技术领域technical field
本发明属于一种呼吸机压力控制通气漏气量的估算方法，具体涉及一种基于流量波形及其峰值，以及基于流量波形的积分容量波形及其峰值，进行压力控制通气漏气量估算的方法。The invention belongs to a method for estimating the leakage volume of pressure-controlled ventilation of a ventilator, and in particular relates to a method for estimating the leakage volume of pressure-controlled ventilation based on the flow waveform and its peak value, and the integrated volume waveform and its peak value based on the flow waveform. .
背景技术Background technique
无创通气不需要建立有创人工气道，具有通气死亡率低、患者耐受性好等优点，已广泛应用于临床治疗呼吸机能不足的患者以及应用于家庭治疗睡眠呼吸暂停综合征。然而，研究发现患者在接受无创通气过程中会产生一些不良反应，如漏气、皮肤刺激、鼻炎、腹胀、头带不适等，其中漏气因其普遍存在性、不可控性和较大危害性，是应用无创通气需要解决的主要问题，需要对漏气进行检测并且估算漏气量，进而对漏气量进行精确补偿。本发明针对无创通气常用的压力控制通气模式，提出一种基于流量波形估算漏气量的方法，具体方法是在压力控制模式无创通气过程中，在呼吸机供气端采集供气流量信号，得到通气流量波形及流量峰值，通过积分得到容量波形及容量峰值，利用采集到的流量波形曲线和积分得到的容量波形曲线分别与流量、容量波形标准曲线进行比对从而确定漏气等级，基于流量峰值-漏气关系和容量峰值-漏气关系利用提取的流量、容量峰值估算一个呼吸周期内的漏气量。Non-invasive ventilation does not require the establishment of an invasive artificial airway. It has the advantages of low ventilation mortality and good patient tolerance. It has been widely used in clinical treatment of patients with insufficient respiratory function and in home treatment of sleep apnea syndrome. However, studies have found that patients will have some adverse reactions during non-invasive ventilation, such as air leakage, skin irritation, rhinitis, abdominal distension, headband discomfort, etc. Among them, air leakage is due to its ubiquity, uncontrollability, and greater harm. , is the main problem that needs to be solved in the application of non-invasive ventilation. It is necessary to detect the air leakage and estimate the air leakage, and then accurately compensate the air leakage. Aiming at the commonly used pressure control ventilation mode of non-invasive ventilation, the present invention proposes a method for estimating air leakage based on the flow waveform. The specific method is to collect the air supply flow signal at the air supply end of the ventilator during the non-invasive ventilation process of the pressure control mode, and obtain Ventilation flow waveform and flow peak value, the capacity waveform and capacity peak value are obtained through integration, and the collected flow waveform curve and the integrated capacity waveform curve are compared with the flow and capacity waveform standard curves to determine the leak level, based on the flow peak value - Leak relationship and volume peak - Leak relationship uses the extracted flow, volume peak to estimate the leak volume in a breathing cycle.
发明内容Contents of the invention
本发明提出一种呼吸机压力控制通气漏气量的估算方法，具体涉及一种基于流量波形及其峰值，以及基于流量波形的积分容量波形及其峰值，进行压力控制通气漏气量估算的方法。The present invention proposes a method for estimating the air leakage volume of ventilator pressure-controlled ventilation, and specifically relates to a method for estimating the air leakage volume of pressure-controlled ventilation based on the flow waveform and its peak value, and the integrated volume waveform and its peak value based on the flow waveform. .
其步骤包括，呼吸机以压力控制模式对患者进行无创通气的同时，在呼吸机供气端采集气路流量信号，得到流量波形及流量峰值，通过计算流量信号的积分得到容量波形及容量峰值，通过与流量、容量波形标准曲线进行比对从而确定漏气等级，基于流量峰值-漏气关系利用提取的流量峰值估算该呼吸周期内的漏气量，基于容量峰值-漏气关系利用提取的容量峰值估算该呼吸周期内的漏气量。The steps include: while the ventilator performs non-invasive ventilation on the patient in the pressure control mode, at the same time, the gas flow signal is collected at the gas supply end of the ventilator to obtain the flow waveform and the flow peak value, and the volume waveform and the capacity peak value are obtained by calculating the integral of the flow signal, The air leakage level is determined by comparing with the standard curve of the flow and volume waveforms, and the extracted flow peak is used to estimate the air leakage in the breathing cycle based on the flow peak-leak relationship, and the extracted volume is used based on the volume peak-leak relationship Peak estimates the leak volume for that breath cycle.
进一步，如上所述的气路流量信号的采集是在呼吸机与患者相连的管路上位于呼吸机吸气端附近设置流量传感器采集气路中的流量信号；Further, the acquisition of the gas path flow signal as described above is to install a flow sensor near the inhalation end of the ventilator on the pipeline connecting the ventilator to the patient to collect the flow signal in the gas path;
进一步，如上所述的流量波形及流量峰值为所采集流量信号的特征，流量波形曲线可通过2个特征点来进行描述，其中包括流量峰值与吸气段的平台值；Further, the above-mentioned flow waveform and flow peak value are the characteristics of the collected flow signal, and the flow waveform curve can be described by two characteristic points, including the flow peak value and the plateau value of the inspiratory segment;
进一步，如上所述的容量波形是通过计算所采集流量信号的积分得到，容量波形曲线可通过2个特征点来进行描述，其中包括容量峰值与吸气段上升曲线切线的斜率；Further, the above-mentioned capacity waveform is obtained by calculating the integral of the collected flow signal, and the capacity waveform curve can be described by two characteristic points, including the slope of the peak capacity and the tangent line of the rising curve of the inspiratory segment;
进一步，上述流量、容量波形标准曲线包括压力控制通气条件下无漏气、少量漏气(漏气10％以下)、中量漏气(漏气10-35％)、大量漏气(漏气大于35％)4种漏气程度所对应的流量、容量波形特点；Further, the standard curves of the above-mentioned flow and volume waveforms include no air leakage, a small amount of air leakage (less than 10% air leakage), medium air leakage (10-35% air leakage), and large amount of air leakage (air leakage greater than 10%) under pressure-controlled ventilation conditions. 35%) the characteristics of the flow and volume waveforms corresponding to the 4 leak levels;
进一步，漏气量的估算是通过将气路流量峰值带入流量峰值-漏气量关系函数进行线性运算得到，或通过将气路容量峰值带入容量峰值-漏气量关系函数进行线性运算得到；Furthermore, the estimation of air leakage is obtained by linear operation by bringing the peak value of the air path flow into the relational function of flow peak-air leakage amount, or by carrying out linear operation by bringing the peak value of the air path capacity into the relational function of capacity peak-air leakage amount ;
进一步，上述流量峰值-漏气量关系函数描述了压力控制通气下气路流量峰值与该呼吸周期漏气量的线性关系，其形式为：Vleak＝K﹒Fmax+B，其中Vleak为一个呼吸周期内近似的漏气量，Fmax为气路流量峰值，K与B为参数是基于漏气检测实验平台，在大量样本实验的基础上得到；Further, the above peak flow-leakage relationship function describes the linear relationship between the peak flow rate of the gas path and the air leakage in the breathing cycle under pressure-controlled ventilation, and its form is: Vleak =K. Fmax +B, where Vleak is the approximate air leakage in a breathing cycle, Fmax is the peak flow rate of the gas path, and K and B are parameters based on the leak detection experimental platform and obtained on the basis of a large number of sample experiments;
进一步，上述容量峰值-漏气量关系函数描述了压力控制通气下气路容量峰值与该呼吸周期漏气量的线性关系，其形式为：Vleak＝K﹒VTmax+B，其中Vleak为一个 呼吸周期内近似的漏气量，VTmax为气路容量峰值，K与B为参数是基于漏气检测实验平台，在大量样本实验的基础上得到；Further, the above peak volume-leakage relationship function describes the linear relationship between the peak volume of the air circuit under pressure-controlled ventilation and the air leakage volume of the respiratory cycle, and its form is: Vleak =K. VTmax +B, where Vleak is the approximate air leakage in a breathing cycle, VTmax is the peak volume of the gas path, and K and B are parameters based on the leak detection experimental platform and obtained on the basis of a large number of sample experiments;
进一步，如上所述的漏气量估算是通过将气路流量峰值带入到流量峰值-漏气量关系函数进行线性运算，或者通过将气路容量峰值带入到容量峰值-漏气量关系函数进行线性运算，得到该呼吸周期内近似漏气量。Further, the above-mentioned air leakage estimation is performed by bringing the peak gas flow rate into the peak flow-leakage relationship function for linear operation, or by bringing the peak capacity of the gas path into the capacity peak-leakage relationship function Perform linear calculation to obtain the approximate air leakage in the breathing cycle.
附图说明Description of drawings
图1方法实施流程图Figure 1 method implementation flow chart
图2一个呼吸周期内气路流量(a)、容量(b)波形特征点标记Figure 2 The characteristic point marks of the air flow (a) and volume (b) waveforms in a breathing cycle
图3流量(a,b,c,d)、容量(e,f,g,h)波形标准曲线Figure 3 Flow (a, b, c, d), capacity (e, f, g, h) waveform standard curve
图4流量峰值-漏气量关系函数曲线(a)、容量峰值-漏气量关系函数曲线(b)Figure 4 Flow peak-air leakage relationship function curve (a), capacity peak-air leakage relationship function curve (b)
具体实施方式detailed description
下面结合附图与具体实施例对本发明做进一步的详细说明。The present invention will be further described in detail below in conjunction with the accompanying drawings and specific embodiments.
如图1所示为一种基于流量波形估算压力控制通气漏气量的方法的主要步骤，具体包括：Figure 1 shows the main steps of a method for estimating the leak volume of pressure-controlled ventilation based on the flow waveform, which specifically includes:
(1)针对呼吸机压力控制无创通气,在呼吸机供气端放置气体流量传感器，随通气过程实时采集气路流量信号；(1) To control non-invasive ventilation according to the pressure of the ventilator, a gas flow sensor is placed at the gas supply end of the ventilator, and the gas flow signal is collected in real time during the ventilation process;
(2)根据所采集到的气路流量信号，形成逐个呼吸周期的流量波形曲线，如图2中(a)所示，并对气路流量信号提取波形曲线特征点，如图2中(a)所标注的A点、B点，其中A点为气路流量的峰值点，B点为吸气段的平台期；(2) According to the collected gas path flow signal, the flow waveform curve of each respiratory cycle is formed, as shown in (a) in Figure 2, and the characteristic points of the waveform curve are extracted from the gas path flow signal, as shown in Figure 2 (a) ) marked point A and point B, where point A is the peak point of the gas path flow, and point B is the plateau period of the inhalation section;
(3)计算所采集到气路流量信号的积分，得到容量波形曲线，如图2中(b)所示，并对气路容量信号提取波形曲线特征点，如图2中(b)所标注的 A点和k，其中A点为气路容量的峰值点，k为吸气段上升曲线切线的斜率；(3) Calculate the integral of the collected gas path flow signal to obtain the capacity waveform curve, as shown in (b) in Figure 2, and extract the characteristic points of the waveform curve from the gas path capacity signal, as marked in Figure 2 (b) Point A and k, where point A is the peak point of the air path capacity, and k is the slope of the tangent line of the rising curve of the suction section;
(4)将得到的气路流量波形曲线与流量波形标准曲线进行比对进而估计漏气程度，如图3中(a-d)所示，当少量漏气(漏气少于10％)时A点有所增加，开始出现B点，当漏气程度不断加大达到中等(10％<漏气量<35％)和大量(漏气量>35％)水平时B点对应的值逐渐增加；(4) Compare the obtained air path flow waveform curve with the flow waveform standard curve to estimate the degree of air leakage, as shown in Figure 3 (a-d), when a small amount of air leakage (air leakage is less than 10%) at point A There is an increase, and point B begins to appear. When the degree of air leakage continues to increase and reaches medium (10%<air leakage<35%) and a large amount (air leakage>35%), the value corresponding to point B gradually increases;
(5)将得到的气路容量波形曲线与容量波形标准曲线进行比对进而估计漏气程度，如图3中(e-h)所示，当少量漏气(漏气少于10％)时A点和k值有所增加，当漏气程度不断加大达到中等(10％<漏气量<35％)和大量(漏气量>35％)水平时k值逐渐增加；(5) Compare the obtained air circuit capacity waveform curve with the capacity waveform standard curve to estimate the degree of air leakage, as shown in (e-h) in Figure 3, when a small amount of air leakage (leakage less than 10%), point A The k value increases, and the k value gradually increases when the degree of air leakage increases to a medium level (10%<air leakage<35%) and a large amount (air leakage>35%);
(6)根据气路流量峰值可以带入到流量峰值-漏气量关系函数中计算求得漏气量的近似值，其中流量峰值-漏气量关系函数为一阶线性函数Vleak＝42Fmax-1895，其曲线如图4中(a)所示；(6) According to the peak flow rate of the gas path, it can be brought into the peak flow-leakage relationship function to calculate the approximate value of the leakage amount, where the peak flow-leakage relationship function is a first-order linear function Vleak = 42Fmax - 1895, its curve is shown in (a) in Figure 4;
(7)根据气路容量峰值可以带入到容量峰值-漏气量关系函数中计算求得漏气量的近似值，其中容量峰值-漏气量关系函数为一阶线性函数Vleak＝Vleak＝VTmax-235，其曲线如图4中(b)所示；(7) According to the peak capacity of the gas path, it can be brought into the peak capacity-leakage relationship function to calculate the approximate value of the leakage volume, where the peak capacity-leakage volume relationship function is a first-order linear function Vleak = Vleak = VTmax -235, its curve is shown in (b) in Fig. 4;
基于流量波形估算压力控制通气漏气量的方法是基于气路流量检测，参照系列流量、容量波形标准曲线及流量、容量峰值-漏气量关系函数实现的。其中利用检测流量、容量波形曲线与流量、容量波形标准曲线比对仅能得到近似的漏气程度，而利用气路流量、容量峰值与漏气量关系函数可以得到定量的漏气量。The method of estimating the leakage of pressure-controlled ventilation based on the flow waveform is based on the detection of the air flow, referring to the standard curve of the series of flow and volume waveforms and the relationship between the peak flow and volume and the leakage volume. Among them, the comparison between the detected flow and capacity waveform curve and the flow and capacity waveform standard curve can only obtain the approximate degree of air leakage, while the quantitative air leakage can be obtained by using the relationship function between the gas path flow, capacity peak value and air leakage.
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