WO2021068160A1 - 一种通气切换控制方法及装置、医用通气设备、存储介质 - Google Patents

一种通气切换控制方法及装置、医用通气设备、存储介质 Download PDF

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WO2021068160A1
WO2021068160A1 PCT/CN2019/110346 CN2019110346W WO2021068160A1 WO 2021068160 A1 WO2021068160 A1 WO 2021068160A1 CN 2019110346 W CN2019110346 W CN 2019110346W WO 2021068160 A1 WO2021068160 A1 WO 2021068160A1
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Prior art keywords
flow rate
ventilation
patient
time
comparison
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PCT/CN2019/110346
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English (en)
French (fr)
Inventor
刘京雷
刘玲
周小勇
徐晓婷
杨毅
邱海波
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深圳迈瑞生物医疗电子股份有限公司
东南大学附属中大医院
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Application filed by 深圳迈瑞生物医疗电子股份有限公司, 东南大学附属中大医院 filed Critical 深圳迈瑞生物医疗电子股份有限公司
Priority to PCT/CN2019/110346 priority Critical patent/WO2021068160A1/zh
Priority to CN201980073160.XA priority patent/CN112969486B/zh
Publication of WO2021068160A1 publication Critical patent/WO2021068160A1/zh

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    • 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. mouth-to-mouth respiration; Tracheal tubes

Definitions

  • the embodiments of the present invention relate to the technical field of medical devices, and in particular to a ventilation switching control method and device, medical ventilation equipment, and storage media.
  • the man-machine synchronization performance is one of the core performances of medical ventilation equipment such as ventilators, that is, the ventilation equipment needs to be able to deliver air in time when the patient inhales hard, and switch to the exhalation phase in time after the patient inhales.
  • typical inhalation triggering methods of ventilator include flow triggering and pressure triggering.
  • the flow triggering method is to trigger the inhalation after the patient's inspiratory flow rate is greater than the trigger sensitivity
  • the pressure triggering method is for the patient to inhale independently to make the airway.
  • the inspiratory trigger is performed after the pressure is lower than the positive end-expiratory pressure.
  • the typical exhalation switching method of the ventilator is to perform exhalation switching when the patient's inspiratory flow rate drops to a certain percentage of the peak inspiratory flow rate.
  • the embodiments of the present invention expect to provide a ventilation switching control method and device, which compares the estimated theoretical ventilation flow rate at the comparison time with the monitored patient ventilation flow rate at the comparison time, so as to accurately determine the patient's breathing Status, and switch the corresponding ventilation mode, which improves the performance of man-machine synchronization.
  • the embodiment of the present invention provides a ventilation switching control method, which is applied to medical ventilation equipment, and the method includes:
  • the medical ventilation device is controlled to switch the ventilation mode according to the recognized breathing state.
  • the method before the step of estimating the theoretical ventilation flow rate at the comparison time based on the time constant, the method further includes:
  • the step of estimating the theoretical ventilation flow rate at the comparison time based on the time constant includes:
  • the theoretical ventilation flow rate at the comparison time is estimated.
  • the comparison moment is any moment after the peak expiratory flow rate is reached in the expiration phase, and the peak expiratory flow rate is the peak expiratory flow rate;
  • the comparison moment is any moment after the peak expiratory flow rate is reached in the inspiratory phase, and the peak respiratory flow rate is the peak inspiratory flow rate.
  • the step of estimating the theoretical ventilation flow rate at the comparison time based on the time constant includes:
  • the starting time corresponding to the preset time period and the comparison time are the time after reaching the peak expiratory flow rate in the expiration phase, or the time after reaching the peak inspiratory flow velocity during the inspiratory phase.
  • the step of identifying the breathing state of the patient based on the estimated theoretical ventilation flow rate at the comparison time and the monitored ventilation flow rate of the patient at the comparison time includes:
  • the step of determining the change in the patient's breathing state includes:
  • the comparison time is any time after the peak expiratory flow rate is reached, if the patient ventilation flow rate at the monitored comparison time is greater than the estimated theoretical ventilation flow rate at the comparison time, and is different from the estimated When the difference between the theoretical ventilation flow rates at the comparison time is greater than the preset threshold, it is determined that the patient's breathing state is spontaneous inhalation;
  • the comparison time is any time after the peak inspiratory flow rate is reached, if the theoretical ventilation flow rate at the estimated comparison time is greater than the monitored patient ventilation flow rate, and is compared with the monitored comparison time If the difference between the ventilation flow rates of the patient is greater than the preset threshold, it is determined that the patient's breathing state is spontaneous exhalation.
  • the controlling the medical ventilation device to switch the ventilation mode according to the recognized breathing state includes:
  • the medical ventilation device is triggered to enter the expiratory ventilation mode.
  • the embodiment of the present invention provides a ventilation switching control device, which is applied to medical ventilation equipment, and the device includes: a flow rate measuring device, a processor, and a memory;
  • the flow rate measuring device is connected to the processor and is used to monitor the patient's ventilation flow rate
  • the processor is connected to the memory, and is configured to execute the ventilation switching control program stored in the memory to implement the following steps:
  • the medical ventilation device is controlled to switch the ventilation mode according to the recognized breathing state.
  • the processor further obtains the patient's peak respiration flow rate through the monitored patient's ventilation flow rate before estimating the theoretical ventilation flow rate at the comparison time based on the time constant;
  • the step of the processor estimating the theoretical ventilation flow rate at the comparison time based on the time constant includes:
  • the theoretical ventilation flow rate at the comparison time is estimated.
  • the comparison time is any time after the peak expiratory flow rate is reached in the expiration phase, and the peak expiratory flow rate is the peak expiratory flow rate
  • the comparison moment is any moment after the peak inspiratory flow rate is reached in the inspiratory phase, and the peak inspiratory flow rate is the peak inspiratory flow rate.
  • the step of the processor estimating the theoretical ventilation flow rate at the comparison time based on the time constant includes:
  • the starting time corresponding to the preset time period and the comparison time are the time after reaching the peak expiratory flow rate in the expiration phase, or the time after reaching the peak inspiratory flow velocity during the inspiratory phase.
  • the processor based on the estimated theoretical ventilation flow rate at the comparison time and the monitored patient ventilation flow rate at the comparison time, the step of identifying the patient's breathing state includes:
  • the step of the processor determining the change of the patient's breathing state includes:
  • the comparison time is any time after the peak expiratory flow rate is reached, if the patient ventilation flow rate at the monitored comparison time is greater than the estimated theoretical ventilation flow rate at the comparison time, and is different from the estimated When the difference between the theoretical ventilation flow rates at the comparison time is greater than the preset threshold, it is determined that the patient's breathing state is spontaneous inhalation;
  • the comparison time is any time after the peak inspiratory flow rate is reached, if the theoretical ventilation flow rate at the estimated comparison time is greater than the patient ventilation flow rate at the monitored comparison time, and is different from the monitored If the difference between the patient's ventilation flow rate at the comparison moment is greater than the preset threshold, it is determined that the patient's breathing state is spontaneous exhalation.
  • the step of the processor controlling the medical ventilation device to switch the ventilation mode according to the recognized breathing state includes:
  • the medical ventilation device is triggered to enter the inspiratory ventilation mode; if the breathing state is autonomous exhalation, the medical ventilation device is triggered to enter the expiratory ventilation mode.
  • the embodiment of the present invention provides a medical ventilation device including the above ventilation switching control device, and the medical ventilation device further includes a gas source and a breathing circuit;
  • the ventilation switching control device includes a flow rate measurement device, a processor, and a memory, and the processor is connected to the flow rate measurement device and the memory;
  • the air source is connected to the processor, and provides ventilation support to the patient under the control of the processor;
  • the breathing circuit is connected with the air source to provide a breathing path during ventilation
  • the flow rate measuring device is connected with the breathing circuit, and the patient's ventilation flow rate is monitored during the ventilation process.
  • An embodiment of the present invention provides a computer-readable storage medium that stores a ventilation switching control program, and the ventilation switching control program can be executed by a processor to realize the above-mentioned ventilation switching control method.
  • the embodiment of the present invention provides a ventilation switching control method, which is applied to a medical ventilation device, and the method includes: monitoring a patient's ventilation flow rate through a flow rate measuring device; obtaining the patient's time constant; estimating the theoretical ventilation flow rate at the comparison time based on the time constant; The estimated theoretical ventilation flow rate at the comparison time and the patient ventilation flow rate at the monitored comparison time are identified to identify the patient's breathing state; the medical ventilation device is controlled to switch the ventilation mode according to the identified breathing state.
  • the technical solution provided by the embodiment of the present invention compares the estimated theoretical ventilation flow rate at the comparison time with the patient ventilation flow rate at the monitored comparison time, which can accurately determine the patient's breathing state and switch the corresponding ventilation mode, which improves Man-machine synchronization performance.
  • Fig. 1 is a schematic structural diagram of a ventilation switching control device provided by an embodiment of the present invention
  • FIG. 2 is a schematic flowchart of a ventilation switching control method provided by an embodiment of the present invention.
  • Figure 3(a) is an exemplary schematic diagram 1 of airway pressure changes during patient ventilation provided by an embodiment of the present invention
  • FIG. 3(b) is an exemplary schematic diagram 1 of the change of the ventilation flow rate during the patient's ventilation process according to an embodiment of the present invention
  • Figure 4 (a) is an exemplary schematic diagram 2 of airway pressure changes during patient ventilation provided by an embodiment of the present invention
  • Fig. 4(b) is an exemplary schematic diagram 2 of the change of the ventilation flow rate during the patient's ventilation process according to the embodiment of the present invention
  • Fig. 5 is a schematic structural diagram of a medical ventilation device provided by an embodiment of the present invention.
  • the embodiment of the present invention provides a ventilation switching control method, which is applied to medical ventilation equipment, and the ventilation switching control method is implemented by a ventilation switching control device.
  • Fig. 1 is a schematic structural diagram of a ventilation switching control device provided by an embodiment of the present invention. As shown in FIG. 1, the ventilation switching control device includes: a flow rate measuring device 101, a processor 102 and a memory 103.
  • the flow rate measuring device 101 is a device with a function of monitoring the gas flow rate, for example, a flow sensor.
  • the specific flow rate measuring device 101 is not limited in the embodiment of the present invention.
  • the processor 102 may be an Application Specific Integrated Circuit (ASIC), a digital signal processor (Digital Signal Processor, DSP), or a digital signal processing device (Digital Signal Processor). Processing Device, DSPD), Programmable Logic Device (PLD), Field Programmable Gate Array (Field Programmable Gate Array, FPGA), Central Processing Unit (CPU), Controller, Microcontroller, At least one of the microprocessors is not limited in the embodiment of the present invention.
  • the memory 103 may be a volatile memory (volatile memory), such as a random access memory (Random Access Memory, RAM); or a non-volatile memory (non-volatile memory). ), such as read only memory (Read Only Memory, ROM), flash memory (flash memory), hard disk (Hard Disk Drive, HDD) or solid-state drive (Solid-State Drive, SSD); or a combination of the above types of memory,
  • volatile memory such as a random access memory (Random Access Memory, RAM); or a non-volatile memory (non-volatile memory).
  • ROM read only memory
  • flash memory flash memory
  • HDD Hard Disk Drive
  • SSD solid-state drive
  • the processor 103 is also provided with a stored breathing recognition program, which is not limited in the embodiment of the present invention.
  • the medical ventilation equipment may be a ventilator, an anesthesia machine, or other medical equipment with ventilation function.
  • the specific medical ventilation equipment is not limited in the embodiment of the present invention.
  • the following describes the ventilation switching control method in detail based on the above-mentioned ventilation switching control device.
  • FIG. 2 is a schematic flowchart of a ventilation switching control method provided by an embodiment of the present invention. As shown in Figure 2, it mainly includes the following steps:
  • the flow rate measuring device 101 of the ventilation switching control device can directly monitor the patient's ventilation flow rate.
  • the patient's ventilation flow rate is the actual ventilation flow rate during the patient's breathing process using the medical ventilation device.
  • the patient's ventilation flow rate is the patient's inspiratory flow rate
  • the patient's ventilation flow rate is the patient's expiratory flow rate.
  • the flow rate measuring device 101 can monitor the patient's ventilation flow rate, and the processor 102 can estimate the theoretical ventilation flow rate at the time of comparison, by comparing the monitored patient's ventilation flow rate at the time of comparison with the estimated By comparing the theoretical ventilation flow rate at the time of comparison, the patient's breathing state can be identified, and the ventilation mode switching of the medical ventilation device can be realized.
  • the processor 102 may obtain the time constant of the patient.
  • the patient's time constant is actually a respiratory mechanics characteristic of the patient.
  • the patient's time constant is theoretically the product of the patient's respiratory resistance and compliance.
  • the processor 102 can obtain the flow or volume change during the patient's ventilation in real time, generate a flow-time curve or a volume-time curve, and use the flow-time curve or the volume-time curve for fitting to obtain The patient's time constant.
  • the processor 102 after obtaining the time constant of the patient, the processor 102 further estimates the theoretical ventilation flow rate at the comparison time based on the time constant.
  • the processor 102 before the processor 102 estimates the theoretical ventilation flow rate at the comparison time based on the time constant, it further includes: obtaining the patient's peak respiratory flow rate through the monitored patient's ventilation flow rate.
  • the flow rate measuring device 101 can continuously monitor the patient's ventilation flow rate.
  • the patient's ventilation flow rate can be measured and monitored multiple times at a fixed time and according to a set frequency. Therefore, the processor 102 can actually determine the patient's peak respiratory flow rate according to the change in the patient's ventilation flow rate monitored by the flow rate measuring device 101.
  • the peak respiratory flow rate can be the peak inspiratory flow rate or the peak expiratory flow rate. For example, when the processor 102 determines that the patient's ventilation flow rate monitored by the flow measurement device 101 is gradually increasing to a certain value during the inspiratory phase, and then gradually begins to decrease, the value can be determined as the peak inspiratory value. Flow rate.
  • the step of the processor 102 to estimate the theoretical ventilation flow rate at the comparison time based on the time constant includes: according to the peak respiratory flow rate, the time constant, and the length of time from reaching the peak respiratory flow rate to the comparison time, Estimate the theoretical ventilation flow rate at the time of comparison.
  • the processor 102 when the comparison time is any time after the peak expiratory flow rate is reached in the expiration phase, the processor 102 actually needs to obtain the patient’s breath from the monitored patient’s ventilation flow rate.
  • the peak flow rate is the peak expiratory flow rate.
  • the processor 102 when the comparison time is any time after the peak inspiratory flow rate is reached in the inspiratory phase, the processor 102 actually needs the patient's peak respiratory flow rate obtained from the monitored patient's ventilation flow rate as the peak inspiratory flow rate.
  • the processor 102 estimates the theoretical ventilation flow rate Flow(t) at the comparison time according to the following formula (1) :
  • t1 is the time from reaching the peak expiratory flow rate to the time of comparison
  • PEF is the peak expiratory flow rate
  • ⁇ is the patient's time constant.
  • the processor 102 estimates the theoretical ventilation flow rate Flow(t) at the comparison time according to the following formula (2) :
  • t2 is the time from reaching the peak inspiratory flow rate to the time of comparison
  • PIF is the peak inspiratory flow rate
  • ⁇ is the patient's time constant.
  • the step of the processor 102 estimating the theoretical ventilation flow rate at the comparison time based on the time constant may further include: estimating the patient ventilation flow rate, the time constant, and the preset time period monitored before the preset time period. Compare the theoretical ventilation flow rate at the moment.
  • the starting time and the comparison time corresponding to the preset time period are the time after the peak expiratory flow rate is reached during the expiration phase, or the peak inspiration is reached during the inhalation phase The moment after the flow rate.
  • the starting time corresponding to the preset time period is actually the monitoring time of the patient's ventilation flow rate monitored before the preset time period.
  • the duration of the preset time period can be determined according to actual needs.
  • the preset time period is 100ms
  • the comparison time is T
  • the corresponding starting time of the preset time period is T-100ms
  • T and T-100ms are the moments after the peak expiratory flow rate is reached in the expiratory phase, or, The moment after the peak inspiratory flow rate is reached during the inspiratory phase.
  • the specific preset time period is not limited in the embodiment of the present invention.
  • the processor 102 may estimate the theoretical ventilation flow rate at the comparison time according to the following formula (3) according to the patient ventilation flow rate, time constant, and the preset time period monitored before the preset time period Flow(t):
  • t is the comparison time
  • ⁇ t is the preset time period
  • Flow(t- ⁇ t) is the patient's ventilation flow rate monitored before the preset time period
  • ⁇ is the patient's time constant.
  • S204 Identify the breathing state of the patient according to the estimated theoretical ventilation flow rate at the comparison time and the monitored ventilation flow rate of the patient at the comparison time.
  • the processor 102 after the processor 102 obtains the estimated theoretical ventilation flow rate at the comparison time, it can identify the patient's breathing state based on the estimated theoretical ventilation flow rate at the comparison time and the monitored patient ventilation flow rate at the comparison time. .
  • the processor 102 recognizes the patient's breathing state according to the estimated theoretical ventilation flow rate at the comparison time and the monitored patient ventilation flow rate at the comparison time, including: if the patient is at the monitored comparison time If the difference between the ventilation flow rate and the theoretical ventilation flow rate at the estimated comparison time is greater than the preset threshold, it is determined that the patient's breathing state has changed.
  • the comparison time is any time after the peak expiratory flow rate is reached, if the monitored patient ventilation flow rate at the comparison time is greater than the estimated theoretical ventilation flow rate at the comparison time, and The difference between the theoretical ventilation flow rate and the estimated comparison time is greater than the preset threshold, then the patient’s breathing state is judged to be spontaneous inhalation; if the comparison time is any time after the peak inspiratory flow rate is reached, if the estimated comparison time is The theoretical ventilation flow rate is greater than the monitored patient's ventilation flow rate at the comparison moment, and the difference between the monitored patient's ventilation flow rate and the monitored patient's ventilation flow rate is greater than a preset threshold, then it is determined that the patient's breathing state is autonomous exhalation.
  • the medical staff can set the preset threshold according to actual needs or experience.
  • the specific preset threshold is not limited in the embodiment of the present invention.
  • the processor 102 can determine whether the patient inhales spontaneously by comparing the difference between the monitored patient's ventilation flow rate and the estimated theoretical ventilation flow rate at the comparison time. Similarly, after the peak inspiratory flow rate is reached during the inspiratory phase, if the patient does not exhale spontaneously, the patient's ventilation flow rate will basically return to zero in an exponentially decreasing form.
  • the processor 102 determines whether the patient exhales spontaneously by comparing the difference between the monitored patient ventilation flow rate at the comparison time and the estimated theoretical ventilation flow rate at the comparison time.
  • FIG. 3(a) is an exemplary schematic diagram 1 of airway pressure changes during patient ventilation provided by an embodiment of the present invention.
  • FIG. 3(b) is an exemplary schematic diagram 1 of the change of the ventilation flow rate during the patient's ventilation process provided by the embodiment of the present invention.
  • the expiratory phase has a shorter duration, and in fact, the spontaneous inhalation occurs at the end of expiration during the expiratory phase.
  • the dotted line is the change in the end-expiratory ventilation flow rate in the expiration phase during the normal ventilation process, which is actually the change in the theoretical ventilation flow rate, while the solid line is the actual monitoring
  • the patient's ventilation flow rate because the patient has spontaneous inhalation, the patient's ventilation flow rate quickly returns to zero
  • PEF is the peak expiratory flow rate
  • PIF is the peak inspiratory flow rate.
  • Fig. 4(a) is a second schematic diagram of an exemplary airway pressure change during ventilation of a patient according to an embodiment of the present invention.
  • Fig. 4(b) is a second schematic diagram of the change of the ventilation flow rate during the ventilation of the patient according to the embodiment of the present invention.
  • the duration of the inhalation phase is relatively short. In fact, the spontaneous exhalation occurs after the peak inspiratory flow rate is reached during the inhalation phase.
  • the dotted line is the change in the ventilation flow rate after reaching the peak expiratory flow rate in the expiration phase during the normal ventilation process, which is actually the change in the theoretical ventilation flow rate, while the solid line is the actual
  • the monitored patient's ventilation flow rate because the patient exhales spontaneously, the patient's ventilation flow rate quickly returns to zero
  • PEF is the peak expiratory flow rate
  • PIF is the peak inspiratory flow rate.
  • S205 Control the medical ventilation device to switch the ventilation mode according to the recognized breathing state.
  • the processor 102 may control the medical ventilation device according to the identified breathing state after identifying the patient's breathing state according to the estimated theoretical ventilation flow rate at the comparison time and the monitored patient ventilation flow rate at the comparison time Switch the ventilation mode.
  • the step of the processor 102 controlling the medical ventilator to switch the ventilation mode according to the breathing state includes: if the breathing state is autonomous inhalation, triggering the medical ventilator to enter the inspiratory ventilation mode; When the state is autonomous exhalation, the medical ventilation device is triggered to enter the expiratory ventilation mode.
  • the embodiment of the present invention provides a ventilation switching control method, which is applied to a medical ventilation device.
  • the method includes: monitoring a patient's ventilation flow rate through a flow rate measuring device; obtaining the patient's time constant; estimating the theoretical ventilation flow rate at the comparison time based on the time constant; The estimated theoretical ventilation flow rate at the comparison time and the monitored patient ventilation flow rate at the comparison time are used to identify the patient's breathing state.
  • the technical solution provided by the embodiment of the present invention compares the estimated theoretical ventilation flow rate at the comparison time with the monitored patient ventilation flow rate at the comparison time, which can accurately determine the patient's breathing state and switch the corresponding ventilation mode, which improves Man-machine synchronization performance.
  • FIG. 1 is a schematic structural diagram of a ventilation switching control device provided by an embodiment of the present invention.
  • the ventilation switching control device includes: a flow rate measuring device 101, a processor 102, and a memory 103;
  • the flow rate measuring device 101 is connected to the processor 102 and is used to monitor the patient's ventilation flow rate;
  • the processor 102 is connected to the memory 103, and is configured to execute the ventilation switching control program stored in the memory 103 to implement the following steps:
  • the processor 102 before estimating the theoretical ventilation flow rate at the comparison time based on the time constant, the processor 102 also obtains the patient's peak respiratory flow rate through the monitored patient's ventilation flow rate;
  • the steps for the processor to estimate the theoretical ventilation flow rate at the comparison time based on the time constant include:
  • the time constant and the time from reaching the peak respiratory flow rate to the time of comparison, estimate the theoretical ventilation flow rate at the time of comparison.
  • the comparison moment is any moment after the peak expiratory flow rate is reached in the expiration phase, and the peak respiratory flow rate is the peak expiratory flow rate;
  • the comparison moment is any moment after the peak expiratory flow rate is reached in the inspiratory phase, and the peak respiratory flow rate is the peak inspiratory flow rate.
  • the step of the processor 102 to estimate the theoretical ventilation flow rate at the comparison time based on the time constant includes:
  • the starting time and comparison time corresponding to the preset time period are the time after the peak expiratory flow rate is reached in the expiration phase, or the time after the peak inspiratory flow rate is reached in the inhalation phase.
  • the processor 102 based on the estimated theoretical ventilation flow rate at the comparison time and the monitored ventilation flow rate of the patient at the comparison time, the step of identifying the respiratory state of the patient includes:
  • the step of the processor 102 to determine that the patient's breathing state is changed includes:
  • the comparison time is any time after reaching the peak expiratory flow rate, if the patient ventilation flow rate at the monitored comparison time is greater than the estimated theoretical ventilation flow rate at the comparison time, and the difference with the estimated theoretical ventilation flow rate at the comparison time If it is greater than the preset threshold, it is judged that the patient's breathing state is autonomous inhalation;
  • the comparison time is any time after the peak inspiratory flow rate is reached, if the theoretical ventilation flow rate at the estimated comparison time is greater than the patient ventilation flow rate at the monitored comparison time, and is different from the patient ventilation flow rate at the monitored comparison time If the difference is greater than the preset threshold, it is determined that the patient's breathing state is spontaneous exhalation.
  • the step of the processor 102 controlling the medical ventilation device to switch the ventilation mode according to the recognized breathing state includes:
  • the medical ventilator is triggered to enter the inspiratory ventilation mode; if the breathing state is spontaneous exhalation, the medical ventilator is triggered to enter the expiratory ventilation mode.
  • the embodiment of the present invention provides a ventilation switching control device, which is applied to medical ventilation equipment, and monitors the patient's ventilation flow rate through the flow measuring device; obtains the patient's time constant; estimates the theoretical ventilation flow rate at the comparison time based on the time constant; according to the estimated comparison time
  • the theoretical ventilation flow rate and the monitored patient ventilation flow rate are used to identify the patient's breathing state; according to the identified breathing state, the medical ventilation device is controlled to switch the ventilation mode.
  • the ventilation switching control device provided by the embodiment of the present invention compares the estimated theoretical ventilation flow rate at the comparison time with the monitored ventilation flow rate of the patient, can accurately determine the patient's breathing state, and switch the corresponding ventilation mode, which improves the human Machine synchronization performance.
  • the embodiment of the present invention also provides a medical ventilation device including the above-mentioned ventilation switching control device.
  • Fig. 5 is a schematic structural diagram of a medical ventilation device provided by an embodiment of the present invention.
  • the medical ventilation equipment not only includes a ventilation switching control device 501, but also includes a gas source 502 and a breathing tube 503;
  • the ventilation switching control device 501 includes a flow rate measuring device 101, a processor 102, and a memory 103, and the processor 102 is connected to the flow rate measuring device 101 and the memory 103;
  • the air source 502 is connected to the processor 102, and provides ventilation support to the patient under the control of the processor 102;
  • the breathing tube 503 is connected to the air source 502 to provide a breathing path during ventilation;
  • the flow rate measuring device 101 is connected to the breathing tube 503 to monitor the patient's ventilation flow rate during ventilation.
  • the embodiment of the present invention provides a computer-readable storage medium, and the computer-readable storage medium stores a ventilation switching control program, and the ventilation switching control program can be executed by a processor to realize the above-mentioned ventilation switching control method.
  • the computer-readable storage medium may be a volatile memory (volatile memory), such as random-access memory (Random-Access Memory, RAM); or a non-volatile memory (non-volatile memory), such as read-only memory (Read Only Memory). -Only Memory, ROM, flash memory, Hard Disk Drive (HDD) or Solid-State Drive (SSD); it can also be a respective device including one or any combination of the above-mentioned memories, Such as mobile phones, computers, tablet devices, personal digital assistants, etc.
  • the embodiments of the present invention can be provided as a method, a system, or a computer program product. Therefore, the present invention may adopt the form of a hardware embodiment, a software embodiment, or an embodiment combining software and hardware. Moreover, the present invention may be in the form of a computer program product implemented on one or more computer-usable storage media (including but not limited to disk storage, optical storage, etc.) containing computer-usable program codes.
  • These computer program instructions can also be stored in a computer-readable memory that can direct a computer or other programmable signal processing equipment to work in a specific manner, so that the instructions stored in the computer-readable memory produce an article of manufacture including the instruction device.
  • the device implements the functions specified in one process or multiple processes in the flowchart and/or one block or multiple blocks in the block diagram.
  • These computer program instructions can also be loaded on a computer or other programmable signal processing equipment, so that a series of operation steps are executed on the computer or other programmable equipment to produce computer-implemented processing, so as to execute on the computer or other programmable equipment.
  • the instructions provide steps for implementing the functions specified in one process or multiple processes in the flowchart and/or one block or multiple blocks in the block diagram.
  • the patient's ventilation flow rate is monitored by the flow rate measuring device; the patient's time constant is obtained; the theoretical ventilation flow rate at the comparison time is estimated based on the time constant; the theoretical ventilation flow rate at the comparison time estimated based on the estimated comparison time and the monitored patient Ventilation flow rate, identify the patient's breathing state; control the medical ventilation equipment to switch the ventilation mode according to the identified breathing state.
  • the technical solution provided by the embodiment of the present invention compares the estimated theoretical ventilation flow rate at the comparison time with the patient ventilation flow rate at the monitored comparison time, which can accurately determine the patient's breathing state and switch the corresponding ventilation mode, which improves Man-machine synchronization performance.

Abstract

公开了一种通气切换控制方法和通气切换控制装置，应用于医用通气设备。该方法包括：通过流速测量设备监测患者通气流速（S201）；获取患者的时间常数（S202）；基于时间常数估算对比时刻的理论通气流速（S203）；根据估算的对比时刻的理论通气流速和监测到的患者通气流速，识别患者的呼吸状态（S204）。

Description

一种通气切换控制方法及装置、医用通气设备、存储介质 技术领域
本发明实施例涉及医疗器械技术领域，尤其涉及一种通气切换控制方法及装置、医用通气设备、存储介质。
背景技术
人机同步性能是呼吸机等医用通气设备的核心性能之一，即需要通气设备能够在病人吸气努力时及时送气，在病人吸气结束后及时切换到呼气阶段。
目前，呼吸机典型的吸气触发方式包括流量触发和压力触发两种，其中，流量触发方式为在病人吸气流速大于触发灵敏度之后进行吸气触发，压力触发方式为病人自主吸气使气道压力低于呼气末正压之后进行吸气触发。呼吸机典型的呼气切换方式为在病人吸气流速降低到吸气峰值流速的一定百分比时进行呼气切换。
然而，对于上述吸气触发方式，由于某些病人自主吸气能力较弱或存在内源性呼气末正压等原因，触发判断可能导致严重的触发延迟或无效触发，并且，对于上述呼气切换方式，由于不同病人吸气转呼气时流速相比与吸气峰值流速的百分比是不尽相同的，因此难以满足不同病人的实际需求，可能会导致切换提前或延迟，即人机同步性能较差。
发明内容
为解决上述技术问题，本发明实施例期望提供一种通气切换控制方法及装置，将估算的对比时刻的理论通气流速与监测到的对比时刻的患者通气流速进行对比，能够准确的判断病人的呼吸状态，并进行相应通气模式的切换，提高了人机同步性能。
本发明实施例的技术方案可以如下实现：
本发明实施例提供了一种通气切换控制方法，应用于医用通气设备，所述方法包括：
通过流速测量设备监测患者通气流速；
获取患者的时间常数；
基于所述时间常数估算对比时刻的理论通气流速；
根据估算的对比时刻的理论通气流速和监测到的对比时刻的患者通气流速，识别患者的呼吸状态；
根据识别到的呼吸状态控制所述医用通气设备进行通气模式切换。
在上述方法中，在所述基于所述时间常数估算对比时刻的理论通气流速的步骤之前，所述方法还包括：
通过监测到的患者通气流速得到患者的呼吸峰值流速；
所述基于所述时间常数估算对比时刻的理论通气流速的步骤包括：
根据所述呼吸峰值流速、所述时间常数，以及从达到所述呼吸峰值流速起，至所述对比时刻的时长，估算对比时刻的理论通气流速。
在上述方法中，所述对比时刻为呼气阶段中达到呼气峰值流速后的任一时刻时，所述呼吸峰值流速为所述呼气峰值流速；
所述对比时刻为吸气阶段中达到呼气峰值流速后的任一时刻时，所述呼吸峰值流速为所述吸气峰值流速。
在上述方法中，所述基于所述时间常数估算对比时刻的理论通气流速的步骤包括：
根据预设时间段前监测到的患者通气流速、所述时间常数，以及所述预设时间段，估算对比时刻的理论通气流速；
所述预设时间段对应的起始时刻和所述对比时刻，为呼气阶段中达到呼气峰值流速后的时刻，或者，吸气阶段中达到吸气峰值流速后的时刻。
在上述方法中，所述根据估算的对比时刻的理论通气流速和监测到的 对比时刻的患者通气流速，识别患者的呼吸状态的步骤包括：
如果所述监测到的对比时刻的患者通气流速与所述估算的对比时刻的理论通气流速之差大于预设阈值，则判断患者呼吸状态变更。
在上述方法中，所述如果所述监测到的对比时刻的患者通气流速与所述估算的对比时刻的理论通气流速之差大于预设阈值，则判断患者呼吸状态变更的步骤包括：
在所述对比时刻为达到呼气峰值流速后的任一时刻的情况下，如果所述监测到的对比时刻的患者通气流速大于所述估算的对比时刻的理论通气流速，且与所述估算的对比时刻的理论通气流速之差大于所述预设阈值，则判断患者呼吸状态为自主吸气；
在所述对比时刻为达到吸气峰值流速后的任一时刻的情况下，如果所述估算的对比时刻的理论通气流速大于所述监测到的患者通气流速，且与所述监测到的对比时刻的患者通气流速之差大于所述预设阈值，则判断患者呼吸状态为自主呼气。
在上述方法中，所述根据识别到的呼吸状态控制所述医用通气设备进行通气模式切换，包括：
如果所述呼吸状态为自主吸气，则触发所述医用通气设备进入吸气通气模式；
如果所述呼吸状态为自主呼气，则触发所述医用通气设备进入呼气通气模式。
本发明实施例提供了一种通气切换控制装置，应用于医用通气设备，所述装置包括：流速测量设备、处理器和存储器；
所述流速测量设备，与所述处理器连接，用于监测患者通气流速；
所述处理器，与所述存储器连接，用于执行所述存储器中存储的通气切换控制程序，以实现以下步骤：
获取患者的时间常数；
基于所述时间常数估算对比时刻的理论通气流速；
根据估算的对比时刻的理论呼吸流速和监测到的对比时刻的患者通气流速，识别患者的呼吸状态；
根据识别到的呼吸状态控制所述医用通气设备进行通气模式切换。
在上述装置中，所述处理器在所述基于所述时间常数估算对比时刻的理论通气流速之前，还通过监测到的患者通气流速得到患者的呼吸峰值流速；
所述处理器基于所述时间常数估算对比时刻的理论通气流速的步骤包括：
根据所述呼吸峰值流速、所述时间常数，以及从达到所述呼吸峰值流速起，至所述对比时刻的时长，估算对比时刻的理论通气流速。
在上述装置中，所述对比时刻为呼气阶段中达到呼气峰值流速后的任一时刻时，所述呼吸峰值流速为所述呼气峰值流速；
所述对比时刻为吸气阶段中达到吸气峰值流速后的任一时刻时，所述呼吸峰值流速为所述吸气峰值流速。
在上述装置中，所述处理器基于所述时间常数估算对比时刻的理论通气流速的步骤包括：
根据预设时间段前监测到的患者通气流速、所述时间常数，以及所述时间差，估算对比时刻的理论通气流速；
所述预设时间段对应的起始时刻和所述对比时刻，为呼气阶段中达到呼气峰值流速后的时刻，或者，吸气阶段中达到吸气峰值流速后的时刻。
在上述装置中，所述处理器根据估算的对比时刻的理论通气流速和监测到的对比时刻的患者通气流速，识别患者的呼吸状态的步骤包括：
如果所述监测到的对比时刻的通气流速与所述估算的对比时刻的理论通气流速之差大于预设阈值，则判断患者呼吸状态变更。
在上述装置中，所述如果所述监测到的对比时刻的患者通气流速与所述估算的对比时刻的理论通气流速之差大于预设阈值，处理器判断患者呼吸状态变更的步骤包括：
在所述对比时刻为达到呼气峰值流速后的任一时刻的情况下，如果所述监测到的对比时刻的患者通气流速大于所述估算的对比时刻的理论通气流速，且与所述估算的对比时刻的理论通气流速之差大于所述预设阈值，则判断患者呼吸状态为自主吸气；
在所述对比时刻为达到吸气峰值流速后的任一时刻的情况下，如果所述估算的对比时刻的理论通气流速大于所述监测到的对比时刻的患者通气流速，且与所述监测到的对比时刻的患者通气流速之差大于所述预设阈值，则判断患者呼吸状态为自主呼气。
在上述装置中，所述处理器根据识别到的呼吸状态控制所述医用通气设备进行通气模式切换的步骤包括：
如果所述呼吸状态为自主吸气，则触发所述医用通气设备进入吸气通气模式；如果所述呼吸状态为自主呼气，则触发所述医用通气设备进入呼气通气模式。
本发明实施例提供了一种包含上述通气切换控制装置的医用通气设备，所述医用通气设备还包括气源和呼吸管路；
所述通气切换控制装置包括流速测量设备、处理器和存储器，所述处理器与所述流速测量设备和所述存储器连接；
所述气源与所述处理器连接，在所述处理器的控制下向患者提供通气支持；
所述呼吸管路与所述气源连接，在通气过程中提供呼吸路径；
所述流速测量设备与所述呼吸管路连接，在通气过程中监测患者通气流速。
本发明实施例提供了一种计算机可读存储介质，所述计算机可读存储 介质存储有通气切换控制程序，所述通气切换控制程序可以被处理器执行，以实现上述通气切换控制方法。
本发明实施例提供了一种通气切换控制方法，应用于医用通气设备，该方法包括：通过流速测量设备监测患者通气流速；获取患者的时间常数；基于时间常数估算对比时刻的理论通气流速；根据估算的对比时刻的理论通气流速和监测到的对比时刻的患者通气流速，识别患者的呼吸状态；根据识别到的呼吸状态控制医用通气设备进行通气模式切换。本发明实施例提供的技术方案，将估算的对比时刻的理论通气流速与监测到的对比时刻的患者通气流速进行对比，能够准确的判断病人的呼吸状态，并进行相应通气模式的切换，提高了人机同步性能。
附图说明
图1为本发明实施例提供的一种通气切换控制装置的结构示意图；
图2为本发明实施例提供的一种通气切换控制方法的流程示意图；
图3(a)为本发明实施例提供的一种示例性的患者通气过程中气道压力变化示意图一；
图3(b)为本发明实施例提供的一种示例性的患者通气过程中通气流速变化示意图一；
图4(a)为本发明实施例提供的一种示例性的患者通气过程中气道压力变化示意图二；
图4(b)为本发明实施例提供的一种示例性的患者通气过程中通气流速变化示意图二；
图5为本发明实施例提供的一种医用通气设备的结构示意图。
具体实施方式
为了能够更加详尽地了解本发明实施例的特点与技术内容，下面结合 附图对本发明实施例的实现进行详细阐述，所附附图仅供参考说明之用，并非用来限定本发明实施例。
本发明实施例提供了一种通气切换控制方法，应用于医用通气设备，该通气切换控制方法由通气切换控制装置实现。图1为本发明实施例提供的一种通气切换控制装置的结构示意图。如图1所示，通气切换控制装置包括：流速测量设备101、处理器102和存储器103。
需要说明的是，在本发明的实施例中，流速测量设备101为具备监测气体流速功能的设备，例如，流量传感器等。具体的流速测量设备101本发明实施例不作限定。
需要说明的是，在本发明的实施例中，处理器102可以为特定用途集成电路(Application Specific Integrated Circuit，ASIC)、数字信号处理器(Digital Signal Processor，DSP)、数字信号处理装置(Digital Signal Processing Device，DSPD)、可编程逻辑装置(Programmable Logic Device，PLD)、现场可编程门阵列(Field Programmable Gate Array，FPGA)、中央处理器(Central Processing Unit，CPU)、控制器、微控制器、微处理器中的至少一种，本发明实施例不作限定。
需要说明的是，在本发明的实施例中，存储器103可以是易失性存储器(volatile memory)，例如随机存取存储器(Random Access Memory，RAM)；或者非易失性存储器(non-volatile memory)，例如只读存储器(Read Only Memory，ROM)，快闪存储器(flash memory)，硬盘(Hard Disk Drive，HDD)或固态硬盘(Solid-State Drive，SSD)；或者以上种类的存储器的组合，并向处理器103提供存储的呼吸识别程序，本发明实施例不作限定。
需要说明的是，在本发明的实施例中，医用通气设备可以为呼吸机、麻醉机等具备通气功能的医用设备。具体的医用通气设备本发明实施例不作限定。
以下基于上述通气切换控制装置，进行通气切换控制方法的详述。
图2为本发明实施例提供的一种通气切换控制方法的流程示意图。如图2所示，主要包括以下步骤：
S201、通过流速测量设备监测患者通气流速。
在本发明的实施例中，通气切换控制装置的流速测量设备101可以直接监测到患者通气流速。
需要说明的是，在本发明的实施例中，患者通气流速即为患者在利用医用通气设备进行呼吸过程中，实际的通气流速。此外，如果患者处于吸气状态，则患者通气流速为患者吸气流速，如果患者处于呼气状态，则患者通气流速为患者呼气流速。
需要说明的是，在本发明的实施例中，流速测量设备101可以监测到患者通气流速，处理器102可以估算对比时刻的理论通气流速，通过将监测到的对比时刻的患者通气流速和估算的对比时刻的理论通气流速进行比较，即可识别出患者的呼吸状态，从而实现医用通气设备的通气模式切换。
S202、获取患者的时间常数。
在本发明的实施例中，处理器102可以获取到患者的时间常数。
可以理解的是，在本发明的实施例中，患者的时间常数实际上为患者的一种呼吸力学特征。
需要说明的是，在本发明的实施例中，患者的时间常数理论上为患者的呼吸阻力和顺应性之积。在实际应用过程中，处理器102可以实时获取到患者通气过程中的流量或者容量变化，生成流量-时间曲线或者容量-时间曲线，利用流量-时间曲线或者容量-时间曲线进行拟合，可以得到患者的时间常数。
S203、基于时间常数估算对比时刻的理论通气流速。
在本发明的实施例中，处理器102在获取到患者的时间常数之后，进一步的，基于时间常数估算对比时刻的理论通气流速。
具体的，在本发明的实施例中，处理器102基于时间常数估算对比时 刻的理论通气流速之前，还包括：通过监测到的患者通气流速得到患者的呼吸峰值流速。
需要说明的是，在本发明的实施例中，流速测量设备101可以持续监测患者通气流速。具体实现时，可以定时、按照设定频率等多次测监测患者通气流速。因此，处理器102实际上可以根据流速测量设备101监测到的患者通气流速的变化，确定出患者的呼吸峰值流速。呼吸峰值流速可以为吸气峰值流速或呼气峰值流速。例如，处理器102在确定出流速测量设备101监测到的患者通气流速在吸气阶段，由逐渐增大到某一数值，之后，逐渐开始下降的变化，即可将该数值确定为吸气峰值流速。
具体的，在本发明的实施例中，处理器102基于时间常数估算对比时刻的理论通气流速的步骤包括：根据呼吸峰值流速、时间常数，以及从达到呼吸峰值流速起，至对比时刻的时长，估算对比时刻的理论通气流速。
需要说明的是，在本发明的实施例中，对比时刻为呼气阶段中达到呼气峰值流速后的任一时刻时，处理器102实际上需要从监测到的患者通气流速得到的患者的呼吸峰值流速为呼气峰值流速。相应的，对比时刻为吸气阶段中达到吸气峰值流速后的任一时刻时，处理器102实际上需要从监测到的患者通气流速得到的患者的呼吸峰值流速为吸气峰值流速。
具体的，在本发明的实施例中，对比时刻为呼气阶段中达到呼气峰值流速后的任一时刻时，处理器102按照以下公式(1)估算对比时刻的理论通气流速Flow(t)：
Flow(t)＝PEF×e -t1/τ        (1)
其中，t1为从达到呼气峰值流速起，至对比时刻的时长，PEF为呼气峰值流速，τ为患者的时间常数。
具体的，在本发明的实施例中，对比时刻为吸气阶段中达到吸气峰值流速后的任一时刻时，处理器102按照以下公式(2)估算对比时刻的理论通气流速Flow(t)：
Flow(t)＝PIF×e -t2/τ       (2)
其中，t2为从达到吸气峰值流速起，至对比时刻的时长，PIF为吸气峰值流速，τ为患者的时间常数。
在本发明的实施例中，处理器102基于时间常数估算对比时刻的理论通气流速的步骤还可以包括：根据预设时间段前监测到的患者通气流速、时间常数，以及预设时间段，估算对比时刻的理论通气流速。
需要说明的是，在本发明的实施例中，预设时间段对应的起始时刻和对比时刻，为呼气阶段中达到呼气峰值流速后的时刻，或者，吸气阶段中达到吸气峰值流速后的时刻。其中，预设时间段对应的起始时刻实际上就是预设时间段前监测到的患者通气流速的监测时刻。此外，预设时间段的时长可以根据实际需求确定。例如，预设时间段为100ms，对比时刻为T，在预设时间段对应的起始时刻为T-100ms，T和T-100ms为呼气阶段中达到呼气峰值流速后的时刻，或者，吸气阶段中达到吸气峰值流速后的时刻。具体的预设时间段本发明实施例不作限定。
具体的，在本发明的实施例中，处理器102可以根据预设时间段前监测到的患者通气流速、时间常数，以及预设时间段，按照以下公式(3)估算对比时刻的理论通气流速Flow(t)：
Flow(t)＝Flow(t-Δt)×e -Δt/τ        (3)
其中，t为对比时刻，Δt为预设时间段，Flow(t-Δt)为预设时间段前监测到的患者通气流速，τ为患者的时间常数。
S204、根据估算的对比时刻的理论通气流速和监测到的对比时刻的患者通气流速，识别患者的呼吸状态。
在本发明的实施例中，处理器102在得到估算的对比时刻的理论通气流速之后，即可根据估算的对比时刻的理论通气流速和监测到的对比时刻的患者通气流速，识别患者的呼吸状态。
具体的，在本发明的实施例中，处理器102根据估算的对比时刻的理论通气流速和监测到的对比时刻的患者通气流速，识别患者的呼吸状态，包括：如果监测到的对比时刻的患者通气流速与估算的对比时刻的理论通气流速之差大于预设阈值，则判断患者呼吸状态变更。
具体的，在本发明的实施例中，在对比时刻为达到呼气峰值流速后的任一时刻的情况下，如果监测到的对比时刻的患者通气流速大于估算的对比时刻的理论通气流速，且与估算的对比时刻的理论通气流速之差大于预设阈值，则判断患者呼吸状态为自主吸气；在对比时刻为达到吸气峰值流速后的任一时刻的情况下，如果估算的对比时刻的理论通气流速大于监测到的对比时刻的患者通气流速，且与监测到的患者通气流速之差大于预设阈值，则判断患者呼吸状态为自主呼气。
需要说明的是，在本发明的实施例中，医护人员可以根据实际需求或者经验设置预设阈值。具体的预设阈值本发明实施例不作限定。
可以理解的是，在本发明的实施例中，在呼气阶段中达到呼气峰值流速后，如果患者没有自主吸气，患者通气流速将基本按照指数递减形式归零，如果患者自主吸气，则患者通气流速会按照加速上升形式归零，因此，处理器102可以通过比较监测到的患者通气流速与估算的对比时刻的理论通气流速的差别，确定患者是否自主吸气。同样的，在吸气阶段中达到吸气峰值流速后，如果患者没有自主呼气，患者通气流速将基本按照指数递减形式归零，如果患者自主呼气，则患者通气流速会按照加速下降形式归零，因此，处理器102通过比较监测到的对比时刻的患者通气流速与估算的对比时刻的理论通气流速的差别，确定患者是否自主呼气。
图3(a)为本发明实施例提供的一种示例性的患者通气过程中气道压力变化示意图一。图3(b)为本发明实施例提供的一种示例性的患者通气过程中通气流速变化示意图一。如图3(a)所示，患者通气过程中，呼气阶段时长较短，实际上在呼气阶段中呼气末期出现了自主吸气的情况。相 应的，如图3(b)所示，虚线部分为正常通气过程中，呼气阶段中呼气末期通气流速的变化，实际上就是理论通气流速的变化，而实线部分为实际监测到的患者通气流速，由于患者出现了自主吸气，因此，患者通气流速很快归零，PEF为呼气峰值流速，PIF为吸气峰值流速。
图4(a)为本发明实施例提供的一种示例性的患者通气过程中气道压力变化示意图二。图4(b)为本发明实施例提供的一种示例性的患者通气过程中通气流速变化示意图二。如图4(a)所示，患者通气过程中，吸气阶段时长较短，实际上在吸气阶段中达到吸气峰值流速后出现了自主呼气的情况。相应的，如图4(b)所示，虚线部分为正常通气过程中，呼气阶段中达到呼气峰值流速后通气流速的变化，实际上就是理论通气流速的变化，而实线部分为实际监测到的患者通气流速，由于患者出现了自主呼气，因此，患者通气流速很快归零，PEF为呼气峰值流速，PIF为吸气峰值流速。。
S205、根据识别到的呼吸状态控制医用通气设备进行通气模式切换。
在本发明的实施例中，处理器102在根据估算的对比时刻的理论通气流速和监测到的对比时刻的患者通气流速，识别患者的呼吸状态之后，可以根据识别到的呼吸状态控制医用通气设备进行通气模式切换。
具体的，在本发明的实施例中，处理器102根据呼吸状态控制医用通气设备进行通气模式切换的步骤包括：如果呼吸状态为自主吸气，则触发医用通气设备进入吸气通气模式；如果呼吸状态为自主呼气，则触发医用通气设备进入呼气通气模式。
本发明实施例提供了一种通气切换控制方法，应用于医用通气设备，该方法包括：通过流速测量设备监测患者通气流速；获取患者的时间常数；基于时间常数估算对比时刻的理论通气流速；根据估算的对比时刻的理论通气流速和监测到的对比时刻的患者通气流速，识别患者的呼吸状态。本发明实施例提供的技术方案，将估算的对比时刻的理论通气流速与监测到的对比时刻的患者通气流速进行对比，能够准确的判断病人的呼吸状态， 并进行相应通气模式的切换，提高了人机同步性能。
本发明实施例提供了一种通气切换控制装置，应用于医用通气设备，图1为本发明实施例提供的一种通气切换控制装置的结构示意图。如图1所示，通气切换控制装置包括：流速测量设备101、处理器102和存储器103；
流速测量设备101，与处理器102连接，用于监测患者通气流速；
处理器102，与存储器103连接，用于执行存储器103中存储的通气切换控制程序，以实现以下步骤：
获取患者的时间常数；基于时间常数估算对比时刻的理论通气流速；根据估算的对比时刻的理论呼吸流速和监测到的对比时刻的患者通气流速，识别患者的呼吸状态；根据识别到的呼吸状态控制医用通气设备进行通气模式切换。
可选的，处理器102在基于时间常数估算对比时刻的理论通气流速之前，还通过监测到的患者通气流速得到患者的呼吸峰值流速；
处理器基于时间常数估算对比时刻的理论通气流速的步骤包括：
根据呼吸峰值流速、时间常数，以及从达到呼吸峰值流速起，至对比时刻的时长，估算对比时刻的理论通气流速。
可选的，对比时刻为呼气阶段中达到呼气峰值流速后的任一时刻时，呼吸峰值流速为呼气峰值流速；
对比时刻为吸气阶段中达到呼气峰值流速后的任一时刻时，呼吸峰值流速为吸气峰值流速。
可选的，处理器102基于时间常数估算对比时刻的理论通气流速的步骤包括：
根据预设时间段前监测到的患者通气流速、时间常数，以及时间差，估算对比时刻的理论通气流速；
预设时间段对应的起始时刻和对比时刻，为呼气阶段中达到呼气峰值 流速后的时刻，或者，吸气阶段中达到吸气峰值流速后的时刻。
可选的，处理器102根据估算的对比时刻的理论通气流速和监测到的对比时刻的患者通气流速，识别患者的呼吸状态的步骤包括：
如果监测到的对比时刻的通气流速与估算的对比时刻的理论通气流速之差大于预设阈值，则判断患者呼吸状态变更。
可选的，如果监测到的对比时刻的患者通气流速与估算的对比时刻的理论通气流速之差大于预设阈值，处理器102判断患者呼吸状态变更的步骤包括：
在对比时刻为达到呼气峰值流速后的任一时刻的情况下，如果监测到的对比时刻的患者通气流速大于估算的对比时刻的理论通气流速，且与估算的对比时刻的理论通气流速之差大于预设阈值，则判断患者呼吸状态为自主吸气；
在对比时刻为达到吸气峰值流速后的任一时刻的情况下，如果估算的对比时刻的理论通气流速大于监测到的对比时刻的患者通气流速，且与监测到的对比时刻的患者通气流速之差大于预设阈值，则判断患者呼吸状态为自主呼气。
可选的，处理器102根据识别到的呼吸状态控制医用通气设备进行通气模式切换的步骤包括：
如果呼吸状态为自主吸气，则触发医用通气设备进入吸气通气模式；如果呼吸状态为自主呼气，则触发医用通气设备进入呼气通气模式。
本发明实施例提供了一种通气切换控制装置，应用于医用通气设备，通过流速测量设备监测患者通气流速；获取患者的时间常数；基于时间常数估算对比时刻的理论通气流速；根据估算的对比时刻的理论通气流速和监测到的患者通气流速，识别患者的呼吸状态；根据识别到的呼吸状态控制医用通气设备进行通气模式切换。本发明实施例提供的通气切换控制装置，将估算的对比时刻的理论通气流速与监测到的患者通气流速进行对比， 能够准确的判断病人的呼吸状态，并进行相应通气模式的切换，提高了人机同步性能。
本发明实施例还提供了一种包含上述通气切换控制装置的医用通气设备。图5为本发明实施例提供的一种医用通气设备的结构示意图。如图5所示，医用通气设备不仅包括通气切换控制装置501，还包括气源502和呼吸管路503；
通气切换控制装置501包括流速测量设备101、处理器102和存储器103，处理器102与流速测量设备101和存储器103连接；
气源502与处理器102连接，在处理器102的控制下向患者提供通气支持；
呼吸管路503与气源502连接，在通气过程中提供呼吸路径；
流速测量设备101与呼吸管路503连接，在通气过程中监测患者通气流速。
本发明实施例提供了一种计算机可读存储介质，计算机可读存储介质存储有通气切换控制程序，通气切换控制程序可以被处理器执行，以实现上述通气切换控制方法。计算机可读存储介质可以是是易失性存储器(volatile memory)，例如随机存取存储器(Random-Access Memory，RAM)；或者非易失性存储器(non-volatile memory)，例如只读存储器(Read-Only Memory，ROM)，快闪存储器(flash memory)，硬盘(Hard Disk Drive，HDD)或固态硬盘(Solid-State Drive，SSD)；也可以是包括上述存储器之一或任意组合的各自设备，如移动电话、计算机、平板设备、个人数字助理等。
本领域内的技术人员应明白，本发明的实施例可提供为方法、系统、或计算机程序产品。因此，本发明可采用硬件实施例、软件实施例、或结合软件和硬件方面的实施例的形式。而且，本发明可采用在一个或多个其中包含有计算机可用程序代码的计算机可用存储介质(包括但不限于磁盘 存储器和光学存储器等)上实施的计算机程序产品的形式。
本发明是参照根据本发明实施例的方法、设备(系统)、和计算机程序产品的流程图和/或方框图来描述的。应理解可由计算机程序指令实现流程图和/或方框图中的每一流程和/或方框、以及流程图和/或方框图中的流程和/或方框的结合。可提供这些计算机程序指令到通用计算机、专用计算机、嵌入式处理机或其他可编程信号处理设备的处理器以产生一个机器，使得通过计算机或其他可编程信号处理设备的处理器执行的指令产生用于实现在流程图一个流程或多个流程和/或方框图一个方框或多个方框中指定的功能的装置。
这些计算机程序指令也可存储在能引导计算机或其他可编程信号处理设备以特定方式工作的计算机可读存储器中，使得存储在该计算机可读存储器中的指令产生包括指令装置的制造品，该指令装置实现在流程图一个流程或多个流程和/或方框图一个方框或多个方框中指定的功能。
这些计算机程序指令也可装载到计算机或其他可编程信号处理设备上，使得在计算机或其他可编程设备上执行一系列操作步骤以产生计算机实现的处理，从而在计算机或其他可编程设备上执行的指令提供用于实现在流程图一个流程或多个流程和/或方框图一个方框或多个方框中指定的功能的步骤。
以上所述，仅为本发明的较佳实施例而已，并非用于限定本发明的保护范围。
工业实用性
在本发明实施例的技术方案中，通过流速测量设备监测患者通气流速；获取患者的时间常数；基于时间常数估算对比时刻的理论通气流速；根据估算的对比时刻的理论通气流速和监测到的患者通气流速，识别患者的呼吸状态；根据识别到的呼吸状态控制医用通气设备进行通气模式切换。本 发明实施例提供的技术方案，将估算的对比时刻的理论通气流速与监测到的对比时刻的患者通气流速进行对比，能够准确的判断病人的呼吸状态，并进行相应通气模式的切换，提高了人机同步性能。

Claims (16)

  1. 一种通气切换控制方法，应用于医用通气设备，其特征在于，所述方法包括：
    通过流速测量设备监测患者通气流速；
    获取患者的时间常数；
    基于所述时间常数估算对比时刻的理论通气流速；
    根据估算的对比时刻的理论通气流速和监测到的对比时刻的患者通气流速，识别患者的呼吸状态；
    根据识别到的呼吸状态控制所述医用通气设备进行通气模式切换。
  2. 根据权利要求1所述的方法，其特征在于，在所述基于所述时间常数估算对比时刻的理论通气流速的步骤前，所述方法还包括：
    通过监测到的患者通气流速得到患者的呼吸峰值流速；
    所述基于所述时间常数估算对比时刻的理论通气流速的步骤包括：
    根据所述呼吸峰值流速、所述时间常数，以及从达到所述呼吸峰值流速起，至所述对比时刻的时长，估算对比时刻的理论通气流速。
  3. 根据权利要求2所述的方法，其特征在于，
    所述对比时刻为呼气阶段中达到呼气峰值流速后的任一时刻时，所述呼吸峰值流速为所述呼气峰值流速；
    所述对比时刻为吸气阶段中达到吸气峰值流速后的任一时刻时，所述呼吸峰值流速为所述吸气峰值流速。
  4. 根据权利要求1所述的方法，其特征在于，所述基于所述时间常数估算对比时刻的理论通气流速的步骤包括：
    根据预设时间段前监测到的患者通气流速、所述时间常数，以及所述预设时间段，估算对比时刻的理论通气流速；
    所述预设时间段对应的起始时刻和所述对比时刻，为呼气阶段中达到 呼气峰值流速后的时刻，或者，吸气阶段中达到吸气峰值流速后的时刻。
  5. 根据权利要求1所述的方法，其特征在于，所述根据估算的对比时刻的理论通气流速和监测到的对比时刻的患者通气流速，识别患者的呼吸状态的步骤包括：
    如果所述监测到的对比时刻的患者通气流速与所述估算的对比时刻的理论通气流速之差大于预设阈值，则判断患者呼吸状态变更。
  6. 根据权利要求5所述的方法，其特征在于，所述如果所述监测到的对比时刻的患者通气流速与所述估算的对比时刻的理论通气流速之差大于预设阈值，则判断患者呼吸状态变更的步骤包括：
    在所述对比时刻为达到呼气峰值流速后的任一时刻的情况下，如果所述监测到的对比时刻的患者通气流速大于所述估算的对比时刻的理论通气流速，且与所述估算的对比时刻的理论通气流速之差大于所述预设阈值，则判断患者呼吸状态为自主吸气；
    在所述对比时刻为达到呼气峰值流速后的任一时刻的情况下，如果所述估算的对比时刻的理论通气流速大于所述监测到的对比时刻的患者通气流速，且与所述监测到的对比时刻的患者通气流速之差大于所述预设阈值，则判断患者呼吸状态为自主呼气。
  7. 根据权利要求1所述的方法，其特征在于，所述根据识别到的呼吸状态控制所述医用通气设备进行通气模式切换，包括：
    如果所述呼吸状态为自主吸气，则触发所述医用通气设备进入吸气通气模式；
    如果所述呼吸状态为自主呼气，则触发所述医用通气设备进入呼气通气模式。
  8. 一种通气切换控制装置，应用于医用通气设备，其特征在于，所述装置包括：流速测量设备、处理器和存储器；
    所述流速测量设备，与所述处理器连接，用于监测患者通气流速；
    所述处理器，与所述存储器连接，用于执行所述存储器中存储的通气切换控制程序，以实现以下步骤：
    获取患者的时间常数；
    基于所述时间常数估算对比时刻的理论通气流速；
    根据估算的对比时刻的理论呼吸流速和监测到的对比时刻的患者通气流速，识别患者的呼吸状态；
    根据识别到的呼吸状态控制所述医用通气设备进行通气模式切换。
  9. 根据权利要求8所述的装置，其特征在于，
    所述处理器在所述基于所述时间常数估算对比时刻的理论通气流速之前，还通过监测到的患者通气流速得到患者的呼吸峰值流速；
    所述处理器基于所述时间常数估算对比时刻的理论通气流速的步骤包括：
    根据所述呼吸峰值流速、所述时间常数，以及从达到所述呼吸峰值流速起，至所述对比时刻的时长，估算对比时刻的理论通气流速。
  10. 根据权利要求9所述的装置，其特征在于，
    所述对比时刻为呼气阶段中达到呼气峰值流速后的任一时刻时，所述呼吸峰值流速为所述呼气峰值流速；
    所述对比时刻为吸气阶段中达到吸气峰值流速后的任一时刻时，所述呼吸峰值流速为所述吸气峰值流速。
  11. 根据权利要求8所述的装置，其特征在于，所述处理器基于所述时间常数估算对比时刻的理论通气流速的步骤包括：
    根据预设时间段前监测到的患者通气流速、所述时间常数，以及所述时间差，估算对比时刻的理论通气流速；
    所述预设时间段对应的起始时刻和所述对比时刻，为呼气阶段中达到呼气峰值流速后的时刻，或者，吸气阶段中达到吸气峰值流速后的时刻。
  12. 根据权利要求8所述的装置，其特征在于，所述处理器根据估算的对比时刻的理论通气流速和监测到的对比时刻的患者通气流速，识别患者的呼吸状态的步骤包括：
    如果所述监测到的对比时刻的通气流速与所述估算的对比时刻的理论通气流速之差大于预设阈值，则判断患者呼吸状态变更。
  13. 根据权利要求12所述的装置，其特征在于，所述如果所述监测到的对比时刻的患者通气流速与所述估算的对比时刻的理论通气流速之差大于预设阈值，处理器判断患者呼吸状态变更的步骤包括：
    在所述对比时刻为达到呼气峰值流速后的任一时刻的情况下，如果所述监测到的对比时刻的患者通气流速大于所述估算的对比时刻的理论通气流速，且与所述估算的对比时刻的理论通气流速之差大于所述预设阈值，则判断患者呼吸状态为自主吸气；
    在所述对比时刻为达到吸气峰值流速后的任一时刻的情况下，如果所述估算的对比时刻的理论通气流速大于所述监测到的对比时刻的患者通气流速，且与所述监测到的对比时刻的患者通气流速之差大于所述预设阈值，则判断患者呼吸状态为自主呼气。
  14. 根据权利要求8所述的装置，其特征在于，所述处理器根据识别到的呼吸状态控制所述医用通气设备进行通气模式切换的步骤包括：
    如果所述呼吸状态为自主吸气，则触发所述医用通气设备进入吸气通气模式；
    如果所述呼吸状态为自主呼气，则触发所述医用通气设备进入呼气通气模式。
  15. 一种包含权利要求8-14任一项所述通气切换控制装置的医用通气设备，其特征在于，所述医用通气设备还包括气源和呼吸管路；
    所述通气切换控制装置包括流速测量设备、处理器和存储器，所述处理器与所述流速测量设备和所述存储器连接；
    所述气源与处理器连接，在所述处理器的控制下向患者提供通气支持；
    所述呼吸管路与所述气源连接，在通气过程中提供呼吸路径；
    所述流速测量设备与所述呼吸管路连接，在通气过程中监测患者通气流速。
  16. 一种计算机可读存储介质，其特征在于，所述计算机可读存储介质存储有通气切换控制程序，所述通气切换控制程序可以被处理器执行，以实现权利要求1-7任一项所述的通气切换控制方法。
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