 20, the correction module 30 is configured to determine the first correction value according to the gas composition and the measured gas concentration, and output the first correction value to the gas concentration monitoring module 10 At the same time, the second correction value is determined according to the pressure related quantity, and the second correction value is output to the respiratory mechanics monitoring module 20.
  • the respiratory mechanics monitoring module 20 receives the first correction value from the correction module 30, corrects the respiratory mechanics parameters according to the predetermined first correction scheme according to the first correction value, and outputs the final respiratory mechanics parameter.
  • the first correction scheme may be a correction scheme formed according to fluid mechanics, for example, compensation according to Reynolds number, but the correction scheme is not limited to compensation according to Reynolds number, and those skilled in the art based on the gas composition measured by the gas concentration monitoring module and Gas concentration to modify the concept of respiratory mechanics parameters, according to fluid mechanics can also form a variety of corrections.
  • the gas concentration monitoring module 10 receives the second correction value from the correction module 30, corrects the gas concentration according to the second correction value according to the second correction rate, and outputs the final gas concentration.
  • the gas monitoring device may also correct the detection result of the respiratory mechanics only by using the parameters in the gas concentration monitoring process, or may correct the gas concentration detection result only by using the parameters in the respiratory mechanics monitoring process.
  • the gas concentration monitoring module 10 and the respiratory mechanics monitoring module 20 in the above embodiments may be integrated in one casing, or may be two separate parts, and the two may have independent power supply parts and processors, or may share a power supply part. And / or processor.
  • the method for monitoring the gas concentration of the airway of the patient is as shown in FIG. 2, and includes the following processes:
  • the gas concentration monitoring module extracts the gas in the airway of the patient and detects the gas, and calculates the concentration of the gas component and/or the measured gas.
  • the gas concentration monitoring module extracts the measured gas from the airway according to a certain flow rate, determines the change of the absorption channel, thereby identifying the gas type and calculating the gas concentration.
  • the gas concentration monitoring module may employ existing or future devices for detecting gas composition and/or measured gas concentration.
  • step S12 the correction module determines the first correction value according to the gas component and the measured gas concentration.
  • the correction module calculates a gas flow property of the mixed gas in the airway of the patient according to the gas composition and the measured gas concentration, the gas flow property including at least the density and viscosity of the mixed gas, and finding out on the pre-stored measurement error curve according to the gas composition and the gas flow property. Corresponding first correction value.
  • Step S13 The respiratory mechanics monitoring module corrects the respiratory mechanics parameters according to the first modified value according to the first correction value, and outputs the final respiratory mechanics parameters.
  • the correction module obtains the gas type and gas concentration in the airway from the measurement result of the gas concentration monitoring module, acquires physical parameters such as density and viscosity of the mixed gas in the airway, and cooperates with the current flow rate of the respiratory mechanics monitoring mode detection. Data, corrected for respiratory mechanics measurements.
  • the measurement error curve f of the system under various conditions is obtained by a large number of test methods using an inert gas in advance. The error curve according to the type of gas and the inert gas can be corrected by the coefficient coff.
  • the correction module can find the correction coefficient err_coff(f*coff) from the error curve f according to the obtained gas type, density and other parameters, that is, the first correction value, and use the correction coefficient err_coff(f*coff) to perform the respiratory mechanics measurement result.
  • the first modification of the correction may be, for example, multiplying the initially obtained respiratory mechanics parameter by a correction coefficient to obtain a final respiratory mechanics parameter.
  • FIG. 3 Based on the above gas monitoring device, the method for performing respiratory mechanics monitoring on the airway of the patient is shown in FIG. 3, and includes the following processes:
  • the respiratory mechanics monitoring module detects the pressure related amount in the airway of the patient, and calculates the respiratory mechanics parameters in the airway of the patient.
  • the respiratory mechanics monitoring module may employ existing or future devices for detecting airway conditions.
  • the respiratory mechanics monitoring module obtains real-time pressure, pressure difference and other parameters according to the change of pressure in the airway, and calculates the real-time flow rate of the obtained gas. According to the parameters such as time, pressure and flow, the remaining parameters are calculated.
  • the correction module acquires the detected pressure related amount in the airway of the patient, determines a second correction value according to the pressure correlation amount, and outputs a second correction value.
  • the correction module is configured to search for a point suitable for calculation according to the airway flow waveform, and send the detection time corresponding to the point as a second correction value to the gas concentration monitoring module.
  • the correction module evaluates the condition of the gas in the airway according to the result detected by the respiratory mechanics monitoring module, and the correction module can determine the stability of the airflow according to the waveform of the airway flow, and can also determine whether turbulence is formed in the airway, whether gas is generated or not.
  • the flow curve has typical inhalation and exhalation waveforms under normal breathing conditions. If the inhalation waveform and the exhalation waveform disappear, or if the waveform is confusing, it indicates that turbulence has occurred.
  • the alarm prompt can be given according to the degree of turbulence occurrence, or the suitable calculation point can be searched according to the waveform characteristics, and the detection time corresponding to the point is notified to the gas concentration calculation device.
  • the correction module can determine the flow condition of the airflow in the airway (ie, the stability of the airflow) according to the shape of the airway flow waveform, for example, detecting the Reynolds number in the airway, and determining the stability of the airflow according to the magnitude of the Reynolds number. Whether or not turbulence is formed.
  • the Reynolds number is the ratio of the inertial force of the fluid to the viscous force. When the Reynolds number is small, the viscous force has a greater influence on the flow field than the inertial force.
  • the disturbance of the flow velocity in the flow field is attenuated by the viscous force, and the fluid flow Stable, laminar flow; conversely, if the Reynolds number is large, the influence of inertial force on the flow field is greater than the viscous force, the fluid flow is unstable, and the small changes in the flow velocity are easy to develop and enhance, forming a disordered, irregular turbulent flow.
  • the gas concentration does not need to be corrected.
  • the gas concentration is corrected according to the second correction according to the second correction scheme.
  • the Reynolds number is greater than the second threshold, an alarm is given, and the calculation of the gas concentration is stopped, and the gas concentration value is not output.
  • the first threshold may be set to 2100
  • the second threshold may be set to 4000
  • the Reynolds number is ⁇ 2100, it is a laminar flow (also referred to as a viscous flow, line flow) state, and no gas concentration is required. Make corrections.
  • 2100 ⁇ Reynolds number ⁇ 4000 it is a transitional flow state.
  • the respiratory mechanics parameters obtained by the respiratory mechanics monitoring module are used to modify the gas concentration obtained by the gas concentration monitoring module.
  • the Reynolds number is >4000, it is a turbulent flow (also called turbulent flow, spoiler) state.
  • an alarm is given, and the gas concentration monitoring module is controlled to stop the output gas concentration value.
  • the gas concentration monitoring module corrects the gas concentration according to the second correction rate according to the second correction value, and outputs the final gas concentration.
  • the second correction scheme may be based on the detection time sent by the correction module, and the gas concentration monitoring module searches for the gas concentration value corresponding to the detection time in the calculated gas concentration, and the gas concentration value corresponding to the detection time is used as the final Gas concentration output.
  • the above steps S11 and S21 are for gas monitoring of the air passages of the same patient at the same time.
  • the gas concentration monitoring module and the respiratory mechanics monitoring module are simultaneously monitored.
  • the gas concentration monitoring module may have a certain time difference with the respiratory mechanics monitoring module at the time of collecting the data.
  • the above gas monitoring device can be applied to a medical device.
  • the medical device has a display
  • the gas concentration monitoring module and the respiratory mechanics monitoring module transmit the corrected detection result to the display for display.
  • the medical device can be a bedside instrument such as a monitor, an anesthesia machine, or a ventilator.

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Abstract

一种气体监测装置、方法及医疗设备，包括气体浓度监测模块（10）、呼吸力学监测模块（20）和修正模块（30）。修正模块（30）根据气体成分和被测气体浓度确定出第一修正值，使呼吸力学监测模块（20）根据第一修正值对呼吸力学参数进行修正，或修正模块（30）根据呼吸力学监测模块（20）检测的压力相关量确定出第二修正值，使气体浓度监测模块（10）根据第二修正值对气体浓度进行修正。本发明提高了呼吸力学参数和气体浓度测量的准确性。

Description

一种气体监测装置、方法及医疗设备
【技术领域】
本发明涉及一种气体监测装置，尤其涉及对患者麻醉过程中的气道进行气体监测的装置。
【背景技术】
气体监测主要包括两大类，气体浓度监测与气道呼吸力学监测。气体浓度监测的测量原理一般是基于非色散红外光谱分析技术（NDIR），即根据被测气体对某一波段红外光的吸收特性，选择特定波段的红外光通过气体样本，通过监测该波段的吸收来测量气体浓度。气体监测种类与红外波段的选取和个数有关。呼吸力学监测的测量原理是通过测量气道内几个点气体的压力，获得气道压力、气道流量和时间三个基本参数，再通过计算获得如潮气量、吸气呼气时间比（I:E rate）、呼气末端正向压力（PEEP Pressure）等参数，用来衡量病人气道通气状况。
现有技术在实现气体浓度监测与气道呼吸力学监测时，往往是单独实现二者的功能，即气体浓度监测是一个独立的监测模块，其用于分析气体成分和/或检测气体浓度，气道呼吸力学监测也是一个独立的监测模块，其用于获得气道压力、气道流量和时间三个基本参数，再通过计算获得如潮气量、吸气呼气时间比（I:E rate）、呼气末端正向压力（PEEP Pressure）等参数。然后各自将结果输出供医务人员参考。在监测过程中，测量环境的变化将会对计算结果有不同程度的影响，这种影响将降低计算结果的准确性。
【发明内容】
本发明提供一种气体监测装置、方法及医疗设备，提高气体浓度监测或气道呼吸力学监测结果的准确性。
根据本发明的第一方面，提供一种气体监测装置,包括：
气体浓度监测模块，用于抽取患者气道内的气体并对气体进行检测，输出气体成分和被测气体浓度；
修正模块，其与气体浓度监测模块的输出端连接，用于获取气体浓度监测模块输出的气体成分和被测气体浓度，所述修正模块被配置为根据气体成分和被测气体浓度确定出第一修正值，并输出第一修正值；
用于检测患者气道内呼吸力学参数的呼吸力学监测模块，其与修正模块的输出端连接，用于从修正模块接收第一修正值，所述呼吸力学监测模块被配置为根据第一修正值按照预定的第一修正方案对呼吸力学参数进行修正，输出最终的呼吸力学参数。
根据本发明的第二方面，提供一种气体监测装置,包括：
呼吸力学监测模块，用于检测患者气道内的压力相关量,并计算出患者气道内的呼吸力学参数；
修正模块，其与呼吸力学监测模块连接，用于获取呼吸力学监测模块检测的患者气道内的压力相关量，所述修正模块被配置为根据压力相关量确定出第二修正值，并输出第二修正值；
气体浓度监测模块，用于抽取患者气道内的气体并对气体进行检测，输出被测气体浓度，所述气体浓度监测模块被配置为根据第二修正值按照预定的第二修正方案对气体浓度进行修正，输出最终的气体浓度。
根据本发明的第三方面，提供一种气体监测方法,包括：
抽取患者气道内的气体并对气体进行检测，计算气体成分和被测气体的浓度；
检测患者气道内的压力相关量,并计算出患者气道内的呼吸力学参数；
根据气体成分和被测气体浓度确定出第一修正值；获取检测的患者气道内的压力相关量，根据压力相关量确定出第二修正值，并输出第二修正值；
根据第一修正值按照预定的第一修正方案对呼吸力学参数进行修正，输出最终的呼吸力学参数，和根据第二修正值按照预定的第二修正方案对气体浓度进行修正，并输出最终的气体浓度。
本发明还提供一种医疗设备，包括上述的气体监测装置。
本发明采用气体浓度监测过程中获得的参数对气道呼吸力学参数进行修正，从而可减少气体类型、气体密度、粘度等因素对气道呼吸力学特性的影响，提高呼吸力学测量结果的准确性。
本发明采用呼吸力学监测过程中获得的参数对气体浓度进行修正，从而可减少因气道状况变化而给气体浓度带来的影响，从而提供了气体浓度测量结果的准确性。
【附图说明】
图1为本发明一种实施例的方框示意图；
图2为本发明一种实施例中对呼吸力学参数进行修正的流程图；
图3为本发明一种实施例中对气体浓度进行修正的流程图。
【具体实施方式】
下面通过具体实施方式结合附图对本发明作进一步详细说明。
在临床实践中，发明人发现在测量气体浓度时，气体浓度往往受气道状态的影响，例如被测者气道不通畅，造成呼出气体与吸入气体混合时，对气体浓度的测量结果产生很大影响，导致测量结果存在一定的误差。而另一方面，在测量呼吸力学时，呼吸力学参数又会受到气体类型的影响，气道内有不同的气体类型，当气道内气体成分变化时，导致气道内气体密度、粘度发生变化，这种变化也会给呼吸力学参数测量结果带来误差，例如，受气体密度、粘度等因素影响，被测者气道呼吸力学特性已发生改变，如不进行修正，则会获得错误的测量结果。
因此，本申请实施例中，将气体浓度监测模块和呼吸力学监测模块一起对患者的气道进行测量，并将气体浓度监测模块检测的参数用以修正呼吸力学监测模块的检测结果，或将呼吸力学监测模块检测的参数用以修正气体浓度监测模块的检测结果。
请参考图1，气体监测装置包括气体浓度监测模块10、呼吸力学监测模块20和修正模块30。修正模块30分别与气体浓度监测模块10和呼吸力学监测模块20连接，修正模块30从气体浓度监测模块10中获取气体成分和气体浓度，根据气体成分和气体浓度确定修正值，使呼吸力学监测模块20根据修正值对检测结果进行修正。或者修正模块30从呼吸力学监测模块20中获取表征气道状态的参数，根据该参数确定修正值，使气体浓度监测模块10根据修正值对检测结果进行修正。
在一种实施例中，仍如图1所示，气体浓度监测模块10用于抽取患者气道内的气体并对气体进行检测，得到气体成分和/或被测气体浓度。呼吸力学监测模块20用于检测的患者气道内的压力相关量,即通过放置在患者气道内的压力传感器，测量气道内几个点气体的压力，获得压力相关量, 压力相关量包括气道压力、气道流量和时间三个参数中的至少一个，本实施例中，检测的压力相关量包括气道压力、气道流量和时间三个基本参数，然后根据气道压力、气道流量和时间通过计算获得呼吸力学参数，呼吸力学参数包括例如潮气量、吸气呼气时间比（I:E rate）、呼气末端正向压力（PEEP Pressure）等参数，通过这些呼吸力学参数可评估病人气道内的通气状况。修正模块30分别与气体浓度监测模块10和呼吸力学监测模块20连接，一方面，修正模块30用于获取气体浓度监测模块10输出的气体成分和被测气体浓度，另一方面，修正模块30用于获取呼吸力学监测模块20检测的患者气道内的压力相关量，修正模块30被配置为根据气体成分和被测气体浓度确定出第一修正值，并输出第一修正值至气体浓度监测模块10，同时根据压力相关量确定出第二修正值，并输出第二修正值至呼吸力学监测模块20。呼吸力学监测模块20从修正模块30接收第一修正值，根据第一修正值按照预定的第一修正方案对呼吸力学参数进行修正，输出最终的呼吸力学参数。第一修正方案可以是根据流体力学形成的修正方案，例如根据雷诺数进行的补偿，但修正方案并不仅限于根据雷诺数进行的补偿，本领域技术人员基于采用气体浓度监测模块测量的气体成分和气体浓度来修正呼吸力学参数的构思，根据流体力学还可以形成很多种修正方案。气体浓度监测模块10从修正模块30接收第二修正值，根据第二修正值按照预定的第二修正方案对气体浓度进行修正，输出最终的气体浓度。
在另外的实施例中，气体监测装置还可以只用气体浓度监测过程中的参数修正呼吸力学的检测结果，也可以只用呼吸力学监测过程中的参数来修正气体浓度的检测结果。
上述实施例中的气体浓度监测模块10和呼吸力学监测模块20可以集成在一个机壳内，也可以是分立的两部分，两者可以具有各自独立的电源部分和处理器，也可以共用电源部分和/或处理器。
基于上述气体监测装置，其对患者的气道进行气体浓度监测的方法如图2所示，包括以下流程：
步骤S11，气体浓度监测模块抽取患者气道内的气体并对气体进行检测，计算气体成分和/或被测气体的浓度。气体浓度监测模块按照一定的流量从气道内抽取被测气体，判断出吸收通道的变化，由此识别出气体类型并计算出气体浓度。气体浓度监测模块可采用已有的或将来的用于检测气体成分和/或被测气体浓度的装置。
步骤S12，修正模块根据气体成分和被测气体浓度确定出第一修正值。修正模块根据气体成分和被测气体浓度计算出患者气道内混合气体的气流性质，所述气流性质至少包括混合气体的密度和粘度，根据气体成分和气流性质在预先存储的测量误差曲线上查找出对应的第一修正值。
步骤S13，呼吸力学监测模块根据第一修正值按照预定的第一修正方案对呼吸力学参数进行修正，输出最终的呼吸力学参数。
在一种具体实例中，修正模块从气体浓度监测模块的测量结果获得气道内气体类型与气体浓度，获取气道内混合气体的密度、粘度等物理参数，并配合呼吸力学监测模检测的当前流量等数据，对呼吸力学测量结果进行修正。本实施例中，预先采用某种惰性气体，通过大量测试方式获得系统在各种条件下的测量误差曲线f。根据气体类型与惰性气体的误差曲线可通过系数coff修正。修正模块可根据获得的气体类型、密度等参数，从误差曲线f查找到修正系数err_coff(f*coff)，即第一修正值,采用该修正系数err_coff(f*coff)对呼吸力学测量结果进行修正，其第一修正方案例如可以是将初步得到的呼吸力学参数乘以修正系数得到最终的呼吸力学参数。
基于上述气体监测装置，其对患者的气道进行呼吸力学监测的方法如图3所示，包括以下流程：
步骤S21，呼吸力学监测模块检测患者气道内的压力相关量,并计算出患者气道内的呼吸力学参数。呼吸力学监测模块可采用已有的或将来的用于检测气道状态的装置。呼吸力学监测模块根据气道内压力的变化，获得实时压力，压差等参数，并计算获得气体的实时流量。根据时间、压力、流量等参数，计算获得其余参数。
步骤S22，修正模块获取检测的患者气道内的压力相关量，根据压力相关量确定出第二修正值，并输出第二修正值。修正模块被配置为根据气道流量波形搜索出适合计算的点，将该点对应的检测时间作为第二修正值发送给气体浓度监测模块。在一种具体实例中，修正模块根据呼吸力学监测模块检测的结果评估气道内气体的状况，修正模块可根据气道流量波形判断气流的稳定性，还可以判断气道内是否形成湍流，是否发生气体混合等，并利用此结果对呼吸力学监测模块计算的呼吸力学参数进行修正或处理。正常呼吸情况下，流量曲线有典型的吸入和呼出波形。若吸入波形和呼出波形消失，或者波形混乱，则表明发生湍流。可根据湍流发生的程度决定给出报警提示，或按照波形特点，搜索出适合计算的点，并将该点对应的检测时间告知气体浓度计算装置。在一种具体实例中，修正模块可根据气道流量波形形态判断气管内气流的流动状况（即气流的稳定性），例如检测气道内的雷诺数，根据雷诺数的大小判断气流的稳定性和是否形成湍流。流体力学中，雷诺数是流体惯性力与黏性力的比值，雷诺数较小时，黏滞力对流场的影响大于惯性力，流场中流速的扰动会因黏滞力而衰减，流体流动稳定，为层流；反之，若雷诺数较大时，惯性力对流场的影响大于黏滞力，流体流动较不稳定，流速的微小变化容易发展、增强，形成紊乱、不规则的紊流流场。雷诺数通常根据流体性质（密度、黏度）、流体速度和一个特征长度或者特征尺寸计算得到，对于在管内的流动，雷诺数定义为： Re=( ρVD )/μ=(VD)/ν=(QD)/（νA）
其中，V是平均流速（国际单位：m/s），D管直径（一般为特征长度）（m），μ流体动力黏度（Pa • s 或N • s/m ²），ν运动黏度（ν = μ / ρ）（m ² /s ），ρ流体密度（kg/m ³），Q 体积流量（m ³ /s），A横截面积（m ²）。
当雷诺数小于第一阈值时，不需要对气体浓度进行修正，当雷诺数位于第一阈值和第二阈值之间时，根据第二修正值按照预定的第二修正方案对气体浓度进行修正，当雷诺数大于第二阈值时进行报警提示，并停止气体浓度的计算，不输出气体浓度值。在一具体实例中，第一阈值可以设为2100，第二阈值可以设为4000，当雷诺数＜2100时为层流（又可称作黏滞流动、线流）状态，不需要对气体浓度进行修正。当2100≤雷诺数≤4000时为过渡流状态，此时，采用呼吸力学监测模块获得的呼吸力学参数对气体浓度监测模块获得的气体浓度进行修改。当雷诺数＞4000时为湍流（又可称作紊流、扰流）状态，此时进行报警提示，并控制气体浓度监测模块停止输出气体浓度值。
步骤S23，气体浓度监测模块根据第二修正值按照预定的第二修正方案对气体浓度进行修正，并输出最终的气体浓度。例如，第二修正方案可以是根据修正模块发送的检测时间，气体浓度监测模块在其计算的气体浓度中查找出该检测时间对应的气体浓度值，将该检测时间对应的气体浓度值作为最终的气体浓度输出。
上述步骤S11和步骤S21是对同一患者同时段的气道进行气体监测，优选方案中，气体浓度监测模块和呼吸力学监测模块同时监测，然而，本领域技术人员应当理解，在误差允许的范围内，气体浓度监测模块在采集数据的时间上可以和呼吸力学监测模块存在一定的时差。
上述气体监测装置可以应用于医疗设备中，当医疗设备具有显示器时，气体浓度监测模块和呼吸力学监测模块将修正后的检测结果传输给显示器进行显示。
医疗设备可以是监护仪、麻醉机、呼吸机等患者床边仪器。
以上内容是结合具体的实施方式对本发明所作的进一步详细说明，不能认定本发明的具体实施只局限于这些说明。对于本发明所属技术领域的普通技术人员来说，在不脱离本发明构思的前提下，还可以做出若干简单推演或替换，都应当视为属于本发明的保护范围。

Claims (10)

  1. 一种气体监测装置,其特征在于包括：
    气体浓度监测模块，用于抽取患者气道内的气体并对气体进行检测，输出气体成分和被测气体浓度；
    修正模块，其与气体浓度监测模块的输出端连接，用于获取气体浓度监测模块输出的气体成分和被测气体浓度，所述修正模块被配置为根据气体成分和被测气体浓度确定出第一修正值，并输出第一修正值；
    用于检测患者气道内呼吸力学参数的呼吸力学监测模块，其与修正模块的输出端连接，用于从修正模块接收第一修正值，所述呼吸力学监测模块被配置为根据第一修正值按照预定的第一修正方案对呼吸力学参数进行修正，输出最终的呼吸力学参数。
  2. 如权利要求1所述的装置，其特征在于，所述修正模块被配置为根据气体成分和被测气体浓度计算出患者气道内混合气体的气流性质，根据气体成分和气流性质在预先存储的测量误差曲线上查找出对应的第一修正值，所述呼吸力学监测模块根据第一修正值和气道流量对呼吸力学参数进行修正。
  3. 如权利要求1或2所述的装置，其特征在于，所述修正模块还与呼吸力学监测模块连接，用于获取呼吸力学监测模块检测的患者气道内的压力相关量，所述修正模块被配置为根据压力相关量确定出第二修正值，并输出第二修正值至气体浓度监测模块，气体浓度监测模块被配置为根据第二修正值按照预定的第二修正方案对气体浓度进行修正，输出最终的气体浓度。
  4. 如权利要求3所述的装置，其特征在于，所述压力相关量包括气道流量和检测时间，所述修正模块被配置为根据气道流量波形搜索出适合计算的点，将该点对应的检测时间作为第二修正值发送给气体浓度监测模块，气体浓度监测模块将所述检测时间对应的气体浓度作为最终的气体浓度。
  5. 如权利要求3或4所述的装置，其特征在于，所述修正模块被配置为根据气道流量波形确定气流的稳定性，根据气流稳定性判断是否需要对气体浓度进行修正和报警提示。
  6. 一种气体监测装置,其特征在于包括：
    呼吸力学监测模块，用于检测的患者气道内的压力相关量,并计算出患者气道内的呼吸力学参数；
    修正模块，其与呼吸力学监测模块连接，用于获取呼吸力学监测模块检测的患者气道内的压力相关量，所述修正模块被配置为根据压力相关量确定出第二修正值，并输出第二修正值；
    气体浓度监测模块，用于抽取患者气道内的气体并对气体进行检测，输出被测气体浓度，所述气体浓度监测模块被配置为根据第二修正值按照预定的第二修正方案对气体浓度进行修正，输出最终的气体浓度。
  7. 如权利要求6所述的装置，其特征在于，所述压力相关量包括气道流量和检测时间，所述修正模块被配置为根据气道流量波形搜索出适合计算的点，将该点对应的检测时间作为第二修正值发送给气体浓度监测模块，气体浓度监测模块将所述检测时间对应的气体浓度作为最终的气体浓度。
  8. 如权利要求7所述的装置，其特征在于，所述修正模块被配置为根据气道流量波形确定气流的稳定性，当气流的稳定性小于第一阈值时，不需要对气体浓度进行修正，当气流的稳定性位于第一阈值和第二阈值之间时，根据第二修正值按照预定的第二修正方案对气体浓度进行修正，当气流的稳定性大于第二阈值时进行报警提示，并终止气体浓度的计算。
  9. 一种气体监测方法,其特征在于包括：
    抽取患者气道内的气体并对气体进行检测，计算气体成分和被测气体的浓度；
    检测患者气道内的压力相关量,并计算出患者气道内的呼吸力学参数；
    根据气体成分和被测气体浓度确定出第一修正值；获取检测的患者气道内的压力相关量，根据压力相关量确定出第二修正值，并输出第二修正值；
    根据第一修正值按照预定的第一修正方案对呼吸力学参数进行修正，输出最终的呼吸力学参数，和根据第二修正值按照预定的第二修正方案对气体浓度进行修正，并输出最终的气体浓度。
  10. 一种医疗设备，其特征在于包括：如权权利要求1-8中任一项所述的气体监测装置。
PCT/CN2012/086293 2011-12-15 2012-12-10 一种气体监测装置、方法及医疗设备 Ceased WO2013086961A1 (zh)

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