ppg单项.pptVIP

PPG波形意义 正常足趾动脉多普勒检查的典型波形分为上升峰值尖锐，并有明显的重博切迹。 PPG波形意义 足趾动脉轻度狭窄将会引起正常血流波形的改变，轻度狭窄的波形主要表现为上升峰值减弱，重博切迹消失。 PPG波形意义 随着足趾动脉狭窄程度的增加，上升峰值迟缓，波峰圆盾。 PPG波形意义 当足趾动脉阻塞时，波形将表现为持续低速曲线。 * 足趾动脉PPG检查 Measuring Toe pressures and TBPI 光电容积PPG原理　PPG Shift Explained 　Vascular Assessment Training Session - Introductory 光电容积描记仪发射并接收红外线，红外线遇到组织时出现散射，遇到红细胞时则被其吸收。 肢体的皮下微循环内血容量增加时被反射的红外线密度减少；反之则增大。 影响PPG检查的因素　Factors affecting APPG measurements 室内温度应保持在20－24摄氏度。The room temperature should be between 20 - 24?C 检查前足趾不应裸露在外。　Always keep toes covered until tests are started 患者检查局部的温度会影响波形（如凉手、凉足） Patient temperature - cold hands and feet will alter the waveform 吸烟-尼古丁会影响波形。　Smoking - nicotine will distort the waveform 患者肢体运动－检测过程中应保持不动。 Patient movement - patients should remain still during the examination PPG波形解释　APPG Waveform Interpretation 正常　Normal 异常　Abnormal 下降坡 重搏切迹 尖峰 基线 重搏切迹消失，下降支轻度上弓 上升支轻度下弓 上升支延迟 波峰园钝 波幅减小 糖尿病患者足趾血压　Diabetics and Toe Pressures 动脉PPG是检查足趾血压的最佳手段。Arterial PPG is the preferred technique to measure toe pressures (Vowden, 2002) 检测脚趾血压比多普勒操作简单得多　Easier than Doppler to measure toe pressures 消除通过声音探测脉搏恢复　Eliminates the need to audibly detect the return of the pulse 探头容易连接手指和脚趾　Sensors easily attach to fingers toes 血压测定时，充气袖带放气速度应为2－3mmHg/秒　Cuffs should be deflated at 2-3mmHg/sec (BHS, 2000) 糖尿病患者足趾血压　Diabetics and Toe Pressures PPG检测足趾血压　Toe Pressures using PPG 135 140 上臂Brachial TBI計算法 TBPI calculations 足趾収縮期血圧　Toe systolic pressure 上臂収縮期血圧最大測定値Highest brachial systolic pressure 140 140 75 115 足趾　Toe = 75 = 0.54 = 115 = 0.82 右TBI Right TBPI 左TBI Left TBI 上臂Brachial 糖尿病患者足趾血压　Diabetics and Toe Pressures 糖尿病患者足趾血压　Diabetics and Toe Pressures TBI 0.65 病变 TBI 0.65-0.7 临界值 TBI 0.7 正常 足部伤口的预后　Foot Lesion Healing Prognosis 愈合百分比%　Percentage probability / 足趾収縮压　Toe Systolic Pressure 足趾压　Toe Pressure 糖尿病患者　　 非糖尿病患者 (mmHg) 　　 Diabetic Non Diabetic Patient 20-30 30-55 55 40% 85% 97% 73% 100% 100% (Carter, 1993) * * * * *