WO2021189197A1

WO2021189197A1 - Respiratory monitoring apparatus and method

Info

Publication number: WO2021189197A1
Application number: PCT/CN2020/080699
Authority: WO
Inventors: 邹心茹; 刘京雷; 周小勇
Original assignee: 深圳迈瑞生物医疗电子股份有限公司
Priority date: 2020-03-23
Filing date: 2020-03-23
Publication date: 2021-09-30
Also published as: CN115297916A

Abstract

A respiratory monitoring apparatus and method. The method comprises: acquiring the pressure of a patient during a ventilation process (200), wherein the pressure reflects the amount of pressure acting on different position points of the respiratory system of the patient during the ventilation process; acquiring a gas flow rate regarding the patient during the ventilation process (100); and calculating, according to the acquired pressure and gas flow rate, the amount of energy acting on the respiratory system of the patient during a mechanical ventilation process (300). By means of the respiratory monitoring apparatus, the pressure and a gas flow rate regarding a patient can be monitored during a ventilation process, and the energy acting on the respiratory system of the patient during mechanical ventilation can be obtained according to the pressure and the gas flow rate regarding the patient, thereby more accurately and truly evaluating lung injuries in real time. Furthermore, information such as the numerical value of the energy can be analyzed, and subsequent operations such as alarm raising and disease condition determination can be performed.

Description

一种呼吸监测装置及方法Respiration monitoring device and method

技术领域Technical field

本发明涉及一种呼吸监测装置、呼吸监测方法。The invention relates to a breathing monitoring device and a breathing monitoring method.

背景技术Background technique

人的呼吸是指周期节律性地吸入和呼出气体，吸收氧气排出二氧化碳，从而实现气体交换。当一些患者无法进行自主呼吸时，则可以通过机械通气来帮助患者完成呼吸；例如对于患者没有自主呼吸的情况，通常可以通过外置的设备如呼吸机等来给患者提供呼吸支持。可以看到，机械通气是利用机械装置来代替、控制或改变患者自主呼吸运动的一种通气方式。但是机械通气在应用时也容易造成患者肺损伤(ventilator induced lung injury，VILI)。为了减少机械通气造成的肺损伤，研究人员和技术人员提出了许多减小肺损伤的通气策略。当前获得广泛认可的是以小潮气量、低吸气末肺泡正压、最佳呼气末正压和允许性碳酸血症为核心的肺保护策略(lung protective ventilation strategy，LPVS)。下面对肺保护通气策略或者说减少肺损伤的策略进行一个说明。Human respiration refers to the periodic inhalation and exhalation of gas, absorbing oxygen and expelling carbon dioxide, thereby realizing gas exchange. When some patients are unable to breathe spontaneously, mechanical ventilation can be used to help the patients complete their breathing; for example, for patients who do not breathe spontaneously, an external device such as a ventilator can usually be used to provide respiratory support to the patient. It can be seen that mechanical ventilation is a way of ventilation that uses mechanical devices to replace, control or change the patient's spontaneous breathing movement. However, mechanical ventilation is also prone to cause lung injury (ventilator induced lung injury, VILI) when applied. In order to reduce lung injury caused by mechanical ventilation, researchers and technicians have proposed many ventilation strategies to reduce lung injury. Currently widely recognized is lung protective strategy (LPVS) with the core of low tidal volume, low end-inspiratory positive alveolar pressure, optimal end-expiratory pressure, and permissive capnemia. The following is an explanation of lung protection ventilation strategies or strategies to reduce lung injury.

一些减少肺损伤策略优先以低潮气量作为指导，但是肺完全膨胀，高潮气量并不是主要有害原因，用低潮气量通气时由急性呼吸窘迫综合征(Acute respiratory distress syndrome，ARDS)引发的死亡率并没有降低，这是由于ARDS患者由于病变类型、病因和病变累及范围不同，塌陷肺泡区域大小和分布不同，导致肺的不均一性，这种不均一性使得不同患者的肺顺应性和可复张肺泡的容积也不同，不同患者真正所需要的潮气量也不同，所以仅以潮气量作为肺损伤的评价指标是不够的。Some strategies to reduce lung injury prioritize low tidal volume as a guide, but the lungs are completely inflated and high tidal volume is not the main harmful cause. There is no mortality caused by acute respiratory distress syndrome (Acute respiratory distress syndrome, ARDS) when ventilation is used with low tidal volume. This is because ARDS patients have different types of lesions, etiology, and lesions involved, and the size and distribution of the collapsed alveolar area are different, resulting in inhomogeneity of the lungs. This inhomogeneity makes the lung compliance of different patients and the recruitment of alveoli The volume is also different, and the actual tidal volume required by different patients is also different, so only tidal volume as an evaluation index of lung injury is not enough.

因此也有一些减少肺损伤策略采用低潮气量联合最佳呼气末正压(PEEP)的方式，但是这种方式也存在非重力依赖区肺泡过度膨胀和重力依赖区肺泡潮汐性塌陷复张，这使得呼吸机相关性肺损伤的发生率仍较高。Therefore, there are also some strategies to reduce lung injury that use low tidal volume combined with optimal positive end expiratory pressure (PEEP). However, this method also has alveolar over-expansion in the non-gravity-dependent area and tidal collapse and recruitment of the alveolar in the gravity-dependent area, which makes The incidence of ventilator-related lung injury is still high.

此外还有一些减少肺损伤策略也采用结合低潮气量和平台压限制的方式，但研究和实践中还是表明，对于塌陷肺泡多的患者，其正常通气肺泡少，过度膨胀明显增高，因此还是会对这部分患者造成肺损伤。In addition, some strategies to reduce lung injury also use a combination of low tidal volume and plateau pressure restriction. However, research and practice have shown that for patients with more collapsed alveoli, there are fewer normally ventilated alveoli, and hyperinflation is significantly increased. These patients cause lung damage.

发明内容Summary of the invention

针对减少肺损伤的问题，本发明主要提供一种呼吸监测装置及方法。Aiming at the problem of reducing lung injury, the present invention mainly provides a breathing monitoring device and method.

根据第一方面，一种实施例中提供一种呼吸监测方法，包括：According to the first aspect, an embodiment provides a breathing monitoring method, including:

获取在通气过程中患者的压力，所述压力反映通气过程中作用于患者呼吸***不同位点的压力；Obtain the pressure of the patient during the ventilation process, and the pressure reflects the pressure acting on different points of the patient's respiratory system during the ventilation process;

获取患者在通气过程中的气体流速；Obtain the gas flow rate of the patient during ventilation;

根据获取的压力和气体流速计算机械通气过程中作用于患者呼吸***的能量。Calculate the energy acting on the patient's respiratory system during mechanical ventilation based on the acquired pressure and gas flow rate.

一实施例中，所述不同位点的压力包括气道压、胸腔内压、隆突压、肺内压、食道压、胃内压、跨肺压和跨膈压中的一种或多种。In an embodiment, the pressure at the different sites includes one or more of airway pressure, intrathoracic pressure, carina pressure, intrapulmonary pressure, esophageal pressure, intragastric pressure, transpulmonary pressure, and transdiaphragmatic pressure .

一实施例中，所述呼吸监测方法还包括：通过在呼气末正压为零和非零的状态下的气道压和食道压对所述跨肺压进行校正。In an embodiment, the breathing monitoring method further includes: correcting the transpulmonary pressure by airway pressure and esophageal pressure in a state where the positive end expiratory pressure is zero and non-zero.

一实施例中，所述呼吸监测方法还包括：通过肺顺应性和胸壁顺应性来对所述跨肺压力进行校正。In an embodiment, the breathing monitoring method further includes: correcting the transpulmonary pressure through lung compliance and chest wall compliance.

一实施例中，所述呼吸监测方法还包括：通过在呼气末正压为零和非零的状态下的食道压和胃内压对所述跨膈压进行校正。In an embodiment, the breathing monitoring method further includes: correcting the transdiaphragmatic pressure by the esophageal pressure and the intragastric pressure in a state where the positive end-expiratory pressure is zero and non-zero.

一实施例中，所述气体流速至少包括吸气流速。In an embodiment, the gas flow rate includes at least an inhalation flow rate.

一实施例中所述根据获取的压力和气体流速计算机械通气过程中作用于患者呼吸***的能量，包括：In an embodiment, the calculation of the energy acting on the patient's respiratory system during mechanical ventilation based on the acquired pressure and gas flow rate includes:

对压力和气体流速进行积分运算，以得到机械通气过程中作用于患者呼吸***的能量。Integrate the pressure and gas flow rate to obtain the energy that acts on the patient's respiratory system during mechanical ventilation.

一实施例中所述对压力和气体流速进行积分运算，包括：The integral operation of pressure and gas flow rate in an embodiment includes:

对压力和气体流速在预设单位时间内进行积分；或者，Integrate pressure and gas flow rate within a preset unit time; or,

对压力和气体流速在一个呼吸周期内进行积分。Integrate pressure and gas flow rate in one breathing cycle.

一实施例中，所述呼吸监测方法还包括：显示所述机械通气作用于患者呼吸***的能量。In an embodiment, the breathing monitoring method further includes: displaying the energy of the mechanical ventilation acting on the patient's respiratory system.

一实施例中，所述显示所述机械通气作用于患者呼吸***的能量，包括：显示机械通气作用于患者呼吸***的能量的实时数值和/或显示机械通气作用于患者呼吸***的能量随时间的变化。In an embodiment, the displaying the energy of the mechanical ventilation acting on the patient's respiratory system includes: displaying the real-time value of the energy of the mechanical ventilation acting on the patient's respiratory system and/or displaying the energy of the mechanical ventilation acting on the patient's respiratory system over time The change.

一实施例中，所述呼吸监测方法还包括：根据机械通气作用于患者呼吸***的能量来进行报警。In an embodiment, the breathing monitoring method further includes: alarming based on the energy of the mechanical ventilation acting on the patient's respiratory system.

一实施例中，所述根据机械通气作用于患者呼吸***的能量来进行报警，包括：In an embodiment, the alarming based on the energy of the mechanical ventilation acting on the patient's respiratory system includes:

当判断机械通气作用于患者呼吸***的能量超过第一阈值时，进行报警；和/或，When it is determined that the energy of the mechanical ventilation acting on the patient's respiratory system exceeds the first threshold, an alarm is issued; and/or,

当判断机械通气作用于患者呼吸***的能量低于第二阈值时，进行报警。When it is judged that the energy of the mechanical ventilation acting on the patient's respiratory system is lower than the second threshold, an alarm is issued.

一实施例中，所述呼吸监测方法还包括：根据机械通气作用于患者呼吸***的能量判断患者病情。In an embodiment, the breathing monitoring method further includes: judging the patient's condition based on the energy of the mechanical ventilation acting on the patient's respiratory system.

一实施例中，所述根据机械通气作用于患者呼吸***的能量判断患者病情，包括：In an embodiment, the judging the patient's condition based on the energy of the mechanical ventilation acting on the patient's respiratory system includes:

根据所述机械通气作用于患者呼吸***的能量的实时值和/或变化趋势来判断患者病情。The patient's condition is judged according to the real-time value and/or change trend of the energy of the mechanical ventilation acting on the patient's respiratory system.

根据第二方面，一种实施例提供一种呼吸监测装置，包括：According to a second aspect, an embodiment provides a breathing monitoring device, including:

压力传感器，采集在通气过程中患者的压力，所述压力反映通气过程中作用于患者呼吸***不同位点的压力；A pressure sensor that collects the pressure of the patient during the ventilation process, and the pressure reflects the pressure acting on different points of the patient's respiratory system during the ventilation process;

流量传感器，采集患者在通气过程中的气体流速；Flow sensor, which collects the gas flow rate of the patient during the ventilation process;

处理器，用于获取在通气过程中患者的压力和患者在通气过程中的气体流速，并根据获取的压力和气体流速计算机械通气过程中作用于患者呼吸***的能量。The processor is used to obtain the pressure of the patient during the ventilation process and the gas flow rate of the patient during the ventilation process, and calculate the energy acting on the respiratory system of the patient during the mechanical ventilation process according to the obtained pressure and gas flow rate.

一实施例中，所述处理器通过在呼气末正压为零和非零的状态下的气道压和食道压对所述跨肺压进行校正。In an embodiment, the processor corrects the transpulmonary pressure by airway pressure and esophageal pressure when the positive end expiratory pressure is zero and non-zero.

一实施例中，所述处理器通过肺顺应性和胸壁顺应性来对所述跨肺压力进行校正。In an embodiment, the processor corrects the transpulmonary pressure through lung compliance and chest wall compliance.

一实施例中，所述处理器通过在呼气末正压为零和非零的状态下的食道压和胃内压对所述跨膈压进行校正。In an embodiment, the processor corrects the transdiaphragmatic pressure through the esophageal pressure and the intragastric pressure in a state where the positive end-expiratory pressure is zero and non-zero.

一实施例中，所述处理器对压力和气体流速进行积分运算，以得到机械通气过程中作用于患者呼吸***的能量。In one embodiment, the processor integrates the pressure and the gas flow rate to obtain the energy that acts on the patient's respiratory system during mechanical ventilation.

一实施例中，所述处理器对压力和气体流速在预设单位时间内进行积分；或者，所述处理器对压力和气体流速在一个呼吸周期内进行积分。In an embodiment, the processor integrates pressure and gas flow rate within a preset unit time; or, the processor integrates pressure and gas flow rate within one breathing cycle.

一实施例中，所述呼吸监测装置还包括显示器，用于显示所述机械通气作用于患者呼吸***的能量。In an embodiment, the breathing monitoring device further includes a display for displaying the energy of the mechanical ventilation acting on the patient's respiratory system.

一实施例中，所述显示器显示机械通气作用于患者呼吸***的能量的实时数值和/或显示机械通气作用于患者呼吸***的能量随时间的变化。In an embodiment, the display displays the real-time value of the energy of the mechanical ventilation on the respiratory system of the patient and/or displays the change over time of the energy of the mechanical ventilation on the respiratory system of the patient.

一实施例中，所述处理器还根据根据机械通气作用于患者呼吸***的能量来进行报警。In an embodiment, the processor also generates an alarm based on the energy acting on the patient's respiratory system based on mechanical ventilation.

一实施例中，当判断机械通气作用于患者呼吸***的能量超过第一阈值时，所述处理器进行报警。In an embodiment, when it is determined that the energy of the mechanical ventilation acting on the patient's respiratory system exceeds the first threshold, the processor issues an alarm.

一实施例中，当判断机械通气作用于患者呼吸***的能量低于第二阈值时，所述处理器进行报警。In an embodiment, when it is determined that the energy of the mechanical ventilation acting on the patient's respiratory system is lower than the second threshold, the processor issues an alarm.

一实施例中，所述处理器还根据机械通气作用于患者呼吸***的能量判断患者病情。In an embodiment, the processor also judges the patient's condition based on the energy of the mechanical ventilation acting on the patient's respiratory system.

一实施例中，所述处理器根据所述机械通气作用于患者呼吸***的能量的实时值和/或变化趋势来判断患者病情。In an embodiment, the processor judges the patient's condition according to the real-time value and/or change trend of the energy of the mechanical ventilation acting on the patient's respiratory system.

一实施例中，所述呼吸监测装置包括病人监护仪、病人监护模块或医用通气设备。In an embodiment, the breathing monitoring device includes a patient monitor, a patient monitoring module, or medical ventilation equipment.

根据第三方面，一种实施例提供一种计算机可读存储介质，包括程序，所述程序能够被处理器执行以实现如本文中任一实施例所述的方法。According to a third aspect, an embodiment provides a computer-readable storage medium including a program that can be executed by a processor to implement the method as described in any of the embodiments herein.

附图说明Description of the drawings

图1为本申请一种实施例的呼吸监测装置的结构原理图；Figure 1 is a schematic structural diagram of a breathing monitoring device according to an embodiment of the application;

图2为本申请另一种实施例的呼吸监测装置的结构原理图；Figure 2 is a schematic structural diagram of a breathing monitoring device according to another embodiment of the application;

图3为本申请再一种实施例的呼吸监测装置的结构原理图；FIG. 3 is a schematic structural diagram of a breathing monitoring device according to another embodiment of the application;

图4为本申请又一种实施例的呼吸监测装置的结构原理图；4 is a schematic structural diagram of a breathing monitoring device according to another embodiment of this application;

图5为本申请的一种实施例的呼吸监测方法的流程图；FIG. 5 is a flowchart of a breathing monitoring method according to an embodiment of the application;

图6为本申请的另一种实施例的呼吸监测方法的流程图；FIG. 6 is a flowchart of a breathing monitoring method according to another embodiment of the application;

图7为本申请的又一种实施例的呼吸监测方法的流程图；FIG. 7 is a flowchart of a breathing monitoring method according to another embodiment of the application;

图8为本申请的再一种实施例的呼吸监测方法的流程图。FIG. 8 is a flowchart of a breathing monitoring method according to still another embodiment of the application.

具体实施方式Detailed ways

下面通过具体实施方式结合附图对本发明作进一步详细说明。其中不同实施方式中类似元件采用了相关联的类似的元件标号。在以下的实施方式中，很多细节描述是为了使得本申请能被更好的理解。然而，本领域技术人员可以毫不费力的认识到，其中部分特征在不同情况下是可以省略的，或者可以由其他元件、材料、方法所替代。在某些情况下，本申请相关的一些操作并没有在说明书中显示或者描述，这是为了避免本申请的核心部分被过多的描述所淹没，而对于本领域技术人员而言，详细描述这些相关操作并不是必要的，他们根据说明书中的描述以及本领域的一般技术知识即可完整了解相关操作。Hereinafter, the present invention will be further described in detail through specific embodiments in conjunction with the accompanying drawings. Among them, similar elements in different embodiments use related similar element numbers. In the following embodiments, many detailed descriptions are used to make this application better understood. However, those skilled in the art can easily realize that some of the features can be omitted under different circumstances, or can be replaced by other elements, materials, and methods. In some cases, some operations related to this application are not shown or described in the specification. This is to avoid the core part of this application being overwhelmed by excessive descriptions. For those skilled in the art, these are described in detail. Related operations are not necessary, they can fully understand the related operations based on the description in the manual and the general technical knowledge in the field.

另外，说明书中所描述的特点、操作或者特征可以以任意适当的方式结合形成各种实施方式。同时，方法描述中的各步骤或者动作也可以按照本领域技术人员所能显而易见的方式进行顺序调换或调整。因此，说明书和附图中的各种顺序只是为了清楚描述某一个实施例，并不意味着是必须的顺序，除非另有说明其中某个顺序是必须遵循的。In addition, the features, operations, or features described in the specification can be combined in any appropriate manner to form various implementations. At the same time, the steps or actions in the method description can also be sequentially exchanged or adjusted in a manner obvious to those skilled in the art. Therefore, the various sequences in the specification and the drawings are only for clearly describing a certain embodiment, and are not meant to be a necessary sequence, unless a certain sequence is required to be followed unless otherwise stated.

本文中为部件所编序号本身，例如“第一”、“第二”等，仅用于区分所描述的对象，不具有任何顺序或技术含义。而本申请所说“连接”、“联接”，如无特别说明，均包括直接和间接连接(联接)。The serial numbers assigned to the components herein, such as "first", "second", etc., are only used to distinguish the described objects and do not have any sequence or technical meaning. The "connection" and "connection" mentioned in this application include direct and indirect connection (connection) unless otherwise specified.

肺损伤VILI是多种类型的损伤的结合，是由过多的动态应变和能量负荷所造成的，因此本实施例通过计算机械通气过程中作用于患者呼吸***的能量，能够较准确、真实和实时地评价肺损伤。Lung injury VILI is a combination of multiple types of injuries and is caused by excessive dynamic strain and energy load. Therefore, in this embodiment, by calculating the energy acting on the patient’s respiratory system during mechanical ventilation, it can be more accurate, true and accurate. Real-time assessment of lung injury.

本发明一些实施例中公开了一种呼吸监测装置，请参照图1，该呼吸监测装置可以包括压力传感器10、流量传感器30和处理器50。本发明的呼吸监测装置可以应用于多种场合，例如本发明的呼吸监测装置在一些实施例中可以是病人监护仪或病人监护模块等，在一些实施例中可以是医用通气装置，例如呼吸机和麻醉机等，下面分别说明。Some embodiments of the present invention disclose a breathing monitoring device. Please refer to FIG. 1. The breathing monitoring device may include a pressure sensor 10, a flow sensor 30, and a processor 50. The breathing monitoring device of the present invention can be applied to many occasions. For example, the breathing monitoring device of the present invention may be a patient monitor or a patient monitoring module in some embodiments, and may be a medical ventilation device, such as a ventilator, in some embodiments. And anesthesia machines, etc., are explained separately below.

一些实施例中呼吸监测装置可以是病人监护仪。In some embodiments, the breathing monitoring device may be a patient monitor.

请参照图2，一些实施例中呼吸监测装置可以具有独立的外壳，外壳面板上可以具有传感器接口区，其中传感器接口区可以集成多个传感器接口，用于与外部的各个生理参数传感器附件111连接，以及一些实施例中还可以用与压力传感器10和流量传感器30连接。外壳面板上还可以包括小型IXD显示器区、显示器70、输入接口电路122和报警电路120(如LED报警区)等中的一个或多个。呼吸监测装置具有用于与病人监护仪、呼吸机、麻醉机等医疗设备主机进行通讯和从医疗设备主机取电的对外通讯接口119和电源接口116。呼吸监测装置还可以支持外插参数模块，可以通过***参数模块形成插件式监护仪主机，作为监护仪的一部分，也可以通过电缆与主机连接，外插参数模块作为监护仪外置的一个配件。呼吸监测装置的内部电路置于外壳内，可以包括一个或多个生理参数对应的信号采集电路112和前端信号处理电路113，信号采集电路112可以选自于心电电路、呼吸电路、体温电路、血氧电路、无创血压电路和有创血压电路等等，这些信号采集电路112分别与相应的传感器接口电连接，用于电连接到不同的生理参数对应的传感器附件111，其输出端耦合到前端信号处理电路113，前端信号处理电路113的通讯口耦合到处理器50，处理器50与对外通讯接口119和电源接口116电连接。各种生理参数对应的传感器附件111和信号采集电路112可采用现有技术中的通用电路，前端信号处理电路113完成信号采集电路112输出信号的采样和模数转换，并输出控制信号控制生理信号的测量过程，这些参数包括但不限于：心电，呼吸，体温，血氧，无创血压和有创血压参数。前端信号处理电路113可采用单片机或其它半导体器件实现，例如可以选用PHLIPS公司的LPC2136，或者ADI的ADuC7021等混合信号单片机，也可以采用ASIC或FPGA实现。前端信号处理电路113可由隔离电源供电，采样得到的数据经过简单处理打包后，通过隔离通讯接口发送至处理器50，例如前端信号处理电路113可以通过隔离电源接口114和通讯接口115耦合到处理器50上。前端信号处理电路113由隔离电源供电的原因是通过变压器隔离的DC/DC电源，起到了隔离患者与供电设备的作用，主要目的是：1、隔离患者，通过隔离变压器，将应用部分浮地，使患者漏电流足够小；2、防止除颤或电刀应用时的电压或能量影响主控板等中间电路的板卡及器件(用爬电距离和电气间隙保证)。当然，前端信号处理电路113还可以通过电缆直接与处理器50连接。处理器50用于完成生理参数的计算，并通过对外通讯接口119将参数的计算结果和波形发送到主机(如带显示器的主机、PC机、中央站等等)；其中处理器50可以通过电缆直接与对外通讯接口119连接以进行通讯，以及通过电缆直接与电源接口116连接以进行取电；呼吸监测装置还可以包括电源和电池管理电路117，电源和电池管理电路117通过电源接口116从主机取电，并经过处理后供应给处理器50，例如整流和滤波等；电源和电池管理电路117还可以对通过电源接口116从主机所取得的电进行监测、管理和供电保护。对外通讯接口119可以是以太网(Ethernet)、令牌环(Token Ring)、令牌总线(Token Bus)以及作为这三种网的骨干网光纤分布数据接口(FDDI)构成的局域网接口中的一个或其组合，还可以是红外、蓝牙、wifi、WMTS通讯等无线接口中的一个或其组合，或者还可以是RS232、USB等有线数据连接接口中的一个或其组合。对外通讯接口119也可以是无线数据传输接口和有线数据传输接口中的一种或两种的组合。主机可以是监护仪的主机、计算机等任何一个计算机设备，安装配合的软件，就能够组成一个监护设备。主机还可以是通讯设备，例如手机，呼吸监测装置通过蓝牙接口将数据发送到支持蓝牙通讯的手机上，实现数据的远程传输。处理器50完成生理参数的计算后，还可判断生理参数是否异常，若异常，可以通过报警电路120进行报警。存储器118可以存储监护仪的中间和最终的数据，以及存储用于被处理器50等执行的程序指令或代码。若监护仪具有血压测量的功能，则还可以包括一个泵阀驱动电路121，泵阀驱动电路121用于在处理器50的控制下进行充气或放气操作。Referring to FIG. 2, in some embodiments, the breathing monitoring device may have an independent housing, and the housing panel may have a sensor interface area, where the sensor interface area may integrate multiple sensor interfaces for connecting with various external physiological parameter sensor attachments 111 , And can also be used to connect with the pressure sensor 10 and the flow sensor 30 in some embodiments. The shell panel may also include one or more of a small LCD display area, a display 70, an input interface circuit 122, and an alarm circuit 120 (such as an LED alarm area). The respiration monitoring device has an external communication interface 119 and a power interface 116 for communicating with the host of medical equipment such as patient monitors, ventilators, anesthesia machines, and taking power from the host of medical equipment. The respiratory monitoring device can also support an external plug-in parameter module. The plug-in monitor host can be formed by inserting the parameter module as a part of the monitor, or it can be connected to the host via a cable. The external plug-in parameter module is used as an external accessory of the monitor. The internal circuit of the breathing monitoring device is placed in the housing, and may include one or more signal acquisition circuits 112 corresponding to physiological parameters and a front-end signal processing circuit 113. The signal acquisition circuits 112 may be selected from the group consisting of electrocardiogram circuits, breathing circuits, body temperature circuits, Blood oxygen circuit, non-invasive blood pressure circuit and invasive blood pressure circuit, etc., these signal acquisition circuits 112 are respectively electrically connected to the corresponding sensor interface for electrical connection to the sensor attachment 111 corresponding to different physiological parameters, and the output terminal is coupled to the front end The signal processing circuit 113 and the communication port of the front-end signal processing circuit 113 are coupled to the processor 50, and the processor 50 is electrically connected to the external communication interface 119 and the power interface 116. The sensor attachment 111 and the signal acquisition circuit 112 corresponding to various physiological parameters can adopt the general circuit in the prior art. The front-end signal processing circuit 113 completes the sampling and analog-to-digital conversion of the output signal of the signal acquisition circuit 112, and outputs the control signal to control the physiological signal. During the measurement process, these parameters include but are not limited to: ECG, respiration, body temperature, blood oxygen, non-invasive blood pressure and invasive blood pressure parameters. The front-end signal processing circuit 113 can be implemented by a single-chip microcomputer or other semiconductor devices. For example, a mixed-signal single-chip microcomputer such as LPC2136 of PHLIPS or ADuC7021 of ADI can be used, or an ASIC or FPGA can be used. The front-end signal processing circuit 113 can be powered by an isolated power source. The sampled data is simply processed and packaged, and then sent to the processor 50 through an isolated communication interface. For example, the front-end signal processing circuit 113 can be coupled to the processor through an isolated power interface 114 and a communication interface 115. 50 up. The reason why the front-end signal processing circuit 113 is powered by the isolated power supply is that the DC/DC power supply isolated by the transformer plays a role in isolating the patient from the power supply equipment. The main purposes are: 1. Isolate the patient, and float the application part through the isolation transformer. Make the patient's leakage current small enough; 2. Prevent the voltage or energy of defibrillation or electrosurgical application from affecting the boards and devices of the intermediate circuit such as the main control board (guaranteed by creepage distance and electrical clearance). Of course, the front-end signal processing circuit 113 can also be directly connected to the processor 50 through a cable. The processor 50 is used to complete the calculation of physiological parameters, and send the calculation results and waveforms of the parameters to the host (such as a host with a display, a PC, a central station, etc.) through the external communication interface 119; wherein the processor 50 can be connected through a cable It is directly connected to the external communication interface 119 for communication, and is directly connected to the power interface 116 through a cable to obtain power; the respiratory monitoring device may also include a power supply and battery management circuit 117, and the power supply and battery management circuit 117 is from the host through the power interface 116 The power is taken and supplied to the processor 50 after processing, such as rectification and filtering. The power supply and battery management circuit 117 can also monitor, manage and protect the power obtained from the host through the power interface 116. The external communication interface 119 can be one of Ethernet, Token Ring, Token Bus, and a local area network interface composed of the backbone fiber distributed data interface (FDDI) of these three networks. Or a combination thereof may also be one or a combination of wireless interfaces such as infrared, Bluetooth, wifi, and WMTS communication, or may also be one or a combination of wired data connection interfaces such as RS232 and USB. The external communication interface 119 may also be one of a wireless data transmission interface and a wired data transmission interface or a combination of both. The host can be any computer equipment such as the host of the monitor or a computer, and a monitoring device can be formed by installing the matching software. The host may also be a communication device, such as a mobile phone. The respiratory monitoring device sends data to a mobile phone that supports Bluetooth communication through a Bluetooth interface to realize remote data transmission. After the processor 50 completes the calculation of the physiological parameter, it can also determine whether the physiological parameter is abnormal, and if it is abnormal, the alarm circuit 120 can be used to give an alarm. The memory 118 can store intermediate and final data of the monitor, and store program instructions or codes for execution by the processor 50 and the like. If the monitor has a blood pressure measurement function, it may also include a pump valve drive circuit 121, which is used to perform inflation or deflation operations under the control of the processor 50.

以上是呼吸监测装置为病人监护仪的一些说明。The above are some descriptions of the respiratory monitoring device as a patient monitor.

一些实施例中呼吸监测装置也可以是呼吸机，呼吸机是一种人工的机械通气装置，用以辅助或控制患者的自主呼吸运动，以达到肺内气体交换的功能，降低人体的消耗，以利于呼吸功能的恢复。请参照图3，一些实施例中呼吸监测装置还可以包括呼吸接口211、气源接口212、呼吸回路、呼吸辅助装置和显示器70。In some embodiments, the breathing monitoring device may also be a ventilator. The ventilator is an artificial mechanical ventilation device used to assist or control the patient's autonomous breathing exercise to achieve the function of gas exchange in the lungs and reduce the consumption of the human body. Conducive to the recovery of respiratory function. Please refer to FIG. 3, in some embodiments, the breathing monitoring device may further include a breathing interface 211, an air source interface 212, a breathing circuit, a breathing assist device, and a display 70.

呼吸回路将气源接口212和患者的呼吸***选择性连通。一些实施例中呼吸回路包括呼气支路213a和吸气支路213b，呼气支路213a连接在呼吸接口211和排气口213c之间，用于将患者呼出的气导出到排气口213c。排气口213c可以通到外界环境，也可以通道专用的气体回收装置中。气源接口212用于与气源(图中未示出)连接，气源用以提供气体，该气体通常可采用氧气和空气等；一些实施例中，该气源可以采用压缩气瓶或中心供气源，通过气源接口212为呼吸机供气，供气种类有氧气O2和空气等，气源接口212中可以包括压力表、压力调节器、流量计、减压阀和空气-氧气比例调控保护装置等常规组件，分别用于控制各种气体(例如氧气和空气)的流量。吸气支路213b连接在呼吸接口211和气源接口212之间，用于为患者提供氧气或空气，例如从气源接口212输入的气体进入吸气支路213b中，然后通过呼吸接口211进入患者的肺部。呼吸接口211是用于将患者连接到呼吸回路，除了将由吸气支路213b传输过来的气体导入到患者外，还可以将患者呼出的气体通过呼气支路213a导入到排气口213c；根据情况，呼吸接口211可以是鼻插管或用于佩戴在口鼻上的面罩。呼吸辅助装置与气源接口212和呼吸回路连接，控制将外部气源提供的气体通过所述呼吸回路输送给患者；一些实施例中呼吸辅助装置可以包括呼气控制器214a和吸气控制器214b，呼气控制器214a设置在呼气支路213a上，用于根据控制指令接通呼气支路213a或关闭呼气支路213a，或控制患者呼出气体的流速或压力。具体实现时，呼气控制器214a可以包括呼气阀、单向阀、流量控制器、PEEP阀等能实现对流量或压力控制的器件中的一个或多个。吸气控制器214b设置在吸气支路213b上，用于根据控制指令接通吸气支路213b或关闭吸气支路213b，或控制输出气体的流速或压力。具体实现时，吸气控制器214b可以包括呼气阀、单向阀或流量控制器等能实现对流量或压力控制的器件中的一个或多个。The breathing circuit selectively communicates the air source interface 212 with the patient's breathing system. In some embodiments, the breathing circuit includes an expiratory branch 213a and an inspiratory branch 213b. The expiratory branch 213a is connected between the breathing interface 211 and the exhaust port 213c, and is used to export the patient's exhaled air to the exhaust port 213c. . The exhaust port 213c may be open to the external environment, or may be a channel dedicated to a gas recovery device. The gas source interface 212 is used to connect with a gas source (not shown in the figure). The gas source is used to provide gas. The gas can usually be oxygen, air, etc.; in some embodiments, the gas source can be a compressed gas cylinder or a center The air supply source, which supplies air to the ventilator through the air source interface 212. The types of air supply include oxygen O2 and air. The air source interface 212 can include pressure gauges, pressure regulators, flow meters, pressure reducing valves and air-oxygen ratios. Conventional components such as regulation and protection devices are used to control the flow of various gases (such as oxygen and air). The inspiratory branch 213b is connected between the breathing interface 211 and the air source interface 212 to provide oxygen or air to the patient. For example, the gas input from the air source interface 212 enters the inspiratory branch 213b, and then enters through the breathing interface 211 The patient's lungs. The breathing interface 211 is used to connect the patient to the breathing circuit. In addition to introducing the gas transmitted from the inspiratory branch 213b to the patient, the patient's exhaled gas can also be introduced to the exhaust port 213c through the expiratory branch 213a; In some cases, the breathing interface 211 may be a nasal cannula or a mask for wearing on the nose and mouth. The breathing assist device is connected to the air source interface 212 and the breathing circuit, and controls the gas provided by the external air source to be delivered to the patient through the breathing circuit; in some embodiments, the breathing assist device may include an exhalation controller 214a and an inhalation controller 214b The exhalation controller 214a is arranged on the exhalation branch 213a, and is used to switch on the exhalation branch 213a or close the exhalation branch 213a according to the control instruction, or to control the flow rate or pressure of the patient's exhaled air. In specific implementation, the exhalation controller 214a may include one or more of the exhalation valve, one-way valve, flow controller, PEEP valve and other devices capable of controlling flow or pressure. The inhalation controller 214b is arranged on the inhalation branch 213b, and is used to switch on the inspiratory branch 213b or close the inspiratory branch 213b according to a control command, or to control the flow rate or pressure of the output gas. In a specific implementation, the inhalation controller 214b may include one or more of devices capable of controlling flow or pressure, such as an exhalation valve, a one-way valve, or a flow controller.

存储器215可以用于存储数据或者程序，例如用于存储传感器所采集的数据、处理器经计算所生成的数据或处理器所生成的图像帧，该图像帧可以是2D或3D图像，或者存储器215可以存储图形用户界面、一个或多个默认图像显示设置、用于处理器的编程指令。存储器215可以是有形且非暂态的计算机可读介质，例如闪存、RAM、ROM、EEPROM等。The memory 215 may be used to store data or programs, for example, to store data collected by the sensor, data generated by the processor through calculation, or image frames generated by the processor. The image frames may be 2D or 3D images, or the memory 215 A graphical user interface, one or more default image display settings, and programming instructions for the processor can be stored. The memory 215 may be a tangible and non-transitory computer-readable medium, such as flash memory, RAM, ROM, EEPROM, and so on.

一些实施例中处理器50用于执行指令或程序，对呼吸辅助装置、气源接口212和/或呼吸回路中的各种控制阀进行控制，或对接收的数据进行处理，生成所需要的计算或判断结果，或者生成可视化数据或图形，并将可视化数据或图形输出给显示器70进行显示。In some embodiments, the processor 50 is used to execute instructions or programs to control various control valves in the breathing assist device, the air source interface 212 and/or the breathing circuit, or process the received data to generate the required calculations Or judge the result, or generate visualization data or graphics, and output the visualization data or graphics to the display 70 for display.

以上是呼吸监测装置为呼吸机的一些描述，需要说明的是，上面图 3只是呼吸机的一种例子，这并不用于限定呼吸机只能是如此的结构。The above is some descriptions of the breathing monitoring device as a ventilator. It should be noted that the above Figure 3 is just an example of the ventilator, which is not used to limit the ventilator to only this structure.

一些实施例中呼吸监测装置也可以是麻醉机，该麻醉机主要用于提供麻醉气体，并将麻醉气体通过呼吸器送至患者的呼吸***，并对麻醉气体吸入量进行控制。请参照图4，一些实施例的呼吸监测装置还可以包括呼吸接口311、气源接口312、呼吸辅助装置320、麻药输出装置330、呼吸回路、存储器350和显示器70。In some embodiments, the breathing monitoring device may also be an anesthesia machine, which is mainly used to provide anesthetic gas and deliver the anesthetic gas to the patient's respiratory system through a respirator, and control the inhalation of anesthetic gas. 4, the breathing monitoring device of some embodiments may further include a breathing interface 311, a gas source interface 312, a breathing assist device 320, an anesthetic output device 330, a breathing circuit, a memory 350, and a display 70.

气源接口312用于与气源(图中未示出)连接，气源用以提供气体。该气体通常可采用氧气、氧化亚氮(笑气)或空气等。一些实施例中，该气源可以采用压缩气瓶或中心供气源，通过气源接口312为麻醉机供气，供气种类有氧气O2、笑气N2O、空气等。气源接口312中可以包括压力表、压力调节器、流量计、减压阀和N2O-O2比例调控保护装置等常规组件，分别用于控制各种气体(例如氧气、笑气和空气)的流量。气源接口312输入的气体进入呼吸回路中，和呼吸回路中原有的气体组成混合气体。The gas source interface 312 is used to connect with a gas source (not shown in the figure), and the gas source is used to provide gas. The gas can usually be oxygen, nitrous oxide (laughing gas), or air. In some embodiments, the gas source may be a compressed gas cylinder or a central gas supply source, and the anesthesia machine is supplied with gas through the gas source interface 312. The gas supply types include oxygen O2, laughing gas N2O, and air. The gas source interface 312 can include conventional components such as pressure gauges, pressure regulators, flow meters, pressure reducing valves, and N2O-O2 proportional control and protection devices, which are used to control the flow of various gases (such as oxygen, laughing gas, and air). . The gas input from the gas source interface 312 enters the breathing circuit and forms a mixed gas with the original gas in the breathing circuit.

呼吸辅助装置320用于为患者的非自主呼吸提供动力，维持气道通畅。一些实施例中呼吸辅助装置320与气源接口312和呼吸回路连接，控制将外部气源提供的气体通过所述呼吸回路输送给患者。一些具体实施例中，呼吸辅助装置320将气源接口312输入的新鲜气体和呼吸回路中患者呼出的气体以及麻药输出装置330输出的***物混合后经吸气支路340b输出到呼吸接口311，以驱动患者吸气，并通过呼气支路340a接收患者呼出的气体。在具体实施例中，呼吸辅助装置320通常包括机控通气模块，机控通气模块的气流管道和呼吸回路连通。在手术过程中的麻醉维持阶段或患者未恢复自主呼吸的状态下，采用机控通气模块为患者提供呼吸的动力。在有的实施例中，呼吸辅助装置320还包括手动通气模块，手动通气模块的气流管道和呼吸回路连通。在手术过程中对患者插管之前的诱导阶段，通常需要采用手动通气模块对患者进行呼吸辅助。当呼吸辅助装置320同时包括机控通气模块和手动通气模块时，可通过机控或手控开关(例如一个三通阀)来切换机控或手动通气模式，以便将机控通气模块或手动通气模块和呼吸回路连通，从而控制患者的呼吸。本领域技术人员应当理解，可以根据具体的需要，麻醉机中可以只包括机控通气模块或手动通气模块。The breathing assist device 320 is used to provide power for the patient's involuntary breathing and maintain the airway patency. In some embodiments, the breathing assist device 320 is connected to the air source interface 312 and the breathing circuit, and controls the gas provided by the external air source to be delivered to the patient through the breathing circuit. In some specific embodiments, the breathing assist device 320 mixes the fresh gas input from the air source interface 312 with the gas exhaled by the patient in the breathing circuit and the anesthetic drug output from the anesthetic output device 330 and then outputs the mixture to the breathing interface 311 through the inhalation branch 340b. To drive the patient to inhale, and to receive the patient's exhaled air through the exhalation branch 340a. In a specific embodiment, the breathing assistance device 320 usually includes a machine-controlled ventilation module, and the airflow pipe of the machine-controlled ventilation module is in communication with the breathing circuit. In the maintenance phase of anesthesia during the operation or when the patient has not resumed spontaneous breathing, the machine-controlled ventilation module is used to provide the patient with breathing power. In some embodiments, the breathing assist device 320 further includes a manual ventilation module, and the airflow pipe of the manual ventilation module is in communication with the breathing circuit. In the induction phase before intubating the patient during the operation, it is usually necessary to use a manual ventilation module to assist the patient in breathing. When the breathing assist device 320 includes both a machine-controlled ventilation module and a manual ventilation module, the machine-controlled or manual ventilation mode can be switched through a machine-controlled or manual switch (such as a three-way valve), so that the machine-controlled ventilation module or manual ventilation mode can be switched The module is connected with the breathing circuit to control the patient's breathing. Those skilled in the art should understand that, according to specific needs, the anesthesia machine may only include a machine-controlled ventilation module or a manual ventilation module.

麻药输出装置330用于提供***物，通常情况下，***物以气体的形式混合到气源接口312引入的新鲜空气中，并被一起输送到呼吸回路中。在一种具体实施例中，麻药输出装置330采用麻药挥发罐实现。麻药通常为液态，存储在麻药挥发罐中，可选的，麻药挥发罐中可包括加热装置，用于加热麻药使之挥发，产生麻药蒸汽，麻药输出装置330与气源接口312的管路连通，麻药蒸汽和气源接口312引入的新鲜空气混合，然后被一起输送到呼吸回路中。The anesthetic output device 330 is used to provide an anesthetic. Generally, the anesthetic is mixed into the fresh air introduced by the air source interface 312 in the form of gas, and is delivered to the breathing circuit together. In a specific embodiment, the anesthetic output device 330 is realized by an anesthetic volatilization tank. The anesthetic is usually liquid and stored in the anesthetic vaporization tank. Optionally, the anesthetic vaporization tank may include a heating device for heating the anesthetic to volatilize and generate anesthetic vapor. The anesthetic output device 330 is connected to the pipeline of the gas source interface 312 , The anesthetic vapor is mixed with the fresh air introduced by the air source interface 312, and then is delivered to the breathing circuit together.

一些实施例中呼吸回路可以包括吸气支路340b、呼气支路340a和钠石灰罐340c，吸气支路340b和呼气支路340a连通构成一闭合回路，钠石灰罐340c设置在呼气支路340a的管路上。气源接口312引入的新鲜空气的混合气体由吸气支路340b的入口输入，通过设置在吸气支路340b的出口处的呼吸接口311提供给患者。呼吸接口311可以是面罩、鼻插管或气管插管。在较佳的实施例中，吸气支路340b上设置有单向阀，该单向阀在吸气相时打开，在呼气相时关闭。呼气支路340a也上设置有单向阀，该单向阀在吸气相时关闭，在呼气相时打开。呼气支路340a的入口和呼吸接口311连通，当患者呼气时，呼出的气体经呼气支路340a进入钠石灰罐340c中，呼出的气体中的二氧化碳被钠石灰罐340c中的物质滤除，滤除二氧化碳后的气体再循环进入吸气支路340b中。In some embodiments, the breathing circuit may include an inspiratory branch 340b, an expiratory branch 340a, and a soda lime tank 340c. The inspiratory branch 340b and the expiratory branch 340a are connected to form a closed circuit, and the soda lime tank 340c is set on the expiratory On the pipeline of branch 340a. The mixed gas of fresh air introduced by the air source interface 312 is input from the inlet of the inspiratory branch 340b, and is provided to the patient through the breathing interface 311 provided at the outlet of the inspiratory branch 340b. The breathing interface 311 may be a mask, a nasal cannula, or a tracheal cannula. In a preferred embodiment, the inhalation branch 340b is provided with a one-way valve, which is opened during the inhalation phase and closed during the expiration phase. The exhalation branch 340a is also provided with a one-way valve, which is closed during the inhalation phase and opened during the expiration phase. The inlet of the expiratory branch 340a is connected to the breathing interface 311. When the patient exhales, the exhaled gas enters the soda lime tank 340c through the expiratory branch 340a, and the carbon dioxide in the exhaled gas is filtered by the substance in the soda lime tank 340c. The gas after the carbon dioxide is filtered out is recycled into the inhalation branch 340b.

存储器350可以用于存储数据或者程序，例如用于存储各传感器所采集的数据、处理器经计算所生成的数据或处理器所生成的图像帧，该图像帧可以是2D或3D图像，或者存储器350可以存储图形用户界面、一个或多个默认图像显示设置、用于处理器的编程指令。存储器350可以是有形且非暂态的计算机可读介质，例如闪存、RAM、ROM、EEPROM等。The memory 350 may be used to store data or programs, for example, to store data collected by various sensors, data generated by the processor through calculation, or image frames generated by the processor. The image frames may be 2D or 3D images, or memory 350 can store a graphical user interface, one or more default image display settings, programming instructions for the processor. The memory 350 may be a tangible and non-transitory computer-readable medium, such as flash memory, RAM, ROM, EEPROM, and so on.

处理器50用于执行指令或程序，对呼吸辅助装置320、气源接口310和/或呼吸回路中的各种控制阀进行控制，或对接收的数据进行处理，生成所需要的计算或判断结果，或者生成可视化数据或图形，并将可视化数据或图形输出给显示器70进行显示。The processor 50 is used to execute instructions or programs to control the breathing assist device 320, the air source interface 310 and/or various control valves in the breathing circuit, or process the received data to generate the required calculation or judgment results , Or generate visualization data or graphics, and output the visualization data or graphics to the display 70 for display.

以上是呼吸监测装置为麻醉机的一些描述，需要说明的是，上面图4只是麻醉机的一种例子，这并不用于限定麻醉机只能是如此的结构。The above is some descriptions of the breathing monitoring device as an anesthesia machine. It should be noted that the above Figure 4 is only an example of an anesthesia machine, which is not used to limit the anesthesia machine to only such a structure.

下面对呼吸监测装置如何计算以及使用机械通气过程中作用于患者呼吸***的能量进行说明。The following describes how the respiratory monitoring device calculates and uses the energy that acts on the patient's respiratory system during mechanical ventilation.

流量传感器30用于采集患者在通气过程中的气体流速。一些实施例中，患者在通气过程中的气体流速至少包括患者的吸气流速。一些实施例中，流量传感器30可以是设置于患者端的流量传感器，例如设置于患者接口处的流量传感器，所述气体流速为该流量传感器在吸气期间所采集的气体流速。一些实施例中，流量传感器30的数量为多个，包括设置于机械通气端的吸气流量传感器和呼气流量传感器，例如对于呼吸机来讲，可以是设置于吸气支路213b中的吸气流量传感器和设置于呼气支路213a中的呼气流量传感器，对于麻醉机来讲，可以是设置于吸气支路340b中的吸气流量传感器和设置于呼气支路340a中的呼气流量传感器；所述气体流速为所述吸气流量传感器和呼气流量传感器在吸气期间所采集的流速的差。一些实施例中流量传感器30也可以是Ypiece流量传感器，通过直接测量病人端流进和流出的流速作为所述气体流速。当然，机械通气过程中作用于患者呼吸***的能量可以考虑用整个呼吸期间的气体流速来计算，包括吸气期间和呼气期间的气体流速。The flow sensor 30 is used to collect the gas flow rate of the patient during the ventilation process. In some embodiments, the gas flow rate of the patient during ventilation includes at least the patient's inspiratory flow rate. In some embodiments, the flow sensor 30 may be a flow sensor disposed at the patient end, such as a flow sensor disposed at the patient interface, and the gas flow rate is the gas flow rate collected by the flow sensor during inhalation. In some embodiments, the number of flow sensors 30 is multiple, including an inspiratory flow sensor and an expiratory flow sensor arranged at the mechanical ventilation end. For example, for a ventilator, it may be an inspiratory set in the inspiratory branch 213b. The flow sensor and the expiratory flow sensor arranged in the expiratory branch 213a, for the anesthesia machine, can be an inspiratory flow sensor arranged in the inspiratory branch 340b and an expiratory flow sensor arranged in the expiratory branch 340a Flow sensor; the gas flow rate is the difference between the flow rate collected by the inspiratory flow sensor and the expiratory flow sensor during inhalation. In some embodiments, the flow sensor 30 may also be a Ypiece flow sensor, which directly measures the flow rate of the gas flowing in and out of the patient end as the gas flow rate. Of course, the energy that acts on the patient's respiratory system during mechanical ventilation can be calculated using the gas flow rate during the entire respiration period, including the gas flow rate during inhalation and expiration.

一些实施例中压力传感器10的数量为一个或多个。压力传感器10用于采集在通气过程中患者的压力，所述压力反映通气过程中作用于患者呼吸***不同位点的压力——例如气道压、胸腔内压、隆突压、肺内压、食道压和胃内压中的一种或多种。In some embodiments, the number of pressure sensors 10 is one or more. The pressure sensor 10 is used to collect the pressure of the patient during the ventilation process, and the pressure reflects the pressure acting on different points of the patient's respiratory system during the ventilation process-such as airway pressure, intrathoracic pressure, carina pressure, intrapulmonary pressure, One or more of esophageal pressure and intragastric pressure.

一些实施例中，压力传感器10可以是导管式压力传感器或者光纤式压力传感器等，通过将压力传感器伸入到患者呼吸***相应位点，就可以采取到相应位点的压力。例如将压力传感器伸入到患者的气道则可以采集到气道压，将压力传感器伸入到食道中则可以采集到食道压，将压力传感器伸入到胃内则可以采集到胃内压，将压力传感器伸入到气管内部的隆突处，则可以采集到隆突压，将压力传感器伸入到胃内则可以采集到胃内压，将压力传感器通过创切口等伸入到胸腔内则可以采集到胸腔内压。当然，也可以采用食道压来近似替代胸腔内压。一些实施例中还可以通过呼吸***中一些位点的压力来代替或计算其他一些位点的压力，下面通过几个例子来说明。In some embodiments, the pressure sensor 10 may be a catheter pressure sensor or an optical fiber pressure sensor. By extending the pressure sensor to a corresponding point in the patient's respiratory system, the pressure at the corresponding point can be taken. For example, if the pressure sensor is inserted into the patient’s airway, the airway pressure can be collected, if the pressure sensor is inserted into the esophagus, the esophageal pressure can be collected, and if the pressure sensor is inserted into the stomach, the intragastric pressure can be collected. The pressure sensor can be inserted into the carina inside the trachea to collect the carina pressure, the pressure sensor can be inserted into the stomach to collect the intragastric pressure, and the pressure sensor can be inserted into the chest cavity through a wound incision. The intrathoracic pressure can be collected. Of course, esophageal pressure can also be used to approximate the intrathoracic pressure. In some embodiments, the pressure at some points in the respiratory system can also be used to replace or calculate the pressure at some other points, which will be illustrated by a few examples below.

一些实施例中，可以采用隆突压来代替肺内压。一些实施例中，可以采取食道压来代替胸腔内压。一些实施例中，可以采用胃内压代替腹内压。In some embodiments, carina pressure may be used instead of intrapulmonary pressure. In some embodiments, esophageal pressure can be used instead of intrathoracic pressure. In some embodiments, intragastric pressure may be used instead of intraabdominal pressure.

一些实施例中，处理器50可以基于气道压来计算肺内压。例如一些实施例中，处理器50通过气道压、呼吸***阻力和上述的气体流速来进行肺内压的计算。一个具体的例子中，可以通过下面的公式来计算：In some embodiments, the processor 50 may calculate intrapulmonary pressure based on airway pressure. For example, in some embodiments, the processor 50 calculates the intrapulmonary pressure based on airway pressure, respiratory system resistance, and the aforementioned gas flow rate. In a specific example, it can be calculated by the following formula:

Plung(t)＝Paw(t)-Raw*Flow(t)；Plung(t)=Paw(t)-Raw*Flow(t);

其中Plung(t)指肺内压随时间t变化的函数，或者说是实时肺内压；Paw(t)指气道压随时间t变化的函数，或者说是实时气道压；Flow(t)是患者在通气过程中的气体流速随时间t变化的函数，或者说是患者在通气过程中的实时气体流速；PEEP为呼气末气道正压，单位可以为cmH ₂O；Raw为呼吸***阻力。 Among them, Plung(t) refers to the function of the change of intrapulmonary pressure with time t, or real-time intrapulmonary pressure; Paw(t) refers to the function of the change of airway pressure with time t, or real-time airway pressure; Flow(t ) Is a function of the patient’s gas flow rate during ventilation with time t, or the patient’s real-time gas flow rate during ventilation; PEEP is the positive end-expiratory airway pressure, and the unit can be cmH ₂ O; Raw is breathing System resistance.

一些实施例中，处理器50可以通过肺内压或气道压中任意一者，减去食道压或胸腔内压中任意一者，来计算得到跨肺压。例如通过将气道压减去食道压来得到跨肺压。一些实施例中，处理器50还可以对跨肺压进行校正，下面具体说明。In some embodiments, the processor 50 may calculate the transpulmonary pressure by subtracting any one of the intrapulmonary pressure or the airway pressure from the esophageal pressure or the intrathoracic pressure. For example, the transpulmonary pressure can be obtained by subtracting the esophageal pressure from the airway pressure. In some embodiments, the processor 50 may also correct the transpulmonary pressure, which will be described in detail below.

在一些实施例中，处理器50还通过在呼气末正压为零和非零的状态下的气道压力值和食道压力值来对跨肺压进行校正；具体地，处理器50获取呼气末正压为非零的状态下的气道压Paw _PEEP和食道压Pes _PEEP，以及获取呼气末正压为零的状态下的气道压Paw _ZEEP和食道压Pes _ZEEP；处理器50将跨肺压加上(Paw _PEEP-Paw _ZEEP)并减去(Pes _PEEP-Pes _ZEEP)得到校正后的跨肺压。 In some embodiments, the processor 50 also corrects the transpulmonary pressure through the airway pressure value and the esophageal pressure value in a state where the positive end expiratory pressure is zero and non-zero; specifically, the processor 50 obtains the expiratory pressure value. _{The airway pressure Paw PEEP} and the esophageal pressure Pes _PEEP in the state where the positive end-expiratory pressure is non-zero _{, and the airway pressure Paw ZEEP} and the esophageal pressure Pes _ZEEP in the state where the positive end-expiratory pressure is zero are obtained; the processor 50 will Add (Paw _PEEP- _{Paw ZEEP} ) and subtract (Pes _PEEP- _{Pes ZEEP} ) to the transpulmonary pressure to obtain the corrected transpulmonary pressure.

在一些实施例中，处理器50还通过肺顺应性和胸壁顺应性来对所述跨肺压力值进行校正；具体地，处理器50获取肺顺应性Clung和胸壁顺应性Ccw；需要说明的是，处理器50获取肺顺应性Clung和胸壁顺应性Ccw的方法有多种，例如处理器50可以通过以下公式获取胸壁顺应性Ccw：In some embodiments, the processor 50 also corrects the transpulmonary pressure value through lung compliance and chest wall compliance; specifically, the processor 50 obtains lung compliance Clung and chest wall compliance Ccw; it should be noted that There are multiple methods for the processor 50 to obtain the lung compliance Clung and the chest wall compliance Ccw. For example, the processor 50 can obtain the chest wall compliance Ccw through the following formula:

其中TV为潮气量，PesI为吸气末食道压，PEEP _es为呼气末食道压； Where TV is the tidal volume, PesI is the end-inspiratory esophageal pressure, and PEEP _es is the end-expiratory esophageal pressure;

接着可以通过以下公式计算总顺应性C _state： _{Then the total compliance C state} can be calculated by the following formula:

其中TV为潮气量，Pplat为平台压，PEEP为呼气末气道正压；在计算得到总顺应性C _state和胸壁顺应性Ccw的情况下，可以通过求解下述等式来计算肺顺应性Clung： Where TV is the tidal volume, Pplat is the plateau pressure, and PEEP is the positive end-expiratory airway pressure; when the total compliance C _state and chest wall compliance Ccw are calculated, the lung compliance can be calculated by solving the following equation Clung:

在获取肺顺应性Clung和胸壁顺应性Ccw后，处理器50可以通过以下公式计算误差补偿值：After obtaining the lung compliance Clung and the chest wall compliance Ccw, the processor 50 may calculate the error compensation value by the following formula:

其中ΔPtrans _erro为误差补偿值，Ptrans为跨肺压力值，Plung为肺内压力值； Where ΔPtrans _erro is the error compensation value, Ptrans is the transpulmonary pressure value, and Plung is the intrapulmonary pressure value;

处理器50将跨肺压减去所述误差补偿值得到校正后的跨肺压。The processor 50 subtracts the error compensation value from the transpulmonary pressure to obtain the corrected transpulmonary pressure.

一些实施例中，处理器50可以通过胸腔内压或食道压任意一者，减去腹内压或胃内压中任意一者，来计算得到跨膈压。例如通过将食道压减去胃内压来得到跨膈压。需要说明的是，一些实施例中，将压力传感器通过创切口等伸入到腹部内则可以采集到腹内压。一些实施例中，处理器50还可以对跨膈压进行校正。例如所述处理器50获取呼气末正压为非零的状态下的食道压Pes _PEEP和胃内压Psto _PEEP，以及获取呼气末正压为零的状态下的食道压Pes _ZEEP和胃内压Psto _ZEEP；处理器50将跨膈压加上(Pes _PEEP-Pes _ZEEP)并减去(Psto _PEEP-Psto _ZEEP)得到校正后的跨膈压。 In some embodiments, the processor 50 may calculate the transdiaphragmatic pressure by subtracting any one of the intra-thoracic pressure or the esophageal pressure from the intra-abdominal pressure or the intragastric pressure. For example, the transdiaphragmatic pressure can be obtained by subtracting the intragastric pressure from the esophageal pressure. It should be noted that in some embodiments, the intra-abdominal pressure can be collected by extending the pressure sensor into the abdomen through a wound incision or the like. In some embodiments, the processor 50 may also correct the transdiaphragmatic pressure. For example, the processor 50 obtains the esophageal pressure Pes _PEEP and the gastric pressure Psto _PEEP _{when the positive end expiratory pressure is non-zero, and obtains the esophageal pressure Pes ZEEP} and the gastric pressure when the positive end expiratory pressure is zero. Press Psto _ZEEP ; the processor 50 adds (Pes _PEEP- _{Pes ZEEP} ) and subtracts (Psto _PEEP- Psto ZEEP) to the _{transdiaphragmatic pressure to obtain the corrected transdiaphragmatic pressure.}

以上就是对气道压、胸腔内压、隆突压、肺内压、食道压和胃内压、腹内压、跨肺压和跨膈压的一些说明。The above are some descriptions of airway pressure, intrathoracic pressure, carina pressure, intrapulmonary pressure, esophageal pressure and intragastric pressure, intra-abdominal pressure, transpulmonary pressure and transdiaphragmatic pressure.

本发明中处理器50接收压力传感器30和流量传感器10的信号，根据采集的压力和气体流速计算机械通气过程中作用于患者呼吸***的能量。一些实施例中，处理器50对所采集的压力和气体流速进行积分运算，得到机械通气过程中作用于患者呼吸***的能量。一些实施例中，处理器50对所采集的压力和气体流速在预设单位时间内——例如1分钟进行积分，以获取机械通气作用于患者呼吸***的能量。一些实施例中，处理器50可以对所采集的压力和气体流速在一个呼吸周期内进行积分，以获取机械通气作用于患者呼吸***的能量。或者，处理器50也可以对所采集的压力和气体流速在一个呼吸周期内进行积分并乘以呼吸率，以获取机械通气作用于患者呼吸***的能量。在本文中，这样对一个呼吸周期所采集的压力和气体流速进行积分，再乘以呼吸率做一个简单的统计周期的变化，也属于对所采集的压力和气体流速在一个呼吸周期内进行积分的方式。下面结合呼吸***不同位点的压力来更进一步说明如何计算机械通气作用于患者呼吸***的能量。In the present invention, the processor 50 receives the signals of the pressure sensor 30 and the flow sensor 10, and calculates the energy acting on the patient's respiratory system during the mechanical ventilation process based on the collected pressure and gas flow rate. In some embodiments, the processor 50 integrates the collected pressure and gas flow rate to obtain the energy that acts on the patient's respiratory system during mechanical ventilation. In some embodiments, the processor 50 integrates the collected pressure and gas flow rate within a preset unit time, such as 1 minute, to obtain the energy that the mechanical ventilation acts on the patient's respiratory system. In some embodiments, the processor 50 may integrate the collected pressure and gas flow rate within one breathing cycle to obtain the energy that the mechanical ventilation acts on the patient's respiratory system. Alternatively, the processor 50 may also integrate the collected pressure and gas flow rate within one breathing cycle and multiply it by the breathing rate to obtain the energy that the mechanical ventilation acts on the patient's respiratory system. In this article, integrating the pressure and gas flow rate collected in a breathing cycle, and then multiplying it by the breathing rate to make a simple statistical cycle change, also belongs to integrating the collected pressure and gas flow rate in a breathing cycle. The way. The following is a further explanation of how to calculate the energy of mechanical ventilation acting on the patient's respiratory system by combining the pressure at different points of the respiratory system.

一些实施例中，处理器50根据气道压和气体流速计算机械通气作用于患者呼吸***的能量。例如将气道压和气体流速进行积分运算得到机械通气作用于患者呼吸***的能量，公式如下：In some embodiments, the processor 50 calculates the energy of the mechanical ventilation acting on the patient's respiratory system based on the airway pressure and the gas flow rate. For example, the airway pressure and gas flow rate are integrated to obtain the energy of mechanical ventilation acting on the patient's respiratory system. The formula is as follows:

其中Energy _rs为单个周期由气道压和气体流速积分得到的机械通气作用于患者呼吸***的能量，Tinsp为每个呼吸周期的吸气时间，Paw为气道压，Flow为气体流速。当然也可以将单个周期计算得到的能量结合呼吸率换算成每分钟的量，公式如下： Among them, Energy _rs is the energy exerted on the patient's respiratory system by mechanical ventilation obtained from the integration of airway pressure and gas flow rate in a single cycle, Tinsp is the inspiratory time of each breathing cycle, Paw is the airway pressure, and Flow is the gas flow rate. Of course, the energy calculated in a single cycle combined with the breathing rate can be converted into an amount per minute. The formula is as follows:

其中气道压Paw的单位为cmH ₂O；气体流速Flow的单位为L/min；每个呼吸周期的吸气时间Tinsp的单位为s；RR为呼吸率，单位为每分钟；由气道压和气体流速积分得到的机械通气作用于患者呼吸***的能量Power _rs的单位为J/min，由于1cmH ₂O*1L/min＝0.098J/min，因此上面的公式中有0.098这一系数。当然，也可以直接将1分钟内所有周期的Energyrs进行累加，得到每分钟的能量。 The unit of airway pressure Paw is cmH ₂ O; the unit of gas flow rate Flow is L/min; the unit of inspiration time Tinsp of each breathing cycle is s; RR is the breathing rate, the unit is per minute; by airway pressure _{The unit of energy Power rs} , which is obtained by integrating the gas flow rate and acting on the patient's respiratory system, is J/min. Since 1cmH ₂ O*1L/min=0.098J/min, there is a coefficient of 0.098 in the above formula. Of course, it is also possible to directly accumulate Energyrs of all cycles within 1 minute to obtain energy per minute.

一些实施例中，根据气道压和气体流速计算机械通气作用于患者呼吸***的能量时，还可以考虑由呼气末正压形成的潮气量部分所产生的势能，这一部分能量一般是一个固定的值，并不会随着机械通气产生变化，并且因为需要额外进行呼气末正压释放，所以也常常可以省略。当考虑这一部分势能时，上面的公式变为：In some embodiments, when calculating the energy of mechanical ventilation acting on the patient's respiratory system based on airway pressure and gas flow rate, the potential energy generated by the tidal volume formed by the positive end-expiratory pressure can also be considered. This part of energy is generally a fixed The value of does not change with mechanical ventilation, and because it requires additional positive end-expiratory pressure release, it can often be omitted. When considering this part of the potential energy, the above formula becomes:

结合呼吸率进行单位换算后得到每分钟的能量：After unit conversion combined with breathing rate, the energy per minute is obtained:

这两个公式中PEEP _Volume为呼气末正压所导致的潮气量，单位为L，具体为呼气末正压降为0时呼出的容积；PEEP则为呼气末正压。 In these two formulas, PEEP _Volume is the tidal volume caused by the positive end-expiratory pressure, in L, specifically the volume that is exhaled when the positive end-expiratory pressure drop is 0; PEEP is the positive end-expiratory pressure.

根据气道压和气体流速计算机械通气作用于患者呼吸***的能量，可以表示机械通气作用于患者整个的呼吸***的能量，例如作用为患者的气管、胸壁和肺等的总的能量。Calculating the energy of mechanical ventilation acting on the patient's respiratory system based on airway pressure and gas flow rate can represent the energy of mechanical ventilation acting on the patient's entire respiratory system, such as the total energy acting on the patient's trachea, chest wall, and lungs.

一些实施例中，处理器50根据肺内压和气体流速值计算机械通气作用于患者呼吸***的能量，需要说明的是，肺内压可以由压力传感器10采集得到，也可以通过气压道等进行估算，上文已进行过详细的描述，在此不再赘述。一些例子中将肺内压和气体流速进行积分运算得到机械通气作用于患者呼吸***的能量，公式如下：In some embodiments, the processor 50 calculates the energy of mechanical ventilation acting on the patient's respiratory system based on the values of intrapulmonary pressure and gas flow rate. It should be noted that the intrapulmonary pressure can be collected by the pressure sensor 10, or can be performed through the air pressure channel, etc. It is estimated that it has been described in detail above and will not be repeated here. In some examples, the pulmonary pressure and gas flow rate are integrated to obtain the energy that mechanical ventilation acts on the patient's respiratory system. The formula is as follows:

其中Energy _lung为单个周期由肺内压和气体流速积分得到的机械通气作用于患者呼吸***的能量，Tinsp为每个呼吸周期的吸气时间，Plung为肺内压，Flow为气体流速。当然也可以将单个周期计算得到的能量结合呼吸率换算成每分钟的能量，公式如下： Among them, Energy _lung is the energy exerted on the patient's respiratory system by mechanical ventilation obtained from the integration of intrapulmonary pressure and gas flow rate in a single cycle, Tinsp is the inspiratory time of each respiratory cycle, Plung is the intrapulmonary pressure, and Flow is the gas flow rate. Of course, the energy calculated in a single cycle combined with the breathing rate can be converted into energy per minute. The formula is as follows:

其中肺内压Plung的单位为cmH ₂O；气体流速Flow的单位为L/min；每个呼吸周期的吸气时间Tinsp的单位为s；RR为呼吸率，单位为每分钟；由肺内压和气体流速积分得到的机械通气作用于患者呼吸***的能量Power _lung的单位可以为J/min，由于1cmH ₂O*1L/min＝0.098J/min，因此上面的公式中有0.098这一系数。当然，根据具体需要可以计算每秒或每小时的能量，此时，对应的单位则为J/s或者J/h。对应地，上述公式中的系数0.098则对应为根据单位换算的其他值。 The unit of intrapulmonary pressure Plung is cmH ₂ O; the unit of gas flow rate Flow is L/min; the unit of inspiration time Tinsp of each breathing cycle is s; RR is the breathing rate, the unit is per minute; from the intrapulmonary pressure _{The unit of energy Power lung} that the mechanical ventilation acts on the patient's respiratory system obtained by integrating the gas flow rate can be J/min. Since 1cmH ₂ O*1L/min=0.098J/min, there is a coefficient of 0.098 in the above formula. Of course, the energy per second or hour can be calculated according to specific needs. At this time, the corresponding unit is J/s or J/h. Correspondingly, the coefficient 0.098 in the above formula corresponds to other values converted according to the unit.

一些实施例中，根据肺内压和气体流速计算机械通气作用于患者呼吸***的能量时，还可以考虑由呼气末肺内压形成的潮气量部分所产生的势能，这一部分能量一般是一个固定的值，并不会随着机械通气产生变化，所以常常可以省略。当考虑这一部分势能时，上面的公式变为：In some embodiments, when calculating the energy of mechanical ventilation acting on the patient’s respiratory system based on the intrapulmonary pressure and gas flow rate, the potential energy generated by the tidal volume formed by the end-expiratory pulmonary pressure can also be considered. This part of energy is generally a The fixed value does not change with mechanical ventilation, so it can often be omitted. When considering this part of the potential energy, the above formula becomes:

这两个公式中PlungE _Volume为呼气末肺内压所导致的潮气量，单位为L，具体为呼气末肺内压降为0时呼出的容积；PlungE则为呼气末肺内压。 In these two formulas, PlungE _Volume is the tidal volume caused by the end-expiratory pulmonary pressure, in L, specifically the volume that is exhaled when the end-expiratory pulmonary pressure drop is 0; PlungE is the end-expiratory pulmonary pressure.

根据肺内压和气体流速计算机械通气作用于患者呼吸***的能量，可以表示机械通气作用于患者呼吸***中肺和胸壁处的能量。Calculating the energy of mechanical ventilation acting on the patient's respiratory system based on the intrapulmonary pressure and gas flow rate can represent the energy of mechanical ventilation acting on the lungs and chest wall of the patient's respiratory system.

一些实施例中，处理器50根据跨肺压和气体流速值计算机械通气作用于患者呼吸***的能量。例如将跨肺压和气体流速进行积分运算得到机械通气作用于患者呼吸***的能量，公式如下：In some embodiments, the processor 50 calculates the energy of the mechanical ventilation acting on the patient's respiratory system based on the values of transpulmonary pressure and gas flow rate. For example, integrating the transpulmonary pressure and gas flow rate to obtain the energy of mechanical ventilation acting on the patient's respiratory system, the formula is as follows:

其中Energy _tr为单个周期由跨肺压和气体流速积分得到的机械通气作用于患者呼吸***的能量；Tinsp为每个呼吸周期的吸气时间，Ptrans为跨肺压，Flow为气体流速。当然也可以将单个周期计算得到的能量结合呼吸率换算成每分钟的能量，公式如下 Among them, Energy _tr is the energy exerted on the patient's respiratory system by mechanical ventilation obtained from the integration of transpulmonary pressure and gas flow rate in a single cycle; Tinsp is the inspiratory time of each respiratory cycle, Ptrans is the transpulmonary pressure, and Flow is the gas flow rate. Of course, the energy calculated in a single cycle can be combined with the respiration rate to convert into energy per minute, the formula is as follows

其中跨肺压Ptrans的单位为cmH ₂O；气体流速Flow的单位为L/min；每个呼吸周期的吸气时间Tinsp的单位为s；RR为呼吸率，单位为每分钟；由跨肺压和气体流速积分得到的机械通气作用于患者呼吸***的能量Power _tr的单位为J/min，由于1cmH ₂O*1L/min＝0.098J/min，因此上面的公式中有0.098这一系数。同样，单位和系数可以根据需要设置。 The unit of transpulmonary pressure Ptrans is cmH ₂ O; the unit of gas flow rate Flow is L/min; the unit of inspiration time Tinsp of each breathing cycle is s; RR is the breathing rate, the unit is per minute; by transpulmonary pressure _{The unit of energy Power tr} of the mechanical ventilation acting on the patient's respiratory system obtained by integrating the gas flow rate is J/min. Since 1cmH ₂ O*1L/min=0.098J/min, there is a coefficient of 0.098 in the above formula. Similarly, the unit and coefficient can be set as required.

一些实施例中，根据跨肺压和气体流速计算机械通气作用于患者呼吸***的能量时，还可以考虑由呼气末跨肺压形成的潮气量部分所产生的势能，这一部分能量一般是一个固定的值，并不会随着机械通气产生变化，所以常常可以省略。当考虑这一部分势能时，上面的公式变为：In some embodiments, when calculating the energy of mechanical ventilation acting on the patient's respiratory system based on transpulmonary pressure and gas flow rate, the potential energy generated by the tidal volume formed by the end-expiratory transpulmonary pressure can also be considered. This part of energy is generally a The fixed value does not change with mechanical ventilation, so it can often be omitted. When considering this part of the potential energy, the above formula becomes:

结合呼吸率进行单位换算成每分钟的能量：Combine the breathing rate to convert the unit into energy per minute:

这两个公式中PtansE _volume为呼气跨肺压所导致的潮气量，单位为L，具体为呼气末跨肺压降为0时呼出的容积；PtransE则为呼气末跨肺压。 In these two formulas, PtansE _volume is the tidal volume caused by expiratory transpulmonary pressure, in L, specifically the volume of exhalation when the end-expiratory transpulmonary pressure drop is 0; PtransE is the end-expiratory transpulmonary pressure.

根据跨肺压和气体流速计算机械通气作用于患者呼吸***的能量，可以表示机械通气作用于患者呼吸***中肺的能量。Calculating the energy of mechanical ventilation acting on the patient's respiratory system based on the transpulmonary pressure and gas flow rate can represent the energy of mechanical ventilation acting on the lungs of the patient's respiratory system.

一些实施例中，处理器50根据跨膈压和气体流速值计算机械通气作用于患者呼吸***的能量。例如将跨膈压和气体流速进行积分运算得到机械通气作用于患者呼吸***的能量，公式如下：In some embodiments, the processor 50 calculates the energy of the mechanical ventilation acting on the patient's respiratory system based on the transdiaphragmatic pressure and the gas flow rate. For example, integrating the transdiaphragmatic pressure and gas flow rate to obtain the energy of mechanical ventilation acting on the patient's respiratory system, the formula is as follows:

其中Energy _di为单个周期由跨膈压和气体流速积分得到的机械通气作用于患者呼吸***的能量；Tinsp为每个呼吸周期的吸气时间，Pdi为跨膈压，Flow为气体流速。当然也可以将单个周期计算得到的能量结合呼吸率换算成每分钟的能量，公式如下 Among them, Energy _di is the energy exerted on the patient's respiratory system by mechanical ventilation obtained from the integration of transdiaphragmatic pressure and gas flow rate in a single cycle; Tinsp is the inspiratory time of each respiratory cycle, Pdi is transdiaphragmatic pressure, and Flow is the gas flow rate. Of course, the energy calculated in a single cycle can be combined with the respiration rate to convert into energy per minute, the formula is as follows

其中跨肺压Pdi的单位为cmH ₂O；气体流速Flow的单位为L/min；每个呼吸周期的吸气时间Tinsp的单位为s；RR为呼吸率，单位为每分钟；由跨膈压和气体流速积分得到的机械通气作用于患者呼吸***的能量Power _di的单位为J/min，由于1cmH ₂O*1L/min＝0.098J/min，因此上面的公式中有0.098这一系数。同样，单位和系数可以根据需要设置。 The unit of transpulmonary pressure Pdi is cmH ₂ O; the unit of gas flow rate Flow is L/min; the unit of inspiration time Tinsp of each respiratory cycle is s; RR is the breathing rate, the unit is per minute; from the transdiaphragmatic pressure _{The unit of energy Power di} of the mechanical ventilation acting on the patient's respiratory system obtained by integrating the gas flow rate is J/min. Since 1cmH ₂ O*1L/min=0.098J/min, there is a coefficient of 0.098 in the above formula. Similarly, the unit and coefficient can be set as required.

一些实施例中，根据跨膈压和气体流速计算机械通气作用于患者呼吸***的能量时，还可以考虑由呼气末跨膈压形成的潮气量部分所产生的势能，这一部分能量一般是一个固定的值，并不会随着机械通气产生变化，所以常常可以省略。当考虑这一部分势能时，上面的公式变为：In some embodiments, when calculating the energy of mechanical ventilation acting on the patient’s respiratory system based on transdiaphragmatic pressure and gas flow rate, the potential energy generated by the tidal volume formed by the end expiratory transdiaphragmatic pressure can also be considered. This part of energy is generally a The fixed value does not change with mechanical ventilation, so it can often be omitted. When considering this part of the potential energy, the above formula becomes:

这两个公式中PdiE _volume为呼气跨膈压所导致的潮气量，单位为L，具体为呼气末跨膈压降为0时呼出的容积；PdiE则为呼气末跨膈压。 In these two formulas, PdiE _volume is the tidal volume caused by the expiratory transdiaphragmatic pressure, in L, specifically the volume of exhalation when the end expiratory transdiaphragmatic pressure drop is 0; PdiE is the end expiratory transdiaphragmatic pressure.

根据跨膈压和气体流速计算机械通气作用于患者呼吸***的能量，可以表示机械通气作用于患者呼吸***中膈肌的能量。According to the transdiaphragmatic pressure and gas flow rate, the energy of mechanical ventilation acting on the patient's respiratory system can be calculated, which can represent the energy of mechanical ventilation acting on the diaphragm of the patient's respiratory system.

以上就是关于计算机械通气作用于患者呼吸***的能量的一些说明。The above are some explanations about calculating the energy that mechanical ventilation acts on the patient's respiratory system.

处理器50计算得到机械通气作用于患者呼吸***的能量后，有许多的后利用，下面具体说明。After the processor 50 calculates the energy that the mechanical ventilation acts on the patient's respiratory system, there are many subsequent uses, which will be described in detail below.

一些研究表明机械通气作用于患者呼吸***的能量的过高与肺损伤有显著的临床相关性，具体地，一些临床中表明，当机械通气作用于患者整个的呼吸***的能量大于25J/min，或机械通气作用于患者呼吸***中肺的能量大于12J/min或13J/min等时，会显著地造成肺损伤；一些临床中表明，当机械通气作用于患者整个的呼吸***的能量大于17J/min时明显增加患者死亡率。Some studies have shown that the excessive energy of mechanical ventilation on the patient’s respiratory system has a significant clinical correlation with lung injury. Specifically, some clinical studies have shown that when the energy of mechanical ventilation on the patient’s entire respiratory system is greater than 25J/min, Or when the energy of mechanical ventilation acting on the lungs of the patient’s respiratory system is greater than 12J/min or 13J/min, etc., it will significantly cause lung damage; some clinical studies have shown that when mechanical ventilation acts on the patient’s entire respiratory system, the energy is greater than 17J/min. Minutes significantly increase the mortality of patients.

因此一些实施例中，显示器70显示计算得到的机械通气作用于患者呼吸***的能量，例如显示机械通气作用于患者呼吸***的能量的实时数值和/或显示机械通气作用于患者呼吸***的能量随时间的变化，例如可以显示机械通气作用于患者呼吸***的能量的变化趋势图、趋势表等。观察者例如医生等可以根据所显示的机械通气作用于患者呼吸***的能量来评价和判断当前对肺损伤的程度和情况。Therefore, in some embodiments, the display 70 displays the calculated energy of the mechanical ventilation acting on the patient's respiratory system, for example, displaying the real-time value of the energy of the mechanical ventilation acting on the patient's respiratory system and/or displaying the energy of the mechanical ventilation acting on the patient's respiratory system. Time changes, for example, can display the change trend graph, trend table, etc. of the energy that mechanical ventilation acts on the patient's respiratory system. Observers such as doctors can evaluate and judge the current degree and condition of lung injury based on the displayed energy of mechanical ventilation acting on the patient's respiratory system.

一些实施例中，处理器50可以根据机械通气作用于患者呼吸***的能量来进行报警。例如当判断机械通气作用于患者呼吸***的能量超过第一阈值时，处理器50进行报警；和/或，当判断机械通气作用于患者呼吸***的能量低于第二阈值时，处理器50进行报警。处理器50进行报警的方式有很多种，例如处理器50可以控制显示器70显示警报信息。一些实施例中第一阈值和第二阈值可以由用户进行设置。In some embodiments, the processor 50 may give an alarm based on the energy exerted on the patient's respiratory system by mechanical ventilation. For example, when it is determined that the energy of the mechanical ventilation acting on the patient's respiratory system exceeds the first threshold, the processor 50 sends an alarm; and/or, when it is determined that the energy of the mechanical ventilation acting on the patient's respiratory system is lower than the second threshold, the processor 50 performs Call the police. There are many ways for the processor 50 to give an alarm. For example, the processor 50 can control the display 70 to display alarm information. In some embodiments, the first threshold and the second threshold may be set by the user.

一些实施例中，处理器50可以根据机械通气作用于患者呼吸***的能量判断患者病情。一些具体实施例中处理器50根据所述机械通气作用于患者呼吸***的能量的实时值和/或变化趋势来判断患者病情。例如在通气参数不变的情况下，当判断机械通气作用于患者呼吸***的能量在预设时间段的变化趋势为降低，则处理器50判断患者病情在改善，并生成相应提示信息；和/或，在通气参数不变的情况下，当判断机械通气作用于患者呼吸***的能量在预设时间段的变化趋势为升高，则处理器50 判断患者病情在恶化，并生成相应提示信息。需要说明的是，通气参数指的是呼吸监测装置尤其是当其为呼吸机或麻醉机时，控制装置进行机械通气的参数，典型的可以是潮气量、吸气流速、驱动压、呼气末正压和吸呼比等参数。In some embodiments, the processor 50 can determine the patient's condition based on the energy of the mechanical ventilation acting on the patient's respiratory system. In some specific embodiments, the processor 50 determines the patient's condition based on the real-time value and/or change trend of the energy of the mechanical ventilation acting on the patient's respiratory system. For example, when the ventilation parameters are unchanged, when it is determined that the change trend of the energy of the mechanical ventilation acting on the patient's respiratory system during the preset time period is decreasing, the processor 50 determines that the patient's condition is improving, and generates corresponding prompt information; and/ Or, when the ventilation parameters remain unchanged, when it is determined that the change trend of the energy of the mechanical ventilation acting on the patient's respiratory system during the preset time period is increasing, the processor 50 determines that the patient's condition is deteriorating, and generates corresponding prompt information. It should be noted that the ventilation parameters refer to the parameters of the respiratory monitoring device, especially when it is a ventilator or anesthesia machine, that the control device performs mechanical ventilation. Typical examples can be tidal volume, inspiratory flow rate, drive pressure, and end expiration. Parameters such as positive pressure and inhalation-expiration ratio.

以上就是本发明公开的呼吸监测装置的一些说明。本发明一些实施例中，还公开一种呼吸监测方法。The above are some descriptions of the breathing monitoring device disclosed in the present invention. In some embodiments of the present invention, a breathing monitoring method is also disclosed.

图5是本发明一些实施例的呼吸监测方法的流程图，该方法包括以下步骤：Fig. 5 is a flowchart of a breathing monitoring method according to some embodiments of the present invention. The method includes the following steps:

步骤100，获取患者在通气过程中的气体流速。Step 100: Obtain the gas flow rate of the patient during the ventilation process.

该气体流速至少包括患者的吸气流速，当然，也可以包括患者吸气期间和呼气期间的流速。上述气体流速可用流量传感器30采集获取。The gas flow rate includes at least the patient's inspiratory flow rate, and of course, may also include the patient's inhalation and expiration flow rates. The above-mentioned gas flow rate can be collected by the flow sensor 30.

步骤200，获取在通气过程中患者的压力。Step 200: Obtain the pressure of the patient during the ventilation process.

所述压力反映通气过程中作用于患者呼吸***不同位点的压力——例如气道压、胸腔内压、隆突压、肺内压、食道压和胃内压中的一种或多种。上述各种压力可以通过压力传感器10获取。The pressure reflects the pressure acting on different points of the patient's respiratory system during ventilation, such as one or more of airway pressure, intrathoracic pressure, carina pressure, intrapulmonary pressure, esophageal pressure, and intragastric pressure. The various pressures mentioned above can be acquired by the pressure sensor 10.

一些实施例中，压力传感器10可以是导管式压力传感器或者光纤式压力传感器等，通过将压力传感器伸入到患者呼吸***相应位点，就可以采取到相应位点的压力。例如将压力传感器伸入到患者的气道则可以采集到气道压，将压力传感器伸入到食道中则可以采集到食道压，将压力传感器伸入到胃内则可以采集到胃内压，将压力传感器伸入到气管内部的隆突处，则可以采集到隆突压，将压力传感器伸入到胃内则可以采集到胃内压，将压力传感器通过创切口等伸入到胸腔内则可以采集到胸腔内压。一些实施例中还可以通过呼吸***中一些位点的压力来代替或计算其他一些位点的压力，下面通过几个例子来说明。In some embodiments, the pressure sensor 10 may be a catheter pressure sensor or an optical fiber pressure sensor. By extending the pressure sensor to a corresponding point in the patient's respiratory system, the pressure at the corresponding point can be taken. For example, if the pressure sensor is inserted into the patient’s airway, the airway pressure can be collected, if the pressure sensor is inserted into the esophagus, the esophageal pressure can be collected, and if the pressure sensor is inserted into the stomach, the intragastric pressure can be collected. The pressure sensor can be inserted into the carina inside the trachea to collect the carina pressure, the pressure sensor can be inserted into the stomach to collect the intragastric pressure, and the pressure sensor can be inserted into the chest cavity through a wound incision. The intrathoracic pressure can be collected. In some embodiments, the pressure at some points in the respiratory system can also be used to replace or calculate the pressure at some other points, which will be illustrated by a few examples below.

一些实施例中，步骤200可以基于气道压来计算肺内压。例如一些实施例中，步骤200通过气道压、呼吸***阻力和上述的气体流速来进行肺内压的计算。一个具体的例子中，可以通过下面的公式来计算：In some embodiments, step 200 may calculate intrapulmonary pressure based on airway pressure. For example, in some embodiments, step 200 calculates the intrapulmonary pressure through airway pressure, respiratory system resistance, and the aforementioned gas flow rate. In a specific example, it can be calculated by the following formula:

Plung(t)＝Paw(t)-Raw*Flow(t)；Plung(t)=Paw(t)-Raw*Flow(t);

其中Plung(t)指肺内压随时间t变化的函数，或者说是实时肺内压；Paw(t)指气道压随时间t变化的函数，或者说是实时气道压；Flow(t)是患者在通气过程中的气体流速随时间t变化的函数，或者说是患者在通气过程中的实时气体流速；Raw为呼吸***阻力。Among them, Plung(t) refers to the function of the change of intrapulmonary pressure with time t, or real-time intrapulmonary pressure; Paw(t) refers to the function of the change of airway pressure with time t, or real-time airway pressure; Flow(t ) Is a function of the patient’s gas flow rate during ventilation with time t, or the patient’s real-time gas flow rate during ventilation; Raw is the resistance of the respiratory system.

一些实施例中，步骤200可以通过肺内压或气道压中任意一者，减去食道压或胸腔内压中任意一者，来计算得到跨肺压。例如通过将气道压减去食道压来得到跨肺压。In some embodiments, step 200 can calculate the transpulmonary pressure by subtracting any one of the intrapulmonary pressure or the airway pressure from the esophageal pressure or the intrathoracic pressure. For example, the transpulmonary pressure can be obtained by subtracting the esophageal pressure from the airway pressure.

一些实施例中，步骤200可以通过胸腔内压或食道压任意一者，减去腹内压或胃内压中任意一者，来计算得到跨膈压。例如通过将食道压减去胃内压来得到跨膈压。需要说明的是，一些实施例中，将压力传感器通过创切口等伸入到腹部内则可以采集到腹内压。In some embodiments, step 200 can calculate the transdiaphragmatic pressure by subtracting any one of the intra-thoracic pressure or the esophageal pressure from the intra-abdominal pressure or the intragastric pressure. For example, the transdiaphragmatic pressure can be obtained by subtracting the intragastric pressure from the esophageal pressure. It should be noted that in some embodiments, the intra-abdominal pressure can be collected by extending the pressure sensor into the abdomen through a wound incision or the like.

一些实施例了，为了使得之后计算的机械通气过程中作用于患者呼吸***的能量更准确，可以在将获取到的患者的压力用于计算前，先对压力进行校正，例如图6就是一个例子，通过引入步骤210来对压力进行校正。In some embodiments, in order to make the subsequent calculation of the energy acting on the patient's respiratory system more accurate during the mechanical ventilation process, the pressure can be corrected before the obtained patient pressure is used in the calculation. For example, Figure 6 is an example. , By introducing step 210 to correct the pressure.

步骤210，对获取到的患者的压力进行校正。步骤210可以是对跨肺压或跨膈压等进行校正，下面具体进行说明。Step 210: Correct the acquired pressure of the patient. Step 210 may be to correct the transpulmonary pressure or transdiaphragmatic pressure, etc., which will be described in detail below.

例如，步骤200中获取到患者的跨肺压后，对该跨肺压进行校正。下面举几例对跨肺压的校正方式具体说明。For example, after the transpulmonary pressure of the patient is obtained in step 200, the transpulmonary pressure is corrected. Here are a few examples of how to correct transpulmonary pressure.

在一些实施例中，步骤210通过在呼气末正压为零和非零的状态下的气道压力值和食道压力值来对跨肺压进行校正；具体地，步骤210获取呼气末正压为非零的状态下的气道压Paw _PEEP和食道压Pes _PEEP，以及获取呼气末正压为零的状态下的气道压Paw _ZEEP和食道压Pes _ZEEP；步骤210将跨肺压加上(Paw _PEEP-Paw _ZEEP)并减去(Pes _PEEP-Pes _ZEEP)得到校正后的跨肺压。 In some embodiments, step 210 corrects the transpulmonary pressure by the airway pressure value and the esophageal pressure value when the positive end expiratory pressure is zero and non-zero; specifically, step 210 obtains the positive end expiratory pressure. _{The airway pressure Paw PEEP} and the esophageal pressure Pes _PEEP when the pressure is non-zero _{, and the airway pressure Paw ZEEP} and the esophageal pressure Pes _ZEEP when the positive end-expiratory pressure is zero; Step 210 adds the transpulmonary pressure Add (Paw _PEEP- _{Paw ZEEP} ) and subtract (Pes _PEEP- _{Pes ZEEP} ) to get the corrected transpulmonary pressure.

在一些实施例中，步骤210还通过肺顺应性和胸壁顺应性来对所述跨肺压力值进行校正；具体地，步骤210获取肺顺应性Clung和胸壁顺应性Ccw；需要说明的是，步骤210获取肺顺应性Clung和胸壁顺应性Ccw的方法有多种，例如步骤210可以通过以下公式获取胸壁顺应性Ccw：In some embodiments, step 210 also corrects the transpulmonary pressure value through lung compliance and chest wall compliance; specifically, step 210 obtains lung compliance Clung and chest wall compliance Ccw; it should be noted that step 210 There are many ways to obtain lung compliance Clung and chest wall compliance Ccw. For example, in step 210, the chest wall compliance Ccw can be obtained by the following formula:

步骤210将跨肺压减去所述误差补偿值得到校正后的跨肺压。Step 210 subtracts the error compensation value from the transpulmonary pressure to obtain the corrected transpulmonary pressure.

又例如，步骤200中获取到患者的跨膈压后，对跨膈压进行校正。下面举例对跨膈压的校正方式具体说明。For another example, after the transdiaphragmatic pressure of the patient is obtained in step 200, the transdiaphragmatic pressure is corrected. The following examples illustrate the correction method of transdiaphragmatic pressure in detail.

步骤210获取呼气末正压为非零的状态下的食道压Pes _PEEP和胃内压Psto _PEEP，以及获取呼气末正压为零的状态下的食道压Pes _ZEEP和胃内压Psto _ZEEP；步骤210将跨膈压加上(Pes _PEEP-Pes _ZEEP)并减去(Psto _PEEP-Psto _ZEEP)得到校正后的跨膈压。 _{Step 210: Obtain the esophageal pressure Pes PEEP} and the intragastric pressure Psto _{PEEP in} a state where the positive end expiratory pressure is non-zero _{, and obtain the esophageal pressure Pes ZEEP} and the intragastric pressure Psto _{ZEEP in} a state where the positive end expiratory pressure is zero; Step 210 adds (Pes _PEEP- _{Pes ZEEP} ) and subtracts (Psto _PEEP- Psto ZEEP) to the _{transdiaphragmatic pressure to obtain the corrected transdiaphragmatic pressure.}

在有的实施例中，也可以略去步骤210，即不对获取到的患者的压力进行校正，例如上文图5就是不包括步骤210的例子，上文中图6就是包括步骤210的例子。In some embodiments, step 210 may also be omitted, that is, the acquired pressure of the patient is not corrected. For example, Figure 5 above is an example that does not include step 210, and Figure 6 above is an example that includes step 210.

步骤300，根据获取的压力和气体流速计算机械通气过程中作用于患者呼吸***的能量。Step 300: Calculate the energy acting on the patient's respiratory system during the mechanical ventilation process based on the obtained pressure and gas flow rate.

一些实施例中，步骤300对所采集的压力和气体流速在预设单位时间内——例如1分钟进行积分，以获取机械通气作用于患者呼吸***的能量。一些实施例中，步骤300对所采集的压力和气体流速在一个呼吸周期内进行积分并乘以呼吸率，以获取机械通气作用于患者呼吸***的能量。当然，步骤300也可以对所采集的压力和气体流速在一个呼吸周期内进行积分，以获取机械通气作用于患者呼吸***的能量。下面结合呼吸***不同位点的压力来更进一步说明如何计算机械通气作用于患者呼吸***的能量。In some embodiments, step 300 integrates the collected pressure and gas flow rate within a preset unit time, such as 1 minute, to obtain the energy of the mechanical ventilation acting on the patient's respiratory system. In some embodiments, step 300 integrates the collected pressure and gas flow rate within one breathing cycle and multiplies it by the breathing rate to obtain the energy that the mechanical ventilation acts on the patient's respiratory system. Of course, in step 300, the collected pressure and gas flow rate can also be integrated in a breathing cycle to obtain the energy of the mechanical ventilation acting on the patient's respiratory system. The following is a further explanation of how to calculate the energy of mechanical ventilation acting on the patient's respiratory system by combining the pressure at different points of the respiratory system.

一些实施例中，步骤300根据气道压和气体流速计算机械通气作用于患者呼吸***的能量，具体的，步骤300将气道压和气体流速进行积分运算得到机械通气作用于患者呼吸***的能量，公式如下：In some embodiments, step 300 calculates the energy of mechanical ventilation acting on the patient's respiratory system based on the airway pressure and gas flow rate. Specifically, step 300 integrates the airway pressure and gas flow rate to obtain the energy of mechanical ventilation acting on the patient's respiratory system. , The formula is as follows:

一些实施例中，步骤300根据肺内压和气体流速值计算机械通气作用于患者呼吸***的能量，需要说明的是，肺内压可以由压力传感器10采集得到，也可以通过气压道等进行估算，上文已进行过详细的描述，在此不再赘述。一些例子中将肺内压和气体流速进行积分运算得到机械通气作用于患者呼吸***的能量，公式如下：In some embodiments, step 300 calculates the energy of mechanical ventilation acting on the patient's respiratory system based on the values of intrapulmonary pressure and gas flow rate. It should be noted that the intrapulmonary pressure can be collected by the pressure sensor 10, or can be estimated through the air pressure channel, etc. , Which has been described in detail above and will not be repeated here. In some examples, the pulmonary pressure and gas flow rate are integrated to obtain the energy that mechanical ventilation acts on the patient's respiratory system. The formula is as follows:

一些实施例中，步骤300根据跨肺压和气体流速值计算机械通气作用于患者呼吸***的能量。例如将跨肺压和气体流速进行积分运算得到机械通气作用于患者呼吸***的能量，公式如下：In some embodiments, step 300 calculates the energy of mechanical ventilation acting on the patient's respiratory system based on the values of transpulmonary pressure and gas flow rate. For example, integrating the transpulmonary pressure and gas flow rate to obtain the energy of mechanical ventilation acting on the patient's respiratory system, the formula is as follows:

一些实施例中，步骤300根据跨膈压和气体流速值计算机械通气作用于患者呼吸***的能量。例如将跨膈压和气体流速进行积分运算得到机械通气作用于患者呼吸***的能量，公式如下：In some embodiments, step 300 calculates the energy of mechanical ventilation acting on the patient's respiratory system based on the values of transdiaphragmatic pressure and gas flow rate. For example, integrating the transdiaphragmatic pressure and gas flow rate to obtain the energy of mechanical ventilation acting on the patient's respiratory system, the formula is as follows:

这两个公式中PdiE _volume为呼气跨膈压所导致的潮气量，单位为L，具体为呼气末跨膈压降为0时呼出的容积；PdiE则为呼气末跨膈压。 In these two formulas, PdiE _volume is the tidal volume caused by expiratory transdiaphragmatic pressure, in L, specifically the volume of exhalation when the end expiratory transdiaphragmatic pressure drop is 0; PdiE is the end expiratory transdiaphragmatic pressure.

在步骤300计算得到机械通气作用于患者呼吸***的能量后，根据该能量后续有许多应用，因此请参照图7，一些实施例中，呼吸监测方法还可以包括步骤310，利用机械通气作用于患者呼吸***的能量。After the energy of mechanical ventilation acting on the patient's respiratory system is calculated in step 300, there are many subsequent applications based on this energy. Therefore, referring to FIG. 7, in some embodiments, the breathing monitoring method may further include step 310, using mechanical ventilation to act on the patient The energy of the respiratory system.

步骤310利用机械通气作用于患者呼吸***的能量，可以是显示该能量、利用该能量来进行报警和指示病人病情等。因此请参照图8，一些实施例中，步骤310可以包括步骤311到步骤313中一者或多者，下面具体说明。Step 310 uses the energy of the mechanical ventilation to act on the patient's respiratory system, which may be to display the energy, use the energy to give an alarm and indicate the patient's condition, and so on. Therefore, referring to FIG. 8, in some embodiments, step 310 may include one or more of steps 311 to 313, which will be described in detail below.

步骤311，显示所述机械通气作用于患者呼吸***的能量。 Step 311, displaying the energy of the mechanical ventilation acting on the patient's respiratory system.

一些实施例中，步骤311显示计算得到的机械通气作用于患者呼吸***的能量，例如显示机械通气作用于患者呼吸***的能量的实时数值和/或显示机械通气作用于患者呼吸***的能量随时间的变化，例如可以显示机械通气作用于患者呼吸***的能量随时间的变化趋势图、趋势表等。观察者例如医生等可以根据所显示的机械通气作用于患者呼吸***的能量来评价和判断当前对肺损伤的程度和情况。In some embodiments, step 311 displays the calculated energy of mechanical ventilation acting on the patient's respiratory system, for example, displaying the real-time value of the energy of mechanical ventilation acting on the patient's respiratory system and/or displaying the energy of mechanical ventilation acting on the patient's respiratory system over time For example, it can display the trend graph and trend table of the energy of mechanical ventilation acting on the patient's respiratory system over time. Observers such as doctors can evaluate and judge the current degree and condition of lung injury based on the displayed energy of mechanical ventilation acting on the patient's respiratory system.

步骤312，根据机械通气作用于患者呼吸***的能量来进行报警。In step 312, an alarm is issued according to the energy exerted on the patient's respiratory system by the mechanical ventilation.

一些实施例中，步骤312可以根据机械通气作用于患者呼吸***的能量来进行报警。例如当判断机械通气作用于患者呼吸***的能量超过第一阈值时，步骤312进行报警；和/或，当判断机械通气作用于患者呼吸***的能量低于第二阈值时，步骤312进行报警。In some embodiments, step 312 may generate an alarm based on the energy exerted on the patient's respiratory system by mechanical ventilation. For example, when it is determined that the energy of mechanical ventilation acting on the patient's respiratory system exceeds the first threshold, step 312 generates an alarm; and/or when it is determined that the energy of mechanical ventilation acting on the patient's respiratory system is lower than the second threshold, step 312 generates an alarm.

步骤312进行报警的方式有很多种，例如步骤312可以控制显示警报信息。一些实施例中第一阈值和第二阈值可以由用户进行设置。There are many ways to perform an alarm in step 312. For example, step 312 can control the display of alarm information. In some embodiments, the first threshold and the second threshold may be set by the user.

步骤313，根据机械通气作用于患者呼吸***的能量判断患者病情。Step 313: Judging the patient's condition based on the energy of the mechanical ventilation acting on the patient's respiratory system.

一些实施例中，步骤313可以根据机械通气作用于患者呼吸***的能量判断患者病情。一些具体实施例中，步骤313根据所述机械通气作用于患者呼吸***的能量的实时值和/或变化趋势来判断患者病情。In some embodiments, step 313 can determine the patient's condition based on the energy of the mechanical ventilation acting on the patient's respiratory system. In some specific embodiments, step 313 determines the patient's condition based on the real-time value and/or change trend of the energy of the mechanical ventilation acting on the patient's respiratory system.

例如在通气参数不变的情况下，当判断机械通气作用于患者呼吸***的能量在预设时间段的变化趋势为降低，则步骤313判断患者病情在改善，并生成相应提示信息；和/或，在通气参数不变的情况下，当判断机械通气作用于患者呼吸***的能量在预设时间段的变化趋势为升高，则步骤313判断患者病情在恶化，并生成相应提示信息。需要说明的是，通气参数指的是呼吸监测装置尤其是当其为呼吸机或麻醉机时，控制装置进行机械通气的参数，典型的可以是潮气量、吸气流速、驱动压、呼气末正压和吸呼比等参数。For example, when the ventilation parameters are unchanged, when it is determined that the change trend of the energy exerted by the mechanical ventilation on the patient's respiratory system during the preset time period is decreasing, step 313 determines that the patient's condition is improving, and generates corresponding prompt information; and/or Under the condition that the ventilation parameters remain unchanged, when it is determined that the change trend of the energy of the mechanical ventilation acting on the patient's respiratory system during the preset time period is increasing, step 313 determines that the patient's condition is deteriorating, and generates corresponding prompt information. It should be noted that the ventilation parameters refer to the parameters of the respiratory monitoring device, especially when it is a ventilator or anesthesia machine, that the control device performs mechanical ventilation. Typical examples can be tidal volume, inspiratory flow rate, drive pressure, and end expiration. Parameters such as positive pressure and inhalation-expiration ratio.

如上所述，，上述步骤311至步骤313，可由用户根据患者的实际情况选择性执行其中的一个或是几个。As described above, the above steps 311 to 313 can be selectively executed by the user according to the actual situation of the patient or several of them.

通过上述呼吸监测装置及呼吸监测方法，可在通气过程中监测患者的压力和气体流速，根据患者的不同种类的压力和气体流速，可得到机械通气作用于患者呼吸***不同部位的能量，从而较准确、真实和实时地评价肺损伤，进一步地，可对该能量的数值等信息进行分析，进行报警和病情判断等后续工作。Through the above-mentioned respiratory monitoring device and respiratory monitoring method, the patient's pressure and gas flow rate can be monitored during ventilation. According to the different types of pressure and gas flow rate of the patient, the energy of mechanical ventilation acting on different parts of the patient's respiratory system can be obtained, so as to compare Accurate, true and real-time evaluation of lung injury, and further, can analyze the value of the energy and other information, and perform follow-up work such as alarm and disease judgment.

本文参照了各种示范实施例进行说明。然而，本领域的技术人员将认识到，在不脱离本文范围的情况下，可以对示范性实施例做出改变和修正。例如，各种操作步骤以及用于执行操作步骤的组件，可以根据特定的应用或考虑与***的操作相关联的任何数量的成本函数以不同的方式实现(例如一个或多个步骤可以被删除、修改或结合到其他步骤中)。This document is described with reference to various exemplary embodiments. However, those skilled in the art will recognize that changes and modifications can be made to the exemplary embodiments without departing from the scope of this document. For example, various operation steps and components used to perform the operation steps can be implemented in different ways according to a specific application or considering any number of cost functions associated with the operation of the system (for example, one or more steps can be deleted, Modify or incorporate into other steps).

在上述实施例中，可以全部或部分地通过软件、硬件、固件或者其任意组合来实现。另外，如本领域技术人员所理解的，本文的原理可以反映在计算机可读存储介质上的计算机程序产品中，该可读存储介质预装有计算机可读程序代码。任何有形的、非暂时性的计算机可读存储介质皆可被使用，包括磁存储设备(硬盘、软盘等)、光学存储设备(CD至ROM、DVD、Blu Ray盘等)、闪存和/或诸如此类。这些计算机程序指令可被加载到通用计算机、专用计算机或其他可编程数据处理设备上以形成机器，使得这些在计算机上或其他可编程数据处理装置上执行的指令可以生成实现指定的功能的装置。这些计算机程序指令也可以存储在计算机可读存储器中，该计算机可读存储器可以指示计算机或其他可编程数据处理设备以特定的方式运行，这样存储在计算机可读存储器中的指令就可以形成一件制造品，包括实现指定功能的实现装置。计算机程序指令也可以加载到计算机或其他可编程数据处理设备上，从而在计算机或其他可编程设备上执行一系列操作步骤以产生一个计算机实现的进程，使得在计算机或其他可编程设备上执行的指令可以提供用于实现指定功能的步骤。In the above embodiments, it may be implemented in whole or in part by software, hardware, firmware, or any combination thereof. In addition, as understood by those skilled in the art, the principles herein can be reflected in a computer program product on a computer-readable storage medium, which is pre-installed with computer-readable program code. Any tangible, non-transitory computer-readable storage medium can be used, including magnetic storage devices (hard disks, floppy disks, etc.), optical storage devices (CD to ROM, DVD, Blu Ray disks, etc.), flash memory and/or the like . These computer program instructions can be loaded on a general-purpose computer, a special-purpose computer, or other programmable data processing equipment to form a machine, so that these instructions executed on the computer or other programmable data processing device can generate a device that realizes the specified function. These computer program instructions can also be stored in a computer-readable memory, which can instruct a computer or other programmable data processing equipment to operate in a specific manner, so that the instructions stored in the computer-readable memory can form a piece of Manufactured products, including realizing devices that realize designated functions. Computer program instructions can also be loaded on a computer or other programmable data processing equipment, thereby executing a series of operation steps on the computer or other programmable equipment to produce a computer-implemented process, so that the execution of the computer or other programmable equipment Instructions can provide steps for implementing specified functions.

虽然在各种实施例中已经示出了本文的原理，但是许多特别适用于特定环境和操作要求的结构、布置、比例、元件、材料和部件的修改可以在不脱离本披露的原则和范围内使用。以上修改和其他改变或修正将被包含在本文的范围之内。Although the principles herein have been shown in various embodiments, many modifications to the structure, arrangement, proportions, elements, materials, and components that are particularly suitable for specific environments and operating requirements can be made without departing from the principles and scope of this disclosure. use. The above modifications and other changes or amendments will be included in the scope of this article.

前述具体说明已参照各种实施例进行了描述。然而，本领域技术人员将认识到，可以在不脱离本披露的范围的情况下进行各种修正和改变。因此，对于本披露的考虑将是说明性的而非限制性的意义上的，并且所有这些修改都将被包含在其范围内。同样，有关于各种实施例的优点、其他优点和问题的解决方案已如上所述。然而，益处、优点、问题的解决方案以及任何能产生这些的要素，或使其变得更明确的解决方案都不应被解释为关键的、必需的或必要的。本文中所用的术语“包括”和其任何其他变体，皆属于非排他性包含，这样包括要素列表的过程、方法、文章或设备不仅包括这些要素，还包括未明确列出的或不属于该过程、方法、***、文章或设备的其他要素。此外，本文中所使用的术语“耦合”和其任何其他变体都是指物理连接、电连接、磁连接、光连接、通信连接、功能连接和/或任何其他连接。The foregoing detailed description has been described with reference to various embodiments. However, those skilled in the art will recognize that various modifications and changes can be made without departing from the scope of this disclosure. Therefore, the consideration of this disclosure will be in an illustrative rather than restrictive sense, and all these modifications will be included in its scope. Likewise, the advantages, other advantages, and solutions to problems of the various embodiments have been described above. However, benefits, advantages, solutions to problems, and any solutions that can produce these or make them more specific should not be construed as critical, necessary, or necessary. The term "including" and any other variants used in this article are non-exclusive inclusions. Such a process, method, article or device that includes a list of elements not only includes these elements, but also includes those that are not explicitly listed or are not part of the process. , Methods, systems, articles or other elements of equipment. In addition, the term "coupled" and any other variations thereof used herein refer to physical connection, electrical connection, magnetic connection, optical connection, communication connection, functional connection and/or any other connection.

具有本领域技术的人将认识到，在不脱离本发明的基本原理的情况下，可以对上述实施例的细节进行许多改变。因此，本发明的范围应仅由以下权利要求确定。Those skilled in the art will recognize that many changes can be made to the details of the above-described embodiments without departing from the basic principles of the present invention. Therefore, the scope of the present invention should only be determined by the following claims.

Claims

还包括：显示所述机械通气作用于患者呼吸***的能量。It also includes: displaying the energy of the mechanical ventilation acting on the patient's respiratory system.
如权利要求9所述的呼吸监测方法，其特征在于，所述显示所述机械通气作用于患者呼吸***的能量，包括：显示机械通气作用于患者呼吸***的能量的实时数值和/或显示机械通气作用于患者呼吸***的能量随时间的变化。The breathing monitoring method according to claim 9, wherein the displaying the energy of the mechanical ventilation on the respiratory system of the patient comprises: displaying the real-time value of the energy of the mechanical ventilation acting on the respiratory system of the patient and/or displaying the mechanical Ventilation acts on the energy of the patient’s respiratory system over time.
如权利要求1至8中任一项所述的呼吸监测方法，其特征在于，还包括：根据机械通气作用于患者呼吸***的能量来进行报警。The breathing monitoring method according to any one of claims 1 to 8, further comprising: alarming according to the energy of the mechanical ventilation acting on the respiratory system of the patient.
如权利要求11所述的呼吸监测方法，其特征在于，所述根据机械通气作用于患者呼吸***的能量来进行报警，包括：The breathing monitoring method according to claim 11, wherein said alarming according to the energy of the mechanical ventilation acting on the respiratory system of the patient comprises:

当判断机械通气作用于患者呼吸***的能量超过第一阈值时，进行报警；和/或，When it is determined that the energy of the mechanical ventilation acting on the patient's respiratory system exceeds the first threshold, an alarm is issued; and/or,

当判断机械通气作用于患者呼吸***的能量低于第二阈值时，进行报警。When it is judged that the energy of the mechanical ventilation acting on the patient's respiratory system is lower than the second threshold, an alarm is issued.
如权利要求1至8中任一项所述的呼吸监测方法，其特征在于，还包括：根据机械通气作用于患者呼吸***的能量判断患者病情。The breathing monitoring method according to any one of claims 1 to 8, further comprising: judging the patient's condition based on the energy of the mechanical ventilation acting on the patient's respiratory system.
如权利要求13所述的呼吸监测方法，其特征在于，所述根据机械通气作用于患者呼吸***的能量判断患者病情，包括：The breathing monitoring method according to claim 13, wherein the judging the patient's condition based on the energy of the mechanical ventilation acting on the patient's respiratory system comprises:

根据所述机械通气作用于患者呼吸***的能量的实时值和/或变化趋势来判断患者病情。The patient's condition is judged according to the real-time value and/or change trend of the energy of the mechanical ventilation acting on the patient's respiratory system.
一种呼吸监测装置，其特征在于，包括：A breathing monitoring device, characterized in that it comprises:

压力传感器，采集在通气过程中患者的压力，所述压力反映通气过程中作用于患者呼吸***不同位点的压力；A pressure sensor that collects the pressure of the patient during the ventilation process, and the pressure reflects the pressure acting on different points of the patient's respiratory system during the ventilation process;

流量传感器，采集患者在通气过程中的气体流速；Flow sensor, which collects the gas flow rate of the patient during the ventilation process;

处理器，用于获取在通气过程中患者的压力和患者在通气过程中的气体流速，并根据获取的压力和气体流速计算机械通气过程中作用于患者呼吸***的能量。The processor is used to obtain the pressure of the patient during the ventilation process and the gas flow rate of the patient during the ventilation process, and calculate the energy acting on the respiratory system of the patient during the mechanical ventilation process according to the obtained pressure and gas flow rate.
如权利要求15所述的呼吸监测装置，其特征在于，所述不同位点的压力包括气道压、胸腔内压、隆突压、肺内压、食道压、胃内压、跨肺压和跨膈压中的一种或多种。The respiratory monitoring device according to claim 15, wherein the pressure at the different sites includes airway pressure, intrathoracic pressure, carina pressure, intrapulmonary pressure, esophageal pressure, intragastric pressure, transpulmonary pressure, and One or more of transdiaphragmatic pressure.
如权利要求15所述的呼吸监测装置，其特征在于，所述气体流速至少包括吸气流速。The respiratory monitoring device according to claim 15, wherein the gas flow rate includes at least an inspiratory flow rate.
如权利要求15至17中任一项所述的呼吸监测装置，其特征在于，所述处理器对压力和气体流速进行积分运算，以得到机械通气过程中作用于患者呼吸***的能量。The respiratory monitoring device according to any one of claims 15 to 17, wherein the processor integrates pressure and gas flow rate to obtain energy that acts on the patient's respiratory system during mechanical ventilation.
如权利要求18所述的呼吸监测装置，其特征在于，还包括显示器，用于显示所述机械通气作用于患者呼吸***的能量。The respiratory monitoring device according to claim 18, further comprising a display for displaying the energy of the mechanical ventilation acting on the respiratory system of the patient.
如权利要求15至17中任一项所述的呼吸监测装置，其特征在于，所述处理器还根据机械通气作用于患者呼吸***的能量来进行报警和/或判断患者病情。The respiratory monitoring device according to any one of claims 15 to 17, wherein the processor further alarms and/or judges the patient's condition based on the energy of the mechanical ventilation acting on the patient's respiratory system.
如权利要求15所述的呼吸监测装置，其特征在于，所述呼吸监测装置包括病人监护仪、病人监护模块或医用通气设备。The respiratory monitoring device according to claim 15, wherein the respiratory monitoring device comprises a patient monitor, a patient monitoring module, or medical ventilation equipment.
一种计算机可读存储介质，其特征在于，包括程序，所述程序能够被处理器执行以实现如权利要求1至14中任一项所述的方法。A computer-readable storage medium, characterized by comprising a program, which can be executed by a processor to implement the method according to any one of claims 1 to 14.