Non-extracorporeal circulation coronary artery bypass transplantation monitoring control method and control device

Abstract

The invention provides a non-extracorporeal circulation coronary artery bypass transplantation monitoring control method and a non-extracorporeal circulation coronary artery bypass transplantation monitoring control device. The control method comprises the following steps: step 1, wearing a non-invasive continuous blood pressure monitor and a TCD monitoring headstock for a surgical patient, and fixing a TCD monitoring probe after a clear image of a monitored blood vessel is obtained; 2, after the patient receives anesthesia for 5-10 minutes, a hemodynamic parameter A initial at the moment is obtained and serves as a basic reference value in an operation, and an alarm system is started; 3, starting an operation, starting timing by a timer, monitoring and recording the hemodynamic parameter A after the operation is started in real time, automatically calculating the ratio delta value of the real-time average cerebral blood flow velocity to the initial average cerebral blood flow velocity, and tracking and recording the delta value in real time; 4, according to the change condition of the delta value, sending out a corresponding alarm prompt; and step 5, adding a record ending mark in the monitoring trend chart, and ending the TCD monitoring. Hemodynamic parameters of a patient in an operation are automatically monitored in real time and recorded and stored in a monitoring trend chart, the accuracy and operation efficiency of diagnosis of abnormal perfusion and embolism events in the operation are improved by means of the functions of voice reminding, automatic timing, intelligent calculation and the like of an alarm system, meanwhile, doctors can conveniently and rapidly know the condition of the patient, and the patient experience is improved. And timely response is made.

Description

Technical Field

[0001] The present invention relates to the field of medical technology, and in particular to a monitoring and control method and a control device for off-pump coronary artery bypass grafting. Background Art

[0002] With the rapid development of the aging population in my country, coronary heart disease (CHD) has become one of the major diseases that seriously threatens the health of the nation. The "China Cardiovascular Health and Disease Report 2023" estimates that there are 330 million people with cardiovascular disease, including 11.39 million with coronary heart disease, and the disease burden is in a continuous growth trend. Since Dr. Favaloro of the Cleveland Clinic successfully pioneered coronary artery bypass grafting (CABG) in 1967, this procedure has gradually become the most effective technical means for CHD revascularization in the past few decades, which can achieve the purpose of relieving symptoms, improving heart function, and improving the quality of life. In China, where there are a large number of cardiovascular patients, CABG surgery has increased year by year at a rate of 6% to 10%. In 2022, a total of 571 hospitals in China carried out CABG, and the number of surgeries that year reached 49,000, accounting for nearly 20% of all cardiovascular surgical operations.

[0003] Although CABG surgery has created an opportunity for many patients with severe cardiovascular diseases to regain their lives, the high incidence of postoperative brain and nervous system damage compared to non-cardiac surgery has become an important problem that plagues clinicians. Previous studies have shown that the incidence of new stroke and cognitive dysfunction after CABG surgery is as high as 24%. Once a stroke occurs in the perioperative period, it will lead to the death of 16%-30% of patients. Therefore, strengthening brain protection during CABG surgery and reducing the occurrence of postoperative neurological complications are important links to ensure surgical safety and improve patient prognosis.

[0004] Although many factors before, during, and after surgery are related to neurological complications, the main mechanisms causing ischemic brain injury can be summarized into the following four categories: embolism, ischemia, inflammatory response, and metabolic disorder. Preventing embolism and ischemia is the top priority to avoid brain injury during surgery. This urgent clinical demand has spawned many intraoperative neurological function monitoring methods, such as transcranial Doppler ultrasound (TCD), near-infrared spectroscopy (NIRS), electroencephalography (EEG), and evoked potentials, which are used to reflect subtle changes in intraoperative cerebral blood perfusion, blood oxygen saturation, or neurological function, so as to promptly detect the risk of brain injury and intervene.

[0005] Although NIRS is widely used due to its ease of operation, its monitoring data is easily affected by the selected location and depth, and can only reflect the changes in brain oxygen in a small area of ​​cortical tissue. It is impossible to clearly identify the possible location / cause of hypoxia, and there is no consensus on the threshold of hypoxia in clinical practice. However, electroencephalograms and evoked potentials are expensive and easily interfered by hypothermia, drugs, and other instruments and equipment during intraoperative monitoring, so they do not have the basic conditions for large-scale development. TCD can intuitively and in real time reflect the hemodynamic changes of cranial and cerebral blood vessels. It is faster and more sensitive than NIRS, which facilitates surgeons and anesthesiologists to adjust perfusion strategies as early as possible to achieve the best dynamic management of intraoperative cerebral blood flow. Moreover, TCD is the only neuroimaging method that can intuitively monitor the detachment of emboli during surgery. It can detect embolic events of intracranial main vessels at the first time, which has indisputable guiding significance for saving patients' lives and ensuring surgical safety.

[0006] At present, the application of TCD in CABG surgery is mainly limited by the barriers of operation technology and data interpretation. After setting up the monitoring probe, professional and technical personnel need to observe the changes in cerebral blood flow and the occurrence of embolic events during the operation throughout the whole process, so as to prompt the operator and the anesthesiologist in time, which is time-consuming and labor-intensive, and the work efficiency is low. Therefore, there is an urgent need for the development of an intelligent control system for accurate and rapid diagnosis of intraoperative perfusion and risk stratification of embolism in the clinic. CN105938520B is a data processing method and system for foaming test inspection, which synchronously marks and starts a stopwatch in the TCD device, automatically and in real time performs embolus monitoring, foaming test embolus statistics, draws blood flow peak trends and embolus relationship diagrams, and provides the operating doctor with whether the patient's Valsalva action in the foaming test meets the requirements, and the basis for the classification of the foaming test results, and the machine automatically records various data and performs timing operations. However, this patent application cannot be used to quickly determine the perfusion of patients during surgery, cannot prompt doctors to respond in time according to the patient's cerebral blood flow perfusion, and only focuses on the embolus situation, and the monitoring of the patient's cerebral blood flow is not comprehensive enough. Summary of the invention

[0007] In view of this, the present invention aims to propose a monitoring and control method and control device for off-pump coronary artery bypass grafting to solve the problem of relying solely on intraoperative monitoring by doctors themselves to observe the changes in cerebral blood flow and the occurrence of embolic events in patients throughout the entire process, and making inaccurate judgments on abnormal conditions of patients during the operation.

[0008] To achieve the above object, the technical solution of the present invention is achieved as follows:

[0009] In one aspect, the present invention provides a monitoring and control method for off-pump coronary artery bypass grafting, comprising the following steps:

[0010] Step 1: Put on the non-invasive continuous blood pressure monitor and TCD monitoring head frame for the surgical patient, and fix the TCD monitoring probe after obtaining a clear image of the monitored blood vessels;

[0011] Step 2: 5 to 10 minutes after the patient receives anesthesia, obtain the hemodynamic parameter A at this time 初始 , and used as the basic reference value during the operation to activate the alarm system;

[0012] Step 3: The operation begins, the timer starts counting, and the hemodynamic parameters A after the operation begins are monitored and recorded in real time. 实时 , automatically calculate the ratio Δ value of the real-time average cerebral blood flow velocity and the average cerebral blood flow velocity at the initial moment, and conduct real-time tracking and recording of Δ value;

[0013] Step 4: According to the change of Δ value, a corresponding alarm prompt is issued;

[0014] Step 5: Add a record end mark in the monitoring trend chart, and TCD monitoring ends.

[0015] Furthermore, the hemodynamic parameters include blood pressure, heart rate and cerebral blood flow velocity, and the cerebral blood flow velocity includes systolic velocity (PSV), diastolic velocity (EDV) and mean velocity (MV), wherein the mean velocity (MV) = (PSV-EDV) / 3+EDV.

[0016] Furthermore, in step four, when the Δ value is greater than 250%, the screen data is displayed in yellow to determine whether this state exceeds the t1 time. If so, the screen data is displayed in red, and a voice alarm of "over-perfusion" is issued; when 0<Δ value<50%, the screen data is displayed in yellow to determine whether this state exceeds the t2 time. If so, the screen data is displayed in red, and a voice alarm of "insufficient perfusion" is issued; when the Δ value is 0%, the monitoring blood flow signal disappears, and a voice alarm of "blood flow interruption, please clarify the reason" is immediately issued, and the cause is immediately investigated.

[0017] Furthermore, the t1 is 1 to 1.5 minutes, and t2 is 4 to 6 minutes.

[0018] Furthermore, in step 4, according to the surgical progress, the surgical operator or anesthesiologist inputs commands by voice, and marks corresponding to different commands and the time when the commands appear are synchronously added to the monitoring trend chart.

[0019] Furthermore, the command includes surgical steps related to changes in cerebral blood perfusion, such as aortic arch side wall clamping and open side wall clamping.

[0020] Furthermore, when the side wall clamp is opened, it is easy to cause the appearance of emboli. At the same time, the hemodynamic parameters A after the operation are monitored. 实时, the number of emboli and the time when emboli appear.

[0021] On the other hand, the present invention also proposes a non-extracorporeal coronary artery bypass grafting monitoring and control device, which adopts the above-mentioned coronary artery bypass grafting monitoring and control method to monitor and remind the patient during coronary artery bypass grafting.

[0022] Furthermore, the control device includes: an ECG monitoring module, which is used to monitor and obtain the patient's ECG data in real time; a blood pressure monitoring module, which is used to monitor and obtain the patient's blood pressure data in real time; a cerebral blood flow velocity monitoring module, which is used to monitor and obtain the patient's systolic flow velocity and diastolic flow velocity data in real time, and calculate and obtain the average flow velocity; an alarm system module, which is used to change the screen display color and issue a voice alarm according to the patient's cerebral blood flow situation during the operation; a time acquisition module, which is used to obtain time information; a control module, which is used to monitor and control the coronary artery bypass grafting process according to the patient's ECG, blood pressure, cerebral blood flow velocity, t1 time, and t2 time information.

[0023] Compared with the prior art, the off-pump coronary artery bypass grafting monitoring and control method and control device described in the present invention have the following advantages:

[0024] (1) By automatically monitoring the patient's hemodynamic parameters in real time during surgery and recording and storing them in the monitoring trend chart, and using the alarm system voice reminders, automatic timing, intelligent calculation and other functions, the accuracy and efficiency of intraoperative perfusion abnormality and embolic event diagnosis are improved. At the same time, it also makes it easier for surgical operators and anesthesiologists to quickly understand the patient's cerebral blood flow changes and respond in a timely manner, providing technical support for optimizing the clinical diagnosis and treatment process.

[0025] (2) Hemodynamic parameters include blood pressure, heart rate, and cerebral blood flow velocity. Blood pressure and heart rate data can be used to retrospectively analyze the real-time impact of blood pressure and heart rate changes on cerebral blood flow during surgery. The monitored Δ value of cerebral blood flow velocity can indicate different types of perfusion abnormalities during surgery and improve the accuracy of judgment of patient abnormalities.

[0026] (3) According to the change of Δ value, the abnormal perfusion or embolism of the patient during the operation is judged in real time, and corresponding alarm prompts are issued. DETAILED DESCRIPTION

[0027] In order to be able to understand the characteristics and technical contents of the embodiments of the present invention in more detail, the present invention is further described below in conjunction with specific embodiments. It should be noted that these embodiments are only used to illustrate the present invention and are not intended to limit the scope of the present invention. In addition, it should be understood that after reading the content of the present invention, those skilled in the art can make various changes or modifications to the present invention, and these changes or modifications also fall within the scope protected by the present application.

[0028] A monitoring and control method for off-pump coronary artery bypass grafting of the present invention comprises the following steps:

[0029] Step 1: Put on the non-invasive continuous blood pressure monitor and TCD monitoring head frame for the surgical patient, and fix the TCD monitoring probe after obtaining a clear image of the monitored blood vessels;

[0030] Step 2: 5 to 10 minutes after the patient receives anesthesia, obtain the hemodynamic parameter A at this time 初始 , and used as the basic reference value during the operation to activate the alarm system;

[0031] Specifically, 5 to 10 minutes after anesthesia, the off-pump coronary artery bypass grafting has not officially started, and the patient's physiological indicators such as blood pressure and heart rate tend to be stable at this time, and this state is the initial stable state. Therefore, it is most appropriate to obtain the hemodynamic parameters at this time as the basic reference value. The hemodynamic parameters include blood pressure, heart rate and cerebral blood flow velocity. The cerebral blood flow velocity includes systolic velocity (PSV), diastolic velocity (EDV) and mean velocity (MV), wherein the mean velocity (MV) = (PSV-EDV) / 3+EDV.

[0032] Step 3: The operation begins, the timer starts counting, and the hemodynamic parameters A after the operation begins are monitored and recorded in real time. 实时 , automatically calculate the ratio Δ value of the real-time average cerebral blood flow velocity and the average cerebral blood flow velocity at the initial moment, and conduct real-time tracking and recording of Δ value;

[0033] Specifically, after the operation begins, the patient's blood pressure will fluctuate slightly during the operation. At the same time, because the heart will be moved from time to time during the operation, the change in position will cause changes in ejection, and the cerebral blood flow will also change synchronously. When monitoring the cerebral blood flow velocity, the average flow velocity (MV) and Δ value are obtained by monitoring the systolic flow velocity and diastolic flow velocity. The real-time tracking and recording of the Δ value makes it easy for the operator and the anesthesiologist to grasp the cerebral blood perfusion at any time.

[0034] The timer counts and displays the timing information in the monitoring trend chart, and records the hemodynamic parameters A at different times accordingly 实时The recorded parameters provide retrospective objective evidence for the occurrence of postoperative neurological complications, and help in the formulation of individualized diagnosis and treatment strategies, thereby reducing the occurrence of perioperative brain injury events during CABG and improving the prognosis of patients.

[0035] The monitored blood pressure and heart rate data can be used to review and analyze the real-time impact of blood pressure and heart rate changes on cerebral blood flow during surgery. The monitored cerebral blood flow velocity delta value can indicate different types of perfusion abnormalities during surgery. The use of blood pressure, heart rate and cerebral blood flow velocity helps to improve the accuracy of judging abnormal conditions of patients.

[0036] Step 4: According to the change of Δ value, a corresponding alarm prompt is issued;

[0037] Specifically, according to the change of Δ value, the abnormal perfusion or embolism of the patient during the operation is judged in real time, and the corresponding alarm prompt is issued. When Δ value>250%, the TCD screen data is displayed in yellow, and it is judged whether this state exceeds the t1 time. If so, the screen data is displayed in red, and a voice alarm of "over-perfusion" is issued; when 0<Δ value<50%, the screen data is displayed in yellow, and it is judged whether this state exceeds the t2 time. If so, the screen data is displayed in red, and a voice alarm of "insufficient perfusion" is issued; when Δ value is 0%, the monitoring blood flow signal disappears, and a voice alarm of "blood flow interruption, please clarify the reason" is immediately issued, and the cause is immediately investigated.

[0038] For the case where the Δ value is greater than 250% and the maintenance time does not exceed t1, and the case where the Δ value is less than 0 and the maintenance time does not exceed t2, it means that the patient's hemodynamic parameters fluctuate but the impact time does not reach the warning value. Therefore, the operator and the anesthesiologist are only alerted by the screen data color display to remind them that there is an abnormal situation. When the maintenance time is longer, it means that the patient's abnormal situation has a greater impact. Therefore, the operator and the anesthesiologist are reminded of the patient's condition and take corresponding measures in time through voice alarms and changes in the screen data color display. When the Δ value is 0%, the operating room should immediately contact a professional monitoring doctor to arrive at the scene to determine whether the TCD monitoring probe is displaced, detached, or acute embolism of the main blood vessels has occurred. When 50%≤Δ value≤250%, it is a normal phenomenon during surgery and there is no need to remind the operator and the anesthesiologist.

[0039] In response to abnormal situations that may occur during the patient's surgery, this application adopts a graded processing and alarm reminder method to facilitate the surgical operator and anesthesiologist to judge the patient's condition based on different alarm information and take corresponding response measures.

[0040] t1 and t2 are determined based on the experience of the surgeon and the actual situation of the surgery. Normally, t1 is 1 to 1.5 minutes, and t2 is 4 to 6 minutes. In neuroscience, during surgery, when the average flow velocity of the cerebral arteries reaches 2.5 times the baseline value, the blood flow is excessively increased. Under the control of the cerebrovascular self-regulation function, the cerebral blood flow should return to the normal range within a few seconds (no more than 1 minute). If it has not recovered after the timeout, it is "overperfusion". The tolerance time for cerebral ischemia is 5 to 7 minutes. If this time is exceeded, brain cell damage will occur. Therefore, an alarm is triggered when the Δ value is greater than 250% and the maintenance time exceeds t1; an alarm is triggered when the Δ value is less than 50% and the maintenance time exceeds t2. Specifically, t1 is 1 minute and t2 is 5 minutes.

[0041] For example, if the operator moves the patient's heart to too large an angle, causing cerebral blood flow to decrease excessively, a Δ value will be displayed on the screen, and a corresponding alarm signal will be issued based on the size and duration of the Δ value.

[0042] Step 5: Add a record end mark in the monitoring trend chart, and TCD monitoring ends.

[0043] Specifically, when the operation is finished, the monitoring of the hemodynamic parameters is also finished, and a record end mark is added to the monitoring trend chart.

[0044] In step four, as a preferred example of the present invention, according to the operation process, the surgical operator or the anesthesiologist inputs commands by voice, and synchronously adds marks corresponding to different commands and the time when the commands appear in the monitoring trend chart.

[0045] Specifically, the command includes aortic arch side wall clamping, open side wall clamping, etc., which are surgical steps related to changes in cerebral blood perfusion.

[0046] Aortic arch clamping is an operation step in coronary artery bypass grafting, at which time the graft vessel and the aortic arch need to be anastomosed. While clamping the aortic arch, the anesthesiologist must significantly reduce the patient's blood pressure to ensure smooth anastomosis of the graft vessel. When blood pressure is significantly reduced, it will inevitably have a greater impact on cerebral blood flow, so more attention needs to be paid to the change of Δ value when clamping the aortic arch.

[0047] After the graft is anastomosed to the aortic arch, the side wall clamp needs to be opened. At this time, some plaque fragments on the aortic arch and a small amount of gas entering the anastomosis often enter the systemic circulation or even the brain. Therefore, it is necessary to pay attention to the changes in intracranial blood flow, the number of gas emboli and emboli. When the side wall clamp is opened, in addition to monitoring and recording the hemodynamic parameters A after the start of the operation, 实时When an embolus is detected, an alarm is sounded and the time and number of emboli appearing are added to the monitoring trend graph. When the side wall clamp is opened, it is easy to cause the appearance of emboli. By simultaneously monitoring the hemodynamic parameters A after the operation, 实时 , the number of emboli, and the time of emboli appearance are used to determine whether the emboli have caused a decrease or interruption in cerebral blood flow, providing a basis for abnormal Δ values ​​for surgical operators and / or anesthesiologists.

[0048] When the aortic arch side wall clamping and open side wall clamping operations occur, the surgical operator or anesthesiologist voice inputs the command corresponding to this operation, and the TCD instrument times the duration of different operations and records them in the monitoring trend chart. The surgical operator and / or anesthesiologist can judge the impact of the aortic arch side wall clamping and open side wall clamping operations on the patient based on the duration of the operation. For example, the timing starts from the time when the side wall clamping of the aortic arch is started and ends when the side wall clamp is opened. This period of time is the time used for anastomosis of the graft blood vessels. Since the patient's blood pressure is usually lowered when anastomosing the graft blood vessels, the shorter the time used, the shorter the time for the passive decrease of cerebral blood flow, which is more beneficial to the patient's brain protection. By recording the time used, it provides a certain basis for doctors to judge the patient's surgical condition and prognosis.

[0049] Since the aortic arch side wall clamping and open side wall clamping operations are more likely to cause abnormal conditions in patients, when the aortic arch side wall clamping and open side wall clamping operations are required during the operation, the operator or anesthesiologist inputs the name of the operation by voice and marks these operation events. The monitoring trend chart can display the time when such operations occurred and the changes in the patient's Δ value. By marking special events and recording them in the monitoring trend chart, it is convenient for the operator and / or anesthesiologist to review the cerebral blood flow images and monitoring trend charts recorded on the TCD screen after the operation to analyze the reasons for abnormal changes in the Δ value.

[0050] For other procedures of coronary artery bypass grafting, aortic arch side wall clamping and open side wall clamping operations are not required, and voice input commands are not required. The voice input marking described in this application is performed according to different surgical steps and different procedures.

[0051] The present invention provides a monitoring and control method for off-pump coronary artery bypass grafting, which automatically monitors the patient's blood pressure, heart rate and cerebral blood flow velocity data in real time during the operation, and records and stores them in a monitoring trend chart. It uses the functions of the alarm system voice reminder, automatic timing, intelligent calculation, etc., to improve the accuracy and operation efficiency of the diagnosis of abnormal perfusion and embolic events during the operation. It also facilitates the surgical operator and anesthesiologist to quickly understand the patient's cerebral blood flow changes and make timely responses, thereby providing technical support for optimizing the clinical diagnosis and treatment process.

[0052] The present invention also proposes a monitoring and control device, which uses the above-mentioned monitoring and control method to monitor and remind patients during coronary artery bypass grafting. The control device includes: an electrocardiogram monitoring module, which is used to monitor and obtain the patient's electrocardiogram data in real time; a blood pressure monitoring module, which is used to monitor and obtain the patient's blood pressure data in real time; a cerebral blood flow velocity monitoring module, which is used to monitor and obtain the patient's systolic flow velocity and diastolic flow velocity data in real time, and calculate and obtain the average flow velocity; an alarm system module, which is used to change the display color of the screen and issue a voice alarm according to the patient's cerebral blood flow during the operation; a time acquisition module, which is used to obtain time information, such as t1, t2, etc.; a control module, which is used to monitor and control the coronary artery bypass grafting process according to the patient's electrocardiogram, blood pressure, cerebral blood flow velocity, t1 time, t2 time and other information.

[0053] The above description is only a preferred embodiment of the present invention and is not intended to limit the present invention. Any modifications, equivalent substitutions, improvements, etc. made within the spirit and principle of the present invention should be included in the protection scope of the present invention.

Claims

1. A method for monitoring and controlling off-pump coronary artery bypass grafting, characterized in that: The steps include: Step 1: Put on the non-invasive continuous blood pressure monitor and TCD monitoring head frame for the surgical patient, and fix the TCD monitoring probe after obtaining a clear image of the monitored blood vessels; Step 2: 5 to 10 minutes after the patient receives anesthesia, obtain the hemodynamic parameter A at this time 初始 , and used as the basic reference value during the operation to activate the alarm system; Step 3: The operation begins, the timer starts counting, and the hemodynamic parameters A after the operation begins are monitored and recorded in real time. 实时 , automatically calculate the ratio Δ value of the real-time average cerebral blood flow velocity and the average cerebral blood flow velocity at the initial moment, and conduct real-time tracking and recording of Δ value; Step 4: According to the change of Δ value, a corresponding alarm prompt is issued; Step 5: Add a record end mark in the monitoring trend chart, and TCD monitoring ends.

2. The method for monitoring and controlling coronary artery bypass grafting according to claim 1, characterized in that: The hemodynamic parameters include blood pressure, heart rate and cerebral blood flow velocity, and the cerebral blood flow velocity includes systolic velocity (PSV), diastolic velocity (EDV) and mean velocity (MV), wherein mean velocity (MV) = (PSV-EDV) / 3+EDV.

3. The method for monitoring and controlling coronary artery bypass grafting according to claim 1, characterized in that: In the step 4, when the Δ value is greater than 250%, the screen data is displayed in yellow, and it is determined whether this state exceeds the t1 time. If so, the screen data is displayed in red, and a voice alarm of "over-perfusion" is issued; When 0<Δ value<50%, the screen data is displayed in yellow to determine whether this state exceeds the t2 time. If so, the screen data is displayed in red and a voice alarm of "insufficient perfusion" is issued; when the Δ value is 0%, the monitoring blood flow signal disappears, and a voice alarm of "blood flow interruption, please clarify the reason" is immediately issued, and the cause is immediately investigated.

4. The method for monitoring and controlling coronary artery bypass grafting according to claim 3, characterized in that: The t1 is 1 to 1.5 minutes, and t2 is 4 to 6 minutes.

5. The method for monitoring and controlling coronary artery bypass grafting according to claim 1, characterized in that: In step 4, according to the surgical progress, the surgical operator or anesthesiologist inputs commands by voice, and synchronously adds marks corresponding to different commands and the time when the commands appear in the monitoring trend chart.

6. The method for monitoring and controlling coronary artery bypass grafting according to claim 5, characterized in that: The commands include aortic arch side wall clamping, open side wall clamping.

7. The method for monitoring and controlling coronary artery bypass grafting according to claim 6, characterized in that: When the side wall clamp is opened, it is easy to cause the appearance of embolus. At the same time, the hemodynamic parameters A after the operation are monitored. 实时 , the number of emboli and the time when emboli appear.

8. A monitoring and control device for off-pump coronary artery bypass grafting, characterized in that: The control device adopts the coronary artery bypass grafting monitoring and control method according to any one of claims 1 to 7, and is used to monitor and remind the patient during coronary artery bypass grafting.

9. The coronary artery bypass grafting monitoring and control device according to claim 8, characterized in that: The control device includes: an electrocardiogram monitoring module, which is used to monitor and obtain the patient's electrocardiogram data in real time; a blood pressure monitoring module, which is used to monitor and obtain the patient's blood pressure data in real time; a cerebral blood flow velocity monitoring module, which is used to monitor and obtain the patient's systolic flow velocity and diastolic flow velocity data in real time, and calculate and obtain the average flow velocity; an alarm system module, which is used to change the display color of the screen and issue a voice alarm according to the patient's cerebral blood flow situation during the operation; a time acquisition module, which is used to obtain time information; and a control module, which is used to monitor and control the coronary artery bypass grafting process according to the patient's electrocardiogram, blood pressure, cerebral blood flow velocity, t1 time, and t2 time information.