CN107045592B - 一种腹腔镜手术操作的人因学评价*** - Google Patents
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Abstract
本发明公开了一种腹腔镜手术操作的人因学评价***,包括腹腔镜摄像头、场景摄像头、眼动仪和单片机,腹腔镜摄像头、场景摄像头、眼动仪分别与单片机相连;所述腹腔镜摄像头采集器械运动轨迹,场景摄像头实时记录手术室场景,眼动仪记录眼球运动的热点区域、瞳孔直径、眨眼频率;从而获得人因学主要评价指标。
Description
技术领域
本发明属于外科人因工程技术领域,涉及一种腹腔镜手术操作的人因学评价***。
背景技术
近年来腹腔镜手术的应用越来越广泛,不同于传统开放手术中医师能够直接看到并感知患者器官及病灶,在腹腔镜手术过程中,医师并不能够直接看到手术部位,需要通过在大脑中建立医学影像和患者实体之间的关系,并通过实时影像引导的方式进行手术操作。因此,腹腔镜手术的眼手配合训练变得更为复杂,也给医师技能训练和客观评价带来了新的挑战。为了评价腹腔镜手术时外科医师的眼手配合熟练度和手术操作的功效学,需要对手术和医师的操作行为进行准确记录。
人因学,又称人因工程学、人机工程学、人类工效学等,是研究人在某种工作环境中的解剖学、生理学和心理学等方面的因素,研究人和机器及环境的相互作用,评价工作效率、人的健康、安全和舒适等问题的学科。由于训练和经验不同,每一位医师对病人和疾病的理解存在差异,对所呈现的医学图像的解读能力存在差异,手术时所表现出的技能也有差异,这就是外科医师的综合能力。对操作者综合能力的研究,通常被称为人因学(Humanfactors),外科医师的工作表现、心理负荷、眼手配合以及外科团队配合等因素即为人因学的评价指标。已有的专利“一种智能外科手术过程视频记录***(103932791B)”将手术摄像***包括摄像设备和视频接收终端的数据进行记录,完整记录手术全过程,可用于保存数据和学术交流;有助于低年资历医师的培养;有助于减少手术失误。另一个专利“多媒体医学记录组件及其数据访问方法(201510106967.2)”,提供了一种多媒体医学记录组件及其数据访问方法。所提供的多媒体医学记录组件包括数据库终端和管理终端,管理终端接收医师和/或患者在远程在线会诊及离线时提供的医学记录。在这些技术中,侧重手术过程的记录、储存和传输,目的仅仅在于手术的回顾、反馈及教学,但是缺乏足够的数据记录用于分析手术人因学,无法达到改进手术工具与方法,降低医疗错误和不良事件的最终目标。
发明内容
本发明的目的在于针对现有技术的不足,提供一种腹腔镜手术操作的人因学评价***,该***记录腹腔镜手术的场景和医师行为,来评价医师手术操作的工作效率和操作能力。
本发明的目的是通过以下技术方案实现的:一种腹腔镜手术操作的人因学评价***,包括腹腔镜摄像头、场景摄像头、眼动仪和单片机,腹腔镜摄像头、场景摄像头、眼动仪分别与单片机相连;所述腹腔镜摄像头采集器械运动轨迹,场景摄像头实时记录手术室场景,眼动仪记录眼球运动的热点区域、瞳孔直径、眨眼频率;评价过程如下:
(1)根据器械运动轨迹,对手术任务进行分割,获得不同手术任务的器械运动轨迹I(x,y)、持续时间Th、难度指数E以及对应的时间帧序列,并输入单片机;
(2)单片机按照步骤1分割的时间帧序列,分别提取不同任务下的手术室场景、眼球运动的热点区域Sp(x,y)、瞳孔直径Ps、眨眼频率Bf和眨眼持续时间Bd;
(3)针对每个手术任务,利用提取的手术室场景,按照视频帧相似度聚类算法计算手术场景干扰值D;根据瞳孔直径Ps,获得该任务的时间帧序列内的波动斜率Pc/Th(Pc为该任务的时间帧序列内的最大瞳孔直径与最小瞳孔直径之差),从而获得医师在执行该手术任务时的人因学评价指标:
手术警觉性:V=E*Th/D;
任务压力指数:TLI=V+(Bf/Bd+Pc/Th)/2;
眼手配合指数:EHCI=100W/Th;W表示器械运动和眼球运动轨迹热点叠合率。
熟练成熟:OPI=E*EHCI/Th。
本发明所达到的有益效果:借助全面的场景记录和人因学指标记录,可用于评价医师工作效率,分析医师操作的准确性,达到降低医疗错误和不良事件,增强患者安全的最终目标。
附图说明
图1为本发明的技术路线图;
图2为本发明的记录装置构造图;
图3为胆囊切除任务下的瞳孔直径Ps变化图;
图4为胆囊动脉结扎任务下的瞳孔直径Ps变化图;
图5为胆囊切除任务下的眼球运动的热点区域Sp(x,y)图;
图6为胆囊动脉结扎任务下的眼球运动的热点区域Sp(x,y)图;
图中,1.场景摄像机 2.器械轨迹跟踪 3.眼动仪 4.单片机。
具体实施方式
本发明一种腹腔镜手术操作的人因学评价***,包括腹腔镜摄像头、场景摄像头、眼动仪和单片机,腹腔镜摄像头、场景摄像头、眼动仪分别与单片机相连;该***通过各个记录装置记录手术场景和眼球运动,具体如下:
1.手术场景记录:包括手术画面记录和手术室环境记录。腹腔镜手术画面通过腹腔镜镜头直接输出,从而得到器械运动轨迹点。手术室场景画面可由四台高清摄像机获取,实时记录手术室和手术床的空间布局,患者的***状态,手术室工作人员(医师、麻醉师、护士等)的工作状态,以及手术过程中各种声音记录,这个过程称之为工作场景记录。
2.眼球运动跟踪记录:由于人眼在盯腔镜显示屏不同位置时,眼球会发生相应的转动,使被观察物体落在视网膜的中央凹上,在假定头部基本不动的情况下,视线方向就同计算机屏幕上的点形成一一对应的关系。这样,通过对眼球状态即视线方向的监测,就可以得知对应在屏幕上的位置了。视线跟踪法(Eye tracking)就是通过眼动仪,利用图像处理技术,使用能锁定眼睛的特殊摄像机,通过摄入从人的眼角膜和瞳孔反射的红外线连续地跟踪记录视线变化,从而达到记录视线追踪过程的目的,然后再对这些原始数据进行加工和分析。眼动仪是眼镜式眼球运动监控装置,医师佩戴时可以监控外科医师的眼球运动轨迹,获取注视点轨迹图,通过眼位定位、坐标变换、注视点定位,精确记录外科医师在手术过程中的视觉关注点,同时可以记录医师手术操作时的瞳孔大小、瞳孔波动曲线,以及眨眼频率等,从而深入地研究医师的警觉力和眼手配合能力。
下面结合实施例对本发明进行进一步说明。
实施例1:本实施例是针对一项胆囊手术,其中主要包含胆囊切除和胆囊动脉结扎两项任务,针对这项手术,采用本发明的***对手术医师的人因学指数进行评下如下:
如图2所示,一种腹腔镜手术操作的人因学评价***,包括腹腔镜摄像头、场景摄像头、眼动仪和单片机,腹腔镜摄像头、场景摄像头、眼动仪分别与单片机相连;腹腔镜摄像头采集器械运动轨迹,场景摄像头实时记录手术室场景,眼动仪记录眼球运动的热点区域、瞳孔直径、眨眼频率;评价过程如下:
(1)根据器械运动轨迹,对手术任务进行分割,获得不同手术任务的器械运动轨迹I(x,y)、持续时间Th、难度指数E以及对应的时间帧序列,并输入单片机;
其中,E为手术任务的级别,根据[国家卫生和计划生育委员会手术分类分级目录2015年版]获得。
(2)单片机按照步骤1分割的时间帧序列(手术任务时间段),分别提取不同任务下的手术室场景、眼球运动的热点区域Sp(x,y)、瞳孔直径Ps、眨眼频率Bf和眨眼持续时间Bd;其中胆囊切除任务下的瞳孔直径Ps变化如图3所示,胆囊动脉结扎任务下的瞳孔直径Ps变化如图4所示。胆囊切除任务下的眼球运动的热点区域Sp(x,y)如图5所示,胆囊动脉结扎任务下的眼球运动的热点区域Sp(x,y)如图6所示。并得到手运动轨迹和眼球热点区域重叠率W如表1所示。
表1
(3)针对每个手术任务,利用提取的手术室场景,按照视频帧相似度聚类算法计算手术场景干扰值D(D为聚类类别数);根据瞳孔直径Ps,获得该任务的时间帧序列内的波动斜率Pc/Th(Pc为该任务的时间帧序列内的最大瞳孔直径与最小瞳孔直径之差),如表2所示。从而获得医师在执行该手术任务时的人因学评价指标:
表2
任务名称 | 干扰值D | Bf(次数) | Bd(min) | Pc/Th |
1.胆囊切除 | 56 | 20 | 2.1 | 0.33 |
2.胆囊动脉结扎 | 34 | 8 | 1.3 | 1.6 |
手术警觉性:V=E*Th/D;V任务1=2*15/56=53.6%;V任务1=1*5/34=14.7%
任务压力指数:TLI=100V+(Bf/Bd+Pc/Th)/2;
TLI任务1=53.6+(20/2.1+0.33)/2=58.5
TLI任务2=14.7+(8/1.3+1.6)/2=18.6
眼手配合指数:EHCI=100W/Th
EHCI任务1=75.7/15=5.0
EHCI任务2=87.6/5=17.5
熟练成熟:OPI=E*EHCI/Th
OPI任务1=2*5.0/15=0.667
OPI任务2=1*17.5/5=3.5
根据上述仪器记录的视频,按照传统的专家打分方法对该医师进行评价,评价结果与本***输出结果进行对照,符合率达到98%,偏差在0.5%以下。因此,本发明的***能广泛应用于医师的人因学评价。
Claims (1)
1.一种腹腔镜手术操作的人因学评价***,其特征在于,包括腹腔镜摄像头、场景摄像头、眼动仪和单片机,腹腔镜摄像头、场景摄像头、眼动仪分别与单片机相连;所述腹腔镜摄像头采集器械运动轨迹,场景摄像头实时记录手术室场景,眼动仪记录眼球运动的热点区域、瞳孔直径、眨眼频率;评价过程如下:
(1)根据器械运动轨迹,对手术任务进行分割,获得不同手术任务的器械运动轨迹I(x,y)、持续时间Th、难度指数E以及对应的时间帧序列,并输入单片机;
(2)单片机按照步骤(1)分割的时间帧序列,分别提取不同手术任务下的手术室场景、眼球运动的热点区域Sp(x,y)、瞳孔直径Ps、眨眼频率Bf和眨眼持续时间Bd;
(3)针对每个手术任务,利用提取的手术室场景,按照视频帧相似度聚类算法计算手术场景干扰值D;根据瞳孔直径Ps,获得该手术任务的时间帧序列内的波动斜率Pc/Th ,Pc为该手术任务的时间帧序列内的最大瞳孔直径与最小瞳孔直径之差,从而获得医师在执行该手术任务时的人因学评价指标:
手术警觉性:V=E*Th/D;
任务压力指数:TLI=V+(Bf/Bd+Pc/Th)/2;
眼手配合指数:EHCI= 100W/Th;W表示器械运动轨迹和眼球运动轨迹热点叠合率;
熟练成熟:OPI=E*EHCI/Th。
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