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使用双探头超声系统间接测量血压(作者译)

[Indirect blood pressure measurement with a two-probe-ultrasound system (author's transl)].

作者信息

Noffke H U, Schirmer G

出版信息

Biomed Tech (Berl). 1981 Jul-Aug;26(7-8):162-7. doi: 10.1515/bmte.1981.26.7-8.162.

Abstract

A two-probe-ultrasound system is described as an example of the indirect measurement of blood pressure. Possible errors of the indirect method as well as attempts of improvement are shown. To receive a separate detection of the systolic, respectively the diastolic pressure, one probe of the two-probe system is fixed to the arteria radialis, the other to the arteria brachialis. The determination of the "Nulkriterium" (coincidence of the pneumatic cuff pressure and the arterial pressure) can be performed either by the investigator or automatically. The measuring systems shows the following advantages: 1. Use of a more reliable "Nulkriterium" (measurement of hypotonic blood pressure values which could no longer be measured by means of the Riva-Rocci/Korotkoff-procedure; no auscultatoric gap appeared at about 20 000 single measurements). 2. No falsification of systolic values by suprasystolic noises (two-probe principle; measurement of the systolic blood pressure by means of a probe outside the region of the pneumatic cuff). 3. Errors which come up by the expectation of the investigator or by the reading of the manometer can be avoided dependent on the mode of the system. The automatic measurement (dynamical compression, selection of frequencies, electronic threshold, delayed ECG coincidence) led to no satisfactory results, especially referring to the diastolic values. Principle criteria, however, come up which should be fulfilled with the construction of an automatic system of indirect blood pressure measurement. A better automatic measurement may be expected, if instead of the "threshold principle" used here a signal analysis is performed by microprocessors. The example of an intraarterial measurement of blood pressure demonstrates the phenomenon of a "mock auscultatoric gap" because of the spontaneous variability of the arterial pressure decreasing for a short time faster than the pneumatic cuff pressure.

摘要

描述了一种双探头超声系统,作为间接测量血压的一个例子。展示了间接测量方法可能存在的误差以及改进的尝试。为了分别单独检测收缩压和舒张压,双探头系统的一个探头固定在桡动脉上,另一个固定在肱动脉上。“零标准”(气袖带压力与动脉压力的一致性)的确定可以由研究人员手动进行,也可以自动完成。该测量系统具有以下优点:1. 使用更可靠的“零标准”(测量用里瓦-罗基/科罗特科夫法无法再测量的低血压值;在约20000次单次测量中未出现听诊间隙)。2. 不会因收缩期上的杂音而使收缩压值出现偏差(双探头原理;通过气袖带区域外的探头测量收缩压)。3. 根据系统模式,可以避免研究人员的预期或血压计读数所产生的误差。自动测量(动态加压、频率选择、电子阈值、延迟心电图同步)并未得出令人满意的结果,尤其是对于舒张压值。然而,出现了在构建间接血压自动测量系统时应满足的主要标准。如果用微处理器进行信号分析,而不是使用此处采用的“阈值原理”,有望实现更好的自动测量。动脉内血压测量的例子表明,由于动脉压力的自发波动在短时间内下降速度比气袖带压力快,会出现“假听诊间隙”现象。

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