Postoperative delayed portal vein blood pressure monitoring method, device, equipment and medium
Patent Information
- Application Number
- CN202510770207.5
- Authority / Receiving Office
- CN · China
- Patent Type
- Applications(China)
- Current Assignee / Owner
- Filing Date
- 2025-06-10
- Publication Date
- 2025-09-12
Smart Images
Figure CN120616482A_ABST
Abstract
Description
Technical Field
[0001] The present application relates to the field of data processing technology, and in particular to a method, device, equipment and medium for monitoring delayed portal blood pressure after surgery. Background Art
[0002] Portal hypertension (PTH) is a key determinant of clinical prognosis in patients with cirrhosis, and its severity directly influences the development and progression of cirrhosis-related complications, such as esophageal and gastric variceal bleeding. Transjugular intrahepatic portosystemic shunt (TIPS), a minimally invasive interventional technique, creates a shunt channel by implanting a stent within the liver parenchyma between the portal and hepatic veins. This structurally reduces blood flow resistance in the portal system, thereby effectively lowering portal pressure. Compared with medical therapy and endoscopic therapy, TIPS can fundamentally lower portal pressure and is an important intervention for the treatment of esophageal and gastric variceal bleeding. Measuring the portal pressure gradient (PPG) after TIPS surgery can determine whether portal hypertension has been alleviated, whether the shunt channel is patency, and assess the risk of portal hypertension after TIPS. However, due to the disadvantages of invasiveness, difficulty in operation, high technical requirements, and high cost, the measurement of PPG after TIPS surgery is difficult to measure routinely in clinical practice. However, there is currently no technical means to non-invasively monitor the size of delayed PPG within a period of time after TIPS surgery.
[0003] Existing technologies can simulate the hemodynamic state of the liver circulatory system after TIPS surgery by constructing a lumped parameter model of the portal vein system (i.e., a zero-dimensional computational model). However, all existing technical solutions using lumped parameter computational models for TIPS hemodynamic simulations combine the cardiovascular system with other arterial circulatory systems or use three-dimensional simulations. These simulations require multiple parameters and are time-consuming. These simulations are intended to predict postoperative hemodynamic status (portal pressure) preoperatively, but are unable to rapidly simulate portal vein hemodynamics some time after TIPS surgery based solely on measured liver-related hemodynamic data, allowing for convenient and noninvasive monitoring of delayed portal vein blood pressure after TIPS surgery. Summary of the Invention
[0004] To overcome the deficiencies in the prior art, the present application provides a method, device, equipment and medium for monitoring delayed postoperative portal blood pressure, which can non-invasively monitor delayed postoperative portal blood pressure based on actual liver-related clinical data after TIPS surgery.
[0005] In a first aspect, the present application provides a method for monitoring delayed portal blood pressure after surgery, the method comprising the following steps: A lumped parameter model was constructed based on the venous phase images of patients before transjugular intrahepatic portosystemic shunt surgery. To obtain the measured clinical data of patients after transjugular intrahepatic portosystemic shunt surgery; The constructed lumped parameter model is calibrated based on the measured clinical data, and the delayed portal blood pressure of the patient after transjugular intrahepatic portosystemic shunt surgery is solved based on the calibrated lumped parameter model.
[0006] In one possible embodiment, constructing a lumped parameter model based on venous phase images of a patient before transjugular intrahepatic portosystemic shunt surgery includes the following steps: Obtain enhanced CT venous phase images of the abdomen before transjugular intrahepatic portosystemic shunt surgery; Constructing a geometric model based on the venous phase image using medical imaging software and marking corresponding geometric parameters; the geometric parameters include the inner diameter and length of the blood vessel; Based on the relationship between blood flow resistance and resistance, blood pressure and voltage, and blood flow and current in each vascular segment, the geometric model is mapped into a circuit topology to form a lumped parameter model including shunts, main portal vein vessels, and the hepatic circulatory system.
[0007] In a possible implementation, the measured clinical data includes a pressure parameter, and the pressure parameter is obtained in the following manner: The arterial blood pressure of patients after transjugular intrahepatic portosystemic shunt surgery was obtained through a monitor, and the inferior vena cava blood pressure and portal vein blood pressure of patients were measured using a catheter.
[0008] In a possible implementation, the measured clinical data further includes flow parameters, and the flow parameters are obtained in the following manner: Doppler ultrasound was used to measure the mean hepatic artery velocity, the middle portal vein velocity and the shunt velocity after transjugular intrahepatic portosystemic shunt surgery.
[0009] In a possible implementation, calibrating the constructed lumped parameter model based on the measured clinical data includes the following steps: calculating mean blood pressure based on the arterial blood pressure, and calculating hepatic sinusoidal blood pressure based on the inferior vena cava blood pressure and the portal vein blood pressure; determining the hepatic artery pressure and the hepatic vein pressure based on a set rule, and calculating the hepatic artery flow, the portal vein flow, and the shunt flow based on the average flow velocity of the hepatic artery, the flow velocity in the middle of the portal vein main trunk, the shunt flow velocity, and the corresponding vascular inner diameters; A resistance parameter is determined according to the acquired pressure parameter and flow parameter.
[0010] In a possible implementation, a resistance parameter is determined based on the acquired pressure parameter and flow parameter based on Poiseuille's law, and the resistance parameter includes hepatic artery resistance, hepatic vein resistance, shunt resistance, and portal vein resistance.
[0011] In one possible implementation, the method of solving the delayed portal blood pressure of a patient after transjugular intrahepatic portosystemic shunt surgery based on the calibrated lumped parameter model includes the following steps: The calibrated lumped parameter model was solved using Python or MATLAB to obtain the delayed portal blood pressure after transjugular intrahepatic portosystemic shunt surgery. The degree of portal hypertension after transjugular intrahepatic portosystemic shunt surgery is evaluated based on the obtained delayed portal blood pressure.
[0012] In a second aspect, the present application provides a device for monitoring delayed portal blood pressure after surgery, the device comprising: A construction module for constructing a lumped parameter model based on venous phase images of patients before transjugular intrahepatic portosystemic shunt surgery; An acquisition module is used to acquire the measured clinical data of the patient after transjugular intrahepatic portosystemic shunt surgery; the measured clinical data includes pressure parameters and flow parameters; The measurement module is used to calibrate the constructed lumped parameter model based on the measured clinical data, and solve the delayed portal blood pressure of the patient after transjugular intrahepatic portosystemic shunt surgery based on the calibrated lumped parameter model.
[0013] In a third aspect, the present application provides an electronic device comprising: a processor, a memory and a bus, wherein the memory stores machine-readable instructions executable by the processor. When the electronic device is running, the processor and the memory communicate through the bus, and when the machine-readable instructions are executed by the processor, the steps of the method for monitoring delayed postoperative portal blood pressure as described in any one of the first aspects are performed.
[0014] In a fourth aspect, the present application provides a computer-readable storage medium having a computer program stored thereon, which, when executed by a processor, executes the steps of the method for monitoring delayed postoperative portal blood pressure as described in any one of the first aspects.
[0015] This embodiment provides a method, apparatus, device, and medium for monitoring delayed postoperative portal blood pressure. The method constructs a lumped parameter model based on venous phase imaging of patients before transjugular intrahepatic portosystemic shunt surgery; obtains actual clinical data from patients after transjugular intrahepatic portosystemic shunt surgery; calibrates the constructed lumped parameter model based on the actual clinical data; and solves the patient's delayed portal blood pressure after transjugular intrahepatic portosystemic shunt surgery based on the calibrated lumped parameter model. This method numerically solves the calibration parameters of the constructed lumped parameter model based on the actual clinical data after surgery, enabling non-invasive monitoring of delayed postoperative portal blood pressure without the need for three-dimensional simulation, thus saving time. BRIEF DESCRIPTION OF THE DRAWINGS
[0016] In order to more clearly illustrate the technical solutions of the embodiments of the present application, the following is a brief introduction to the drawings required for use in the embodiments. It should be understood that the following drawings only illustrate certain embodiments of the present invention and therefore should not be regarded as limiting the scope. For ordinary technicians in this field, other relevant drawings can be obtained based on these drawings without paying any creative work.
[0017] Figure 1 A flow chart showing a method for monitoring delayed postoperative portal blood pressure according to an embodiment of the present application is shown; Figure 2 A flowchart of constructing a lumped parameter model based on venous phase images of a patient before transjugular intrahepatic portosystemic shunt surgery is shown in one embodiment of the present application; Figure 3 A schematic diagram showing the structure of a lumped parameter model constructed in one embodiment of the present application is shown; Figure 4 A scatter plot showing the correlation between the actual portal blood pressure value and the simulated portal blood pressure value according to an embodiment of the present application is shown; Figure 5 A schematic diagram illustrating an embodiment of the present application for evaluating the consistency between a measured portal blood pressure value and a simulated portal blood pressure value is shown; Figure 6 A schematic structural diagram of a device for monitoring delayed portal blood pressure after surgery according to an embodiment of the present application is shown; Figure 7 A structural block diagram of an electronic device according to an embodiment of the present application is shown. DETAILED DESCRIPTION
[0018] In order to make the purpose, technical solutions and advantages of the embodiments of the present application clearer, the technical solutions in the embodiments of the present application will be clearly and completely described below in conjunction with the drawings in the embodiments of the present application. It should be understood that the drawings in the present application only serve the purpose of illustration and description and are not used to limit the scope of protection of the present application. In addition, it should be understood that the schematic drawings are not drawn to scale. The flowcharts used in this application illustrate the operations implemented according to some embodiments of the present application. It should be understood that the operations of the flowcharts can be implemented out of sequence, and steps without logical context can be reversed or implemented simultaneously. In addition, those skilled in the art, under the guidance of the contents of this application, can add one or more other operations to the flowchart, or remove one or more operations from the flowchart.
[0019] In addition, the described embodiments are only a part of the embodiments of the present application, rather than all of the embodiments. The components of the embodiments of the present application generally described and shown in the drawings here can be arranged and designed in various configurations. Therefore, the following detailed description of the embodiments of the present application provided in the drawings is not intended to limit the scope of the claimed application, but merely represents selected embodiments of the present application. Based on the embodiments of the present application, all other embodiments obtained by those skilled in the art without making creative work are within the scope of protection of the present application.
[0020] It should be noted that the term "comprising" will be used in the embodiments of the present application to indicate the existence of the features declared thereafter, but does not exclude the addition of other features.
[0021] In view of the technical problems raised by the background technology, the present application provides a method, device, equipment and medium for monitoring delayed portal blood pressure after surgery, which can non-invasively monitor delayed portal blood pressure after TIPS surgery based on actual liver-related clinical data.
[0022] In one embodiment, see the attached Figure 1 The present application provides a method for monitoring delayed portal blood pressure after surgery, comprising the following steps: S1. Construct a lumped parameter model based on the venous phase images of patients before transjugular intrahepatic portosystemic shunt surgery. S2. Obtain the patient's measured clinical data after transjugular intrahepatic portosystemic shunt surgery; S3. Calibrate the constructed lumped parameter model based on the measured clinical data, and solve the delayed portal blood pressure of the patient after transjugular intrahepatic portosystemic shunt surgery based on the calibrated lumped parameter model.
[0023] Specifically, in step S1, the constructed lumped parameter model differs from existing computational models in that it employs a lumped parameter model of the isolated free hepatic circulation. This zero-dimensional model encompasses the shunt tract, the main portal vein vessels, and the complete hepatic circulation upstream and downstream. This model can monitor and simulate the localized flow field of the transjugular intrahepatic portosystemic shunt (TIPS) shunt tract and the larger hemodynamic state of the liver's circulatory system.
[0024] See the instructions attached Figure 2 The method of constructing a lumped parameter model based on the venous phase images of the patient before transjugular intrahepatic portosystemic shunt surgery includes the following steps: S101. Obtain enhanced CT venous phase images of the abdomen before transjugular intrahepatic portosystemic shunt surgery. S102, constructing a geometric model based on the venous phase image using medical imaging software, and marking corresponding geometric parameters; the geometric parameters include the inner diameter and length of the blood vessel; S103. Based on the relationship between blood flow resistance and resistance, blood pressure and voltage, and blood flow and current in each vascular segment, the geometric model is mapped into a circuit topology to form a lumped parameter model including the shunt, the main portal vein, and the hepatic circulatory system.
[0025] In step S101, pre-transjugular intrahepatic portosystemic shunt abdominal contrast-enhanced CT venous phase images and DICOM (Digital Imaging and Communications in Medicine) files can be collected. DICOM files store a wealth of medical image information, including image pixel data, patient information, and scanning parameters, clearly displaying the anatomical structure, blood flow patterns, and lesion characteristics of the abdominal venous system. In step S102, using relevant software, such as Mimics, a commonly used tool for medical image modeling, after importing the DICOM file, image segmentation techniques are used to extract the contours of the TIPS shunt and surrounding vascular structures based on the grayscale differences between the vessels and surrounding tissues on the CT images. A geometric model of the TIPS shunt with specified parameters (such as length and inner diameter) is constructed. In step S103, based on the similarities between hemodynamics and circuit theory, the vascular system can be analogized to an electrical circuit, where blood pressure corresponds to voltage, blood flow corresponds to current, and vascular resistance corresponds to resistance. This geometric model is then mapped to a circuit topology, forming a lumped parameter model encompassing the shunt, the main portal vein, and the hepatic circulatory system.
[0026] In one embodiment, the lumped parameter model formed can be found in the appendix of the specification. Figure 3 Among them, P IVC represents the inferior vena cava blood pressure; P SIN represents the blood pressure at the level of the hepatic sinusoids; P AO represents the mean blood pressure of the abdominal aorta; R HV Connect to PIVC and P SIN It simulates the obstruction of the hepatic vein to blood flow and represents the blood flow resistance of the hepatic venous system; R HA Connect to P SIN and P AO Between represents the blood flow resistance of the hepatic artery system; R SH R represents the blood flow resistance of the shunt (such as TIPS stent and other shunt structures); L1 、R L2 Parallel connection in P SIN On the left branch of the left hepatic branch, the resistance of different branch vessels in the left liver to blood flow is simulated, indicating the blood flow resistance of the left hepatic branch; R R R represents the blood flow resistance of the right branch of the portal vein perfusion area; PV Represents portal vein blood flow resistance; R M represents mesenteric blood flow resistance, R S Represents the blood flow resistance of other organs upstream of the portal vein, such as the spleen and stomach.
[0027] Crucially, in the centralized parameter model constructed in the present application, parameter calibration is required based on the actual clinical data of patients after transjugular intrahepatic portosystemic shunt surgery, which is used as a constraint to limit the model calculation.
[0028] In one embodiment, the measured clinical data includes pressure parameters and flow parameters. The pressure parameters are obtained by measuring the patient's arterial blood pressure using a monitor after TIPS stent implantation, and by measuring the patient's inferior vena cava blood pressure and portal vein blood pressure using a catheter. The flow parameters are obtained by measuring the mean hepatic artery flow velocity, the mid-portal vein flow velocity, and the shunt flow velocity in patients undergoing transjugular intrahepatic portosystemic shunt surgery using Doppler ultrasound. Based on the measured clinical data after transjugular intrahepatic portosystemic shunt surgery, other parameters of the lumped parameter model are determined, enabling the model to reflect the patient's true postoperative hemodynamic state.
[0029] For example, the mean arterial blood pressure P is calculated based on the measured arterial blood pressure. AO ; Due to the hepatic sinusoidal blood pressure P SIN The blood pressure in the core area where the portal vein and hepatic artery blood flow mix is not directly measurable. Based on the physiological characteristics of normal liver blood flow resistance distribution, the pressure drop from the portal vein to the hepatic sinusoids (P PV -P SIN ) is the pressure drop from the hepatic sinusoid to the inferior vena cava (P SIN -P IVC ), based on the formula = (preset proportional coefficient N=10), and the measured inferior vena cava blood pressure P IVC and the portal blood pressure P PV Calculate hepatic sinusoidal blood pressure P SIN ; According to the empirical formula Determine the hepatic artery pressure P HA ,in, is the proportionality coefficient (usually 1.5-2.0), hepatic venous pressure Equivalent to right atrial pressure (taking population average data); and based on the formula Calculation of hepatic artery flow , portal vein flow and diversion channel flow .in, represents the measured mean hepatic artery flow velocity, portal vein mid-main trunk flow velocity, and shunt flow velocity; represents the corresponding blood vessel inner diameter, obtained through the geometric model generated in step S1; And based on Poiseuille's law, blood flow resistance is the pressure difference between the two ends of the blood vessel segment, Q is the blood flow, and the resistance parameter is determined based on the pressure parameter and the flow parameter. For example, the blood flow resistance of the hepatic artery system Hepatic venous system blood flow resistance Shunt blood flow resistance Portal vein blood flow resistance .
[0030] Then, in step S3, the boundary conditions and calculation parameters of the calibrated lumped parameter model are set using R / Python or other software, and a numerical solution is completed to obtain the delayed portal blood pressure after the patient undergoes transjugular intrahepatic portosystemic shunt surgery. The specific calculation process is a technical means well known to those skilled in the art and is not the key point of this application, so it is not detailed here.
[0031] In one embodiment, a normal color Doppler ultrasound (CDU) report after TIPS surgery revealed: abnormal liver morphology and size, an irregular capsule, thickened and uneven liver parenchyma echogenicity, clear intrahepatic vascular course, and no dilatation of the intrahepatic bile duct. The portal vein was 15 mm long, with a visible shunt proximally, demonstrating unobstructed blood flow. The gallbladder measured approximately 110 x 37 mm, with normal morphology, a wall thickness of 5-7 mm, and a rough, poorly translucent lumen. Within the bladder, punctate medium to slightly hyperechoic deposits were visible, covering an area approximately 70 x 33 mm. The common bile duct was not wide. The pancreas was clearly visualized, with normal morphology and size, and no significant abnormal echogenicity. The spleen was 62 mm thick, 200 mm in length; the spleen was 55 mm below the ribs, with uniform echogenicity. The splenic vein was approximately 14 mm wide. Both kidneys were normal in size and morphology, with clear structures and no significant separation of the collecting systems. CDFI revealed normal renal blood flow distribution. Ureters were not significantly dilated. No significant effusion was observed in the abdominal and pelvic cavities. The superior mesenteric vein had an internal diameter of 11 m, a clear lumen, and good internal sonography. CDFI showed unobstructed blood flow. The hepatic artery had an internal diameter of 4.5 m and an average flow velocity of 119 cm / s; the right hepatic vein had an internal diameter of 5.9 m and an average flow velocity of 24.7 cm / s; the middle hepatic vein had an internal diameter of 5 m and an average flow velocity of 27.2 cm / s; and the left hepatic vein had an internal diameter of 4.5 m and an average flow velocity of 22.2 cm / s. The average flow velocity in the middle of the portal vein was 40.7 cm / s; the shunt had an internal diameter of 6 m and a flow velocity of 203 cm / s. Combined with the manometric data, the postoperative blood pressure was 124 / 76 mmHg and the portal venous pressure was 15 mmHg. By extracting the valid parameters and substituting them into the data, a preliminary calculation of the simulated portal venous pressure of 16.74 mmHg was achieved.
[0032] In another example, after TIPS surgery, the patient had an 8 mm diameter stent with a 7 cm covered segment length, located at an angle of approximately 55 degrees to the left branch of the portal vein, approximately 10 cm from the portal vein bifurcation. After stent placement, brachial artery blood pressure (systolic / diastolic) was 109 / 72 mmHg, portal vein blood pressure was 36 mmHg, and inferior vena cava blood pressure was 18 mmHg. The average flow velocity in the middle of the portal vein trunk was 0.5314 m / s, with an inner diameter of 13.1 mm; the average flow velocity in the shunt was 1.5467 m / s, with an inner diameter of 8.0 mm; and the average flow velocity in the hepatic artery was 0.3250 m / s, with an inner diameter of 3.1 mm. Extracting the valid parameters and substituting them into the data yielded a preliminary calculation of the simulated portal vein pressure of 34.66 mmHg.
[0033] Furthermore, the present application collected 12 data and carried out a correlation analysis, and the result was r = 0.89, p < 0.0001, where r is the Pearson correlation coefficient and p is the statistical significance level. Figure 4 and instructions attached Figure 5A scatter plot and a schematic diagram showing the correlation between the measured in vivo portal pressure and the simulated portal pressure are presented. The results show a strong correlation and high consistency between the simulated and measured values, indicating its clinical value in monitoring delayed portal pressure after TIPS surgery.
[0034] It can be seen that the method for monitoring delayed portal blood pressure after surgery provided by this application is different from the prior art in that the data used in the construction and parameter calibration of the proposed centralized parameter model are all clinical data after TIPS surgery. Therefore, the construction and calculation need to be completed after the TIPS stent is actually implanted, so as to realize the monitoring of delayed portal blood pressure or portal pressure gradient when using stents of different sizes after the TIPS stent is implanted, and then evaluate the degree of portal hypertension after transjugular intrahepatic portosystemic shunt surgery based on the monitoring results, and formulate corresponding treatment plans. In addition, compared with the prior art, there is no need for a three-dimensional modeling process, which can save manual time. In addition, during the calculation process, the boundary conditions of the shunt channel and the main vascular area of the portal vein are not specified fixed values, but are calibrated based on the actual measured clinical data of the patient after TIPS surgery, which improves the accuracy and clinical applicability of the monitoring results.
[0035] Based on the same inventive concept, an embodiment of the present application also provides a monitoring device for delayed postoperative portal vein blood pressure. Since the principle of solving the problem by the device in the embodiment of the present application is similar to the above-mentioned monitoring method for delayed postoperative portal vein blood pressure in the embodiment of the present application, the implementation of the device can refer to the implementation of the method, and the repeated parts will not be repeated.
[0036] As the instruction manual Figure 6 As shown, an embodiment of the present application provides a device for monitoring delayed portal blood pressure after surgery, the device comprising: A construction module 601 is used to construct a lumped parameter model based on the venous phase images of the patient before transjugular intrahepatic portosystemic shunt surgery; An acquisition module 602 is configured to acquire measured clinical data of a patient after transjugular intrahepatic portosystemic shunt surgery; the measured clinical data includes pressure parameters and flow parameters; The measurement module 603 is configured to calibrate the constructed lumped parameter model based on the measured clinical data, and solve the delayed portal blood pressure of the patient after transjugular intrahepatic portosystemic shunt surgery based on the calibrated lumped parameter model.
[0037] In one embodiment, the construction module 601 constructs a lumped parameter model based on the venous phase image of the patient before transjugular intrahepatic portosystemic shunt surgery, including: obtaining the abdominal enhanced CT venous phase image of the patient before transjugular intrahepatic portosystemic shunt surgery; constructing a geometric model based on the venous phase image using medical imaging software, and marking the corresponding geometric parameters; the geometric parameters include the inner diameter and length of the blood vessel; based on the relationship between the blood flow resistance of each blood vessel segment corresponding to the resistance, the blood pressure corresponding to the voltage, and the blood flow corresponding to the current, the geometric model is mapped into a circuit topology to form a lumped parameter model including the shunt duct, the main blood vessels of the portal vein and the hepatic circulatory system.
[0038] In one embodiment, the measured clinical data include pressure parameters and flow parameters, and the acquisition module 602 obtains the measured clinical data of the patient after transjugular intrahepatic portosystemic shunt surgery, including: obtaining the patient's arterial blood pressure after transjugular intrahepatic portosystemic shunt surgery through a monitor, and using a catheter to measure the patient's inferior vena cava blood pressure and portal vein blood pressure; using Doppler ultrasound to measure the patient's average hepatic artery flow velocity, the middle portal vein main trunk flow velocity and the shunt duct flow velocity after transjugular intrahepatic portosystemic shunt surgery.
[0039] In one embodiment, the measurement module 603 calibrates the constructed lumped parameter model based on the measured clinical data, including: calculating the mean blood pressure based on the arterial blood pressure, and calculating the hepatic sinusoidal blood pressure based on the inferior vena cava blood pressure and the portal vein blood pressure; determining the hepatic artery pressure and hepatic vein pressure based on set rules, and calculating the hepatic artery flow, portal vein flow, and shunt flow based on the mean hepatic artery flow velocity, the middle portal vein main trunk flow velocity, the shunt flow velocity, and the corresponding vascular inner diameter; and determining the resistance parameter based on the obtained pressure parameter and the flow parameter. The resistance parameter is determined based on the obtained pressure parameter and the flow parameter based on Poiseuille's law, and the resistance parameter includes hepatic artery resistance, hepatic vein resistance, shunt resistance, and portal vein resistance.
[0040] In one embodiment, the measurement module 603 solves the delayed portal blood pressure of the patient after transjugular intrahepatic portosystemic shunt surgery based on the calibrated lumped parameter model, including: using Python or MATLAB to solve the calibrated lumped parameter model to obtain the delayed portal blood pressure of the patient after transjugular intrahepatic portosystemic shunt surgery; and evaluating the degree of portal hypertension of the patient after transjugular intrahepatic portosystemic shunt surgery based on the obtained delayed portal blood pressure.
[0041] This application provides a device for monitoring delayed portal blood pressure after surgery. The device uses a construction module to construct a lumped parameter model based on venous phase images of patients before transjugular intrahepatic portosystemic shunt surgery. An acquisition module acquires the patient's measured clinical data after transjugular intrahepatic portosystemic shunt surgery. A measurement module calibrates the constructed lumped parameter model based on the measured clinical data, and then uses the calibrated lumped parameter model to calculate the patient's delayed portal blood pressure after transjugular intrahepatic portosystemic shunt surgery. This allows for non-invasive monitoring of delayed portal blood pressure after surgery without the need for three-dimensional simulation, saving time.
[0042] Based on the same concept of the present invention, the specification Figure 7 As shown, an embodiment of the present application provides a structure of an electronic device 700, which includes: at least one processor 701, at least one network interface 704 or other user interface 703, a memory 705, and at least one communication bus 702. The communication bus 702 is used to implement connection and communication between these components. The electronic device 700 optionally includes a user interface 703, including a display (e.g., a touch screen, LCD, CRT, holographic imaging (Holographic) or projector (Projector), etc.), a keyboard or a pointing device (e.g., a mouse, trackball (trackball), touchpad or touch screen, etc.).
[0043] The memory 705 may include a read-only memory and a random access memory, and provides instructions and data to the processor 701. A portion of the memory 705 may also include a non-volatile random access memory (NVRAM).
[0044] In some embodiments, the memory 705 stores the following elements, executable modules, or data structures, or a subset or extended set thereof: Operating system 7051, including various system programs for implementing various basic services and processing hardware-based tasks; The application module 7052 includes various application programs, such as a launcher, a media player, and a browser, and is used to implement various application services.
[0045] In an embodiment of the present application, by calling the program or instructions stored in the memory 705, the processor 701 is used to execute steps in a method for monitoring delayed postoperative portal blood pressure, which can non-invasively monitor delayed postoperative portal blood pressure based on actual liver-related clinical data after TIPS surgery.
[0046] The present application also provides a computer-readable storage medium having a computer program stored thereon. When the computer program is executed by a processor, the steps in the method for monitoring delayed portal blood pressure after surgery are executed.
[0047] Specifically, the storage medium can be a general storage medium, such as a mobile disk, a hard disk, etc. When the computer program on the storage medium is run, the above-mentioned method for monitoring delayed portal vein blood pressure after surgery can be executed.
[0048] In the embodiments provided in this application, it should be understood that the disclosed devices and methods can be implemented in other ways. The device embodiments described above are merely schematic. For example, the division of units is only a logical function division. There may be other division methods in actual implementation. For example, multiple units or components can be combined or integrated into another system, or some features can be ignored or not executed. Another point is that the mutual coupling or direct coupling or communication connection shown or discussed can be through some communication interface, the indirect coupling or communication connection of the device or unit can be electrical, mechanical or other forms.
[0049] Units described as separate components may or may not be physically separate, and components shown as units may or may not be physical units, that is, they may be located in one place or distributed across multiple network units. Some or all of these units may be selected to achieve the purpose of this embodiment according to actual needs.
[0050] In addition, each functional unit in the embodiments provided in the present application may be integrated into one processing unit, or each unit may exist physically separately, or two or more units may be integrated into one unit.
[0051] If the function is implemented in the form of a software functional unit and sold or used as an independent product, it can be stored in a computer-readable storage medium. Based on this understanding, the technical solution of the present application, or the part that contributes to the existing technology, or the part of the technical solution, can be embodied in the form of a software product. The computer software product is stored in a storage medium and includes a number of instructions for enabling a computer device (which can be a personal computer, server, or network device, etc.) to execute all or part of the steps of the various embodiments of the present application. The aforementioned storage medium includes: U disk, mobile hard disk, read-only memory (ROM, Read-Only Memory), random access memory (RAM, Random Access Memory), disk or optical disk, and other media that can store program code.
[0052] Finally, it should be noted that the above embodiments are only specific implementation methods of the present application, which are used to illustrate the technical solutions of the present application, rather than to limit them. The scope of protection of the present application is not limited thereto. Although the present application has been described in detail with reference to the above embodiments, those skilled in the art should understand that any person skilled in the art can modify or easily conceive of changes to the technical solutions described in the above embodiments within the technical scope disclosed in the present application, or replace some of the technical features therein with equivalents. However, these modifications, changes, or replacements do not deviate the essence of the corresponding technical solutions from the spirit and scope of the technical solutions of the embodiments of the present application. They should all be included in the scope of protection of the present application. Therefore, the scope of protection of the present application should be based on the scope of protection of the claims.
Claims
1. A method for monitoring delayed portal blood pressure after surgery, characterized in that: The method comprises the following steps: A lumped parameter model was constructed based on the venous phase images of patients before transjugular intrahepatic portosystemic shunt surgery. To obtain the actual clinical data of patients after transjugular intrahepatic portosystemic shunt surgery; The constructed lumped parameter model is calibrated based on the measured clinical data, and the delayed portal blood pressure of the patient after transjugular intrahepatic portosystemic shunt surgery is solved based on the calibrated lumped parameter model.
2. The method for monitoring delayed portal blood pressure after surgery according to claim 1, characterized in that: The method of constructing a lumped parameter model based on the venous phase images of the patient before transjugular intrahepatic portosystemic shunt surgery includes the following steps: Obtain enhanced CT venous phase images of the abdomen before transjugular intrahepatic portosystemic shunt surgery; Constructing a geometric model based on the venous phase image using medical imaging software and marking corresponding geometric parameters; the geometric parameters include the inner diameter and length of the blood vessel; Based on the relationship between blood flow resistance and resistance, blood pressure and voltage, and blood flow and current in each vascular segment, the geometric model is mapped into a circuit topology to form a lumped parameter model including shunts, main portal vein vessels, and the hepatic circulatory system.
3. The method for monitoring delayed portal blood pressure after surgery according to claim 2, characterized in that: in, The measured clinical data includes pressure parameters, and the pressure parameters are obtained in the following manner: The arterial blood pressure of patients after transjugular intrahepatic portosystemic shunt surgery was obtained through a monitor, and the inferior vena cava blood pressure and portal vein blood pressure of patients were measured using a catheter.
4. The method for monitoring delayed portal blood pressure after surgery according to claim 3, characterized in that: in, The measured clinical data also includes flow parameters, and the flow parameters are obtained in the following manner: Doppler ultrasound was used to measure the mean hepatic artery velocity, the middle portal vein velocity and the shunt velocity after transjugular intrahepatic portosystemic shunt surgery.
5. The method for monitoring delayed portal blood pressure after surgery according to claim 4, characterized in that: The calibrating the constructed lumped parameter model based on the measured clinical data comprises the following steps: calculating mean blood pressure based on the arterial blood pressure, and calculating hepatic sinusoidal blood pressure based on the inferior vena cava blood pressure and the portal vein blood pressure; determining the hepatic artery pressure and the hepatic vein pressure based on a set rule, and calculating the hepatic artery flow, the portal vein flow, and the shunt flow based on the average flow velocity of the hepatic artery, the flow velocity in the middle of the portal vein main trunk, the shunt flow velocity, and the corresponding vascular inner diameters; A resistance parameter is determined according to the acquired pressure parameter and flow parameter.
6. The method for monitoring delayed portal blood pressure after surgery according to claim 5, characterized in that: in, The resistance parameter is determined based on the Poiseuille law according to the acquired pressure parameter and flow parameter, and the resistance parameter includes hepatic artery resistance, hepatic vein resistance, shunt resistance, and portal vein resistance.
7. The method for monitoring delayed portal blood pressure after surgery according to claim 6, characterized in that: The method of solving the delayed portal blood pressure of a patient after transjugular intrahepatic portosystemic shunt surgery based on the calibrated lumped parameter model comprises the following steps: The calibrated lumped parameter model was solved using Python or MATLAB to obtain the delayed portal blood pressure after transjugular intrahepatic portosystemic shunt surgery. The degree of portal hypertension after transjugular intrahepatic portosystemic shunt surgery is evaluated based on the obtained delayed portal blood pressure.
8. A monitoring device for delayed portal blood pressure after surgery, characterized in that: The device comprises: A construction module for constructing a lumped parameter model based on venous phase images of patients before transjugular intrahepatic portosystemic shunt surgery; An acquisition module is used to acquire the measured clinical data of the patient after transjugular intrahepatic portosystemic shunt surgery; the measured clinical data includes pressure parameters and flow parameters; The measurement module is used to calibrate the constructed lumped parameter model based on the measured clinical data, and solve the delayed portal blood pressure of the patient after transjugular intrahepatic portosystemic shunt surgery based on the calibrated lumped parameter model.
9. An electronic device, characterized in that: include: A processor, a memory and a bus, wherein the memory stores machine-readable instructions executable by the processor, and when the electronic device is running, the processor and the memory communicate via the bus, and when the machine-readable instructions are executed by the processor, the steps of the method for monitoring delayed postoperative portal blood pressure as described in any one of claims 1 to 7 are performed.
10. A computer-readable storage medium, characterized in that The computer-readable storage medium stores a computer program, which, when executed by a processor, executes the steps of the method for monitoring delayed postoperative portal blood pressure according to any one of claims 1 to 7.