基于可穿戴式设备视觉刺激的意识障碍客观评价系统研究  

Objective evaluation system for DOC based on visual stimulation of wearable device

作　　者：张兆琦 张鑫[2] 张旭[3] 张志强[4] Zhang Zhaoqi;Zhang Xin;Zhang Xu;Zhang Zhiqiang(Center of Materials and Equipment,Beijing Chao-yang Hospital,Capital Medical University,Beijing 100020,China;Institute of Automation,Chinese Academy of Sciences,Beijing 100190,China;School of Biomedical Engineering,Capital Medical University,Beijing 100069,China;Center of Medical Security,Chinese PLA General Hospital,Beijing 100039,China)

机构地区：[1]首都医科大学附属北京朝阳医院物资器械中心,北京100020 [2]中国科学院自动化研究所,北京100190 [3]首都医科大学生物医学工程学院,北京100069 [4]解放军总医院医疗保障中心,北京100039

出　　处：《中国医学装备》2025年第4期34-38,共5页China Medical Equipment

摘　　要：目的:构建基于可穿戴式设备视觉刺激的意识障碍客观评价系统,对临床意识障碍患者进行客观评价,以降低误诊率,为临床意识障碍治疗方案提供参考。方法:选取2019年3月至5月在解放军总医院第七医学中心就诊的12例植物状态(VS)、最小意识状态(MCS)和疑似VS的意识障碍患者纳入意识障碍组,同期招募12名健康受试者纳入健康对照组,基于格拉斯哥昏迷量表(GCS)、昏迷恢复量表(CRS-R)和中国植物状态量表(CVSS),运用穿戴式设备对受试者实施视觉刺激,采集眼动反馈数据设计量化标尺,对视觉定位方案和视觉追踪方案的眼动数据评分进行对比分析。结果:健康对照组视觉追踪方案评分为(0.967±0.033)分,视觉定位方案评分为(0.005±0.004)分,与3种状态的意识障碍组患者两种方案评分比较,差异有统计学意义(F=97.88、23.04,P<0.05)。根据两组眼动数据分布特征,设计出了意识障碍客观评价标尺。结论:采用基于可穿戴式设备视觉刺激的意识障碍客观评价系统,通过采集基于视觉刺激的眼动反馈数据并加以处理分析设计的量化标尺,以客观数据指标弥补了临床意识障碍评估结果主观性过高的缺陷。Objective:To construct an objective evaluation system for disorders of consciousness(DOC)on the basis of visual stimulation of wearable device,so as to objectively evaluate DOC patients in clinical practice,and reduce misdiagnosis rate,and provide references for clinical treatment plans aimed at DOC.Methods:Twelve patients with disorders of consciousness,including vegetative state(VS),minimally conscious state(MCS),and suspected VS,who were treated at the Seventh Medical Center of Chinese People's Liberation Army General Hospital from March to May 2019,were selected and included in the DOC group.Twelve healthy subjects recruited during the same period were included in the healthy control group.Based on the Glasgow Coma Scale(GCS),the Coma Recovery Scale-Revised(CRS-R),and the Chinese Vegetative State Scale(CVSS),wearable devices were used to apply visual stimulation to the subjects,and eye movement feedback data were collected to design a quantitative scale.The scores of eye movement data in the visual positioning scheme and the visual tracking scheme were compared and analyzed.Results:The score of the visual tracking scheme in the healthy control group was(0.967±0.033)points,and the score of the visual positioning scheme was(0.005±0.004)points.There were statistically significant differences compared with the scores of patients in the DOC group in the three states(F=97.88,23.04,P<0.05).According to the distribution characteristics of the eye movement data of the two groups,an objective evaluation scale for DOC was designed.Conclusion:The objective DOC evaluation system based on visual stimulation of wearable device can compensate the defect of higher subjectivity in the assessed results of clinical DOC by the indicators with objective data after it collects feedback data of eye-tracking based on visual stimulation,and processes and analyzes the designed quantitative scale.

关 键 词：意识障碍 意识量表 视觉刺激 客观评价 可穿戴式设备 

分 类 号：R318.6[医药卫生—生物医学工程]