本研究主要目的，是希望利用非侵入之血管容積變化信號（Photo-Plethysmography, PPG），來評估手術病患舒張壓的變化趨勢。現今醫療上所使用的血壓量測方式分為兩大類：侵入式（Invasive）與非侵入式（Non-Invasive）。此兩種量測方法各有其優、缺點；對於侵入式血壓而言，大部分使用時機是在進行手術外科時才會使用，其所量測的血壓值為血管中的連續絕對壓力，此亦為其優點，但是因為是侵入式的量測，所以需要在專業醫師評估後才能以此方式量測血壓，具有一定的不便性；而非侵入式血壓量測雖然具有不侵犯人體的優點，但同時亦具有量測值為估測值的缺點，且每次量測都存在時間盲點；本研究的血壓評估方法是介於侵入式與非侵入式之血壓量測，不但為非侵入式，而且具有血壓變化趨勢連續評估的優點，可以降低非侵入式血壓量測過程中，因時間盲點所造成的不確定性，因此適用於輔助非侵入式血壓量測。本研究之評估對象為非外因性血壓變化之手術病患，非外因性指的是沒有大量失血與輸血；並嘗試以單一種PPG訊號之特徵參數，連續評估一分鐘內的血壓上升變化趨勢。

The purpose of this research is the estimation for the trend of diastolic pressure of surgical patients utilizing non-invasive photo-plethysmography (PPG) signal. There are two major ways to measure blood pressure during medical treatment : invasive and non-invasive methods. Both them have advantages and disadvantages. For invasive method, it is used for surgical operations. Although it can response the true situation of arterial blood pressure, the damage and uncomfortable are the most disadvantages for itself. And for non-invasive method, it is convenient to use but the measurement results have lower accuracy. In this research, we try to estimate the continuous trend of diastolic pressure utilizing PPG signal. And calculate the accuracy of the results.

目 錄


目錄……………………………………………………………………i
圖目錄…………………………………………………………………iv
表目錄…………………………………………………………………viii
中文摘要………………………………………………………………ix
Abstract…………………………………………………………………x

第一章 緒論…………………………………………………………1
1.1 前言…………………………………………………………1
1.2 研究動機與目的……………………………………………2
1.3 本研究遭遇之困難……………………………………………4
1.4 研究方法………………………………………………………6
1.5 論文架構………………………………………………………6

第二章 基本醫學背景、原理與方法…………………………………7
2.1 臨床血壓量測原理…………………………………………7
2.1.1 非侵入式血壓（NIBP）量測原理…………………7
2.1.2 侵入式血壓（ABP）量測原理………………………9
2.1.3 臨床血壓量測之現況………………………………10
2.1.4 sABP重要特徵………………………………………11
2.2 血管容積變化信號量測原理………………………………12
2.2.1 何謂「血管容積變化信號（PPG）」…………………12
2.2.2 PPG量測方式與原理………………………………14
2.2.3 PPG臨床使用之現況………………………………16
2.2.4 PPG重要特徵………………………………………17
2.3 PPG與ABP於生理上之相關性……………………………19

第三章 工程分析方法與原理………………………………………20
3.1 週期信號峰谷值偵測………………………………………20
3.1.1 峰谷值偵測之重要性………………………………20
3.1.2 峰谷偵測演算法………………………………………21
3.1.3 峰值與谷值標示………………………………………25
3.2 重搏波（Dicrotic Notch）之偵測…………………………30
3.2.1 Dicrotic Notch之特徵……………………………30
3.2.2 小波轉換（Wavelet Transform）之介紹………………31
3.2.3 利用小波轉換標示Dicrotic Notch…………………38
3.3 利用小波（Wavelet）粹取低頻變化趨勢…………………40
3.4 相關性分析與事件標示……………………………………47
3.4.1 相關性分析之對象……………………………………47
3.4.2 相關係數……………………………………………47
3.4.3 ABP與PPG之相關性分析…………………………47
3.4.4 PPG事件標示………………………………………51
第四章 實驗結果……………………………………………………54
4.1 病例選擇……………………………………………………54
4.2 實驗步驟……………………………………………………54
4.3 實驗結果……………………………………………………55

第五章 討論與結論…………………………………………………62
5.1 結果討論……………………………………………………62
5.2 結論…………………………………………………………62

參考文獻………………………………………………………………63

參考文獻

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