CN-121987252-A - Computer equipment for executing inferior vena cava ultrasonic image real-time analysis and evaluation method in hemodialysis

Abstract

The invention provides computer equipment for executing a real-time analysis and evaluation method of inferior vena cava ultrasonic image in hemodialysis, which comprises a memory, a processor and a computer program, wherein the processor is realized when executing the program, and is used for acquiring inferior vena cava ultrasonic image data in the hemodialysis process, identifying delay time of an internal diameter contraction response, determining duration of a hysteresis platform period based on a period that the internal diameter of a blood vessel is maintained relatively stable after the liquid removal speed changes, identifying that the rebound speed of the wall of the blood vessel is higher than the internal diameter contraction speed according to the duration of the hysteresis platform period, acquiring a blood volume safety range and a contraction speed threshold according to an internal diameter fluctuation range corresponding to the high elasticity reserve, acquiring a blood volume measurement value at an ultrafiltration rate intervention time, triggering reverse regulation when the blood volume measurement value exceeds the blood volume safety range, and extracting the internal diameter contraction speed after the blood volume is stable.

Inventors

• LI WEIWEI
• ZHANG HAIXIA

Assignees

• 核工业总医院

Dates

Publication Date

20260508

Application Date

20260324

Claims (10)

1. 1. A computer device for performing a method for real-time analysis and evaluation of inferior vena cava ultrasound images in hemodialysis, comprising a memory, a processor and a computer program stored on the memory and executable on the processor, characterized in that the processor performs the following steps when executing the program: Acquiring inferior vena cava ultrasonic image data in the hemodialysis process, identifying delay time of an inner diameter contraction response, and determining duration of a hysteresis platform period based on a period of time during which the inner diameter of a blood vessel is maintained relatively stable after the liquid removal speed is changed; Extracting the rebound speed and the inner diameter shrinkage speed of the blood vessel wall in a corresponding period according to the duration of the hysteresis plateau, identifying the blood vessel wall as high-elasticity reserve when the rebound speed of the blood vessel wall is higher than the inner diameter shrinkage speed, and acquiring a blood volume safety range and a shrinkage speed threshold according to the inner diameter fluctuation range corresponding to the high-elasticity reserve; Identifying a pseudo steady-state interval based on the delay time of the inner diameter shrinkage response and the difference value between the maximum inner diameter and the minimum inner diameter, determining that the real-time inner diameter is in the pseudo steady-state interval as a high oscillation risk, and determining that the real-time inner diameter is in the pseudo steady-state interval as a low oscillation risk otherwise; The real-time inner diameter measured value is traced back to the corresponding time of the delay time length, time sequence alignment is carried out to obtain an inner diameter estimated value after delay compensation, ultrafiltration rate adjustment amplitude is determined according to the relation between the inner diameter estimated value after delay compensation and the inner diameter threshold corresponding to the blood volume safety range, and ultrafiltration rate adjustment advice is generated by combining the oscillation risk to obtain an optimized ultrafiltration rate output value; Determining a single ultrafiltration rate adjustment amplitude based on the difference value between the optimized ultrafiltration rate output value and the real-time ultrafiltration rate output value, and uniformly distributing the adjustment amplitude according to the delay time section when the single ultrafiltration rate adjustment amplitude is not matched with the delay time of the inner diameter shrinkage response, so as to determine an ultrafiltration rate intervention time point; and acquiring a blood volume measurement value at an ultrafiltration rate intervention time point, triggering reverse regulation when the blood volume measurement value exceeds a safe range of the blood volume, and extracting the inner diameter shrinkage speed after the blood volume is stable.
2. 2. The computer device for performing the method for real-time analysis and evaluation of inferior vena cava ultrasound image in hemodialysis according to claim 1, wherein the acquiring of the inferior vena cava ultrasound image data in hemodialysis procedure, identifying the delay period of the inside diameter contraction response, determining the duration of the lag plateau based on the period during which the inside diameter of the blood vessel remains relatively stable after the change in the liquid removal rate, comprises: Obtaining ultrasonic image data of the inferior vena cava in the hemodialysis process, identifying the inner and outer boundaries of the blood vessel wall through edge detection, calculating the current inner diameter value, extracting an inner diameter value sequence in a preset time period after the dialysis starts from a historical database, calculating the average value of the inner diameter change rate of adjacent time points as a historical inner diameter change standard, carrying out difference operation according to the historical inner diameter change standard and the current inner diameter change rate, determining a response starting point, tracking the inner diameter value change from the response starting point, judging to enter a relatively stable state when the inner diameter fluctuation amplitude of the continuous sampling point is smaller than a preset fluctuation threshold, calculating the delay time of inner diameter shrinkage response from the response starting point to the relatively stable state, carrying out piecewise scanning on the inner diameter data after the delay time by adopting a sliding window, obtaining a fitting curve through least square fitting, identifying the continuous time period of which the slope of the fitting curve is close to zero and the inner diameter fluctuation range is maintained in the preset range, determining the continuous time of the delay platform period, and obtaining the time difference between the starting time and the ending time of the delay platform period.
3. 3. The computer device for performing the method for real-time analysis and evaluation of inferior vena cava ultrasound image in hemodialysis according to claim 1, wherein the extracting the rebound velocity and the inner diameter contraction velocity of the blood vessel wall according to the duration of the hysteresis plateau, and identifying the blood vessel wall as a high elasticity reserve when the rebound velocity of the blood vessel wall is faster than the inner diameter contraction velocity, and acquiring the blood volume safety range and the contraction velocity threshold according to the inner diameter fluctuation range corresponding to the high elasticity reserve, comprises: extracting time sequence change data of the blood vessel wall according to the duration of the hysteresis platform period, acquiring a shrinkage speed curve of the inner diameter from the end time of the platform period by differential operation, tracking the change of the inner boundary and outer boundary of the blood vessel wall, determining the time required for the blood vessel wall to recover from the maximum compression state to the thickness value before compression as a rebound period, calculating the rebound speed of the blood vessel wall, judging the rebound speed of the blood vessel wall as a high elasticity storage state when the rebound speed of the blood vessel wall is larger than the average value of the shrinkage speeds of the inner diameter, extracting the maximum value and the minimum value of the inner diameter from the time period corresponding to the high elasticity storage state, taking the difference value of the maximum value and the minimum value of the inner diameter as an inner diameter fluctuation range, determining the blood volume safety range according to the inner diameter fluctuation range, sequencing the inner diameter shrinkage speed sequence in the high elasticity storage state, and determining the shrinkage speed threshold.
4. 4. A computer device for performing a method for real-time analysis and evaluation of inferior vena cava ultrasound images in hemodialysis according to claim 1, wherein said identifying a pseudo steady-state interval based on the delay time of the inner diameter contraction response and the difference between the maximum inner diameter and the minimum inner diameter, the real-time inner diameter being determined to be at high risk of oscillation when it is within the pseudo steady-state interval, and otherwise being determined to be at low risk of oscillation, comprises: The method comprises the steps of obtaining a current ultrafiltration rate output value of dialysis equipment, calculating a current blood volume reduction rate, comparing an allowable blood volume change rate range corresponding to a blood volume safety range, determining a deviation degree, calculating a difference value between a maximum inner diameter value and a minimum inner diameter value as an inner diameter fluctuation range according to the deviation degree and a delay time length of an inner diameter contraction response, calculating an expected inner diameter change amount during the delay period according to the delay time length, identifying a pseudo steady-state interval when the real-time inner diameter change amount is smaller than a preset proportion of the expected change amount, and comparing the real-time inner diameter measurement value with a boundary value of the pseudo steady-state interval to determine an oscillation risk level.
5. 5. The computer device for performing the method for real-time analysis and evaluation of inferior vena cava ultrasound image in hemodialysis according to claim 1, wherein the identification of the pseudo steady-state interval comprises obtaining a buffer maintenance capacity of the vessel wall from a duration of the hysteresis plateau, collecting a degree of elastic recovery from a rebound velocity of the vessel wall, analyzing a buffer strength of the vessel wall to maintain a stable inner diameter when liquid is removed, evaluating a declining state of the degree of elastic recovery after a decrease in an inner diameter contraction velocity, determining a turning moment of the vessel wall from active buffer to passive maintenance, and identifying a pseudo steady state after the buffer capacity is exhausted in the hysteresis plateau.
6. 6. A computer device for performing a method for real-time analysis and evaluation of inferior vena cava ultrasound images in hemodialysis according to claim 1, wherein identifying a pseudo steady-state interval comprises: The method comprises the steps of extracting vascular wall deformation response data from the duration of a hysteresis platform period, dividing the duration into a plurality of equal-length intervals, calculating the mean value of vascular wall deformation amplitude in each interval, judging the variation trend of a buffering effect through the difference value of the mean values of adjacent intervals, determining the attenuation rate of buffering maintenance capability, extracting the maximum rebound velocity from a vascular wall rebound velocity sequence as the peak velocity according to the attenuation rate of the buffering maintenance capability, calculating the ratio of the current rebound velocity to the peak velocity as the elastic recovery degree, calculating the moving average value of the inner diameter shrinkage velocity, marking the moving average value as a shrinkage slowing state when the moving average value is lower than a preset threshold value, comparing the numerical difference of the elastic recovery degree before and after shrinkage slowing down to determine the grade of a decline state, determining the turning moment when the elastic recovery degree continuously decreases and is lower than the preset ratio of the peak value according to the variation sequence of the decline of the grade of the decline state along time, simultaneously determining the slope of the buffering maintenance capability to be turned moment from active buffering to passive maintenance, judging the stable state when the inner diameter fluctuation characteristic after the turning moment is smaller than the preset threshold value, and the ultrafiltration rate is maintained constantly to lead to continuous liquid removal, and identifying the stable state of the inner diameter after the false buffering capability in the platform period.
7. 7. The computer device for performing a method for real-time analysis and evaluation of inferior vena cava ultrasound images in hemodialysis according to claim 1, wherein the performing time-series alignment of the real-time inner diameter measurement value back to the time corresponding to the delay time length to obtain a delay-compensated inner diameter evaluation value, determining an ultrafiltration rate adjustment amplitude according to the relationship between the delay-compensated inner diameter evaluation value and the inner diameter threshold corresponding to the blood volume safety range, generating an ultrafiltration rate adjustment suggestion in combination with the oscillation risk, and obtaining an optimized ultrafiltration rate output value comprises: The method comprises the steps of obtaining a real-time inner diameter measured value and a timestamp thereof, tracing back a corresponding time point forward according to delay time length of inner diameter shrinkage response, extracting an inner diameter value of the time point from a historical inner diameter sequence, processing a non-integer time point through linear interpolation, calculating a difference value between a current real-time inner diameter and a tracing back inner diameter to serve as a response quantity, correcting the current measured value by the response quantity to obtain an inner diameter estimated value after delay compensation, comparing the inner diameter estimated value after delay compensation with an inner diameter upper limit threshold value and a lower limit threshold value corresponding to a blood volume safety range, respectively calculating an adjustment coefficient exceeding the upper limit or being lower than the lower limit, multiplying the adjustment coefficient with a preset reference change quantity to obtain a basic adjustment amplitude, correcting the basic adjustment amplitude according to an oscillation risk level to obtain an ultrafiltration rate adjustment recommended value, uniformly distributing the difference value within a preset transition time length according to a difference value between the ultrafiltration rate adjustment recommended value and the current ultrafiltration rate, and gradually adjusting an ultrafiltration rate set value to obtain an optimized ultrafiltration rate output value.
8. 8. The computer device for performing a method for real-time analysis and evaluation of inferior vena cava ultrasound image in hemodialysis according to claim 1, wherein the determining a single ultrafiltration rate adjustment amplitude based on a difference between the optimized ultrafiltration rate output value and the real-time ultrafiltration rate output value, the single ultrafiltration rate adjustment amplitude being uniformly distributed in segments according to a delay duration when the delay duration of the single ultrafiltration rate adjustment amplitude and the inner diameter contraction response are not matched, the determining an ultrafiltration rate intervention time point comprises: The method comprises the steps of optimizing ultrafiltration rate output values, calculating a difference value according to the optimized ultrafiltration rate output values and real-time ultrafiltration rate output values to obtain single ultrafiltration rate adjustment amplitude, obtaining delay time length of inner diameter shrinkage response, calculating quotient value obtained by dividing the single adjustment amplitude by the delay time length, comparing the quotient value with a preset change rate threshold value to judge whether the quotient value is matched or not, dividing the delay time length into equal time periods in a non-matching state, dividing the single ultrafiltration rate adjustment amplitude by the number of segments to obtain adjustment quantity of each segment, and distributing the adjustment quantity to each time period, wherein the starting moment of each time period is used as an ultrafiltration rate intervention time point.
9. 9. The computer device for performing a method for real-time analysis and evaluation of inferior vena cava ultrasound image in hemodialysis according to claim 1, wherein the step of obtaining the blood volume measurement value at the time of intervention of ultrafiltration rate, triggering the reverse regulation when the blood volume measurement value exceeds the safe range of blood volume, extracting the inner diameter shrinkage speed after the stabilization of blood volume, comprises: The method comprises the steps of obtaining a blood volume measurement value of an ultrafiltration rate intervention time point, comparing the blood volume measurement value with the upper limit and the lower limit of a blood volume safety range, determining an out-of-limit direction, increasing the ultrafiltration rate in a positive out-of-limit direction according to the out-of-limit direction, reducing the ultrafiltration rate in a negative out-of-limit direction, limiting a single adjustment range through a suppression coefficient, continuously monitoring blood volume change, judging that the blood volume reaches a stable state when the blood volume fluctuation range is smaller than a stable threshold value in a continuous preset time period, and obtaining the stable inner diameter contraction speed.
10. 10. The computer device for performing the method for real-time analysis and evaluation of inferior vena cava ultrasound image in hemodialysis according to claim 1, wherein the method further comprises updating the elastic reserve level according to the relationship between the stabilized inner diameter contraction speed and the contraction speed threshold, determining the image acquisition sensitivity according to the elastic reserve level, processing the subsequent inferior vena cava ultrasound image data according to the image acquisition sensitivity, and determining the initial inner diameter measurement value for the next periodic capacity correction.

Description

Computer equipment for executing inferior vena cava ultrasonic image real-time analysis and evaluation method in hemodialysis Technical Field The invention relates to the technical field of information, in particular to computer equipment for executing a method for analyzing and evaluating inferior vena cava ultrasonic images in hemodialysis in real time. Background In the medical field, hemodialysis is a life-saving treatment means, which is vital for maintaining the life of end-stage renal patients, and this technique regulates the fluid balance in the patient by removing excess water and toxins from the body, and is centered on the precise control of blood volume. However, how to monitor and adjust the liquid removal rate in real time during the treatment process to avoid placing excessive burden on the patient's body becomes a non-negligible challenge. The current prior art is often difficult to accurately capture the dynamic response of the human blood vessel to the change of the liquid removal speed, and the adaptation capability and buffering mechanism of the blood vessel are easy to ignore. Such neglect leads to problems of delayed or excessive regulation during the regulation process, thereby affecting the safety and stability of the treatment. The root of the above technical problem is the compliant cushioning effect of the vessel wall. The vessel wall is composed of layers of elastic fibers and muscle tissue, has natural stretch and rebound properties, and does not simply change shape immediately upon removal of the fluid. In a clinical setting, when the device is activated to rapidly remove fluid, the vessel wall will temporarily expand or maintain its original diameter by its elasticity, absorbing some of the volume changes, and thus exhibiting a temporary steady state. For example, at the beginning of dialysis, the patient's blood vessel may still show a plateau in blood pressure and blood volume indicators after removal of a few hundred milliliters of fluid, but this is often the result of vessel wall buffering, not true equilibrium. This condition masks the true hypovolemia condition, resulting in a monitoring system that cannot timely determine if the patient is approaching a dangerous fluid imbalance condition. Further, the response delay caused by such a buffering effect makes it possible that the actual state of the patient may deviate from the safe range when the regulation system issues a regulation command, causing fluctuations and instability of the subsequent regulation. In particular during hemodialysis, when a physician or device decides to rapidly increase the fluid removal rate based on initial data, the vessel diameter may not be immediately reduced, but rather a short stabilization phase is maintained by fine-tuning the wall thickness and support of the surrounding tissue. The occurrence of the false image is caused by the fact that the elastic fiber of the blood vessel wall preferentially absorbs the capacity change through self deformation when being pressed, but is not directly transmitted to the inner diameter of the blood vessel, so that the inner diameter measured value relied by the monitoring system presents a false stable state in a buffer period, when the elastic reserve of the blood vessel wall is gradually exhausted, the buffer capacity of the blood vessel wall is suddenly lost, the inner diameter of the blood vessel is rapidly contracted in a short time, and at the moment, the monitoring system still maintains the original liquid removal speed based on the early stable data, the removal rhythm is not synchronously reduced, and the actual blood volume is suddenly reduced at the moment of buffer failure. Such artefacts make the system misunderstand that the patient is in a normal state, for example, cardiac output and peripheral resistance indexes look coordinated, but fail to capture potential hypovolemic signals, and as a result, the blood volume may be suddenly reduced, and the patient suddenly has symptoms such as dizziness, nausea or hypotension. In another common scenario, when the patient does not keep pace with the removal of rhythm during dialysis, the buffer effect can further lengthen the response time, delay perceived circulatory blood volume decline, causing repeated blood pressure fluctuations and treatment interruption risks. Therefore, how to accurately identify the pseudo-steady state and adjust the liquid removal speed in time before the unbalance of the blood volume on the basis of fully considering the compliance buffer effect of the blood vessel wall becomes a key problem in the real-time monitoring and control of hemodialysis. Disclosure of Invention The invention provides a computer device for executing a method for analyzing and evaluating inferior vena cava ultrasonic image in hemodialysis in real time, which comprises a memory, a processor and a computer program stored on the memory and capable of running on the processor, wherein the proce