This paper proposes a Van der Pol (VDP) oscillator screening for peripheral arterial disease (PAD) in patients with diabetes mellitus. The long-term elevated blood sugar levels produce a high risk of peripheral neurop...This paper proposes a Van der Pol (VDP) oscillator screening for peripheral arterial disease (PAD) in patients with diabetes mellitus. The long-term elevated blood sugar levels produce a high risk of peripheral neuropathy and peripheral vascular disease, especially in the foot of a diabetic. Early detection is important, in order to prevent foot problems for diabetic patients with PAD. Photoplethysmography (PPG) is a non-invasive method for the detection of blood volume changes in peripheral arteries. Because of changes in the resistance-compliance, the rise time and transit time for the PPG signals increase and change in their shape are highly correlated with PAD severity. In this study, the Burg autoregressive (AR) method is used to determine the characteristic frequencies of the right-and left-side PPG signals. For bilateral frequency spectra, the VDP oscillator uses asynchronous signals. This produces damped sinusoidal responses and the oscillation overshoot (OS) is an approximating function only of the damped factor. This index is used to estimate the degree of PAD, including normal the condition and diabetic patients with PAD. The results show that the proposed method is efficient and more accurate in the estimation of PAD.展开更多
目的构建重症监护病房(intensive care units,ICU)患者外周动脉管路护理管理指标,提高重症患者动脉置管规范化管理水平。方法2022年6月—7月通过文献复习法、一对一半结构式访谈初步拟定ICU患者外周动脉管路护理管理指标条目池。2022年...目的构建重症监护病房(intensive care units,ICU)患者外周动脉管路护理管理指标,提高重症患者动脉置管规范化管理水平。方法2022年6月—7月通过文献复习法、一对一半结构式访谈初步拟定ICU患者外周动脉管路护理管理指标条目池。2022年8月—9月选择17名专家采用德尔菲法(Delphi)对该护理管理指标进行2轮专家咨询,最终确立重症监护病房患者外周动脉管路护理管理指标。结果17名专家均完成两轮德尔菲法,两轮专家咨询积极系数均为100.0%,权威程度系数均为0.89;第一轮三级指标函询各条目的重要性均数范围为4.09~4.83,变异系数范围0.10~0.25,满分比0.53~0.88;第二轮三级指标函询各条目的重要性均数范围为4.29~4.83,变异系数范围为0.08~0.21,满分比0.59~0.88;第二轮一、二、三级指标Kendall协调系数W分别为0.462,0.478,0.431。经过两轮专家函询后,形成含有3个一级指标(置管与拔除、采血、导管维护),9个二级指标(置管准备、置管与穿刺、检查固定、管路更换、管路拔除、采血工具、操作要求、管路维护、并发症管理)和42个三级指标的ICU患者外周动脉置管护理管理指标。结论本研究构建的ICU患者外周动脉管路护理管理指标,经过统计分析咨询结果可靠,专家的积极程度、权威程度、协调程度与集中程度均较高,具有一定的可靠性和实用性,能为ICU护士实施外周动脉管路管理提供规范化的指引。展开更多
背景目前下肢动脉疾病(LEAD)的发病率正逐渐上升,LEAD与心脑血管疾病及全因死亡率之间的相关性也得到大量研究证明。以往,LEAD的确诊依赖于异常踝臂指数(ABI≤0.9),其主要通过多普勒法获得。示波血压测量法同步测量四肢血压不仅能获得...背景目前下肢动脉疾病(LEAD)的发病率正逐渐上升,LEAD与心脑血管疾病及全因死亡率之间的相关性也得到大量研究证明。以往,LEAD的确诊依赖于异常踝臂指数(ABI≤0.9),其主要通过多普勒法获得。示波血压测量法同步测量四肢血压不仅能获得示波踝臂指数(OS-ABI),还能同时获得臂间血压差异(IAD)及踝间血压差异(IAND)。目的评价OS-ABI及IAND筛查LEAD的价值。方法选取2017年10月-2018年4月在南昌大学第二附属医院就诊的206例血管外科患者。采用示波血压测量法同时测量患者四肢血压,得到OS-ABI和IAND,以OS-ABI≤0.9或IAND≥15 mm Hg(1 mm Hg=0.133 kPa)作为LEAD的诊断标准。同时患者完善CT血管造影检查(CTA),以CTA检查结果为金标准。结果依据CTA结果,206例患者中,182例(88.3%)诊断为LEAD,169例(82.0%)OS-ABI≤0.9,106例(51.5%)IAND≥15 mm Hg。OS-ABI≤0.9诊断LEAD的灵敏度、特异度和准确性分别为91.8%、91.7%和91.7%。IAND≥15 mm Hg诊断LEAD的灵敏度、特异度和准确性分别为55.5%、79.2%和58.3%。当OS-ABI≤0.9和IAND≥15 mm Hg联合应用时,诊断LEAD的灵敏度、特异度和准确性分别提高至96.2%、70.8%和93.2%。结论 OS-ABI是筛查LEAD的有效指标,联合IAND可提高其筛查价值,值得在临床上推广应用。展开更多
文摘This paper proposes a Van der Pol (VDP) oscillator screening for peripheral arterial disease (PAD) in patients with diabetes mellitus. The long-term elevated blood sugar levels produce a high risk of peripheral neuropathy and peripheral vascular disease, especially in the foot of a diabetic. Early detection is important, in order to prevent foot problems for diabetic patients with PAD. Photoplethysmography (PPG) is a non-invasive method for the detection of blood volume changes in peripheral arteries. Because of changes in the resistance-compliance, the rise time and transit time for the PPG signals increase and change in their shape are highly correlated with PAD severity. In this study, the Burg autoregressive (AR) method is used to determine the characteristic frequencies of the right-and left-side PPG signals. For bilateral frequency spectra, the VDP oscillator uses asynchronous signals. This produces damped sinusoidal responses and the oscillation overshoot (OS) is an approximating function only of the damped factor. This index is used to estimate the degree of PAD, including normal the condition and diabetic patients with PAD. The results show that the proposed method is efficient and more accurate in the estimation of PAD.
文摘目的构建重症监护病房(intensive care units,ICU)患者外周动脉管路护理管理指标,提高重症患者动脉置管规范化管理水平。方法2022年6月—7月通过文献复习法、一对一半结构式访谈初步拟定ICU患者外周动脉管路护理管理指标条目池。2022年8月—9月选择17名专家采用德尔菲法(Delphi)对该护理管理指标进行2轮专家咨询,最终确立重症监护病房患者外周动脉管路护理管理指标。结果17名专家均完成两轮德尔菲法,两轮专家咨询积极系数均为100.0%,权威程度系数均为0.89;第一轮三级指标函询各条目的重要性均数范围为4.09~4.83,变异系数范围0.10~0.25,满分比0.53~0.88;第二轮三级指标函询各条目的重要性均数范围为4.29~4.83,变异系数范围为0.08~0.21,满分比0.59~0.88;第二轮一、二、三级指标Kendall协调系数W分别为0.462,0.478,0.431。经过两轮专家函询后,形成含有3个一级指标(置管与拔除、采血、导管维护),9个二级指标(置管准备、置管与穿刺、检查固定、管路更换、管路拔除、采血工具、操作要求、管路维护、并发症管理)和42个三级指标的ICU患者外周动脉置管护理管理指标。结论本研究构建的ICU患者外周动脉管路护理管理指标,经过统计分析咨询结果可靠,专家的积极程度、权威程度、协调程度与集中程度均较高,具有一定的可靠性和实用性,能为ICU护士实施外周动脉管路管理提供规范化的指引。
文摘背景目前下肢动脉疾病(LEAD)的发病率正逐渐上升,LEAD与心脑血管疾病及全因死亡率之间的相关性也得到大量研究证明。以往,LEAD的确诊依赖于异常踝臂指数(ABI≤0.9),其主要通过多普勒法获得。示波血压测量法同步测量四肢血压不仅能获得示波踝臂指数(OS-ABI),还能同时获得臂间血压差异(IAD)及踝间血压差异(IAND)。目的评价OS-ABI及IAND筛查LEAD的价值。方法选取2017年10月-2018年4月在南昌大学第二附属医院就诊的206例血管外科患者。采用示波血压测量法同时测量患者四肢血压,得到OS-ABI和IAND,以OS-ABI≤0.9或IAND≥15 mm Hg(1 mm Hg=0.133 kPa)作为LEAD的诊断标准。同时患者完善CT血管造影检查(CTA),以CTA检查结果为金标准。结果依据CTA结果,206例患者中,182例(88.3%)诊断为LEAD,169例(82.0%)OS-ABI≤0.9,106例(51.5%)IAND≥15 mm Hg。OS-ABI≤0.9诊断LEAD的灵敏度、特异度和准确性分别为91.8%、91.7%和91.7%。IAND≥15 mm Hg诊断LEAD的灵敏度、特异度和准确性分别为55.5%、79.2%和58.3%。当OS-ABI≤0.9和IAND≥15 mm Hg联合应用时,诊断LEAD的灵敏度、特异度和准确性分别提高至96.2%、70.8%和93.2%。结论 OS-ABI是筛查LEAD的有效指标,联合IAND可提高其筛查价值,值得在临床上推广应用。
