【作者】 王东城；

【导师】 王怀阳；

【作者基本信息】 中国海洋大学 ， 信号与信息处理， 2004， 硕士

【摘要】 体外反搏系统是一种无创伤的体外辅助循环装置，在增加心、脑等器官的血液供应，促进缺血组织器官侧支循环的建立等方面具有显著的临床疗效。体外反搏可以无创地提供与主动脉内气囊反搏相似的功能：提高舒张压和冠脉血流。其原理是通过检测心电信号和监控动脉血压波形，对包裹在患者的小腿、大腿和臀部的密闭气囊进行无创性序贯加压。整个过程的血液动力学可以提高舒张压和冠脉的血流灌注，降低收缩期心脏的负荷和心肌耗氧量。 本文设计的控制系统采用先进的PC机和16位单片机80C196Kc并行中断通讯控制技术组成的智能检测与控制系统。在算法上使用新的体外反搏充排气时序控制算法，使病人反搏时在舒张期出现的反搏波恰好发生在主动脉瓣关闭之际，从而使反搏血流以最充分的时间向缺血器官进行灌注，而又不加重心脏的负荷。在心脏进入收缩期能使收缩压降至最低，最大限度地降低心脏射血期负荷，从而达到最大的反搏效应。 为了精确实现算法，本文采用三阈值法完成对心电信号的QRS波进行识别，结合指脉脉搏波判定充排气时机。同时在系统中充分考虑系统的安全性，增强出错预警处理能力，保障病人在非正常情况下的安全。 最后为了保证本文设计的体外反搏控制系统可以适应于各种治疗环境，不干扰附件其他设备，亦不受别的设备干扰，在系统的设计上采取了多种抗干扰措施，保证设备的电磁兼容性。更多还原

【Abstract】 External counterpulsation (EGP) is a noninvasive assisted circulation device. It plays a positive and curative role in increasing the blood supply for the heart and brain; promoting collateral circulation of the ischemic tissue and organs; This noninvasive technique provides augmentation of diastolic blood flow and coronary blood flow similar to the intraortic balloon pump, utilizing the serial inflation of three sets of cuffs which wrap around the calves, thighs and buttocks. Inflation and deflation is timed to the patient’ s Electrocardiograph (ECG) and the arterial pressure waveform is monitored noninvasively. The overall hemodynamic effect is to provide diastolic augmentation and thus increase coronary perfusion pressure, to unload systolic cardiac workload and therefore decrease myocardial oxygen demand.An intelligent test and control system, which consists of advanced computer and 16-bit microcontroller, is developed for controlling counterpulsation and monitoring the system and patient. A new algorithm about the inflation and deflation timing is adopted in this system, which makes the diastolic augmentation emerge as soon as the aortic valve closed. In this case, the blood has enough time to pour into the organs that are short of blood, by doing so, a best effect of the ECP will be achieved.In this paper, "three thresholds" method is adopted to distinguish the R wave from the characteristic of ECG signal. Integrated with the finger pulse wave, the system can extract the start point of the inflation and deflation timing. Ensure the patients’ safety, the "error early warning" function is designed in this system.The electromagnetic compatibility (EMC) was an ability for electronicequipment to work well under the anticipant electromagnetic environment, it is an important technical performance for electronic equipment especially the medical devices. So some kinds of analogue and digital circuitries were designed for ECP to enhance the EMC ability of the system.更多还原