阅读说明：本技术 动静脉压力的动态监测方法及系统 (Dynamic monitoring method and system for arteriovenous pressure ) 是由 高光勇 陈飞 童锦 李绍林 朱平 于 2021-08-12 设计创作，主要内容包括：本发明提出了一种动静脉压力的动态监测方法及系统。该方法为：实时判断血液净化设备运行状态是否改变；如果运行状态改变,则在运行状态发生改变后的t1时长内,根据预先设置的动静脉压力上下限值对动静脉压力进行监测；在运行状态发生改变的t1时长后,计算动态动静脉压力上下限值,根据动态动静脉压力上下限值对动静脉压力进行监测；如果运行状态未改变,则监测当前运行状态运行时长是否已达到t1时长,如未达到,则根据预先设置的动静脉压力上下限值对动静脉压力进行监测；如已达到t1时长,则计算动态动静脉压力上下限值,根据动态动静脉压力上下限值对动静脉压力进行监测。该方法增强了动静脉压力上下限报警的有效性和治疗的安全性。(The invention provides a dynamic monitoring method and a dynamic monitoring system for arteriovenous pressure. The method comprises the following steps: judging whether the running state of the blood purification equipment is changed or not in real time; if the running state is changed, monitoring the arteriovenous pressure according to the preset upper and lower limit values of the arteriovenous pressure within the time length t1 after the running state is changed; after the time length t1 when the operation state changes, calculating the upper and lower limit values of the dynamic arteriovenous pressure, and monitoring the arteriovenous pressure according to the upper and lower limit values of the dynamic arteriovenous pressure; if the running state is not changed, monitoring whether the running time of the current running state reaches the time of t1, if not, monitoring the arteriovenous pressure according to the preset upper and lower limit values of the arteriovenous pressure; and if the time duration of t1 is reached, calculating the upper and lower limit values of the dynamic arteriovenous pressure, and monitoring the arteriovenous pressure according to the upper and lower limit values of the dynamic arteriovenous pressure. The method enhances the effectiveness of the upper and lower limits of arteriovenous pressure alarm and the safety of treatment.)

1. A dynamic monitoring method for arteriovenous pressure is characterized by comprising the following steps:

judging whether the running state of the blood purification equipment changes in real time in the working process of the blood purification equipment;

if the operation state is changed, monitoring the arteriovenous pressure by taking preset upper and lower limit values of the arteriovenous pressure as upper and lower alarm limit values of the arteriovenous pressure within the time length t1 after the operation state is changed; after the time length t1 when the operation state changes, calculating the upper and lower limit values of dynamic arteriovenous pressure, and monitoring the arteriovenous pressure by taking the upper and lower limit values of the dynamic arteriovenous pressure as upper and lower alarm limit values of the arteriovenous pressure;

if the running state is not changed, monitoring whether the running time of the current running state reaches the time of t1, if not, monitoring the arteriovenous pressure by taking the preset upper and lower limit values of the arteriovenous pressure as upper and lower alarm limit values of the arteriovenous pressure; and if the time duration of t1 is reached, calculating the upper and lower dynamic arteriovenous pressure limits, and monitoring the arteriovenous pressure by using the upper and lower dynamic arteriovenous pressure limits as upper and lower arteriovenous pressure alarm limits.

2. The dynamic arteriovenous pressure monitoring method according to claim 1, wherein if the calculated dynamic arterial pressure upper limit value is higher than a preset arterial pressure upper limit value, the arterial pressure is monitored according to the preset arterial pressure upper limit value, otherwise, the arterial pressure is monitored according to the dynamic arterial pressure upper limit value;

if the calculated dynamic arterial pressure lower limit value is lower than the preset arterial pressure lower limit value, monitoring the arterial pressure according to the preset arterial pressure lower limit value, otherwise, monitoring the arterial pressure according to the dynamic arterial pressure lower limit value;

if the calculated dynamic venous pressure lower limit value is lower than the preset venous pressure lower limit value, monitoring the venous pressure according to the preset venous pressure lower limit value, otherwise, monitoring the venous pressure according to the dynamic venous pressure lower limit value;

and if the calculated dynamic venous pressure upper limit value is higher than the preset venous pressure upper limit value, monitoring the venous pressure according to the preset venous pressure upper limit value, otherwise, monitoring the venous pressure according to the dynamic venous pressure upper limit value.

3. The dynamic arteriovenous pressure monitoring method according to claim 1 or 2, characterized in that the dynamic arteriovenous pressure upper and lower limit value calculation method is as follows:

when the time length is within the period of t1-t2 after the operation state is changed, the upper limit value of dynamic arterial pressure is PT1+ AmmHg, the lower limit value of dynamic arterial pressure is PT1-AmmHg, the upper limit value of dynamic venous pressure is PT2+ AmmHg, and the lower limit value of dynamic venous pressure is PT2-AmmHg, wherein PT1 is the average value of the arterial pressure within the time length of t1 after the operation state is changed, and PT2 is the average value of the venous pressure within the time length of t1 after the operation state is changed;

when the time length of the change of the running state is t2, the upper limit value of the dynamic arterial pressure is PT3+ BmmHg, the lower limit value of the dynamic arterial pressure is PT3-BmmHg, the upper limit value of the dynamic venous pressure is PT4+ BmmHg, the lower limit value of the dynamic venous pressure is PT4-BmmHg, wherein PT3 is the average value of the arterial pressure in the time length of t1-t2 after the change of the running state, and PT4 is the average value of the venous pressure in the time length of t1-t2 after the change of the running state.

4. The dynamic arteriovenous pressure monitoring method of claim 1 wherein the conditions of a change in operating state include a change in treatment mode, a change in blood pump flow, and a change in fluid replacement pump flow.

5. The dynamic arteriovenous pressure monitoring method of claim 1 wherein upper and lower arteriovenous pressure limit values corresponding thereto are preset for each treatment mode.

6. A dynamic monitoring system for arteriovenous pressure is characterized by comprising a control unit, a blood purification equipment running state sensing unit, an arteriovenous pressure acquisition unit and an alarm unit; the blood purification equipment operation state sensing unit and the arteriovenous pressure acquisition unit are respectively connected with the control unit, the blood purification equipment operation state information and the arteriovenous pressure information are sent to the control unit in real time, the control unit is connected with the alarm unit, and the control unit monitors the arteriovenous pressure according to the dynamic monitoring method of the arteriovenous pressure in any one of claims 1 to 5.

Technical Field

The invention relates to the field of blood purification, in particular to a dynamic monitoring method and system for arteriovenous pressure.

Background

Venous pressure refers to the pressure at which blood flows from the dialyzer back into the venous blood vessel of the patient. The level of venous pressure is related to factors such as blood flow, intravascular pressure, and whether the blood circuit is open. Possible reasons for venous pressure exceeding the upper or lower alarm limit are: (1) blood coagulation blockage of the venous lumen filter screen; (2) the vein side blood way is folded, and the blood backflow is blocked; (3) a sudden rise in blood pressure; (4) the vein needle is displaced to cause the puncture part to swell; (5) the blood pressure is reduced, and the effective circulating blood volume is insufficient; (6) severe clotting of the arterial ampule or dialyzer; (7) rupture of the blood pump posterior vascular tract; (8) venous pressure probe is not connected, probe line clamp is not opened, etc.

The arterial pressure reflects the pressure required to introduce blood at the arterial end of the patient's vascular access to the blood pump segment line. Possible reasons for the arterial pressure exceeding the upper or lower alarm limit are: (1) the joint of the arterial pipeline and the needle or the catheter is disconnected; (2) the blood pump is loosely combined with the pump pipe to enable blood to flow back; (3) blood coagulation in a dialyzer; (4) the venous duct is blocked and the blood flow is not smooth; (5) blockage of the venipuncture site, etc. Therefore, the method has important significance for effectively monitoring whether the arteriovenous pressure exceeds the upper limit or the lower limit of the alarm.

The existing arteriovenous pressure monitoring is mainly characterized in that a machine operator manually sets an upper alarm limit and a lower alarm limit of arteriovenous pressure, and when the arteriovenous pressure exceeds the upper alarm limit or the lower alarm limit, corresponding arteriovenous pressure alarm is generated. However, the upper limit and the lower limit of the artificial arteriovenous pressure alarm are manually set, the effectiveness and the practicability of the alarm are completely determined by operators of machines, and the reliability cannot be guaranteed.

Disclosure of Invention

In order to overcome the defects in the prior art, the invention aims to provide a dynamic monitoring method and a dynamic monitoring system for arteriovenous pressure.

In order to achieve the above object, the present invention provides a dynamic monitoring method for arteriovenous pressure, comprising the following steps:

judging whether the running state of the blood purification equipment changes in real time in the working process of the blood purification equipment;

if the operation state is changed, monitoring the arteriovenous pressure by taking preset upper and lower limit values of the arteriovenous pressure as upper and lower alarm limit values of the arteriovenous pressure within the time length t1 after the operation state is changed; after the time length t1 when the operation state changes, calculating the upper and lower limit values of dynamic arteriovenous pressure, and monitoring the arteriovenous pressure by taking the upper and lower limit values of the dynamic arteriovenous pressure as upper and lower alarm limit values of the arteriovenous pressure;

if the running state is not changed, monitoring whether the running time of the current running state reaches the time of t1, if not, monitoring the arteriovenous pressure by taking the preset upper and lower limit values of the arteriovenous pressure as upper and lower alarm limit values of the arteriovenous pressure; and if the time duration of t1 is reached, calculating the upper and lower dynamic arteriovenous pressure limits, and monitoring the arteriovenous pressure by using the upper and lower dynamic arteriovenous pressure limits as upper and lower arteriovenous pressure alarm limits.

According to the dynamic monitoring method for the arteriovenous pressure, the upper limit and the lower limit of the arteriovenous pressure alarm are adjusted in real time according to the treatment state, the effectiveness of the upper limit and the lower limit of the arteriovenous pressure alarm and the treatment safety are enhanced, and the defects caused by the traditional manual setting of the upper limit and the lower limit of the arteriovenous pressure alarm are overcome.

The preferable scheme of the dynamic monitoring method for the arteriovenous pressure is as follows: if the calculated dynamic arterial pressure upper limit value is higher than the preset arterial pressure upper limit value, monitoring the arterial pressure according to the preset arterial pressure upper limit value, otherwise, monitoring the arterial pressure according to the dynamic arterial pressure upper limit value;

if the calculated dynamic arterial pressure lower limit value is lower than the preset arterial pressure lower limit value, monitoring the arterial pressure according to the preset arterial pressure lower limit value, otherwise, monitoring the arterial pressure according to the dynamic arterial pressure lower limit value;

if the calculated dynamic venous pressure lower limit value is lower than the preset venous pressure lower limit value, monitoring the venous pressure according to the preset venous pressure lower limit value, otherwise, monitoring the venous pressure according to the dynamic venous pressure lower limit value;

and if the calculated dynamic venous pressure upper limit value is higher than the preset venous pressure upper limit value, monitoring the venous pressure according to the preset venous pressure upper limit value, otherwise, monitoring the venous pressure according to the dynamic venous pressure upper limit value.

The preferable scheme further reduces the upper and lower limits of the arteriovenous pressure alarm in the normal treatment process, and improves the safety of treatment.

The preferable scheme of the dynamic monitoring method for the arteriovenous pressure is as follows: the method for calculating the upper and lower limit values of the dynamic arteriovenous pressure comprises the following steps:

when the time length is within the period of t1-t2 after the operation state is changed, the upper limit value of dynamic arterial pressure is PT1+ AmmHg, the lower limit value of dynamic arterial pressure is PT1-AmmHg, the upper limit value of dynamic venous pressure is PT2+ AmmHg, and the lower limit value of dynamic venous pressure is PT2-AmmHg, wherein PT1 is the average value of the arterial pressure within the time length of t1 after the operation state is changed, and PT2 is the average value of the venous pressure within the time length of t1 after the operation state is changed;

when the time length of the change of the running state is t2, the upper limit value of the dynamic arterial pressure is PT3+ BmmHg, the lower limit value of the dynamic arterial pressure is PT3-BmmHg, the upper limit value of the dynamic venous pressure is PT4+ BmmHg, the lower limit value of the dynamic venous pressure is PT4-BmmHg, wherein PT3 is the average value of the arterial pressure in the time length of t1-t2 after the change of the running state, and PT4 is the average value of the venous pressure in the time length of t1-t2 after the change of the running state.

According to the optimal scheme, clinical actual data are referred, the optimal scheme has clinical practical significance, the obtained dynamic arteriovenous pressure upper and lower limit values have reference values, and the arteriovenous pressure can be better monitored.

The preferable scheme of the dynamic monitoring method for the arteriovenous pressure is as follows: the change of the running state comprises the change of a treatment mode, the change of the flow of a blood pump and the change of the flow of a fluid infusion pump. The upper and lower limit values of the arteriovenous pressure corresponding to each treatment mode are preset.

The invention also provides a dynamic monitoring system of the arteriovenous pressure, which comprises a control unit, a blood purification equipment running state sensing unit, an arteriovenous pressure acquisition unit and an alarm unit; the blood purification equipment operation state sensing unit and the arteriovenous pressure acquisition unit are respectively connected with the control unit, and send blood purification equipment operation state information and arteriovenous pressure information to the control unit in real time, the control unit is connected with the alarm unit, and the control unit monitors the arteriovenous pressure according to the arteriovenous pressure dynamic monitoring method.

The invention has the beneficial effects that: the invention adjusts the upper and lower limits of the arteriovenous pressure alarm in real time according to the treatment state, further reduces the upper and lower limits of the arteriovenous pressure alarm in the normal treatment process, and enhances the effectiveness of the upper and lower limits of the arteriovenous pressure alarm and the safety of treatment.

Additional aspects and advantages of the invention will be set forth in part in the description which follows and, in part, will be obvious from the description, or may be learned by practice of the invention.

Drawings

The above and/or additional aspects and advantages of the present invention will become apparent and readily appreciated from the following description of the embodiments, taken in conjunction with the accompanying drawings of which:

fig. 1 is a schematic flow chart of a dynamic monitoring method of arteriovenous pressure.

Detailed Description

Reference will now be made in detail to embodiments of the present invention, examples of which are illustrated in the accompanying drawings, wherein like or similar reference numerals refer to the same or similar elements or elements having the same or similar function throughout. The embodiments described below with reference to the accompanying drawings are illustrative only for the purpose of explaining the present invention, and are not to be construed as limiting the present invention.

In the description of the present invention, unless otherwise specified and limited, it is to be noted that the terms "mounted," "connected," and "connected" are to be interpreted broadly, and may be, for example, a mechanical connection or an electrical connection, a communication between two elements, a direct connection, or an indirect connection via an intermediate medium, and specific meanings of the terms may be understood by those skilled in the art according to specific situations.

As shown in fig. 1, the present invention provides a dynamic monitoring method of arteriovenous pressure, comprising the following steps:

and judging whether the running state of the blood purification equipment is changed or not in real time in the working process of the blood purification equipment, and detecting the pressure of the artery and the vein in real time. The change of the running state comprises the change of a treatment mode, the change of the flow of a blood pump and the change of the flow of a fluid infusion pump, and the changes can be autonomously sensed by the blood purification equipment.

If the operation state is changed, monitoring the arteriovenous pressure by taking the preset upper and lower limit values of the arteriovenous pressure as upper and lower limit values of arteriovenous pressure alarm within the time length t1 after the operation state is changed, and alarming if the arteriovenous pressure exceeds the preset upper and lower limit values of the arteriovenous pressure; and (4) after t1 time length when the operation state is changed, calculating the upper and lower limit values of the dynamic arteriovenous pressure, monitoring the arteriovenous pressure by taking the upper and lower limit values of the dynamic arteriovenous pressure as upper and lower limit values of arteriovenous pressure alarm, and alarming if the arteriovenous pressure exceeds the upper and lower limit values of the dynamic arteriovenous pressure.

If the operation state is not changed, monitoring whether the operation time of the current operation state reaches t1 time, if not, monitoring the arteriovenous pressure by taking the preset upper and lower limit values of the arteriovenous pressure as upper and lower limit values of arteriovenous pressure alarm, and if the arteriovenous pressure exceeds the preset upper and lower limit values of the arteriovenous pressure, alarming; and if the time duration of t1 is reached, calculating the upper and lower dynamic arteriovenous pressure values, monitoring the arteriovenous pressure by using the upper and lower dynamic arteriovenous pressure values as upper and lower arteriovenous pressure alarm limit values, and if the arteriovenous pressure exceeds the upper and lower dynamic arteriovenous pressure values, alarming.

The upper and lower limit values of the arteriovenous pressure in the application are the general names of the upper limit value of the arterial pressure, the lower limit value of the arterial pressure, the upper limit value of the venous pressure and the lower limit value of the venous pressure. When the venous pressure is higher than the upper limit of the venous pressure alarm, generating a venous pressure alarm; when the venous pressure is lower than the lower venous pressure alarm limit, a venous pressure reduction alarm is generated; when the arterial pressure is higher than the upper limit of the arterial pressure alarm, generating an arterial pressure alarm; when the arterial pressure is lower than the lower limit of the arterial pressure alarm, an arterial pressure alarm is generated.

And (3) presetting upper and lower limit values of the arteriovenous pressure corresponding to each treatment mode, and monitoring the arteriovenous pressure according to the preset upper and lower limit values of the arteriovenous pressure corresponding to the current operation state if the operation state is changed or not changed and the arteriovenous pressure is monitored according to the preset upper and lower limit values of the arteriovenous pressure corresponding to the current operation state.

However, the upper and lower limit values of the dynamic arteriovenous pressure calculated sometimes exceed the upper and lower limit values of the preset arteriovenous pressure, so that when the upper and lower limit values of the dynamic arteriovenous pressure are calculated, if the upper limit value of the dynamic arteriovenous pressure obtained by calculation is higher than the upper limit value of the preset arteriovenous pressure, the arterial pressure is monitored according to the preset upper limit value of the arterial pressure, otherwise, the arterial pressure is monitored according to the upper limit value of the dynamic arterial pressure; if the calculated dynamic arterial pressure lower limit value is lower than the preset arterial pressure lower limit value, monitoring the arterial pressure according to the preset arterial pressure lower limit value, otherwise, monitoring the arterial pressure according to the dynamic arterial pressure lower limit value; if the calculated dynamic venous pressure lower limit value is lower than the preset venous pressure lower limit value, monitoring the venous pressure according to the preset venous pressure lower limit value, otherwise, monitoring the venous pressure according to the dynamic venous pressure lower limit value; and if the calculated dynamic venous pressure upper limit value is higher than the preset venous pressure upper limit value, monitoring the venous pressure according to the preset venous pressure upper limit value, otherwise, monitoring the venous pressure according to the dynamic venous pressure upper limit value.

Specifically, the method for calculating the upper and lower limit values of the dynamic arteriovenous pressure comprises the following steps:

when the time length after the change of the operation state is within a time length of t1-t2, the upper limit value of the dynamic arterial pressure is PT1+ AmmHg, the lower limit value of the dynamic arterial pressure is PT1-AmmHg, the upper limit value of the dynamic venous pressure is PT2+ AmmHg, and the lower limit value of the dynamic venous pressure is PT2-AmmHg, wherein PT1 is the average value of the arterial pressure in the time length of t1 after the change of the operation state, and PT2 is the average value of the venous pressure in the time length of t1 after the change of the operation state.

When the time length of the change of the running state is t2, the upper limit value of the dynamic arterial pressure is PT3+ BmmHg, the lower limit value of the dynamic arterial pressure is PT3-BmmHg, the upper limit value of the dynamic venous pressure is PT4+ BmmHg, the lower limit value of the dynamic venous pressure is PT4-BmmHg, wherein PT3 is the average value of the arterial pressure in the time length of t1-t2 after the change of the running state, and PT4 is the average value of the venous pressure in the time length of t1-t2 after the change of the running state.

In this embodiment, t1, t2, and A, B are all positive real numbers, and may be set according to a specific practical situation, where t1< t 2.

The application also provides an embodiment of the dynamic monitoring system of the arteriovenous pressure, which comprises a control unit, a blood purification equipment running state sensing unit, an arteriovenous pressure acquisition unit and an alarm unit. The blood purification equipment operation state sensing unit and the arteriovenous pressure acquisition unit are respectively connected with the control unit, the blood purification equipment operation state information and the arteriovenous pressure information are sent to the control unit in real time, the control unit is connected with the alarm unit, and the control unit monitors the arteriovenous pressure according to the arteriovenous pressure dynamic monitoring method. The blood purification equipment operation state perception unit in this embodiment, arteriovenous pressure collection unit all can adopt the device of blood purification equipment self-carrying to perception or collection.

In the description herein, references to the description of the term "one embodiment," "some embodiments," "an example," "a specific example," or "some examples," etc., mean that a particular feature, structure, material, or characteristic described in connection with the embodiment or example is included in at least one embodiment or example of the invention. In this specification, the schematic representations of the terms used above do not necessarily refer to the same embodiment or example. Furthermore, the particular features, structures, materials, or characteristics described may be combined in any suitable manner in any one or more embodiments or examples.

While embodiments of the invention have been shown and described, it will be understood by those of ordinary skill in the art that: various changes, modifications, substitutions and alterations can be made to the embodiments without departing from the principles and spirit of the invention, the scope of which is defined by the claims and their equivalents.