CN102046069A - Method and system for monitoring a health condition - Google Patents

Method and system for monitoring a health condition Download PDF

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Publication number
CN102046069A
CN102046069A CN2009801189249A CN200980118924A CN102046069A CN 102046069 A CN102046069 A CN 102046069A CN 2009801189249 A CN2009801189249 A CN 2009801189249A CN 200980118924 A CN200980118924 A CN 200980118924A CN 102046069 A CN102046069 A CN 102046069A
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monitoring
device
computing device
patient
treatment
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CN2009801189249A
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Chinese (zh)
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达恩·古尔·弗曼
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心脏技术有限公司
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Priority to US12/119,462 priority Critical
Priority to US12/119,339 priority patent/US20080287800A1/en
Priority to US12/119,339 priority
Priority to US12/119,325 priority patent/US8298148B2/en
Priority to US12/119,325 priority
Priority to US12/119,315 priority
Priority to US12/119,462 priority patent/US9037208B2/en
Priority to US12/119,315 priority patent/US8442606B2/en
Priority to US12/206,885 priority patent/US20090048518A1/en
Priority to US12/206,885 priority
Application filed by 心脏技术有限公司 filed Critical 心脏技术有限公司
Priority to PCT/IB2009/006081 priority patent/WO2009138881A2/en
Publication of CN102046069A publication Critical patent/CN102046069A/en

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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Detecting, measuring or recording for diagnostic purposes; Identification of persons
    • A61B5/145Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissue
    • A61B5/1455Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissue using optical sensors, e.g. spectral photometrical oximeters
    • A61B5/1459Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissue using optical sensors, e.g. spectral photometrical oximeters invasive, e.g. introduced into the body by a catheter
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Detecting, measuring or recording for diagnostic purposes; Identification of persons
    • A61B5/02Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
    • A61B5/02007Evaluating blood vessel condition, e.g. elasticity, compliance
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Detecting, measuring or recording for diagnostic purposes; Identification of persons
    • A61B5/145Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissue
    • A61B5/14542Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissue for measuring blood gases
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Detecting, measuring or recording for diagnostic purposes; Identification of persons
    • A61B5/48Other medical applications
    • A61B5/4887Locating particular structures in or on the body
    • A61B5/489Blood vessels
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/04Measuring blood pressure
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/06Measuring blood flow
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/12Diagnosis using ultrasonic, sonic or infrasonic waves in body cavities or body tracts, e.g. by using catheters
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/44Constructional features of the ultrasonic, sonic or infrasonic diagnostic device
    • A61B8/4483Constructional features of the ultrasonic, sonic or infrasonic diagnostic device characterised by features of the ultrasound transducer
    • A61B8/4494Constructional features of the ultrasonic, sonic or infrasonic diagnostic device characterised by features of the ultrasound transducer characterised by the arrangement of the transducer elements

Abstract

A system and method for monitoring a health condition are disclosed. The system includes a patient management application, a data store and a monitoring device. The monitoring device includes an optical sensor, a Doppler sensor, and a computing device adapted to provide health parameter values including oxygen saturation of the blood, blood flow, blood pressure, heart rate, and cardiac output.

Description

用于监视健康状况的方法和系统 Method for monitoring the health of systems and

[0001] 优先权要求 [0001] PRIORITY CLAIM

[0002] 本申请要求2008年5月12日提交的题为“光学传感器装置及其使用方法”的美国专利申请第12/119315号、题为“多普勒运动传感器装置及其使用方法”的美国专利申请第12/119339号、题为“集成的心脏监视设备及其使用方法”的美国专利申请第12/119325 号、题为“用于监视健康状况的方法和系统”的美国专利申请第12/119462号以及2008年9月9日提交的题为“多普勒运动传感器装置及其使用方法”的美国专利申请第12/206885 号的优先权,所有这些专利申请是由相同的发明人提出的,并且其全部内容通过参引合并到本文中。 [0002] This application claims priority on May 12, 2008, entitled "filed optical sensor device and methods of use" U.S. Patent Application No. 12/119315, entitled "Doppler motion sensor apparatus and method of use" in US patent application US Patent application No. 12/119339 entitled "integration of cardiac monitoring devices and methods of use" No. 12/119325, US patent application entitled "method for monitoring the health status and the system" No. 12/119462 entitled September 9, 2008 filed "Doppler motion sensor device and methods of use" priority of US Patent application No. 12/206885, all of which patent application is a person of the same invention raised, and the entire contents of which is hereby incorporated by reference herein. 技术领域 FIELD

[0003] 本发明涉及健康监视系统和方法,更具体而言,涉及包括用于监视心脏行为的设备的系统和方法。 [0003] The present invention relates to a health monitoring systems and methods, and more particularly, relates to a system and method for monitoring the behavior of the heart of the apparatus.

[0004] 背景技术和发明内容 [0004] BACKGROUND AND SUMMARY OF THE INVENTION

[0005] 心血管疾病在全世界范围内是一个大的、增长的健康问题。 [0005] cardiovascular disease worldwide is a large and growing health problem. 一些研究显示大约15%的西方世界遭受着一个或多个心血管疾病。 Some studies show that about 15% of the Western world suffer from one or more cardiovascular disease. 在美国,每年几乎25%的人口受到影响,导致多于六百万人住院治疗。 In the United States, nearly 25 percent of the population each year by the impact, led to more than six million people were hospitalized.

[0006] 存在不同的设备用于监视与心脏性能相关的某些参数。 [0006] There are different devices for monitoring certain parameters related to cardiac performance. 在一些情况下,患者的活体参数可能需要被监视一段时间。 In some cases, the biological parameters of the patient may need to be monitored for some time. 心脏的心律不齐在引起心脏泵血遍及身体的电脉冲的正常序列中发生变化。 Cardiac arrhythmia caused by changes in the heart to pump blood throughout the body's normal electrical pulse sequence. 因为反常的心脏搏动改变可能仅偶尔地发生,所以可能需要持续的监视来检测心律不齐。 Because abnormal heart beat changes may occur only occasionally, it may require continuous monitoring to detect arrhythmias. 由持续的监视,医务人员可以描绘心脏的状况并且建立合适的治疗疗程。 By the continuous monitoring, medical personnel can describe well the heart and establish an appropriate course of treatment.

[0007] —个测量心率的现有技术设备是美敦力(美国明尼苏达州明尼阿波利斯市)的“显示”监视器。 [0007] - a measure heart rate prior art device is Medtronic (Minneapolis, Minnesota City) "display" monitor. 这个设备包括可植入的心脏监视器,用于例如确定患者的晕厥(昏倒)是否与心律问题有联系。 This device includes an implantable heart monitor, for example, to determine the patient's syncope (fainting) is it connected with heart rhythm problems. 该“显示”监视器持续地监视心脏的速率和节律达到14个月。 The "Display" monitor continuously monitors the heart rate and rhythm up to 14 months. 在从昏倒期醒来之后,患者将记录设备放置到植入的“显示”监视器之上的皮肤外面,并且按动按钮将数据从监视器传送到记录设备。 After waking up from a collapsed stage, the patient is placed outside the recording apparatus over the skin of the implanted monitor, "Display", and pressing a button to transfer data from the monitor to the recording apparatus. 将所述记录设备提供给医生,该医生分析存储在记录设备中的信息以确定反常的心律是否被记录。 The recording apparatus is provided to the doctor, the doctor analyzes the information stored in the recording device to determine whether the heart rhythm is abnormal recording. 记录设备的使用既不是自动的也不是自主的,因此需要患者是有意识的或者需要另一人的干涉来将信息从监视器传送到记录设备。 Recording apparatus using neither automatic nor autonomous, requiring the patient is conscious or require intervention by another person communicating information from the monitor to the recording apparatus.

[0008] 可植入传感设备的另一已知类型是应答器型设备,其中应答器被植入患者并且随后由手持电磁读出器以非侵入形式进行读取。 [0008] Another known type of implantable sensing device is a transponder type device in which the transponder is implanted in the patient and read a non-invasive form subsequently held by a magnetic reader. 在美国专利第5833603号中描述了设备的后一类型的一个实例。 In U.S. Patent No. 5,833,603 describes an example of the latter type of apparatus.

[0009] 在许多情况下,医务人员对于收集与心脏的行为和患者的状况有关的多种类型的数据感兴趣。 [0009] In many cases, medical personnel data of interest related to various types of conditions for collection and the heart and the patient's behavior. 此外,如以上所提到的,不需要患者访问健康护理提供者(HCP)而获得尽可能多的相关数据是理想的。 In addition, as mentioned above, the patient does not need to visit a health care provider (HCP) to obtain as much relevant data is ideal. 相关信息可以包括流过主动脉的血流量的氧饱和度等级、血压、心率、血流量、搏出量、心输出量、心脏的电活动(用于产生心电图(ECG)数据)和身体温度。 Related information may include an oxygen saturation level of blood flow through the aortic flow, blood pressure, heart rate, blood flow, stroke volume, cardiac output, heart's electrical activity (for generating an electrocardiogram (ECG) data), and body temperature.

[0010] 在这里公开了一种用于监视健康状况的方法和系统。 [0010] In the herein disclosed method and system for monitoring health. 在根据本发明的系统的一个实施例中,该系统包括监视设备、患者监视应用程序和数据存储器。 In a system according to the present embodiment of the invention, the system comprises a monitoring device, a patient monitoring application and data memory. 所述监视设备包括多普勒传感器、光学传感器和计算设备。 The monitoring device comprises a Doppler sensor, an optical sensor and a computing device. 传感器和计算设备被封装在外壳中。 Sensor and computing devices are encapsulated in a housing. 患者监视应用程序接收来自监视应用程序的参数值并且将参数值存储在数据存储器中。 Patient monitoring application receives parameter values ​​from the monitoring of the application and the parameter values ​​stored in the data memory.

[0011] 在一个实施例中,提供了一种用于监视健康状况的方法。 [0011] In one embodiment, a method is provided for monitoring the health. 该方法包括提供如在紧接着的上一段落中描述的监视设备的步骤,和由监视设备计算一个或多个血液动力学参数。 The method includes providing a monitoring device as described in the immediately preceding paragraph in step, and is calculated by the monitoring device of one or more hemodynamic parameters. 该方法进一步包括基于血液动力学参数诊断健康状况的步骤和响应该健康状况执行功能。 The method further includes the step of diagnosis based on hemodynamic parameters in response to the health and the health of executive function.

[0012] 在另一实施例中,用于监视健康状况的方法包括提供如以上所描述的监视设备的步骤,并且进一步包括通信设备。 Method [0012] In another embodiment, for monitoring the health status comprises the step of providing the monitoring apparatus as described above, and further comprising a communication device. 该方法进一步包括发送命令给监视设备的步骤以及响应该命令执行功能。 The method further comprises the step of sending a command to the monitoring device in response to the command execution.

[0013] 通过结合以下附图参考下面对本发明实施例的描述,本发明的特征、以及实现这些特征的方式将变得更加明显,发明本身将更容易理解。 [0013] The description of embodiments in conjunction with the embodiment of the present invention, the following reference to the following drawings, features of the present invention, and the manner of implementation of these features will become more apparent, the invention itself, will be more readily understood. 附图说明 BRIEF DESCRIPTION

[0014] 图1和图2是根据本发明的一个实施例的系统的示意图。 [0014] FIG. 1 and FIG. 2 is a diagram of a system according to one embodiment of the present invention.

[0015] 图3是根据本发明的一个实施例的监视设备的侧视示意图。 [0015] FIG. 3 is a schematic side view of monitoring apparatus in accordance with one embodiment of the present invention.

[0016] 图4是根据本发明的一个实施例的计算设备的概念视图。 [0016] FIG. 4 is a conceptual view of a computing device in accordance with one embodiment of the present invention.

[0017] 图5和图6是用于执行根据本发明的方法的实施例的治疗方案的概念性表达。 [0017] FIG. 5 and FIG. 6 is a conceptual expression of a therapeutic program for performing the method according to an embodiment of the present invention.

[0018] 图7是根据本发明的方法的另一实施例的流程图。 [0018] FIG. 7 is a flowchart of a method according to another embodiment of the present invention.

[0019] 相应的附图标号指示了遍及几个视图的相应部件。 [0019] Corresponding reference numerals indicate corresponding parts throughout the several views. 尽管附图代表了本发明的实施例,但为了更好的阐明和解释本发明,附图没有必要按比例绘制并且某些特征可能被夸大。 Although the drawings represent embodiments of the present invention, but in order to better illustrate and explain the present invention, the drawings are not necessarily to scale and certain features may be exaggerated. 这里陈述的范例阐明了几种形式的本发明的实施例并且这样的范例并不以任何方式限制发明的范围。 Examples set forth herein illustrate embodiments of the present invention in several forms and such exemplifications are not to limit the scope of the invention in any way. 具体实施方式 Detailed ways

[0020] 以下所讨论的实施例并不意图是穷尽的或将本发明限于在以下的详细描述中所公开的精确形式。 [0020] The embodiments discussed below are not intended to be exhaustive or to limit the invention to the following detailed description as to the precise forms disclosed. 而是,所选择和描述的实施例使得本领域的其它技术人员可以使用他们的发明。 Rather, the embodiments chosen and described so that others skilled in the art of the present invention may use their.

[0021] 图1和图2示出了根据本发明的一个实施例的系统。 [0021] Figures 1 and 2 illustrate a system according to an embodiment of the present invention. 系统100包括:位于患者102 上的监视设备1,以及外部通信设备120,例如个人数字助理或黑莓设备。 The system 100 comprising: a monitoring device on a patient 1021, and an external communication device 120, such as a personal digital assistant, or BlackBerry device. 外部通信设备可以是任何适于接收无线或者因特网通信的设备,例如分别由中继单元、电话和计算机示例的通信设备110、132和142。 External communication device may be adapted to receive any wireless communication device or the Internet, for example, by the relay unit, respectively, telephone and computer communications devices 110, 132 and 142 of the example. 通信设备120和132以及可选的110通过电信网络130无线地传送信息。 120 and communication device 132 and optionally 110 transmits information via the telecommunication network 130 wirelessly. 通信设备110也可以包括用于不使用电信网络130而与监视设备1无线地进行通信的蓝牙适配器或者另外的适配器。 Communication device 110 may also include a telecommunications network 130 is not used to communicate with the monitoring apparatus 1 wirelessly Bluetooth adapter or another adapter. 电信网络130可操作地连接到用数字140代表的因特网,所述因特网将信息从电信网络传送到通信设备142。 Telecommunications network 130 is operatively connected to the Internet 140 on behalf of a number, the Internet information is transmitted from the telecommunication network to the communication device 142. 在一个实施例中,系统100进一步包括含有网页和存在于服务器144中的网站(未示出)。 In one embodiment, the system 100 further comprises a page and site comprising (not shown) exist on the server 144. 在另一实施例中,系统100也包括适于给患者102的心脏提供治疗的心脏设备150。 In another embodiment, the system 100 also includes a cardiac device 150 is adapted to provide treatment to the patient's heart 102.

[0022] 系统100包括:患者管理应用程序200和数据存储器210。 [0022] The system 100 comprising: a patient management application 200 and data memory 210. 患者管理应用程序200 是被配置为从监视设备1和其他计算设备接收数据并将数据存储在数据存储器210中的程序。 Patient management application program 200 is configured from the monitoring device 1 and the other computing device to receive the data stored in the data memory 210. 患者管理应用程序200可以存在于服务器144中。 Patient management application 200 in the server 144 may be present. 患者管理应用程序200可以是客户端/服务器应用程序,其客户端程序存在于通信设备中,能通过因特网访问。 Patient Management application 200 may be a client / server application, the client program which is present in the communication device, via Internet access. 数据存储器210存储与患者102有关的数据。 Data memory 210 stores data relating to the patient 102. 数据可以包括患者简档(profile)212,该患者简档212 包括用于将患者102与特定的监视设备1相联系并且使得能够访问传感设备的例如地址、 保险信息、联系信息和设备识别信息的患者信息。 Patient data may include a profile (Profile) 212, 212 comprises the patient profile 102 for a particular patient monitoring apparatus 1 and causes the associated address, for example, insurance information sensing device can access contact information and the device identification information and patient information. 数据也可以包括值214,该值214包括从相关监视设备1获取的参考、测量和参数值。 Value may also include data 214, the correlation value 214 from the reference monitoring device comprises an acquired parameter value and measured. 患者管理应用程序200可以以不同方式显示值来帮助HCP管理患者健康。 Patient management application 200 can display values ​​in different ways to help patients manage health HCP. 数据也可以包括治疗方案216。 Data 216 may also include a therapeutic regimen.

[0023] 患者管理应用程序200具有许多功能。 [0023] patient management application 200 has many functions. 该患者管理应用程序从监视设备1获取数据。 The patient management application get data from the monitoring device 1. 它也更新参考值和治疗方案。 It also updates the reference value and a treatment regimen. 它也给监视设备1发送命令。 It also sends a command to the monitoring apparatus 1. 在一个实施例中,患者管理应用程序200将命令发送给监视设备1并且监视设备1响应该命令执行功能。 In one embodiment, the patient management application 200 sends commands to a monitoring apparatus and a monitoring apparatus 1 in response to the command execution. 在另一实施例中,HCP使用外部通信设备来与客户管理应用程序200进行通信并且响应于HCP通信, 客户管理应用程序200与监视设备1进行通信。 In another embodiment, an external communication device HCP used to communicate with client management application 200 in response to the HCP communications, client management application 200 communicates with the monitoring apparatus 1. 在另一实施例中,HCP通过可由因特网访问的网站而访问患者管理应用程序200。 In another embodiment, HCP and access to patient management application 200 via the Internet by accessing the website.

[0024] 图3描述的监视设备1通常包括多个部件。 [0024] The monitoring apparatus described in FIG. 31 typically comprises a plurality of components. 一个或多个部件可以被合并到监视设备1中以适合根据本发明的方法的应用。 One or more components may be incorporated into a monitoring device suitable for use in the method according to the invention. 监视设备1可以包括计算设备20、通信设备30、 能量存储设备40、光学传感器组件2、包括探针50A和50B的ECG传感器(下文将其一起称为ECG传感器50)、多普勒传感器60和温度传感器70,每个部件安装在板80上并且与计算设备20进行电通信。 Monitoring device 1 20 may include a computing device, communication device 30, the energy storage device 40, an optical sensor assembly 2, includes a probe ECG sensor 50A and 50B (hereinafter collectively referred to ECG sensor 50), and Doppler sensor 60 temperature sensor 70, each member 80 mounted on the board and in electrical communication with the computing device 20. 这些部件被封装在外壳90内。 These components are enclosed within the housing 90.

[0025] 系统100可操作地将监视设备1与一个或多个适于与监视设备1交换数据的通信设备相连接。 [0025] system 100 to the monitoring apparatus 1 is operable with one or more devices adapted to communicate with the monitoring apparatus 1 is connected to exchange data. 数据包括命令、测量、参数和参考值以及治疗方案。 Data including commands, measurements, and the parameter values ​​and the reference treatment. 监视设备1获得测量值, 根据治疗方案处理测量值,这在许多情况下包括将测量值与参考值作和诊断的简档对比来诊断反常的状况,然后基于诊断根据响应的简档来执行功能。 Monitoring apparatus 1 obtains measurement values, processing the measured values ​​according to the treatment plan, which includes profile comparison of the measured value with a reference value and diagnosis in many cases to diagnose abnormal condition, and then based diagnostics to perform functions according to the profile response .

[0026] 命令是从外部通信设备提供给计算设备20的指令。 [0026] command is a command to the computing device 20 from the external communication device. 通常,命令是用于执行功能的指令。 Typically, commands are instructions for executing a function. 功能包括发送数据、执行治疗、更新参考值和更新治疗方案。 Functions include data transmission, treatment is performed, and the updated reference value is updated treatment regimen.

[0027] 参考值代表患者正常或者稳定的状况。 [0027] The normal or reference value representing a stable condition of the patient. 监视设备1可以用参考值进行编程或者可以被编程为在将设备放置于患者102上时来收集测量值,并且存储初始测量值或参数值作为参考值。 Monitoring apparatus 1 may be programmed with a reference value or may be programmed to place the device on the measured values ​​collected on the patient 102, and stores the initial measurement or parameter values ​​as the reference value. 如以下所详细说明的,关于计算设备20,参数值包括例如脉搏速率、氧饱和度、心输出量和血压以及温度的血液动力学参数。 As described in detail below, on the calculation 20, the device comprises a parameter value, for example, pulse rate, oxygen saturation, cardiac output and hemodynamic blood pressure, and temperature parameters.

[0028] 参考值可以包括目标值和可接受的变化范围或者限制。 [0028] The reference value may include a target value and the limit or acceptable variations. 当参数值落到参考目标值或范围以外时,参数值可以指示异常。 When the parameter value falls outside the reference range or target value, the parameter value may indicate anomalies. 在一些实施例中,参数值可以产生例如移动平均值的统计量,并且当参数统计量与参考统计量的不同大于预期量时,将会检测出异常。 In some embodiments, the parameter values ​​may be generated, for example, moving average statistics, and when different parameter statistic statistics with a reference amount than expected, will detect an abnormality.

[0029] 一个反常的医疗状况是心脏的心律不齐。 [0029] a medical condition is abnormal cardiac arrhythmia. 计算设备20可以被配置为执行对测量值的分析来确定例如心律是否是指示心律不齐的不规则。 The computing device 20 may be configured to perform an analysis of the measured values ​​to determine whether, for example, indicating an irregular cardiac arrhythmia. 其它反常的状况包括低氧饱和度、低心输出量和高或低的血压。 Other abnormal conditions include low oxygen saturation, cardiac output and low-high or low blood pressure. 其他反常的状况可以依赖于不同血液动力学参数值的组I=IO Other abnormal conditions may depend on the kinetic parameters of the different value of the blood group I = IO

[0030] 治疗方案包括诊断和响应简档。 [0030] Diagnosis and treatment regimen comprises response profiles. 诊断简档为计算设备20提供用于诊断反常状况的的决定标准。 Diagnostic profile for the computing device 20 to provide decision criteria for the diagnosis of abnormal conditions. 响应简档为计算设备20提供用于响应于诊断执行功能的指令。 Response profiles for the computing device to provide instructions for performing a function in response to a diagnosis 20. 最初,一个或多个治疗方案可以被编程到监视设备1中。 Initially, one or more treatment regimen may be programmed into the monitoring apparatus 1. 在最初治疗方案中的响应简档可以响应于反常状况指示计算设备20切换到第二治疗方案。 Response profile in the initial treatment regimen in response to abnormal conditions indicating a second computing device 20 is switched to the treatment regimen. 在一个实施例中,通过通信设备30治疗方案可以被下载到计算设备20。 In one embodiment, it can be downloaded to the computing device 20 via the communication device 30 regimen.

[0031] 1.监视设备 [0031] 1. The monitoring apparatus

[0032] 遍及本申请,关于监视设备1的引用指的是在这里通过上述参引合并的、在“集成的设备”的申请中描述的监视设备1。 [0032] Throughout this application, references regarding monitoring apparatus 1 refers herein by reference in the above-described combined monitoring device in the application "Integrated device" described in 1. 同样,关于光学传感器组件2的引用指的是在这里通过上述参引合并的、在“光学传感器装置”的申请中描述的光学传感器组件2。 Similarly, regarding the reference refers to optical sensor assembly 2 is incorporated herein by reference incorporated above, the optical sensor assembly application "optical sensor means" described in 2. 此外,关于多普勒传感器60的引用指的是通过上述参引合并的、在“多普勒运动传感器装置”的申请中描述的多普勒传感器60。 Further, regarding Doppler sensor reference means 60 is combined by the above references, the Doppler sensor 60 application "Doppler motion sensor device" described herein. 在本申请中将不再重复对监视设备1、光学传感器组件2和多普勒传感器60的完整描述。 Not be repeated in the present application, a complete description of the optical sensor assembly 12 and the monitoring apparatus 60 of the Doppler sensor.

[0033] 通信信号意思是这样的信号,其具有一个或多个其特征被设置了或改变了以编码信号中的信息。 [0033] means a communication signal is a signal that has one or more of its characteristics set or changed is the information in the encoded signal. 例如,但并不限于此,通信信号包括声学的、射频、红外线的、其它无线介质和上述任何组合。 For example, but not limited to, communication signals including acoustic, RF, infrared, and other wireless media, and any combination thereof. 中继单元110位于患者身体的外部,例如,夹在患者的皮带上。 The relay unit 110 is located outside the patient's body, e.g., a patient on a belt clip. 中继单元110可以包括用于接收来自通信设备30的发射的接收器,和用于给另一外部通信设备再次发送通信信号的发射器。 The relay unit 110 may include a receiver for receiving transmissions from the communication device 30, and re-transmitting communication signals to a transmitter for another external communication device. 中继单元110也可以是固定的并且硬连接的,用于连接到因特网或者直接连接到健康护理提供者的计算机。 The relay unit 110 may be fixed and rigid connection, for connecting to the Internet or connected directly to a health care provider's computer. 同样地,中继单元110可以接收来自健康护理提供者的通信信号并且向通信设备30发送信号。 Similarly, the relay unit 110 may receive a communication signal from the health care provider 30 and sends a signal to the communication device.

[0034] 光学传感器组件2包括多个光子发射器和多个用于检测多个光学信号的光子检测器。 [0034] The optical sensor assembly 2 comprises a plurality of emitters and a plurality of photon-photon detector for detecting the plurality of optical signals. 所述发射器和检测器面对着主动脉。 The emitter and detector facing the aorta. 计算设备20操作着多个发射器和检测器并且处理多个光学信号来获得代表主动脉的位置和尺寸以及流过主动脉的血液的氧饱和度的光学测量值。 The computing device operating a plurality of emitters 20 and detectors and the processing of optical signals to obtain a plurality of optical measurements representative of the position and size of the aorta and saturation of the blood flowing through the aorta oxygen.

[0035] 多普勒传感器60发射和检测多个超声波。 [0035] The Doppler sensor 60 a plurality of transmitting and detecting ultrasonic waves. 计算设备20也操作多普勒传感器60 并且在使用光学传感器组件2所获得的光学测量值的帮助下,处理多个超声波来获得代表心率、血流、搏出量、血压和心输出量的多普勒测量值。 The computing device 20 also operates the Doppler sensor 60 and with the help of optical measurements using an optical sensor assembly 2 obtained by processing the representation of the plurality of ultrasound heart rate, blood flow, stroke volume, cardiac output and blood pressure more Doppler measurements.

[0036] ECG传感器50检测引起心脏泵血的电信号。 [0036] ECG sensor 50 detects an electric signal caused by the heart pumping. 温度传感器70测量患者的温度。 Temperature sensor 70 measures the temperature of the patient. 根据这里公开的方法的不同实施例,能量存储设备40向计算设备20、各个传感器和通信设备30提供电力,所述通信设备30被配置为发送采集的数据或者与采集的数据相关的信息。 According to different embodiments of the methods disclosed herein, the energy storage device 40 supplies power to 20, various sensors and the communication device 30 the computing device, the communication device 30 is configured to transmit data associated with the data acquisition or acquisition of information. 传感器、计算设备20、通信设备30和能量存储设备40被封装在外壳90内。 Sensor, computing device 20, communication device 30 and the energy storage device 40 is enclosed within the housing 90.

[0037] 将多个传感器和在以上所提及的其它部件集成于监视设备1中,允许安装在患者身体的一个位置的单个设备精确地测量包括心输出量的、与心脏的行为相关的一套综合的参数。 [0037] A plurality of sensors and other components mentioned above are integrated in the monitoring apparatus 1, allows a single device installed in a position of the patient's body comprises accurately measure cardiac output, cardiac-related behavior of a comprehensive set of parameters. 此外,与输出原始数据用于由另一设备进行分析的其它传感设备不同,监视设备1可以执行参数的分析以及响应于“板上”分析来执行功能。 Further, the raw data output devices for sensing various other analysis by another device, monitoring device 1 may perform the analysis parameters in response to a "plate" analysis to perform functions. 如以上所示的,监视设备1也与其它设备无线地进行通信,否则提供信息并且接收命令和数据。 As described above, the monitoring apparatus 1 also communicate wirelessly with other devices, or provide information and receive commands and data. 如此,不用任何人工干预,监视设备1采集、分析和传送数据。 So, without any human intervention, the monitoring device 1 to collect, analyze and transmit data.

[0038] 用“患者”的意思是人类或动物。 [0038] with the "patient" means a human or animal. 在根据本发明的一个实施例中,监视设备1被植入患者身体的皮下。 In accordance with one embodiment of the invention, the monitoring device 1 is implanted subcutaneously in a patient's body. 然而,应当明白,使用不同的植入技术,监视设备1可以被植入不同的位置。 However, it should be understood that the use of different implantation techniques, monitoring device 1 may be implanted in different locations. 例如,监视设备1可以被植入肋骨架下的胸腔。 For example, monitoring device 1 may be implanted in the chest under the rib cage. 外壳90可以形成为圆形或椭圆形圆盘的形状,其尺寸与两个层叠的25美分硬币粗略地相似。 Housing 90 may be formed in a circular shape or an elliptical disk, the size of the two 25-cent coins stacked roughly similar. 更具体地说,外壳90可以近似为三厘米的直径以及近似为一厘米的厚度。 More specifically, the housing 90 may be a diameter of approximately three centimeters and a thickness of approximately one centimeter. 当然,取决于应用,外壳90可以被配置为其它不同形状和尺寸。 Of course, depending on the application, the housing 90 may be configured as other different shapes and sizes. 光学传感器组件2、多普勒传感器60、ECG传感器50和温度传感器70定位于面向内部,而能量存储设备40的能量耦合器部件面向外部。 The optical sensor assembly 2, Doppler sensor 60, ECG sensor 50 and the temperature sensor 70 is positioned facing the inside, while the external energy coupling member 40 facing the energy storage device. [0039] 监视设备1可以与例如起搏器、心脏再同步化治疗(CRT)设备、植入式心律转复除颤器(I⑶)等的植入的心脏设备150进行集成。 [0039] The monitoring device 1 can be integrated with such as pacemakers, cardiac resynchronization therapy (CRT) devices, implantable cardioverter defibrillator (I⑶) such as implantable cardiac device 150. 在这样的实施例中,监视设备1可以与植入的心脏设备进行通信并且从植入的心脏设备以及从监视设备自身的传感器提供信息给外部设备。 In such an embodiment, monitoring device 1 may communicate with the implanted cardiac device and provide the device information to the external apparatus from the implantable cardiac monitoring device itself, and from the sensors. 由于许多植入的心脏设备通常是容易理解的和常规规定的,所以将监视设备1 集成到其他这样的设备可以为得到市场的接受提供一种有效的方法。 Since many implantable cardiac devices are generally conventional and readily understood predetermined, the monitoring device 1 will be integrated into other such devices may provide an effective method to obtain market acceptance.

[0040] 以上描述的集成可以通过将监视设备1的部件与心脏设备相结合而完成。 [0040] can be obtained by the above monitoring device integrated member combined cardiac device 1 described is completed. 如果心脏设备包括计算设备,例如实现根据本发明功能的算法可以集成在心脏设备的计算设备中,而不是增加第二计算设备。 If the cardiac device includes a computing device, for example, may be implemented in a computing device integrated cardiac device, instead of adding the second computing device function according to the algorithm of the present invention. 以类似的方式,能量存储器可以与通信设备合并以避免重复并且降低成本。 In a similar manner, the energy storage can be combined with the communication device to avoid duplication and reduce costs.

[0041] 监视设备1可以定位于患者身体的外部。 [0041] The monitoring device 1 may be positioned outside the patient's body. 提供了支持元件来支持监视设备1到身体的外部。 Providing the support member to support the monitor apparatus 1 to the outside of the body. 支持元件可以永久地或者临时地连接到监视设备1。 Support elements can be permanently or temporarily connected to the monitoring apparatus 1. 支持元件可以包括粘合层用于将支持元件粘连到患者的身体或者可以包括可以是弹性的带,用于保持监视设备1在患者的身体上。 Supporting element may include an adhesive layer for adhering to the support member may comprise a body of a patient or may be an elastic band, for holding the monitoring device in a patient's body.

[0042] 在例如超声机器的外部映射系统的帮助下,监视设备1可以被植入或定位于患者上。 [0042] In the mapping system with the help of an external ultrasound machine, the monitoring device 1 may be positioned on the patient or implanted. 适当的放置确保了例如主动脉的感兴趣的血管位于监视设备1的各传感器的感测范围内。 Ensure proper placement within the sensing range, for example of the aorta vessel of interest is located in the monitoring device 1 of the respective sensors. 例如,监视设备1可以被定位于患者的胸腔或背部的能够减少肋骨对以这里所描述的方式获得的测量的干扰的位置。 For example, monitoring device 1 may be positioned on the chest or back of a patient to reduce the interference of the ribs measured in the manner described herein to obtain a position.

[0043] 计算设备20包括多个部件。 [0043] Computing device 20 comprises a plurality of components. 尽管这里所描述的部件像是独立的部件,部件可以被合并为例如应用专用集成电路的单独设备。 Although the components described herein such as a separate member component may be incorporated, for example, a single application specific integrated circuit devices. 如图4所示,计算设备20包括A/D转换器22 (也将光信号转换为电信号)、处理器对、存储器沈、程序观、数据四、输入23和输出25。 4, computing device 20 includes A / D converter 22 (also the optical signal into an electrical signal), processor, memory Shen, program concept, four data input 23 and output 25. 存储器沈可以包括、但不限于随机存取存储器(RAM)、只读存储器(ROM)、电可擦除只读存储器(EEPROM)、闪存存储器或者其他存储器技术。 Memory sink may include, but are not limited to, a Random Access Memory (RAM), a read only memory (ROM), electrically erasable programmable read only memory (EEPROM), flash memory or other memory technology. A/D转换器22、处理器M和存储器沈可以构造为集成电路。 A / D converter 22, a processor and a memory M can be configured as an integrated circuit Shen. 集成电路可以进一步包括:发射器阵列100、检测器阵列200和通信设备30。 The integrated circuit may further comprise: a transmitter array 100, detector array 200 and communication device 30.

[0044] 程序28代表用于指示处理器M响应于数据四执行任务的计算机指令。 [0044] 28 denotes a program for instructing a computer processor in response to the instruction data M perform four tasks. 程序28 位于存储器沈中。 Program memory 28 is located in the sink. 数据四包括值和治疗方案,并且也位于存储器沈中。 Comprising four data values ​​and treatment regimens, and also located in a memory sink. 参考数据可以被存储在ROM中或者可以被存储在RAM中,使得参考数据可以响应于外部输入或者响应于随着时间所收集的测量数据的特征而随着时间被修改。 The reference data may be stored in ROM, or may be stored in the RAM, so that the reference data in response to an external input or in response to a characteristic time as the collected measurement data is modified over time. 用于响应测量值的治疗方案也可以被提供。 Treatment regimen in response to measured values ​​may also be provided. 治疗方案可以被存储在永久的存储器或者可以被存储在例如RAM的非永久的存储ο Therapeutic regimen may be stored in persistent memory, for example, or may be stored in a non-permanent storage of ο RAM

[0045] 如果检测出反常的状况,尤其确定是严重的或危险的状况,计算设备20可以被配置为使通信设备30发送警报。 [0045] If an abnormal condition is detected, in particular to determine serious or dangerous situation, the computing device 20 may be configured to send an alert that the communication device 30. 活跃的治疗方案中的诊断简档提供标准来确定状况是正常的或是反常的,并且如果是反常的,确定严重程度。 Active treatment regimens profile provides diagnostic criteria to determine the condition is normal or abnormal, and if it is abnormal, determine the severity. 治疗方案中的响应简档提供标准来响应诊断。 Treatment program in response to the response profile provides a standard diagnosis. 警报的发送是响应的一个例子。 Sending an alert is an example of the response. 警报可以被用来发动报警或者警报患者采取补救行动。 Alarms can be used to launch an alarm or alert patients to take remedial action. 补救行动可以是终止或者减少身体的活动。 Remedial action can be terminated or reduce physical activity. 警报也可以为紧急服务提供全球定位(GPS)信息。 Alerts can also provide global positioning (GPS) information to the emergency services. 参照图1,当发现呈现出反常状况时,警报也可以被显示在外部通信设备110、 120、132和/或142上。 Referring to FIG 1, when found to exhibit abnormal situation, an alarm may be displayed on the external communication device 110, or 120, 132 and / 142. 警报可以包括文本信息或与状况相应的码。 May include text information or alarm conditions and corresponding code. 根据治疗方案,计算设备20也可以开始新的测量周期并且响应于反常状况的检测而持续地测量。 The treatment regimen, 20 can start a new measurement cycle in response to detection of a computing device anomalous condition is continuously measured.

[0046] 计算设备20也可以根据响应简档或者响应于命令开始治疗。 [0046] Computing device 20 may be a profile or in response to the start of treatment according to the response command. 监视设备1通过通信设备30可以接收外部命令来执行治疗以响应警报。 Monitoring device 1 may receive an external command via the communication device 30 to perform the treatment in response to the alert. 可选地,基于治疗方案,反常的状况也可以被用于指导适于提供治疗的设备来递送这样的治疗。 Alternatively, based on the treatment regimen, abnormal condition can also be used to guide therapy device adapted to provide delivery of such treatment. 治疗可以包括例如电击或者给药。 Treatment may include, for example, or electric shock is administered.

[0047] 参数值和/或其它信息可以与外部设备进行通信。 [0047] The parameter value, and / or other information may be in communication with an external device. 参数值可以被存储于存储器沈中并且通过通信设备30被无线地发送。 Parameter values ​​may be stored in memory and the sink are transmitted via the wireless communication device 30. 响应于反常的状况、响应于外部接收的命令、当存储器的使用超过预定的量或者能量存储水平被确定是低的时,定期地激活通信设备30的通信信号(例如,每天一次、每周一次等);建立后面两种状况以防止存储器溢出或能量损耗导致的数据损失。 In response to the abnormal condition, in response to a command received from the outside, when the memory exceeds a predetermined amount or an energy storage level is determined to be low, the communication signal periodically activates the communication device 30 (e.g., once a day, once a week etc.); both conditions established behind memory to prevent data loss or energy loss due to overflow. 也应当理解监视设备1可以包括除通信设备30之外的通信设备。 It should also be appreciated that the monitoring apparatus 1 may include a communication device other than the communication device 30. 例如,如果通信设备30是蜂窝的调制解调器,监视设备1也可以包括备份蓝牙或射频(RF)通信设备。 For example, if the communication device 30 is a cellular modem, monitoring device 1 may also include a backup Bluetooth or radio frequency (RF) communication device. 这种备份设备在下述情况下是理想的,在一次或多次尝试之后,很明显蜂窝调制解调器不可能发送信息(例如,由于低可用功率、差的网络覆盖等)。 Such backup device in the following cases is desirable, after one or more attempts, it is clear that the cellular modem is not possible to send information (e.g., due to the low available power, poor network coverage, etc.). 在这种情况下,计算设备20可以激活备份通信设备以发送信息或警报给可替代的外部通信设备。 In this case, the computing device 20 may activate the backup communications device to transmit an alert message or alternatively to an external communication device.

[0048] 可替代地或者除以上描述的传输之外,通过使通信设备30发送请求的数据或者代表请求的数据的信息,计算设备20可以被编程为响应由通信设备30接收到的数据请求。 [0048] Alternatively or in addition to the above-described transmission, by the information communication device 30 transmits the requested data or data representative of a request, the data requesting device 20 may be programmed to respond to a communication received by the computing device 30.

[0049] 通过接近患者的设备可以接收通信信号以警告患者状况,或者通过健康护理提供者、亲戚或者其它预定的接受者远程地(例如通过网络)接收信号。 [0049] access to the patient through the device may receive a communication signal to alert the patient condition, or (e.g., via a network) the received signal by a health care provider, relatives, or other intended recipient remotely.

[0050] 应当理解光学传感器组件2、多普勒传感器60、ECG传感器50和温度传感器70中的每个或某些在设计上可以是模块化的。 [0050] It should be appreciated that the optical sensor assembly 2, Doppler sensor 60, ECG sensor 50 and temperature sensor 70 in each or some of the design can be modular. 这样,多个不同的多普勒传感器60例如可以产生不同的性能特性(例如,不同的输出频率)。 Thus, a plurality of different Doppler sensor 60, for example, can produce different performance characteristics (e.g., different output frequencies). 取决于应用,多个传感器中的任意个可以被安装在监视设备1上以获得想要的性能。 Depending on the application, any number of a plurality of sensors may be mounted on the monitoring device 1 to obtain the desired performance. 一旦监视设备1装配有所选的传感器,计算设备20 可以被编程为对不同的算法进行修改来适应所选的传感器。 Once the monitoring apparatus 1 is equipped with selected sensor, computing device 20 may be programmed to modify the algorithm to adapt to different selected sensor. 以这种方式,包括计算设备20、 通信设备30等的基本的监视设备1可以与各种传感器中的任意个一起被“定制”地构建, 并且被编程来与所选传感器一起操作。 In this manner, computing device 20 comprises a communication device 30 such as basic monitoring apparatus 1 may be "customized" constructed with any number of various sensors, and is programmed to operate with selected sensor.

[0051] 应当理解尽管在这里描述的光学传感器组件2、多普勒传感器60和温度传感器70 被相对不经常地(至少在正常状况下)激活以获得测量值以保存能量时,随着电池技术的改进,可以增加这些传感器的激活频率。 [0051] It should be understood that although the optical sensor assembly described herein 2, Doppler sensor 60 and a temperature sensor 70 is activated relatively infrequently (at least under normal conditions) to obtain a measurement value to conserve energy, as the battery technology improvements, the frequency may be increased to activate these sensors. 同样,当监视设备1佩戴在外部时,连接器85可以被用来提供电源给传感设备85,因此消除了相关的能量损耗的担心并且允许对这些传感器的频繁的或甚至连续的操作。 Likewise, when the monitoring apparatus 1 is worn in the external connector 85 may be used to provide power to the sensing device 85, thus eliminating concerns related to energy consumption and to allow frequent or continuous operation even for these sensors. 此外,连接器85可以被用来可操作地将其它传感器与监视设备1相连接。 Further, the connector 85 may be used with other sensor operatively connected to a monitoring device.

[0052] 在本发明的一个实施例中,通信设备30是双向通信设备,例如,通过蜂窝电话系统和/或GPS卫星系统,例如诺基亚模型号KNL1147-V。 [0052] In one embodiment of the present invention, the communication device 30 is a two-way communications device, e.g., via a cellular telephone system and / or a GPS satellite system, such as the Nokia Model No. KNL1147-V. 在可替代的实施例中,通信设备30 能够发送信息,但不能接收信息或命令。 In alternative embodiments, the communication device 30 can transmit information, but not receive information or commands.

[0053] 在根据本发明的一个实施例中,可以提供用于再充电能量存储设备40的系统。 [0053] In accordance with one embodiment of the present invention, the system may be provided for recharging the energy storage device 40. 计算设备20从能量存储设备40接收能量。 The computing device 20 receives energy from the energy storage device 40. 能量存储设备40包括例如电池的能量存储部件。 The energy storage device 40 comprises, for example, battery energy storage component. 可选地,监视设备1也可以包括用于从外部源接收能量以对能量存储设备40进行充电的能量耦合器。 Alternatively, the monitoring device 1 may include an energy coupler for charging the energy storage device 40 is receiving energy from an external source.

[0054] 能量耦合器的一个例子是例如电感线圈的电磁设备,用于接收外部电磁信号并将电磁信号转换为电能量用于对能量存储部件再充电。 [0054] One example of an energy coupler is a device such as an electromagnetic induction coil, an electromagnetic signal and for receiving an external electromagnetic signal into electrical energy for recharging the energy storage means. 外部电磁设备产生电磁信号,该电磁信号通过能量存储设备40接收并且被转换为电能量。 External electromagnetic device generates an electromagnetic signal, an electromagnetic signal received by the energy storage device 40 and is converted into electrical energy. 能量存储设备40可以提供充电信号给计算设备20。 The energy storage device 40 may provide a charging signal to the computing device 20. 计算设备20可以将充电信号与参考充电信号相对比,并且产生低充电通信信号用于向患者和/或健康护理提供者报警。 The computing device 20 may be charged to the reference signal as opposed to the charging signal, and generates a low charge for a communication signal to alert a patient and / or health care provider. 可替代地,例如电压传感器的检测器可以被用来监视能量存储设备40的电量,并且当电量下降到低于阀值时,提供信号给计算设备20。 Alternatively, for example, the detector voltage sensor may be used to monitor the power energy storage device 40, and when the power drops below a threshold value, providing a signal to the computing device 20. 电磁设备可以被放置于接近监视设备1以对能量存储设备40进行充电。 Electromagnetic device may be placed in proximity monitoring apparatus 1 to charge the energy storage device 40.

[0055] 能量可以代替或另外地以超声波振动的形式被提供。 [0055] The energy may be used instead or additionally be provided in the form of ultrasonic vibrations. 例如,在监视设备1中可以引入压电变换器。 For example, in the monitoring device 1 can be introduced into the piezoelectric transducer. 超声波振动可以在外部提供。 Ultrasonic vibration may be provided externally. 当由超声波振动驱动时,变换器发电。 When driven by the ultrasonic vibration generating transducer. 如这里所示的,能量或功率也可以通过连接器85被提供到监视设备1。 As shown herein, energy or power may also be provided to the monitor apparatus 1 through the connector 85.

[0056] 2.诊断和操作 [0056] 2. The diagnostic and operational

[0057] 恰当地诊断心脏状况是重要的。 [0057] properly diagnose heart conditions is important. 不恰当的诊断可以引起不恰当的治疗,这种治疗可以导致患者的死亡或者严重的永久性的残疾。 Improper diagnosis can lead to inappropriate treatment, this treatment can result in death or serious permanent disability of the patient. 由于潜在的危害,充分谨慎是自然的。 Because of the potential hazard, caution is fully natural. 然而,充分的谨慎增加了治疗费用,总体上为社会增加了费用。 However, adequate care increases the cost of treatment, the overall increase in the cost to society. 恰当的诊断可以减少治疗费用,也可能改善患者的状况。 Proper diagnosis can reduce the cost of treatment may also improve the condition of the patient.

[0058] 心脏衰竭可以由任何结构的或功能的心脏失调引起,其损害心脏泵足够量的血液遍及身体的能力。 [0058] Heart failure can be caused by heart disorders or any function of the structure, a sufficient amount of damage the heart pump blood throughout the body's ability. 心脏衰竭是由任何状况引起的,这些状况通过损害或超负荷减少了的心肌层的效率,包括心肌梗塞(其中心肌缺氧并且遭到损坏)和高血压(其增加了需要泵血的收缩力并且经常引起心肌变厚,导致肌功能改变)。 Heart failure is caused by any condition, the overload condition by damaging or reducing the efficiency of the myocardium, including myocardial infarction (myocardial ischemia and wherein damaged) and hypertension (which increases the need for pumping of the contractile force and often cause myocardial thickening, leading to changes in muscle function).

[0059] 除了监视或者立即响应反常情况之外,发展带有慢性心脏衰竭的患者的生理历史以防止潜在的致命的事故是重要的。 [0059] In addition to monitoring or unusual circumstances beyond the immediate response, with the development of the history of physiology in patients with chronic heart failure to prevent potentially fatal accidents is important. 心脏衰竭可以是慢性的和充血的,或者代偿失调的。 Heart failure can be chronic and congestion, or decompensation. 当患者的慢性心脏衰竭发展为急性的症状时,代偿失调的心脏衰竭发生。 When patients with chronic heart failure the development of acute symptoms, decompensation of heart failure occur. 症状可以是基于涉及的心脏的侧面、即右边或左边,衰竭的类型、即心脏舒张或者心脏收缩,是否是由于低心输出量引起的反常,以及由反常引起的功能损耗的程度(基于功能的分级)。 Symptoms may be based on a side of the heart involved, i.e., right or left, the type of failure, i.e., diastole or systole, whether it is due to the abnormally low cardiac output due to, and the extent (based on the function of a function anomalous loss caused classification).

[0060] 对于心脏衰竭没有通用地被接受了的诊断标准。 [0060] diagnostic criteria for heart failure have not been universally accepted in. 不同的标准包括Framingham、 Boston和Duke标准(由相关的研究命名)。 Different criteria, including Framingham, Boston and Duke criteria (named by the relevant research). 纽约心脏协会功能分类将症状的严重性进行了分类并且可以用来评估对治疗的响应。 New York Heart Association functional classification of the severity of the symptoms were classified and can be used to assess response to therapy. 等级I中的患者在任何活动中不受限制并且在普通的活动中没有症状。 Patients with grade I, are not limited in any activity and no symptoms in common activities. 等级II中的患者经历微小的、轻微的活动限制,但是在休息时是舒适的或者有轻微的费力。 Class II patients are experiencing a slight, slight activity limitations, but are comfortable at rest or with a slight effort. 等级III中的患者在任何活动中受限并且仅在休息时是舒适的。 In patients with class III is limited in any event only at rest and is comfortable. 等级IV中的患者在任何体力活动中经受不适并且在休息时也有症状。 Patients with grade IV is subjected to discomfort in any physical activity and at rest have symptoms. 患者的分类可以被编程并且可以被用于识别治疗方案来响应诊断。 The classification of the patient may be programmed and may be used to identify a diagnosis response to treatment regimen.

[0061] 随着时间,增加心脏工作负荷的状况将对心脏本身产生改变,所以监视心脏性能变化是重要的,该变化可以引起对患者的再分类,并在治疗上作相应变化。 [0061] Over time, the increase in cardiac workload situation would itself produce a change of heart, so it is important to monitor cardiac performance changes, which may lead to further changes in the classification of patients, and make the appropriate changes in treatment. 心脏变化包括由于心室的超负载造成的减少的收缩性或收缩力、减少的心搏量、增加的收缩末期容量(通常由减少的收缩性引起)、减少的舒张末期容量(通常由受损伤的心室充盈引起)、减少的备用容量和为了维持心输出量由增加的交感活动所刺激的心率的增加。 Changes include cardiac contractile force or reduced contractility of the ventricles due overload caused by a reduced stroke volume, increased systolic volume (usually caused by decreased contractility), reduced diastolic volume (typically by a damaged ventricular filling caused), and a reduced spare capacity in order to maintain cardiac output increased by an increase in the sympathetic activity stimulated heart rate.

[0062] 左侧衰竭的显著的呼吸道症状是在费力时或休息时气短(呼吸困难)以及容易疲劳。 [0062] The left side of the notable failure is shortness of breath, respiratory symptoms (dyspnea) when the effort or rest and fatigue. 其他症状包括在躺下时增加的呼吸急促和在睡眠时严重的呼吸急促,通常在上床睡觉后的几小时。 Other symptoms include increased shortness of breath when lying down during sleep and severe shortness of breath, usually a few hours after going to bed in. 身体的不良循环引起晕眩和混乱。 The body of poor circulation caused dizziness and confusion. 心脏的右侧泵去氧血并且右侧的衰竭引起周围组织的阻塞。 The right side of the heart pumps deoxygenated blood and the right side of failure caused by obstruction of the surrounding tissue. 由于并发的疾病、心肌梗塞、心率不齐和不受控制的高血压以及其它原因,心脏衰竭容易代偿失调。 Due to concurrent disease, myocardial infarction, arrhythmias, and uncontrolled high blood pressure and other reasons, easy to decompensation of heart failure. 指示可能的心脏衰竭的通常的迹象包括向侧面移位的心尖搏动(由于心脏增大了)、在代偿失调情况下的快节奏(额外的心脏声音)和作为起因(如主动脉狭窄)或者由于心脏衰竭的、可能表明心脏瓣膜病的心脏杂音。 Usually an indication of possible signs of heart failure include laterally displaced apex beat (due to the increased heart), fast-paced (extra heart sound) in the case of decompensation and as a cause (such as aortic stenosis) or Because heart failure, valvular heart disease may indicate a heart murmur. 超声心动图可以被用来识别潜在的心脏衰竭的这些通常迹象。 Echocardiography can be used to identify potential heart failure usually these signs.

[0063] 由收缩功能紊乱引起的心脏衰竭是心脏泵血功能的衰竭。 [0063] Failure by the systolic dysfunction is caused by failure of the heart function. 心脏衰竭以减少的射血率为特征(少于50%,并且经常显著地降低)。 Heart failure in order to reduce the ejection efficiency characteristics (less than 50%, and often significantly reduced). 通常,射血率应该在50%到70%之间。 Typically, ejection rate should be between 50% to 70%. 心室收缩的强度变弱并且对于产生充足的心搏量是不充分的,导致不充分的心输出量。 Weak strength of ventricular contraction and for generating a sufficient stroke volume is insufficient, leading to insufficient cardiac output. 由于心室没有被充分地排空,所以心室舒张期末压和容积增加。 As the ventricle is not sufficiently emptied, so ventricular end-diastolic pressure and volume increase. 在心脏的左侧,增加的压力引起肺水肿。 On the left side of the heart, pulmonary edema caused by increased pressure. 在心脏的右侧,增加的压力导致依赖的周围水肿。 On the right side of the heart, resulting in increased pressure dependent peripheral edema. 多普勒传感器60可以被用来确定心脏功能的重要决定因素一搏出量(SV)。 An important determinant of the Doppler sensor 60 may be used to determine cardiac function in a stroke volume (SV).

[0064] 由舒张功能紊乱引起的心脏衰竭是心室充分舒张的衰竭以及典型地指示了硬的心室壁。 [0064] caused by heart failure, diastolic dysfunction ventricular diastolic failure, and sufficient typically indicates hard ventricular wall. 这样引起不充分的心室填充,导致了不充分的搏出量。 This causes insufficient filling of the ventricle, resulting in an insufficient stroke volume. 心室舒张的衰竭也导致升高的舒张期末压,该舒张期末压导致水肿。 Ventricular diastolic failure also leads to an elevated end-diastolic pressure, the diastolic pressure leading to edema. 如果收缩功能得到了保持,舒张功能紊乱可能不会自己显露,除非在生理的极端情况下,因此,患者在休息时可以是完全无临床症状的。 If systolic function was maintained, diastolic dysfunction may not reveal themselves except in extreme cases physiology, so the patient at rest can be completely asymptomatic. 然而,舒张功能紊乱对心率和血压的增加是高度灵敏的。 However, diastolic dysfunction is highly sensitive to the increase in heart rate and blood pressure. 一阵阵突然的心动过速可以由费力、 发烧或者脱水引起。 Sudden bouts of tachycardia can, fever or dehydration caused by the effort. ECG传感器50通过将心率和参考值对比可以追踪心率的增加。 ECG sensor 50 and the reference value of the heart rate by comparison of increase in heart rate can be tracked. 升高的血压可以以相似的方式用多普勒传感器来识别。 Elevated blood pressure can be identified in a similar manner using a Doppler sensor. 参数可以及时地进行相关,以潜在地诊断舒张功能紊乱。 Parameters can be related in a timely manner to potentially diagnose diastolic dysfunction.

[0065] 下面将描述假设的方案来举例证明响应于心脏衰竭事件的治疗方案。 [0065] exemplified below with response to treatment regimen heart failure event hypothetical scheme will be described. 该方案基于假设的症状。 The program based on the assumption symptoms.

[0066] 在第一实例中,患者为65岁并且在事件之前遭受前壁心肌梗塞两年时间。 [0066] In the first instance, the patient was 65 years and suffered anterior myocardial infarction two years before the event. 在事件之前那年内,他遭受充血性心力衰竭,特征为在轻微地用力、疲劳时的呼吸困难和在休息时少见的气短。 Prior to the events of that year, he suffered congestive heart failure, characterized by the slightly forced, difficulty breathing and shortness of breath at rest rare when fatigue. 他的纽约心脏协会功能分类定义为II-III级。 His New York Heart Association functional classification is defined as a class II-III. 他接受包括导致一些功能性改进的ACE抑制剂、β-受体阻断剂和安体舒通的敷药。 He received comprises causing some functional improvements ACE inhibitors, β- receptor blocker and spironolactone the dressing. 在经历总体上的虚弱和一些呼吸困难之后,患者呼叫他的HCP并且传达他的症状。 After experiencing weakness and breathing difficulty on the overall number of patients and HCP call him to convey his symptoms.

[0067] 在基础方案中,患者并没有从使用监视设备1中获益。 [0067] In the base case, the patient does not benefit from the use of a monitoring device. 在通常状况下,症状将会几乎确定地导致HCP怀疑代偿失调的心力衰竭。 Under normal conditions, the symptoms will almost certainly lead to HCP suspected decompensated heart failure. 典型的响应将是派出移动的加强护理单元来收治患者。 A typical response would be sent to a mobile intensive care unit patients admitted. 如果代偿失调的心力衰竭不存在,收治患者将会是不必要的。 If there is no decompensated heart failure, patients will be treated unnecessarily. 然而,如果代偿失调的心力衰竭确实存在,并且患者在事件后多于两或三小时到达健康护理设施,则较晚的治疗可能是危险的并且偶尔地、是威胁生命的。 However, if decompensated heart failure does exist, and patients than after the event two or three hours to reach a health care facility, the later treatment can be dangerous and occasionally, be life-threatening.

[0068] 在下面举例说明根据本发明方法的不同实施例的可替代的案例中,患者从使用监视设备1中获益。 [0068] exemplified below depending on the case of an alternative embodiment of the method of the present invention, benefit from the use of the patient monitoring apparatus 1. 在事件之前,HCP用治疗方案对监视设备1进行编程,该治疗方案相应于患者的历史和纽约心脏协会功能分类或者其它分类。 Prior to the event, HCP monitoring device 1 to be programmed with a treatment plan, treatment programs corresponding to the patient's history and the New York Heart Association functional classification or other classification. 该治疗方案可以不时地进行更新。 The treatment regimen may be updated from time to time.

[0069] 在第一方案中,一旦接收的电话呼叫,HCP访问外部的通信设备来通过通信设备30获得脉搏率数据,以确定任何心率不齐是否存在。 [0069] In a first aspect, upon receiving the telephone call, the HCP access external communication device to obtain the pulse rate data through the communication device 30, to determine whether there is any arrhythmia. 然后,HCP获取氧饱和度测量值。 Then, HCP obtain oxygen saturation measurement. 通常的饱和度(> 98% )将会几乎确定地排除严重的事件。 Typically saturation (> 98%) will almost certainly exclude serious incident. 为了完成检查,HCP通过电话指示患者静坐两到三分钟,之后HCP命令监视设备1计算心输出量和血压。 In order to complete the inspection, the phone indicates that the patient sit HCP two to three minutes, after the HCP command monitoring apparatus 1 calculates the cardiac output and blood pressure. 该信息对于确定是否病人确实遭受代偿失调将是充足的。 The information for determining whether patients actually suffered decompensation would be sufficient. 如果他不是遭受代偿失调,则可以避免不必要地来健康护理设施的行程。 If he is not suffering from decompensation, you can avoid unnecessary travel to health care facilities.

[0070] 在这个方案中,HCP使用外部的通信设备发送命令给监视设备1。 [0070] In this embodiment, HCP using an external communication apparatus 1 sends a command to the monitoring apparatus. HCP可以选择来自患者管理应用程序200的命令,患者管理应用程序200可以包括专用于支持这样的通信的网站。 HCP can select commands from a patient management application 200, patient management application 200 may include a website dedicated to support such communication. 可替代地,外部通信设备可以是电话132,并且命令可以包括拨用于访问通信设备30的电话号码,在此情况下,电话调制解调器输入用于访问监视设备1上的数据的数字访问码,并且随后输入用于获取数据的、对应于治疗方案的数字码。 Alternatively, the external communication device 132 may be a telephone, and the command may include dialing a telephone number for accessing the communication device 30, in this case, a telephone modem access code input digital data on an access monitoring device, and input data is then used to obtain the corresponding digital code to a treatment regimen. 治疗方案可以是指单独的参数或者多于一个的参数。 Therapeutic regimen may refer to more than a single parameter or parameters. 监视设备1通过发送一串数据来响应每个命令。 Monitoring device 1 by transmitting a series of data in response to each command.

[0071] 参照图5,示出了典型的治疗方案组。 [0071] Referring to FIG 5, there is shown a typical treatment regimen. HCP激活治疗方案A以获取脉搏和氧饱和度数据。 HCP A treatment regimen for activation pulse and the oxygen saturation data. 因为这些参数是由低功率设备ECG传感器50和光学传感器组件2获得的,所以获得这些值不用消耗很多能量。 Since these parameters are a low-power devices ECG sensor 50 and the optical sensor assembly 2 obtained, these values ​​is obtained without consuming much energy. 如果患者具有包括显示屏的中继单元110,治疗方案B也可以被激活来指导病人休息两或三分钟。 If the patient has a relay unit 110 includes a display screen, the treatment regimen B may be activated to guide the patient to rest for two or three minutes. 最终,HCP激活治疗方案C以获取心输出量和血压值。 Finally, HCP C activation treatment regimen for cardiac output and blood pressure values. 这些是由比光学传感器组件2消耗更多能量的多普勒传感器60所获得的。 These by consuming more energy than the optical sensor 60 is a Doppler sensor assembly 2 obtained. 可替代地,患者可能一直在休息并且在激活治疗方案C之前HCP可能不需要等待。 Alternatively, the patient may have been at rest and prior to activation treatment regimen may not need to wait for C HCP.

[0072] 在第二种方案中,显示了一些自动操作,一旦接收到电话呼叫,HCP访问外部通信设备以激活诊断治疗方案D。 [0072] In a second embodiment, showing some automatic operation, upon receiving a telephone call, the HCP access to an external communication device to activate the diagnostic regimen D. 治疗方案D然后可以引起计算设备20来(a)发送脉搏和氧饱和度数据,(b)等待并发送“等待”消息给中继单元110,以及(c)发送心输出量和血压数据。 D treatment plan may then cause the computing device 20 (a) transmitting a pulse and oxygen saturation data, (b) and waits for transmit "Waiting" message cardiac output and the blood pressure data to the relay unit 110, and (c). 换句话说,治疗方案D自动激活治疗方案AC。 In other words, the treatment regimen automatic activation program D AC. 当发送命令来激活治疗方案D以及在外部通信设备上接收信息时,患者HCP可以与患者保持通话。 When sending a command to activate and treatment regimen D information is received, the call may be maintained HCP patient with the patient on the external communication device. 如果患者没有中继单元,则HCP 可以指示患者休息。 If the patient is not a relay unit, the HCP may indicate that the patient rest.

[0073] 在第三种方案中,显示了更多的自动操作,患者在中继单元上执行命令。 [0073] In a third embodiment, the display operation more automatic, patients execute commands on the relay unit. 中继单元110可以是能够发送无线命令给监视设备1的通信设备。 The relay unit 110 may be capable of sending commands to the wireless communication device 1 of the monitoring device. 例如,中继单元110可以包括指定作为“恐慌”按钮的按钮,该按钮在患者或别人担心的情况下可以按压。 For example, the relay unit 110 may include specifying a "panic" button is a button, the button can be pressed if the patient or someone else to worry about. 在经历总体上的虚弱和呼吸急促时,患者102按压惊慌按钮以命令监视设备1来激活治疗方案E。 When subjected to weakness and shortness of breath on the whole, the patient presses the panic button 102 to instruct the monitoring apparatus 1 to activate the treatment regimen E. 治疗方案E 指导计算设备20来激活治疗方案D并且也可以激活治疗方案F来通知HCP惊慌按钮被按下。 Scheme E treatment guidance computing device 20 to activate the treatment regimen D and F may be activated to inform the treatment regimen HCP panic button is pressed. HCP可以从通信设备向中继单元110发送用于患者的额外指令的文本信息,或者采取其它自由行动。 HCP may send a text message patient additional instructions to the relay unit from the communication device 110, or take other action freedom. 治疗方案E节省了患者呼叫HCP以及HCP激活治疗方案D所需的时间。 E treatment program saves time patients call HCP HCP activation treatment programs as well as the required D.

[0074] 参照图6,在第四种展示全自动操作的方案中,监视设备1诊断反常并执行根据治疗方案F的功能。 [0074] Referring to FIG 6, showing the fourth embodiment of the automatic operation, the monitoring device 1 and performs a function F abnormal diagnosis based treatment regimen. 在监视设备1中的诊断简档指导设备以预定的时间间隔监视心脉搏率的改变、心输出量、氧饱和度或这些参数的组合的改变。 1 changes the diagnostic monitoring device profile guide device to a predetermined time interval to monitor heart pulse rate, changing the combination of cardiac output, oxygen saturation or these parameters. 如果改变超过了预定量,则该简档也指导设备将改变与参考值作对比以及指示反常的状况。 If the change exceeds the predetermined amount, the apparatus also directs the profile will change with a reference value for comparison indicating abnormal condition. 响应简档指导设备执行响应于反常状况的功能。 In response profile guiding device to perform a function in response to an abnormal situation. 在一个实施例中,如果值与参考值的不同在范围内,则监视设备1给HCP发送消息或数据。 In one embodiment, if the different value and the reference value range, the monitoring apparatus 1 transmits a message or data to the HCP. 在另一实施例中,如果值超出了范围,预示着紧急情况,则监视设备1给HCP 发送警报。 In another embodiment, if the value exceeds the range, it indicates an emergency situation, the monitoring apparatus transmits an alert to the HCP. 该警报也可以被发送到患者的指定的看管者,或者甚至发送警报给健康护理设施、救护车服务或者救火部门。 The alarm can also be sent to the patient's designated caretaker, or even send an alert to health care facilities, ambulance service or fire department. 此外,监视设备1可以发送消息给患者102可以读到的中继单元110。 Further, the monitoring apparatus 1 may send a message to the relay unit 102 may read a patient 110. 例如,中继单元可以显示指示患者坐、休息、喝水等信息。 For example, the relay unit may display an indication patients sit, rest, water and other information.

[0075] 在第二种情况下,60岁的患者在冠状动脉旁路手术之后的两周经历了事件。 [0075] In the second case, 60-year-old patient two weeks after coronary artery bypass surgery experienced events. 他的健康状况很好,已经每天步行45分钟并且开始在家做一些办公室工作。 His good health, the 45-minute walk every day and start doing some office work at home. 他经历了悸动、一些呼吸急促和眩晕。 He experienced the throbbing some shortness of breath and dizziness. 症状可以是由于心房扑动/纤维性颤动,这在旁路手术后的前几周是经常发送的。 Symptoms may be due to atrial flutter / fibrillation, which in the first few weeks after bypass surgery is frequently transmitted. 在这种情况下的诊断需要脉搏、血饱和度、血压和心输出量数据。 In this case, the diagnosis requires a pulse, blood saturation, blood pressure and cardiac output data. 对比参考值、 如果数据显示正常,患者被指示休息并且心脏参数在一至两个小时内被再次检查。 Comparison reference value, if the data is normal, the patient is instructed to rest and cardiac parameters are checked again within one to two hours. 第二次检查可以由HCP执行而不需要电话呼叫来联系患者。 Without the need for a second inspection can be executed by the HCP in a telephone call to contact patients. 如果所有参数是稳定的并且患者感觉良好一他可以呆在家里。 If all parameters are stable and he can feel good about a patient to stay at home. [0076] 在第三种情况下,患者具有植入的I⑶(除纤颤器)。 [0076] In the third case, the patient has an implanted I⑶ (defibrillator). 再从下午的小憩中醒来之后, 患者有点困惑并且具有一些胸腔不适。 After wake up from a nap in the afternoon, a little confused patient and have some chest discomfort. 他担心I⑶可能已经充电(charged)并且担心他可能有严重的心律不齐。 He may have been worried I⑶ charge (charged) and is worried that he may have serious arrhythmia.

[0077] 在一种方案中,包含了监视设备1,集成在或可操作地连接到I⑶。 [0077] In one embodiment, the monitoring device 1 comprises, integrated in or operatively connected to I⑶. 如果I⑶确定去心脏纤颤是恰当的,则ICD将确定传达给监视设备1。 I⑶ determine if defibrillation is appropriate, then the ICD will determine communicated to the monitoring device 1. 监视设备1检查血液动力学参数(脉搏、氧饱和度、血压、心输出量)并且核实指示去心脏纤颤是恰当的反常状况或确定其不是恰当的。 A monitoring device checks hemodynamic parameters (pulse, oxygen saturation, blood pressure, cardiac output) and verifies indicates defibrillation is appropriate to determine the abnormal condition or not appropriate. 如果是后者,监视设备1指示ICD不要充电。 If the latter, the monitoring device 1 indicates ICD not charge. 监视设备1也可能发送事件信息给HCP。 Monitoring device 1 may send event information to HCP. HCP可以询问设备来采集血液动力学参数并且确定心律不齐是否确实发生。 HCP can ask the device to collect hemodynamic parameters and to determine whether the arrhythmia does occur. 如果没有心律不齐被检测出并且血液动力学参数是正常的,不需要更进一步的调查。 If no arrhythmia is detected and hemodynamic parameters are normal, we do not need further investigation.

[0078] 在另一种方案中,监视设备1不包含在I⑶中。 [0078] In another embodiment, the monitoring apparatus 1 are not included in the I⑶. 监视设备1可以被编程为检测I⑶ 何时充电。 Monitoring device 1 may be programmed to detect when the charging I⑶. 患者可以通过电话、惊慌按钮或以上描述的其他任何方式与HCP进行通信来确定ICD是否充电。 The patient may, panic buttons or any other manner described above with HCP communicate via telephone ICD determines whether charging. 在另一实施例中,在中继单元110中显示充电事件供患者来读取。 In another embodiment, the display unit 110 in the relay charging event for the patient to read. 在其它实施例中,其它心脏设备与监视设备1可操作地进行集成,通过结合的特征以改进他们共同的性能。 In other embodiments, other cardiac device and monitoring apparatus 1 operatively integrated, characterized by a common bound to improve their performance.

[0079] 图7示出根据本发明一个实施例的患者管理方法的实施例。 [0079] FIG. 7 shows an embodiment of a patient management method according to an embodiment of the present invention. 起初,HCP建立监视设备1用于与患者102 —起使用。 Initially, HCP established for patient monitoring apparatus 1 102-- used together. HCP用包括患者历史、监视设备识别信息和其他与患者102相关的信息写入(populate)数据存储器210。 HCP including patient history with monitoring device identification information 102, and other data related to the patient information is written (the populate) memory 210. HCP也选择治疗方案来下载到监视设备1。 HCP can be downloaded to the choice of treatment monitoring apparatus 1. 当监视设备1被停靠在停靠站时,使用连接器85可以下载治疗方案。 When the monitoring device is docked in a docking station, the connector 85 can be downloaded using the treatment regimen. 在超声波机器的帮助下,监视设备1被置于患者上。 With the help of the ultrasound machine, the monitoring device 1 is placed on the patient. 在初始设置中,HCP可以获得基准测量值并且可以将测量值存储为计算设备20中的参考值。 In the initial settings, HCP reference measured value can be obtained and the measured value may be stored as a reference value calculation device 20.

[0080] 在步骤700,监视设备1监视患者102。 [0080] In step 700, monitoring device 1 monitors patient 102. 根据如以上描述的治疗方案F或根据另一治疗方案,监视可以被执行。 According to another embodiment treatment or monitoring treatment may be performed in accordance with Scheme F as described above. 监视包括激活传感器来获得测量值、计算参数值、根据治疗方案将值与参考值作对比、以及诊断正常或反常状况。 Monitoring includes activating a sensor to obtain the measurement values, calculated parameter values, according to the treatment regimen will compare the value with a reference value, and normal or abnormal condition diagnosis. 如果值超出参考值的范围,监视设备1 可以前进到步骤712,或者在诊断出反常状况前可以开始新的测量循环来核实参数数据。 If the value exceeds the reference value range, the monitoring device 1 may proceed to step 712, or prior diagnosis of abnormal conditions may start a new measurement cycle to verify the parameter data. 否贝U,监视设备1前进到步骤720并且然后返回到步骤700。 No shell U, monitoring device 1 proceeds to step 720 and then returns to step 700.

[0081] 在步骤710,监视设备1接收来自外部通信设备的命令。 [0081] In step 710, the monitoring device 1 receives a command from the external communication device. 该命令可以指导监视设备1来发送根据治疗方案的参数值,或更新治疗方案或更新程序。 This command may direct the monitoring device transmits a parameter value according to a treatment regimen, treatment regimen or update or updates.

[0082] 在步骤712,监视设备激活治疗方案。 [0082] In step 712, the monitoring device activation treatment. 治疗方案可以指示要感测哪个参数、要获取多少数据(分钟、小时和天)、持续测量的频率。 Therapeutic regimen may indicate which parameter, the continuous measurement frequency sense, how much data to obtain (hours and days min). 治疗方案由从步骤700接收的或者响应于监视治疗方案的命令所确定。 Treatment regimen received by the step 700 or the command response to the monitoring of the treatment regimen determined. 外部通信设备可以是计算机142。 The external communication device 142 may be a computer. 计算机142可以包括患者管理应用程序200或者可以通过因特网访问患者管理应用程序200。 A patient management computer 142 may include applications 200 or may access patient management application 200 via the Internet. 患者管理应用程序200 可以提供显示可用治疗方案的选择菜单并且可以包括用于保护患者隐私以及健康的安全特征。 Patient management application 200 may provide a display of available treatment options and menu choices may include security features to protect patient privacy and health. 外部通信设备也可以是通信设备110、120和132。 External communication device may be a communication device 110, 120 and 132. 在这个步骤中,监视设备1激活产生信号的传感器,该信号由计算设备20接收。 In this step, the monitoring device 1 activates the sensor generates a signal, the signal received by the computing device 20. 计算设备20调整信号并且将这些信号转换为测量值,然后分析测量值并且计算参数值。 The computing device 20 adjusts the signal and converts these signals to the measured value, the measured values ​​are then analyzed and calculated parameter values. 最后,计算设备20执行治疗方案提供的额外的指令。 Finally, the treatment device 20 provides additional instruction execution.

[0083] 在另一实施例中,通信设备不使用患者管理应用程序直接访问监视设备1。 [0083] In another embodiment, the communication device does not use direct access to patient management application monitoring apparatus 1. 通信设备可以拨打监视设备1并且通过键盘提供命令。 The communication device can call a monitoring device and provide commands through the keyboard.

[0084] 在步骤714,监视设备1执行命令来更新治疗方案。 [0084] In step 714, the monitoring device 1 to update the Run treatment regimen. 更新可以包含改变用于确定反常状况的参考值,或者改变用于区分反常状况的严重性、例如紧急情况的参考值。 Update may contain the changed reference value for determining the abnormal condition, or a change for distinguishing the severity of abnormal conditions, such as the reference value of the emergency situation. 其他更新包括改变步骤的顺序或者改变在响应简档中的响应。 Other updates include changing the order of the steps or changes in response to the response profiles. 在这个步骤中,可以增加额外的治疗方案。 In this step, you can add additional treatment. 治疗方案可以被更新来反映患者状况、历史或其他因素的改变。 Treatment programs can be updated to reflect the change in the patient's condition, history or other factors.

[0085] 在步骤716中,监视设备1执行命令来更新程序。 [0085] In step 716, the monitoring apparatus 1 to update the program execution command. 程序可以包括模块,该模块包括用于处理来自传感器的信号的算法。 May include program modules, the processing module includes an algorithm for the signal from the sensor. 模块可以被更新来反映带有改进特征的新的模块。 Modules to reflect the new module with improved features may be updated. 此夕卜,模块可以被更新来反映外部的或额外的传感器的增加。 Bu this evening, the module may be updated to reflect an increase or additional external sensors.

[0086] 在步骤718中,监视设备1执行功能。 [0086] In step 718, the monitoring device 1 executes functions. 功能可以包括发送通信信号、执行治疗或者其他在治疗方案的响应简档中指定的功能。 Transmitting communication signals may include functions, or other specified treatment is performed in response to a treatment regimen of the profile function. 响应简档可以指示要发送的参数,要发送多少数据(分钟、小时、天),以及持续测量的频率。 Response profile may indicate parameters to be transmitted, the number of data to be transmitted continuously measured frequency (minutes, hours, days), as well.

[0087] 在步骤720中,监视设备1存储测量值。 [0087] In step 720, monitoring apparatus 1 stores the measurement values. 值可以被存储为在步骤712中激活的治疗方案或正常的状况的结果。 Value may be stored as the result in step 712 the activation treatment regimen or normal condition. 例如,一旦反常的状况被检测出则步骤720可以被执行,以便基本上实时地更新看护者。 For example, once the abnormal condition is detected, step 720 may be performed substantially in real time so as to update the caregiver. 步骤720也可以以规则的间隔被执行,例如每天一次、每周一次、 每月一次等。 Step 720 may also be carried out at regular intervals, such as once a day, once a week, once a month and so on. 可替代地或者除了这些发送之外,计算设备20可以被编程为通过使得通信设备30发送请求的数据或代表请求的数据的信息,来响应对通信设备30接收到的数据(例如,来自健康护理提供者)的请求。 Alternatively or in addition to the transmission, the computing device 20 may be programmed such that the information data through the communication device 30 transmits a request on behalf of the requested data or, in response to data received by the communication device 30 (e.g., from a health care provider) request.

[0088] 尽管本发明被描述为具有典型的设计,在本公开的精神和范围内,本发明可以被进一步修改。 [0088] Although the present invention has been described as having a typical design, within the spirit and scope of the present disclosure, the present invention can be further modified. 因此本申请打算覆盖使用它的一般原则的任何变化、使用或者对发明的适应性修改。 This application is therefore intended to cover any variations using its general principles, use or adaptation of the invention. 此外,本申请打算覆盖属于本发明涉及的技术领域内已知的或者惯用的实践的自本公开的偏离。 Further, this application is intended to cover part of the present disclosure or departing from the conventional practice known in the technical field of the present invention relates.

Claims (19)

1. 一种用于监视健康状况的方法,包括: 提供监视设备,该监视设备包括: 光学传感器,用于感测脉管的相对位置,多普勒传感器,用于感测所述脉管中流动的流体的速率,以及计算设备,用于操作所述光学传感器和所述多普勒传感器,以获得参数值,所述计算设备包括一个或多个用于诊断和响应健康状况的治疗方案,并且所述光学传感器、所述多普勒传感器和所述计算设备被封装在外壳内;用所述监视设备计算一个或多个血液动力学参数; 基于所述一个或多个血液动力学参数诊断健康状况;以及响应于所述健康状况执行功能。 1. A method for monitoring a health condition, comprising: providing a monitoring device, the monitoring apparatus comprising: an optical sensor for sensing a relative position of the vessel, the Doppler sensor for sensing the vessel rate of fluid flow, and a computing device, the optical sensor and the Doppler sensor for operation, to obtain a parameter value, the computing device includes one or more programs for diagnostic and therapeutic response to health, and the optical sensor, a Doppler sensor and the computing device is enclosed within the housing; calculating one or more hemodynamic parameters of the monitoring device; diagnosis based on the one or more hemodynamic parameters health; and in response to execution of the health function.
2.如权利要求1所述的方法,其中所述血液动力学参数包括氧饱和度、搏出量、血压和心输出量中的一个。 2. The method according to claim 1, wherein the hemodynamic parameter comprises oxygen saturation, a stroke volume, cardiac output and blood pressure in the.
3.如权利要求1所述的方法,其中所述健康状况是反常的状况。 The method according to claim 1, wherein said abnormal condition is a healthy condition.
4.如权利要求3所述的方法,其中所述监视设备进一步包括通信设备。 4. The method according to claim 3, wherein said monitoring device further comprises a communication device.
5.如权利要求4所述的方法,其中所述功能是传送警报。 5. The method according to claim 4, wherein said transfer function is an alarm.
6.如权利要求4所述的方法,其中所述功能是连续地传送参数值。 The method as claimed in claim 4, wherein said function is continuously transmitted parameter value.
7.如权利要求1所述的方法,其中所述功能是开始治疗。 7. The method according to claim 1, wherein said function is the start of treatment.
8.如权利要求1所述的方法,其中所述监视设备进一步包括通信设备,所述状况是正常的状况,并且所述功能周期性地传送参数值。 8. The method according to claim 1, wherein said monitoring device further comprises a communication device, the condition is a normal condition, and periodically transmit the function parameters.
9.用于监视健康状况的方法,包括: 提供监视设备,该监视设备包括: 光学传感器,用于感测脉管的相对位置,多普勒传感器,用于感测在所述脉管中流动的流体的速率,计算设备,用于操作所述光学传感器和所述多普勒传感器以获得参数值,所述光学传感器、所述多普勒传感器和所述计算设备被封装于外壳内,以及通信设备,连接到所述计算设备;以及发送命令给所述监视设备;以及响应于所述命令执行功能。 9. A method for monitoring health, comprising: providing a monitoring device, the monitoring apparatus comprising: an optical sensor for sensing a relative position of the vessel Doppler sensor for sensing flow in the vessel the rate of the fluid, a computing device for operating the optical sensor and the Doppler sensor to obtain a parameter value, the optical sensor, a Doppler sensor and the computing device is encapsulated within a housing, and a communication device connected to the computing device; and send a command to the monitoring device; and in response to the command execution.
10.如权利要求9所述的方法,其中,功能是计算来自组的参数,所述组包括:氧饱和度、搏出量、血压、心脉搏和心输出量。 10. The method as claimed in claim 9, wherein the functional group is calculated from the parameters of the group comprising: oxygen saturation, stroke volume, blood pressure, heart pulse rate and cardiac output.
11.如权利要求9所述的方法,其中,所述功能是发送参数值。 11. The method according to claim 9, wherein the function is a transmission parameter values.
12.如权利要求9所述的方法,其中,计算设备包括治疗方案并且所述功能是根据所述治疗方案发送参数值。 12. The method as claimed in claim 9, wherein the computing device comprises a treatment regimen, and the function is a value according to the transmission parameters regimen.
13.如权利要求12所述的方法,其中,所述功能是更新所述治疗方案。 13. The method of claim 12, wherein said function is an update of the treatment regimen.
14.如权利要求9所述的方法,其中,所述功能是开始治疗。 14. The method according to claim 9, wherein said function is the start of treatment.
15.如权利要求13所述的方法,其中,所述治疗是电击。 15. The method according to claim 13, wherein the treatment is an electric shock.
16.如权利要求13所述的方法,其中,所述治疗是给药。 16. The method according to claim 13, wherein the treatment is administered.
17. 一种用于监视健康状况的系统,包括:监视设备,所述监视设备包括:用于感测脉管的相对位置的光学传感器,用于感测流体在脉管中流动的速率的多普勒传感器,用于操作所述光学传感器和所述多普勒传感器来获得参数值的计算设备,所述光学传感器和所述多普勒传感器以及所述计算设备被封装在外壳内;患者监视应用程序,用于向所述监视设备发送数据以及用于接收来自监视设备的参数值;以及数据存储器,用于存储参数值。 17. A system for monitoring health, comprising: a monitoring apparatus, said monitoring apparatus comprising: an optical sensor for sensing the relative position of the vessel, for sensing the rate of fluid flowing in a multi-vessel Doppler sensor, for operating the optical sensor and the Doppler sensor device to obtain a calculated parameter value, the optical sensor and the Doppler sensor and the computing device is enclosed within the housing; patient monitoring application, for transmitting data to the monitoring apparatus and means for receiving a parameter value from the monitoring equipment; and a data memory for storing parameter values.
18.如权利要求17所述的系统,其中,所述参数值包括:氧饱和度、搏出量、血压和心输出量中的一个或多个。 18. The system according to claim 17, wherein the parameter value comprises: oxygen saturation, the one or more stroke volume, cardiac output and blood pressure in the.
19.如权利要求17所述的系统,其中,所述参数值包括心脉搏。 19. The system according to claim 17, wherein the parameter value comprises a heart pulse.
CN2009801189249A 2005-12-08 2009-05-12 Method and system for monitoring a health condition CN102046069A (en)

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US12/206,885 US20090048518A1 (en) 2006-12-10 2008-09-09 Doppler motion sensor apparatus and method of using same
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