抢救危重病人的心血管循环反馈治疗仪及动物实验

An Automatic Feedback Control System of Drug Administration for Rescuing the Critical Patients with Blood Pressure Out of Control and Animal Experiments

目的国内外医疗仪器的发展正朝着自动化、智能化、模块化方向发展, 但主要集中于诊断方面,用于治疗仪器极少.设计原理及工作程序心血管循环反馈治疗仪是综合临床上的丰富成功经验设计研制的,其程序结合实验中的数学模型汇编而成,通过在线闭环自动检测,直接、快速、连续、高密度地采集血压, 肺毛细血管契压(PCW)、心率等重要生理参数,经压力传感器、A/D转换卡实时连续地输入计算机.通过用户界面人机对话,由医生选择药物,经数学模型及程序的运算,D/A转换器输出指令经输液器来控制给药量,而药物在机体的反应又及时、迅速地经在线闭环自动检测系统反馈回计算机,计算机不断更新计算结果,以此调节给药的速率及剂量.此外该系统还具有监控、报警、故障自诊断、智能化运行等特点.实验结果通过八只犬的实验表明,计算机取样及时、准确、快速,可以避免一些人为的误差以及取样间隔时间过长的不足.实验中给药结果证明能按照预期设计要求达到治疗目的.因此实用性强,高科技含量高,可以预测将来应用于临床抢救危重病人,可靠性、精确性将大大高于传统方法.讨论传统的临床治疗方法从收集病人数据到决定准确的给药量反馈过程太长,还有不少人为及计算的干扰和误差,因此抢救成功率极低.动物试验中发现该系统从获取血压变化到多次反馈调整给药整个周期短(2～5min)、计算准确,疗效可靠.当某药无效则可以及时提示医生换药,为临床争取了时间.是一个很有发展前景的抢救危重病人的系统与仪器,目前该系统及仪器仍待进入临床评价.

The purpose of deslgn and developing The development of medical instrument in domestic and international towards the direction of automation, intelligent and the module. At present, the instrument is very few for clinic treatment instead of diagnose mainly. Our research purpose is to design and develop an automatic feedback controlled system of administration drugs （AFCSAD） for rescuing the critical patient （such as the large area of Acute Myocardial Infarction （AMI）, malignant hypertension, shock and so on）. Design principle and working routine The design and developing of automatic feedback-controlled system of administration drugs is based on the abundant and suecessful clinic experience, the program was made by combining with mathematics model which come from the data of experiment. The blood pressure was collected and gathered online in direct, fast, continuous, high density through close ring measure automatically. BP, PCW, rate of heart beat etc. Important physiological parameters were inputted into computer real-time in succession by pressure sensor, A/D change card. The drugs were chosen by the doctor through user＇ s interface of human -machine dialogue, passing the operation of mathematics model and program, outputting orders by D/A converter to control the amount of medicine given by transfusion system, and the responses to medicine in organism were rapidly feedback to computer in time by automatic detection system of the close ring online feedback, the computer brought in constant renewal in the result of calculation, so as to regulate the speed and dosage of the medicine. In addition this system also had the characteristics such as controlling, alarm, trouble shorting, operating intelligently. Experimental result The results of eight dogs experiment indicated： the computer took a sample promptly, accurately and fast, it can prevent from some error made by people and the deficiency of sample spacing interval pass long. It was demonstrated that results of experiment could be expected the goal of medicine treating in designing requirement. So practicability was strong, the high-tech content was high, it could be predicted that it will apply to rescue the critical patient clinically in the future. The dependability, accuracy of the system will be much higher than that of traditional method. Discussion The course from collect patient＇s data feedback to decision accurately giving medicine is too long in traditional clinical method, It easy causes error and interference and leading extremely low success rate of rescuing. In animal experiments, it was fond that whole cycle from taking exampling BP to adjust the amounts of medicine was short （2-5 minutes）. Calculating accurately and curative effect was rehable. The doctors were told to change medicine in time as some medicine is invalid. It could race against time clinically. This instrument has good future for rescuing critical patients, at present, the instrument still wait to enter clinical appraisal.