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CN107320088B - Non-invasive continuous pulse blood pressure measuring method - Google Patents

Non-invasive continuous pulse blood pressure measuring method Download PDF

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CN107320088B
CN107320088B CN201710487953.9A CN201710487953A CN107320088B CN 107320088 B CN107320088 B CN 107320088B CN 201710487953 A CN201710487953 A CN 201710487953A CN 107320088 B CN107320088 B CN 107320088B
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meanvalue
arterial pressure
blood pressure
pressure
pressure signal
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CN107320088A (en
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叶娅兰
侯孟书
廖建明
陈天祥
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Chengdu Xinkang Xingtai Technology Co ltd
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Measuring for diagnostic purposes; Identification of persons
    • A61B5/02Detecting, measuring or recording for evaluating the cardiovascular system, e.g. pulse, heart rate, blood pressure or blood flow
    • A61B5/021Measuring pressure in heart or blood vessels
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Measuring for diagnostic purposes; Identification of persons
    • A61B5/02Detecting, measuring or recording for evaluating the cardiovascular system, e.g. pulse, heart rate, blood pressure or blood flow
    • A61B5/021Measuring pressure in heart or blood vessels
    • A61B5/02141Details of apparatus construction, e.g. pump units or housings therefor, cuff pressurising systems, arrangements of fluid conduits or circuits
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Measuring for diagnostic purposes; Identification of persons
    • A61B5/72Signal processing specially adapted for physiological signals or for diagnostic purposes
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B2560/00Constructional details of operational features of apparatus; Accessories for medical measuring apparatus
    • A61B2560/02Operational features
    • A61B2560/0223Operational features of calibration, e.g. protocols for calibrating sensors
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B2562/00Details of sensors; Constructional details of sensor housings or probes; Accessories for sensors
    • A61B2562/02Details of sensors specially adapted for in-vivo measurements
    • A61B2562/0247Pressure sensors

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  • Life Sciences & Earth Sciences (AREA)
  • Cardiology (AREA)
  • Engineering & Computer Science (AREA)
  • Heart & Thoracic Surgery (AREA)
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  • Signal Processing (AREA)
  • Measuring Pulse, Heart Rate, Blood Pressure Or Blood Flow (AREA)

Abstract

The invention relates to a noninvasive continuous blood pressure measuring method, which comprises the following steps: (1) obtaining an arterial pressure signal sequence x [ n ], removing a direct current component MeanValue to obtain x1[ n ] = x [ n ] -MeanValue; (2) scaling the residual alternating current component after the direct current component is removed to obtain x2[ n ] = x1[ n ]. multidot.Kr; (3) adding the scaled AC component and the compensation DC component MeanValue ' to restore the waveform to the arterial pressure signal, i.e. x ' [ n ] = x2[ n ] + MeanValue '; (4) the maximum value max ' and the minimum value min ' of the pulse pressure sequence x ' [ n ] are obtained, and the systolic pressure SP = g (max ') and the diastolic pressure DP = g (min ') are obtained respectively, wherein g (x) is a functional relation between the signal and the arterial pressure. The invention compensates the pressure loss generated in the process that the blood pressure signal is transmitted to the pressure sensor through tissues such as tendon, skin and the like by processing such as straightening, zooming, restoring and the like on the blood pressure signal output by the pressure sensor, thereby ensuring the accuracy of blood pressure measurement.

Description

Non-invasive continuous pulse blood pressure measuring method
Technical Field
The application relates to the field of physiological parameter measurement, in particular to a noninvasive continuous blood pressure measurement technology.
Background
Blood pressure is a basic vital sign parameter of a human body and is also a very important monitoring factor in clinic, and continuous blood pressure monitoring is often required for patients in various medical treatment centers such as operating rooms, intensive care units, emergency rooms and the like. The arterial blood pressure of each cardiac cycle of the patient is continuously measured, and the trend of the blood pressure change and the condition of instantaneous change are reflected, so that medical staff can deeply and comprehensively know the disease condition, can make corresponding treatment at the first time, and is the basic condition for ensuring medical safety.
The importance of continuous blood pressure monitoring is: (1) for severe shock and critical patients, arterial infusion or blood transfusion is needed, so that time can be won, blood pressure can be increased, and blood supply of important organs such as heart, brain, kidney and the like can be improved; (2) plays an active role in controlling the blood pressure of patients with complex illness, critical and major operations; (3) the controlled blood pressure reduction is carried out on patients with more blood loss in the operation process, and accurate data information is provided, so that the blood pressure is effectively controlled, and the blood loss of the wound surface in the operation is obviously reduced.
Blood pressure measurement methods are classified into invasive measurement methods and non-invasive measurement methods. The invasive measurement method is an arterial puncture catheter method, and the invasive measurement method is realized by inserting a catheter into an arterial vessel and detecting the blood pressure of a human body through a pressure sensor. The non-invasive measurement method is to indirectly measure the blood pressure of the human body, and is divided into two categories, namely intermittent measurement and continuous measurement according to whether the measurement result is continuous or not. Wherein, the discontinuous measurement comprises a Korotkoff sound auscultation method and an oscillography; the continuous measurement includes a constant volume method, a flat tension measurement method, a pulse wave velocity measurement method, a pulse wave characteristic parameter measurement method and the like.
Applanation tonometry, which performs blood pressure measurement according to the theory of arterial tension by placing a pressure sensor on the skin directly above an arterial blood vessel, obtains a blood pressure value directly by converting the measured pressure value. Although the method can realize continuous monitoring of the blood pressure of the human body for a long time, the loss value needs to be reduced in an effort to ensure the measurement accuracy because the pressure loss exists in the process that the blood pressure signal is transmitted to the pressure sensor through tissues such as tendons, skin and the like.
Disclosure of Invention
In order to overcome the problem that the measurement accuracy is reduced due to the pressure loss in the process that a blood pressure signal is transmitted to a pressure sensor through tissues such as tendons, skin and the like in the conventional continuous non-invasive blood pressure measurement technology, in particular to a flat tension measurement technology, the application provides a blood pressure measurement method, which comprises the following steps:
step 1: acquiring an arterial pressure signal sequence x [ n ], removing a direct-current component MeanValue, and obtaining an alternating-current component x1[ n ] ═ x [ n ] -MeanValue;
step 2: scaling the alternating current component obtained after the direct current component is removed to obtain a scaled alternating current component x2[ n ] ═ x1[ n ]. Kr, wherein Kr is a scaling coefficient;
and step 3: adding the scaled alternating current component and the compensation direct current component to restore the waveform into an arterial pressure signal, namely the restored arterial pressure signal x ' [ n ] ═ x2[ n ] + MeanValue ', wherein MeanValue ' is the compensation direct current component;
and 4, step 4: the maximum value max ' and the minimum value min ' of the arterial pressure signal sequence x ' [ n ] are obtained, and the systolic pressure SP is g (max ') and the diastolic pressure DP is g (min '), respectively, wherein g (x) is a functional relation between the blood pressure signal and the arterial pressure signal.
Preferably, the method further comprises a blood pressure measurement calibration step, the calibration step comprising the sub-steps of:
step A: judging whether the waveform of the arterial pressure is stable or not, and if not, adjusting an arterial pressure signal sampling device;
and B: acquiring a current blood pressure value as a reference value;
and C: acquiring systolic pressure SP 'and diastolic pressure DP' of a reference blood pressure value;
step D: the sequence of arterial pressure signals x [ n ] is acquired for one cycle and the maximum value max and the minimum value min are taken, the values for max and min being Pmax ═ g (max) and Pmin ═ g (min), respectively, then the scaling factor Kr ═ SP '-DP')/(Pmax-Pmin).
Preferably, the method for acquiring the dc component includes: the direct current component MeanValue is obtained by averaging the signal sequence.
Preferably, in the step 3, the method for compensating the dc component includes: g (MeanValue ') ═ DP' + (SP '-DP'). K, where K is within the interval 0 to 1.
Preferably, the reference blood pressure value is derived from a manual calibration input.
Preferably, the reference blood pressure value is derived from an automatic calibration input, i.e. measured by a data processing centre controlling an electronic sphygmomanometer.
The invention carries out treatment such as straightening, scaling, reduction and the like on the blood pressure signal output by the pressure sensor, compensates pressure loss generated in the process that the blood pressure signal is transmitted to the pressure sensor through tissues such as tendons, skin and the like, and ensures the accuracy of blood pressure measurement.
Drawings
FIG. 1 is a schematic diagram of signal components;
FIG. 2 is a flow chart of blood pressure calculation;
FIG. 3 is a schematic diagram of blood pressure calibration parameters;
FIG. 4 is a blood pressure calibration flow chart;
FIG. 5 is a schematic diagram of the DC component removal operation;
fig. 6 is a signal scaling diagram.
Detailed Description
The technical solutions in the embodiments of the present invention will be clearly and completely described below with reference to the drawings in the embodiments of the present invention, and it is obvious that the described embodiments are only a part of the embodiments of the present invention, and not all of the embodiments. All other embodiments, which can be derived by a person skilled in the art from the embodiments given herein without making any creative effort, shall fall within the protection scope of the present invention.
The present application is described below with reference to figures 1-6 of the specification.
The signal measured by the pressure sensor consists of two parts, wherein one part is a signal component Fb generated by the tension of the blood vessel wall to the acting force of the sensor; another part is the signal component Fc which is generated when the system presses the sensor down on the skin, which will have a reaction force on the sensor, which is a constant force over a certain time.
As can be seen from fig. 1, the component of the available input signal is divided into two parts Fb and Fc as shown in fig. 1, where Fc is a dc component and Fb is a mixture of an ac component and a dc component.
As can be seen from the flow chart of the blood pressure calculation algorithm shown in fig. 2, the blood pressure calculation method provided by the present application includes:
step 1: acquiring an arterial pressure signal sequence x [ n ], removing a direct-current component MeanValue, and obtaining an alternating-current component x1[ n ] ═ x [ n ] -MeanValue;
step 2: scaling the alternating current component left after the direct current component is removed to obtain a scaled alternating current component x2[ n ] ═ x1[ n ] × Kr, wherein Kr is a scaling coefficient;
and step 3: adding the scaled alternating current component and the compensation direct current component to restore the waveform into an arterial pressure signal, namely the restored arterial pressure signal x ' [ n ] ═ x2[ n ] + MeanValue ', wherein MeanValue ' is the compensation direct current component;
and 4, step 4: the maximum voltage value max ' and the minimum voltage value min ' of the arterial pressure sequence x ' [ n ] are obtained, and the systolic pressure SP ═ g (max ') and the diastolic pressure DP ═ g (min ') are obtained respectively, wherein g (x) refers to the functional relation between the blood pressure signal and the arterial pressure signal.
For this method, calibration of the blood pressure measurement may be involved, and calibration is required before the blood pressure calculation in one measurement (with the sensor in place and without offset), and the main contents of calibration include the acquisition of the blood pressure reference value and the determination of the calibration parameters. The blood pressure reference value is obtained, before the blood pressure measurement is started, the numerical calibration is carried out, and the current blood pressure value needs to be obtained as the blood pressure reference value. The blood pressure reference value is obtained in two cases, one is manually input, and the other is automatically calibrated input. The manual input is the input of calibration values through interface operation, the automatic calibration is the measurement by controlling the electronic sphygmomanometer through the data processing center, and an operator only needs to select one of the calibration values and the automatic calibration. After obtaining the systolic pressure (SP ') and the diastolic pressure (DP') of the reference blood pressure value, a scaling ratio Kr is calculated from the reference value and the input signal. And acquiring a signal sequence of a period, taking the maximum value and the minimum value, wherein the signal sequence is x [ n ], summing the x [ n ], and averaging to obtain a direct current component MeanValue, and the maximum value and the minimum value are max and min respectively. As shown in fig. 3, max and min correspond to the calculated Systolic (SP) and Diastolic (DP) pressures, respectively, and the values Pmax ═ g (max) and Pmin ═ g (min). By referring to the theoretical pulse pressure difference of merit SP '-DP', the pulse pressure difference at which the unprocessed arterial pressure signal was obtained in practice is Pmax-Pmin. During the measurement, the conduction of force will lose energy, and the pulse pressure difference and the blood pressure value will decrease, assuming that the energy loss is linearly proportional to the pulse pressure difference, and the ratio Kr ═ SP '-DP')/(Pmax-Pmin) is the scaling of the signal.
Because the amplitude of the input signal is not completely consistent in each period time, in order to reduce errors, a signal sequence of 3-5 periods is obtained in the calibration process, the signal sequence is x [ n ], the maximum value and the minimum value in each signal period are obtained to obtain a maximum value sequence max [ i ] and a minimum value sequence min [ i ], the maximum value sequence and the minimum value sequence are averaged to obtain max and min values, Kr is obtained, and the signal sequence is averaged to obtain MeanValue. The calibration flow chart is shown in fig. 4.
For blood pressure signal scaling, in one measurement, after calibration, the signal sequence is obtained as x [ n ], the signal period is calculated, the signal is scaled, the waveform after scaling can be used for blood pressure calculation, and the signal scaling comprises three steps of direct current component removal, scaling and restoration.
First, the dc component is removed, and in the present algorithm design, the device does not move during one measurement, so the dc component does not change, i.e. the operation of removing the dc component is x1[ n ] ═ x [ n ] -MeanValue, which is the MeanValue calculated in the calibration process, and the effect is shown in fig. 5.
After the dc component is removed, only the ac portion of the waveform is left at this time by scaling the ac portion of the signal. The scaling of the alternating current is to supplement the energy loss during the transmission process, specifically, x2[ n ] ═ x1[ n ] × Kr, which shows the schematic effect as fig. 6, where the solid line curve is the signal before scaling and the dotted line is the signal after scaling.
After the alternating current part is scaled, a direct current component is added to restore the waveform to an arterial pressure signal, wherein the direct current component comprises two parts, and the direct current part generated by the arterial blood vessel and the direct current part of the reaction force generated in the process of pressing down the device sensor have different propagation processes, so the loss ratio of the direct current components of the two parts is different. Since the dc component cannot be divided into two parts by calculation and the loss of the dc component due to the reaction force cannot be determined, it is not possible to effectively compensate for the scaling of the dc component.
In the present invention, the converted dc portion after compensation is converted into a pressure value that must be within the interval of the blood pressure calibration values systolic pressure SP ' and diastolic pressure DP ', and the position thereof can be represented as DP ' + (SP ' -DP '). multidot.k, where K is within the interval of 0 to 1. Assuming that the compensated dc component is MeanValue ', corresponding to a certain value of the pressure value between DP ' and SP ', equation (1) can be obtained, where g (x) is the functional relationship between the blood pressure signal and the arterial pressure signal.
g(MeanValue')=DP'+(SP'-DP')*K (0<K<1) (1)
After the MeanValue ' is obtained, the waveform may be restored, and x ' [ n ] ═ x2[ n ] + MeanValue '.
For blood pressure calculation, the signal is scaled and the blood pressure can be evaluated. Within a signal cycle sequence, the maximum value max 'and the minimum value min' in the sequence are determined, and SP ═ g (max ') and DP ═ g (min').
It should be noted that, for simplicity of description, the above-mentioned embodiments of the method are described as a series of acts or combinations, but those skilled in the art should understand that the present application is not limited by the order of acts described, as some steps may be performed in other orders or simultaneously according to the present application. Further, those skilled in the art should also appreciate that the embodiments described in the specification are preferred embodiments and that the acts and elements referred to are not necessarily required in this application.
In the above embodiments, the descriptions of the respective embodiments have respective emphasis, and for parts that are not described in detail in a certain embodiment, reference may be made to related descriptions of other embodiments.
It will be understood by those skilled in the art that all or part of the processes of the methods of the embodiments described above can be implemented by a computer program, which can be stored in a computer-readable storage medium, and when executed, can include the processes of the embodiments of the methods described above. The storage medium may be a magnetic disk, an optical disk, a ROM, a RAM, etc.
The above disclosure is only for the purpose of illustrating the preferred embodiments of the present invention, and it is therefore to be understood that the invention is not limited by the scope of the appended claims.

Claims (4)

1. An arterial pressure signal measuring method is characterized in that: the arterial pressure signal measuring method comprises the following steps:
step 1: obtaining an arterial pressure signal sequence x [ n ], removing a direct current component MeanValue to obtain x1[ n ] = x [ n ] -MeanValue;
step 2: scaling the residual alternating current component after the direct current component is removed to obtain x2[ n ] = x1[ n ]. multidot.Kr, wherein Kr is a scaling coefficient;
and step 3: the scaled ac component is added with the compensated dc component to reduce the waveform into the arterial pressure signal, i.e. x ' [ n ] = x2[ n ] + MeanValue ', where MeanValue ' is the compensated dc component, and the method for compensating the dc component is as follows: g (MeanValue ') = DP' + (SP '-DP'). K, where K is within the interval 0 to 1, the g (MeanValue ') being a function of the compensated direct current component MeanValue' and the arterial pressure signal;
and 4, step 4: obtaining the maximum value max ' and the minimum value min ' of the arterial pressure signal sequence x ' [ n ];
further comprising an arterial pressure signal measurement calibration step, said calibration step comprising the sub-steps of:
step A: judging whether the waveform of the arterial pressure is stable or not, and if not, adjusting an arterial pressure signal sampling device;
and B: acquiring a current blood pressure value as a reference value;
and C: acquiring systolic pressure SP 'and diastolic pressure DP' of a reference blood pressure value;
step D: obtaining a sequence x [ n ] of arterial pressure signals of one cycle and taking a maximum value max and a minimum value min, the values corresponding to max = g (max) and Pmin = g (min), respectively, where Pmax and Pmin are the maximum value and the minimum value of the obtained unprocessed arterial pressure signals, respectively, and g (x) is a functional relationship between the blood pressure signals and the arterial pressure signals, then a scaling factor Kr = (SP '-DP')/(Pmax-Pmin).
2. A method of measuring an arterial pressure signal according to claim 1, characterized by: the method for acquiring the direct current component comprises the following steps: the direct current component MeanValue is obtained by averaging the signal sequence.
3. A method of measuring an arterial pressure signal according to claim 1, characterized by: the reference blood pressure value is derived from a manual calibration input.
4. A method of measuring an arterial pressure signal according to claim 1, characterized by: the reference blood pressure values are derived from automatic calibration inputs, i.e. measurements made by the electronic sphygmomanometer controlled by the data processing center.
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