新型無氣囊血壓量測裝置之開發

Development of the novel cuff-less blood pressure measurement device

高耀臨(Yao-Lin Kao)

指導教授 ： 徐良育

中原大學/工學院/醫學工程研究所/碩士(2010年)

https://doi.org/10.6840/CYCU.2010.00560

摘要

高血壓，糖尿病，腦中風為國人主要的慢性疾病，三者中又以高
血壓最為世人隱憂。在臨床應用上，侵入性血壓量測裝置可紀錄連續
血壓訊號，雖精準卻不能在一般例行性檢查中進行。雖然非侵入式血
壓量測計可應用於一般檢查或居家環境中，可是目前市面上常見的非
侵入式血壓計主要缺點是必須搭配充氣幫浦而造成患者不適，在體積
方面也過於龐大而無法隨身攜帶。因此本研究建構一個新型無氣囊血
壓量測裝置，透過本研究設計矽膠血壓擷取裝置擷取血壓訊號，並以
8051F321 主控系統流程與運算，以達到可攜式即時系統的目的。
本研究針對十位正常年輕自願受測者利用本研究所研發之新型
無氣囊血壓量測裝置進行血壓量測，同時與床邊監視器(Spacelabs
Medical, model 90367 )，血壓量測結果進行比對。發現不管是平均血
壓、收縮壓和舒張壓本系統所計算出的值都比床邊監視器來的高。包
括所有的量測結果時，兩系統在平均血壓、收縮壓以及舒張壓之相關
度分別為0.15、0.18 以及0.29。重新檢視各受測者的原始訊號發現，
當受測者在施壓過程中有加壓過快、加壓過慢或不符合震盪法特性的
血壓波形現象時，結果即會出現較大的差異性。將具有上述情形的量
測剔除後，相關度上收縮壓為0.16，平均血壓為0.16，舒張壓為0.38，
發現並無太大差別。進一步檢視，我們辨識出另一個可能干擾量測結
果的干擾因數，亦及量測過程中必須包括八個以上的有效血壓脈衝同
時這些血壓脈衝的封包必須符合震盪法之特徵。去除此類型的紀錄
後，收縮壓的相關度上升為0.71，平均血壓上升為0.60，舒張壓則上
升為0.41。
由上述現象發現如果能在使用規範上更嚴格的定義，則準確度能
有效的提升。上述的干擾因素均可以利用微處理機即時偵測剔除，如
此在實際運用時能提供較可靠的血壓量測。
雖然本系統仍有低準確性的困擾，如果能改進準確率的問題，希
望將來能取代傳統的電子血壓計應用於一般日常生活中。

關鍵字

舒張壓 ； 血壓量測 ； 收縮壓 ； 平均血壓

並列摘要

Hypertension, diabetes and stroke are the three major chronic
diseases of the people in Taiwan. In the clinical applications, the benefit
of invasive blood pressure measurement is that it can record the
continuous pressure pulse accurately. However, it can’t be used in routine
examination. Although the non-invasive blood pressure measurement can
be used at home and in routine examination, it causes discomfort during
measurement due to the high air pressure applied by the air pump.
Besides, it can not be easily carried around because of its size. For these
reasons, this study purposes to construct a novel blood pressure
measurement device without the air cuff. The proposed device measures
blood pressure through a mechanism that is made of silicon rubber. The
system consists of a 8051F321 to control the measurement flow and
perform necessary computation. Thus, the final result is a portable
real-time non-invasive blood pressure measurement system.
In this study, blood pressure readings were obtained using the new
system and bedside monitor (Spacelabs Medical, model 90367) from ten
young volunteers. The results of mean pressure, systolic pressure and
diastolic pressure from the new system were all higher than those from
bedside monitor. Including all measured blood pressure readings, the
correlation coefficient between these two system for mean, systolic and
diastolic pressures were 0.15, 0.18 and 0.29, respectively. Re-exam the
collected data, we found that when the speed of pressure application is
too fast or too slow or the obtained blood pressure waveform
characteristic did not coincide with typical oscillometric measurement,
large variations appear. However, after exclude the above mentioned
measurements, there is no significant improvement, the correlation
coefficients of mean, systolic and diastolic pressures were 0.16, 0.16 and
0.38, respectively.
Further examination, we identified one more factor that can
influence the measurement result that is, during the measurement, there
must included more than eight blood pressure pulses that conformed with
oscillometric blood pressure measurement characteristic. After
eliminating these recorded, the correlation coefficient increased to 0.71,
0.60 and 0.41 for diastolic pressure, mean pressure and systolic pressure,
respectively.
We can conclude from these results that the accuracy can be
improved effectively by defining the user regulation more precisely. The
above mentioned interference factors can be identified and eliminated by
the microprocessor to provide a reliable blood pressure measurement in
practical applications.
In this study, low accuracy is still troubling the current system. If the
accuracy can be improved by incorporating the foregoing findings, this
new system may replace the traditional devices in the future.

並列關鍵字

diastolic pressure ； mean pressure ； non-invasive blood pressure measurement ； systolic pressure

參考文獻

[1] Carr, J. J., Brown, J. M., “Introduction to biomedical equipment

technology”, Prentice hall, fourth edition, 2001

[2] Webster, J. G., “Medical Instrumentation – Application and Design,

3rd edition”,John Wiley & Sons, Inc., pp.309, 1998

Pressure Waveforms in Humans”, Computers and Biomedical