CN103040460A - Monitor and monitoring parameter display method thereof - Google Patents
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- CN103040460A CN103040460A CN201110314153XA CN201110314153A CN103040460A CN 103040460 A CN103040460 A CN 103040460A CN 201110314153X A CN201110314153X A CN 201110314153XA CN 201110314153 A CN201110314153 A CN 201110314153A CN 103040460 A CN103040460 A CN 103040460A
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Abstract
The invention discloses a monitor and a monitoring parameter display method thereof. The monitor comprises a monitoring module, wherein the monitoring module comprises at least one of an electrocardiogram module, a blood pressure module and a muscle relaxing module and a bilateral bispectral (BIS) index module. The monitor generates image data according to monitoring data output by at least one of the electrocardiogram module, the blood pressure module and the muscle relaxing module and an BIS index output by the bilateral BIS index module and displays the change curve of the BIS index with the time and the change curve of at least one of the heart rate, the blood pressure and the muscle relaxing parameter with the time in the same display interface, so that monitoring parameters have the same system time and the work clock, waveforms of monitoring parameters are consistent in the aspect of time, a doctor can combine the BIS index and other monitoring parameters to evaluate the depth of anesthesia easily, and the accuracy and the reliability of the evaluation result of the depth of anesthesia by the doctor are improved.
Description
Technical field
The present invention relates to a kind of monitor and monitored parameters display packing thereof.
Background technology
Clinically, all need to use various monitors in a lot of situations, the monitor on the ordinary meaning is mainly used to the physiological parameters such as the blood pressure, heart rate of monitor patients.
When performing the operation for patient, need to anaesthetize patient according to surgery situation, so that patient's consciousness dies down or loses the pain sensation.Need to control well depth of anesthesia when patient is anaesthetized, the assessment of depth of anesthesia or the consciousness degree of depth is the important topic in anesthesiology field always.But the assessment of depth of anesthesia is neither one the recognized standard quantization method still so far.In clinical practice, know the malpractice that causes in deep anaesthesia and the art of common occurrence.No matter to patient, families of patients still concerning the doctor, the potential risk that anesthesia brings all is quite high.Depth of anesthesia control too little, patient is clear-headed in may art, cause suffering to patient, and depth of anesthesia control is too large, and patient may be disabled or be become the plant man.And anesthesia is minute calm, analgesia and several anesthesia methods of flesh pine, and calmness is realized patient and died down, and analgesia weakens patient's pain sensation, and the flesh pine can't move patient but consciously and the pain sensation, if mismatch also can be brought misery to patient.For example there is a hospital when doing open chest surgery to a patient, to do general anesthesia to patient, patient has lost the pain sensation but consciousness is regained consciousness, patient has write down whole operation process, it is just very painful that postoperative patient is often remembered the terrified process of operation, at last hospital is taken to court, caused medical tangle.So depth of anesthesia is a very important parameter in the operation process.
The at present anesthesia educational circles relatively method of judgement depth of anesthesia commonly used mainly is to carry out the calmness scoring.In numerous methods of marking, more commonly Ramsay scoring and OAA/S scoring.
The Ramsay scoring, standards of grading are as follows:
1 minute: restlessness;
2 minutes: quiet cooperation;
3 minutes: drowsiness, can obey command;
4 minutes: sleep state, can wake up;
5 minutes: respiratory reaction was blunt;
6 minutes: deep sleep, do not call and wake up;
Wherein, 1 is divided into agitation, and 2-4 is divided into calm satisfied, and 5-6 is divided into excessively calm.
The OAA/S standards of grading are as shown in the table:
Wherein, score value 0～1 is comparatively ideal general anesthesia operation state.
The shortcoming of Ramsay scoring and OAA/S scoring obviously.Be mainly manifested in following some:
1) evaluation methodology is too subjective, and concordance is not high as a result;
2) the evaluation result grade resolution to depth of anesthesia is low, all only has 6 grades;
3) can't estimate continuously, be interrupted to estimate requiring high to labor workload;
4) degree of excessive anesthesia lacked assessment.
Recently, some high-end hospital, particularly the anaesthetist of some hospitals in Europe also begins to attempt patient is observed with the brain electricity of 2-4 passage patient's narcotism.Its advantage is to observe patient in real time.
Brain Bispectral index (BIS) is a kind of new method of the special judgement anesthesia of patient degree of depth, but this method can only be as the auxiliary judgment of depth of anesthesia.The manufacturer that is used for the BISx equipment of depth of anesthesia assessment declares that also the BIS technology only is used for the instrument of the auxiliary judgment anesthesia of patient degree of depth, U.S.'s anesthesiology meeting (ASA) also only recommends it as aid, can not only rely on the BIS index to assess depth of anesthesia, otherwise it is inaccurate probably to cause depth of anesthesia to be judged.
The anesthesia of patient degree of depth is judged that inaccurate harm is very large, concerning patient, anaesthetized deeply, may cause patient death or brain injury.Anaesthetized the shallow malpractice such as must cause knowing in the art.And just present, when this malpractice of unfortunate generation is appealed to law court or arbitration organ, lack objective evidence and clue and assist law court or arbitration organ that accident responsibility is made correct judgement.
Summary of the invention
The main technical problem to be solved in the present invention is, provides a kind of monitor and monitored parameters thereof to show or processing method, can judge more accurately depth of anesthesia.
According to an aspect of the present invention, provide a kind of monitor, comprising:
Monitoring module, described monitoring module comprises:
Be used for to measure electrocardiogram (ECG) data the electrocardio module, be used for the blood pressure module of Measure blood pressure data and be used for measuring at least one of flesh rapping piece of skeletal muscle relaxation data, the corresponding monitoring of its output data; With
Be used for measuring the bilateral cerebral Bispectral index module of eeg data, it exports the BIS index at least;
Data processing unit, it receives the monitoring data of each monitoring module output, and the monitoring data that comprise the bilateral cerebral Bispectral index that monitoring module is exported are processed into view data to be shown and output;
Display unit, the view data of receive data processing unit output demonstrates at same display interface and respectively to guard the time dependent waveform of data.
According to a further aspect in the invention, also provide the monitored parameters display packing of above-mentioned monitor, comprising:
Data processing unit is with the BIS index of the monitoring data of at least one output in electrocardio module, blood pressure module and the flesh rapping piece and the output of bilateral cerebral Bispectral index module together image data generating;
The view data of display unit receive data processing unit output, with the BIS index over time at least one in curve and heart rate, blood pressure and the flesh pine parameter over time curve display in same display interface.
Description of drawings
Fig. 1 is the structural representation of monitor in an embodiment of the present invention;
Fig. 2 is the structural representation of monitor among the another kind of embodiment of the present invention;
Fig. 3 is the structural representation of monitor among the another kind of embodiment of the present invention;
Fig. 4 is monitor display interface schematic diagram in an embodiment of the present invention;
Fig. 5 is the structural representation of monitor among the another kind of embodiment of the present invention;
Fig. 6 is the structural representation of monitor among another embodiment of the present invention.
The specific embodiment
By reference to the accompanying drawings the present invention is described in further detail below by the specific embodiment.
At first the term of using among the application is made an explanation.
Display interface refers to the content that display demonstrates at its display screen.
Working interface, it belongs to the part of display interface, and a display interface can comprise one or more working interfaces, and a working interface namely is the window that shows by after a work system or the application system operation.For monitor, can only have a working interface on its display interface, also can demonstrate several working interfaces, the waveform of a plurality of physiological parameters may be displayed on same working interface, also can be presented at respectively in the different working interfaces, but each working interface independent operation.Has same time shaft between the parameter waveform in the same working interface.
According to clinical practice, bilateral cerebral Bispectral index (BIS index) can be used as the foundation of judging depth of anesthesia, can more comprehensively, more safely detect the activity of two hemisphere of brain by bilateral BIS index.But can not only rely on bilateral BIS index and judge depth of anesthesia, because when some surgical event having occured patient has been had stimulation, patient can react to some extent, if only rely on bilateral BIS index and judge depth of anesthesia this moment, therefore the judgement that may lead to errors need to combine the judgement depth of anesthesia with other physiological parameter and bilateral BIS index.
According to clinical practice, the application's imagination is with heart rate, in blood pressure and the flesh pine parameter at least one and bilateral BIS index combine the judgement depth of anesthesia, therefore will be for the electrocardio module of measuring electrocardiogram (ECG) data in the application's embodiment, be used for the blood pressure module of Measure blood pressure data and be integrated into same monitor at least one of the flesh rapping piece of measuring the skeletal muscle relaxation data with for the bilateral cerebral Bispectral index module (BISx4 module) of measuring the bilateral eeg data, and monitoring data that will be separately are sent to the display device of monitor, with heart rate, the display interface that in blood pressure and the flesh pine parameter at least one and bilateral BIS index are shown to same display device simultaneously.
Please refer to Fig. 1, in one embodiment, monitor 10 comprises measurement terminal 11, monitoring module 12, data processing unit 13 and display unit 14.Measurement terminal 11 comprises patient end and interface end, patient end is used for contacting with patient 15 regulation body part, the fixing the corresponding interface that maybe can be connected to monitoring module 12 of interface end with plugging, variation with caused some physical quantity of induction human physiological activity, and be the signal of telecommunication with the change transitions of this physical quantity, for example voltage or electric current, then in real time with electrical signal transfer to monitoring module.Monitoring module 12 is used for receiving the signal of telecommunication that measurement terminal 11 transmits, the signal of telecommunication is processed, for example amplify, then the analogue signal after will processing outputs to data processing unit 13 by adaptable interface, 13 pairs of analog signal samplings of data processing unit and analog digital conversion form digital signal, digital signal is outputed to display unit 14 in conjunction with other interface assembly image data generating show.
In the present embodiment, monitoring module 12 can configure as required, and monitoring module 12 is monitoring modules of multiparameter, comprises at least the BISx4 module, also comprises in electrocardio module, blood pressure module and the flesh rapping piece at least one.
Please refer to Fig. 2, in the embodiment shown in Figure 2, monitoring module 12 comprises BISx4 module 121, blood pressure module 122, electrocardio module 123 and flesh rapping piece 124, the measurement data of monitoring module output is called the monitoring data, the bilateral cerebral Bispectral index of BISx4 module output belongs to a kind of monitoring data, and the flesh pine parameter of the blood pressure data of the heart rate data of electrocardio module output, blood pressure module output and the output of flesh rapping piece also belongs to respectively a kind of monitoring data.BISx4 module 121 is used for measuring eeg data, its Data Input Interface is fixing maybe can to connect brain electric transducer 111 with plugging, the bio electricity of brain electric transducer 111 induction human brains self, with this electric signal transmission to BISx4 module 121, BISx4 module 121 is processed the parameters such as rear generation brain wave data, left side brain Bispectral index (BIS_L) and right side brain Bispectral index (BIS_R) to this signal of telecommunication, BISx4 module 121 outputs to data processing unit 13 with the parameter that generates.Blood pressure module 122 is used for measuring human blood-pressure, and its Data Input Interface is fixing maybe can to connect blood pressure intubate 112 with plugging, and outfan outputs to data processing unit 13 with the blood pressure data that generates.Electrocardio module 123 is used for measuring electrocardiogram (ECG) data, and its Data Input Interface is fixing maybe can to connect electrocardioelectrode 113 with plugging, and outfan outputs to data processing unit 13 with the heart rate data that generates.Flesh rapping piece 124 is used for measuring the skeletal muscle relaxation data, the fixing flesh pine sensor 114 that maybe can connect of its Data Input Interface with plugging, and outfan outputs to data processing unit 13 with the flesh pine parameter that generates.Above-mentioned monitoring module can adopt prior art to realize.
The present embodiment is simultaneously displayed on bilateral BIS exponential sum heart rate, blood pressure and flesh pine parameter has following effect in the same display interface:
1, in operation process, the thing that the doctor need to consider and operate is a lot, needs to assess out very soon depth of anesthesia and make corresponding reaction.The present embodiment makes the doctor only need to check a display screen when the assessment depth of anesthesia, and the waveform with bilateral BIS exponential waveform and other monitored parameters on a display screen compares observation, thus the assessment depth of anesthesia.If the waveform of bilateral BIS exponential waveform and other monitored parameters is presented on the different display screens, not even on the display screen of same custodial care facility, must cause the doctor to check a plurality of display screens, and then the monitoring waveform of certainly being about on a plurality of display screens combines the assessment depth of anesthesia, this must prolong the evaluation time, cause the doctor can not in time make corresponding reaction, to such an extent as to bring injury to patient.
2, the doctor is combining other monitored parameters of BIS exponential sum assessment during depth of anesthesia, must be that other monitored parameters of bilateral BIS exponential sum with synchronization combines.If bilateral BIS exponential waveform adopts a custodial care facility to show, and the waveform of other monitored parameters adopts another custodial care facility to show, owing to there are differences between the system time of distinct device, work clock is also incomplete same, so be difficult to find other monitored parameters of BIS exponential sum of synchronization.And in the present embodiment, because bilateral BIS exponential sum heart rate, blood pressure, flesh pine parameter is processed by same data processing unit, in processing procedure, have same system time and work clock, so their waveform is consistent in time, the doctor is when observing the waveform of bilateral BIS exponential waveform and other monitored parameters, be easy to observe other monitored parameters of bilateral BIS exponential sum of synchronization or period, thereby make the doctor that bilateral BIS index is assessed depth of anesthesia together in conjunction with other monitored parameters and become easier, and improved accuracy and reliability to the depth of anesthesia assessment result.
As the improvement to the present embodiment, data processing unit can be processed into the monitoring data of each monitoring module output the view data in the same working interface, and the monitoring data that will read and the monitor system time during from each adaptable interface reading out data are generated as the view data the two-dimensional coordinate system, in two-dimensional coordinate system, transverse axis is time shaft, and the longitudinal axis is the data axle of expression monitoring data value.Be that bilateral BIS exponential sum heart rate, blood pressure and flesh pine parameter are simultaneously displayed in the same window, share a two-dimensional coordinate system.The data axle can be one, and all parameters share a data axle.The data axle also can be two, lays respectively at the two ends of time shaft, and first data axle represents bilateral cerebral Bispectral index data value, and the second data axle represents the data axle of other monitoring data.For the waveform that adopts the present embodiment to demonstrate, the doctor is when the assessment depth of anesthesia, only need to see that the variation tendency of this window bilateral BIS index and the variation tendency of other monitored parameters get final product, do not need to observe whole display interface, and in same working interface, each parameter is keeping highly consistent aspect the time, the doctor does not need to consider whether the detection time of each parameter is synchronous when observing parameter waveform.
Certainly, those skilled in the art are appreciated that according to the disclosed content of the application above-mentioned monitor also can not configure the electrocardio module, or do not configure blood pressure module, or do not configure flesh rapping piece, or do not configure in electrocardio module, blood pressure module and the flesh rapping piece any both.
In another embodiment, as shown in Figure 3, monitor 30 also comprises input equipment 35 and amount of infusion monitoring means 36 except comprising measurement terminal 31, monitoring module 32, data processing unit 33 and display unit 34.Measurement terminal 31, monitoring module 32, data processing unit 33 and display unit 34 can with above-described embodiment in identical or different, input equipment 35 and amount of infusion monitoring means 36 are coupled to respectively data processing unit 33.Input equipment 35 is used for receiving event information, and this event information can comprise surgical event information etc.Wherein, surgical event refers to the operation in the operation process patient done, surgical event information comprises the time of origin of surgical event and this surgical event, surgical event includes but not limited to intubate, pendulum mass position, drop cloth, cuts skin, non-narcotic class medication, electric knife, stitching, suction sputum, tube drawing, remove the operations such as machine, and these depth of anesthesia to patient, blood pressure and hrv parameter all can be influential.Input equipment 35 can be man-machine interactive system, and at the display interface ejection human computer conversation window of display unit, the doctor is by equipment incoming event information such as keyboard, handwriting equipment or touch screens.Data processing unit 33 receives the event information of input equipment 35 outputs, inquires about the time of origin information in this event information, and the sign that represents this surgical event is presented on the time point corresponding with time of origin on the working interface.Amount of infusion monitoring means 36 is for detection of various medicaments perfusion consumptions in the operation process, and amount of infusion monitoring means 36 can be the flow transducer of tracer liquid flow, or detects the induction apparatus etc. of the injection speed of the syringe pump that is used for the perfusion medicament.Data processing unit 33 receives the medicament perfusion usage data that amount of infusion monitoring means 36 is exported, and each medicament is constantly poured into usage data with the time image data generating of monitoring data according to generation.
In operation process, a lot of surgical event all cause interference to patient, patient's bilateral BIS index can change, in this case when bilateral BIS exponential quantity changes, very difficult assessment is that patient's depth of anesthesia has changed, or because surgical event causes patient's consciousness to change, thereby cause cerebral biological electricity to change.If know the time point that surgical event occurs, on this time point, the variation tendency of bilateral BIS index and the variation of other monitored parameters (for example heart rate, blood pressure or flesh pine parameter) are combined the objectively depth of anesthesia of evaluating patient, will make assessment result more accurately and reliably.
In one embodiment, the sign that represents surgical event is marked on the curve of BIS index according to the time point on time shaft corresponding to this Time To Event, more convenient variation tendency and event with the BIS index combines the assessment depth of anesthesia.
When patient performs the operation, for the health aspect that alleviates patient and the misery of psychological aspects, need to anaesthetize patient.Anesthesia be divided into two parts, first is preoperative induction of anesthesia, injection volume is larger, after the patient injection very F.F. enter the sleep state.Second portion is anesthesia in the operation, and the patient in the operation is carried out the anaesthetic perfusion, usually adopts syringe pump, according to the accurate quantification injection, keeps patient and is in satisfied narcotism.The anaesthetic of perfusion generally includes three kinds: analgesics, tranquilizer and muscle relaxant.The operation medication generally is that depth of anesthesia, blood pressure situation and the changes in heart rate according to patient carried out targetedly medication.Also to observe variation and the effect of these parameters after the medication.For example, the doctor can determine to change the groundwater increment of medicament according to the variation tendency of the variation tendency of the bilateral BIS index on the display screen and other monitored parameters (for example heart rate, blood pressure or flesh pine parameter), adjust patient's bilateral BIS index, keep patient and be in satisfied narcotism.
In one embodiment, the anaesthetic perfusion information obtains and exports to data processing unit 33 by amount of infusion monitoring means 36.
In another embodiment, the event information that input equipment 35 receives can also comprise the medication event information except surgical event, and this medication event information mainly comprises administration time, nomenclature of drug and dosage etc.Various medicament perfusion dosage and administration time in the operation process are obtained by input equipment 35 as the medication event, and export the medication event information to data processing unit 33 by input equipment 35.Therefore do not need in the present embodiment amount of infusion monitoring means 36 is connected connection with data processing unit.The same, this input equipment 35 can be man-machine interactive system, and at the display interface ejection human computer conversation window of display unit, the doctor is by the equipment such as keyboard, handwriting equipment or touch screen input medication event information; In addition, this input equipment 35 also can be for the devices interconnect interface etc., receives the medication event information of other coupled armarium (such as the medicament perfusion equipment etc.) input by this input equipment 35.The medication event information that data processing unit 33 receives input equipment 35 is presented on the time point corresponding with time of origin on the working interface or in the time interval.
Show the medication event information at working interface, be convenient to the doctor and judge depth of anesthesia in conjunction with this medication event; Simultaneously, show the medication event information at same working interface, also can so that whether the perfusion consumption of monitoring medicament be unusual.
In above-described embodiment, the BIS module adopts bilateral cerebral Bispectral index (BISx4) module, and the BIS index comprises BIS exponential sum right side, left side BIS index, and display unit preferably demonstrates the waveform of BIS exponential sum right side, left side BIS index simultaneously on working interface.Because the activity of two hemisphere of brain is different, compares with the BISx technology of only monitoring the monolateral activity of brain, bilateral cerebral Bispectral index (BISx4) is safer more comprehensively.
In operation process, monitor detects patient's physiological parameter by above-mentioned measurement terminal and monitoring module, and these physiological parameters are presented on same display interface or the same working interface present to the doctor, please refer to Fig. 4, Figure 4 shows that the present embodiment is with left and right sides BIS index, heart rate and blood pressure, and the event information in the operation process and anaesthetic perfusion consumption is simultaneously displayed on the schematic diagram of same working interface, and the doctor comes the depth of anesthesia of evaluating patient by the variation of observing these parameters.Among the figure, the darker BISL of color represents the time dependent waveform of left side BIS index, the more shallow BISR of color represents the time dependent waveform of right side BIS index, HR represents the time dependent waveform of heart rate, BP represents the time dependent waveform of blood pressure, RF represents the time dependent waveform of perfusion consumption of analgesics in the dotted portion below among the figure, PRO represents the time dependent waveform of ataractic perfusion consumption, TRA represents the time dependent waveform of perfusion consumption of muscle relaxant, event represents with sign " ↓ " among the figure, induction of anesthesia during label 8 expression operation beginning, label 1 expression tracheal intubation, label 2 expression patient pendulum mass positions, label 3 expressions cover, label 4 expression electric knifes, and label 5 expressions are sewed up, label 6 expression injection neostigmine (a kind of vasoconstriction class medicament) and atropine (a kind of cardiac tonic), label 7 expression suction sputum and tube drawings.During the operation beginning, patient is carried out induction of anesthesia, to simultaneously this medication event information be input to data processing unit 33 by input equipment 35, after 33 pairs of these information processings of data processing unit, with this medication event flag on the BIS exponential curve, as shown in the reference numeral 8, can find out from left and right side BIS exponential curve, after the induction of anesthesia event, left and right side BIS index reduces rapidly, and the expression patient has entered narcotism.When being between the 40-60, the BIS index thinks that depth of anesthesia is more moderate.When the BIS index is lower than 40 even when being lower than 30, if the doctor only just thinks that according to the BIS index depth of anesthesia is excessive, just might cause judging by accident.Also need to come together to assess depth of anesthesia in conjunction with blood pressure of the same period or heart rate this moment.Waveform from figure, after induction of anesthesia event 8, left and right side BIS index reduces, patient's blood pressure BP also descends thereupon, heart rate HR raises simultaneously, with left and right side BIS index in conjunction with blood pressure of the same period or heart rate after the doctor can draw judgement, it is because the impact of induction of anesthesia event is not to be that depth of anesthesia is excessive that left and right side BIS index reduces.When operating time is 30-40 minute, left and right side BIS index raises, and in the time of about 32 minutes, patient was carried out electric knife event 4, if rising just judges that depth of anesthesia diminishes according to left and right side BIS index, might cause erroneous judgement, event stimulates because patient is subjected to electric knife, also might cause left and right side BIS index to raise.In this case, the doctor also needs to assess depth of anesthesia in conjunction with blood pressure of the same period or heart rate.At this moment, observing blood pressure has the trend of reduction, and heart rate has the trend of rising, integrate, the doctor judges that depth of anesthesia diminishes, and it is clear-headed that patient is tending towards, so change narcotic groundwater increment, on scheming, can find out that the doctor has increased the groundwater increment of tranquilizer PRO, reduce simultaneously the groundwater increment of analgesics RF, left and right side BIS index is returned to about 50.
As seen, left and right side BIS index is excessively low, might not mean that depth of anesthesia is large and needs reduce narcotic consumption, and left and right side BIS index raises and means not necessarily also that depth of anesthesia is little and needs increasing anaesthetic pours into consumption.Above-described embodiment is presented at same working interface with left and right side BIS exponential sum blood pressure, heart rate, can guarantee like this each monitored parameters concordance in time, and what make each monitored parameters waveform of same time becomes very easy in conjunction with observing, help thus the doctor with the combinations such as left and right side BIS exponential sum blood pressure, heart rate assessment depth of anesthesia the time, to improve accuracy and the reliability of assessment result, can effectively reduce the event that anesthesia is not enough and anesthesia is excessive, thereby the minimizing malpractice, and saved anaesthetic.
Certainly, those skilled in the art are appreciated that in the above-mentioned monitor according to the disclosed content of the application also can not design input equipment, or does not design the amount of infusion monitoring means.
In another embodiment, as shown in Figure 5, monitor 50 comprises measurement terminal 51, monitoring module 52, data processing unit 53, display unit 54 and alarm monitoring unit 55, measurement terminal 51, monitoring module 52, data processing unit 53 and display unit 54 can with above-described embodiment in identical or different, monitoring module 52 comprise in BISx4 module and blood pressure module, electrocardio module and the flesh rapping piece any or a plurality of.Described alarm monitoring unit 55 reads BIS exponential sum right side, left side BIS index, BIS exponential sum right side, left side BIS index is compared with the HiAlm limit and the low alarm limit that set in advance respectively, when arbitrary in the BIS index of BIS exponential sum right side, left side exceeds HiAlm limit or low alarm limit, the first prompt messages is exported in the alarm monitoring unit, output to corresponding equipment and carry out the warnings such as sound/light, to remind the busy doctor that performing the operation to observe the demonstration of monitor, improve the safety of guarding.Described alarm monitoring unit 55 also calculates the difference of BIS exponential sum right side, left side BIS index, and described difference and the difference threshold that sets in advance are compared, and when described difference during greater than described difference threshold, the second prompt messages is exported in the alarm monitoring unit.20 such as this threshold value is set, so | just report to the police in BIS_L-BIS_R|＞=20, like this can be in the situation that the larger prompting of left and right side BIS index difference doctor notices that the left and right brain situation of current patient difference is larger, when a left side or right side BIS index exceeded HiAlm limit or low alarm limit and report to the police, the doctor should consider that according to left and right side BIS Index Assessment depth of anesthesia the time its left and right BIS value difference value is originally with regard to large factor.
First, second prompt messages can output to the display device pop-up window and point out, or outputs to speaker and carry out auditory tone cues, or outputs to display lamp and carry out light prompt.
Alarm monitoring unit 55 can be independently parts, chip independently for example, and this chip can be connected to the outfan of the BISx4 module in the monitoring module, obtains BIS exponential sum right side, left side BIS index from the BISx4 module.This chip also can be connected to data processing unit 53, obtains BIS exponential sum right side, left side BIS index from data processing unit 53.Alarm monitoring unit 55 also can be integrated into a chip with data processing unit 53.
In another embodiment, as shown in Figure 6, monitor 60 comprises measurement terminal 61, monitoring module 62, data processing unit 63, display unit 64 and is used for the memory element 65 of storing image data, and memory element 65 links to each other with data processing unit 63.View data in the memory element 65 can be with graphical format or data format storage.
Each monitoring module obtains monitored parameters and waveform from the signal that the human body collection comes by certain algorithm based on its sensor.Each monitoring module sends to these parameters and waveform the display unit 64 of monitor.Simultaneously, in operation process, Anesthetist or nurse can and change medication event information and surgical event information according to the practical situation input.Monitor system provides the user interface of these information of input.When the user inputs these information, monitor is these information real-time update in display unit 64, and will guard data and event information is kept in the memory element 65.So just formed the omnidistance record of an operation case.Such record can be stored in the compatible format of figure or data on the various storage mediums for browsing in various browsers.When doctor-patient dispute occurs when, can be with the data readback of preserving, for law court or arbitration organ produce evidence.
The present embodiment utilizes measurement result and the electrocardio of multi-parameter monitor and the measurement result of blood pressure parameter and flesh pine (Neuro-Muscular Transmission) parameter of bilateral cerebral Bispectral index (BISx4) module, with a kind of display packing of suitable clinical practice with these information, comprise event in the operation process, present to intuitively the doctor in real time or in the review mode.The doctor can in conjunction with the one or more and bilateral BIS Index Assessment depth of anesthesia in electrocardio, blood pressure, the flesh pine, make assessment result more reliable.
According to the disclosed content of the application, it will be appreciated by those skilled in the art that except above-described embodiment, memory element, alarm monitoring unit, input equipment and amount of infusion monitoring means can also be carried out the combination of alternate manner to realize new embodiment.
Monitored parameters display packing based on above-mentioned monitor comprises following step display:
Data processing unit is with the bilateral cerebral Bispectral index of the monitoring data of at least one output in electrocardio module, blood pressure module and the flesh rapping piece and the output of bilateral cerebral Bispectral index module together image data generating; The view data of display unit receive data processing unit output, with the bilateral cerebral Bispectral index over time at least one in curve and heart rate, blood pressure and the flesh pine parameter over time curve display in same display interface.Preferably the waveform with each monitoring data is displayed in the two-dimensional coordinate system, and transverse axis is time shaft, and the longitudinal axis is the data axle of expression monitoring data value.
In improved embodiment, monitor is gone back presented event information at same display interface (preferred same working interface), may further comprise the steps: receive the event information of input, described event information comprises event and time of origin; The sign of presentation of events was presented on the time corresponding with this Time To Event of same working interface.
Event can comprise surgical event and medication event, the sign that preferably will represent surgical event is marked on the curve of bilateral cerebral Bispectral index according to the time point on time shaft corresponding to this Time To Event, and will be shown as the time dependent curve of dosage in the medication event of long period perfusion.For example for the anaesthetic perfusion event of operation process, monitor receives various medicament perfusion usage data; With medicament pour into usage data over time curve with the monitoring data over time curve be presented in the same working interface.Medicament perfusion usage data can be obtained by input equipment, also can be obtained by the amount of infusion monitoring means.
Above content is in conjunction with concrete embodiment further description made for the present invention, can not assert that implementation of the present invention is confined to these explanations.For the general technical staff of the technical field of the invention, without departing from the inventive concept of the premise, can also make some simple deduction or replace, all should be considered as belonging to protection scope of the present invention.
Claims (18)
1. monitor is characterized in that comprising:
Monitoring module, described monitoring module comprises:
Be used for to measure electrocardiogram (ECG) data the electrocardio module, be used for the blood pressure module of Measure blood pressure data and be used for measuring at least one of flesh rapping piece of skeletal muscle relaxation data, the corresponding monitoring of its output data; With
Be used for measuring the bilateral cerebral Bispectral index module of bilateral eeg data, output bilateral cerebral Bispectral index;
Data processing unit, it receives the monitoring data of each monitoring module output, and the monitoring data that comprise the bilateral cerebral Bispectral index that monitoring module is exported are processed into view data to be shown and output;
Display unit, the view data of receive data processing unit output demonstrates at same display interface and respectively to guard the time dependent waveform of data.
2. monitor as claimed in claim 1 is characterized in that, described electrocardio module, blood pressure module and flesh rapping piece be connected at least one be connected with data processing unit with adaptable interface that bilateral cerebral Bispectral index module is connected separately.
3. monitor as claimed in claim 1 or 2 is characterized in that, described data processing unit is processed into view data in the same working interface with the monitoring data of each monitoring module output.
4. monitor as claimed in claim 3, it is characterized in that, the monitor system time when monitoring data that data processing unit will read from each adaptable interface and reading out data is generated as the view data the two-dimensional coordinate system, in two-dimensional coordinate system, transverse axis is time shaft, and the longitudinal axis is the data axle of expression monitoring data value.
5. monitor as claimed in claim 4 is characterized in that, described data axle is two, and first data axle is the data axle of other monitoring data of expression for the data axle of expression bilateral cerebral Bispectral index data value, the second data axle.
6. monitor as claimed in claim 4, it is characterized in that, also comprise for the input equipment that receives event information, data processing unit is coupled in described input equipment, data processing unit receives the event information of input equipment output, inquire about the time of origin information in this event information, the sign of presentation of events was marked on the time corresponding with Time To Event on the working interface.
7. monitor as claimed in claim 4, it is characterized in that, also comprise the amount of infusion monitoring means for detection of various medicament perfusion consumptions in the operation process, described amount of infusion monitoring means is coupled to data processing unit, data processing unit receives the medicament perfusion usage data that the amount of infusion monitoring means is exported, and each medicament is constantly poured into usage data with the time image data generating of monitoring data according to generation.
8. monitor as claimed in claim 1, it is characterized in that, also comprise measurement terminal, described measurement terminal comprises patient end and interface end, described patient end is used for contacting with the regulation position of patient body, the fixing the corresponding interface that maybe can be connected to monitoring module of described interface end with plugging.
9. such as each described monitor among the claim 1-8, it is characterized in that, also comprise the memory element for storing image data, memory element links to each other with data processing unit.
10. monitor as claimed in claim 9 is characterized in that, the view data in the described memory element is with graphical format or data format storage.
11. monitor as claimed in claim 1, it is characterized in that, the bilateral cerebral Bispectral index comprises left side brain Bispectral index and right side brain Bispectral index, and described display unit demonstrates the waveform of left side brain Bispectral index and right side brain Bispectral index simultaneously on working interface.
12. monitor as claimed in claim 11, it is characterized in that, also comprise the alarm monitoring unit, described alarm monitoring unit reads left side brain Bispectral index and right side brain Bispectral index, left side brain Bispectral index and right side brain Bispectral index are compared with the HiAlm limit and the low alarm limit that set in advance respectively, when arbitrary in left side brain Bispectral index and the right side brain Bispectral index exceeded HiAlm limit or low alarm limit, the first prompt messages was exported in the alarm monitoring unit.
13. monitor as claimed in claim 12, it is characterized in that, described alarm monitoring unit also calculates the difference of left side brain Bispectral index and right side brain Bispectral index, and described difference and the difference threshold that sets in advance compared, when described difference during greater than described difference threshold, the second prompt messages is exported in the alarm monitoring unit.
14. the monitored parameters display packing of monitor as claimed in claim 1 is characterized in that, comprising:
Data processing unit is with the bilateral cerebral Bispectral index of the monitoring data of at least one output in electrocardio module, blood pressure module and the flesh rapping piece and the output of bilateral cerebral Bispectral index module together image data generating;
The view data of display unit receive data processing unit output, with the bilateral cerebral Bispectral index over time at least one in curve and heart rate, blood pressure and the flesh pine parameter over time curve display in same display interface.
15. method as claimed in claim 14 is characterized in that, described waveform of respectively guarding data is displayed in the two-dimensional coordinate system, and transverse axis is time shaft, and the longitudinal axis is the data axle of expression monitoring data value.
16. method as claimed in claim 15 is characterized in that, described monitor comprises that also data processing unit is coupled in described input equipment for the input equipment that receives incoming event information, and described display packing also comprises:
Receive the event information of input, described event information comprises event and time of origin;
The sign of presentation of events was presented on the time corresponding with this Time To Event of same working interface.
17. method as claimed in claim 16 is characterized in that, the sign that represents surgical event is marked on the curve of bilateral cerebral Bispectral index according to the time point on time shaft corresponding to this Time To Event.
18. such as each described method among the claim 15-17, it is characterized in that, described display packing also comprises:
Receive various medicament perfusion usage data;
With medicament pour into usage data over time curve with the monitoring data over time curve be presented in the same working interface.
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