中文摘要
胸外按压和电击除颤是抢救心脏骤停患者的核心急救措施。目前,在该领域亟待解决的问题主要表现在以下两个方面:1)缺乏权衡血流灌注与骨折风险的胸外按压决策优化能力;2)缺乏无需额外硬件支持的抗按压干扰除颤节律辨识能力。本项目拟在前期研究工作基础上,以数据挖掘、建立算法、实验评估为主线,分三个阶段开展研究。首先,基于动物模型,挖掘血流灌注程度和骨折风险的特征参数,以及原始胸外按压分量和原始心电信号分量的时频域特征值;其次,设计血流灌注、骨折风险分级辨识规则,重建原始心电波形,建立胸外按压优化策略和抗按压干扰心电节律辨识算法;最后,研制辨识决策虚拟仪器系统,开展对比实验,对辨识决策效果做出整体评价;基于评价结果,进行算法优化,实现临床移植。本项目有望解决心肺复苏智能化和自动化过程中的瓶颈问题,为心肺复苏技术的普及推广,提高心肺复苏的成功率和心脏骤停患者的存活率,提供必要的理论和技术支持。
英文摘要
Chest compression (CC) and defibrillation have been the cornerstones of cardiopulmonary resuscitation (CPR). At present, there are two problems needed to be solved during CC, which are the lack of an effective trade-off between blood flow Improvement and ribs fracture reduction and the disability to detect shock rhythm from CPR artifact corrupted ECG using the ECG alone. On the basis of summarizing previous works, this study will be carried out as the three major parts: extraction of the characteristic parameters, algorithm building and experimental tests. Firstly, based on animal model, the key characteristic parameters and data which can identify the degree of blood flow, chest injury sensitively and the time-frequency characteristic of CC artifact and original ECG signal will be extracted. Secondly, the rule for identifying the degree of blood flow and ribs fracture will be designed; the original ECG waveform will be estimated; the algorithm for optimal CC strategy and rhythm identification during CC will be finally established. Thirdly, the support identification system and the support decision system for CPR will be developed with the designing idea of virtual medical instrument, and will be compared with the traditional CPR treatment; the algorithm will then be improved for the clinical application. The algorithms described by the present study may be taken into account as a resolution for intelligent and automatic CPR. Therefore, with the present algorithm, it is likely to promote the popularized application of CPR and improve the survival rate of cardiac patient and the success rate of CPR.
