北京生物醫(yī)學(xué)工程

一種激光散斑和溫度刺激儀器在壓瘡早期診斷的研究

Early diagnosis studies of pressure ulcer with laser speckle and temperature stimulation instrument

作者：彭士恒張清棟劉鵬丁呈彪邵鵬飛

單位：中國(guó)科學(xué)技術(shù)大學(xué)工程科學(xué)學(xué)院(合肥 230026) 安徽醫(yī)科大學(xué)第二附屬醫(yī)院(合肥 230601)

關(guān)鍵詞：壓瘡診斷; 激光散斑; 溫度刺激; 動(dòng)態(tài)血流;

分類(lèi)號(hào)：R318.6

出版年·卷·期（頁(yè)碼）：2020·39·6（582-587）

摘要：

目的設(shè)計(jì)了一款具有血流成像以及溫度刺激的系統(tǒng)，用于測(cè)量壓瘡區(qū)域與非壓瘡區(qū)域的特征，并通過(guò)對(duì)動(dòng)物壓瘡模型進(jìn)行參數(shù)測(cè)量，驗(yàn)證該系統(tǒng)在早期壓瘡診斷中的作用。方法系統(tǒng)主要由相機(jī)、環(huán)形光源、激光二極管、長(zhǎng)焦溫度傳感及液氮噴射器組成，可以實(shí)現(xiàn)激光散斑血流成像，同時(shí)利用液氮噴射器給皮膚降溫，使該系統(tǒng)獲取皮膚動(dòng)態(tài)血流特性。采用脂肪乳模擬血流，驗(yàn)證該系統(tǒng)血流速度測(cè)量的準(zhǔn)確性。通過(guò)對(duì)5只兔子的背部，進(jìn)行壓力裝置下的加壓200 mmHg持續(xù)1 h，再恢復(fù)血流灌注20 min，反復(fù)兩次，制作出早期壓瘡模型。利用該系統(tǒng)對(duì)動(dòng)物壓瘡模型降溫之前到降溫再到恢復(fù)的整個(gè)過(guò)程，進(jìn)行血流成像及血流參數(shù)分析。結(jié)果系統(tǒng)性能測(cè)試結(jié)果中，該系統(tǒng)測(cè)量的散斑值得到的流速與脂肪乳實(shí)際的流速成正比關(guān)系。動(dòng)物實(shí)驗(yàn)測(cè)試結(jié)果中，非壓瘡區(qū)域與壓瘡區(qū)域的制冷后恢復(fù)時(shí)間（time to peak）分別為89.88 s5.70 s和112.69 s19.67 s，且P值為0.04，具有統(tǒng)計(jì)學(xué)差異，可作為壓瘡區(qū)域與非壓瘡區(qū)域的區(qū)分特征。結(jié)論本研究設(shè)計(jì)的系統(tǒng)可以提供一種客觀診斷早期壓瘡的方法，將為早期壓瘡診斷提供了一種新的思路。

Objective In this study, an instrument with blood flow imaging and temperature stimulation was designed to measure the characteristics of pressure ulcer areas and non-pressure ulcer areas, and the parameters of animal pressure ulcer models were measured to verify that the instrument is in the early diagnosis of pressure ulcers. Methods The system is mainly composed of a camera, a ring light source, a laser diode, a telephoto temperature sensor, and a liquid nitrogen injector. It can realize laser speckle blood flow imaging, and at the same time use a liquid nitrogen injector to cool the skin, so that the system can obtain dynamic skin blood flow characteristic. Using fat emulsion to simulate blood flow to verify the accuracy of the blood flow velocity measurement of the system. Early pressure ulcer model for 5 rabbits was created by applying pressure of 200 mmHg on the back of rabbit under pressure for 1 h, and then restoring blood flow for 20 min, and repeating it twice. The instrument was used to perform blood flow imaging and blood flow parameter analysis on the whole process from the animal pressure ulcer model temperature reduction to the temperature recovery. Results In the system performance test results, the flow rate obtained by the speckle value measured by the system is directly proportional to the actual flow rate of the fat emulsion. In animal experiment test results, the time to peak of the non-pressure ulcer area and the pressure ulcer area were 89.88 ± 5.70s and 112.69 ± 19.67s, respectively, and the P value was 0.037, which had a significant difference, which can be used as the distinguishing feature between the pressure ulcer area and the non-pressure ulcer area. Conclusions The instrument designed in this study provides an objective method for early diagnosis of pressure ulcers, and it will provide a new idea for early diagnosis of pressure ulcers.

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