北京生物医学工程

一种激光散斑和温度刺激仪器在压疮早期诊断的研究

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

作者：彭士恒张清栋刘鹏丁呈彪邵鹏飞

单位：中国科学技术大学工程科学学院(合肥 230026) 安徽医科大学第二附属医院(合肥 230601)

关键词：压疮诊断; 激光散斑; 温度刺激; 动态血流;

分类号：R318.6

出版年·卷·期（页码）：2020·39·6（582-587）

摘要：

目的设计了一款具有血流成像以及温度刺激的系统，用于测量压疮区域与非压疮区域的特征，并通过对动物压疮模型进行参数测量，验证该系统在早期压疮诊断中的作用。方法系统主要由相机、环形光源、激光二极管、长焦温度传感及液氮喷射器组成，可以实现激光散斑血流成像，同时利用液氮喷射器给皮肤降温，使该系统获取皮肤动态血流特性。采用脂肪乳模拟血流，验证该系统血流速度测量的准确性。通过对5只兔子的背部，进行压力装置下的加压200 mmHg持续1 h，再恢复血流灌注20 min，反复两次，制作出早期压疮模型。利用该系统对动物压疮模型降温之前到降温再到恢复的整个过程，进行血流成像及血流参数分析。结果系统性能测试结果中，该系统测量的散斑值得到的流速与脂肪乳实际的流速成正比关系。动物实验测试结果中，非压疮区域与压疮区域的制冷后恢复时间（time to peak）分别为89.88 s5.70 s和112.69 s19.67 s，且P值为0.04，具有统计学差异，可作为压疮区域与非压疮区域的区分特征。结论本研究设计的系统可以提供一种客观诊断早期压疮的方法，将为早期压疮诊断提供了一种新的思路。

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.

参考文献：

[1] Scheel-Sailer A, Frotzler A, Mueller G, et al. Biophysical skin properties of grade 1 pressure ulcers and unaffected skin in spinal cord injured and able-bodied persons in the unloaded sacral region [J]. Journal of Tissue Viability, 2017, 26(2): 89-94.
[2] Barakat-Johnson M, Lai M, Wand T, et al. The incidence and prevalence of medical device-related pressure ulcers in intensive care: a systematic review [J]. Journal of Wound Care, 2019, 28(8): 512-521.
[3] Moore Z, Patton D, Rhodes SL, et al. Subepidermal moisture (SEM) and bioimpedance: a literature review of a novel method for early detection of pressure‐induced tissue damage (pressure ulcers) [J]. International Wound Journal, 2017, 14(2): 331-337.
[4] Swisher SL, Lin MC, Liao A, et al. Impedance sensing device enables early detection of pressure ulcers in vivo [J]. Nature Communications, 2015, 6: 6575.
[5] Diaz D, Lafontant A, Neidrauer M, et al. Pressure injury prediction using diffusely scattered light [J]. Journal of Biomedical Optics, 2017, 22(2): 025003.
[6] Qi H, Kong L, Wang C, et al. A hand-held mosaicked multispectral imaging device for early stage pressure ulcer detection [J]. Journal of Medical Systems, 2011, 35(5): 895-904.
[7] Heeman W, Steenbergen W, van Dam GM, et al. Clinical applications of laser speckle contrast imaging: a review [J]. Journal of Biomedical Optics, 2019, 24(8): 080901.
[8] Gnyawali SC, Blum K, Pal D, et al. Retooling laser speckle contrast analysis algorithm to enhance non-invasive high resolution laser speckle functional imaging of cutaneous microcirculation [J]. Scientific Reports, 2017, 7:41048.
[9] Liu J, Xu B, Zhou W, et al. Establishing diffuse speckle contrast signal relationship with blood flow[C]//AOPC 2019: Optical Spectroscopy and Imaging. Beijing: International Society for Optics and Photonics, 2019, 11337: 113370Y.
[10]Perez-Corona CE, Peregrina-Barreto H, Ramírez-San-Juan JC. Space-directional approach to improve blood vessel visualization and temporal resolution in laser speckle contrast imaging [J]. Journal of Biomedical Optics, 2019, 25(3): 032009.
[11] Wang Q, Zhu L, Xing F, et al. The comparison of the effects of local cooling and heating on apoptosis and pyroptosis of early‐stage pressure ulcers in rats[J]. Journal of Cellular Biochemistry, 2020, 121(2): 1649-1663.
[12] Ahmed A, Goodwin C, Sarabia-Estrada R, et al. A non-invasive method to produce pressure ulcers of varying severity in a spinal cord-injured rat model [J]. Spinal Cord, 2016, 54(12): 1096-1104.

服务与反馈：

【文章下载】【加入收藏】

提示：您还未登录，请登录！点此登录