JP4797103B2 - Treatment support program, recording medium thereof, and treatment support system - Google Patents

Description

  The present invention relates to a kidney disease, a lifestyle-related disease related to kidney disease (diabetes, heart disease, hypertension, dyslipidemia, etc.) and a program for supporting treatment of the reserve army, its recording medium and system, It is effective for patients with primary diseases such as diabetes, kidney disease, hyperlipidemia, hypertension, ischemic heart disease, weakness, muscle weakness, malignant tumor, cerebrovascular disorder, dementia and the like.

  In general, there is a misunderstanding that it is cumbersome and difficult to store the entire amount of urine excreted by a patient at home for 24 hours. That is, in 24-hour urine storage without temperature control, bacteria can propagate in urine depending on the temperature environment, so nitrogen compounds in urine are consumed as a nitrogen source for bacterial growth, and urease converts urea into ammonia, etc. Therefore, it is considered difficult to acquire data that should be obtained by storing the whole amount of urine because urea is reduced.

  For this reason, as a technique related to the diagnosis of kidney disease, for example, there is “diagnosis of human kidney disease” disclosed in Patent Document 1 below, but as represented by this disclosed technique, it is collected only once at a medical site. The “spot urine” is used, and “the amount of urine protein per gram of creatinine in urine” and “the value obtained by dividing the protein concentration of spot urine by the creatinine concentration” are substituted for the daily urine protein amount. .

  However, the amount of urinary protein excretion differs greatly between daytime and nighttime, and the amount of creatinine excretion varies greatly depending on the tubules. Therefore, the amount of urinary protein excretion does not necessarily match that of creatinine. Therefore, the inventor of the present application requested the development of a “urine storage cold box” disclosed in Patent Document 2 below, and reproduction of bacteria and the like was suppressed for urine excreted by a patient at home during 24 hours. It was possible to store urine for 24 hours in a cold state kept at a temperature below ℃.

JP 2002-543386 gazette JP 2006-162532 A

  By the way, as described above, it has been generally considered that 24-hour full-volume urine storage by a patient at home has been complicated and difficult, so there is useful data on lifestyle habits obtained by 24-hour urine storage. Regardless, life guidance for individual patients based on this was not fully implemented. That is, for patients at home, routine blood collection is difficult considering the burden on the patient, and therefore, the treatment policy is generally determined based on blood data obtained by temporary blood collection. There were not many treatments that considered much about lifestyles that should be different for each patient.

  In addition, if you can accumulate more than several thousand cases of data analyzed for 24-hour refrigerated urine storage, it will be possible to perform multivariate analysis including various lifestyle habits for each patient that has not been analyzed. Even if a computer program that can analyze chilled 24-hour urine storage collected by patients and collect the data on the host computer is distributed to each medical facility, data input at each medical facility This will impose a great burden of labor. On the other hand, since the aggregated data is once analyzed by the host computer and then fed back to each medical facility, it is difficult to use immediately in clinical practice. For this reason, it is difficult to obtain approval even if each medical facility is requested to cooperate in data collection by such a host computer.

The present invention has been made to solve the above-described problems, and a computer program capable of supporting the implementation of life guidance and the like for the lifestyle of a patient by a doctor or a medical staff (hereinafter referred to as “doctor” or the like), and a recording medium therefor And to provide a system.
Another object of the present invention is to provide a computer program capable of facilitating collection of urine storage analysis data obtained by analyzing cold urine storage in each medical facility, and a recording medium and system thereof.

In order to achieve the above object, the technical means of claims 1, 4 and 7 described in claims are adopted. According to these means, the urine accumulation data acquisition means obtains urine accumulation analysis data obtained by analyzing the urine excreted during 24 hours and the cold urine stored in a cold storage environment of 10 ° C. or less, The volume data acquisition means acquires the urine volume of cold-reserved urine, the identification information acquisition means acquires identification information unique to the patient, and the date information acquisition means acquires date information related to the date on which the patient accumulated or examined. Further, the life guidance information generation means performs calculation processing based on lifestyle index data related to lifestyle among the urine storage analysis data to generate life guidance information related to the patient's lifestyle, and further, the treatment guideline information generation means generates urine storage analysis data. Among them, calculation processing based on disease-related index data relating to a predetermined disease is performed to generate treatment guideline information related to the patient, and the data registration means provides the life guidance information, treatment guideline information, and urine storage analysis data with identification information and date information. Are added and registered in the database. Then, from the plurality of life guidance information and treatment guideline information registered and accumulated in the database by the tabulation editing means, a plurality of life guidance information and treatment guideline corresponding to the patient from the past to the present Based on the identification information unique to the patient, the information is arranged in read time series and edited into a tabulation table, and the tabulation table is output to the output device by the data output means. The life guidance information generation means multiplies the urine concentration by the urine concentration of phosphorus contained in the urine storage analysis data as a calculation process based on the lifestyle index data related to lifestyle among the urine storage analysis data. The amount of excretion in daily urinary urine is calculated as one, and the treatment guideline information generation means calculates the urine content of magnesium contained in the urine storage analysis data as a calculation process based on the disease-related index data related to the predetermined disease among the urine storage analysis data. By dividing the magnesium clearance obtained by multiplying the concentration by the urine volume and dividing it by the blood magnesium concentration, and further dividing by the creatinine clearance, the% magnesium clearance is calculated as one of the treatment guideline information, and the data output means The totals output by the table shows daily excretion in phosphorus and% magnesium clear run It is included.

Further, the technical means of claims 2, 5 and 8 described in claims are adopted. According to these means, the summary table output by the data output means further includes daily intake protein amount, daily salt urinary excretion amount, daily potassium urinary excretion amount and% creatinine production as life guidance information. At least one of the rates is included, and the treatment guideline information includes at least one of 24-hour endogenous creatinine clearance and daily urinary protein excretion.

  Further, the technical means of claims 3, 6 and 9 described in the claims are adopted. According to these means, blood data acquisition means obtains blood analysis data obtained by analyzing a patient's blood collection, and data registration means adds identification information and date information to the blood analysis data and registers them in the database. To do. Then, from the plurality of blood analysis data registered and accumulated in the database by the table tabulation editing means, a plurality of blood analysis data corresponding to the patient and from the past to the present are obtained. Based on the identification information, it is read out and edited into the tabulation table in addition to a plurality of life guidance information and treatment guideline information, and the tabulation table including the blood analysis data is output to the output device by the data output means.

In the first, fourth, and seventh inventions, the tabulation table output from the output device includes a plurality of life guidance information and treatment guideline information corresponding to the patient from the past to the present in time series. side by side has been edited, it is included in the daily Rin'nyo excretion in life guidance information, also% magnesium clearance to guide treatment information is included. For this reason, it is possible to provide information that is arranged in time series as useful information that is instantly useful for a patient such as a kidney disease and that is individually adapted to the patient at a clinical site. Therefore, for example, the doctor in charge of the patient can provide the patient with lifestyle guidance on lifestyle based on information that shows these time-series changes at the clinical site. It can support the implementation of life guidance. In addition, since identification information and date information are added to the urine storage analysis data and registered in the database, it provides useful information that is immediately useful in clinical settings corresponding to the patient individually, while the urine storage analysis data Collection is also accompanied. Therefore, it functions not only as a clinical support tool for supporting lifestyle improvement guidelines and treatment guidelines, but also as a tool for collecting the urine storage analysis data. Collection of collected urine storage analysis data can be facilitated.

In the inventions of claims 2, 5 and 8, the summary table output from the output device further includes daily intake protein amount, daily saline excretion amount, daily potassium urine excretion as life guidance information. At least one or more of the amount and% creatinine production rate is included, and the treatment guideline information includes at least one or more of 24-hour endogenous creatinine clearance and daily urinary protein excretion. For this reason, it is also possible to provide information that is arranged in time series as useful information that is instantly useful for each patient in a clinical setting for patients with renal diseases, etc. It is possible to support the implementation of lifestyle guidance for patients' lifestyles.

In the inventions of claims 3, 6 and 9, the tabulation table output from the output device includes a plurality of blood analysis data corresponding to the patient and from the past to the present, In addition to treatment guideline information, it is edited in chronological order, so information obtained from these blood analysis data (eg urea nitrogen (serum), serum creatinine, serum albumin concentration, uric acid (serum), sodium (serum) ), Potassium (serum), inorganic phosphorus (serum), calcium (serum), intact PTH (serum), bicarbonate ion, hematocrit (whole blood), hemoglobin A _1C (whole blood) It is possible to provide information that is arranged in time series as useful information that is individually useful and immediately useful.

It is explanatory drawing which shows the structural example of the renal disease database registration system which concerns on embodiment of this invention. It is a flowchart which shows the flow of the renal disease database registration process performed by the slave computer which comprises this system. It is a flowchart which shows the flow of the process by each subroutine (Medical data management process, test | inspection data taking-in process, medical-data taking-in process) shown in FIG. It is a flowchart which shows the flow of a process by each subroutine (Aggregate table operation process, consent form / procedure book print process, medicine data management process) shown in FIG. It is explanatory drawing which shows the example of an input by the new registration process of the patient of the medical treatment data management process shown to FIG. 3 (A). It is explanatory drawing which shows the example of input by the urine storage analysis data acquisition process of the test | inspection data acquisition process shown to FIG. 3 (B). It is explanatory drawing which shows the example of input by the blood analysis data acquisition process of the test | inspection data acquisition process shown to FIG. 3 (B). It is explanatory drawing which shows the example of input by the related data acquisition process of the test | inspection data acquisition process shown to FIG. 3 (B). It is explanatory drawing which shows the continuation of the example of input by the related data taking-in process shown in FIG. FIG. 5 is an explanatory diagram illustrating an output example of a printing process for a predetermined number of times before the aggregation table operation process illustrated in FIG.

  Hereinafter, embodiments of a treatment support program, a recording medium thereof, and a treatment support system of the present invention will be described with reference to the drawings. In the present embodiment, an example in which the treatment support system of the present invention is applied to a renal disease database registration system (hereinafter “registration system”) will be mainly described. Among them, the treatment support program of the present invention and its recording medium An application example will be described together.

  In this embodiment, “patients with renal disease” are assumed as examples of kidney diseases, lifestyle-related diseases related to kidney diseases (diabetes, heart diseases, hypertension, dyslipidemia, etc.) and reserve patients. Each patient with primary diseases such as diabetes, heart disease, hypertension, dyslipidemia, ischemic heart disease, frailty, muscle weakness, malignant tumor, cerebrovascular disorder, dementia and their reserves The same can be applied to other patients.

[Configuration of Registration System 20]
First, a configuration example of the registration system 20 will be described with reference to FIG. FIG. 1 is an explanatory diagram showing a configuration example of the registration system 20.
As shown in FIG. 1, the registration system 20 is a computer system provided in a medical facility α through which patients with renal diseases attend. For example, a slave computer 21, a display 22, a database 23, a printer 24, a communication device 26, and an analysis device 28. Etc. As shown in FIG. 1, the registration system 20 and the like are similarly configured in the medical facilities β and γ. Here, the registration system 20 of the medical facility α will be described as a representative.

  The slave computer 21 is an information processing device (computer) that can execute the kidney disease data registration program of the present invention. For example, a general-purpose personal computer is used, and an associated input device (display 22, keyboard, mouse, etc.) (Not shown). The slave computer 21 is installed with a general-purpose OS such as MS-Windows (registered trademark) or Mac-OS (registered trademark), and further, general-purpose spreadsheet software that operates on the OS, such as Excel (registered). Trademark) is also installed. A registration program 30 described later is also installed.

  The display 22 is an output device connected to the slave computer 21 and is configured so that the result of information processing by the slave computer 21 can be displayed in color on the screen. In this embodiment, for example, a general liquid crystal display device of TFT type is used.

  The database 23 is a large-capacity information storage device such as a hard disk device, a DVD device, or an optical disk device, which is built in or externally attached to the slave computer 21 and is connected to the slave computer 21. It is configured so that various related data can be registered and stored.

  The printer 24 is an output device connected to the slave computer 21 and is configured to be capable of color printing the result of information processing by the slave computer 21 on a predetermined sheet. In this embodiment, for example, a laser color printer is used.

  The communication device 26 is interposed between the slave computer 21 and an ISP (Internet Services Provider) and the like so that the slave computer 21 can be connected to the Internet 100. For example, the ISP can support the communication device 26. An ADSL modem, a gateway, etc. correspond to this.

  The analyzer 28 is a urine storage analysis means that can analyze components contained in the urine storage sample 70 and blood sample 80 of the patient, and is connected to the slave computer 21 via a general-purpose interface such as USB in this embodiment. . Therefore, the analysis data (urine collection analysis data) of the urine storage sample 70 analyzed by the analyzer 28 and the analysis data (blood analysis data) of the blood sample 80 are automatically captured by the slave computer 21 by the capture software of the slave computer 21. It is possible. That is, it also functions as an input device that enables input of analysis data of the urine storage sample 70 and blood sample 80.

  The registration program 30 is a computer program that can execute a kidney disease database registration process, which will be described later, in the slave computer 21, and is configured based on general-purpose spreadsheet software. In this embodiment, it is comprised so that it can be used, for example using the Excel (Excel; registered trademark) by a Microsoft company. As a result, it can be used as it is on a personal computer owned by each medical facility α or the like, and it is possible to collect data for a database with a simple operation by utilizing the characteristics of spreadsheet software.

  The slave computer 21 is installed via, for example, a CD-ROM distributed to the medical facility α from a distributor (supplier) of the registration program 30. The registration program 30 is an example of an embodiment of the renal disease data registration program of the present invention, and the CD-ROM is a computer-readable recording medium that records the renal disease data registration program of the present invention.

  The urine cold storage box 50 is made of, for example, styrene foam, and contains a polyethylene urine storage bag with a chuck and a cold storage agent inside, so that the temperature of the urine in the urine storage bag is 10 ° C. or less except during the first urine collection ( The average temperature is 7 ° C. or lower). This urine cold storage box 50 was developed by the inventor of the present invention, as described in the section of “Background Art”, and was requested to be developed by a design / manufacturer of a polystyrene foam product. Details thereof are disclosed in JP-A-2006-162532. Is disclosed.

  The patient stores the urine excreted for 24 hours (predetermined time) in a cold storage environment of 10 ° C. or less (average of 7 ° C. or less) using this urine cold storage box 50 on a predetermined day (urine storage day). After the completion, the refrigerated 24-hour urine storage 60 in the urine storage bag is agitated and homogenized, and about 10 ml (milliliter) of urine is collected in a test tube with a dropper, and this is taken as a urine storage sample 70 to the medical facility α. In addition, the test tube is affixed with a label on which the patient name and the date of urine collection can be entered. At this time, the blood sample 80 is collected by the medical facility α.

  As described above, the registration system 20 including the medical facilities α, β, γ, and the like is connected to the center system 10 of the data center X via the Internet 100. Here, the configuration of the center system 10 is as follows. Briefly described.

  As shown in FIG. 1, the center system 10 configured in the data center X mainly includes a host computer 12 and a database 14 and is configured to be connectable to the Internet 100 via a communication device 16. The host computer 12 is a computer having an array processor capable of vector operation, for example, with a higher information processing capability than the slave computer 21. A large-capacity hard disk device of 100 terabytes is used.

  By configuring the center system 10 of the data center X in this way, as will be described later, urine accumulation analysis data or blood for each patient sent from each of more than 1,000 medical facilities such as medical facilities α, β, γ, etc. Analysis data can be stored in the database 14, and high-speed arithmetic processing can be performed by the host computer 12 in multivariate analysis of the accumulated data of thousands or more cases. If such high-speed arithmetic processing is not particularly required, for example, a general-purpose personal computer may be used as the host computer 12 in the same manner as the slave computer 21.

[Information processing by registration system 20]
Next, the flow of the renal disease database registration process will be described with reference to FIGS. This process is realized by executing the above-described registration program 30 with the Excel software of the slave computer 21.

  As shown in FIG. 2, when the kidney disease database registration process is started on the slave computer 21, a menu screen (not shown) is first displayed on the display 22 in step S101. This screen includes, for example, “medical data management”, “test data capture”, “medical data capture”, “aggregate table operation”, “consent form / procedure manual print”, “drug data management”, and “end”. Since seven buttons are displayed on the display 22, a button having a desired processing content is selected by a pointing device such as a mouse.

  In the subsequent step S103, a selection button determination process is performed. That is, the type of the button selected in step S101 is determined in this process, and the corresponding process is called to shift the process. When “medical data management” is selected, step S200, when “taken examination data” is selected, step S300, when “medical data fetch” is selected, step S400, “aggregate table operation” is selected. Is selected, the process proceeds to step S500, "consent form / procedure document print" is selected, step S600 is selected, and "medicine data management" is selected, step S700 is entered. If “end” is selected, the renal disease database registration process is ended. Here, for example, it is assumed that “medical data management” is selected.

  If it is determined in step S103 that “medical data management” has been selected (S103; “medical data management”), the process proceeds to the medical data management process (S200) shown in FIG. In this process, first, in step S201, a chart number receiving process for receiving a chart number (medical chart No) input and a checkup date is performed. This process accepts the input of a chart number (identification information) unique to the patient to be examined. For example, the chart number and examination date corresponding to the patient are input by an input device such as a keyboard (identification information acquisition means) Date information acquisition means, date information acquisition means).

  In the next step S202, processing is performed to determine whether or not the chart number input in step S201 is new, that is, whether it has not been used in the past. For example, a chart number list stored in the database 23 is searched to determine whether the number exists. If it does not exist (S202; Yes), the process proceeds to the subsequent step S203 to perform a new registration process for the patient. On the other hand, if it already exists (S202; No), since it is not necessary to perform a new registration process, the process proceeds to step S206.

  In step S203, a new registration process for the patient is performed. In this process, for example, an input screen as shown in FIG. 5 is displayed on the display 22, and accordingly, predetermined necessary items are input by an input device such as a keyboard. In the display example of FIG. 5, personal information about the patient, such as input of the patient's name in kanji, katakana, etc., date of birth (age), gender, prefecture name of residence, etc. It is configured to input data (medical data) that is a basis for medical treatment of renal diseases such as a person and accompanying information such as an examination date. Note that the chart number input in step S201 is input in advance. In addition, there is a field for inputting information on disease / clinic facility as medical facility information, but each of these input frames are displayed in the already input state like the chart number. Further, the age (XX years △ months) can be obtained by calculating the number of years from the date of birth to the date of entry.

  In subsequent step S204, a database registration process for registering the new registration information of the patient input in step S203 in the database 23 is performed. As a result, the number is registered in the chart number list, and the new registration information is stored in the database 23 in association with the chart number.

  Step S206 is a registration information reading process that is performed when it is determined in step S202 that it already exists (S202; No), and personal information and the like related to the patient is read from the database 23. The patient's medical data is used for “inspection data acquisition”, “medical data acquisition”, and the like shown in FIG.

  When such a series of medical data management processing ends, the process returns to step S101 shown in FIG. 2 to display a menu screen on the display 22 and wait for input of a selection button. This time, the description will be continued assuming that, for example, “taken inspection data” is selected.

  If it is determined that “inspection data acquisition” is selected in step S103 (S103; “inspection data acquisition”), the process proceeds to inspection data acquisition processing (S300) shown in FIG. In this process, a diagnosis number acquisition process is first performed to acquire a diagnosis number in step S301. This examination number is managed by, for example, five digits (00001 to 99999), and is managed so that the same number is not generated unless all numbers are used up continuously or randomly. The acquisition of the chart number has already been acquired by the medical data management process (S200) described above, and is referred to.

  In the subsequent step S302, urine storage analysis data acquisition processing (urine storage data acquisition means, urine storage data reception means) for acquiring urine storage analysis data is performed. In this embodiment, since the analyzer 28 and the slave computer 21 are connected via a general-purpose interface, when the urine storage sample 70 brought by the patient is set in the analyzer 28, the analyzer 28 stores the urine for 24 hours by cooling. 60 component analysis is automatically performed, and urine accumulation analysis data is output to the slave computer 21 as the analysis result. That is, the slave computer 21 can automatically capture the urine accumulation analysis data of the patient from the analyzer 28. At this time, from the label of the test tube containing the urine storage sample 70, the patient name and the urine storage date are read, and these pieces of information are input to the slave computer 21 (date information acquisition means, date information acquisition means). In the case of visual observation, an input device such as a keyboard is used. In the case of an image recognition device, automatic input is performed via a predetermined input interface.

As a result of being automatically taken in from the analyzer 28, for example, urinary components (Cre (creatinine), UN (urea nitrogen), Na (sodium), K (potassium), P ( Phosphorus ), Mg (magnesium), and protein) are displayed on the display 22 as having been input. That is, the urine concentration of each of these components is obtained as urine storage analysis data. Note that the urine volume and the intake of meat fish are input through an input device such as a keyboard, for example, information obtained by a questionnaire or an inquiry.

  In the next step S303, blood analysis data acquisition processing (blood data acquisition means) for acquiring blood analysis data is performed. Similarly to step S302, in this process, when the blood sample 80 collected from the patient is set in the analyzer 28, the analysis of the blood component is automatically performed by the analyzer 28, and the blood analysis data is obtained as a result of the analysis. The data is output to the computer 21. In other words, the slave computer 21 can automatically capture blood analysis data of the patient from the analyzer 28.

As a result of being automatically taken in from the analyzer 28, for example, the blood component (Cre (creatinine)) in the input screen shown in FIG. In addition, blood components, Hb (hemoglobin), Ht (hematocrit), serum Fe (iron), ferritin, TIBC (total iron binding ability), Alb (albumin), each cholesterol, UN (urea nitrogen), BUN (blood) Urea nitrogen), Na (sodium), K (potassium), Ca (calcium), P ( phosphorus ), Mg (magnesium), CRP (C-reactive protein), blood glucose, HbA _1C (glycohemoglobin A _1C ), intact There are columns for PTH (parathyroid hormone), HBs (hepatitis B), HCV (hepatitis C virus), cystatin C workup, and pentosidine. If measured by the analyzer 28, values are entered in these columns. .

  In addition, when the analysis work of the urine storage sample 70 and the blood sample 80 is outsourced to an external analysis center or the like without using the analyzer 28 as described above (when an outsourced inspection is requested), the analysis result of the analysis center Is stored in an information recording medium (for example, a flexible disk or a CD-ROM) as urine storage analysis data or blood analysis data, and reaches the requesting medical facility. Therefore, in such a case, even if the information recording medium is set in the slave computer 21 (or an information recording medium reader) and the urine accumulation analysis data or blood analysis data is read therefrom, the information is stored in the slave computer 21. good. In addition, in the case where an electric communication line such as the Internet is used as an information transmission medium instead of such an information recording medium, urine storage analysis data and blood analysis data may be downloaded to the slave computer 21 from an analysis center computer or the like. good.

  In the subsequent step S304, related data obtained by analysis of urine and blood, for example, acid-base balance shown in FIG. 8, occasional urine, onset, erythropoietin, renal biopsy, NESP (registered trademark), pre-existing disease, Processing for obtaining (accepting) the current complication, medication information, and the like shown in FIG. 9 is performed. For example, data (information) listed in the following Table 1 excluding data that has already been captured in steps S302 and S303 is an input target. For example, these data inputs are automatically fetched from a receipt computer (not shown) connected to the slave computer 21 via a network (not shown), which is a computer that creates a medical fee description, hereinafter referred to as “Rececon”. As for the device, it is performed through an input device such as a keyboard. In the title of Table 1 below, “database creation software” is read as “kidney disease data registration program”.

  In step S305, calculation processing is performed to calculate calculation data for a predetermined item using the analysis data obtained in steps S302 and S303. For example, arithmetic processing based on lifestyle index data related to lifestyle among the urine storage analysis data is performed. More specifically, the “lifestyle index data” here means meal index data (for example, urinary UN (urea nitrogen)) related to food intake and exercise index data (for example, urinary serum Cre (creatinine)) related to physical exercise. ).

  In other words, since it is possible to determine whether or not an appropriate meal is being eaten, the daily protein intake can be determined based on UN (urea nitrogen) obtained from the urine storage analysis data of cold refrigerated 24-hour urine storage. To estimate. In other words, UN (urea nitrogen) obtained from urine accumulation analysis data is the daily urea nitrogen excretion, and based on this, the daily protein intake is estimated. It can be an indicator. Since normal protein catabolism cannot be significantly increased in normal life, a protein catabolization rate (normalized PCR; nPCR) with respect to ideal body weight is obtained, and this value is used as an estimated daily protein intake.

The protein catabolism rate (PCRg / kg / day) is calculated by Maroni's formula (the following formula (1)), and the protein catabolism rate (normalized PCR; nPCR) with respect to the ideal body weight is obtained.
nPCR (g / kg / day) = 6.25 [Urea urea nitrogen excretion per unit ideal body weight (g / kg / day) + 0.031] ... (1)
Ideal weight (kg) = 22 x Height (m) ² ... (2)

  On the other hand, creatinine is made by muscle, and the amount of urinary excretion in creatinine for 24 hours is a value determined by the amount of muscle and the amount of exercise, so whether or not you are exercising properly depends on the% creatinine production rate (%) It becomes possible.

Since Cre (creatinine) obtained from urine storage analysis data of cold-reserved 24-hour urine storage is the amount of urinary excretion in 24-hour creatinine, the% creatinine production rate (%) is obtained from the following equation (3) based on this.
% Creatinine production rate (%) = 24-hour creatinine urinary excretion (g / kg / day) ÷ average value of 24-hour creatinine production rate by sex and age of healthy subjects x 100 (3)

  In step S305, calculation processing based on disease-related index data relating to a predetermined disease in the urine accumulation analysis data is performed. In patients with impaired renal function, 24-hour endogenous creatinine clearance does not accurately represent glomerular filtration rate, but there is accumulation of data from old tests, and chilled 24-hour urine storage has urinary creatinine concentration Can be kept stable and stable results can be obtained, so that data of each case can be compared over time. For this reason, here, an eGFR (glomerular filtration rate based on an estimation formula) useful as an index at the time of follow-up of each case, that is, a clinical index, is obtained by the following formulas (4) and (5) (for adults).

For men: eGFR (ml / min / 1.73m ² )
= 194 x serum creatinine ^-1.094 x age ^-0.287 (4)
For women: eGFR (ml / min / 1.73m ² )
= EGFR (male) x 0.739 (5)

  In addition, as information required for calculation based on urine storage analysis data of cold-reserved 24-hour urine storage, as guidance information on meal intake (meal guidance information), daily excretion amount in salt urine (g / day), in daily potassium urine There are excretion (mg / day) and daily urinary excretion (mg / day), which are calculated by multiplying each urine concentration obtained by the analyzer 28 by the daily urine output. Can do.

  Similarly, guidance information (treatment guideline information) for a given disease obtained by calculation from urine accumulation analysis data of cold 24-hour urine storage includes% magnesium clearance (% Fractional Excretion of Mg). Magnesium clearance is expressed as creatinine clearance. There is a thing (unit:%) which calculated the percentage by dividing. The daily urinary protein excretion can also be calculated by multiplying the urine protein concentration obtained by the analyzer 28 by the daily urine volume.

These are summarized as follows.
* Guidance information on meal intake (meal guidance information)
-Daily protein intake (calculated by the above formulas (1) and (2))
-Daily salt urine excretion-Daily potassium urine excretion-Daily phosphoric excretion * Guidance information on physical exercise (exercise guidance information)
-% Creatinine production rate (calculated by the above formula (3))
* Guidance information on specific diseases (treatment guideline information)
・ 24-hour endogenous creatinine clearance (calculated by the above formulas (4) and (5))
-% Magnesium clearance-Daily urinary protein excretion

  The result of the arithmetic processing in step S305 is processed in a predetermined work file or a predetermined work in the hard disk device or the memory device of the slave computer 21 so that information can be processed by a summary table operation process (S500) described later. It is stored in the area.

  In step S306, a database storage process is performed in which the medical record number and the examination number of the patient are given to the analysis data captured in steps S302 and S303 and the analysis data input in step S304, and stored in the database 23 in a predetermined data format. Is called. Thereby, in the database 23, analysis data can be managed for each chart number, that is, for each patient, and when a plurality of analysis data exist for one patient, it is possible to distinguish them by the examination number. It becomes. In addition, instead of the examination number, date information such as the examination date entered in the chart number receiving process (S201) or the urine collection date (urine collection date) entered in the urine collection analysis data capturing process (S302) It may be added as identification information unique to the patient.

  Further, the lifestyle index data and disease-related index data obtained by the calculation process in step S305 may be stored in the database 23 together with the analysis data taken in in steps S302 and S303 or separately in a predetermined data format. Thereby, since it is not necessary to perform this arithmetic processing again, the burden of information processing can be reduced.

  By setting the storage location of the analysis data in step S306 in the host computer 12 of the center system 10 connected to the Internet 100, the urine storage analysis data and blood analysis data collected at the medical facility α and the like can be remotely It can be stored in the database 14 of the center system 10.

  In addition, once stored in the local database 23, analysis data for a plurality of patients is collected by batch processing that performs information processing in a time zone in which a job of the slave computer 21 is relatively free such as a midnight time zone. 10 may be transferred. Furthermore, the load load on the connection line between the Internet 100 and the center system 10 can be reduced by shifting the starting time of such batch processing for each medical facility α, β, γ, and the database by the host computer 12 can be reduced. 14 can be smoothly performed.

  When such a series of inspection data capture processing is completed, the process returns to step S101 shown in FIG. 2 to display the menu screen on the display 22 and wait for input of a selection button. Next, the description will be continued assuming that, for example, “acquisition of medical data” is selected.

  If it is determined in step S103 that “medical data fetching” has been selected (S103; “medical data fetching”), the processing shifts to the clinical data fetching process (S400) shown in FIG. In this process, first, a chart number to be imported is acquired in step S401, and medical data corresponding to the chart number is read from the database 23 in step S403. The “medical data” here includes analysis data and the like stored in the database 23.

  When the medical data fetching process is completed, the process returns to step S101 shown in FIG. 2 again to display the menu screen on the display 22 and wait for selection button input. Next, the description will be further continued assuming that, for example, “tabulation table operation” is selected.

  In this process, the analysis data described so far is displayed in a table format on the screen of the display 22 or printed on a predetermined sheet of the printer 24 in a form format. The flow is illustrated in FIG. ing. First, in step S501, a medical record number to be tabulated is acquired. The acquisition of the chart number has already been acquired by the medical data management process (S200) described above, and is referred to.

  In the subsequent step S502, all the analysis data stored in the database 23 corresponding to the chart number acquired in step S501 is read and compiled and edited in a predetermined table format. For example, as shown in FIG. 10, the vertical (row) sequence is set as examination items, and the horizontal (column) sequence is set in chronological order according to the examination date. Below the table, “↑” (red display) indicates that each test value has increased compared to the previous value, and “↓” (blue) indicates that it has decreased compared to the previous value. Display). Moreover, you may display the explanatory note with respect to each item so that the said patient can understand the content of a test | inspection item etc. on the lower side of a table | surface.

In the case of this embodiment, as shown in FIG. 10, the body weight, urine volume, and blood pressure are displayed, and the information obtained from the blood sample 80 (urea nitrogen (serum), serum creatinine, serum albumin concentration, uric acid ( Serum), sodium (serum), potassium (serum), inorganic phosphorus (serum), calcium (serum), intact PTH (serum), bicarbonate ion, hematocrit (whole blood), hemoglobin A _1C (whole blood)), Information obtained from urine collection sample 70 (endogenous creatinine clearance, protein intake,% creatinine production rate, salt intake, urine protein, urinary potassium, FEMg, total phosphorus excretion) and others (total cholesterol) , Triglycerides) and items are displayed separately. The eGFR may be displayed in addition to the information item obtained from the urine storage sample 70.

  Of these, protein intake, salt intake, urinary potassium and phosphorus excretion are related to dietary intake as lifestyle guidance information, and% creatinine production rate is related to physical exercise as lifestyle guidance information. It is. Furthermore, endogenous creatinine clearance is treatment guideline information regarding the patient's renal disease.

  In step S503, the table edited in step S502 is displayed on the display 22, and in the subsequent step S504, it is asked whether or not to print it further on the printer 24. When printing (S204; Yes), Then, the process proceeds to step S505.

  In step S505, a printing process is performed for a predetermined number of times before printing data arranged a predetermined number of times (for example, 10 times) from the current examination in time series. If there is no need for printing by the printer 24 (S504; No), a series of tabulation operation processing is terminated after waiting for a display termination instruction in step S503.

  Thus, in this embodiment, in the display process of the display 22 in step S503 and the print process of the printer 24 in step S505, as shown in FIG. Display treatment guideline information on diseases (display example) or print (form example). In addition, in order to grasp the change with time, display or printing is performed with arrows (increase: ↑ (red), decrease: ↓ (blue)) pointing up and down with the previous value. As a result, it is possible to visually grasp the increase / decrease of each value and changes in the past nine times, etc. with respect to the previous examination. For example, the doctor in charge clearly shows the effect of treatment or improvement for the patient Based on this, it is possible to make more appropriate proposals regarding lifestyle improvement guidelines and treatment guidelines.

  In addition, when the increase or decrease of each value with respect to the previous inspection exceeds a predetermined ratio (for example, 50%), the numerical value itself corresponds to the notation that can be notified, for example, the numerical value itself is displayed in bold font or red font. The display of may be changed. Further, instead of or in addition to the numerical value and arrow display, the numerical value increase / decrease may be displayed in a graph display (line graph, bar graph, etc.) that can be discriminated at a glance.

  In this way, it is possible to notify not only the doctor in charge but also the patient concerned by adopting a display and printing mode that can immediately grasp the improvement state visually. It can greatly help to improve patient motivation. In other words, the improvement of lifestyle habits varies greatly depending on the patient's own intentions in daily life, so by providing a display that can be easily understood by the patient, Motivation can be performed relatively easily, and the level of the effect can be easily notified.

  In the display example and the form example shown in FIG. 10, medication information is not included, but, for example, a medicine name item is added to a test item arranged in a vertical (row), and medication is given at each test. The presence / absence of the drug and the dose may be displayed or printed. Thereby, since the effect of treatment and improvement can be confirmed together with medication information, it is possible to make more appropriate proposals from the aspect of drug prescription regarding lifestyle improvement guidelines and treatment guidelines.

  In addition, in the display example and the form example shown in FIG. 10, information on complications is not included, but for example, a disease name item that may develop due to merging with test items arranged in a vertical (row) row is added. Then, at the time of each inspection, the presence / absence of the possibility, the degree of risk, and the like may be displayed or printed. Thereby, since the effect of treatment and improvement can be confirmed together with complication information, it is possible to make more appropriate proposals from the aspect of complications regarding lifestyle improvement guidelines and treatment guidelines.

  Here, returning to step S101 shown in FIG. 2 again, for example, if it is determined that “Consent Form / Procedure Print” is selected (S103; “Consent Form / Procedure Print”), the consent form shown in FIG. / Proceed to the procedure manual printing process (S600). This process is a document (consent form) that asks for consent to register test results, treatment details, etc. in the database 23 or to present at a conference in a state where an individual cannot be identified for the patient, a urine storage cold box The printer 24 prints a document (procedure manual) describing the procedure and procedure for appropriately storing the urine for 24 hours in the cold storage.

  First, the chart number of the patient to whom the consent form and the procedure manual are to be obtained is obtained by the chart number obtaining process in step S601. This chart number is used in step S605 and the like to specify the name of the patient.

  In the subsequent step S602, processing for selecting a document to be printed is performed. For example, by clicking a button displayed on the screen of the display 22 with a mouse or the like, either an agreement or a procedure is selected. To do.

  Then, it is determined which one has been selected in step S603, and if a consent form is selected, a consent form in which the name of the patient is described is printed by the printer 24 in step S605. If it is determined in step S603 that the procedure manual has been selected, the printer 24 prints the procedure manual in which the name of the patient is described in step S606.

  If it is not necessary to print the patient's name on the consent form, the chart number acquisition process in step S601 is not necessary. When printing by the printer 24 is completed, a series of consent form / procedure form printing is terminated.

  Returning again to step S101 shown in FIG. 2, for example, if it is determined that “medicine data management” has been selected (S103; “drug data management”), the process proceeds to the drug data management process of step S700. This process is performed for drug master data loaded from a not-shown receptacle connected to the slave computer 21 and stored in the database 23. The flow of the process is shown in FIG. .

  First, in step S701, referring to the medicine master data stored in the database 23, a process of displaying a list of registered medicines registered in the master data on the display 22 is performed. On the screen where this list is displayed, the “take” (update) button of the drug master data and the “end” button of the list display are displayed, and one of them is selected by clicking with the mouse or the like. As a result, the process proceeds to step S703.

  In step S703, processing is performed to determine whether or not the button selected in step S701 is a “take-in” button. If it is determined that the “take-in” button is selected (S703; Yes), the process proceeds to step S705, and processing for loading (loading) drug master data from the receptacle is performed. If it is determined that the “take-in” button has not been selected (S703; No), the selected button is “end”, and thus the process jumps to step S705 to end the drug data management process. Even when the loading of the medicine master data is completed in step S705, the medicine data management process is terminated.

  In step S701, a “print” button for printing the list of registered medicines by the printer 24 is provided, and the selection processing of the “print” button is added to the determination processing in step S703, and it is determined that it has been selected. In such a case, a list of medicine master data currently stored in the database 23 may be printed by the printer 24.

  As described above, according to the registration system 20 according to the present embodiment, the urine excreted by the patient in 24 hours by the urine accumulation analysis data capturing process (S302) by the slave computer 21 is stored in a cold storage environment of 10 ° C. or less. The input of urine storage analysis data obtained by analyzing the stored refrigerated 24-hour urine storage 60 is received, and the arithmetic processing based on the lifestyle index data related to lifestyle among the urine storage analysis data is performed by the arithmetic processing (S305) by the slave computer 21. And generate information related to food intake and physical exercise as life guidance information related to the lifestyle of the patient. In addition, the arithmetic processing (S305) by the slave computer 21 performs arithmetic processing based on the disease-related index data relating to the predetermined disease in the urine accumulation analysis data to generate treatment guideline information relating to the patient's renal disease. Then, the life guidance information and the treatment guideline information are output to the display 22 and the printer 24 by the display display process (S503) by the slave computer 21 and the printing process (S505) for a predetermined number of times.

  As a result, life guidance information related to the lifestyle of the patient obtained from the urine storage analysis data and treatment guideline information related to kidney disease are generated and output to the display 22 and the printer 24. Useful information can be provided. Therefore, for example, the doctor in charge of the patient can provide lifestyle guidance on lifestyle based on such information to the patient at the clinical site. Can help.

  In addition, according to the registration system 20 according to the present embodiment, a chart number unique to the patient is acquired by the chart number receiving process (S201) by the slave computer 21, and the examination is performed by the chart number receiving process (S201) by the slave computer 21. Date information related to the date is obtained, and the urine accumulation analysis data to which the medical record number and the examination date are added is stored (registered) in the database 23 by the database storing process (S306) by the slave computer 21. )

  As a result, since the urine accumulation analysis data to which the medical record number and the examination date are added is registered in the database 23, while providing useful information immediately useful in the clinical field corresponding to the patient individually, The collection of urine analysis data is also accompanied. Therefore, it functions not only as a clinical support tool for supporting lifestyle improvement guidelines and treatment guidelines, but also as a tool for collecting the urine storage analysis data. Collection of collected urine storage analysis data can be facilitated.

  Furthermore, according to the registration system 20 according to the present embodiment, it is possible to deal with a patient from among a plurality of life guidance information and treatment guideline information registered and accumulated in the database 23 by the tabulation editing process (S502) by the slave computer 21. A plurality of life guidance information and treatment guideline information from the past to the present are arranged in a reading time series based on a chart number unique to the patient, edited into an aggregation table, and output to the display 22 or the printer 24. . Such life guidance information includes at least one of daily protein intake, daily salt urine excretion, daily potassium urinary excretion, daily phosphoric excretion,% creatinine production rate. In addition, the treatment guideline information includes at least one of 24-hour endogenous creatinine clearance,% magnesium clearance, and daily urinary protein excretion.

  As a result, life guidance information (daily intake protein amount, daily saline excretion, daily potassium urinary excretion, daily phosphorus, etc.) can be used as useful information that can be instantly useful for individual patients in clinical settings. Urinary excretion,% creatinine production rate) and treatment guideline information (24-hour endogenous creatinine clearance,% magnesium clearance, daily urinary protein excretion) can be provided side by side in chronological order. Therefore, for example, the doctor in charge of the patient can provide the patient with lifestyle guidance on lifestyle based on information that shows these time-series changes at the clinical site. It can support the implementation of life guidance.

  In the embodiment described above, the urine excreted during “24 hours” by the patient is described as an example of the cold-reserved urine stored in the cold-reserved environment of 10 ° C. or less. However, the application of the present invention is not limited to this. In the case of spot urine, for example, the present invention is also applied to cold urine storage stored in a cold storage environment of 10 ° C. or lower with urine excreted during an arbitrary predetermined time such as 8 hours or 12 hours. Can be applied, and actions and effects peculiar to the present invention described above can be obtained.

  In the embodiment described above, since the treatment support system of the present invention is applied to the registration system 20, as shown in FIG. 3B, after performing the calculation process in step S305, the database storage process in step S306 is performed. Function (function of registering urine accumulation analysis data in the database 23 of the slave computer 21 or the database 14 of the host computer 12 connected to the slave computer 21 via the Internet 100), but such a function is not always necessary. The calculation processing result may be immediately displayed in step S502 on the display 22 in step S502 and displayed on the display 22 in step S503, or may be printed on the printer 24 in step S505 (printed a predetermined number of times before). Thereby, the system configuration can be simplified. The same applies to the application example of the treatment support program and the recording medium of the present invention, and the function of performing the database storage process in step S306 after performing the calculation process in step S305 may be excluded.

  Further, in the embodiment described above, the urine storage sample 70 is analyzed by the analyzer 28 in step S302 and the urine storage analysis data is taken in. Then, in step S303, the blood sample 80 is analyzed by the analyzer 28 and the blood analysis data is obtained. However, the processing order of the both may be reversed, and since the blood analysis data is not necessary for the items that can be obtained only from the urine storage analysis data, the blood analysis data acquisition processing in step S303 is not necessarily required information processing. is not.

Therefore, for example, items relating to blood shown in FIG. 10 (urea nitrogen (serum), serum creatinine, serum albumin concentration, uric acid (serum), sodium (serum), potassium (serum), inorganic phosphorus (serum), calcium (serum ), Intact PTH (serum), bicarbonate ion, hematocrit (whole blood), hemoglobin A _1C (whole blood)), lifestyle guidance information on the patient's lifestyle and treatment guidelines for kidney disease Only information (endogenous creatinine clearance, protein intake,% creatinine production rate, salt intake, urine protein, urinary potassium, FEMg, total phosphorus excretion) is generated and output to the display 22 and printer 24 If so, the blood analysis data capture process (S303) is deleted from the test data capture process (S300) shown in FIG. It becomes the composition.

  Further, in the embodiment described above, the urine storage sample 70 is analyzed by the analyzer 28 in step S302, and based on the urine storage analysis data, a calculation process (S305) indicates that “lifestyle index data related to lifestyle among the urine storage analysis data”. Information processing (life guidance information generating means) for generating life guidance information related to a patient's lifestyle by performing calculation processing based on the patient and performing calculation processing based on disease-related index data relating to a predetermined disease in urine storage analysis data Information processing for generating treatment guideline information (treatment guideline information generating means) ”is performed, but it is not always necessary to provide both of these information processing, and either one may be used. As a result, only necessary indices and information can be presented to the patient, so that it is difficult to give a visually complicated impression by avoiding display of unnecessary items.

  In the embodiment described above, the CD-ROM is exemplified as the computer-readable recording medium on which the renal disease data registration program of the present invention is recorded. However, the embodiment is recorded on a DVD, a flexible disk device, or a semiconductor memory device. May be. In addition, instead of such a recording medium, the Internet can be installed as an information transmission medium by downloading the renal disease data registration program of the present invention from a server (computer having a server function) connected to the Internet. May be.

  In the embodiment described above, the treatment support program of the present invention, the recording medium thereof, and the treatment support system are used for kidney diseases, lifestyle-related diseases related to kidney diseases (diabetes, heart diseases, hypertension, dyslipidemia, etc.). However, it is not limited to this, for example, diabetes, heart disease, hypertension, dyslipidemia, ischemic heart disease, weakness, weakness, The present invention can also be applied to patients having primary diseases such as malignant tumors, cerebrovascular disorders, dementia and the like, and patients of the reserve army. Furthermore, the treatment support program of the present invention, its recording medium, and treatment support system can be used for confirmation of treatment effects and treatment effects in home care management, and confirmation of various rehabilitation effects for the purpose of improving muscle weakness and weakness. Can be applied. Further, the present invention can be applied to a system capable of confirming an effect of improving a person's lifestyle including food and exercise.

  In addition, if each invention demonstrated above is grasped | ascertained as creation of a technical idea, it can be expressed as follows.

<Treatment support program>
(1) Connect the computer
Urine storage data receiving means for receiving input of urine storage analysis data obtained by analyzing chilled urine stored in a cold storage environment of 10 ° C. or less with urine excreted during a predetermined time by the patient;
Life guidance information generating means for performing calculation processing based on lifestyle index data related to lifestyle among the urine storage analysis data and generating lifestyle guidance information related to the lifestyle of the patient;
Treatment guideline information generating means for generating treatment guideline information about the patient by performing arithmetic processing based on disease-related index data related to a predetermined disease among the urine storage analysis data,
Functioning as data output means for outputting the life guidance information and the treatment guideline information to an output device connected to the computer.
(2) The computer described in (1)
Identification information acquisition means for acquiring identification information unique to the patient;
Date information acquisition means for acquiring date information related to the date of urine collection or screening;
Analysis data registration means for registering the urine accumulation analysis data to which the identification information and the date information are added to a database of the computer or a database of a host computer connected to the computer via an electric communication line;
To function as.
(3) Regarding (1) or (2),
The lifestyle index data includes meal index data related to meal intake and exercise index data related to physical exercise,
The life guidance information includes “meal guidance information regarding meal intake of the patient generated by calculation processing based on the meal index data” and “daily exercise of the patient generated by calculation processing based on the motion index data. Exercise guidance information about.

<Computer-readable recording medium>
(4) Connect the computer
Urine storage data receiving means for receiving input of urine storage analysis data obtained by analyzing refrigerated urine stored in an environment of 10 ° C. or less with urine excreted during a predetermined time by the patient;
Life guidance information generating means for performing calculation processing based on lifestyle index data related to lifestyle among the urine storage analysis data and generating lifestyle guidance information related to the lifestyle of the patient;
Treatment guideline information generating means for generating treatment guideline information about the patient by performing arithmetic processing based on disease-related index data related to a predetermined disease among the analysis data;
Recording a treatment support program for causing the life guidance information and the treatment guideline information to function as data output means for outputting to an output device connected to the computer.
(5) In addition, the computer of (4)
Identification information acquisition means for acquiring identification information unique to the patient;
Date information acquisition means for acquiring date information related to the date of urine collection or screening;
Analysis data registration means for registering the urine accumulation analysis data to which the identification information and the date information are added to a database of the computer or a database of a host computer connected to the computer via a telecommunication line Recorded a treatment support program to make it work.
(6) Regarding (4) or (5),
The lifestyle index data includes meal index data related to meal intake and exercise index data related to physical exercise,
The life guidance information includes “meal guidance information regarding meal intake of the patient generated by calculation processing based on the meal index data” and “daily exercise of the patient generated by calculation processing based on the motion index data. Exercise guidance information about.

<Treatment support system>
(7) urine storage analysis means for analyzing refrigerated urine stored in a refrigerated environment of 10 ° C. or less with urine excreted by a patient during a predetermined time and obtaining urine storage analysis data;
Life guidance information generating means for extracting lifestyle index data related to lifestyle among the urine storage analysis data and performing calculation processing based on this data to generate lifestyle guidance information regarding the lifestyle of the patient;
Treatment guideline information generating means for extracting disease-related index data relating to a predetermined disease from the urine storage analysis data and performing treatment processing based on this data to generate treatment guideline information relating to the patient;
Data output means for outputting the life guidance information and the treatment guideline information to an output device;
Be provided.
(8) Regarding the treatment support system of (7),
Identification information acquisition means for acquiring identification information unique to the patient;
Date information acquisition means for acquiring date information related to the date of urine collection or screening;
Analysis data registration means for registering the urine storage analysis data to which the identification information and the date information are added to a database or a database of a host computer via a telecommunication line.
(9) About (6) or (7)
The lifestyle index data includes meal index data related to meal intake and exercise index data related to physical exercise,
The life guidance information includes “meal guidance information regarding meal intake of the patient generated by calculation processing based on the meal index data” and “daily exercise of the patient generated by calculation processing based on the motion index data. Exercise guidance information about.

According to the technical idea described in the above (1) or (4), it is obtained by analyzing the cold-reserved urine stored in the cold-reserved environment of 10 ° C. or less with the urine excreted by the patient during a predetermined time by the urine storage data receiving means. Urine storage analysis data input is received, life guidance information generation means performs calculation processing based on lifestyle index data related to lifestyle among the urine storage analysis data to generate lifestyle guidance information related to the patient's lifestyle, and treatment The guide information generating means generates the treatment guideline information about the patient by performing arithmetic processing based on the disease-related index data related to the predetermined disease among the urine storage analysis data, and the life guidance information and the treatment guideline information are connected to the computer by the data output means. Output to the output device.
As a result, life guidance information related to the lifestyle of the patient obtained from urine storage analysis data and treatment guideline information related to the patient are generated and output to the output device. Useful information can be provided. Therefore, for example, the doctor in charge of the patient can provide lifestyle guidance on lifestyle based on such information to the patient at the clinical site. Can help.

According to the technical idea described in the above (7), the urine excreted during a predetermined time by the urine accumulation analysis means by the urine accumulation analysis means to analyze the refrigerated urine stored in a refrigerated environment of 10 ° C. or less to obtain urine accumulation analysis data, The life guidance information generation means performs calculation processing based on the lifestyle index data related to lifestyle among the urine storage analysis data to generate life guidance information related to the patient's lifestyle, and the treatment guideline information generation means includes the urine storage analysis data. Calculation processing based on disease-related index data relating to a predetermined disease is performed to generate treatment guideline information related to the patient, and life guidance information and treatment guideline information are output to an output device connected to the computer by the data output means.
As a result, life guidance information related to the lifestyle of the patient obtained from urine storage analysis data and treatment guideline information related to the patient are generated and output to the output device. Useful information can be provided. Therefore, for example, the doctor in charge of the patient can provide lifestyle guidance on lifestyle based on such information to the patient at the clinical site. Can help.

According to the technical idea described in (2), (5) or (8) above, the identification date specific to the patient is acquired by the identification information acquisition means, and the date of urine collection or examination by the date information acquisition means The urine storage analysis data to which the identification information and the date information are added by the analysis data registration means is obtained from the computer database or the host computer connected to the computer via the telecommunication line. Register in the database.
As a result, the urine accumulation analysis data to which the identification information and the date information are added is registered in the database, so that useful information that is immediately useful in the clinical field corresponding to each patient is provided, while the urine accumulation data is provided. Analysis data is also collected. Therefore, it functions not only as a clinical support tool for supporting lifestyle improvement guidelines and treatment guidelines, but also as a tool for collecting the urine storage analysis data. Collection of collected urine storage analysis data can be facilitated.

According to the technical idea described in the above (3), (6) or (9), the lifestyle index data includes meal index data related to food intake and exercise index data related to physical exercise. The information is “meal guidance information related to the patient's meal intake generated by arithmetic processing based on meal index data” and “exercise guidance information related to daily exercise of the patient generated by arithmetic processing based on exercise index data”. Therefore, the meal output information, exercise instruction information, and treatment guideline information are output to the output device connected to the computer by the data output means.
As a result, the dietary guidance information, exercise guidance information, and treatment guideline information are output to the output device connected to the computer by the data output means, so that dietary guidance information and exercise that are particularly important as lifestyle related to kidney disease Providing improvement guidelines for guidance information can be supported in clinical settings. Therefore, it is possible to more specifically support the implementation of lifestyle guidance on the lifestyle habits of patients by doctors and the like, and it is possible to further promote the collection of urine storage analysis data in each medical facility.

10 ... Center system 12 ... Host computer (computer)
14 ... Database 20 ... Registration system 21 ... Slave computer (computer, urine accumulation data acquisition means, urine accumulation data reception means, identification information acquisition means, date information acquisition means, date information acquisition means, data registration means, analysis data registration means, Living guidance information generation means, treatment guideline information generation means, data output means, blood data acquisition means)
22. Display (output device)
23 ... Database 24 ... Printer (output device)
26 ... Communication device 28 ... Analyzing device (input device, urine storage analyzing means, blood analyzing means)
30 ... Registration program (kidney disease data registration program)
50 ... urine storage cold box 60 ... refrigerated 24-hour urine storage 70 ... urine storage sample 80 ... blood sample 100 ... internet (electric communication line)
X ... data center α, β, γ ... medical facility S201 (identification information acquisition means, date information acquisition means, date information acquisition means), S203 (identification information acquisition means), S302 (urine accumulation data acquisition means, urine accumulation data reception) Means), S303 (blood data acquisition means), S305 (life guidance information generation means, treatment guideline information generation means), S306 (data registration means, analysis data registration means), S502 (table tabulation editing means), S503 (data output) Means), S505 (data output means)

Claims (9)

In a treatment support program that supports the treatment of patients,
Computer
Urine storage data acquisition means for acquiring urine storage analysis data obtained by analyzing refrigerated urine stored in a cold storage environment of 10 ° C. or less with urine excreted by a patient for 24 hours;
Urine volume data acquisition means for acquiring the urine volume of the cold storage urine,
Identification information acquisition means for acquiring identification information unique to the patient;
Date information acquisition means for acquiring date information relating to the date on which the patient accumulated urine or was examined,
Life guidance information generating means for performing calculation processing based on lifestyle index data related to lifestyle among the urine storage analysis data and generating lifestyle guidance information related to the lifestyle of the patient;
Treatment guideline information generating means for generating treatment guideline information about the patient by performing arithmetic processing based on disease-related index data related to a predetermined disease among the urine storage analysis data,
Data registration means for adding the identification information and the date information to the database by adding the identification information and the date information to the life guidance information, the treatment guideline information, and the urine accumulation analysis data,
Among the plurality of life guidance information and the treatment guideline information registered and accumulated in the database, a plurality of the life guidance information and the treatment guideline information corresponding to the patient and from the past to the present are obtained. Table tabulation editing means for editing a tabulation table arranged in a reading time series based on the identification information unique to the patient,
Data output means for outputting the summary table to an output device;
A treatment support program that functions as
The life guidance information generating means multiplies the urine amount by the urine concentration of phosphorus contained in the urine storage analysis data as a calculation process based on lifestyle index data related to lifestyle among the urine storage analysis data, Calculate daily urinary excretion as one of the life guidance information,
The treatment guideline information generation means multiplies the urine volume by the urine concentration of magnesium contained in the urine storage analysis data as a calculation process based on disease-related index data relating to a predetermined disease in the urine storage analysis data, By dividing the magnesium clearance obtained by dividing by the medium magnesium concentration, further dividing by the creatinine clearance, the% magnesium clearance is calculated as one of the treatment guideline information,
The treatment support program characterized in that the total table output by the data output means includes the daily urinary excretion and the% magnesium clearance.   The summary table output by the data output means further includes at least one of daily intake protein amount, daily salt urine excretion amount, daily potassium urine excretion amount and% creatinine production rate as the life guidance information. The treatment according to claim 1, wherein at least one of 24 hour endogenous creatinine clearance and daily urinary protein excretion is included as the treatment guideline information. Support program. The treatment support program according to claim 1 or 2, further comprising:
Functioning as blood data acquisition means for acquiring blood analysis data obtained by analyzing blood collection of the patient,
The data registration means adds the identification information and the date information to the blood analysis data and registers it in the database,
The tabulation editing means is adapted to store a plurality of blood analysis data from the past to the present corresponding to the patient among the plurality of blood analysis data registered and accumulated in the database. Read based on the unique identification information, edit the summary table in addition to the plurality of life guidance information and treatment guideline information,
The data output means outputs the summary table including the blood analysis data to the output device. In a computer-readable recording medium recording a treatment support program for supporting a patient's treatment,
Computer
Urine storage data acquisition means for acquiring urine storage analysis data obtained by analyzing refrigerated urine stored in a cold storage environment of 10 ° C. or less with urine excreted by a patient for 24 hours;
Urine volume data acquisition means for acquiring the urine volume of the cold-reserved urine;
Identification information acquisition means for acquiring identification information unique to the patient;
Date information acquisition means for acquiring date information relating to the date on which the patient accumulated urine or was examined,
Life guidance information generating means for performing calculation processing based on lifestyle index data related to lifestyle among the urine storage analysis data and generating lifestyle guidance information related to the lifestyle of the patient;
Treatment guideline information generating means for generating treatment guideline information about the patient by performing arithmetic processing based on disease-related index data related to a predetermined disease among the urine storage analysis data,
Data registration means for adding the identification information and the date information to the database by adding the identification information and the date information to the life guidance information, the treatment guideline information, and the urine accumulation analysis data,
Among the plurality of life guidance information and the treatment guideline information registered and accumulated in the database, a plurality of the life guidance information and the treatment guideline information corresponding to the patient and from the past to the present are obtained. Table tabulation editing means for editing a tabulation table arranged in a reading time series based on the identification information unique to the patient,
Data output means for outputting the summary table to an output device connected to the computer;
A computer-readable recording medium that records a treatment support program to function as
The life guidance information generating means multiplies the urine amount by the urine concentration of phosphorus contained in the urine storage analysis data as a calculation process based on lifestyle index data related to lifestyle among the urine storage analysis data, Calculate daily urinary excretion as one of the life guidance information,
The treatment guideline information generation means multiplies the urine volume by the urine concentration of magnesium contained in the urine storage analysis data as a calculation process based on disease-related index data relating to a predetermined disease in the urine storage analysis data, By dividing the magnesium clearance obtained by dividing by the medium magnesium concentration, further dividing by the creatinine clearance, the% magnesium clearance is calculated as one of the treatment guideline information,
The computer-readable recording medium characterized in that the total table output by the data output means includes the daily urinary excretion and the% magnesium clearance.   The summary table output by the data output means further includes at least one of daily intake protein amount, daily salt urine excretion amount, daily potassium urine excretion amount and% creatinine production rate as the life guidance information. 5. The computer according to claim 4, wherein at least one of 24 hours endogenous creatinine clearance and daily urinary protein excretion is included as the treatment guideline information. A readable recording medium. The computer-readable recording medium according to claim 4 or 5, further comprising:
Wherein there is provided a computer readable recording medium recording the blood data acquisition means as a function is not Ru therapeutic support program for acquiring blood analysis data obtained by analyzing the blood of the patient,
The data registration means adds the identification information and the date information to the blood analysis data and registers it in the database,
The tabulation editing means is adapted to store a plurality of blood analysis data from the past to the present corresponding to the patient among the plurality of blood analysis data registered and accumulated in the database. Read based on the unique identification information, edit the summary table in addition to the plurality of life guidance information and treatment guideline information,
The computer-readable recording medium, wherein the data output means outputs the summary table including the blood analysis data to the output device. A treatment support system for supporting treatment of a patient,
Urine storage data acquisition means for acquiring urine storage analysis data obtained by analyzing refrigerated urine stored in a cold storage environment of 10 ° C. or less with urine excreted by a patient during 24 hours;
Urine volume data acquisition means for acquiring the urine volume of the cold storage urine,
Identification information acquisition means for acquiring identification information unique to the patient;
Date information acquisition means for acquiring date information related to the date on which the patient accumulated urine or examined;
Life guidance information generating means for performing calculation processing based on lifestyle index data related to lifestyle among the urine storage analysis data and generating lifestyle guidance information related to the lifestyle of the patient;
Treatment guideline information generating means for generating treatment guideline information about the patient by performing arithmetic processing based on disease-related index data related to a predetermined disease among the urine storage analysis data;
Data registration means for adding the identification information and the date information to the database by adding the identification information and the date information to the life guidance information, the treatment guideline information, and the urine accumulation analysis data,
Among the plurality of life guidance information and the treatment guideline information registered and accumulated in the database, a plurality of the life guidance information and the treatment guideline information corresponding to the patient and from the past to the present are obtained. Table tabulation editing means for editing a tabulation table arranged in a reading time series based on the identification information unique to the patient,
Data output means for outputting the summary table to an output device;
With
The life guidance information generating means multiplies the urine amount by the urine concentration of phosphorus contained in the urine storage analysis data as a calculation process based on lifestyle index data related to lifestyle among the urine storage analysis data, Calculate daily urinary excretion as one of the life guidance information,
The treatment guideline information generation means multiplies the urine volume by the urine concentration of magnesium contained in the urine storage analysis data as a calculation process based on disease-related index data relating to a predetermined disease in the urine storage analysis data, By dividing the magnesium clearance obtained by dividing by the medium magnesium concentration, further dividing by the creatinine clearance, the% magnesium clearance is calculated as one of the treatment guideline information,
The totalization table output by the data output means includes the daily urinary excretion amount and the% magnesium clearance.   The summary table output by the data output means further includes at least one of daily intake protein amount, daily salt urine excretion amount, daily potassium urine excretion amount and% creatinine production rate as the life guidance information. 8. The treatment according to claim 7, wherein the treatment guideline information includes at least one of 24-hour endogenous creatinine clearance and daily urinary protein excretion. Support system. The treatment support system according to claim 7 or 8, further comprising:
Blood data acquisition means for acquiring blood analysis data obtained by analyzing blood collection of the patient,
The data registration means adds the identification information and the date information to the blood analysis data and registers it in the database,
The tabulation editing means is adapted to store a plurality of blood analysis data from the past to the present corresponding to the patient among the plurality of blood analysis data registered and accumulated in the database. Read based on the unique identification information, edit the summary table in addition to the plurality of life guidance information and treatment guideline information,
The data output means outputs the summary table including the blood analysis data to the output device.

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