CN101496923A - Critical illness monitoring, infusion controlling, diagnosis and treatment integrated system and control method thereof - Google Patents
Critical illness monitoring, infusion controlling, diagnosis and treatment integrated system and control method thereof Download PDFInfo
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- CN101496923A CN101496923A CNA2009100377168A CN200910037716A CN101496923A CN 101496923 A CN101496923 A CN 101496923A CN A2009100377168 A CNA2009100377168 A CN A2009100377168A CN 200910037716 A CN200910037716 A CN 200910037716A CN 101496923 A CN101496923 A CN 101496923A
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Abstract
The invention discloses a critical care, transfusion control, and diagnosis and treatment integrated system and a control method thereof. The system comprises a transfusion device, a transfusion care base station, a central monitoring server and a medical PDA, wherein the transfusion care base station forms a transfusion scheme and performs open-loop control on the transfusion device by a wireless or wire mode, or adjusts transfusion parameters according to a corresponding closed-loop algorithm by monitoring and analyzing physiological parameters of patients during the transfusion execution, and performs closed-loop control on the transfusion device by the wireless or wire mode; the central monitoring server is connected with the transfusion care base station by the wireless or wire mode and monitors the operating state of the transfusion care base station; and the medical PDA is connected with the transfusion care base station and/or the central monitoring server by the wireless mode and is used for displaying transfusion condition and managing transfusion process. The system organically combines a treatment means (venous transfusion) and the effect of the treatment means (the monitoring of the physiological parameters) into one system, thereby realizing the closed-loop control of one or more transfusion devices, and improving medical quality and work efficiency of medical personnel.
Description
Technical field
The present invention relates to a kind of armarium, particularly a kind of be applied to ICU (Intensive Care Unit, intensive care unit(ICU)) and operating room, critical illness monitoring and transfusion control diagnosis and treatment integral system and control method thereof.
Background technology
The common state of an illness of the Cavity in Critical Patients of ICU is critical, the physiological status disorder, even serious multiple organ injury is arranged, and conditions of patients is complicated and changeable, and this physiological parameters of patients monitoring has been conventional medical measure; In addition, the patient of ICU 100% needs liquid to control, great majority are multiple medicine and multi-path while drug treatment, and need adjust dosage regimen at any time according to change of illness state, use the infusion pump and the syringe pump administration of a plurality of routines, these pumps are separately independently, and medical personnel operate very inconvenient, and are difficult to satisfy the needs of critical patient's treatment.The anesthesia patient of operating room also needs the multi-path administration, intravenous anesthesia agent, analgesics and the in stable condition medication or the like that earns a bare living.
Patient's liquid undergoing treatment of ICU is as one of important treatment means, and is also very high to the infusion treatment prescription.All generally use infusion pump and syringe pump at present, ICU medical personnel are often to the supervision and the adjustment of infusion of drug, artificial operation is difficult to well critical patient's physiological status is controlled within the target zone sometimes, influence therapeutic effect, and medical personnel's work is very heavy.Since Sheppard, various computer closed loop control automatic chemical feeding algorithms constantly occur, and have obtained than the better effect of dosage regimen that relies on manual adjustment.The computer closed loop control automatic chemical feeding can reduce the drug use accumulated dose significantly when stablizing patient's physiological status better.
Venous transfusion is a kind of the most frequently used clinical treatment method, though more infusion pump, syringe pump and multi-parameter monitor are arranged in the market, many wireless networked critical illness monitor systems are also arranged, also have the transfusion control system of a small amount of networking, but these two systems are separate.Venous transfusion and critical illness monitoring be as ICU, the operating room diagnosis and treatment means of extensive use the most, and it is carried out Comprehensive Control and management is the internal need of clinical position.
Summary of the invention
The present invention is directed to existing infusion treatment guards with physiology and is separated, and then can not realize the shortcoming of the real-time closed-loop control of critical patient's infusion treatment process, proposes a kind ofly to be applicable to that the critical illness monitoring of ICU, operating room and transfusion control diagnosis and treatment integral system and control method thereof.The objective of the invention is to realize ICU and surgical patient physiological status real-time detection and adjust the speed, infusion total amount etc. of fluid delivery apparatus in real time according to the variation of physiological parameter, reach the closed loop control (also can realize open loop control) of infusion process; Based on the pharmacokinetics and the pharmacodynamics model of medicine, formulate the given way of drug dose, thereby make infusion treatment more effective, realize the scheme of individual administration.Reduce malpractice, improve medical personnel's work efficiency, improve the treatment level of ICU.
For achieving the above object, technical scheme of the present invention is: a kind of critical illness monitoring and transfusion control diagnosis and treatment integral system, it comprises fluid delivery apparatus (fluid delivery apparatus comprises infusion pump and syringe pump), monitoring transfusion base station, central monitoring server and medical care PDA.Fluid delivery apparatus links to each other with the monitoring transfusion base station by wireless or wired communication modes, and the infusion treatment to patient, the status information of concurrent feedback liquid equipment are implemented in the control of reception monitoring transfusion base station.The monitoring transfusion base station has the transfusion control function of physiological parameters of patients monitoring and one or more fluid delivery apparatus, transfusion control can form transfusion plan according to the information of patient, medicine and treatment prescription by medical personnel, realize the open loop of fluid delivery apparatus is controlled by wireless or wired mode, also can be by monitoring and analyze patient's physiological parameter in the transfusion implementation, adjust infusion parameter in real time according to corresponding feedback algorithm, realize closed loop control by wireless or wired mode, patient is carried out the infusion treatment of open loop or close-loop control mode fluid delivery apparatus.Central monitoring server is connected a plurality of monitoring transfusions base station their running status of Centralized Monitoring by wireless with wired mode, and central monitoring server also links to each other with hospital information system, fuses with hospital information system.Medical care PDA is connected with monitoring transfusion base station and/or central monitoring server by wireless mode, can understand transfusion situation and management infusion process.Each inter-module of system is formed a system by cable network or wireless network mode.
Described monitoring transfusion base station comprises as lower module:
Subscriber interface module: be used to offer user's input and finish corresponding human-computer interaction function, show the information of the fluid delivery apparatus of this monitoring transfusion base station control in the infusion process and patient's major physiological parameter monitoring information; Import infusion parameter and form transfusion plan according to the information of patient, medicine and treatment prescription.
Physiology monitoring module: comprise physiology monitoring detection module and physiology monitoring administration module, be used to monitor the real-time monitoring information of patient's physiological parameter such as electrocardio, blood oxygen saturation, body temperature, non-invasive blood pressure, breathing, analyze and preserve monitoring information, for the demonstration of the physiological parameter of subscriber interface module and the transfusion closed loop control of closed loop control module provide information; Physiology monitoring detection module is made up of physiological parameter sensors, signal conditioning circuit, AD conversion, single-chip microcomputer and communication submodule, is used to detect physiologic information; Physiology supervision reason is surveyed analysis and the hold function that module is finished physiological parameter;
Transfusion administration module: be used for management and control fluid delivery apparatus, transfusion plan is converted to the transfusion control instruction, or accept the transfusion control instruction of closed loop control module, and the control instruction of will infusing is fixed time by each and is sent to specified fluid delivery apparatus by the network communication module at interval;
Closed loop control module: by receiving the data of the physiological parameter of measuring patient, instruct, and control instruction is sent to transfusion transfusion administration module according to feedback algorithm output transfusion; This closed loop control module comprises the data fetch submodule, feedback algorithm submodule and control submodule, the data fetch submodule extracts patient's blood pressure data as input from the physiology monitoring module, use for the feedback algorithm submodule, the feedback algorithm submodule is analyzed required physiological parameter respectively according to the corresponding closed-loop control algolithm, judge, the result that the feedback algorithm submodule draws sends to the control submodule, which fluid delivery apparatus the control submodule is adjusted according to result's decision of feedback algorithm, and the amplitude of adjusting, form the transfusion control instruction and send to tube for transfusion reason module, implement the closed loop control of transfusion.
Alarm module: the physiological parameter information of patient in infusion process and the information of fluid delivery apparatus are monitored, when physiological parameter exceeds normal range, when perhaps fluid delivery apparatus operation appearance is unusual, in time warning message is presented at user interface, simultaneously warning message is saved to monitoring transfusion base station local data base.
Information management module: be used to manage patient's essential information, the medicine essential information;
The network communication module: by wired or wireless mode realize between central monitoring server and the monitoring transfusion base station, transfer of data between monitoring transfusion base station and the fluid delivery apparatus; Realize transfer of data between monitoring transfusion base station and the medical care PDA by wireless mode.
Described central monitoring server comprises as lower module:
Subscriber interface module: be used to offer user's input and finish corresponding human-computer interaction function, the main information of each monitoring transfusion base station of centralized displaying also can show the patient of a certain monitoring transfusion base station and the major physiological parameter and the infusion information of each fluid delivery apparatus; Can the monitoring transfusion base station of its management be imported infusion parameter and form transfusion plan according to the information of patient, medicine and treatment prescription.
Monitoring transfusion BTS management module: remote centralized is controlled the work of a plurality of monitoring transfusions base station, handle infusion data, warning message and the patient care information of the online fluid delivery apparatus of each monitoring transfusion base station, the working condition of each monitoring transfusion base station is monitored;
Information management module: be used to manage patient's essential information, medicine essential information, employee's essential information, berth behaviour in service or patient's hospitalization information;
The network communication module: by wired or wireless mode realize between central monitoring server and the monitoring transfusion base station, transfer of data between central monitoring server and the hospital information system; Realize transfer of data between central monitoring server and the medical care PDA by wireless mode.
Described fluid delivery apparatus comprises infusion pump and syringe pump:
This syringe pump comprises one-chip computer module, human-computer interaction module, motor module, injects mechanical module, sensor assembly, network communication module and power management module.
Single-chip microcomputer is the core control section of syringe pump, receives the given control instruction in monitoring transfusion base station through communication module, and the operation of control step motor is injected mechanical module thereby drive, pushing syringe, thus realize injection operation; Single-chip microcomputer is sent to the monitoring transfusion base station with the syringe pump status information of gathering through communication module simultaneously, realizes real-time monitoring and the control of monitoring transfusion base station to syringe pump.
This infusion pump comprises one-chip computer module, human-computer interaction module, motor module, finger-like wriggling mechanical module, sensor assembly, network communication module and power management module.
Thereby the motor of infusion pump drives the finger-like wriggling sheet extruding tube for transfusion of finger-like wriggling mechanical module and realizes transfusion operation, the sensor assembly of infusion pump is made up of motor speed probe, pressure transducer and sonac, and pressure transducer and sonac are used for detecting the bubble and the obstruction of infusion process.
Network communication module: realize transfer of data between monitoring transfusion base station and the fluid delivery apparatus by wired or wireless mode
Described medical care PDA:
Medical care PDA shows the situation of arbitrary monitoring transfusion base station by wireless network access monitoring transfusion base station and/or central monitoring server, accepts warning message and jingle bell or/and the control parameter of carrying out fluid delivery apparatus is regulated in vibration.
The network communication structure of described system:
This system's employing is wired, the networking mode of wireless compatibility, and each inter-module of system can be communicated by letter by wired or wireless mode.Between central monitoring server and the monitoring transfusion base station, all form the network communication structure of master slave system between monitoring transfusion base station and the fluid delivery apparatus.Medical care PDA can carry out communication by wireless mode and monitoring transfusion base station or central server.Wired mode is the network communication structure of monitoring transfusion base station by bus apparatus and network communication apparatus and a plurality of fluid delivery apparatus composition master-slave mode; Adopt between central monitoring server and the monitoring transfusion base station.That wireless mode can adopt is infrared, bluetooth, Wi-Fi, wireless radio-frequency, the Zigbee technology, ultra broadband (UWB) technology or the like is formed WLAN, as long as can realize in the ward that the technology of the radio communication function of syringe pump and monitoring transfusion base station all can adopt.
This system monitoring transfusion base station also is extended to the other treatment instrument of ICU or operating room by wireless and wired mode, as respirator, anesthetic machine or the like.
The control method of a kind of critical illness monitoring and transfusion control diagnosis and treatment integral system may further comprise the steps:
The information that A, medical personnel import patient, medicine and treatment prescription at central monitoring server forms transfusion plan, and is kept in the central monitoring server local data base, sends to the monitoring transfusion base station by the network communication module; Also can be kept in the local data base of monitoring transfusion base station at monitoring transfusion base station end input transfusion plan.
Suitable fluid delivery apparatus is selected according to the current transfusion plan of patient in B, monitoring transfusion base station, and transfusion plan changed into the transfusion control instruction, and send each by the network communication module and fix time at interval, thereby begin to carry out transfusion plan to corresponding fluid delivery apparatus;
C, fluid delivery apparatus receive the transfusion control instruction, are converted into the control signal of fluid delivery apparatus by single-chip microcomputer, and mechanical module is carried out corresponding transfusion operation;
The physiology monitoring module of D, monitoring transfusion base station end detect patient physiological signal, input as the closed loop control module, the closed loop control module is analyzed required physiological parameter respectively according to the corresponding closed-loop control algolithm, judge, analysis result sends the transfusion administration module to, corresponding fluid delivery apparatus is adjusted, thereby the closed loop feedback that realizes infusion process is controlled.
E, while fluid delivery apparatus are fixed time by communication module current transfusion state information and are fed back to the monitoring transfusion base station at interval by each, and show and record the local data base of monitoring transfusion base station in real time by the subscriber interface module of monitoring transfusion base station.
The warning function of described system occurs when unusual when physiological parameter exceeds set point, or the fluid delivery apparatus operation occurs unusually, and at first Xiang Guan fluid delivery apparatus stops transfusion operation, and sends warning; The abnormal alarm information of fluid delivery apparatus sends to the monitoring transfusion base station by network communication module, and end also sends the transfusion alarm signal in the monitoring transfusion base station, and warning message is carried out record, after solution is unusual, proceeds transfusion operation.
Description of drawings
Fig. 1 system structure of the present invention is formed sketch map;
The principle schematic of Fig. 2 closed loop feedback control of the present invention;
The modular structure sketch map of Fig. 3 central monitoring server;
The modular structure sketch map of Fig. 4 monitoring transfusion base station;
The structural representation of the wireless syringe pump of Fig. 5;
The structural representation of the wireless infusion pump of Fig. 6;
The control method sketch map of Fig. 7 critical illness monitoring of the present invention and transfusion control diagnosis and treatment integral system.
The specific embodiment
Describe the present invention below in conjunction with accompanying drawing.
As shown in Figure 1 and Figure 2, the invention provides a kind of critical illness monitoring and transfusion control diagnosis and treatment integral system, fluid delivery apparatus, monitoring transfusion base station and the central monitoring server of closed loop feedback when it comprises by wired or wireless network implementation reality, fluid delivery apparatus links to each other with the monitoring transfusion base station by wireless or wired communication modes, the infusion treatment to patient, the status information of concurrent feedback liquid equipment are implemented in the control of reception monitoring transfusion base station.The monitoring transfusion base station has the transfusion control function of physiological parameters of patients monitoring and one or more fluid delivery apparatus, transfusion control can be by medical personnel according to patient, the information of medicine and treatment prescription forms transfusion plan, realize the open loop of fluid delivery apparatus is controlled by wireless or wired mode, also can be by monitoring and analyze patient's physiological parameter in the transfusion implementation, adjust infusion parameter in real time according to corresponding feedback algorithm, realize closed loop control by wireless or wired mode to fluid delivery apparatus, patient is carried out the infusion treatment of open loop or close-loop control mode.Central monitoring server is connected a plurality of monitoring transfusions base station their running status of Centralized Monitoring by wireless with wired mode, and central monitoring server also links to each other with hospital information system, fuses with hospital information system.Medical care PDA is connected with monitoring transfusion base station and/or central monitoring server by wireless mode, can understand transfusion situation and management infusion process.Each inter-module of system is formed a system by cable network or wireless network mode.This system organically is combined in treatment means (venous transfusion) and effect (physiological parameter monitoring) thereof in the system.
Native system is the center with the monitoring transfusion base station, and a plurality of fluid delivery apparatus are integrated, and patient is treated.It is a service for patients that a plurality of fluid delivery apparatus of a monitoring transfusion base station and its control are formed a monitoring transfusion treatment unit.Monitoring transfusion BTS hardware structure is based on PC or industrial computer, based on the operating system of Windows, be aided with that various Embedded software and hardwares are realized as: the wireless network card of the ZigBee communication module of wireless dragon, prosperous touch screen, NetGear and fly shuttle knob etc. along TouchKit SX-104-W4R-F.The Zigbee communication module provides communication hardware platform between monitoring transfusion base station and the wireless fluid delivery apparatus; Touch screen and to fly the shuttle knob be system's interactive interface efficiently of providing convenience.Central monitoring server can be treated unitary information to several monitoring transfusions and be carried out integrated management.Central monitoring server also can be connected with hospital information system, the database information of shared hospital information system.Medical personnel can be on bedside monitoring be infused the base station, and the Database Systems on the remote access central monitoring server are checked patient, medicine and the relevant information of infusion treatment.Central monitoring server is a hardware with the double-core server, is equipped with the 802.11b wireless network card with the communication of realization with whole monitoring transfusion base station and medical care PDA.The software of monitoring server uses the WEB technological development based on the operating system of Windows.
As shown in Figure 3, described monitoring transfusion base station comprises as lower module:
Subscriber interface module: be used to offer user's input and finish corresponding human-computer interaction function, show the information of the fluid delivery apparatus of this monitoring transfusion base station control in the infusion process, use the waveform of wave shape playback function playback physiological parameters of patients; Digital form shows physiological parameter; Import infusion parameter and form transfusion plan according to the information of patient, medicine and treatment prescription.
Authority management module: the scope of application of control validated user in system.User in the system is divided into different role, every kind of role has different system's scopes of application, such as certain user's role is the manager, and he can check the module that compares core in the system, such as information management module and authority management module etc., and these modules are carried out some operation; If certain user's role is the general user, he just can only inquire about or revise patient's information so, but can not carry out deletion action, adopt the mode of this limited subscriber scope of application, limit some low rights users the system core is partly produced maloperation, thereby reduce some unnecessary risks.
Physiology monitoring module: comprise physiology monitoring detection module and physiology monitoring administration module, be used to monitor patient's physiological parameter, analyze and preserve the analytic function that monitoring information realizes the monitoring data.Physiology monitoring detection module is made up of physiological parameter sensors, signal conditioning circuit, AD conversion, single-chip microcomputer and communication submodule.Physiological parameters such as detection patient's electrocardio, breathing, body temperature, blood oxygen saturation, non-invasive blood pressure, pulse frequency; The patient physiological parameter data that physiology monitoring administration module handle collects etc. all is retained in the monitoring data file, and data are carried out self-defining trend analysis, for the demonstration of the physiological parameter of subscriber interface module and the transfusion closed loop control of closed loop control module provide information;
Transfusion administration module: be used for management and control fluid delivery apparatus, carry out transfusion plan, transfusion plan is converted to the transfusion control instruction, or accept the transfusion control instruction of closed loop control module, and the control instruction of will infusing is fixed time by each and is sent to specified fluid delivery apparatus by the network communication module at interval; The management of medicine essential information; The execution command of schedules of infusion is sent to each fluid delivery apparatus of being connected and receives, show and preserve the real time information of fluid delivery apparatus feedback by wireless network, as transfusion speed etc.
Closed loop control module: according to a preset algorithm, as realize the closed loop feedback control of infusion process based on the homeostatic control algorithm of vital sign, based on pharmacodynamics, pharmacokinetic model scheduling algorithm, the input of control is the data of each physiological parameter of measuring of patient, and the output of control is the regulating command of transfusion; This closed loop control module comprises the data fetch submodule, feedback algorithm submodule and control submodule, the data fetch submodule extracts patient's data such as blood pressure as input from the physiology monitoring module, use for the algorithm in the whole closed loop feedback module, the feedback algorithm submodule is analyzed required physiological parameter respectively according to selected algorithm, judge, the result that the feedback algorithm submodule draws sends to control module, which fluid delivery apparatus the control submodule is adjusted according to result's decision of feedback algorithm, and the amplitude of adjusting, transmitting control commands is implemented the closed loop control of transfusion to specified fluid delivery apparatus then, reaches the purpose of the integrated and individualized treatment of diagnosis and treatment.
Alarm module: the warning conceptual design, design corresponding warning scheme in the time of can be to the different state of an illness of different patients; The physiological parameter information of patient in infusion process and the information of fluid delivery apparatus are monitored, when physiological parameter exceeds normal range, when perhaps fluid delivery apparatus operation appearance is unusual, in time warning message is presented at user interface, simultaneously warning message is saved to monitoring transfusion base station local data base.Obtain the warning message of each assembly of system, and in time warning message is presented at monitor terminal, simultaneously alert data is preserved warehouse-in.
Information management module: be used to manage patient's essential information, the medicine essential information, medical personnel's information, system carries out limiting operation and information record for the user of this system of each operation;
The network communication module: by wired or wireless mode realize between central monitoring server and the monitoring transfusion base station, transfer of data between monitoring transfusion base station and the fluid delivery apparatus; Realize transfer of data between monitoring transfusion base station and the medical care PDA by wireless mode.
As shown in Figure 4, described central monitoring server comprises as lower module:
Subscriber interface module: be used to offer user's input and finish corresponding human-computer interaction function, the main information of each monitoring transfusion base station of centralized displaying also can show the patient of a certain monitoring transfusion base station and the major physiological parameter and the infusion information of each fluid delivery apparatus; Can the monitoring transfusion base station of its management be imported infusion parameter and form transfusion plan according to the information of patient, medicine and treatment prescription.
Monitoring transfusion BTS management module: remote centralized is controlled the work of a plurality of monitoring transfusions base station, handle infusion data, warning message and the patient care information of the online fluid delivery apparatus of each monitoring transfusion base station, the working condition of each monitoring transfusion base station is monitored;
Information management module: be used to manage patient's essential information, medicine essential information, employee's essential information, berth behaviour in service or patient's hospitalization information; As patient information management module and drug information administration module, be used to manage patient's essential information, the medicine essential information, employee's essential information, berth behaviour in service or patient's hospitalization information, satisfying under the prerequisite of system applies, for outpatient service subsystem, pharmacy subsystem, employee's managerial subsystem and the ward management subsystem that connects hospital information system provides interface;
The network communication module: by wired or wireless mode realize between central monitoring server and the monitoring transfusion base station, transfer of data between central monitoring server and the hospital information system; Realize transfer of data between central monitoring server and the medical care PDA by wireless mode.
Described fluid delivery apparatus comprises syringe pump and infusion pump, and as shown in Figure 5, this syringe pump comprises one-chip computer module, human-computer interaction module, motor, injects mechanical module, sensor assembly, network communication module and power management module.
One-chip computer module is the core control section of syringe pump, receives the given control instruction in monitoring transfusion base station through communication module, according to the operation of control instruction control step motor, thereby drives machine driving module pushing syringe; The oneself state data of gathering are sent to the monitoring transfusion base station through communication module, realize of real-time control and the monitoring of monitoring transfusion base station syringe pump.Human-computer interaction module is regulated the running parameter of infusion pump by the work state information of display screen display device and patient's basic physiological information by button.The motor module comprises motor and drive integrated circult chip thereof, and the drive integrated circult chip internal is integrated with drive circuit, pulsqe distributor, fly-wheel diode and overheating protection circuit, and collection drives and be protected in one.Inject mechanical module and form the threaded engagement of syringe push pedal and screw mandrel by change-speed gearing group, screw mandrel and syringe push pedal.Motor promotes change-speed gearing and rotates, and change-speed gearing drives screw mandrel and rotates, thereby makes the syringe push pedal move.Sensor assembly is made up of motor speed probe, pressure transducer, syringe position sensor and syringe size pick off, the rotating speed of motor when being used to respond to the syringe pump operation, the pressure of liquid-transport pipe-line, the position of syringe and size.Power management module is one-chip computer module, human-computer interaction module, motor and driver module thereof, sensor assembly and communication module power supply by power line.Communication module: syringe pump can carry out communication by wired or wireless mode and monitoring transfusion base station.Between monitoring transfusion base station and the fluid delivery apparatus there be wired mode of communication: communication is carried out by RS485 bus and a plurality of fluid delivery apparatus in the monitoring transfusion base station, also can adopt control modes such as other buses such as CAN bus.Wireless communication module can also adopt Bluetooth Communication Technology, the Wi-Fi wireless local area network technology, wireless radio-frequency, Zigbee technology, ultra broadband (UWB) technology or the like is as long as can realize in the ICU ward that the technology of the radio communication function of syringe pump and monitoring transfusion base station all can adopt.
As shown in Figure 6, the basic structure of infusion pump is similar to syringe pump, thereby the mechanical module of injecting of infusion pump that different is drives finger-like wriggling sheet extruding tube for transfusion by motor and realizes transfusion to patient, the sensing system of infusion pump is made up of motor speed probe, pressure transducer and sonac, and pressure transducer and sonac are used for detecting the bubble and the obstruction of infusion process.
This system also comprises medical care PDA, and PDA shows the situation of arbitrary monitoring transfusion base station by wireless network visit monitoring transfusion base station and central monitoring server, accepts warning message and jingle bell or/and the control parameter of carrying out fluid delivery apparatus is regulated in vibration.
As ambulatory medical device, system adopts wireless communication mode.Wherein, the network structure relative fixed between central monitoring server, monitoring transfusion base station and the medical care PDA exists lot of data mutual, and needs to visit the original cable LAN of hospital sometimes.802.11b be that IEEE formulates also WLAN (WLAN) standard of the global general-use of extensive use, have wired local area network (LAN) the same safety, manageability and scalability, can be well and the cable LAN compatibility, and have higher transmission speed (high transmission speed is 11Mbps).Therefore, adopt the 802.11b communications protocol to form WLAN between central monitoring server, monitoring transfusion base station and the medical care PDA.
As shown in Figure 7, the control method of a kind of critical illness monitoring and transfusion control diagnosis and treatment integral system may further comprise the steps:
A, medical personnel form transfusion plan by the information at central monitoring server input patient, medicine and treatment prescription after the authentication, and are kept among the central monitoring server data base, send to the monitoring transfusion base station by the network communication module; Also can be kept in the local data base of monitoring transfusion base station at monitoring transfusion base station end input transfusion plan.
Suitable fluid delivery apparatus is selected according to the current transfusion plan of patient in B, monitoring transfusion base station, and the monitoring transfusion base station changes into the transfusion control command to transfusion plan, and sends to transfusion mechanism by the network communication module, thereby begins to carry out transfusion plan;
C, fluid delivery apparatus receive the transfusion control instruction, are converted into the control signal of fluid delivery apparatus by single-chip microcomputer, and mechanical module is carried out corresponding transfusion operation;
The physiology monitoring module of D, monitoring transfusion base station end detect patient physiological signal, and be converted to the signal of telecommunication, by signal conditioner to the signal of telecommunication amplify, pretreatment such as filtering, isolation.And then pass the signal to communication module, be responsible for monitoring information is sent to the physiology monitoring module of monitoring transfusion base station by communication module.The physiology monitoring module of monitoring transfusion base station sends to detected patient's physiological parameter data the physiology monitoring administration module of monitoring infusion base station with the form of packet.
E, monitoring transfusion base station unpack the monitoring data that receive, patient the physiological parameter data bag as the input of closed loop control module, the closed loop control module is analyzed required physiological parameter respectively according to the corresponding closed-loop control algolithm, judge, analysis result sends the transfusion administration module to, corresponding fluid delivery apparatus is adjusted, thereby the closed loop feedback that realizes infusion process is controlled.
F, on the monitoring transfusion base station, medical personnel can adjust the infusion velocity of fluid delivery apparatus according to patient's physiological situation, and these control informations are packaged into the control data bag, and are transferred to the fluid delivery apparatus end of need adjusting.
G, while fluid delivery apparatus are fixed time by communication module current transfusion state information and are fed back to the monitoring transfusion base station at interval by each, and show and record the local data base of monitoring transfusion base station in real time by the subscriber interface module of monitoring transfusion base station.
H, occur unusual when fluid delivery apparatus, at first fluid delivery apparatus stops transfusion operation, and send transfusion and report to the police, by communication module transfusion abnormal alarm information is sent to the monitoring transfusion base station then, end also sends the transfusion alarm signal in the monitoring transfusion base station, and warning message carried out record, solve unusual after, proceed transfusion operation.
I, fluid delivery apparatus end unpack the control data bag of receiving, adjust the infusion velocity of fluid delivery apparatus by control instruction.
The infusion data bag of J, monitoring transfusion base station end and monitoring information packet send to the central monitoring server end according to certain time interval.
K, medical personnel can carry out communication with the monitoring transfusion base station of just carrying out transfusion plan by PDA in hospital's scope, inquiry patient's physiological status parameter and transfusion state data, and can adjust infusion parameter by PDA is long-range.
The feature of all explanations among the present invention, and equal replacement or the combination done according to method of the present invention and technical scheme are so these conversion and combination are all within the scope of the present invention.
Claims (9)
1, a kind of critical illness monitoring and transfusion control diagnosis and treatment integral system is characterized in that comprising fluid delivery apparatus, monitoring transfusion base station, central monitoring server and medical care PDA;
Fluid delivery apparatus links to each other with the monitoring transfusion base station by wireless or wired communication modes, and the infusion treatment to patient, the status information of concurrent feedback liquid equipment are implemented in the control of reception monitoring transfusion base station;
The monitoring transfusion base station has the transfusion control function of physiological parameters of patients monitoring and one or more fluid delivery apparatus, transfusion control forms transfusion plan by medical personnel according to the information of patient, medicine and treatment prescription, realize the open loop of fluid delivery apparatus is controlled by wireless or wired mode, or in the transfusion implementation by monitoring and analyze patient's physiological parameter, adjust infusion parameter in real time according to corresponding feedback algorithm, realize closed loop control fluid delivery apparatus by wireless or wired mode;
Central monitoring server connects a plurality of monitoring transfusions base station and concentrates their running status of monitoring by wireless or wired mode, and central monitoring server also links to each other with hospital information system;
Medical care PDA is connected with monitoring transfusion base station and/or central monitoring server by wireless mode, is used to show transfusion situation and management infusion process.
2, critical illness monitoring according to claim 1 and transfusion control diagnosis and treatment integral system, it is characterized in that: described monitoring transfusion base station comprises as lower module:
Subscriber interface module: be used to offer user's input and finish corresponding human-computer interaction function, show the information of the fluid delivery apparatus of this monitoring transfusion base station control in the infusion process and patient's physiological parameter monitoring information, also import infusion parameter and form transfusion plan according to the information of patient, medicine and treatment prescription;
Physiology monitoring module: comprise physiology monitoring detection module and physiology monitoring administration module, be used to monitor patient's physiological parameter, analyze and preserve monitoring information, for the demonstration of the physiological parameter of subscriber interface module and the transfusion closed loop control of closed loop control module provide information; Physiology monitoring detection module is made up of physiological parameter sensors, signal conditioning circuit, AD conversion, single-chip microcomputer and communication submodule, is used to detect physiologic information; Physiology supervision reason is surveyed analysis and the hold function that module is finished physiological parameter;
Transfusion administration module: be used for management and control fluid delivery apparatus, transfusion plan is converted to the transfusion control instruction, or accept the transfusion control instruction of closed loop control module, and the control instruction of will infusing is fixed time by each and is sent to specified fluid delivery apparatus by the network communication module at interval;
Closed loop control module: by receiving the data of the physiological parameter of measuring patient, instruct, and control instruction is sent to transfusion transfusion administration module according to feedback algorithm output transfusion; This closed loop control module comprises the data fetch submodule, feedback algorithm submodule and control submodule, the data fetch submodule extracts patient's blood pressure data as input from the physiology monitoring module, use for the feedback algorithm submodule, the feedback algorithm submodule is analyzed required physiological parameter respectively according to the corresponding closed-loop control algolithm, judge, the result that the feedback algorithm submodule draws sends to the control submodule, which fluid delivery apparatus the control submodule is adjusted according to result's decision of feedback algorithm, and the amplitude of adjusting, form the transfusion control instruction and send to tube for transfusion reason module, implement the closed loop control of transfusion;
Alarm module: the physiological parameter information of patient in infusion process and the information of fluid delivery apparatus are monitored, when physiological parameter exceeds normal range, when perhaps fluid delivery apparatus operation appearance is unusual, in time warning message is presented at user interface, simultaneously warning message is saved to monitoring transfusion base station local data base;
Information management module: be used to manage patient's essential information, the medicine essential information;
The network communication module: by wired or wireless mode realize between central monitoring server and the monitoring transfusion base station, transfer of data between monitoring transfusion base station and the fluid delivery apparatus; Realize transfer of data between monitoring transfusion base station and the medical care PDA by wireless mode.
3, critical illness monitoring according to claim 2 and transfusion control diagnosis and treatment integral system, it is characterized in that: described central monitoring server comprises as lower module:
Subscriber interface module: be used to offer user's input and finish corresponding human-computer interaction function, the main information of each monitoring transfusion base station of centralized displaying, or show the patient of a certain monitoring transfusion base station and the physiological parameter and the infusion information of each fluid delivery apparatus, and to the monitoring transfusion base station of its management, according to the information input infusion parameter of patient, medicine and treatment prescription and form transfusion plan;
Monitoring transfusion BTS management module: remote centralized is controlled the work of a plurality of monitoring transfusions base station, handle infusion data, warning message and the patient care information of the online fluid delivery apparatus of each monitoring transfusion base station, the working condition of each monitoring transfusion base station is monitored;
Information management module: be used to manage patient's essential information, medicine essential information, employee's essential information, berth behaviour in service or patient's hospitalization information;
The network communication module: by wired or wireless mode realize between central monitoring server and the monitoring transfusion base station, transfer of data between central monitoring server and the hospital information system; Realize transfer of data between central monitoring server and the medical care PDA by wireless mode.
4, critical illness monitoring according to claim 3 and transfusion control diagnosis and treatment integral system, it is characterized in that: described fluid delivery apparatus comprises infusion pump and syringe pump;
This syringe pump comprises single-chip microcomputer, human-computer interaction module, motor, injects mechanical module, sensor assembly, communication module and power management module; Single-chip microcomputer is the core control section of syringe pump, receives the given control instruction in monitoring transfusion base station through communication module, and the operation of control step motor is injected mechanical module thereby drive, pushing syringe, thus realize injection operation; Single-chip microcomputer is sent to the monitoring transfusion base station with the syringe pump status information of gathering through communication module simultaneously, realizes real-time monitoring and the control of monitoring transfusion base station to syringe pump;
This infusion pump comprises single-chip microcomputer, human-computer interaction module, motor, finger-like wriggling mechanical module, sensor assembly, communication module and power management module; Tube for transfusion is realized transfusion operation thereby the motor of infusion pump drives the extruding of finger-like wriggling mechanical module, the sensor assembly of infusion pump comprises motor speed probe, pressure transducer and sonac, and pressure transducer and sonac are respectively applied for bubble and the obstruction that detects in the infusion process.
5, according to each described critical illness monitoring of claim 1 to 4 and transfusion control diagnosis and treatment integral system, it is characterized in that: the network communication structure of described system:
This system's employing is wired, the networking mode of wireless compatibility, and each inter-module of system is communicated by letter by wired or wireless mode; The network communication structure of all forming between central monitoring server and the monitoring transfusion base station, between monitoring transfusion base station and the fluid delivery apparatus, medical care PDA carries out communication by wireless mode and monitoring transfusion base station or central server.
6, critical illness monitoring according to claim 5 and transfusion control diagnosis and treatment integral system is characterized in that: above-mentioned networking mode is that the monitoring transfusion base station is by bus apparatus and network communication apparatus and a plurality of fluid delivery apparatus composition network communication structure; Adopt Ethernet to carry out the information transmission between central monitoring server and the monitoring transfusion base station, wherein wireless mode adopts infrared, bluetooth, Wi-Fi, wireless radio-frequency, the WLAN that Zigbee technology or super-broadband tech are formed.
7, according to each described critical illness monitoring of claim 1 to 4 and transfusion control diagnosis and treatment integral system, it is characterized in that: this system monitoring transfusion base station also is connected to the therapeutic equipments of ICU or operating room by wireless and wired mode, described therapeutic equipments comprises respirator and anesthetic machine.
8, a kind of control method of infuse control and critical illness monitoring diagnosis and treatment integral system is characterized in that may further comprise the steps:
The information that A, medical personnel import patient, medicine and treatment prescription at central monitoring server forms transfusion plan, and is kept among the central monitoring server data base, sends to the monitoring transfusion base station by the network communication module; Or, be kept in the local data base of monitoring transfusion base station at monitoring transfusion base station end input transfusion plan;
Suitable fluid delivery apparatus is selected according to the current transfusion plan of patient in B, monitoring transfusion base station, and transfusion plan changed into the transfusion control instruction, and fix time at each and at interval to send to corresponding fluid delivery apparatus, thereby begin to carry out transfusion plan by the network communication module;
C, fluid delivery apparatus receive the transfusion control instruction, are converted into the control signal of fluid delivery apparatus by single-chip microcomputer, and control syringe pump or infusion pump are carried out corresponding transfusion operation;
The physiology monitoring module of D, monitoring transfusion base station detect patient physiological signal, input as the closed loop control module, the closed loop control module is analyzed required physiological parameter respectively according to the corresponding closed-loop control algolithm, judge, analysis result sends the transfusion administration module to, corresponding fluid delivery apparatus is adjusted, thereby the closed loop feedback that realizes infusion process is controlled;
E, fluid delivery apparatus are fixed time by communication module current transfusion state information and are fed back to the monitoring transfusion base station at interval by each, and show and record the local data base of monitoring transfusion base station in real time by the subscriber interface module of monitoring transfusion base station.
9, control method according to claim 8 is characterized in that: occur when unusual when physiological parameter exceeds set point, or the fluid delivery apparatus operation occurs when unusual, relevant fluid delivery apparatus stops transfusion operation, and sends warning; The abnormal alarm information of fluid delivery apparatus sends to the monitoring transfusion base station by network communication module, also sends the transfusion alarm signal in the monitoring transfusion base station, and warning message is carried out record, after solution is unusual, proceeds transfusion operation.
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Effective date of registration: 20091023 Address after: 135, West Xingang Road, Guangdong, Guangzhou Province, China: 510275 Applicant after: Sun Yat-sen University Co-applicant after: Guangzhou Zhongda Medical Instrument Co., Ltd. Address before: 135, West Xingang Road, Guangdong, Guangzhou Province, China: 510275 Applicant before: Sun Yat-sen University |
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