围术期麻醉深度的模糊控制

针对手术过程中麻醉深度的控制问题,提出了一种PID参数自整定模糊控制策略。应用这种方法对麻醉过程中平均动脉血压的控制进行了计算机仿真研究,获得了良好的仿真结果。理论分析和仿真结果证明了此方法的准确性和可靠性,为围术期麻醉深度的控制提供了一种新方法。。     

基于排序熵算法的麻醉深度检测系统设计

为辅助医生在手术过程中对患者麻醉深度状态的判断,设计了一种基于排序熵算法的麻醉深度检测系统。该系统主要包含3个部分,前端脑电预处理电路、排序熵算法数据处理电路和人机交互软件。前端电路主要包括各类放大电路和滤波电路;排序熵算法数据处理是基于stm32单片机完成;人机交互软件主要用于对测试结果进行记录显示等工作,辅助医生对患者麻醉状况的判断。依据以上方案制作了检测系统,并在实验室环境下进行了测试,能完成相关数据检测。     

低剂量丁丙诺啡对小儿全麻下腹腔镜疝气修补术后镇痛作用观察

目的: 探讨少量丁丙诺啡对小儿全麻下腹腔镜疝气修补术后镇痛作用。方法: 选取我院麻醉科自2016年1月至2017年6月全麻腹腔镜下行疝气手术患儿62例，随机分为对照组和研究组，各31例，研究组于麻醉诱导时静脉输注丁丙诺啡3.0 μg/kg，对照组于麻醉诱导时静脉输注等容量生理盐水，于丁丙诺啡输注前（T₀）、术后6 h（T₁）、术后12 h（T₂）、术后24 h（T₃）时采血测定炎症因子、免疫功能指标，观察并记录术后6 h（T₁）、术后12 h（T₂）、术后24 h（T₃）的疼痛与镇静评分，同时对比临床相应指标及躁动分级程度。结果: 相对于T₀，对照组T₁、T₂、T₃时血清C反应蛋白（CRP）、TNF-α、皮质醇（Cor）含量升高，CD₄⁺、CD₈⁺、CD₄⁺/CD₈⁺含量降低，研究组T₁、T₂时血清CRP、TNF-α、Cor含量升高，CD₄⁺、CD₈⁺、CD₄⁺/CD₈⁺含量降低（P＜0.05）；相对于对照组，研究组T₁、T₂、T₃时血清CRP、TNF-α、Cor含量较低，CD₄⁺、CD₈⁺、CD₄⁺/CD₈⁺含量较高（P＜0.05）；相对于T₁，对照组T₂、T₃时镇静评分降低，研究组T₂、T₃时疼痛与镇静评分降低（P＜0.05）；相对于对照组，研究组T₂、T₃时疼痛与镇静评分较低（P＜0.05）；研究组呛咳反应、躁动评分低于对照组，躁动分级程度优于对照组（P＜0.05）。结论: 少量丁丙诺啡对小儿全麻下腹腔镜疝气修补术后具有良好的镇痛、镇静作用，可以降低炎症指标，提高免疫功能。     

Adaptive disturbance rejection control for compartmental systems with application to intraoperative anesthesia influenced by hemorrhage and hemodilution effects

Compartmental system models involve dynamic states whose values are nonnegative. These models are widespread in biological and physiological sciences and play a key role in understanding these processes. In this paper, we develop a direct adaptive disturbance rejection control framework for compartmental dynamical systems with exogenous bounded disturbances. The proposed framework is Lyapunov based and guarantees partial asymptotic stability of the closed‐loop system, that is, asymptotic stability with respect to part of the closed‐loop system states associated with the plant dynamics. The remainder of the states associated with the adaptive controller gains are shown to be Lyapunov stable. In the case of bounded energy ??₂ disturbances, the proposed approach guarantees a nonexpansivity constraint on the closed‐loop input–output map between the plant disturbances and performance variables. Finally, a numerical example involving the infusion of the anesthetic drug propofol for maintaining a desired constant level of depth of anesthesia for surgery in the face of continuing hemorrhage and hemodilution is provided. Copyright © 2008 John Wiley & Sons, Ltd.     

一种基于神经网络的诱发电位提取方法

文章提出一种改进的利用径向基函数神经网络算法,对诱发电位进行自适应提取的较传统的方法,并在性能上有较大的提高。     

Physiological activity of water beetle defensive agents. II. Absorption of selected anesthetic steroids and norsesquiterpenes across gill membranes of the minnowPimephales promelas Raf.

The uptake of selected steroids and norsesquiterpenes by live minnows,Pimephales promelas, was studied when the compounds were administered externally in aqueous solution. The gills of minnows absorbed 80% of the steroid removed from solution. Steroid absorption across minnow gills is apparently a nonmediated process as rate saturation could not be demonstrated. Initial absorption rates of test compounds were inversely correlated with (1) the degree of oxygenation, (2) water solubility, and (3) polarity on silica gel thin-layer chromatography. These findings support the Stein model of non-mediated transport. The majority of compounds anesthetic and toxic to minnows exerted their effects at a similar internal concentration. Anesthesia occurred at ca. 10^–6–10^–5 M and death at 10^–4–10^–3 M. Since various agents causing membrane stabilization and lysis in in vitro systems act in an identical concentration range, it is proposed that the defensive steroids and norsesquiterpenes of water beetles act via membrane stabilization and lysis.     

CO2激光穴位麻醉拔牙的研究

采用自动心电监护仪对100例老年患者用CO2激光穴位照射麻醉拔牙,了解其麻醉效果,同时,采用患者自身对照方法,观察其对心血管系统的影响。结果表明,采用本法麻醉拔牙,其麻醉优良率为80%,成功率为94%.心电监护结果表明,绝大多数患者术前、术后心电图无变化,说明用麻醉拔牙也是安全的,但需指出的是该法也存着镇痛不全的缺点。同时,还对激光穴位麻醉的机理进行了探讨。     

Neuroadaptive output feedback control for nonlinear nonnegative dynamical systems with actuator amplitude and integral constraints

A neuroadaptive output feedback control architecture for nonlinear nonnegative dynamical systems with input amplitude and integral constraints is developed. Specifically, the neuroadaptive controller guarantees that the control amplitude as well as the integral of the control input over a given time interval are constrained, and the physical system states remain in the nonnegative orthant of the state space. The proposed approach is used to control the infusion of the anesthetic drug propofol for maintaining a desired constant level of depth of anesthesia for noncardiac surgery in the face of infusion rate constraints and an integral drug dosing constraint over a specified time period. Copyright © 2010 John Wiley & Sons, Ltd.     

基于分形理论的麻醉监测诱发脑电信号识别方法研究

提出了一种基于分形理论的麻醉监测诱发脑电信号识别方法.首先给出了麻醉监测中潜伏期听觉诱发脑电信号的数学模型,产生与实际信号相符的模拟脑电信号,然后对脑电信号进行小波降噪,提取降噪后脑电信号的关联维数,最后通过关联维数的大小识别麻醉状态下中潜伏期听觉诱发脑电信号的类型.实验仿真结果表明:提出的识别方法具有较高的识别率.     

基于模型的闭环MCPS设计与仿真

针对患者间的差异导致医疗闭环控制系统具有不确定性的问题,基于MCPS的概念提出一种基于模型的闭环自适应控制体系架构,以BIS信号为控制变量来控制麻醉中的催眠深度。控制方案使用患者的药代动力学/药效学模型,将计算结果作为标准PID控制器的反馈信号来修正模型的不确定性。模型中,参数的调整使用遗传算法离线执行,以此最优化患者数据集的性能指标。提出的方法可以自动调节麻醉药物的输注速率,使麻醉深度保持在一个稳定的目标值。对该方法进行了仿真模拟,加入了噪声块进行了鲁棒性测试,采用蒙特卡洛方法验证了该方法在广泛人群上的有效性。仿真结果表明,该方法能够在规定时间内稳定地达到目标值,且具有良好的干扰排斥反应。