WO2014067248A1 - 低负荷膀胱尿量实时监测与自动报警方法 - Google Patents

低负荷膀胱尿量实时监测与自动报警方法 Download PDF

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WO2014067248A1
WO2014067248A1 PCT/CN2013/072651 CN2013072651W WO2014067248A1 WO 2014067248 A1 WO2014067248 A1 WO 2014067248A1 CN 2013072651 W CN2013072651 W CN 2013072651W WO 2014067248 A1 WO2014067248 A1 WO 2014067248A1
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impedance
threshold
real
time
value
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French (fr)
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刘官正
蒋庆
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Sun Yat Sen University
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Sun Yat Sen University
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Measuring for diagnostic purposes; Identification of persons
    • A61B5/05Detecting, measuring or recording for diagnosis by means of electric currents or magnetic fields; Measuring using microwaves or radio waves
    • A61B5/053Measuring electrical impedance or conductance of a portion of the body
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Measuring for diagnostic purposes; Identification of persons
    • A61B5/20Measuring for diagnostic purposes; Identification of persons for measuring urological functions restricted to the evaluation of the urinary system
    • A61B5/202Assessing bladder functions, e.g. incontinence assessment
    • A61B5/204Determining bladder volume
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Measuring for diagnostic purposes; Identification of persons
    • A61B5/20Measuring for diagnostic purposes; Identification of persons for measuring urological functions restricted to the evaluation of the urinary system
    • A61B5/207Sensing devices adapted to collect urine

Definitions

  • the invention relates to a real-time monitoring method for bladder urine volume, in particular to a real-time monitoring and automatic urinating alarm method for low-load bladder urine volume based on bioelectrical impedance.
  • the methods of detecting bladder conditions mostly adopt ultrasonic, pressure, displacement and other technical means, and all of them adopt static monitoring methods, which cannot grasp the urine volume of patients in time.
  • urinary insufficiency such as urinary incontinence, cystitis, spinal cord injury, etc.
  • Remote monitoring is achieved by wired (or wireless) communication methods, and current methods of monitoring bladder urine volume do not meet the above requirements.
  • Bioelectrical impedance technology utilizes the electrical properties of biological tissues and organs to extract non-invasive detection techniques for human physiological and pathological information. Existing measurement methods and devices are unable to clearly and accurately determine the appropriate alarm points based on the measurement data, prompting the patient to urinate.
  • a bioresistance-based bladder urine volume monitoring device is disclosed, and a linear method such as threshold value and curve fitting is used to predict the amount of urine.
  • the human bladder organ is an extremely complex adaptive system
  • the mathematical model between the electrical impedance change and the urine volume change is extremely complicated, and there are obvious individual and temporal and spatial differences, further complicating the model.
  • a simple linear relationship is used to predict the amount of urine, which inevitably has a great error. Therefore, based on the in-depth discussion of the relationship between the bladder organ and its electrical impedance, the present invention proposes an adaptive prediction model based on fuzzy logic and expert knowledge to achieve more accurate urine volume prediction and urination alarm.
  • the object of the present invention is to overcome the deficiencies of the prior art, and to provide a non-invasive urinary prediction method based on bioelectrical impedance, combined with clinical expert experience and experimental data characteristics, and using fuzzy logic method to achieve more accurate bladder urine volume prediction and alarm. It is safer to operate, more resistant to interference, and more accurate to prompt patients to urinate in time and avoid the risk of excessive urination.
  • the present invention provides a real-time monitoring and automatic alarm method for low-load bladder urine volume, and the steps thereof include:
  • the low-load bladder urine volume real-time monitoring and automatic alarm method of the present invention further includes part or all of the following technical features:
  • the bioelectrical impedance measuring device comprises a test electrode, a lower position machine and a host computer, and a multi-way switch module connecting the two is arranged between the test electrode and the lower position machine, and the lower position machine is responsible for the electrical impedance data.
  • the data is collected and wirelessly communicated with the host computer.
  • the host computer is responsible for the electrical impedance data processing and automatic alarm.
  • the lower computer main control board comprises a main control module and a power module connected to the main control module, an amplitude/phase measurement module, a measurement signal filtering module, an intermediate frequency sinusoidal signal generation module, a voltage controlled constant current source module, and a transmission.
  • the module and the receiving module; the power module realizes long-time measurement through energy consumption management, the measurement signal filtering module is used to remove the interference signal, the voltage-controlled constant current source module is used to provide a stable excitation current, and the transmitter is used to be worn on the patient's lower abdomen
  • the lower end corresponds to the test position of the bladder to input current excitation, and the receiver is used to collect the electrical impedance data of the human body and wirelessly transmit it to the upper computer.
  • the data communication communication between the upper computer and the lower computer is realized by an RS232 wireless module set in the lower computer.
  • the digital filtering algorithm is a low-pass point-by-point filtering algorithm with a very low cutoff frequency, which can effectively remove interference signals such as breathing, heartbeat, high frequency and power frequency in real time, and improve signal noise. ratio.
  • the digital filtering algorithm is a low-pass point-by-point filtering algorithm using an extremely low cutoff frequency of less than or equal to 0.01. Considering that the physiological characteristics such as breathing and heartbeat also affect the measurement accuracy to a certain extent, this finding specifies that the low-pass filter cutoff frequency must be less than or equal to 0.01.
  • updating the electrical impedance maximum means that the maximum impedance value is recorded and updated in real time, and the impedance maximum value ⁇ 42> is recorded in the register in real time, if the current time impedance value is ⁇ Z ( k) > greater than the previous impedance maximum value ⁇ Max(Z) >, the current impedance value ⁇ Z (k, > is restarted into the register, the previous data is automatically discarded; otherwise, no data replacement work is done. .
  • the step of calculating the impedance threshold and the rate of change in step 2) is based on subtracting the impedance maximum value from the current impedance value to obtain an impedance threshold and a rate of change thereof, and then performing a parameter blurring step according to the knowledge base:
  • the threshold and threshold rate of change are calculated according to the following formula:
  • TR k- respectively represent the current rate of change of the threshold, the threshold of the previous moment, the sampling period
  • Parameter fuzzification is to change the exact value of threshold and threshold change rate into fuzzy value.
  • the threshold fuzzy value is divided into 4 levels such as positive ( ⁇ ), center ( ⁇ ), positive (PS), and zero (Z).
  • the threshold change rate fuzzy value is divided into five levels such as positive (PB), small (PS), zero (Z), negative (NS), and negative (NB).
  • the following fuzzy rules are formulated:
  • the IF threshold is centered (PM) and the threshold change rate is zero (Z) / negative small (NS) / negative large (NB), THEN urination alarm;
  • the IF threshold is positive (PS) and the rate of change of the threshold is positive (PB), THEN urinating alarm;
  • PS positive
  • PB positive
  • THEN urinating alarm if the test time reaches a certain time (such as 2.5 hours), there is still no alarm, the test system performs Urinary alarm, and check the test device and electrode.
  • the low-load bladder urine volume real-time monitoring and automatic alarm method of the invention further comprises selecting an electrode placement position, adopting a multi-way switch module to perform measurement position switching, realizing multi-position measurement and comparison, finding an optimal measurement position, and reducing Measurement error caused by small individual differences.
  • individual differences such as fat, height, waist circumference, etc.
  • this discovery has developed a multi-way switch circuit module (as shown in Figure 7), which can achieve different measurements.
  • Position comparison (such as different height, test electrode width, relative distance between test electrode and stimulating electrode, etc.), to obtain the best electrode placement position for different subjects, to minimize the inherent interference caused by individual differences, improve measurement accuracy.
  • the technical solution of the present invention at least includes the following beneficial effects:
  • the multi-way switch circuit module has been added to compare the measurement results at different positions to obtain the best electrode placement position, which can reduce the interference caused by individual differences.
  • FIG. 1 is a flow chart of a real-time monitoring and automatic alarm method for low-load bladder urine provided by the implementation of the present invention Figure.
  • FIG. 2 is a schematic view showing the wearing of the test electrode used in the embodiment of the present invention.
  • Fig. 3A is a diagram showing the structure of the impedance threshold membership function in the embodiment of the present invention.
  • Fig. 3B is a diagram showing the membership function of the impedance threshold change rate in the embodiment of the present invention.
  • FIG. 4 is a flow chart of an alarm algorithm in an embodiment of the present invention.
  • Figure 5 is a comparison of sampled data in an embodiment of the present invention.
  • Figure 6 is a display interface in an embodiment of the present invention.
  • Figure 7 shows the system structure in the embodiment of the present invention.
  • a real-time monitoring and automatic alarming method for low-load bladder urine volume includes the following steps:
  • the measurement position includes three adjustable parameters (the vertical height from the electrode to the navel, the distance from the measuring electrode to the center line, and the distance from the stimulating electrode to the center line).
  • three adjustable parameters the vertical height from the electrode to the navel, the distance from the measuring electrode to the center line, and the distance from the stimulating electrode to the center line.
  • a multi-way switch Figure 7 to compare the different positions to find the best electrode installation position. , to minimize the inherent interference of the human body and improve the signal to noise ratio.
  • the measuring electrode and the stimulating electrode are at the same horizontal line (Fig. 2).
  • the cutoff frequency is generally lower than 0. 01Hz, to remove the interference signals such as breathing, heartbeat, high frequency, power frequency, improve the resistance Anti-signal to noise ratio.
  • Real-time search and bubble method are used to obtain the maximum value of dynamic impedance and calculate the impedance threshold and its rate of change.
  • the impedance threshold is the dynamic maximum value to reduce the current value of the impedance
  • the threshold change rate is the current threshold minus the last time threshold.
  • FIG. 3 is a schematic diagram of the membership function of the threshold and threshold rate of change.
  • the fuzzy inference rules are as follows:
  • the IF threshold is positive (PB), THEN urinary alarm;
  • IF threshold is centered (PM) and the threshold change rate is zero (Z) / negative small (NS) / negative large (NB), THEN urination alarm; [3] IF threshold is positive (PS) and threshold change rate is positive (PB), THEN urinary report
  • test time reaches a certain time (such as 2. 5 hours)
  • a certain time such as 2. 5 hours
  • the test system performs a forced urination alarm to avoid the risk caused by the test error. And check the test equipment and electrodes in time.
  • the alarm rules and threshold values can be corrected based on the knowledge of expert knowledge, and clinical test data and expert new knowledge are added as the main basis for knowledge update.
  • this process mainly includes three parts: electrode wear and impedance data acquisition, data pre-processing and feature extraction, feature defuzzification and diagnostic alarm.
  • the wearing of the electrode includes the selection and placement of the electrode position.
  • the position selection is based on the comparison of the multiplex switch to obtain the best placement position.
  • Fig. 2 is a perspective view showing the wearing of the test electrode in the embodiment of the present invention.
  • multiple test electrodes must be in the same horizontal plane, with two measuring electrodes inside and two stimulating electrodes outside, where multiple test electrodes must be symmetrical about the midline.
  • This electrode wearing method conforms to the anatomical and electric field distribution principles and helps to obtain the best results.
  • the low-load bladder urine volume real-time monitoring and automatic alarm method includes the selection of the electrode placement position, uses the multi-way switch module to perform measurement position switching, realizes multi-position measurement and comparison, finds the best measurement position, and reduces individual differences. The resulting measurement error.
  • individual differences such as fat, height, waist circumference, etc.
  • this discovery has developed a multi-way switch circuit module (as shown in Figure 7), which can achieve different measurements.
  • Position comparison (such as different height, test electrode width, relative distance between test electrode and stimulating electrode, etc.), to obtain the best electrode placement position for different subjects, to minimize the inherent interference caused by individual differences, improve measurement accuracy.
  • the digital filtering algorithm is a low-pass point-by-point filtering algorithm using a very low cutoff frequency, which can effectively remove interference signals such as breathing, heartbeat, high frequency, and power frequency in real time, and improve Signal to noise ratio.
  • the digital filtering algorithm is a low-pass point-by-point filtering algorithm using an extremely low cutoff frequency of less than or equal to 0.01. Considering that the physiological characteristics such as breathing and heartbeat will also affect the measurement accuracy to a certain extent, this finding specifies that the cutoff frequency of the low-pass filter must be less than or equal to 0.01.
  • the updated resistance reactance maximum means that the maximum impedance value is recorded and updated in real time, and the impedance maximum value ⁇ ⁇ (Z) > is recorded in the register in real time, if the current time impedance value ⁇ 2( ) > is greater than the previous impedance maximum The value ⁇ ⁇ 4 ⁇ ) >, the current time impedance value ⁇ Z(fc) > is restarted into the register, and the previous data is automatically discarded; otherwise, no data replacement work is performed.
  • the calculation of the impedance threshold and its rate of change in step 2) is based on the impedance maximum and the current impedance. The value is subtracted to obtain the impedance threshold and its rate of change, and then the parameter fuzzification step is performed according to the knowledge base:
  • the threshold value and the threshold change rate are calculated according to the following formula:
  • TR and Max(k) represent the current time impedance threshold, the maximum impedance at the current time, and the impedance at the current time.
  • TR k- respectively represent the current rate of change of the threshold, the threshold of the previous moment, the sampling period
  • Parameter fuzzification is to change the exact value of threshold and threshold change rate into fuzzy value.
  • the threshold fuzzy value is divided into 4 levels such as positive ( ⁇ ), center ( ⁇ ), positive (PS), and zero (Z).
  • the threshold change rate fuzzy value is divided into five levels such as positive (PB), small (PS), zero (Z), negative (NS), and negative (NB).
  • Fig. 3B is a diagram showing the membership function of the impedance threshold change rate in the embodiment of the present invention.
  • Figure 3A shows the membership function of the impedance threshold. Considering that the impedance threshold is always greater than zero, its value is divided into three positive intervals, including positive (PS), medium (PM) and positive (PB), respectively.
  • PS positive
  • PM medium
  • PB positive
  • the function of triangle, ladder and unilateral trapezoids, the choice of value can be selected and optimized according to test experience.
  • Figure 3B is a threshold function of the threshold change rate.
  • the threshold change rate is divided into five intervals according to the principle of symmetry, including negative large (NB), negative small (NS), zero (Z), positive small (PS) and positive (PB), respectively, using unilateral trapezoids and trapezoids. , triangles, trapezoids, and unilateral trapezoidal functions, whose value can be selected and optimized through test experience.
  • FIG. 4 is a flow chart of an alarm algorithm according to an embodiment of the present invention. First, the patient must be reminded to drain the urine before the measurement to ensure that the initial value of the urine in the bladder is close to zero.
  • the second step is to set the parameters, mainly including the setting of the electrode placement position. If the patient is using the instrument for the first time, the comparison test of the multi-way switch must be performed to obtain the best measurement position, and the electrode placement is completed, and the monitoring is started. instrument.
  • pre-processing and feature extraction of impedance data such as dynamic acquisition and filtering are performed to obtain more accurate parameters such as maximum impedance value, impedance threshold, and impedance threshold change rate.
  • the membership function and the fuzzy inference rule base provided in the database are used to perform impedance characterization (threshold and threshold change rate) to defuzzify and urinate event diagnosis, match the urinary alarm successfully, and store the data in the database. In, to update the database. If the match is unsuccessful, start the abnormal diagnosis program, and notify the engineer and the clinical expert to diagnose the fault together, and eliminate the interference factors such as battery power failure, electrode aging and falling off, and abnormal abnormal operation of the patient, and ensure the next measurement is correct.
  • impedance characterization threshold and threshold change rate
  • step 3 of the embodiment of the present invention based on expert knowledge and clinical testing experience, the following fuzzy rules are formulated:
  • the IF threshold is positive (PB), THEN urinary alarm;
  • the IF threshold is centered (PM) and the threshold change rate is zero (Z) / negative small (NS) / negative large (NB), THEN urination alarm;
  • threshold is positive (PS) and threshold change rate is positive (PB), THEN urinary alarm;
  • PB threshold change rate
  • the test system performs Urinary alarm, and check the test device and electrode.
  • Figure 5 compares sampled data in an embodiment of the invention.
  • the above figure shows the raw data of bladder bioelectrical impedance.
  • the figure below shows the data after pre-processing such as low-pass filtering.
  • Figure 6 shows the display interface in the embodiment of the present invention.
  • the invention adopts Labviw program design display interface, including motion button and serial channel selection, raw data and filtered dynamic data display, alarm indicator and abnormal condition indicator light, status display box (prompt whether normal monitoring), monitoring time and other information .
  • Labviw program design display interface including motion button and serial channel selection, raw data and filtered dynamic data display, alarm indicator and abnormal condition indicator light, status display box (prompt whether normal monitoring), monitoring time and other information .
  • FIG. 7 shows the system structure in the embodiment of the present invention.
  • the system structure is the bioelectrical impedance measuring device, comprising a test electrode, a lower position machine and a host computer, wherein the test electrode and the lower position machine are provided with a multi-way switch module connecting the two, and the lower position machine is responsible for the resistance Anti-data acquisition, and wireless communication with the host computer, the host computer is responsible for electrical impedance data processing and automatic alarm.
  • the multiplexer selection module is mainly used to compare the effects of different measurement positions to help the first-time patient to obtain the best measurement position and improve the measurement accuracy.
  • the main control board of the lower computer comprises a main control module and a power module connected to the main control module, an amplitude/phase measurement module, a measurement signal filtering module, an intermediate frequency sinusoidal signal generation module, a voltage controlled constant current source module, a transmitting module, and a receiving
  • the power module manages long-term measurement through energy management, the measurement signal filtering module is used to remove the interference signal, the voltage-controlled constant current source module is used to provide a stable excitation current, and the transmitter is used to wear the bladder at the lower end of the patient's lower abdomen.
  • the test electrode of the position is input with current excitation, and the receiver is used to collect the electrical impedance data of the human body and wirelessly transmit it to the upper computer.
  • the data communication communication between the upper computer and the lower computer is realized by the RS232 wireless module set in the lower computer.
  • the upper computer alarm algorithm module is mainly responsible for electrical impedance data preprocessing (filtering, detrending, etc.), feature extraction (impedance maximum, threshold, threshold change rate, etc.), feature fuzzification and diagnosis, etc. Correct the knowledge base and improve the accuracy of the alarm. Then, according to the diagnosis result of the alarm algorithm, the sound and light alarm is used to remind the patient to urinate in time.
  • the method and the measuring device of the present invention can also measure the thickness of the fat, the condition of the ascites, the food retained in the stomach, and the respiratory condition, etc., which are all within the scope of the present invention.

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Abstract

一种低负荷膀胱尿量实时监测与自动报警方法,包括如下步骤:1)将多个测试电极紧贴患者的测试部位,根据生物电阻抗技术,通过生物电阻抗测量装置实时测量膀胱的电阻抗值(101);2)通过数字滤波算法,选择合适参数,去除干扰信号,提高电阻抗信噪比,并实时更新电阻抗最大值,计算阻抗阈值及其变化率(102);3)根据医学知识与临床经验,建立专家诊断系统,对阻抗阈值和阈值变化率进行模糊化处理,制定模糊规则,然后根据模糊规则实现自动排尿报警,以提示患者及时排尿或通知医务人员(103)。采用该方法能够实时、准确地对膀胱尿量进行动态预测与排尿报警,提示患者及时排尿,或通过无线网络远程监控病情,操作更加安全方便、抗干扰能力强。

Description

说 明 书
低负荷膀胱尿量实时监测与自动报警方法
技术领域
本发明涉及一种膀胱尿量实时监测方法, 尤其涉及基于生物电阻抗的低负 荷膀胱尿量实时监测与排尿自动报警方法。
技术背景
目前膀胱状况检测方法多采用超声、 压力、 位移等技术手段, 采用的都是 静态监测方法, 无法及时掌握患者尿量。 对于像尿失禁、 膀胱炎、 脊髓损伤等 尿意缺失患者, 需要实时监测膀胱尿量, 并及时提醒患者排尿, 才能预防积尿 过多、 排尿过频或排尿不尽等并发症; 同时, 也可以通过有线 (或无线) 通信 方法实现远程监控, 目前的膀胱尿量监测方法无法满足上述要求。
生物电阻抗技术利用了生物组织及器官的电特性提取人体生理与病理信息 的无创检测技术。 现有测量方法和装置都无法清晰准确根据测量数据, 寻找到 合适的报警点, 及时提示患者排尿。 现有技术中公开了一种基于生物电阻抗的 膀胱尿量监测装置, 并采用阀值与曲线拟合等线性方法来预测尿量多少。 但是, 考虑到人体膀胱器官是一种极其复杂的自适应系统, 其电阻抗变化与尿量变化 之间的数学模型极其复杂, 同时存在明显的个体与时空差异性, 进一步将模型 复杂化, 因此, 现有技术中采用简单的线性关系来预测尿量必然存在极大误差。 为此, 本发明基于对膀胱器官及其电阻抗关系深入探讨的基础上, 提出了一种 基于模糊逻辑和专家知识的自适应预测模型, 实现更加精确地尿量预测与排尿 报警。
发明内容
本发明的目的是克服现有技术的不足, 提供一种基于生物电阻抗的非侵入 式排尿预测方法, 结合临床专家经验与实验数据特征, 采用模糊逻辑方法实现 更加精准膀胱尿量预测与报警。 其操作更安全、 抗干扰能力更强、 更加准确提 醒患者及时排尿, 并避免过于频繁排尿的风险。
本发明实施提供了一种低负荷膀胱尿量实时监测与自动报警方法, 其步骤 包括:
1 ) 将多个测试电极紧贴患者的测试部位, 根据生物电阻抗技术, 通过生物 电阻抗测量装置实时测量膀胱的电阻抗值;
2 ) 通过数字滤波算法, 选择包括截止频率、 阶数在内的合适参数, 去除包 括呼吸、 心跳、 高频、 工频在内的干扰信号, 提高电阻抗信噪比; 然后, 实时 更新电阻抗最大值, 计算阻抗阀值及其变化率;
3 ) 根据医学知识与临床测试经验, 建立专家诊断系统, 即对阻抗阀值、 阀 值变化率进行模糊化处理, 制定模糊规则; 然后根据模糊规则判据实现自动排 尿报警, 以提示患者及时排尿或通知医务人员。
作为本发明技术方案的优选实施方式, 本发明的低负荷膀胱尿量实时监测 与自动报警方法进一步包括如下技术特征的部分或者全部:
优选地, 所述的生物电阻抗测量装置, 包括测试电极、 下位机和上位机, 所述测试电极与所述下位机之间设置有连接二者的多路开关模块, 下位机负责 电阻抗数据采集, 并通过无线方式与上位机进行数据通讯, 上位机负责电阻抗 数据处理与自动报警。
优选地, 下位机主控板包括主控模块和与所述主控模块相连的电源模块、 幅值 /相位测量模块、 测量信号滤波模块、 中频正弦信号发生模块、 压控恒流源 模块、 发射模块、 接收模块; 所述电源模块通过能耗管理实现长时间测量, 测 量信号滤波模块用于去除干扰信号, 压控恒流源模块用于提供稳定的激励电流, 发射器用于通过佩戴在患者小腹下端对应膀胱位置的测试电极输入电流激励, 接收器用于采集人体电阻抗数据, 并通过无线方式传输到上位机。
优选地,上位机及下位机之间的数据通讯通信是通过下位机中设置的 RS232 无线模块实现。
优选地, 所述步骤 2 ) 中, 数字滤波算法是采用极低截止频率的低通逐点滤 波算法, 可以实时有效地去除呼吸、 心跳、 高频、 工频在内的干扰信号, 提高 信噪比。 进一步地, 在本发明的一个优选实施例中看, 所述步骤 2 ) 中, 数字滤 波算法是采用小于或等于 0. 01的极低截止频率的低通逐点滤波算法。 考虑到呼 吸、 心跳等生理特征也会在一定程度影响到测量精度, 本发现特规定低通滤波 器截止频率必须小于或等于 0. 01 。
优选地, 所述步骤 2 ) 中, 更新电阻抗最大值是指实时录找并更新最大阻抗 值, 实时地将阻抗最大值〈 42) >记录在寄存器中, 如果当前时刻的阻抗值 < Z(k) >大于之前的阻抗最大值〈 Max(Z) >,则将当前时刻的阻抗值〈 Z(k、 >重新开始 写入寄存器中, 以前的数据自动丢掉; 反之, 不做任何数据取代工作。
优选地, 步骤 2 )中计算阻抗阀值及其变化率是根据阻抗最大值与当前的阻 抗值相减得到阻抗阀值及其变化率, 再根据知识库进行参数模糊化步骤:
阀值及阀值变化率根据如下公式计算:
TR(k) = Max(Z) - Z(k) , k = 0, 1,2,...
其中 TR d、 Max{k) , 分别表示当前时刻阻抗阀值, 当前时刻的最大阻 抗值, 当前时刻的阻抗值。 卿 ) = — — D, k = 2,3,4,...
T
其中 , TR k-、 , 分别表示当前时刻阀值变化率, 前一时刻阀值, 采样周期;
参数模糊化是将阀值、 阀值变化率的精确值变成模糊值, 阀值模糊值均分 4 个等级如正大 (ΡΒ)、 正中 (ΡΜ)、 正小 (PS )、 零 (Z)。 阀值变化率模糊值均分 5个等级如正大 (PB)、 正小 (PS )、 零 (Z)、 负小 (NS)、 负大 (NB)。
优选地, 所述步骤 3 ) 中, 根据专家知识与临床测试经验, 制定如下模糊规 则:
[ 1] IF 阀值为正大 (PB), THEN 排尿报警;
[2] IF 阀值为正中(PM ) and 阀值变化率为零(Z ) /负小(NS ) /负大(NB), THEN排尿报警;
[3] IF 阀值为正小 (PS ) and 阀值变化率为正大 (PB), THEN排尿报警; 此外, 如果测试时间达一定时间 (如 2. 5小时), 仍然没有报警, 测试系统 进行排尿强制报警, 并排查测试装置与电极。
优选地, 本发明的低负荷膀胱尿量实时监测与自动报警方法还包括电极安 放位置的选择, 采用多路开关模块进行测量位置切换, 实现多位置测量与比较, 找到最佳的测量位置, 减小个体差异造成的测量误差。 考虑到个体差异 (如脂 肪、 身高、 腰围等) 直接影响到测试电极位置的选择, 为此, 本发现专门开发 了一款多路切换开关电路模块 (如图 7所示), 可实现不同测量位置对比 (如不 同高度, 测试电极宽度, 测试电极与刺激电极相对距离等), 针对不同受试者获 得其最佳的电极安放位置, 最大化减小个体差异所带来的人体固有干扰, 提高 测量精度。
相比与现有技术, 本发明的技术方案至少包括如下有益效果:
1 . 采用模糊逻辑理论, 有助于缩短临床专家语言与工程数据特征之间的距 离, 更好地学习临床专家经验, 更充分的获取阻抗特征, 提高报警精度。
2. 结合阀值、 阀值变化率、 时间等多特征的专家报警方法, 可以更加准确 地捕获排尿这一生理特征, 更合理进行排尿提醒与报警!
3. 增加了多路开关电路模块, 比较不同位置测量效果, 获得最佳的电极安 放位置, 可以减小个体差异带来的干扰。
附图说明
图 1 是本发明实施提供的低负荷膀胱尿量实时监测与自动报警方法的流程 图。
图 2是本发明实施例中所用测试电极的佩戴示意图。
图 3A是本发明实施例中阻抗阀值隶属度函数结构。
图 3B是本发明实施例中阻抗阀值变化率隶属度函数结构。
图 4是本发明实施例中报警算法流程图。
图 5是本发明实施例中采样数据比较。
图 6是本发明实施例中显示界面。
图 7本发明实施例中系统结构。
具体实施方式
为使本发明的目的、 技术方案和优点更加清楚, 下面将结合附图对本发明 作优选地详细描述。
如图 1 所示, 本发明实施提供的一种低负荷膀胱尿量实时监测与自动报警 方法, 包括以下步骤:
①、 选择最佳的测量位置, 如图 2所示, 测量位置包括三个可调参数 (电 极到肚脐的垂直高度,测量电极到中线的距离, 刺激电极到中线的距 离)。 考虑到膀胱周围组织的干扰、 电流在人体器官中流向的不确性 和膀胱位置的个体差异, 我们可采用多路开关进行 (如图 7 ) 不同位 置比较实验, 从而找到最佳的电极安装位置, 最大化减小人体固有干 扰, 提高信号噪比。 根据解剖学和电场分布原理, 测量电极和刺激电 极处于同一水平线 (如图 2 )。
②、 通过实时低通滤波算法, 选择合适的参数包括截止频率、 阶数等, 截 止频率一般要低于 0. 01Hz,以去除呼吸、 心跳、 高频、 工频在内的干 扰信号, 提高电阻抗信噪比。 采用实时搜索和冒泡法, 获取动态的电 阻抗最大值, 并同时计算阻抗阀值及其变化率。 其中阻抗阀值为动态 最大值减小阻抗的当前值, 阀值变化率为当前阀值减去上一时刻的阀 值。
③、 结合医学知识与临床实验数据特征, 建立专家诊断系统, 即对阀值、 阀值变化率进行模糊化处理, 变成临床语言; 制定模糊规则, 实现自 动报警, 以提示患者及时排尿。 其中附图 3为阀值与阀值变化率的隶 属度函数示意图。 模糊推理规则如下:
[1] IF 阀值为正大 (PB), THEN 排尿报警;
[2] IF 阀值为正中 (PM) and 阀值变化率为零 (Z ) /负小 (NS ) /负大 (NB), THEN排尿报警; [3] IF 阀值为正小 (PS) and 阀值变化率为正大 (PB), THEN排尿报
[4]如果测试时间达一定时间 (如 2. 5小时), 仍然没有报警, 测试系统 进行排尿强制报警, 避免因测试出错引起风险。 并及时排查测试装 置与电极。
[5]此外, 报警规则和阀值隶所度函数可以根据专家知识的知识更新进 行修正, 而临床测试数据与专家新知识增加为知识更新的主要依据。 有图 1 可见, 本流程主要包括三部分: 电极的佩戴与阻抗数据采集, 数据 的预处理与特征提取, 特征的去模糊化与诊断报警。
电极的佩戴包括电极位置的选择与安放, 位置的选择基于多路开关的比较 获得最佳安放位置; 电极的安放前, 最好要剃除皮肤表面的不洁净物质, 再用 酒精试擦其表面, 以减小对测量的影响。 图 2 为本发明实施例中测试电极的佩 戴示意。 通过示意图显示, 多个测试电极必须处于同一水平面, 两个测量电极 在内, 两个刺激电极在外, 其中多个测试电极必须关于中线对称。 此种电极佩 戴方法, 符合解剖学与电场分布原理, 有助于获得最佳的效果。
本发明的低负荷膀胱尿量实时监测与自动报警方法中包括电极安放位置的 选择, 采用多路开关模块进行测量位置切换, 实现多位置测量与比较, 找到最 佳的测量位置, 减小个体差异造成的测量误差。 考虑到个体差异 (如脂肪、 身 高、 腰围等) 直接影响到测试电极位置的选择, 为此, 本发现专门开发了一款 多路切换开关电路模块(如图 7所示), 可实现不同测量位置对比(如不同高度, 测试电极宽度, 测试电极与刺激电极相对距离等), 针对不同受试者获得其最佳 的电极安放位置, 最大化减小个体差异所带来的人体固有干扰, 提高测量精度。
在本发明优选实施例的步骤 2 )中, 数字滤波算法是采用极低截止频率的低 通逐点滤波算法, 可以实时有效地去除呼吸、 心跳、 高频、 工频在内的干扰信 号, 提高信噪比。进一步地, 在本发明的一个优选实施例中看, 所述步骤 2 )中, 数字滤波算法是采用小于或等于 0. 01的极低截止频率的低通逐点滤波算法。 考 虑到呼吸、 心跳等生理特征也会在一定程度影响到测量精度, 本发现特规定低 通滤波器截止频率必须小于或等于 0. 01 。 而更新电阻抗最大值是指实时录找 并更新最大阻抗值, 实时地将阻抗最大值〈 ^(Z) >记录在寄存器中, 如果当前 时刻的阻抗值〈2( ) >大于之前的阻抗最大值〈 Ϊ4Ζ) >, 则将当前时刻的阻抗值 〈Z(fc) >重新开始写入寄存器中, 以前的数据自动丢掉; 反之, 不做任何数据取代 工作。
其中, 步骤 2 )中计算阻抗阀值及其变化率是根据阻抗最大值与当前的阻抗 值相减得到阻抗阀值及其变化率, 再根据知识库进行参数模糊化步骤: 阀值及阀值变化率根据如下公式计算:
TR(k) = Max(Z) - Z(k) , k = 0, 1,2,...
其中 TR 、 Max(k) , 分别表示当前时刻阻抗阀值, 当前时刻的最大阻 抗值, 当前时刻的阻抗值。 ) =剛— — , k = 2,3,4,...
T
其中 , TR k-、 , 分别表示当前时刻阀值变化率, 前一时刻阀值, 采样周期;
参数模糊化是将阀值、 阀值变化率的精确值变成模糊值, 阀值模糊值均分 4 个等级如正大 (ΡΒ)、 正中 (ΡΜ)、 正小 (PS )、 零 (Z)。 阀值变化率模糊值均分 5个等级如正大 (PB)、 正小 (PS )、 零 (Z)、 负小 (NS)、 负大 (NB)。
图 3B是本发明实施例中阻抗阀值变化率隶属度函数结构。 图 3A为阻抗阀 值的隶属度函数, 考虑到阻抗阀值恒大于零, 所以其值划分为三个正的区间, 包括正小 (PS )、 正中 (PM ) 和正大 (PB ) , 分别采用三角、 梯型与单边梯形的 函数表示, 其值的选择可以根据测试经验进行选择与优化。
图 3B为阀值变化率隶属度函数。阀值变化率则按对称原则划分为 5个区间, 包括负大 (NB)、 负小 (NS)、 零 (Z)、 正小 (PS ) 和正大 (PB ) , 分别采用单边 梯形、 梯形、 三角形、 梯形和单边梯形函数, 其值的大小变可以通过测试经验 进行选择与优化。
图 4 为本发明实施例中报警算法流程。 首先, 测量前必须提醒患者排尽尿 量, 以确保膀胱中尿量初值接近零。
第二步进行参数设定, 主要包括电极安放位置的设定, 如果患者是第一次 使用仪器, 必须进行多路开关的比较测试, 获得最佳的测量位置, 并完成电极 的安放, 启动监测仪器。
接着, 进行阻抗数据的动态采集、 滤波等预处理、 特征提取, 获得比较准 确的最大阻抗值、 阻抗阀值、 阻抗阀值变化率等重要参数。
下一步, 采据数据库中提供的隶属度函数与模糊推理规则库, 进行阻抗特 征 (阀值与阀值变化率) 去模糊化与排尿事件诊断, 匹配成功进行排尿报警, 并将数据存入数据库中, 以更新数据库。 如果匹配不成功, 启动异常诊断程序, 并通知工程师和临床专家一起进行故障诊断, 排除电池掉电、 电极老化与脱落、 患者异常动作过多等干扰因素, 保下次测量正确。
与此同时, 为了避免异常错误产生而影响患者健康, 本发现参加了一个强 制报警措施, 以保护患者健康。
此外, 临床专家新的知识、 测试过程的导常情况、 新数据的加入等都可以 进一步完善数据库和知识库, 修正隶属度函数和推理规则等, 从而实现自适应 的排尿报警方法, 达到最佳精度。 在本发明实施例的步骤 3 ) 中, 根据专家知识 与临床测试经验, 制定如下模糊规则:
[4] IF 阀值为正大 (PB), THEN 排尿报警;
[5] IF 阀值为正中(PM) and 阀值变化率为零(Z ) /负小(NS) /负大(NB), THEN排尿报警;
[6] IF 阀值为正小 (PS) and 阀值变化率为正大 (PB), THEN排尿报警; 此外, 如果测试时间达一定时间 (如 2. 5小时), 仍然没有报警, 测试系统 进行排尿强制报警, 并排查测试装置与电极。
图 5 本发明实施例中采样数据比较。 上图为膀胱生物电阻抗原始数据, 下 图为经过低通滤波等预处理后的数据。
图 6本发明实施例中显示界面。 本发明采用 Labviw程序设计显示界面, 包 括运动按钮和串口通道选择、 原始数据与滤波后的动态数据显示、 报警指示灯 与异常情况指标灯、 状态显示框 (提示是否正常监测)、 监测时长等信息。 通过 界面显示, 可以清楚地掌握仪器的运行状态。
图 7 本发明实施例中系统结构。 该系统结构即为所述的生物电阻抗测量装 置, 包括测试电极、 下位机和上位机, 所述测试电极与所述下位机之间设置有 连接二者的多路开关模块, 下位机负责电阻抗数据采集, 并通过无线方式与上 位机进行数据通讯, 上位机负责电阻抗数据处理与自动报警。 多路开关选择模 块主要用于比较不同测量位置效果, 以帮助初次实验的患者获得最佳的测量位 置, 提高测量精度。
下位机主控板包括主控模块和与所述主控模块相连的电源模块、 幅值 /相位 测量模块、 测量信号滤波模块、 中频正弦信号发生模块、 压控恒流源模块、 发 射模块、 接收模块; 所述电源模块通过能耗管理实现长时间测量, 测量信号滤 波模块用于去除干扰信号, 压控恒流源模块用于提供稳定的激励电流, 发射器 用于通过佩戴在患者小腹下端对应膀胱位置的测试电极输入电流激励, 接收器 用于采集人体电阻抗数据, 并通过无线方式传输到上位机。 在本发明优选实施 例中, 上位机及下位机之间的数据通讯通信是通过下位机中设置的 RS232 无线 模块实现。
上位机报警算法模块主要负责电阻抗数据预处理 (滤波、 去趋势等)、 特征 提取 (阻抗最大值、 阀值、 阀值变化率等)、 特征模糊化处理与诊断等, 并时实 修正知识库, 提高报警精度。 然后, 根据报警算法诊断结果, 通过声光报警, 以提醒患者及时排尿。
应当指出, 对于本技术领域的普通技术人员来说, 在不脱离本发明原理的 前提下还可以做出若干改进和变动, 这些改进和变动也视为本发明的保护范围。 需要说明的是, 采用本发明的方法和测量装置还可以测量脂肪厚度, 腹腔积水 病情, 胃部滞留的食物, 以及呼吸情况等等, 这些都属于本发明保护的范围。

Claims

1. 一种低负荷膀胱尿量实时监测与自动报警方法, 其特征在于, 包括如下步骤:
1 ) 将多个测试电极紧贴患者的测试部位, 根据生物电阻抗技术, 通过生物电阻 抗测量装置实时测量膀胱的电阻抗值;
2 ) 通过数字滤波算法, 选择包括截止频率、 阶数在内的合适参数, 去除包括呼 吸、 心跳、 高频、 工频在内的干扰信号, 提高电阻抗信噪比; 然后, 实时更新电阻 抗最大值, 计算阻抗阀值及其变化率;
3 ) 根据医学知识与临床测试经验, 建立专家诊断系统, 即对阻抗阀值、 阀值变 化率进行模糊化处理, 制定模糊规则; 然后根据模糊规则判据实现自动排尿报警, 以提示患者及时排尿或通知医务人员。
2. 按照权利要求 1所述的一种低负荷膀胱尿量实时监测与自动报警方法, 其特 征在于: 所述的生物电阻抗测量装置, 包括测试电极、 下位机和上位机, 所述测试 电极与所述下位机之间设置有连接二者的多路开关模块, 下位机负责电阻抗数据采 集, 并通过无线方式与上位机进行数据通讯, 上位机负责电阻抗数据处理与自动报
3. 按照权利要求 2所述的一种低负荷膀胱尿量实时监测与自动报警方法, 其特 征在于: 下位机主控板包括主控模块和与所述主控模块相连的电源模块、 幅值 /相位 测量模块、 测量信号滤波模块、 中频正弦信号发生模块、 压控恒流源模块、 发射模 块、 接收模块; 所述电源模块通过能耗管理实现长时间测量, 测量信号滤波模块用 于去除干扰信号, 压控恒流源模块用于提供稳定的激励电流, 发射器用于通过佩戴 在患者小腹下端对应膀胱位置的测试电极输入电流激励, 接收器用于采集人体电阻 抗数据, 并通过无线方式传输到上位机。
4. 按照权利要求 2所述的一种低负荷膀胱尿量实时监测与自动报警方法, 其特 征在于: 上位机及下位机之间的数据通讯通信是通过下位机中设置的 RS232 无线模 块实现。
5. 按照权利要求 1 所述的一种低负荷膀胱尿量实时监测与自动报警方法,其特 征在于: 所述步骤 2 ) 中, 数字滤波算法是采用极低截止频率的低通逐点滤波算法, 可以实时有效地去除呼吸、 心跳、 高频、 工频在内的干扰信号, 提高信噪比。
6. 按照权利要求 5所述的一种低负荷膀胱尿量实时监测与自动报警方法, 其特 征在于: 所述步骤 2 ) 中, 数字滤波算法是采用小于或等于 0. 01的极低截止频率的 低通逐点滤波算法。
7. 按照权利要求 5所述的一种低负荷膀胱尿量实时监测与自动报警方法, 其特 征在于: 所述步骤 2) 中, 更新电阻抗最大值是指实时录找并更新最大阻抗值, 实时 地将阻抗最大值〈 4 >记录在寄存器中,如果当前时刻的阻抗值〈2 )〉大于之前的 阻抗最大值〈M (Z)>,则将当前时刻的阻抗值〈^ )>重新开始写入寄存器中, 以前的 数据自动丢掉; 反之, 不做任何数据取代工作。
8. 按照权利要求 1所述的一种低负荷膀胱尿量实时监测与自动报警方法, 其特 征在于: 步骤 2)中计算阻抗阀值及其变化率是根据阻抗最大值与当前的阻抗值相减 得到阻抗阀值及其变化率, 再根据知识库进行参数模糊化步骤:
阀值及阀值变化率根据如下公式计算:
TR(k)=Max(Z)-Z(k), k = 0,1,2,...
其中 7^)、 fer )、Z )分别表示当前时刻阻抗阀值,当前时刻的最大阻抗值, 当前时刻的阻抗值; )=剛— — , k = 2,3,4,...
T
其中 dTi , TRm 分别表示当前时刻阀值变化率, 前一时刻阀值, 采样 周期;
参数模糊化是将阀值、 阀值变化率的精确值变成模糊值, 阀值模糊值均分 4个 等级如正大 (PB)、 正中 (PM)、 正小 (PS)、 零 (Z)。 阀值变化率模糊值均分 5个等 级如正大 (PB)、 正小 (PS)、 零 (Z)、 负小 (NS)、 负大 (NB)。
9. 按照权利要求 1所述的一种低负荷膀胱尿量实时监测与自动报警方法, 其特 征在于: 所述步骤 3) 中, 根据专家知识与临床测试经验, 制定如下模糊规则:
[1]IF 阀值为正大 (PB), THEN 排尿报警;
[2] IF 阀值为正中 (PM) and 阀值变化率为零 (Z) /负小 (NS) /负大 (NB), THEN排尿报警;
[3] IF 阀值为正小 (PS) and 阀值变化率为正大 (PB), THEN排尿报警; 此外, 如果测试时间达一定时间 (如 2.5小时), 仍然没有报警, 测试系统进行 排尿强制报警, 并排查测试装置与电极。
10. 按照权利要求 1 所述的低负荷膀胱尿量实时监测与自动报警方法, 其特征 在于: 还包括电极安放位置的选择, 采用多路开关模块进行测量位置切换, 实现多 位置测量与比较, 找到最佳的测量位置, 减小个体差异造成的测量误差。
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