WO2023115482A1 - 用于除颤仪的节律分析和决策方法、装置以及存储介质 - Google Patents

用于除颤仪的节律分析和决策方法、装置以及存储介质 Download PDF

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WO2023115482A1
WO2023115482A1 PCT/CN2021/140965 CN2021140965W WO2023115482A1 WO 2023115482 A1 WO2023115482 A1 WO 2023115482A1 CN 2021140965 W CN2021140965 W CN 2021140965W WO 2023115482 A1 WO2023115482 A1 WO 2023115482A1
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rhythm
state
analysis
term
decision
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French (fr)
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胡咪咪
蒋浩宇
洪俊标
黄飞云
何先梁
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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 PCT/CN2021/140965 priority patent/WO2023115482A1/zh
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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
    • A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
    • A61B5/316—Modalities, i.e. specific diagnostic methods
    • A61B5/318—Heart-related electrical modalities, e.g. electrocardiography [ECG]
    • A61B5/346—Analysis of electrocardiograms
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/38—Applying electric currents by contact electrodes alternating or intermittent currents for producing shock effects
    • A61N1/39—Heart defibrillators

Definitions

  • the present application relates to the technical field of defibrillators, and more particularly relates to a rhythm analysis and decision-making method, device and storage medium for defibrillators.
  • the defibrillator is a medical device that uses a strong pulse current to pass through the heart to eliminate arrhythmia and restore it to sinus rhythm. It is an essential first aid equipment in the operating room. Defibrillation is one of the most important steps in performing CPR. Cardiopulmonary Resuscitation (CPR) compressions need to be combined with electrocardiograph (ECG) signals for rhythm analysis. In CPR compressions, reliable rhythm analysis mainly depends on reliable segmental rhythm analysis and reliable multi-time segmental rhythm status synthesis. decision making.
  • rhythm comprehensive decision-making methods in the process of CPR mainly focus on two aspects: one is to use short-term rhythm analysis state to comprehensively output rhythm decision-making, and the other is to use long-term rhythm analysis state to comprehensively output rhythm decision-making.
  • comprehensive decision-making only using the short-term rhythm analysis state is easily affected by local disturbances, leading to rhythm misjudgment; only relying on the long-term rhythm analysis state for comprehensive decision-making reflects a long-term stable rhythm state and is not sensitive to local rhythm fluctuations. Insensitivity, rhythm switching response is not timely.
  • a rhythm analysis and decision-making method for a defibrillator includes: acquiring an ECG signal of the target object during cardiopulmonary resuscitation of the target object; The time series is divided into multiple analysis areas, and the state corresponding to each analysis area is determined, and the state includes first aid treatment state and/or filtering state; for each of the analysis areas, based on the state corresponding to the analysis area, the determination The segmental rhythm analysis mode of the analysis area, and perform rhythm analysis on the analysis area based on the segmental rhythm analysis mode, so as to obtain the segmental rhythm state of the analysis area; Perform long-term rhythm analysis on the segmental rhythm states of a plurality of the analysis regions to obtain long-term rhythm state characteristics; perform short-term rhythm analysis based on the segmental rhythm states of at least one of the analysis regions within the second preset time period from the rhythm decision-making moment Rhythm analysis, obtaining short-term rhythm state characteristics, wherein the first preset time period is greater than the second preset time period;
  • Another aspect of the present application provides a rhythm analysis and decision-making method for a defibrillator, the method comprising: acquiring a reference signal during cardiopulmonary resuscitation of a target object and the original ECG signal of the target object;
  • the reference signal performs compression detection to obtain the time-domain compression event marker of the reference signal;
  • the instantaneous compression interval is determined based on the time-domain compression event marker, and the original ECG signal is processed based on the instantaneous compression interval performing filtering to obtain filtered ECG signals; dividing the ECG signals of the target object into multiple analysis areas in time series, and performing rhythm analysis on each analysis area to obtain fragments of each analysis area Rhythm state, wherein, the ECG signal of the target object only includes the filtered ECG signal, or, the ECG signal of the target object includes the original ECG signal and the filtered ECG signal ; Long-term rhythm analysis is performed based on the segmental rhythm states of a plurality of the analysis regions in the first preset time period from the rhythm decision-
  • a rhythm analysis and decision-making device in yet another aspect of the present application, includes a memory and a processor, the memory stores a computer program run by the processor, and the computer program is executed by the processor.
  • the rhythm analysis and decision-making method described above for the defibrillator is implemented at runtime.
  • a storage medium on which a computer program is stored, and the computer program executes the above rhythm analysis and decision-making method for a defibrillator when running.
  • the rhythm decision is determined by combining the long-term rhythm state characteristics and the short-term rhythm state characteristics, which can not only avoid local interference, but also avoid local rhythm fluctuations. Sensitive, resulting in more reliable rhythm decisions. Moreover, since different rhythm analysis modes are selected according to ECG signals in different states, the accuracy of the rhythm analysis result, that is, the segmental rhythm state, can be further improved, thereby further improving the reliability of rhythm decision-making.
  • Fig. 1 shows a schematic flowchart of a rhythm analysis and decision-making method for a defibrillator according to an embodiment of the present application.
  • Fig. 2 shows an exemplary flowchart of a rhythm analysis and decision-making method for a defibrillator according to an embodiment of the present application.
  • Fig. 3 shows a process diagram of a rhythm analysis and decision-making method for a defibrillator according to an embodiment of the present application.
  • Fig. 4 shows a schematic flowchart of a rhythm analysis and decision-making method for a defibrillator according to another embodiment of the present application.
  • Fig. 5 shows an exemplary flowchart of a rhythm analysis and decision-making method for a defibrillator according to another embodiment of the present application.
  • Fig. 6 shows an exemplary flowchart of a rhythm analysis and decision-making method for a defibrillator according to yet another embodiment of the present application.
  • Fig. 7 shows a schematic block diagram of a rhythm analysis and decision-making device for a defibrillator according to an embodiment of the present application.
  • Fig. 1 shows a schematic flowchart of a rhythm analysis and decision-making method 100 for a defibrillator according to an embodiment of the present application.
  • a rhythm analysis and decision-making method 100 for a defibrillator may include the following steps:
  • step S110 the electrocardiographic signal of the target object is acquired during the process of performing cardiopulmonary resuscitation on the target object.
  • step S120 the electrocardiographic signal is divided into a plurality of analysis areas in time series, and a state corresponding to each analysis area is determined, and the state includes an emergency treatment state and/or a filtering state.
  • step S130 for each of the analysis areas, the segmental rhythm analysis mode of the analysis area is determined based on the state corresponding to the analysis area, and the rhythm analysis is performed on the analysis area based on the segmental rhythm analysis mode to obtain Segmental rhythm status of the analyzed region.
  • step S140 long-term rhythm analysis is performed based on the segmental rhythm states of the plurality of analysis regions within the first preset time period from the rhythm decision-making moment to obtain long-term rhythm state characteristics.
  • step S150 short-term rhythm analysis is performed based on the segmental rhythm state of at least one of the analysis regions within a second preset time period from the rhythm decision-making moment to obtain short-term rhythm state characteristics, wherein the first preset time period greater than the second preset time period.
  • step S160 a rhythm decision is determined based on the long-term rhythm state feature and the short-term rhythm state feature, and the rhythm decision is output.
  • the state corresponding to each analysis area (emergency treatment state and/or filter state), for the analysis areas with different states
  • different segmental rhythm analysis modes are used for rhythm analysis, and the segmental rhythm status of each analysis area is obtained.
  • the long-term rhythm status analysis and the long-short rhythm State analysis combined with long-term rhythm state characteristics and short-term rhythm state characteristics to determine rhythm decision-making, can not only avoid local interference, but also avoid insensitivity to local rhythm fluctuations, so that more reliable rhythm decision-making can be obtained.
  • different rhythm analysis modes are selected according to ECG signals in different states, the accuracy of the rhythm analysis result, that is, the segmental rhythm state, can be further improved, thereby further improving the reliability of rhythm decision-making.
  • the ECG signal of the target object acquired in step S110 may be the original ECG signal and/or the filtered ECG signal.
  • the filtered ECG signal is obtained based on reference signals related to chest compressions and original ECG signals during cardiopulmonary resuscitation.
  • time-domain compression event detection and identification of compression events can be performed on reference signals (such as chest impedance signals collected by defibrillation transthoracic electrodes, blood oxygen signals, respiratory signals, and signals sensed by CPR sensors, etc.).
  • the domain component assists in the detection of compression events, and then uses the adaptive filtering model to filter out the CPR interference of the original ECG signal waveform, realizes CPR chest compression detection and filtering, and obtains the filtered ECG signal.
  • the ECG signal is divided into multiple analysis areas in time series, and each analysis area can have the same time length; or, the time length of each analysis area can be changed as required .
  • each analysis area can be continuous or discontinuous in time.
  • they may partially overlap or not overlap in time.
  • the status of each analysis area includes first aid treatment status and/or filtering status.
  • the first aid treatment state reflects the first aid operation state of the first aid personnel on the target object in the time period corresponding to the analysis area;
  • the filtering state reflects whether the ECG signal in the time period corresponding to the analysis area needs to be filtered.
  • the state of each analysis area of the ECG signal is determined, and the appropriate (corresponding) segmental rhythm analysis mode is determined according to the state of each analysis area of the ECG signal, which is conducive to performing rhythm analysis on each analysis area more accurately , to obtain a more accurate segmental rhythm state, which is conducive to obtaining a more reliable rhythm decision.
  • the first aid treatment state may further include a compression progress state (also referred to simply as a compression state), a compression transition state, and a compression pause state.
  • the filtering status may further include a filtering status and a filtering status.
  • determining the segmental rhythm analysis mode of the analysis area based on the state corresponding to the analysis area may include: when the first aid treatment state of the analysis area is the pressing pause state and/or the filtering state of the analysis area is When no filtering state is required, determine that the segmental rhythm analysis mode of the analysis area is the non-interference mode; when the first aid treatment state of the analysis area is a pressing state or a pressing transition state, and the filtering state of the analysis area is a filtering state When , it is determined that the segmental rhythm analysis mode of the analysis region is an interference mode.
  • the first aid treatment status of an analysis area is the compression progress state or the compression transition state
  • the filtering state of an analysis area is a filtering state
  • the rhythm analysis can be performed based on the filtered ECG signal only; or, the original ECG signal and the filtered ECG signal can be combined with Rhythm analysis with interfering rhythm strategies.
  • the emergency treatment state may also include an electric shock state
  • the determination of the segmental rhythm analysis mode of the analysis area based on the state corresponding to the analysis area may also include: when the first aid treatment of the analysis area
  • the state is the electric shock state
  • the electric shock state a new round of compression cycle can be started by default, the rhythm analysis is initialized, and the first analysis after the electric shock is used as the initial state of the rhythm analysis, and the rhythm information before the electric shock is no longer considered.
  • the shock status can be sensed when the first responder presses the shock confirmation button.
  • determining the state corresponding to each analysis area in step S120 may further include: acquiring reference signals related to chest compressions during cardiopulmonary resuscitation of the target object; Divide it into a plurality of sub-analysis areas, and determine the pressing situation corresponding to each sub-analysis area; for each analysis area of the ECG signal, based on the Press the condition to determine the first aid treatment status for each of said analyzed regions.
  • a reference signal such as chest impedance signal, blood oxygen signal, respiratory signal, and signal sensed by the CPR sensor, etc.
  • the collected by the defibrillation transthoracic electrode is obtained and divided into a plurality of sub-analysis areas, and one of the reference signals
  • One or more sub-analysis areas correspond to one analysis area of the ECG signal. Therefore, according to the pressing situation of one or more sub-analysis areas corresponding to one analysis area, the emergency treatment status of the analysis area is determined.
  • the determining the first aid treatment status of each analysis area based on the pressing situation of one or more sub-analysis areas corresponding to the analysis area may include: When the corresponding pressing situation of each of the sub-analysis areas is that there is a pressing event, it is determined that the emergency treatment state of the analysis area is the pressing-in-progress state; When the pressing situation of some sub-analysis areas is that there is a pressing event, and the pressing situation of the remaining sub-analysis areas is that there is no pressing event, it is determined that the emergency treatment state of the analysis area is a pressing transition state; when each corresponding to the analysis area When there is no compression event in each of the sub-analysis areas, it is determined that the emergency treatment state of the analysis area is the compression pause state.
  • the determination of the pressing situation corresponding to each sub-analysis area may include: performing time-domain analysis and/or frequency-domain analysis on the reference signal to obtain time-domain pressing features and/or frequency-domain analysis.
  • Press feature perform press detection on each sub-analysis area of the reference signal based on the time-domain press feature and/or the frequency-domain press feature, so as to determine whether there is a press event in each sub-analysis area.
  • it may be determined whether there is a pressing event in each sub-analysis area based on time-domain pressing features, frequency-domain pressing features, or a combination of time-domain and frequency-domain pressing features, so as to more accurately determine whether there is a pressing event in each sub-analysis area. press event.
  • determining the state corresponding to each analysis area may include: acquiring a reference signal during cardiopulmonary resuscitation of the target object; dividing the reference signal into multiple sub-analysis areas in time series ; For each analysis area of the ECG signal, perform correlation analysis on the reference signal of one or more sub-analysis areas corresponding to the analysis area and the noise in the analysis area, according to the correlation Determine the filtering mode of the analysis area according to the result of the property analysis, and determine the filtering state of the analysis area according to the filtering mode of the analysis area.
  • a reference signal (such as chest impedance signal, blood oxygen signal, respiratory signal, and signal sensed by the CPR sensor, etc. collected by the defibrillation transthoracic electrode) is obtained and divided into a plurality of sub-analysis areas, and one of the reference signals
  • One or more sub-analysis areas correspond to an analysis area of the electrocardiogram signal, therefore, the correlation is performed according to the reference signal part corresponding to one or more sub-analysis areas corresponding to one analysis area and the noise condition of the analysis area Analysis, you can determine the filtering mode of the analysis area, so as to determine the filtering status of the analysis area.
  • the filtering state of the analysis region is a required filtering state.
  • the correlation analysis determines that the ECG filtering mode of an analysis region is no filtering, it can be determined that the filtering state of the analysis region is no filtering.
  • the segmental rhythm analysis is performed on each analysis area using the segmental rhythm analysis mode corresponding to each analysis area , so as to obtain the segmental rhythm status of each analysis area, as described in step S130.
  • a long-term rhythm analysis and a short-term rhythm analysis are respectively performed in steps S140 and S150, which will be described in detail below.
  • long-term rhythm analysis is performed based on segmental rhythm states of multiple analysis regions within a first preset time period from the rhythm decision-making moment to obtain long-term rhythm state characteristics. That is to say, the long-term rhythm state is obtained by performing rhythm analysis on the segmental rhythm states of multiple analysis areas, and the multiple analysis areas are multiple analysis areas within a first preset time period from the rhythm decision-making moment.
  • the first preset time period refers to the time period from the moment when the decision-making moment goes back to the first preset time to the rhythm decision-making moment, and the end point of this time period can be the rhythm decision-making moment, or Instead of a rhythmic decision moment, it can be a certain time away from that decision moment.
  • the analysis duration of the long-term rhythm analysis is the time range of more than 10 seconds closest to the rhythm decision-making moment, but not exceeding the current compression cycle (generally 2 minutes or 3 minutes), including segmental rhythms of at least 5 analysis regions state.
  • the current compression cycle generally 2 minutes or 3 minutes
  • multiple segmental rhythm states within 2 minutes from the rhythm decision-making moment can be analyzed to calculate long-term rhythm state features.
  • the above-mentioned first preset time period is equal to 2 minutes.
  • the long-term rhythm state characteristics may include at least one of the following: the proportion of each segment rhythm state in the set of segment rhythm states of each of the multiple analysis regions; When the respective segmental rhythm states of the analysis areas are sorted by time, the proportion of the same segmental rhythm states for multiple consecutive times; in the corresponding state sets of the plurality of analysis areas, the time proportions of different states and/or different states The proportion of each fragment rhythm state; the weighted score of each fragment rhythm state in the collection of fragment rhythm states of multiple said analysis regions, wherein the weight of the fragment rhythm state of each said analysis region is The size depends on the time distance between the analysis area and the rhythm decision moment and/or the state corresponding to the analysis area.
  • the first aid treatment status is the compression pause state or the filtering state is no filtering state
  • the ECG signal without CPR interference is analyzed at this time, and the segmental rhythm state analysis results are relatively reliable, and the segmental rhythm state at the corresponding time is given.
  • the first weight coefficient if the state of first aid treatment is the state of pressing and the state of filtering is the state of needing filtering, at this time the analysis is the ECG signal interfered by CPR, the reliability of the segmental rhythm state analysis results is reduced, and the segmental rhythm state at the corresponding moment is given Assign a second weight coefficient (the second weight coefficient is less than the first weight coefficient); if the pressing state of the current analysis area is a pressing transition state and the filtering state is a state requiring filtering, the signals analyzed at this time include ECG signals interfered by CPR and without For ECG signals interfered by CPR, due to the influence of CPR filtering, there may be large differences in amplitude and shape between the ECG signals after CPR filtering and the ECG signals without CPR filtering in the compression transition region, and the analysis results of segmental rhythm status are unreliable.
  • a third weight coefficient is assigned to the segmental rhythm state at the corresponding moment (the third weight coefficient is smaller than the second weight coefficient).
  • the rhythm state weight allocation criteria of the signal reliability dimension and the time dimension can be integrated, and the segmental rhythm states of different analysis areas can be assigned respective weights, and weighted combinations can be performed to obtain the weighted score of each rhythm state. value. If the emergency treatment state of the current analysis area is electric shock state, enter the initialization mode, initialize the long-term rhythm analysis, and start a new round of compression cycle by default. Preshock rhythm information is no longer considered.
  • short-term rhythm analysis is performed based on the segmental rhythm state of at least one analysis region within a second preset time period from the rhythm decision-making moment to obtain short-term rhythm state characteristics. That is to say, the long-term rhythm state is obtained by performing rhythm analysis on the segmental rhythm state of at least one analysis area, and the at least one analysis area is at least one analysis area within the second preset time period from the rhythm decision-making moment.
  • the second preset time period refers to the time period from the decision-making moment back to the second preset time to the rhythm decision-making moment, and the end of the time period can be the rhythm decision-making moment, or Instead of a rhythmic decision moment, it can be a certain time away from that decision moment.
  • the analysis duration of the short-term rhythm analysis is the time range within 10 seconds closest to the rhythm decision-making moment, and at least includes the segmental rhythm state of one analysis area.
  • one or more segments of the rhythm state within 10 seconds from the rhythm decision-making moment can be analyzed to calculate short-term rhythm state characteristics.
  • the aforementioned second preset time period is equal to 10 seconds.
  • the characteristics of the short-term rhythm state may include at least one of the following: the proportion of each segment rhythm state in the set of segment rhythm states of each of the multiple analysis regions; When the respective segmental rhythm states of the analysis areas are sorted by time, the proportion of the same segmental rhythm states for multiple consecutive times; in the corresponding state sets of the plurality of analysis areas, the time proportions of different states and/or different states The proportion of each fragment rhythm state; the weighted score of each fragment rhythm state in the collection of fragment rhythm states of multiple said analysis regions, wherein the weight of the fragment rhythm state of each said analysis region is The size depends on the time distance between the analysis area and the rhythm decision-making moment and/or the state corresponding to the analysis area; among the analysis areas whose state is the pressing pause state or the no-filtering state, the analysis area closest to the rhythm decision-making moment is the same as the rhythm decision-making moment. The temporal distance of the moment and the percentage of its fragment rhythmic state.
  • the first aid treatment status is the compression pause state or the filtering state is no filtering state
  • the ECG signal without CPR interference is analyzed at this time, and the segmental rhythm state analysis results are relatively reliable, and the segmental rhythm state at the corresponding time is given.
  • the first weight coefficient if the state of first aid treatment is the state of pressing and the state of filtering is the state of needing filtering, at this time the analysis is the ECG signal interfered by CPR, the reliability of the segmental rhythm state analysis results is reduced, and the segmental rhythm state at the corresponding moment is given Assign a second weight coefficient (the second weight coefficient is less than the first weight coefficient); if the pressing state of the current analysis area is a pressing transition state and the filtering state is a state requiring filtering, the signals analyzed at this time include ECG signals interfered by CPR and without For ECG signals interfered by CPR, due to the influence of CPR filtering, there may be large differences in amplitude and shape between the ECG signals after CPR filtering and the ECG signals without CPR filtering in the compression transition region, and the analysis results of segmental rhythm status are unreliable.
  • a third weight coefficient is assigned to the segmental rhythm state at the corresponding moment (the third weight coefficient is smaller than the second weight coefficient).
  • the rhythm state weight allocation criteria of the signal reliability dimension and the time dimension can be integrated, and the segmental rhythm states of different analysis areas can be assigned respective weights, and weighted combinations can be performed to obtain the weighted score of each rhythm state. value. If the first aid treatment status of the current analysis area is the electric shock state, enter the initialization mode, initialize the short-term rhythm analysis, start a new round of compression cycle by default, and no longer consider the rhythm information before the electric shock.
  • the rhythm decision is determined by combining the two.
  • the determining the rhythm decision based on the long-term rhythm state characteristics and the short-term rhythm state characteristics may include: when the long-term rhythm state characteristics and the short-term rhythm state characteristics are respectively When the distribution of the reflected segmental rhythm state is consistent, the rhythm decision is determined according to the distribution of the segmental rhythm state reflected by the long-term rhythm state feature or the short-term rhythm state feature; when the long-term rhythm state feature and the When the distributions of the segmental rhythm states reflected by the short-term rhythm state characteristics are inconsistent, the rhythm decision is determined according to the more reliable of the two distributions, or, according to the segmental rhythm state embodied by the short-term rhythm state characteristics The distribution determines the rhythm decision, or the output does not determine the rhythm decision.
  • the analysis regions of different states correspond to different ECG signals, and the reliability of the analysis results of the segmental rhythm states is also different. Therefore, the reliability of the distribution of the segmental rhythm state represented by the long-term rhythm state feature and the short-term rhythm state feature is related to the state of the analysis area used in the long-term rhythm analysis and the short-term rhythm analysis respectively.
  • the decision whether to defibrillate is made according to the judgment criterion established by the distribution characteristics of the long-term rhythm state and the short-term rhythm state. If the distribution characteristics of the long-term rhythm state are consistent with the distribution characteristics of the short-term rhythm state, the output can be defibrillated according to the rhythm state represented by the distribution characteristics; if the distribution characteristics of the long-term rhythm state and the distribution characteristics of the short-term rhythm state If the distribution characteristics of the long-term rhythm state are inconsistent with the distribution characteristics of the short-term rhythm state, and the two None of the distribution features are reliable, and the output is uncertain rhythm decision.
  • the weighted score feature in the long-term rhythm analysis indicates that the long-term rhythm status is shockable
  • the weighted score is large, and there are no compression pauses or periods without filtering in the short-term rhythm analysis, and the shockable
  • the proportion of rhythm state is relatively large, and the output can be defibrillated rhythm decision; if the characteristics of rhythm state percentage and weighted score in the long-term rhythm analysis have little distinction on whether the rhythm state can be defibrillated or not, but in the short-term rhythm analysis.
  • the defibrillable rhythm state can also be output in the period of time when the compression is paused or does not need to be filtered, and the time period closest to the rhythm decision-making moment has a large proportion of the defibrillable rhythm state.
  • the determining the rhythm decision based on the long-term rhythm state characteristics and the short-term rhythm state characteristics may include: for each segment rhythm state, according to the long-term rhythm state characteristics The weighted combination of the feature corresponding to the segmental rhythm state and the short-term rhythmic state feature and the feature corresponding to the segmental rhythm state obtains the weighted score of the segmental rhythm state; according to each segment The weighted score of the rhythm status determines the rhythm decision.
  • the weighted score obtained through weighted combination is used for rhythm decision-making, which can be expressed as the following formula:
  • RhythmScore is a weighted score of a certain rhythm state. According to the weighted score of the rhythm state, it can be defibrillated, not defibrillated, or uncertain.
  • LongTimeScore is a numerical value for measuring the long-term rhythm state distribution characteristics of a certain rhythm state, and may be a value for measuring the distribution characteristics of a long-term rhythm state or a combined value for measuring the distribution characteristics of multiple long-term rhythm states.
  • LongTimeScore can be the distribution value (such as percentage) of different rhythm states in the long-term rhythm state feature, or it can be converted from the distribution values of different rhythm states in the long-term rhythm state feature (such as weighted score normalized value).
  • the combination method may be, for example, performing normalization, averaging, weighted average, and other calculations on various long-duration and long-duration rhythm state distribution characteristics to obtain combined values and the like.
  • ShortTimeScore is a numerical value for measuring the distribution characteristics of a short-term rhythm state of a certain rhythm state, and may be a value for measuring the distribution characteristics of a short-term rhythm state or a combined value for measuring the distribution characteristics of multiple short-term rhythm states.
  • A, B, and C are weight coefficients obtained from regression analysis.
  • the rhythm decision can be output, for example, at the end of the compression cycle, and according to the rhythm decision result, the emergency personnel are instructed to perform first aid treatment. If the rhythm decision output can be defibrillated rhythm decision, instruct the emergency personnel to give electric shock, if the rhythm decision output is not defibrillation rhythm decision, instruct the emergency personnel to continue to press, if the rhythm decision output is not sure rhythm decision, instruct the emergency personnel to suspend compression, for no compression ECG signal under interference for rhythm confirmation.
  • the rhythm analysis and decision-making method 100 for a defibrillator is described above by taking the fixed CPR operation mode as an example. Cardiopulmonary resuscitation, giving rhythm decisions after the compression cycle, instructing first responders to perform first aid treatment.
  • the method 100 can also be used in the continuous CPR operation mode, wherein the continuous CPR operation mode means that there is no fixed compression cycle during the cardiopulmonary resuscitation process of the emergency personnel, and the rhythm decision is continuously made during the CPR process.
  • the rhythm decision is made, the defibrillation rhythm is output.
  • Immediately instruct the emergency personnel to perform electric shock treatment, or the emergency personnel initiate a rhythm analysis request give rhythm decisions, and instruct the emergency personnel to perform first aid treatment.
  • the analysis duration of the long-term rhythm analysis may be in the time range of more than 10 seconds to the nearest rhythm decision moment, but not more than 3 minutes, including at least 5 analyses. Segmental rhythm status of the region; the analysis duration of short-term rhythm analysis is within 10 seconds from the moment of rhythm decision-making, including the segmental rhythm status of at least one analysis region, and rhythm decision-making is continued during the CPR process. If the analysis time or the number of analysis regions before the rhythm decision-making moment does not meet the analysis conditions of long-term rhythm analysis, the long-term rhythm state remains the default initial state (uncertain rhythm), and the long-term default initial rhythm state and short-term rhythm state are combined in rhythm decision-making.
  • Rhythm state characteristics using the rhythm decision-making strategy, output defibrillation, non-shockable or uncertain rhythm decision.
  • Rhythm decision-making strategies at this time include but are not limited to the following methods: directly output uncertain rhythm decision-making; determine whether to defibrillate according to the judgment criteria formulated by the characteristics of the short-term rhythm state.
  • the output is uncertain rhythm decision (for example, if there is a pause in compression or no The period of time for filtering, and the proportion of the defibrillable rhythm state in the time period closest to the rhythm decision-making moment is relatively large, and the defibrillable rhythm decision is output); according to the characteristics of the long-term default initial rhythm state and short-term rhythm state, after weighted combination
  • the obtained weighted score is used for rhythm decision-making, which can be expressed as the following formula:
  • RhythmScore is the weighted score of a certain rhythm state, according to the weighted score of the rhythm state, the decision of defibrillation, non-defibrillation or uncertain rhythm is made; LongTimeScore is the value to measure the long-term default initial rhythm state; ShortTimeScore is the value to measure a certain
  • the value of the short-term rhythm state distribution characteristics of a rhythm state can be a value that measures the distribution characteristics of a short-term rhythm state or a combined value that measures the distribution characteristics of multiple short-term rhythm states; A, B, and C are obtained by regression analysis weight factor.
  • the emergency personnel are instructed to perform first aid treatment.
  • the emergency personnel do not actively initiate a rhythm analysis request, once the rhythm decision outputs a defibrillable rhythm, the emergency personnel are immediately instructed to give an electric shock. If the rhythm decision outputs other rhythms, the emergency personnel are not instructed or instructed to continue compressions.
  • the emergency personnel initiate a rhythm analysis request and give a rhythm decision, if the rhythm decision outputs a defibrillable rhythm, immediately instruct the emergency personnel to give an electric shock; if the rhythm decision outputs a defibrillable rhythm, instruct the emergency personnel to continue pressing; if the rhythm decision output is uncertain Rhythm, which instructs the rescuer to pause compressions and perform rhythm confirmation on the ECG signal without compression interference.
  • FIG. 2 shows a rhythm analysis and decision-making method according to the embodiment of the application.
  • Exemplary flow chart (wherein it mainly shows each link and its trend in the whole process)
  • Fig. 3 shows a schematic diagram of the process of rhythm analysis and decision-making according to the embodiment of the present application (wherein it mainly shows various signals, State and rhythm state analysis considerations, weight distribution, etc.), you can better understand the content described above according to Figure 2 and Figure 3, and will not repeat them here.
  • the rhythm analysis and decision-making method 100 for a defibrillator not only considers the short-term rhythm state before the rhythm decision-making moment, but also considers the long-term rhythm state before the rhythm decision-making moment.
  • the rhythm state in the cycle is generally relatively stable. By paying attention to the rhythm state in the CPR compression cycle for a long time before the rhythm decision-making moment, the stable rhythm state in the CPR compression cycle can be obtained.
  • rhythm state in a short period of time before the decision-making moment, the short-term instantaneous rhythm state is obtained, the long-term stable rhythm state and the short-term instantaneous rhythm state are integrated, the rhythm decision is made, and the emergency personnel are instructed to perform first aid treatment.
  • the rhythm analysis and decision-making method 100 for a defibrillator combines long-term rhythm state features and short-term rhythm state features to determine rhythm decisions, which can avoid local interference and avoid Insensitivity to local rhythm fluctuations enables more reliable rhythm decisions. Moreover, since different rhythm analysis modes are selected according to ECG signals in different states, the accuracy of the rhythm analysis result, that is, the segmental rhythm state, can be further improved, thereby further improving the reliability of rhythm decision-making.
  • a rhythm analysis and decision-making method 400 for a defibrillator may include the following steps:
  • step S410 the reference signal during cardiopulmonary resuscitation of the target object and the original ECG signal of the target object are acquired.
  • step S420 press detection is performed on the reference signal to obtain a time-domain press event marker of the reference signal.
  • step S430 the instantaneous compression interval is determined based on the time-domain compression event marker, and the original electrocardiographic signal is filtered based on the instantaneous compression interval to obtain a filtered electrocardiographic signal.
  • step S440 the ECG signal of the target object is divided into multiple analysis areas in time series, and rhythm analysis is performed on each analysis area to obtain the segmental rhythm state of each analysis area, wherein the target The ECG signal of the subject only includes the filtered ECG signal, or, the ECG signal of the target object includes the original ECG signal and the filtered ECG signal.
  • step S450 long-term rhythm analysis is performed based on the segmental rhythm states of the plurality of analysis regions within the first preset time period from the rhythm decision-making moment to obtain long-term rhythm state characteristics.
  • step S460 short-term rhythm analysis is performed based on the segmental rhythm state of at least one of the analysis regions within a second preset time period from the rhythm decision-making moment to obtain short-term rhythm state characteristics, wherein the first preset time period greater than the second preset time period.
  • step S470 a rhythm decision is determined based on the long-term rhythm state feature and the short-term rhythm state feature, and the rhythm decision is output.
  • the time-domain compression event marker is obtained based on the compression detection of the reference signal, and the instantaneous compression interval can be determined based on the time-domain compression event marker, so that the original ECG signal is filtered based on the instantaneous compression interval to obtain the filtered subsequent ECG signal.
  • the ECG signal of the target object during cardiopulmonary resuscitation (wherein, the ECG signal of the target object may only include the filtered
  • the electrocardiographic signal, or the electrocardiographic signal of the target object may include the original electrocardiographic signal and the filtered electrocardiographic signal) are divided into a plurality of analysis areas in time series, and according to the segmental rhythm of each analysis area Long-term rhythm state analysis and short-term rhythm state analysis are carried out according to the state, and rhythm decision-making is determined by combining the characteristics of long-term rhythm state and short-term rhythm state, which can not only avoid local interference, but also avoid insensitivity to local rhythm fluctuations, so that more For reliable rhythm decisions.
  • this embodiment is similar to the above-mentioned embodiments, except that some steps are omitted.
  • this embodiment is similar to the above-mentioned embodiments, except that some steps are omitted.
  • the operations in this embodiment are outlined here, and the details of these operations can be referred to the contents of the foregoing embodiments.
  • performing time-domain press detection on the reference signal at step S420 to obtain a time-domain press event marker of the reference signal may include: performing time-domain analysis on the reference signal and/or Frequency-domain analysis to obtain time-domain pressing features and/or frequency-domain pressing features; performing pressing detection on the reference signal based on the time-domain pressing features and/or the frequency-domain pressing features to obtain the reference signal Time-domain compression event markers.
  • pressing detection may be performed based on time-domain features, frequency-domain features or a combination of the two, so as to obtain the time-domain pressing event marker of the reference signal.
  • the long-term rhythm status characteristics and the short-term rhythm status characteristics obtained in step S450 and step S460 may each include at least one of the following: In the collection of the respective fragment rhythm states of a plurality of said analysis areas, the proportion of each fragment rhythm state; when the respective fragment rhythm states of a plurality of said analysis regions are sorted by time, the proportion of the same fragment rhythm state for multiple consecutive times ratio; in the respective corresponding state sets of a plurality of said analysis areas, the time ratio of different states and/or the proportion of each segment rhythm state in different states; the respective segment rhythm states of a plurality of said analysis areas In the set of , the weighted score of each fragment rhythm state, wherein the weight of the fragment rhythm state of each analysis area depends on the time distance between the analysis area and the rhythm decision moment and/or the corresponding analysis area status.
  • determining the rhythm decision based on the long-term rhythm state characteristics and the short-term rhythm state characteristics in step S470 may include: when the long-term rhythm state When the characteristics and the distribution of the segmental rhythm state embodied by the short-term rhythm state feature are consistent, the rhythm decision is determined according to the distribution of the segmental rhythm state embodied by the long-term rhythm state feature or the short-term rhythm state feature; when When the distribution of the segmental rhythm state represented by the long-term rhythm state feature and the short-term rhythm state feature are inconsistent, the rhythm decision is determined according to the more reliable one of the two distributions, or, according to the short-term rhythm state The distribution of the segmental rhythmic state embodied by the rhythmic state feature determines the rhythmic decision, or outputs an indeterminate rhythmic decision.
  • determining the rhythm decision based on the long-term rhythm state features and the short-term rhythm state features in step S470 may include: for each segmental rhythm state, A weighted combination of the corresponding features and the features corresponding to the short-term rhythm state and the segmental rhythm state to obtain the weighted score of the segmental rhythm state; determine according to the weighted score of each segmental rhythm state Rhythm decision.
  • the method 400 can be applied to the fixed cardiopulmonary resuscitation operation mode and the continuous cardiopulmonary resuscitation operation mode.
  • the continuous cardiopulmonary resuscitation operation mode if the rhythm decision time before When the analysis area is not enough for the long-term rhythm analysis, the long-term rhythm analysis is not performed, and the rhythm decision is determined according to the preset long-term default initial rhythm state and the characteristics of the short-term rhythm state.
  • FIG. 5 shows an example of the rhythm analysis and decision-making according to this embodiment
  • a general flow chart (which mainly shows each link in the whole process and its direction), the content of the method 400 described above can be better understood according to the flow chart, and will not be repeated here.
  • the above-mentioned method 400 can omit steps S410 to S430, and start to execute directly from step S440.
  • the electrocardiogram signal in step S440 can refer to the electrocardiogram after band-pass filtering of conventional ECG.
  • the signal may also refer to the ECG signal filtered by CPR.
  • the electrocardiographic signal can be analyzed as a compression reference signal, as shown in the exemplary flow chart of FIG. 6 , which can be used as a variant of the method 400 .
  • the rhythm analysis and decision-making method 400 for a defibrillator according to the embodiment of the present application and its deformation scheme combine long-term rhythm state characteristics and short-term rhythm state characteristics to determine rhythm decision-making, which can avoid local interference, It can also avoid insensitivity to local rhythm fluctuations, so that more reliable rhythm decisions can be obtained.
  • FIG. 7 shows a schematic block diagram of a rhythm analysis and decision-making device 700 for a defibrillator according to an embodiment of the present application. As shown in FIG.
  • the rhythm analysis and decision-making device 700 for a defibrillator may include a memory 710 and a processor 720, the memory 710 is stored with a computer program run by the processor 720, and the computer program is executed by the processor 720
  • the rhythm analysis and decision-making method for the defibrillator according to the embodiment of the present application described above is executed during runtime.
  • the rhythm analysis and decision-making device 700 for a defibrillator may also include a signal acquisition component 730, which may be used to acquire ECG signals and/or Reference signals related to chest compressions are sent to the processor 720, so that it can execute the rhythm analysis and decision-making method for the defibrillator according to the embodiment of the present application.
  • the above-mentioned device 700 may be a defibrillator.
  • Those skilled in the art can understand the structure and operation of each component of the rhythm analysis and decision-making apparatus 700 for defibrillators according to the embodiment of the present application in combination with the foregoing descriptions, and for the sake of brevity, details are not repeated here.
  • the storage medium may include, for example, a memory card of a smart phone, a storage unit of a tablet computer, a hard disk of a personal computer, a read only memory (ROM), an erasable programmable read only memory (EPROM), a portable compact disk read only memory (CD), etc. -ROM), USB memory, or any combination of the above storage media.
  • the computer readable storage medium can be any combination of one or more computer readable storage medium.
  • a computer program is also provided, and the computer program may be stored in a cloud or a local storage medium.
  • the computer program is run by a computer or a processor, it is used to execute the corresponding steps of the rhythm analysis and decision-making method for a defibrillator in the embodiment of the present application.
  • the rhythm analysis and decision-making method and device for defibrillator combine long-term rhythm state characteristics and short-term rhythm state characteristics to determine rhythm decision-making, which can avoid local interference and avoid Insensitivity to local rhythm fluctuations enables more reliable rhythm decisions.
  • different rhythm analysis modes can be selected according to ECG signals in different states, which can further improve the accuracy of the rhythm analysis results, that is, the segmental rhythm state, Thereby further improving the reliability of rhythm decision-making.
  • the disclosed devices and methods may be implemented in other ways.
  • the device embodiments described above are only illustrative.
  • the division of units is only a logical function division. In actual implementation, there may be other division methods.
  • multiple units or components can be combined or integrated. to another device, or some features may be ignored, or not implemented.
  • the various component embodiments of the present application may be realized in hardware, or in software modules running on one or more processors, or in a combination thereof.
  • a microprocessor or a digital signal processor (DSP) may be used in practice to implement some or all functions of some modules according to the embodiments of the present application.
  • DSP digital signal processor
  • the present application can also be implemented as an apparatus program (for example, a computer program and a computer program product) for performing a part or all of the methods described herein.
  • Such a program implementing the present application may be stored on a computer-readable medium, or may be in the form of one or more signals.
  • Such a signal may be downloaded from an Internet site, or provided on a carrier signal, or provided in any other form.

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Abstract

一种用于除颤仪的节律分析和决策方法、装置以及存储介质，该方法包括：获取对目标对象进行心肺复苏过程中目标对象的心电信号；将心电信号在时间序列上划分为多个分析区域，并确定每个分析区域对应的状态；对于每个分析区域，基于对应的状态确定片段节律分析模式，并进行节律分析，以得到分析区域的片段节律状态；基于距离节律决策时刻第一预设时间段内的多个分析区域的片段节律状态进行长时节律分析，得到长时节律状态特征；基于距离节律决策时刻第二预设时间段内的至少一个分析区域的片段节律状态进行短时节律分析，得到短时节律状态特征；基于长时节律状态特征和短时节律状态特征确定并输出节律决策。本申请能够得到更为可靠的节律决策。

Description

用于除颤仪的节律分析和决策方法、装置以及存储介质
说明书
技术领域
本申请涉及除颤仪技术领域，更具体地涉及一种用于除颤仪的节律分析和决策方法、装置以及存储介质。
背景技术
除颤仪是利用较强的脉冲电流通过心脏来消除心律失常，使之恢复窦性心律的一种医疗器械，是手术室必备的急救设备。对于进行心肺复苏，除颤是很重要的步骤之一。心肺复苏(Cardiopulmonary Resuscitation，CPR)按压中需要结合心电(Electrocardiograph，ECG)信号进行节律分析，CPR按压中，可靠的节律分析主要依赖于可靠的片段节律分析和可靠的多个时间片段节律状态综合决策。
目前，CPR过程中节律综合决策方法主要集中在两方面：一种是利用短时间节律分析状态综合输出节律决策，另一种是利用长时间节律分析状态综合输出节律决策。然而，仅利用短时间节律分析状态进行综合决策，容易受局部干扰影响，导致节律误判；仅依靠长时间节律分析状态进行综合决策，反映的是长时间稳定的节律状态，又对局部节律波动不敏感，节律转换响应不及时。
发明内容
本申请一方面，提供了一种用于除颤仪的节律分析和决策方法，该方法包括：获取对目标对象进行心肺复苏过程中所述目标对象的心电信号；将所述心电信号在时间序列上划分为多个分析区域，并确定每个分析区域对应的状态，所述状态包括急救处理状态和/或滤波状态；对于每个所述分析区域，基于所述分析区域对应的状态确定所述分析区域的片段节律分析模式，并基于所述片段节律分析模式对所述分析区域进行节律分析，以得到所述分析区域的片段节律状态；基于距离节律决策时刻第一预设时间段 内的多个所述分析区域的片段节律状态进行长时节律分析，得到长时节律状态特征；基于距离节律决策时刻第二预设时间段内的至少一个所述分析区域的片段节律状态进行短时节律分析，得到短时节律状态特征，其中，所述第一预设时间段大于所述第二预设时间段；基于所述长时节律状态特征和所述短时节律状态特征确定节律决策，并输出所述节律决策。
本申请另一方面，提供了一种用于除颤仪的节律分析和决策方法，该方法包括：获取对目标对象进行心肺复苏过程中的参考信号和所述目标对象的原始心电信号；对所述参考信号进行按压检测，以得到所述参考信号的时域按压事件标记；基于所述时域按压事件标记确定瞬时按压间期，并基于所述瞬时按压间期对所述原始心电信号进行滤波，以得到滤波后的心电信号；将所述目标对象的心电信号在时间序列上划分为多个分析区域，并对每个分析区域进行节律分析，以得到每个分析区域的片段节律状态，其中，所述目标对象的心电信号仅包括所述滤波后的心电信号，或者，所述目标对象的心电信号包括所述原始心电信号和所述滤波后的心电信号；基于距离节律决策时刻第一预设时间段内的多个所述分析区域的片段节律状态进行长时节律分析，得到长时节律状态特征；基于距离节律决策时刻第二预设时间段内的至少一个所述分析区域的片段节律状态进行短时节律分析，得到短时节律状态特征，其中，所述第一预设时间段大于所述第二预设时间段；基于所述长时节律状态特征和所述短时节律状态特征确定节律决策，并输出所述节律决策。
本申请再一方面，提供了一种节律分析和决策装置，该装置包括存储器和处理器，所述存储器上存储有由所述处理器运行的计算机程序，所述计算机程序在被所述处理器运行时执行上述用于除颤仪的节律分析和决策方法。
本申请又一方面，提供了一种存储介质，所述存储介质上存储有计算机程序，所述计算机程序在运行时执行上述用于除颤仪的节律分析和决策方法。
根据本申请实施例的用于除颤仪的节律分析和决策方法和装置结合长时节律状态特征和短时节律状态特征确定节律决策，既能避免受到局部干扰，又能避免对局部节律波动不敏感，从而能够得到更为可靠的节律决 策。而且，由于是根据不同状态的心电信号选择不同的节律分析模式，能够进一步提高节律分析结果即片段节律状态的准确性，从而进一步提高节律决策的可靠性。
附图说明
图1示出根据本申请一个实施例的用于除颤仪的节律分析和决策方法的示意性流程图。
图2示出根据本申请一个实施例的用于除颤仪的节律分析和决策方法的一个示例性流程框图。
图3示出根据本申请一个实施例的用于除颤仪的节律分析和决策方法的过程示意图。
图4示出根据本申请另一个实施例的用于除颤仪的节律分析和决策方法的示意性流程图。
图5示出根据本申请另一个实施例的用于除颤仪的节律分析和决策方法的一个示例性流程框图。
图6示出根据本申请又一个实施例的用于除颤仪的节律分析和决策方法的一个示例性流程框图。
图7示出根据本申请实施例的用于除颤仪的节律分析和决策装置的示意性框图。
具体实施方式
为了使得本申请的目的、技术方案和优点更为明显，下面将参照附图详细描述根据本申请的示例实施例。显然，所描述的实施例仅仅是本申请的一部分实施例，而不是本申请的全部实施例，应理解，本申请不受这里描述的示例实施例的限制。基于本申请中描述的本申请实施例，本领域技术人员在没有付出创造性劳动的情况下所得到的所有其他实施例都应落入本申请的保护范围之内。
在下文的描述中，给出了大量具体的细节以便提供对本申请更为彻底的理解。然而，对于本领域技术人员而言显而易见的是，本申请可以无需一个或多个这些细节而得以实施。在其他的例子中，为了避免与本申请发 生混淆，对于本领域公知的一些技术特征未进行描述。
应当理解的是，本申请能够以不同形式实施，而不应当解释为局限于这里提出的实施例。相反地，提供这些实施例将使公开彻底和完全，并且将本申请的范围完全地传递给本领域技术人员。
在此使用的术语的目的仅在于描述具体实施例并且不作为本申请的限制。在此使用时，单数形式的“一”、“一个”和“所述/该”也意图包括复数形式，除非上下文清楚指出另外的方式。还应明白术语“组成”和/或“包括”，当在该说明书中使用时，确定所述特征、整数、步骤、操作、元件和/或部件的存在，但不排除一个或更多其他的特征、整数、步骤、操作、元件、部件和/或组的存在或添加。在此使用时，术语“和/或”包括相关所列项目的任何及所有组合。
为了彻底理解本申请，将在下列的描述中提出详细的步骤以及详细的结构，以便阐释本申请提出的技术方案。本申请的较佳实施例详细描述如下，然而除了这些详细描述外，本申请还可以具有其他实施方式。
首先，参考图1描述根据本申请一个实施例的用于除颤仪的节律分析和决策方法。图1示出了根据本申请一个实施例的用于除颤仪的节律分析和决策方法100的示意性流程图。如图1所示，用于除颤仪的节律分析和决策方法100可以包括如下步骤：
在步骤S110，获取对目标对象进行心肺复苏过程中所述目标对象的心电信号。
在步骤S120，将所述心电信号在时间序列上划分为多个分析区域，并确定每个分析区域对应的状态，所述状态包括急救处理状态和/或滤波状态。
在步骤S130，对于每个所述分析区域，基于所述分析区域对应的状态确定所述分析区域的片段节律分析模式，并基于所述片段节律分析模式对所述分析区域进行节律分析，以得到所述分析区域的片段节律状态。
在步骤S140，基于距离节律决策时刻第一预设时间段内的多个所述分析区域的片段节律状态进行长时节律分析，得到长时节律状态特征。
在步骤S150，基于距离节律决策时刻第二预设时间段内的至少一个所述分析区域的片段节律状态进行短时节律分析，得到短时节律状态特征，其中，所述第一预设时间段大于所述第二预设时间段。
在步骤S160，基于所述长时节律状态特征和所述短时节律状态特征确定节律决策，并输出所述节律决策。
在本申请的实施例中，将对目标对象进行心肺复苏过程中目标对象的心电信号在时间序列上划分为多个分析区域后，确定每个分析区域对应的状态(急救处理状态和/或滤波状态)，针对具有不同状态的分析区域采用不同的片段节律分析模式进行节律分析，得到每个分析区域的片段节律状态，最后根据各分析区域的片段节律状态进行长时节律状态分析和长短节律状态分析，结合长时节律状态特征和短时节律状态特征确定节律决策，既能避免受到局部干扰，又能避免对局部节律波动不敏感，从而能够得到更为可靠的节律决策。而且，由于是根据不同状态的心电信号选择不同的节律分析模式，能够进一步提高节律分析结果即片段节律状态的准确性，从而进一步提高节律决策的可靠性。
在本申请的实施例中，在步骤S110中获取的目标对象的心电信号可以原始心电信号和/或滤波后的心电信号。其中，滤波后的心电信号是基于心肺复苏过程中与胸外按压相关的参考信号和原始心电信号得到的。具体地，可对参考信号(诸如除颤经胸电极采集的胸阻抗信号、血氧信号、呼吸信号以及CPR传感器感知的信号等)进行时域按压事件检测识别按压事件，也可以结合参考信号频域成分辅助按压事件检测，再采用自适应滤波模型滤除原始心电信号波形的CPR干扰，实现CPR胸按压检测与滤波，得到滤波后的心电信号。
在本申请的实施例中，在步骤S120将心电信号在时间序列上划分为多个分析区域，每个分析区域可以具有相同的时间长度；或者，每个分析区域的时间长度可以按需改变。此外，对于两个相邻的分析区域，它们在时间上可以是连续的，也可以是间断的。此外，对于两个相邻的分析区域，它们在时间上可以是部分重叠的，也可以是不重叠的。
在本申请的实施例中，每个分析区域的状态包括急救处理状态和/或滤波状态。其中，急救处理状态反映该分析区域所对应时间段急救人员对目标对象的急救操作状态；滤波状态反映该分析区域所对应时间段的心电信号是否需要滤波。由于不同的急救操作状态和心电信号是否需要滤波的情况均反映了一个时间段内心电信号是否受到CPR干扰，而心电信号是否受 CPR干扰又影响节律分析和决策，因此，在本申请的实施例中，确定心电信号每个分析区域的状态，根据心电信号每个分析区域的状态确定合适的(对应的)片段节律分析模式，有利于更准确地对每个分析区域进行节律分析，得到更准确的片段节律状态，从而有利于得到更可靠的节律决策。
在本申请的实施例中，急救处理状态可以进一步包括按压进行状态(也可以简称为按压状态)、按压过渡状态和按压暂停状态。滤波状态可以进一步包括需要滤波状态和无需滤波状态。在本申请的实施例中，基于分析区域对应的状态确定分析区域的片段节律分析模式，可以包括：当所述分析区域的急救处理状态为按压暂停状态和/或所述分析区域的滤波状态为无需滤波状态时，确定所述分析区域的片段节律分析模式为无干扰模式；当所述分析区域的急救处理状态为按压进行状态或者按压过渡状态，并且所述分析区域的滤波状态为需要滤波状态时，确定所述分析区域的片段节律分析模式为有干扰模式。
如前所述的，不同的急救操作状态和心电信号是否需要滤波的情况均反映了一个时间段内心电信号是否受到CPR干扰，而心电信号是否受CPR干扰又影响节律分析和决策。因此，当确定一个分析区域的急救处理状态为按压暂停状态时，表明此时心电信号受CPR干扰小，因而采用无干扰模式进行片段节律分析即可。类似地，当确定一个分析区域的滤波状态为无需滤波状态时，表明此时心电信号受CPR干扰小，因而采用无干扰模式进行片段节律分析即可。在无干扰模式下，原始心电信号和滤波后的心电信号均可以用于节律分析，因此，可基于原始心电信号和/或滤波后心电信号，采用无干扰节律策略进行节律分析。
当确定一个分析区域的急救处理状态为按压进行状态或者按压过渡状态时，表明此时心电信号受CPR干扰大，因而需要采用有干扰模式进行片段节律分析。类似地，当确定一个分析区域的滤波状态为需要滤波状态时，表明此时心电信号受CPR干扰大，因而需要采用有干扰模式进行片段节律分析。在有干扰模式下，由于心电信号受CPR干扰，因此可以仅基于滤波后的心电信号采用有干扰节律策略进行节律分析；或者，可以结合原始心电信号和滤波后的心电信号，采用有干扰节律策略进行节律分析。
在本申请的实施例中，急救处理状态还可以包括电击状态，所述基于 所述分析区域对应的状态确定所述分析区域的片段节律分析模式，还可以包括：当所述分析区域的急救处理状态为电击状态时，确定所述分析区域的片段节律分析模式为初始化模式。在电击状态下，可以默认启动新一轮的按压周期，节律分析初始化，电击后第一次分析作为节律分析的初始状态，不再考虑电击前节律信息。示例性地，电击状态可以在急救人员按下电击确认按钮时感测到。
在本申请的实施例中，在步骤S120确定每个分析区域对应的状态，可以进一步包括：获取对目标对象进行心肺复苏过程中与胸外按压相关的参考信号；将所述参考信号在时间序列上划分为多个子分析区域，并确定各子分析区域对应的按压情况；对于所述心电信号的每个分析区域，基于与所述分析区域相对应的一个或多个所述子分析区域的按压情况，确定每个所述分析区域的急救处理状态。在该实施例中，获取参考信号(诸如除颤经胸电极采集的胸阻抗信号、血氧信号、呼吸信号以及CPR传感器感知的信号等)，将其划分为多个子分析区域，参考信号的一个或多个子分析区域与心电信号的一个分析区域相对应，因此，根据与一个分析区域相对应的一个或多个子分析区域的按压情况来确定该分析区域的急救处理状态。
在一个示例中，所述基于与所述分析区域相对应的一个或多个所述子分析区域的按压情况，确定每个所述分析区域的急救处理状态，可以包括：当与所述分析区域对应的每个所述子分析区域的按压情况均为存在按压事件时，确定所述分析区域的急救处理状态为按压进行状态；当与所述分析区域对应的多个所述子分析区域中，部分子分析区域的按压情况为存在按压事件，且其余子分析区域的按压情况为不存在按压事件时，确定所述分析区域的急救处理状态为按压过渡状态；当与所述分析区域对应的每个所述子分析区域的按压情况均为不存在按压事件时，确定所述分析区域的急救处理状态为按压暂停状态。
在本申请的实施例中，所述确定各子分析区域对应的按压情况，可以包括：对所述参考信号进行时域分析和/或频域分析，以得到时域按压特征和/或频域按压特征；基于所述时域按压特征和/或所述频域按压特征对所述参考信号的各子分析区域进行按压检测，以确定所述各子分析区域是否存在按压事件。在该实施例中，可以基于时域按压特征、频域按压特征、或 者时域频域按压特征的结合来进行确定各子分析区域是否存在按压事件，以更准确地确定各子分析区域是否存在按压事件。
以上是确定每个分析区域的急救处理状态的示例描述。下面描述每个分析区域的滤波状态的确定。在本申请的实施例中，确定每个分析区域对应的状态，可以包括：获取对所述目标对象进行心肺复苏过程中的参考信号；将所述参考信号在时间序列上划分为多个子分析区域；对于所述心电信号的每个分析区域，对与所述分析区域相对应的一个或多个所述子分析区域的参考信号与所述分析区域的噪声进行相关性分析，根据所述相关性分析的结果确定所述分析区域的滤波方式，并根据所述分析区域的滤波方式确定所述分析区域的滤波状态。
在该实施例中，获取参考信号(诸如除颤经胸电极采集的胸阻抗信号、血氧信号、呼吸信号以及CPR传感器感知的信号等)，将其划分为多个子分析区域，参考信号的一个或多个子分析区域与心电信号的一个分析区域相对应，因此，根据与一个分析区域相对应的一个或多个子分析区域对应的参考信号部分以及该分析区域的噪声情况这两者进行相关性分析，可以确定该分析区域的滤波方式，从而确定该分析区域的滤波状态。示例性地，当通过相关性分析确定一个分析区域的ECG滤波方式为低阶滤波或高阶滤波时，可确定该分析区域的滤波状态为需要滤波状态。当通过相关性分析确定一个分析区域的ECG滤波方式为无需滤波时，可确定该分析区域的滤波状态为无需滤波状态。
在本申请的实施例中，在确定各分析区域的状态并由此确定了各分析区域的片段节律分析模式后，采用与各分析区域相对应的片段节律分析模式对各分析区域进行片段节律分析，从而得到各分析区域的片段节律状态，如步骤S130所述的。在此之后，根据所得的片段节律状态，在步骤S140和步骤S150分别执行长时节律分析和短时节律分析，下面对此详细描述。
在本申请的实施例中，基于距离节律决策时刻第一预设时间段内的多个分析区域的片段节律状态进行长时节律分析，得到长时节律状态特征。也就是说长时节律状态是通过对多个分析区域的片段节律状态进行节律分析而得到的，该多个分析区域是距离节律决策时刻第一预设时间段内的多个分析区域。此处，第一预设时间段指的是从决策时刻往回退第一预设时间 的时刻起至节律决策时刻点这一段的时间段，该时间段的终点可以是节律决策时刻，也可以不是节律决策时刻，而是可以与该决策时刻相距一定时间。在一个示例中，长时节律分析的分析时长为距离节律决策时刻最近的10秒以上的时间范围，但不超过当前按压周期(一般2分钟或3分钟)，至少包括5个分析区域的片段节律状态。通常可以分析距离节律决策时刻最近2分钟的多个片段节律状态，计算长时节律状态特征，在该示例中，上述第一预设时间段等于2分钟。
在本申请的实施例中，长时节律状态特征可以包括以下中的至少一项：多个所述分析区域各自的片段节律状态的集合中，每种片段节律状态所占的比例；多个所述分析区域各自的片段节律状态按照时间排序时，连续多次相同片段节律状态所占的比例；多个所述分析区域各自的对应的状态集合中，不同状态的时间占比和/或不同状态下每种片段节律状态所占的比例；多个所述分析区域各自的片段节律状态的集合中，每种片段节律状态的加权分值，其中每个所述分析区域的片段节律状态的权重的大小取决于所述分析区域距离节律决策时刻的时间远近和/或所述分析区域对应的状态。
在本申请的实施例中，对于一个分析区域：所述分析区域距离节律决策时刻越近，对所述分析区域的片段节律状态分配的权重越大；以及当所述分析区域的急救处理状态为按压暂停状态或者滤波状态为无需滤波状态时，对所述分析区域的片段节律状态分配第一权重；当所述分析区域的急救处理状态为按压进行状态并且滤波状态为需要滤波状态时，对所述分析区域的片段节律状态分配第二权重，其中所述第二权重小于所述第一权重；当所述分析区域的急救处理状态为按压过渡状态并且滤波状态为需要滤波状态时，对所述分析区域的片段节律状态分配第三权重，其中所述第三权重小于所述第二权重。
在该实施例中，从时间维度上，距离节律决策时刻越近，给对应时刻的片段节律状态分配的权重越大。从信号可靠性维度上，若急救处理状态为按压暂停状态或滤波状态为无需滤波状态，此时分析的是无CPR干扰的ECG信号，片段节律状态分析结果相对可靠，给对应时刻的片段节律状态分配第一权重系数；若急救处理状态为按压进行状态且滤波状态为需要滤波状态，此时分析的是受CPR干扰的ECG信号，片段节律状态分析结果 可靠性降低，给对应时刻的片段节律状态分配第二权重系数(第二权重系数小于第一权重系数)；若当前分析区域的按压状态为按压过渡状态且滤波状态为需要滤波状态，此时分析的信号包括受CPR干扰的ECG信号和无CPR干扰的ECG信号，由于CPR滤波影响，按压过渡区域中CPR滤波后的ECG信号与未经CPR滤波的ECG信号在幅度乃至形态上可能出现较大的差异，片段节律状态分析结果不可靠，给对应时刻的片段节律状态分配第三权重系数(第三权重系数小于第二权重系数)。在本申请的实施例中，可以综合信号可靠性维度与时间维度的节律状态权重分配准则，给不同分析区域的片段节律状态分配各自的权重，进行加权组合，求取每种节律状态的加权分值。若当前分析区域的急救处理状态为电击状态，进入初始化模式，长时节律分析初始化，默认启动新一轮按压周期，待电击后第一次片段节律分析作为长时节律分析的初始片段节律状态，不再考虑电击前节律信息。
在本申请的实施例中，基于距离节律决策时刻第二预设时间段内的至少一个所述分析区域的片段节律状态进行短时节律分析，得到短时节律状态特征。也就是说长时节律状态是通过对至少一个分析区域的片段节律状态进行节律分析而得到的，该至少一个分析区域是距离节律决策时刻第二预设时间段内的至少一个分析区域。此处，第二预设时间段指的是从决策时刻往回退第二预设时间的时刻起至节律决策时刻点这一段的时间段，该时间段的终点可以是节律决策时刻，也可以不是节律决策时刻，而是可以与该决策时刻相距一定时间。在一个示例中，短时节律分析的分析时长为距离节律决策时刻最近的10秒以内的时间范围，至少包括1个分析区域的片段节律状态。通常可以分析距离节律决策时刻最近10秒的一个或多个片段节律状态，计算短时节律状态特征。在该示例中，上述第二预设时间段等于10秒。
在本申请的实施例中，短时节律状态特征可以包括以下中的至少一项：多个所述分析区域各自的片段节律状态的集合中，每种片段节律状态所占的比例；多个所述分析区域各自的片段节律状态按照时间排序时，连续多次相同片段节律状态所占的比例；多个所述分析区域各自的对应的状态集合中，不同状态的时间占比和/或不同状态下每种片段节律状态所占的比例；多个所述分析区域各自的片段节律状态的集合中，每种片段节律状态的加 权分值，其中每个所述分析区域的片段节律状态的权重的大小取决于所述分析区域距离节律决策时刻的时间远近和/或所述分析区域对应的状态；状态为按压暂停状态或无需滤波状态的分析区域中，距离节律决策时刻最近的分析区域与节律决策时刻的时间距离以及其片段节律状态所占的百分比。
在本申请的实施例中，与前文描述长时节律分析时类似的，在短时节律分析中，对于一个分析区域：所述分析区域距离节律决策时刻越近，对所述分析区域的片段节律状态分配的权重越大；以及当所述分析区域的急救处理状态为按压暂停状态或者滤波状态为无需滤波状态时，对所述分析区域的片段节律状态分配第一权重；当所述分析区域的急救处理状态为按压进行状态并且滤波状态为需要滤波状态时，对所述分析区域的片段节律状态分配第二权重，其中所述第二权重小于所述第一权重；当所述分析区域的急救处理状态为按压过渡状态并且滤波状态为需要滤波状态时，对所述分析区域的片段节律状态分配第三权重，其中所述第三权重小于所述第二权重。
在该实施例中，从时间维度上，距离节律决策时刻越近，给对应时刻的片段节律状态分配的权重越大。从信号可靠性维度上，若急救处理状态为按压暂停状态或滤波状态为无需滤波状态，此时分析的是无CPR干扰的ECG信号，片段节律状态分析结果相对可靠，给对应时刻的片段节律状态分配第一权重系数；若急救处理状态为按压进行状态且滤波状态为需要滤波状态，此时分析的是受CPR干扰的ECG信号，片段节律状态分析结果可靠性降低，给对应时刻的片段节律状态分配第二权重系数(第二权重系数小于第一权重系数)；若当前分析区域的按压状态为按压过渡状态且滤波状态为需要滤波状态，此时分析的信号包括受CPR干扰的ECG信号和无CPR干扰的ECG信号，由于CPR滤波影响，按压过渡区域中CPR滤波后的ECG信号与未经CPR滤波的ECG信号在幅度乃至形态上可能出现较大的差异，片段节律状态分析结果不可靠，给对应时刻的片段节律状态分配第三权重系数(第三权重系数小于第二权重系数)。在本申请的实施例中，可以综合信号可靠性维度与时间维度的节律状态权重分配准则，给不同分析区域的片段节律状态分配各自的权重，进行加权组合，求取每种节律状态的加权分值。若当前分析区域的急救处理状态为电击状态，进入初始化 模式，短时节律分析初始化，默认启动新一轮按压周期，不再考虑电击前节律信息。
在得到长时节律状态特征和短时节律状态特征之后，结合这两者确定节律决策。在本申请的实施例中，所述基于所述长时节律状态特征和所述短时节律状态特征确定节律决策，可以包括：当所述长时节律状态特征和所述短时节律状态特征各自体现的片段节律状态的分布情况一致时，根据所述长时节律状态特征或所述短时节律状态特征体现的片段节律状态的分布情况确定节律决策；当所述长时节律状态特征和所述短时节律状态特征各自体现的片段节律状态的分布情况不一致时，根据两种分布情况中可靠性更高的一者确定节律决策，或者，根据所述短时节律状态特征体现的片段节律状态的分布情况确定节律决策，或者，输出不确定节律决策。其中，如前文关于信号可靠性维度方面描述的，不同状态的分析区域对应的ECG信号不同，其片段节律状态的分析结果的可靠性也不同。因此，所述长时节律状态特征和所述短时节律状态特征各自体现的片段节律状态的分布情况的可靠性与长时节律分析和短时节律分析中各自采用的分析区域的状态相关。
在该实施例中，根据长时节律状态与短时节律状态的分布特征制定的判断准则，进行是否可除颤决策。若长时节律状态的分布特征与短时节律状态的分布特征一致，根据分布特征所表现的节律状态，输出是否可除颤决策；若长时节律状态的分布特征与短时节律状态的分布特征不一致，根据从时间维度与信号可靠性维度衡量较可靠的分布特征所表现的节律状态，输出是否可除颤决策；若长时节律状态的分布特征与短时节律状态的分布特征不一致，且两者的分布特征均不可靠，输出不确定节律决策。例如，若长时节律分析中的加权分值特征指示长时节律状态为可除颤的加权分值较大，同时短时节律分析中不存在按压暂停或无需滤波的时间段，且可除颤节律状态的比重较大，输出可除颤节律决策；若长时节律分析中的节律状态百分比、加权分值等特征对于是否可除颤节律状态的区分度不大，但短时节律分析中存在按压暂停或无需滤波的时间段，且其中距离节律决策时刻最近的时间段的可除颤节律状态比重较大，也可输出可除颤节律决策。
在本申请的另一个实施例中，所述基于所述长时节律状态特征和所述 短时节律状态特征确定节律决策，可以包括：对于每种片段节律状态，根据所述长时节律状态特征与所述片段节律状态相对应的特征和所述短时节律状态特征与所述片段节律状态相对应的特征这两者的加权组合，得到所述片段节律状态的加权分值；根据每种片段节律状态的加权分值确定节律决策。在该实施例中，根据长时节律状态与短时节律状态的分布特征，经过加权组合得到的加权分值，进行节律决策，可表示为如下公式：
RhythmScore＝A*LongTimeScore+B*ShortTimeScore+C，
其中，RhythmScore为某种节律状态的加权分值，根据节律状态的加权分值决策可除颤、不可除颤还是不确定。LongTimeScore为衡量某种节律状态的长时节律状态分布特征的数值，可以是衡量一种长时节律状态分布特征的数值或衡量多种长时节律状态分布特征的组合数值。例如，LongTimeScore可以是长时节律状态特征中不同节律状态的分布数值(如百分比)，也可以是由长时节律状态特征中不同节律状态的分布数值经过一些数值转换而来的(如加权分值的归一化数值)。其中，组合方式例如可以是对多种长时长时节律状态分布特征再进行归一化、平均、加权平均等计算，得到组合数值等等。ShortTimeScore为衡量某种节律状态的短时节律状态分布特征的数值，可以是衡量一种短时节律状态分布特征的数值或衡量多种短时节律状态分布特征的组合数值。A、B、C为回归分析得到的权重系数。
在确定节律决策后，可例如在按压周期结束时刻输出节律决策，根据节律决策结果，指示急救人员进行急救处理。若节律决策输出可除颤节律决策，指示急救人员进行电击，若节律决策输出不可除颤节律决策，指示急救人员继续按压，若节律决策输出不确定节律决策，指示急救人员暂停按压，对无按压干扰下的ECG信号进行节律确认。
以上以用于固定CPR操作模式为例来描述根据本申请实施例的用于除颤仪的节律分析和决策方法100，其中，固定CPR操作模式是指急救人员按照系统设定的固定按压周期进行心肺复苏，在按压周期结束后给予节律决策，指示急救人员进行急救处理。该方法100也可以用于连续CPR操作模式，其中，连续CPR操作模式是指急救人员进行心肺复苏过程中没有固定的按压周期，CPR过程中持续进行节律决策，一旦节律决策输出可除 颤节律，立即指示急救人员进行电击处理，或急救人员主动发起节律分析请求，给予节律决策，指示急救人员进行急救处理。
在用于连续CPR操作模式的实施例中，在一个示例中，长时节律分析的分析时长可以为距离节律决策时刻最近的10秒以上的时间范围，但不超过3分钟，至少包括5个分析区域的片段节律状态；短时节律分析的分析时长为距离节律决策时刻最近的10秒以内的时间范围，至少包括1个分析区域的片段节律状态，CPR过程中持续进行节律决策。若节律决策时刻之前的分析时长或分析区域个数不满足长时节律分析的分析条件，长时节律状态保持默认初始状态(不确定节律)，在节律决策时结合长时默认初始节律状态和短时节律状态特征，利用节律决策策略，输出可除颤、不可除颤或不确定的节律决策。此时的节律决策策略包括但不仅限于以下方式：直接输出不确定节律决策；根据短时节律状态特征制定的判断准则，进行是否可除颤决策，若从时间维度与信号可靠性维度衡量，短时节律状态较可靠，根据相应分布特征所表现的节律状态，输出是否可除颤决策；若短时节律状态不可靠，输出不确定节律决策(例如，若短时节律分析中存在按压暂停或无需滤波的时间段，且其中距离节律决策时刻最近的时间段的可除颤节律状态比重较大，输出可除颤节律决策)；根据长时默认初始节律状态与短时节律状态特征，经过加权组合得到的加权分值，进行节律决策，可表示为如下公式：
RhythmScore＝A*LongTimeScore+B*ShortTimeScore+C，
其中，RhythmScore为某种节律状态的加权分值，根据节律状态的加权分值进行可除颤、不可除颤或不确定节律决策；LongTimeScore为衡量长时默认初始节律状态的数值；ShortTimeScore为衡量某种节律状态的短时节律状态分布特征的数值，可以是衡量一种短时节律状态分布特征的数值或衡量多种短时节律状态分布特征的组合数值；A、B、C为回归分析得到的权重系数。
根据节律决策结果，指示急救人员进行急救处理。当急救人员未主动发起节律分析请求，一旦节律决策输出可除颤节律，立即指示急救人员进行电击，若节律决策输出其他节律，不指示或指示急救人员继续按压。当急救人员主动发起节律分析请求，给予节律决策，若节律决策输出可除颤 节律，立即指示急救人员进行电击，若节律决策输出不可除颤节律，指示急救人员继续按压，若节律决策输出不确定节律，指示急救人员暂停按压，对无按压干扰下的ECG信号进行节律确认。
以上示例性地示出根据本申请实施例的用于除颤仪的节律分析和决策方法100，为了更好地理解该方法，图2示出了根据本申请实施例的节律分析和决策的一个示例性流程框图(其中主要示出整个流程中的各环节及其走向)，图3示出了根据本申请实施例的节律分析和决策的过程示意图(其中主要示出各种信号、不同时刻的状态以及节律状态分析考虑因素、权重分配等)，可以根据图2和图3更好地理解前文所述的内容，此处不再赘述。
总体上，根据本申请实施例的用于除颤仪的节律分析和决策方法100不仅考虑了节律决策时刻之前的短时节律状态，还考虑了节律决策时刻之前的长时节律状态，在CPR按压周期内节律状态一般相对稳定，通过关注CPR按压周期内节律决策时刻之前长时间内的节律状态，获取CPR按压周期内的稳定节律状态，同时，为了及时响应局部节律波动，关注CPR按压周期内节律决策时刻之前短时间内的节律状态，获取短时瞬时节律状态，综合长时稳定节律状态与短时瞬时节律状态，进行节律决策，指示急救人员进行急救处理。
基于上面的描述，根据本申请实施例的用于除颤仪的节律分析和决策方法100结合长时节律状态特征和短时节律状态特征确定节律决策，既能避免受到局部干扰，又能避免对局部节律波动不敏感，从而能够得到更为可靠的节律决策。而且，由于是根据不同状态的心电信号选择不同的节律分析模式，能够进一步提高节律分析结果即片段节律状态的准确性，从而进一步提高节律决策的可靠性。
下面结合图4描述根据本申请另一实施例的用于除颤仪的节律分析和决策方法400。如图4所示，用于除颤仪的节律分析和决策方法400可以包括如下步骤：
在步骤S410，获取对目标对象进行心肺复苏过程中的参考信号和所述目标对象的原始心电信号。
在步骤S420，对所述参考信号进行按压检测，以得到所述参考信号的时域按压事件标记。
在步骤S430，基于所述时域按压事件标记确定瞬时按压间期，并基于所述瞬时按压间期对所述原始心电信号进行滤波，以得到滤波后的心电信号。
在步骤S440，将所述目标对象的心电信号在时间序列上划分为多个分析区域，并对每个分析区域进行节律分析，以得到每个分析区域的片段节律状态，其中，所述目标对象的心电信号仅包括所述滤波后的心电信号，或者，所述目标对象的心电信号包括所述原始心电信号和所述滤波后的心电信号。
在步骤S450，基于距离节律决策时刻第一预设时间段内的多个所述分析区域的片段节律状态进行长时节律分析，得到长时节律状态特征。
在步骤S460，基于距离节律决策时刻第二预设时间段内的至少一个所述分析区域的片段节律状态进行短时节律分析，得到短时节律状态特征，其中，所述第一预设时间段大于所述第二预设时间段。
在步骤S470，基于所述长时节律状态特征和所述短时节律状态特征确定节律决策，并输出所述节律决策。
在该实施例中，首先根据对参考信号进行按压检测得到时域按压事件标记，基于时域按压事件标记可确定瞬时按压间期，从而基于瞬时按压间期对原始心电信号进行滤波，得到滤波后的心电信号。与前文所述实施例类似的，在该实施例中，仍然将对目标对象进行心肺复苏过程中目标对象的心电信号(其中，所述目标对象的心电信号可以仅包括所述滤波后的心电信号，或者，所述目标对象的心电信号可以包括所述原始心电信号和所述滤波后的心电信号)在时间序列上划分为多个分析区域，根据各分析区域的片段节律状态进行长时节律状态分析和长短节律状态分析，结合长时节律状态特征和短时节律状态特征确定节律决策，既能避免受到局部干扰，又能避免对局部节律波动不敏感，从而能够得到更为可靠的节律决策。不同之处在于，在本实施例中，无需确定每个分析区域对应的状态，而是直接对每个分析区域进行节律分析，得到每个分析区域的片段节律状态。因此，本实施例与前文所述实施例部分类似，仅是省略了一些步骤，为了简洁，此处仅概述本实施例中的操作，这些操作中的细节内容可参见前述实施例的内容。
在本申请的实施例中，在步骤S420对所述参考信号进行时域按压检测，以得到所述参考信号的时域按压事件标记，可以包括：对所述参考信号进行时域分析和/或频域分析，以得到时域按压特征和/或频域按压特征；基于所述时域按压特征和/或所述频域按压特征对所述参考信号进行按压检测，以得到所述参考信号的时域按压事件标记。在该实施例中，可以基于时域特征、频域特征或者这两者的结合来进行按压检测，以得到参考信号的时域按压事件标记。
在本申请的实施例中，与前文所述实施例类似的，步骤S450和步骤S460各自得到的所述长时节律状态特征和所述短时节律状态特征可以均包括以下中的至少一项：多个所述分析区域各自的片段节律状态的集合中，每种片段节律状态所占的比例；多个所述分析区域各自的片段节律状态按照时间排序时，连续多次相同片段节律状态所占的比例；多个所述分析区域各自的对应的状态集合中，不同状态的时间占比和/或不同状态下每种片段节律状态所占的比例；多个所述分析区域各自的片段节律状态的集合中，每种片段节律状态的加权分值，其中每个所述分析区域的片段节律状态的权重的大小取决于所述分析区域距离节律决策时刻的时间远近和/或所述分析区域对应的状态。
在本申请的实施例中，与前文所述实施例类似的，步骤S470中基于所述长时节律状态特征和所述短时节律状态特征确定节律决策，可以包括：当所述长时节律状态特征和所述短时节律状态特征各自体现的片段节律状态的分布情况一致时，根据所述长时节律状态特征或所述短时节律状态特征体现的片段节律状态的分布情况确定节律决策；当所述长时节律状态特征和所述短时节律状态特征各自体现的片段节律状态的分布情况不一致时，根据两种分布情况中可靠性更高的一者确定节律决策，或者，根据所述短时节律状态特征体现的片段节律状态的分布情况确定节律决策，或者，输出不确定节律决策。或者，步骤S470中基于所述长时节律状态特征和所述短时节律状态特征确定节律决策，可以包括：对于每种片段节律状态，根据所述长时节律状态特征与所述片段节律状态相对应的特征和所述短时节律状态特征与所述片段节律状态相对应的特征这两者的加权组合，得到所述片段节律状态的加权分值；根据每种片段节律状态的加权分值确定节律 决策。
在本申请的实施例中，与前文所述实施例类似的，方法400能够应用于固定心肺复苏操作模式和连续心肺复苏操作模式，当应用于连续心肺复苏操作模式时，如果节律决策时刻之前的分析区域不够用于长时节律分析时，不执行长时节律分析，根据预设长时默认初始节律状态和所述短时节律状态特征确定节律决策。
以上示例性地示出根据本申请实施例的用于除颤仪的节律分析和决策方法400，为了更好地理解该方法，图5示出了根据该实施例的节律分析和决策的一个示例性流程框图(其中主要示出整个流程中的各环节及其走向)，可以根据该流程框图更好地理解前文所述方法400的内容，此处不再赘述。此外，在本申请的又一个实施例中，上述方法400可以省略步骤S410到S430，直接从步骤S440开始执行，此时步骤S440中的心电信号可以是指常规ECG带通滤波后的心电信号，也可以是指CPR滤波后的心电信号。在该实施例中，可以将心电信号作为按压参考信号分析，如图6的示例性流程框图所示的，它可以作为方法400的变形方案。
基于上面的描述，根据本申请实施例的用于除颤仪的节律分析和决策方法400及其变形方案结合长时节律状态特征和短时节律状态特征确定节律决策，既能避免受到局部干扰，又能避免对局部节律波动不敏感，从而能够得到更为可靠的节律决策。
以上示例性地描述了根据本申请实施例的用于除颤仪的节律分析和决策方法。下面结合图7描述根据本申请另一方面提供的用于除颤仪的节律分析和决策装置。图7示出了根据本申请实施例的用于除颤仪的节律分析和决策装置700的示意性框图。如图7所示，用于除颤仪的节律分析和决策装置700可以包括存储器710和处理器720，存储器710上存储有由处理器720运行的计算机程序，所述计算机程序在被处理器720运行时执行前文所述的根据本申请实施例的用于除颤仪的节律分析和决策方法。在本申请的进一步的实施例中，用于除颤仪的节律分析和决策装置700还可以包括信号采集部件730，其可以用于采集对目标对象进行心肺复苏过程中的心电信号和/或与胸外按压相关的参考信号，并传送至处理器720，以由其执行前文所述的根据本申请实施例的用于除颤仪的节律分析和决策方法。在本 申请的实施例中，上述装置700可以是除颤仪。本领域技术人员可以结合前文所述理解根据本申请实施例的用于除颤仪的节律分析和决策装置700各部件的结构和操作，为了简洁，此处不再赘述。
此外，根据本申请实施例，还提供了一种存储介质，在存储介质上存储了程序指令，在程序指令被计算机或处理器运行时用于执行本申请实施例的用于除颤仪的节律分析和决策方法的相应步骤。存储介质例如可以包括智能电话的存储卡、平板电脑的存储部件、个人计算机的硬盘、只读存储器(ROM)、可擦除可编程只读存储器(EPROM)、便携式紧致盘只读存储器(CD-ROM)、USB存储器、或者上述存储介质的任意组合。计算机可读存储介质可以是一个或多个计算机可读存储介质的任意组合。
此外，根据本申请实施例，还提供了一种计算机程序，该计算机程序可以存储在云端或本地的存储介质上。在该计算机程序被计算机或处理器运行时用于执行本申请实施例的用于除颤仪的节律分析和决策方法的相应步骤。
基于上面的描述，根据本申请实施例的用于除颤仪的节律分析和决策方法和装置结合长时节律状态特征和短时节律状态特征确定节律决策，既能避免受到局部干扰，又能避免对局部节律波动不敏感，从而能够得到更为可靠的节律决策。而且，根据本申请实施例的用于除颤仪的节律分析和决策方法和装置可以根据不同状态的心电信号选择不同的节律分析模式，能够进一步提高节律分析结果即片段节律状态的准确性，从而进一步提高节律决策的可靠性。
尽管这里已经参考附图描述了示例实施例，应理解上述示例实施例仅仅是示例性的，并且不意图将本申请的范围限制于此。本领域普通技术人员可以在其中进行各种改变和修改，而不偏离本申请的范围和精神。所有这些改变和修改意在被包括在所附权利要求所要求的本申请的范围之内。
本领域普通技术人员可以意识到，结合本文中所公开的实施例描述的各示例的单元及算法步骤，能够以电子硬件、或者计算机软件和电子硬件的结合来实现。这些功能究竟以硬件还是软件方式来执行，取决于技术方案的特定应用和设计约束条件。专业技术人员可以对每个特定的应用来使用不同方法来实现所描述的功能，但是这种实现不应认为超出本申请的范 围。
在本申请所提供的几个实施例中，应该理解到，所揭露的装置和方法，可以通过其他的方式实现。例如，以上所描述的装置实施例仅仅是示意性的，例如，单元的划分，仅仅为一种逻辑功能划分，实际实现时可以有另外的划分方式，例如多个单元或组件可以结合或者可以集成到另一个装置，或一些特征可以忽略，或不执行。
在此处所提供的说明书中，说明了大量具体细节。然而，能够理解，本申请的实施例可以在没有这些具体细节的情况下实践。在一些实例中，并未详细示出公知的方法、结构和技术，以便不模糊对本说明书的理解。
类似地，应当理解，为了精简本申请并帮助理解各个发明方面中的一个或多个，在对本申请的示例性实施例的描述中，本申请的各个特征有时被一起分组到单个实施例、图、或者对其的描述中。然而，并不应将该本申请的方法解释成反映如下意图：即所要求保护的本申请要求比在每个权利要求中所明确记载的特征更多的特征。更确切地说，如相应的权利要求书所反映的那样，其发明点在于可以用少于某个公开的单个实施例的所有特征的特征来解决相应的技术问题。因此，遵循具体实施方式的权利要求书由此明确地并入该具体实施方式，其中每个权利要求本身都作为本申请的单独实施例。
本领域的技术人员可以理解，除了特征之间相互排斥之外，可以采用任何组合对本说明书(包括伴随的权利要求、摘要和附图)中公开的所有特征以及如此公开的任何方法或者装置的所有过程或单元进行组合。除非另外明确陈述，本说明书(包括伴随的权利要求、摘要和附图)中公开的每个特征可以由提供相同、等同或相似目的的替代特征来代替。
此外，本领域的技术人员能够理解，尽管在此的一些实施例包括其他实施例中所包括的某些特征而不是其他特征，但是不同实施例的特征的组合意味着处于本申请的范围之内并且形成不同的实施例。例如，在权利要求书中，所要求保护的实施例的任意之一都可以以任意的组合方式来使用。
本申请的各个部件实施例可以以硬件实现，或者以在一个或者多个处理器上运行的软件模块实现，或者以它们的组合实现。本领域的技术人员应当理解，可以在实践中使用微处理器或者数字信号处理器(DSP)来实 现根据本申请实施例的一些模块的一些或者全部功能。本申请还可以实现为用于执行这里所描述的方法的一部分或者全部的装置程序(例如，计算机程序和计算机程序产品)。这样的实现本申请的程序可以存储在计算机可读介质上，或者可以具有一个或者多个信号的形式。这样的信号可以从因特网网站上下载得到，或者在载体信号上提供，或者以任何其他形式提供。
应该注意的是上述实施例对本申请进行说明而不是对本申请进行限制，并且本领域技术人员在不脱离所附权利要求的范围的情况下可设计出替换实施例。在权利要求中，不应将位于括号之间的任何参考符号构造成对权利要求的限制。本申请可以借助于包括有若干不同元件的硬件以及借助于适当编程的计算机来实现。在列举了若干装置的单元权利要求中，这些装置中的若干个可以是通过同一个硬件项来具体体现。单词第一、第二、以及第三等的使用不表示任何顺序。可将这些单词解释为名称。
以上，仅为本申请的具体实施方式或对具体实施方式的说明，本申请的保护范围并不局限于此，任何熟悉本技术领域的技术人员在本申请揭露的技术范围内，可轻易想到变化或替换，都应涵盖在本申请的保护范围之内。本申请的保护范围应以权利要求的保护范围为准。

Claims (26)

  1. 一种用于除颤仪的节律分析和决策方法，其特征在于，所述方法包括：
    获取对目标对象进行心肺复苏过程中所述目标对象的心电信号；
    将所述心电信号在时间序列上划分为多个分析区域，并确定每个分析区域对应的状态，所述状态包括急救处理状态和/或滤波状态；
    对于每个所述分析区域，基于所述分析区域对应的状态确定所述分析区域的片段节律分析模式，并基于所述片段节律分析模式对所述分析区域进行节律分析，以得到所述分析区域的片段节律状态；
    基于距离节律决策时刻第一预设时间段内的多个所述分析区域的片段节律状态进行长时节律分析，得到长时节律状态特征；
    基于距离节律决策时刻第二预设时间段内的至少一个所述分析区域的片段节律状态进行短时节律分析，得到短时节律状态特征，其中，所述第一预设时间段大于所述第二预设时间段；
    基于所述长时节律状态特征和所述短时节律状态特征确定节律决策，并输出所述节律决策。
  2. 根据权利要求1所述的方法，其特征在于，所述急救处理状态包括按压进行状态、按压过渡状态和按压暂停状态，所述滤波状态包括需要滤波状态和无需滤波状态，所述基于所述分析区域对应的状态确定所述分析区域的片段节律分析模式，包括：
    当所述分析区域的急救处理状态为按压暂停状态和/或所述分析区域的滤波状态为无需滤波状态时，确定所述分析区域的片段节律分析模式为无干扰模式；
    当所述分析区域的急救处理状态为按压进行状态或者按压过渡状态，并且所述分析区域的滤波状态为需要滤波状态时，确定所述分析区域的片段节律分析模式为有干扰模式。
  3. 根据权利要求2所述的方法，其特征在于，所述急救处理状态还包括电击状态，所述基于所述分析区域对应的状态确定所述分析区域的片段节律分析模式，还包括：
    当所述分析区域的急救处理状态为电击状态时，确定所述分析区域的 片段节律分析模式为初始化模式。
  4. 根据权利要求2所述的方法，其特征在于，所述心电信号包括原始心电信号和滤波后的心电信号，在所述无干扰模式下，基于所述原始心电信号和/或滤波后心电信号，采用无干扰节律策略进行节律分析；在所述有干扰模式下，仅基于滤波后心电信号，或者基于所述原始心电信号和所述滤波后的心电信号，采用有干扰节律策略进行节律分析。
  5. 根据权利要求2所述的方法，其特征在于，所述确定每个分析区域对应的状态，包括：
    获取对目标对象进行心肺复苏过程中与胸外按压相关的参考信号；
    将所述参考信号在时间序列上划分为多个子分析区域，并确定各子分析区域对应的按压情况；
    对于所述心电信号的每个分析区域，基于与所述分析区域相对应的一个或多个所述子分析区域的按压情况，确定每个所述分析区域的急救处理状态。
  6. 根据权利要求5所述的方法，其特征在于，所述基于与所述分析区域相对应的一个或多个所述子分析区域的按压情况，确定每个所述分析区域的急救处理状态，包括：
    当与所述分析区域对应的每个所述子分析区域的按压情况均为存在按压事件时，确定所述分析区域的急救处理状态为按压进行状态；
    当与所述分析区域对应的多个所述子分析区域中，部分子分析区域的按压情况为存在按压事件，且其余子分析区域的按压情况为不存在按压事件时，确定所述分析区域的急救处理状态为按压过渡状态；
    当与所述分析区域对应的每个所述子分析区域的按压情况均为不存在按压事件时，确定所述分析区域的急救处理状态为按压暂停状态。
  7. 根据权利要求5所述的方法，其特征在于，所述确定各子分析区域对应的按压情况，包括：
    对所述参考信号进行时域分析和/或频域分析，以得到时域按压特征和/或频域按压特征；
    基于所述时域按压特征和/或所述频域按压特征对所述参考信号的各子分析区域进行按压检测，以确定所述各子分析区域是否存在按压事件。
  8. 根据权利要求2所述的方法，其特征在于，所述确定每个分析区域对应的状态，包括：
    获取对所述目标对象进行心肺复苏过程中的参考信号；
    将所述参考信号在时间序列上划分为多个子分析区域；
    对于所述心电信号的每个分析区域，对与所述分析区域相对应的一个或多个所述子分析区域的参考信号与所述分析区域的噪声进行相关性分析，根据所述相关性分析的结果确定所述分析区域的滤波方式，并根据所述分析区域的滤波方式确定所述分析区域的滤波状态。
  9. 根据权利要求2所述的方法，其特征在于，所述长时节律状态特征和所述短时节律状态特征均包括以下中的至少一项：
    多个所述分析区域各自的片段节律状态的集合中，每种片段节律状态所占的比例；
    多个所述分析区域各自的片段节律状态按照时间排序时，连续多次相同片段节律状态所占的比例；
    多个所述分析区域各自的对应的状态集合中，不同状态的时间占比和/或不同状态下每种片段节律状态所占的比例；
    多个所述分析区域各自的片段节律状态的集合中，每种片段节律状态的加权分值，其中每个所述分析区域的片段节律状态的权重的大小取决于所述分析区域距离节律决策时刻的时间远近和/或所述分析区域对应的状态。
  10. 根据权利要求9所述的方法，其特征在于，所述短时节律状态特征还包括：状态为按压暂停状态或无需滤波状态的分析区域中，距离节律决策时刻最近的分析区域与节律决策时刻的时间距离以及其片段节律状态所占的百分比。
  11. 根据权利要求9所述的方法，其特征在于，对于一个分析区域：
    所述分析区域距离节律决策时刻越近，对所述分析区域的片段节律状态分配的权重越大；以及
    当所述分析区域的急救处理状态为按压暂停状态或者滤波状态为无需滤波状态时，对所述分析区域的片段节律状态分配第一权重；
    当所述分析区域的急救处理状态为按压进行状态并且滤波状态为需 要滤波状态时，对所述分析区域的片段节律状态分配第二权重，其中所述第二权重小于所述第一权重；
    当所述分析区域的急救处理状态为按压过渡状态并且滤波状态为需要滤波状态时，对所述分析区域的片段节律状态分配第三权重，其中所述第三权重小于所述第二权重。
  12. 根据权利要求1所述的方法，其特征在于，所述基于所述长时节律状态特征和所述短时节律状态特征确定节律决策，包括：
    当所述长时节律状态特征和所述短时节律状态特征各自体现的片段节律状态的分布情况一致时，根据所述长时节律状态特征或所述短时节律状态特征体现的片段节律状态的分布情况确定节律决策；
    当所述长时节律状态特征和所述短时节律状态特征各自体现的片段节律状态的分布情况不一致时，根据两种分布情况中可靠性更高的一者确定节律决策，或者，根据所述短时节律状态特征体现的片段节律状态的分布情况确定节律决策，或者，输出不确定节律决策。
  13. 根据权利要求12所述的方法，其特征在于，所述长时节律状态特征和所述短时节律状态特征各自体现的片段节律状态的分布情况的可靠性与长时节律分析和短时节律分析中各自采用的分析区域的状态相关。
  14. 根据权利要求1所述的方法，其特征在于，所述基于所述长时节律状态特征和所述短时节律状态特征确定节律决策，包括：
    对于每种片段节律状态，根据所述长时节律状态特征与所述片段节律状态相对应的特征，和，所述短时节律状态特征与所述片段节律状态相对应的特征的加权组合，得到所述片段节律状态的加权分值；
    根据每种片段节律状态的加权分值确定节律决策。
  15. 根据权利要求1所述的方法，其特征在于，所述方法能够应用于固定心肺复苏操作模式和连续心肺复苏操作模式，当应用于连续心肺复苏操作模式时，如果节律决策时刻之前的分析区域不够用于长时节律分析时，不执行长时节律分析，根据预设长时默认初始节律状态和所述短时节律状态特征确定节律决策。
  16. 根据权利要求1所述的方法，其特征在于，所述分析区域具有以下属性中的至少一个：
    每个所述分析区域具有相同的时间长度或者能够按需改变时间长度；
    任意两个所述分析区域在时间上是连续的或者间断的；
    任意两个所述分析区域在时间上部分重叠或者不重叠。
  17. 一种用于除颤仪的节律分析和决策方法，其特征在于，所述方法包括：
    获取对目标对象进行心肺复苏过程中的参考信号和所述目标对象的原始心电信号；
    对所述参考信号进行按压检测，以得到所述参考信号的时域按压事件标记；
    基于所述时域按压事件标记确定瞬时按压间期，并基于所述瞬时按压间期对所述原始心电信号进行滤波，以得到滤波后的心电信号；
    将所述目标对象的心电信号在时间序列上划分为多个分析区域，并对每个分析区域进行节律分析，以得到每个分析区域的片段节律状态，其中，所述目标对象的心电信号仅包括所述滤波后的心电信号，或者，所述目标对象的心电信号包括所述原始心电信号和所述滤波后的心电信号；
    基于距离节律决策时刻第一预设时间段内的多个所述分析区域的片段节律状态进行长时节律分析，得到长时节律状态特征；
    基于距离节律决策时刻第二预设时间段内的至少一个所述分析区域的片段节律状态进行短时节律分析，得到短时节律状态特征，其中，所述第一预设时间段大于所述第二预设时间段；
    基于所述长时节律状态特征和所述短时节律状态特征确定节律决策，并输出所述节律决策。
  18. 根据权利要求17所述的方法，其特征在于，对所述参考信号进行按压检测，以得到所述参考信号的时域按压事件标记，包括：
    对所述参考信号进行时域分析和/或频域分析，以得到时域按压特征和/或频域按压特征；
    基于所述时域按压特征和/或所述频域按压特征对所述参考信号进行按压检测，以得到所述参考信号的时域按压事件标记。
  19. 根据权利要求17所述的方法，其特征在于，所述长时节律状态特征和所述短时节律状态特征均包括以下中的至少一项：
    多个所述分析区域各自的片段节律状态的集合中，每种片段节律状态所占的比例；
    多个所述分析区域各自的片段节律状态按照时间排序时，连续多次相同片段节律状态所占的比例；
    多个所述分析区域各自的对应的状态集合中，不同状态的时间占比和/或不同状态下每种片段节律状态所占的比例；
    多个所述分析区域各自的片段节律状态的集合中，每种片段节律状态的加权分值，其中每个所述分析区域的片段节律状态的权重的大小取决于所述分析区域距离节律决策时刻的时间远近和/或所述分析区域对应的状态。
  20. 根据权利要求17所述的方法，其特征在于，所述基于所述长时节律状态特征和所述短时节律状态特征确定节律决策，包括：
    当所述长时节律状态特征和所述短时节律状态特征各自体现的片段节律状态的分布情况一致时，根据所述长时节律状态特征或所述短时节律状态特征体现的片段节律状态的分布情况确定节律决策；
    当所述长时节律状态特征和所述短时节律状态特征各自体现的片段节律状态的分布情况不一致时，根据两种分布情况中可靠性更高的一者确定节律决策，或者，根据所述短时节律状态特征体现的片段节律状态的分布情况确定节律决策，或者，输出不确定节律决策。
  21. 根据权利要求17所述的方法，其特征在于，所述基于所述长时节律状态特征和所述短时节律状态特征确定节律决策，包括：
    对于每种片段节律状态，根据所述长时节律状态特征与所述片段节律状态相对应的特征，和，所述短时节律状态特征与所述片段节律状态相对应的特征的加权组合，得到所述片段节律状态的加权分值；
    根据每种片段节律状态的加权分值确定节律决策。
  22. 根据权利要求17所述的方法，其特征在于，所述方法能够应用于固定心肺复苏操作模式和连续心肺复苏操作模式，当应用于连续心肺复苏操作模式时，如果节律决策时刻之前的分析区域不够用于长时节律分析时，不执行长时节律分析，根据预设长时默认初始节律状态和所述短时节律状态特征确定节律决策。
  23. 一种节律分析和决策装置，其特征在于，所述装置包括存储器和处理器，所述存储器上存储有由所述处理器运行的计算机程序，所述计算机程序在被所述处理器运行时执行权利要求1-22中的任一项所述的用于除颤仪的节律分析和决策方法。
  24. 根据权利要求23所述的装置，其特征在于，所述装置还包括信号采集部件，所述信号采集部件用于采集对目标对象进行心肺复苏过程中与胸外按压相关的参考信号。
  25. 根据权利要求24所述的装置，其特征在于，所述装置为除颤仪。
  26. 一种存储介质，其特征在于，所述存储介质上存储有计算机程序，所述计算机程序在运行时执行如权利要求1-22中的任一项所述的用于除颤仪的节律分析和决策方法。
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