Development of a New Ambulatory Monitoring System for Indirect Beat-to-Beat Arterial Blood Pressure Using the Volume-compensation Method

在第一个项目中，我们已经开发了一种新的便携式瞬时动脉血压监测仪，它使用我们先前提出的体积补偿法来进行动态血压监测。选择颞浅动脉作为测量部位，以最大限度地减少对受试者的束缚，避免长期监测中静脉充血。使用腰带将带有反射型光电传感器的圆盘型血流量检测袖带牢牢地固定在受试者的头部，受试者携带袖带压力(Pc)控制(CPC)单元(32x65x110 mm，210g)和基于微处理器的中央处理和记录(MCPR)单元(85x185x200 mm，800g)。今年还开发了一个交互式软件，用于在监测期间自动进行顺序测量控制和数据存储。CPC装置主要由一个用于压缩空气供应的微型空气泵和一个微型压电阀(PVAA8000120H，JUPITOR Co.)组成。用于Pc控制。The…更多的MCPR单元执行伺服参考值的自动设置和伺服增益的控制，处理和存储每拍间接收缩压(PCS)、平均血压(PCM)、舒张压(PCD)和瞬时心率(HR)。每个数据的总共60,000个节拍可以存储在存储IC单元中。监测结束后，使用常规个人计算机或专门订购的数据分析设备(ECM-1DS，ESCOM Co.)再现和分析存储的数据。为了获得PC、PCM、PCD和HR的趋势图和直方图，在第二个项目年中，对该仪器进行了以下进一步的改进，并通过临床和模具实验对该仪器在手术中的性能进行了评估。新设计了一种喷嘴-挡板式微型Pc控制电空转换器，它安装在圆盘式袖带内，并配以微型压力传感器用于Pc测量。通过这些改进，Pc伺服控制系统的频率响应很高，并且只有一个对象携带了包括微型空气泵在内的改进的MCPR单元。为了评价该仪器测量血压的准确性，对留置尿管的患者同时测量了直接的臂浅动脉压和间接的颞浅动脉压，两者与压力波形有较好的一致性。用该仪器成功地进行了野外作业、高速公路驾驶、理疗等过程中的动态监测，表明该仪器具有良好的操作性能，是监测非限制性受试者血压瞬时变化的一种有效手段。由于采用了颞浅动脉作为测量部位，因此可以对受不适影响较小的受试者进行长期监测，整个研究项目均在项目期限内完成，取得了满意的效果。较少

A new portable instrument for the ambulatory monitoring of instantaneous arterial blood pressure using the volume-compensation method previously proposed by us has been developed in the first project year. The superficial temporal artery was chosen as a measuring site order to minimize restraint for a subject and to avoid venous congestion during the long-term monitoring. A disc-type cuff with a reflectance-type photo-sensor for blood volume detection was firmly placed to the subject's head using a belt and the subject carried a cuff-pressure (Pc) control (CPC) unit (32x65x110mm, 210g) and a microprocessor-based central processing & recording (MCPR) unit (85x185x200mm, 800g). An interactive software was also developed in this year for sequential measurement control and data storage in an automatic manner during the monitoring. The CPC unit consisted mainly of a micro air pump for compressed air supply and a miniature piezo-electric valve (PVAA8000120H, JUPITOR Co.) for Pc control. The … More MCPR unit performs the automatic setting of the servo-reference value and control of the servo-gain, processing and storing of beat-to-beat indirect systolic (Pcs), mean (Pcm) and diastolic blood pressure (Pcd) and instantaneous heart rate (HR). Altogether 60,000 beats of each data can be stored in a memory IC unit. After the monitoring, the stored data are reproduced and analyzed using a conventional personal computer or a specially ordered equipment for data analysis (ECM-1DS, ESCOM CO.) to obtain trend charts and histograms of Pcs, Pcm, Pcd and HR.In the second project year, the instrument was further improved as follows and the performance in an operation was evaluated through the clinical and dieldwork experiments. A nozzle-flapper type miniature electro-pneumatic converter for Pc control was newly designed, which was installed in the disc-type cuff together with a miniature pressure toansducer for Pc measurement. Through these modification, the frequency response of the Pc servocontrol system was highly and only the improved MCPR unit including a micro-air pump was carried by a subject. In order to evaluate the accuracy for blood pressure measurement by this instrument, simultaneous measurements of direct brachial and indirect superficial temporal arterial pressure were made in catheterised patients, showing fairly good agreements between these two values and pressure wave forms. With this instrument, ambulatory monitorings during fieldwork, highway driving, physicotherapeutics and so on, were successfully carried out, revealing that the instrument seems to have good operating performances and to be an useful means to monitor instantaneous variations of blood pressure in unrestricted subjects. Because the superficial temporal artery was adopted as a measuring site, the long-term monitoring could be made in the subjects being little affected by discomfort.The whole programs of this research project were completed within the project term with satisfactory results as described above. Less