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[用于实验室及血流动力学心脏导管插入术测量的数据处理系统]

[Data processing system for laboratory and hemodynamic heart catheterization measurements].

作者信息

Jensch P, Meyer J, Mattar E, Ameling W, Effert S

出版信息

Z Kardiol. 1976 Oct;65(10):850-81.

PMID:997705
Abstract

In cooperation with the Department of Electronic Data Processing Systems we have developed a data processing unit for the analysis of hemodynamic data at the Department of Internal Medicine I. The aim was to design a computer-system for the daily routine in heart-catheterizations as well as for the solution of scientific problems during hemodynamic studies. In the on-line-mode besides the ECG up to four pressures can be analysed simultaneously. Analog and digital tapes can also be processed off-line on demand. The concept of the whole system and the individual steps of computer-handling are adjusted to the problems of data-analysis in praxis from the viewpoint of the examining cardiologist. Since the system is interactive after each measurement and each given command the computer-results are displayed on the video-scope. Because of the modular structure of the program new medical criteria can easily be implemented at any time. Since the computer-system is not effectively used with only one cath-lab other units possibly of different hard-ware configuration can be connected simultaneously to the computer. Each cath-lab shares 16 K out of the total 32 K core-memory. The results are displayed graphically and alpha-numerically on video-scope, x-y-plotter and line printer. The sampling-rate for fluid-filled catheters is 200 Hz and for catheter-tip-manometers 400 Hz. Smothing and differentiation-procedures are adapted to the respective catheter-material. The computer-program calibrates the different pressure amplifiers automatically. After defining the catheter-position the pressure-signals are sampled for 10 s and immediately afterwards analyzed by the computer. The ECG and the corresponding pressure-curves are displayed on the video-scope. The automatically selected representative beat as well as each of the identified and numerated other beats of the sampling-phase can be displayed selectively together with its numerical results. The computer marks the positions within the pressure-curves, where the individual measurements were taken. Besides the systolic and diastolic pressures in valvular stenosis the maximal and mean systolic or diastolic gradients, ejection- or filling-period, valve-flow and valve-area are calculated autonomously. The calculation of cardiac-output, different volume-indices and stroke-work-index are based on Fick-method, thermo- or indicator-dilution technique. The contractility-parameters max dp/dt, t-max dp/dt, max dp/dt/DP, max dp/dt/P, VPM, V40, min dp/dt and the stiffness are computed for the left and on demand also for the right ventricle. Data of the patient and the operating-team, catheter-technique, complications and free comments are transmitted to the computer via terminal together with the actual time. The computer-system was drafted for permanent use. Therefore possible technical defects have been anticipated in the design of hard- and soft-ware. In cases of failure suitable steps allow the immediate restart of the system without loosing information...

摘要

我们与电子数据处理系统部合作,为内科一部研发了一个用于分析血液动力学数据的数据处理单元。目的是设计一种计算机系统,用于心脏导管插入术的日常工作以及解决血液动力学研究中的科学问题。在联机模式下,除了心电图外,还可同时分析多达四种压力。模拟和数字磁带也可根据需要进行脱机处理。从检查心脏病专家的角度来看,整个系统的概念和计算机操作的各个步骤都针对实际中的数据分析问题进行了调整。由于系统是交互式的,每次测量和每个给定命令后,计算机结果都会显示在视频显示器上。由于程序的模块化结构,新的医学标准可以随时轻松实现。由于仅在一个心导管实验室中使用计算机系统效率不高,其他可能具有不同硬件配置的单元可以同时连接到计算机。每个心导管实验室共享32K核心内存中的16K。结果以图形和字母数字形式显示在视频显示器、X-Y绘图仪和行式打印机上。充液导管的采样率为200Hz,导管尖端压力计的采样率为400Hz。平滑和微分程序适用于各自的导管材料。计算机程序会自动校准不同的压力放大器。定义导管位置后,压力信号会被采样10秒,然后立即由计算机进行分析。心电图和相应的压力曲线会显示在视频显示器上。自动选择的代表性搏动以及采样阶段中识别和编号的其他每个搏动都可以与其数值结果一起选择性显示。计算机标记压力曲线中进行各个测量的位置。除了瓣膜狭窄中的收缩压和舒张压外,还会自动计算最大和平均收缩或舒张梯度、射血或充盈期、瓣膜流量和瓣膜面积。心输出量、不同的容积指数和搏功指数的计算基于菲克法、热稀释或指示剂稀释技术。为左心室计算收缩性参数最大dp/dt、t-最大dp/dt、最大dp/dt/DP、最大dp/dt/P、VPM、V40、最小dp/dt和刚度,如有需要也可为右心室计算。患者和手术团队的数据、导管技术、并发症和自由评论会与实际时间一起通过终端传输到计算机。该计算机系统设计为可长期使用。因此,在硬件和软件设计中已经预见到了可能的技术缺陷。在出现故障的情况下,适当的步骤可使系统立即重新启动而不会丢失信息……

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