CN1249478A - Aid system for doctors in same community - Google Patents
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- CN1249478A CN1249478A CN 99121908 CN99121908A CN1249478A CN 1249478 A CN1249478 A CN 1249478A CN 99121908 CN99121908 CN 99121908 CN 99121908 A CN99121908 A CN 99121908A CN 1249478 A CN1249478 A CN 1249478A
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Abstract
本发明属于计算机及医疗技术领域,包括多个社区医院客户端和一个中心医院服务器端两部分,客户端包括一台多参数生理信息检测仪、一台PC机和数据采集卡和通信接口,以及数据库及数据库管理和生理信息检测程序;中心医院服务器端包括一台PC机和通信接口,以及数据库及远程监测和远程专家会诊程序:两部分通过通讯网络相连。本发明可充分发挥的社区医院和中心医院的优势,提高了社区医院对广大居民的健康护理与疾病防治的能力。
The invention belongs to the field of computer and medical technology, and includes two parts: a plurality of community hospital clients and a central hospital server. The client includes a multi-parameter physiological information detector, a PC, a data acquisition card and a communication interface, and Database and database management and physiological information detection program; the central hospital server includes a PC and communication interface, as well as database and remote monitoring and remote expert consultation program: the two parts are connected through a communication network. The invention can give full play to the advantages of the community hospital and the central hospital, and improves the ability of the community hospital to provide health care and disease prevention for the majority of residents.
Description
The invention belongs to electronics, communication, computing machine and field of medical technology, particularly a kind of is the community doctor assistant system of one towards community hospital, collection multi-parameter physiological information test and data base administration.
Building community hospital becomes the emphasis of current medical system reform.With the quickening pace of modern life and growth in the living standard, people recognize the importance of physical examination and health care gradually.At present, big-and-middle-sized hospital is primarily aimed at the diagnosis and the treatment of disease, can't bear the task of community resident's health care, and at the community hospital of resident living area because the restriction of factors such as medical condition and hospital management also can't be brought into play the health care effect to local resident well.Its reason have following some:
One, community hospital focuses on the control of health care, nursing and disease to the resident.But the Medical Devices of community hospital are generally more outmoded, can't adapt to the needs that numerous community residents carried out physical examination, are function singleness mostly and be used for the Medical Instruments that physiologic information detects in the market, cost an arm and a leg, and are not suitable for promoting in community hospital.
They are two years old, the service object of community hospital is all community residents, therefore be faced with problem to the management of all community resident health archives, if still adopt over way to manage to patient history, the doctor of community is taken much time and energy is used for the management and the renewal of health account.
Its three because the restriction of community hospital's Medical Instruments and way to manage, make the program complexity that residents ' health is checked, expense is also than higher.So community hospital is badly in need of and the inspection and the health account of the multiple physiologic information of resident can be managed the Medical Devices that be integrated in one at present, simplifies the management of health account and the program of physical examination, reduces the expense of resident's health check-up.
Its four, another ubiquitous problem of community hospital be lack between community hospital, the effective means of information interchange between community hospital and central hospital, this has limited the performance of community hospital to community resident's medical care effect greatly.
The objective of the invention is for overcoming the weak point of prior art, develop at community hospital and be used for the physiologic information detection of community resident health health care and the community doctor assistant system of data base administration, its characteristics are that the health care with the community resident is the center, the community hospital that gives full play to and the advantage of central hospital, strengthened the contact of community hospital and central hospital, improved the ability of community hospital numerous residents' health care and disease prevention and cure.
A kind of community doctor assistant system that the present invention proposes, it is characterized in that, comprise a plurality of community hospitals client and central hospital's server end two parts, said client comprises a multi-parameter physiological information test instrument, a PC and is arranged on the multiple physiological parameter that in this PC the physiologic information detector is obtained is converted to digital signal through data data collecting card and communication interface, and be stored in database and data base administrator in the PC, physiologic information trace routine; Said central hospital server end comprises a PC and is arranged on the interior communication interface of this PC, and is stored in database and remote monitoring program and remote expert consultation program in the PC; Said two parts link to each other by communication network.
The said multi-parameter physiological information test instrument of the present invention comprises electrocardio processing module, non-invasive blood pressure module, blood oxygen processing module, respiration transducer and electronic thermometer parts, and the signal output part of each parts directly links to each other with the hyperchannel of said data collecting card.
The intelligent data acquisition card of said data collecting card under the control of PC, can automatically gathering, store to the simulating signal of respective channel.
Principle of work of the present invention is: client is positioned at community hospital, can realize the detection of the multiple physiologic information of community resident and the management of health account.Server end is positioned at central hospital, has the physiologic information from client is carried out remote monitoring and two kinds of functions of remote expert consultation.The present invention is intended to set up the network service system based on a plurality of community hospitals and a central hospital, forms a kind of provincialism medical network, makes the doctor of community can obtain the expert's of central hospital technical support and guidance by present networks.When patient need accept diagnoses and treatment in central hospital, the doctor of central hospital can obtain the medical archive of patient in community hospital quickly by native system, and the doctor of community can realize and the consulting and the consultation of doctors between the expert on the net by means of the distinctive Communications service management of native system.
Client application of the present invention is in community hospital, and patient's physiologic information converts digital signal to by data collecting card and enters computing machine after multi-parameter physiology information measurement instrument detects.Its function is to finish the detection of the multiple physiologic information of community resident and the management of health account, and where necessary local patient's physiologic information or health account is sent to central hospital, or obtains expert's help or consultation of doctors result from central hospital.
The detection of multiple physiologic information of the present invention can realize I, II, the accurate limb leads cardiogram of III beacon, pulse are involved the real-time monitoring of respiratory waveform, can measure a series of physiological parameters such as instantaneous heart rate, respiratory rate, blood pressure, blood oxygen saturation and body temperature simultaneously.This multi-parameter measurer directly links to each other with the client microcomputer of community hospital, real-time waveform and the measured value that records physiological parameter is presented on the screen, and deposits measurement result in health account.This measuring instrument has easy to use, dependable performance, and low-cost characteristics are suitable for community hospital and use.
Client computer of the present invention links to each other with measuring instrument by built-in intelligent data acquisition card, capture card under the control of computing machine automatically the simulating signal to respective channel gather, store, and pass through the isa bus and the computing machine communication of standard.Computing machine can demonstrate detected electrocardio, breathing and blood oxygen waveform in real time, and the numerical value of physiological parameters such as blood pressure, blood oxygen saturation, heart rate, respiratory rate and body temperature.
The management of client health account of the present invention comprises operations such as newly-built, the inquiry, renewal, deletion of health account and to the retrospective analysis two parts of physiological parameter testing result in the database.By analyzing and processing, can estimate community resident's health status and the variation of finding health more all sidedly to the multiple physiological-parameter long-term check result of community resident.The result of the each physical examination of resident deposits in its corresponding health account, realized digital management to whole community residents ' health archives, remove the doctor of community and will spend the plenty of time to write the hard work of case history everyday, can provide medical record information for central hospital where necessary again.
Client of the present invention is by communication mediums such as public telephone network, ISDN or Internet, data such as the detected person's of seing patients physiologic information and health account can be sent to central hospital, or receive the expert consultation information and the suggestion of sending by central hospital, manage between the different doctors of community or doctor of community and the doctor on duty of central hospital between online communation etc.
Server end of the present invention is used for central hospital, has two kinds of functions of remote physiological information monitoring and remote expert consultation.The remote monitoring program makes the testee's that doctor on duty and consulting consultant can send Terminal Server Client physiologic information carry out real time monitoring, make in the process that the anxious severe case that community hospital goes to a doctor is treating, can allow the doctor of central hospital understand patient's the state of an illness and corresponding help is provided.In addition, community hospital can send to central hospital with resident's health account (comprising general information, multiple physiological parameter measurement data, and other check results are as biochemistry, pathology, image etc.), is used for remote expert consultation.Simultaneously, the result that will hold a consultation of central hospital deposits database in, calling and inquiring about for community hospital.
Community doctor assistant system of the present invention has following characteristic:
(1) with the detection of multiple physiologic information, the management of health account and be integrated in a system with communication function
In the system, greatly reduce the cost of system.
(2), alleviated the administrative burden of community hospital, letter with the administering digitalization of community resident health archive
Change community resident's health check-up program, reduced the expense that community resident health is checked.
(3) have stronger network communication function, realized testee's long distance monitoring and remote medical consultation with specialists,
Strengthened between community hospital and the getting in touch of community hospital and central hospital.
Brief Description Of Drawings:
Fig. 1 is a community doctor assistant system structural representation of the present invention
The standard limb leads ecg signal amplifier structural representation of Fig. 2 embodiment of the invention
The breath signal processing module schematic diagram of Fig. 3 embodiment of the invention
The body temperature processing module schematic diagram of Fig. 4 embodiment of the invention
The client software structure diagram of Fig. 5 embodiment of the invention
The data base administrator structure diagram of Fig. 6 embodiment of the invention
The server software structure diagram of Fig. 7 embodiment of the invention
The central station server end connection diagram of Fig. 8 embodiment of the invention
The present invention has designed a kind of community doctor assistant system and method embodiment thereof that is used for the community resident health health care, is described in detail as follows in conjunction with each accompanying drawing:
The system architecture of the community doctor assistant system of present embodiment comprises a plurality of community hospitals client and the server end two large divisions of central hospital as shown in Figure 1, and both link to each other by communication networks such as public telephone network or Internet.System software comprises the physiologic information trace routine, data base administrator and network communication program.The each several part composition is described below respectively:
Community hospital of first client
Community hospital's client of present embodiment is made up of a multi-parameter physiological information test instrument, data collecting card and a PC.The multiple physiological parameter that the physiologic information detector obtains is converted to digital signal through data collecting card, is used for more new user interface and deposits database in.Simultaneously, PC can send to long-range server end with detected physiologic information by Internet or public telephone network.
The data collecting card of present embodiment adopts the patented product that the inventor develops voluntarily (utility model patent number: 97248967.3), 89C51 single-chip microcomputer on the capture card as the control chip of capture card realize accurate timing sampling and with the PC communication, 8 passages programmable A/D conversion chip MAX155 can gather 8 channel analog signals simultaneously, also can be to the signal sampling of arbitrary passage under the control of computing machine, data bit is 8.Random access memory 62256 provides the data buffer of 32KB for capture card.The sampling rate of capture card and mode of operation (mode of operation is by two kinds: some passage of setting is changed or only changed to 8 passages simultaneously) are by computer installation.Capture card signal to respective channel under the control of PC is gathered, is stored, and passes through the isa bus slot computing machine communication of standard.
The multi-parameter physiological information test instrument of present embodiment comprises parts such as electrocardio processing module, non-invasive blood pressure module, blood oxygen processing module, respiration transducer, electronic thermometer, its function is to measure the accurate limb leads cardiogram of three beacons, breathing and blood oxygen waveform, and the numerical value of physiological parameters such as blood pressure, blood oxygen saturation, heart rate, respiratory rate and body temperature.Each several part function and structure are described in detail as follows.
The structure of the electrocardio processing module of present embodiment as shown in Figure 2, this electrocardio processing module can be measured I, II, the accurate limb leads cardiogram of III beacon simultaneously.The electrocardio processing module mainly comprises amplifying circuit, isolation amplification, filtering circuit and the insulating power supply etc. of input protection, preposition amplification, block isolating circuit, adjustable gain.Input protection is divided into two-stage, and in 60-70V, the second level makes input voltage be no more than 10V with the two-way series diode to first order use neon bulb voltage limit.That preposition amplification is adopted is exact instrument amplifier-integrated three amplifier INA131 that BB company produces, and gain is 100 times (RG=2.63k Ω).The cutoff frequency of block isolating circuit is 0.08Hz, the Gain Adjustable main amplifying circuit four shelves are arranged: 10,20,30 and 60, the mode by wire jumper realizes.The effect of isolating amplifier stage is to realize the isolation on electric of human body and part on the spot, signal is delivered to grounded part from floating ground part (connecing the part of human body) through the photoelectricity isolation level, two parts do not have contacting directly on the electric current, and the leakage current that constitutes by ground wire is equipped with inhibition fully.Floating ground part is by the power supply of DC-DC (BCT-12D12/40) insulating power supply, and part is by the stabilized voltage supply power supply on the spot, and buffer circuit adopts is coupling amplifying circuit by the complementary type of photoelectric coupled device (TLP-521) design.The 50Hz trap circuit adopted typical twin-T network the 50Hz rejection filter, its notch depth reaches-25dB, bandwidth is 10Hz (45-55Hz), satisfies the requirement that electrocardio detects.In order to suppress high frequency interference, afterbody at amplifying circuit has added low-pass filter, that select for use is the fertile low pass switching capacity filter TLC04/14 (TI company) now of quadravalence Bart, guaranteed the maximally-flat degree in the signal passband scope, cutoff frequency is adjustable by clock, and the cutoff frequency of electrocardio amplifying circuit is 200Hz in the present embodiment.
With usually lead more the electrocardio detection method different be, three to lead electrocardiosignal be synchronous acquisition in the native system, rather than switch by the timesharing between respectively leading and to obtain, so just make that the standard limb leads cardiogram that obtains by native system really is a strict synchronism, there are not phase place and mistiming between signal, this just provides diagnosis basis more fully for the doctor of community, and lays a good foundation for doing three real-time Synchronization Analysis and the cardiopathic correct diagnosis of leading the ECG signal later on.
What the measurement of present embodiment blood pressure was adopted is the non-invasive blood pressure module that U.S. ALTA OEM company produces.This module has multiple test pattern, both can be fit to the measurement that the adult also can be fit to blood pressure of children.Reading by client-side program of blood pressure measurement and data controlled, artificial motion or other are wrong to be taken place if having in deflation course, and module will be inflated to cuff current target pressure again and repeat deflation course (repeat 3 times or overflow up to safety timer).
What the measurement of blood oxygen saturation was adopted in the present embodiment is the blood oxygen processing module that is provided by USA I E company, and it has, and volume is little, low in energy consumption, interface is simple, is convenient to characteristics such as operation.When measuring blood oxygen saturation, also can obtain pulse wave and heart rate value.
The breath signal of present embodiment is to finish by the signal that the processing respiration transducer records.In the respiration transducer is PN junction structure thermal sensing element, its pressure drop changes with temperature, thereby the temperature variation that causes owing to respiratory air flow in the respiratory is changed into the variation of voltage signal on the PN junction, breathe processing module with this signal after processing such as amplifications, filtering, can obtain reflecting the respiratory waveform of depth of respiration, respiratory rate is calculated by respiratory waveform simultaneously.
Fig. 3 is for breathing the processing module schematic diagram, and voltage stabilizing diode D1 is fixed on the current potential of amplifier U1 reverse input end-2V, and U1 provides a constant current source for respiration transducer, and electric current is 200 μ A.The cutoff frequency of the Hi-pass filter that capacitor C and resistance R are formed is 0.003Hz, is used for the DC component of filtering breath signal, obtains not having the breath signal of DC component.Amplifier U2 is a main amplifying circuit, and enlargement factor is adjustable between 68-101.In order to reduce the interference of high-frequency signal, obtain level and smooth respiratory waveform, added second-order low-pass filter, the cutoff frequency of wave filter is 100Hz.
Present embodiment has adopted electronic thermometer, and its adopts temperature-sensitive PN junction as temperature sensor, and its principle is the same with respiration transducer, have highly sensitive, characteristics such as response speed is fast.This body temperature probe can be used for detecting the temperature of body surface, rectum or respiratory tract, and (34 ℃-42 ℃) have the good linearity in the measurement of bldy temperature scope.Be well suited for long body temperature monitoring to the testee.
Fig. 4 is a body temperature processing module schematic diagram, and output voltage of this circuit and temperature to be measured have linear relationship.Voltage stabilizing diode D1 is fixed on the current potential of amplifier U1 reverse input end-2V, and amplifier U1 provides a constant current source for the body temperature sensor, and electric current is 74 μ A.Can make that by regulating P1 circuit is output as 0 under a certain specified temp.(U2, U3), enlargement factor is adjustable in the 20-40 scope through the two-stage amplification for signal.In order to reduce the interference of high-frequency signal, behind the U1 output passive low ventilating filter (cutoff frequency 200Hz) that at first process R, C forms, handle (cutoff frequency is 100Hz) through U2, U3 two-stage low-pass filter again, improved thermometric stability with repeatable.Simultaneously, need to reduce the thermonoise of components and parts in the circuit, need select low drift, high-accuracy amplifier and high-precision metalfilmresistor for use, what potentiometer need be with accurate multi-turn type.
The software of present embodiment client is that platform adopts Visual C++ 6.0 exploitations with the PC, operates under the Windows95/98 operating system.Client software comprises physiologic information trace routine and data base administrator.The function of physiologic information trace routine is to make the doctor of community obtain testee's many conventional physiological parameter easily and quickly, as standard limb leads cardiogram, pulse wave, blood pressure, heart rate, blood oxygen saturation, body temperature, respiratory rate etc.These necessary sign parameter indexs can be obtained by the simple operations to computing machine by the doctor fully, have reduced or remitted a series of loaded down with trivial details test procedure that needs execution in the general hospital.The function of data base administrator is that the result of testee's general information, each physical examination and diagnosis result all can be logged in its health account automatically for each community resident sets up the complete health account of a cover.
The structure diagram of physiologic information trace routine as shown in Figure 5, it is made up of main thread and worker thread.In main thread, realize mainly that system interface upgrades, response user operation, show measured result, carry out net connection, monitor network packet and testee's physiologic information is sent to work such as central hospital in real time; Worker thread is mainly realized data acquisition, and the result is stored in the data buffering.Main thread and worker thread are worked simultaneously, and main thread and worker thread communicate by message and data buffering.The Event triggered mode is adopted in the design of this client-side program.Have three main driving incidents in the program:
Incident 1 is the various operations (measurement of physiological parameter, data storage, Network Transmission) of user by system interface, and this is the event message that is independently sent by the user.
Incident 3 is when receiving Socket bag incident.When sending packet, central station will produce this incident.
After user's start detection program, enter the measurement interface of physiologic information, the physiological parameter that selection will be measured, press " beginning to measure " button in the tool bar, the computer starting capture card begins to gather the simulating signal of respective channel, the data acquisition back capture card that finishes is sent out data efficient message trigger event 2 to computing machine, and computing machine is presented at the user interface from the data buffer reading of data of capture card and the measurement result that will obtain corresponding physiologic information.If testee's physiologic information need be preserved, " data storage " option in the selection tool bar, at first open testee's health account, import corresponding information (health account number and health check-up date) after, resulting measurement result just deposits in the database.Between detection period, if desired testee's physiologic information is mail to long-range server end (central hospital), the user selects " network connection " option, the IP address of input server end, client is convenient to server end and has been set up connection (under the situation of server end start) by Socket, server end can demonstrate the real-time ECG of long-range testee, breathing and pulse wave, and the measured value of other physiological parameter.When center hospital by network when community hospital sends message with trigger event 3, client software unpacks data, and the notice client the user make corresponding processing.
The structure diagram of data base administrator as shown in Figure 6, the database of community resident health archive adopts the Access data base management system (DBMS) to develop, the software of client can utilize ODBC and SQL query language that database is carried out various operations.Behind the log-on data library manager, the user mainly contains four kinds of selections: the processing of health account is used for the operation such as newly-built, inquiry, renewal, deletion of community resident health archive; The review of physiological parameter, the measured value that accesses cardiogram, breathing and the pulse wave stored in certain residents ' health archives and other physiological parameters is used for doctor's diagnostic analysis; The statistical study of physiologic information is converted into time dependent trend map and patterned analysis result with the long-term physiological parameter measurement value in the health account, thereby reflects the variation of testee's health status; Testee's health account is printed in the output of health account, or cardiogram, respiratory waveform, pulse wave and the patterned analysis result of other physiological parameters.Above function has satisfied the needs of community hospital to the residents ' health file administration substantially.
Second portion central hospital server end
The server end that is used for central hospital in the present embodiment is a hardware platform with Pentium 586 microcomputers, and links to each other with Internet or public telephone network.Software systems adopt visual c++ 6.0 developing instruments based on Windows98/NT operating system.The major function of central hospital's server end be realize testee's physiologic information remote monitoring and and the doctor of community between remote expert consultation, its software configuration is as shown in Figure 7.Two main driving incidents are arranged in the remote monitoring program:
Incident 1 is the various operations of user by system interface, and this is the event message that is independently sent by the user, comprises various operations of this machine and the order that sends to Terminal Server Client.
After the remote monitoring program of operation physiologic information, the user is " network connection " button on the selection tool bar at first, opens the Socket oracle listener, is used for monitoring incident 2.When packet that client is sent, monitoring facilities is the decomposition data bag at first, the data that obtain are used for more new user interface (real-time cardiogram, pulse wave, respiratory wave, and the measured value of blood pressure, heart rate, blood oxygen saturation, respiratory rate and body temperature), also deposit the database of server end simultaneously in.
The structure of remote expert consultation program is similar to the data base administrator of client, also is to adopt the Access Development of Database Management System, utilizes ODBC and SQL query language that database is operated.After entering data base administrator, the user is from local or access patient's health account from the database of Terminal Server Client by network, check patient's information such as medical history, main suit, cardiogram, breathing and the pulse wave of being stored in the review health account and the measured value of other physiological parameters, the diagnostic analysis that is used for the doctor of central hospital, and the result that will hold a consultation deposits database in, calls and inquires about for community hospital.
The logic of the central station server end of present embodiment connects as shown in Figure 8, and it comprises a plurality of community hospitals client, a plurality of consultant's clients and a central station server.Server connects by Socket with each client (comprising all doctor of community front ends that link to each other with server, central station doctor on duty, consultant etc.), all there is a Socket to be connected between each client and server like this, therefore server can either with each client's exchange data packets, can help the client to realize exchanges data between the client simultaneously again.
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| CN 99121908 CN1249478A (en) | 1999-10-14 | 1999-10-14 | Aid system for doctors in same community |
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| CN 99121908 CN1249478A (en) | 1999-10-14 | 1999-10-14 | Aid system for doctors in same community |
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| CN100440230C (en) * | 2003-03-28 | 2008-12-03 | 商之器科技股份有限公司 | Method and device for remote control of medical instrument |
| CN101727532A (en) * | 2008-10-14 | 2010-06-09 | 邱小益 | Health management system and method based on Internet |
| CN101480339B (en) * | 2009-01-09 | 2010-08-11 | 清华大学深圳研究生院 | Method and system for realizing measurements of various physiological parameters |
| CN101051991B (en) * | 2006-04-05 | 2010-12-29 | 迈世亚（北京）科技有限公司 | Data pushing system and method |
| CN102298664A (en) * | 2010-06-22 | 2011-12-28 | 精联电子股份有限公司 | Hospital bed call system and control method based on Internet communication protocol |
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