CN107292110B

CN107292110B - Anticoagulation management method and device for medical auxiliary terminal equipment and rear-end equipment

Info

Publication number: CN107292110B
Application number: CN201710506869.7A
Authority: CN
Inventors: 李业涛
Original assignee: Guizhou Provincial Peoples Hospital
Current assignee: Guizhou Provincial Peoples Hospital
Priority date: 2017-06-28
Filing date: 2017-06-28
Publication date: 2021-01-22
Anticipated expiration: 2037-06-28
Also published as: CN107292110A

Abstract

The application discloses an anticoagulation management method and device for medical auxiliary terminal equipment and back-end equipment. The anticoagulation management method for the medical auxiliary terminal equipment comprises the following steps: receiving a current international normalized ratio of plasma; calculating the warfarin dose according to the existing warfarin dose, the current international standardized ratio and the target international standardized ratio, wherein the target international standardized ratio is read from medical auxiliary back-end equipment; and calculating the dosage of 1/4 tablets according to the warfarin dosage; and displaying the dosage. According to the technical scheme provided by the embodiment of the application, the warfarin dosage is calculated according to the previous warfarin dosage, the current international standard ratio and the target international standard ratio, so that the problem of low calculation efficiency caused by a traditional manual mode can be solved.

Description

Anticoagulation management method and device for medical auxiliary terminal equipment and rear-end equipment

Technical Field

The present disclosure relates generally to the field of data processing, and more particularly, to an anticoagulation management method and apparatus for medical auxiliary terminal devices and backend devices.

Background

Long-term anticoagulation treatment of warfarin after mechanical valve replacement has been a difficult problem in the clinic. Despite the significant advances in the development of new anticoagulant drugs, warfarin, the oldest orally available anticoagulant drug, remains the most commonly used drug for long-term anticoagulant therapy in patients. After the valve replacement, a patient can reduce the stroke incidence by more than half by orally taking warfarin and carrying out good anticoagulation management. However, the therapeutic window for warfarin is relatively narrow: an increased risk of embolism when the International Normalized Ratio (INR) is below 2.0; above 3.0, the risk of bleeding is high. This requires maintaining the INR value of anticoagulated patients after mechanical valve replacement at a relatively stable desired level for a long period of time.

At present, after the INR value of plasma is detected, many data related to anticoagulation are calculated manually, which causes heavy workload and low efficiency for doctors.

Disclosure of Invention

In view of the above-mentioned drawbacks and deficiencies of the prior art, it is desirable to provide a method and an apparatus for anticoagulation management of medical auxiliary equipment, which automatically calculate anticoagulation-related data according to the detection result.

In a first aspect, an anticoagulation management method for a medical assistance terminal device, the method comprising:

receiving a current international normalized ratio of plasma;

calculating the warfarin dose according to the existing warfarin dose, the current international standardized ratio and the target international standardized ratio, wherein the target international standardized ratio is read from medical auxiliary back-end equipment; and

calculating the dosage of 1/4 tablets according to the warfarin dosage;

and displaying the dosage.

In a second aspect, a method for anticoagulation management for a medical-assisted backend device, the method comprising:

receiving patient information, the patient information including condition information;

according to the disease information, calculating a corresponding target international standardized ratio for the medical auxiliary terminal equipment to calculate the warfarin dosage according to the previous warfarin dosage, the current international standardized ratio and the target international standardized ratio, wherein the target international standardized ratio is read from the medical auxiliary rear-end equipment; and calculating the dosage of 1/4 tablets according to the warfarin dosage, and displaying the dosage.

In a third aspect, an anticoagulation management device for medical auxiliary terminal equipment, the method includes:

a receiving unit: a current international normalized ratio configured to receive plasma;

warfarin dose calculation unit: configured to calculate a warfarin dose based on the existing warfarin dose, the current international normalized ratio, and a target international normalized ratio, the target international normalized ratio read from the medical assistance backend device; and

a dose calculation unit: configured to calculate 1/4 tablets based on warfarin dosage

The dosage per unit;

a display unit: is configured to display the dosage.

In a fourth aspect: an anticoagulation management apparatus for a medical assistance backend device, the method comprising:

a patient information receiving unit: configured to receive patient information, the patient information including condition information;

target international normalized ratio calculation unit: the system is configured to calculate a corresponding target international standardized ratio according to the disease information, so that the medical auxiliary terminal equipment can calculate the warfarin dosage according to the past warfarin dosage, the current international standardized ratio and the target international standardized ratio, and the target international standardized ratio is read from the medical auxiliary rear-end equipment; and calculating the dosage of the 1/4 tablets according to the warfarin dosage, and displaying the dosage.

In a fifth aspect: an ancillary medical device, the device comprising:

one or more processors;

a memory for storing one or more programs,

when the one or more programs are executed by the one or more processors, cause the one or more processors to perform anticoagulation management methods for medical assistance terminal devices provided by embodiments of the present application; or

The one or more programs, when executed by the one or more processors, cause the one or more processors to perform a method for anticoagulation management for a medical assistance backend device provided by the embodiments of the present application.

A sixth aspect: a computer-readable storage medium storing a computer program,

the program is executed by a processor to realize an anticoagulation management method for the medical auxiliary terminal device provided by the embodiments of the present application; or

The program, when executed by a processor, implements a method for anticoagulation management for a medical assistance backend device provided by various embodiments of the present application.

According to the technical scheme provided by the embodiment of the application, the warfarin dosage is calculated according to the existing warfarin dosage, the current international standard ratio and the target international standard ratio, so that the problem of low calculation efficiency caused by the traditional manual mode can be solved. Further, according to some embodiments of the present application, by calculating the dosage of 1/4 tablets according to the warfarin dosage, the problem of difficult tablet splitting caused by dosage that is inconvenient to take medicine can be solved, and a favorable medicine taking effect can be obtained.

Drawings

Other features, objects and advantages of the present application will become more apparent upon reading of the following detailed description of non-limiting embodiments thereof, made with reference to the accompanying drawings in which:

FIG. 1 illustrates an exemplary system architecture to which embodiments of the present application may be applied;

fig. 2 shows an exemplary flow chart of a anticoagulation management method for a medical assistance terminal device according to an embodiment of the application;

fig. 3 shows an exemplary flowchart of the dose calculation method of step S13 according to an embodiment of the present application;

fig. 4 shows an exemplary flow diagram of a anticoagulation management method for a medical-assisted backend device according to an embodiment of the present application;

fig. 5 shows an exemplary structural block diagram of an anticoagulation management device for a medical auxiliary terminal device according to an embodiment of the present application;

fig. 6 shows an exemplary block diagram of an anticoagulation management apparatus for a medical auxiliary back-end device according to an embodiment of the present application;

fig. 7 shows an exemplary block diagram of a medical assistance device according to an embodiment of the present application.

Detailed Description

The present application will be described in further detail with reference to the following drawings and examples. It is to be understood that the specific embodiments described herein are merely illustrative of the relevant invention and not restrictive of the invention. It should be noted that, for convenience of description, only the portions related to the present invention are shown in the drawings.

It should be noted that the embodiments and features of the embodiments in the present application may be combined with each other without conflict. The present application will be described in detail below with reference to the embodiments with reference to the attached drawings.

FIG. 1 illustrates an exemplary system architecture to which embodiments of the present application may be applied. As shown in fig. 1, the system architecture 100 may include medical assistance

terminal devices

101, 102, a network 103, and a medical assistance backend device 104. The network 103 is used to provide a medium for a communication link between the medical assistance

terminal devices

101, 102 and the medical assistance backend device 104. Network 103 may include various connection types, such as wired, wireless communication links, or fiber optic cables, to name a few.

The user 110 may use the medical

assistance terminal device

101, 102 to interact with the medical assistance backend device 104 over the network 103 to receive or send messages or the like.

The medical assistance

terminal devices

101, 102 may be a variety of electronic devices including, but not limited to, personal computers, smart phones, smart watches, tablet computers, plasma International Normalized Ratio (INR) devices, personal digital assistants, and the like.

The medical assistance backend device 104 may be a server that provides various services. The server can store, analyze and the like the received data and feed back the processing result to the terminal equipment.

It should be noted that the anticoagulation management method for the medical auxiliary terminal device provided in the embodiment of the present application may be executed by the medical auxiliary

terminal devices

101 and 102, or may be executed by the medical auxiliary backend device 104, and the anticoagulation management apparatus for the medical auxiliary terminal device may be disposed in the medical auxiliary

terminal devices

101 and 102, or may be disposed in the medical auxiliary backend device 104.

In some embodiments, the target international normalized ratio may be calculated in the medical assistance back-end device 104 for recall by the medical assistance terminal device. The warfarin dosage and the drug amount are calculated and displayed on the medical auxiliary

terminal equipment

101, 102.

In some embodiments, the target international standardized ratio, warfarin dose, and medication amount calculations may be performed in the medical assistance backend device 104, with the calculated warfarin dose and medication amount being stored in the medical assistance backend device 104 for medical assistance terminal device recall and display.

It should be understood that the number of medical assistance terminal devices, networks and medical assistance backend devices in fig. 1 is merely illustrative. There may be any number of medical assistance terminal devices, networks and medical assistance backend devices, as required by the implementation.

The embodiment of the invention specifically comprises two parts, wherein the first part is an anticoagulation management method for medical auxiliary terminal equipment, and the second part is an anticoagulation management method for medical auxiliary back-end equipment.

Referring to fig. 2, an exemplary flowchart of an anticoagulation management method for a medical assistance terminal device according to an embodiment of the present application is shown. The anticoagulation management method comprises the following steps:

step S11: receiving a current international normalized ratio of plasma;

step S12: calculating the warfarin dose according to the existing warfarin dose, the current international standardized ratio and the target international standardized ratio, wherein the target international standardized ratio is read from the medical auxiliary back-end equipment; and

step S13: calculating the dosage of 1/4 tablets according to the warfarin dosage;

step S14: and displaying the dosage.

Wherein, in step S11, the medical assistance terminal device receives the current international standardized ratio of the inputted plasma.

In step S12, the previous warfarin dose is the previously entered warfarin dose.

Preferably, when the current international normalized ratio is less than 3.5, the warfarin dose is calculated as:

D2＝(D1+0.2D1×(INRtarget-INR2)×ABS(INRtarget-INR2))× F1/F2 (1)

in formula 1, D2 is the current warfarin dose, D1 is the previous warfarin dose, INRtarget is the target international normalized ratio, INR2 is the current international normalized ratio, INR2<3.5, F1 is the previous warfarin dosage form, and F2 is the current warfarin dosage form.

In some preferred embodiments, when INR2 is 3.5 ≦ 4.0, the warfarin dose for the day and the next day is calculated as: d2 ═ 0; the formula for warfarin dosage from the third day is:

D2＝(D1+0.2D1×(INRtarget-INR2)×ABS(INRtarget-INR2))× F1/F2。

preferably, when INR2>4.0, the warfarin dose is calculated as: d2 ═ 0; and prompt the patient for physician guidance.

To study the warfarin dosage formula, several points of attention were organized as follows: 1. dose was not adjusted within 0.5 range above and below target INR; 2. the adjusting range is 5-20% every time; 3. the currently detected INR is larger than the target INR range, and the dosage is reduced; less than the target INR range, increasing the dose; the farther the INR value deviates from the target INR range, the greater the variation amplitude to restore to the target INR range as soon as possible; 5. special treatment when the dosage is too low and too high, and the like.

Thus, warfarin dose calculation depends on 3 factors as follows: the amount of warfarin used in the past, denoted by D1; the INR value for this review, denoted by INR 2; and a target INR value, denoted by INRtarget. The warfarin recommended amount is represented by D2, and the preliminary calculation formula is as follows: d2 ═ D1+ D1 × variation amplitude.

The warfarin variation amplitude needs to be determined according to the following requirements: the farther the INR value deviates from the target INR range, the greater the range of variation as possible to recover to the target INR range as soon as possible; the closer the INR value deviates from the target INR range, the smaller the magnitude of the change is to avoid frequent adjustments to warfarin dosage. Thus, the magnitude of the change is associated with the difference (INRtarget-INR 2). The linear change of the primary function can not meet the condition, and the selection of a quadratic function curve and a cubic function curve can be considered. And the change amplitude of the cubic function curve is too large, and finally, the quadratic function curve is selected.

The change amplitude of the INR relative to the target INR is increased and decreased in two directions, namely positive and negative changes. Whereas the quadratic function has no direction change, for which absolute values are introduced. Such as y ═ n²If the formula is changed into y ═ nx × abs (x), the direction and the polarity change.

The warfarin dosage formula is then set to:

D2＝D1+nD1×(INRtarget-INR2)×ABS(INRtarget-INR2)

and when the current INR value is equal to the target INR value, the dose adjustment amplitude is 0, and the formula meets the requirement.

Wherein the coefficient n is determined taking into account the following factors: the warfarin dose should vary by 20% if the INR value fluctuates within 1 up and down of the target INR value. If the INR value is outside of 1 above or below the target INR value, then the risk of bleeding or embolism is higher and the dose will increase as the difference between the INR value and the target INR value increases, so that the INR value returns to near the target INR value as quickly as possible. Adjusting warfarin dose when INR value fluctuates within 0.5 range above and below target INR value; above 0.5, the dose needs to be adjusted, and the warfarin dose varies by 5% when the INRtarget-INR2 value is + -0.5. When n is equal to 0.2, the above factors are satisfied. Thus, the formula for the warfarin dose obtained is:

D2＝D1+0.2D1×(INRtarget-INR2)×ABS(INRtarget-INR2)。

considering that warfarin exists in different dosage forms, such as 2.5 mg/tablet or 3.0 mg/tablet, dosage form conversion coefficient F1/F2 is added, and warfarin dosage (number of tablets) is calculated according to new dosage forms when warfarin dosage forms are changed. The final warfarin dose was calculated as:

D2＝(D1+0.2D1×(INRtarget-INR2)×ABS(INRtarget-INR2))× F1/F2。

and also considers dividing into several different application scenes according to the disease characteristics of the INR in different ranges.

When INR is too low, e.g., 1.2 or less, to prevent risk of embolism, the variation range of warfarin dosage should be 25%, not limited to the upper limit of 20%, while requiring 3 days later for review.

When the current INR value is too high, the bleeding risk needs to be vigilant, and the measures recommended for the abnormal increase of the INR are as follows:

4.5> INR >3.0 under the condition of no bleeding complications, properly reducing the variation range (5-20%) of warfarin dosage or stopping taking for 1 time, and rechecking the INR after 1-2 days. The warfarin dose was adjusted to resume treatment when the INR returned to within ± 0.5 of the target value. Or to monitor whether INR can return to therapeutic levels in a robust manner while looking for factors that may increase INR.

When no bleeding complication is 10> INR >4.5, the warfarin is stopped, vitamin K (1.0-2.5 mg) is injected intramuscularly, and the INR is rechecked after 6-12 h. Treatment was resumed with a small dose of warfarin after INR <3.

No bleeding complication INR is more than or equal to 10.0, warfarin is stopped, vitamin K (5mg) is injected intramuscularly, and the INR is rechecked after 6-12 h. Treatment was resumed with a small dose of warfarin after INR <3.

Through research, it is decided to adopt more strict measures for preventing bleeding risk:

when 3.5< ═ INR2< ═ 4.0, the administration was stopped for two days, and the administration was reduced by 25% after 2 days.

When INR2>4.0, warfarin was withheld and the patient was advised to immediately seek physician guidance.

The application of the warfarin dose formula to different INR ranges was initially set as:

1. when 1.2< INR2<3.5

D2＝(D1+0.20D1×(INRtarget-INR2)×ABS(INRtarget-INR2))×F1/F2；

2. When INR2< ═ 1.2, D2 ═ D1+0.25D1 × F1/F2

3. When 3.5< ═ INR2< ═ 4.0, D2 < > 0, and D2 after 2 days (D1-0.25D1) × F1/F2

4. When INR2>4.0, D2 ═ 0

After software development, virtual patient information is input and is handed to a clinician for trial. During the trial, some clinicians pose the following problems: 1. at too high and too low INR values, the dose adjustment is not sufficient. The adjustment amplitude is lower than the physician's experience value when INR is too high and too low. Sometimes the software gives unreasonable doses: the dose is constant after the INR value is above or below a certain value and does not change with the INR value.

Through studies, it was found that the clinician reflected the condition centered on INR values less than 1.2 and greater than 3.5. If the target INR value is 2.25, INR3.6, as originally designed, the dose calculated according to the above application 3 case is a 25% reduction. In practice, at an INR value equal to 3.45, the dose calculated according to application 1 above is a 28% reduction. 3.45 is smaller than 3.6, and the dosage changes more widely, which is more satisfactory. The same applies to INR values that are too low.

It was considered through studies that there was irrational dose adjustment when INR2 ═ 1.2 and 3.5 ═ INR2 ═ 4.0, as originally designed, and that the warfarin dose was calculated according to the following formula in both cases:

D2＝(D1+0.2D1×(INRtarget-INR2)×ABS(INRtarget-INR2))× F1/F2。

dose formula after F1/F2 adjustment:

1. when INR2<3.5, the dose formula is as follows:

D2＝(D1+0.2D1×(INRtarget-INR2)×ABS(INRtarget-INR2))× F1/F2。

F1/F22, when 3.5 ═ INR2 ═ 4.0, D2 ═ 0 (warfarin off for 2 days), after 2 days, the dose formula is as follows:

D2＝(D1+0.2D1×(INRtarget-INR2)×ABS(INRtarget-INR2))× F1/F2。

3. when INR2>4.0, D2 ═ 0, (warfarin stopped, and patients were advised to seek physician guidance immediately.

Wherein D1 is the dosage of warfarin in the past; d2 is warfarin recommended amount; INR2 is the INR value currently reviewed; INRtarget is the target INR value; f1 is a previous warfarin dosage form (mg/tablet); f2 is the current warfarin dosage form (mg/tablet).

The formulaic processing of warfarin dosage provides a calculation basis for realizing the electronic data processing of warfarin dosage and reduces the heavy calculation workload of doctors.

In step S13, in order to convert the warfarin dose, which is inconvenient to take, into a dose amount easy to divide, the warfarin dose in step S12 is converted into a dose amount of 1/4 tablets as a unit.

In step S14, the calculated amount of the 1/4 tablets taken is displayed so that the patient can take the medicine easily.

Fig. 3 shows an exemplary flowchart of the medicine dosage calculation method according to step S13 of the present application. The method for calculating the dosage comprises the following steps:

step S131: according to the principle that 7 days are the maximum cycle period and at least 4 days are taken as once, 1/4 tablet doses are taken as one interval dose, each interval dose is divided into a plurality of taking arrays in a sequence from small to large, elements of each taking array consist of m/4 and 1/4+ m/4, wherein m is a natural number, the value of an array element is the taking amount of one day, the arrangement sequence of the array elements is the taking sequence, and the number of the elements in each array is the cycle period;

step S132: and comparing the warfarin dose with the average daily dose of each administration array, and taking the administration array corresponding to the closest average daily dose as the administration amount of the warfarin dose so as to convert the warfarin dose into integral multiple of 1/4 tablets.

In step S12, the warfarin dose obtained by calculation according to the previous warfarin dose, the current international normalized ratio and the target international normalized ratio is an arbitrary number equal to or greater than zero, such as 0.1, 0.38, 0.63, 0.87, 1.46. One problem is faced with the above doses: how do patients divide the tablets? Typically, multiples of 1/4 are well divided, such as 1/4, 1/2, 3/4. However, the division is not good for 4/5, 5/6, 1/7, 1/12 and 1/14. Thus, a scheme has been proposed to convert warfarin doses to integer multiples of 1/4 tablets. And given the following equation 2:

P(m_1)＝m/4；

P(m_2)＝m/4+1/4,m/4，m/4，m/4；

P(m_3)＝m/4+1/4,m/4，m/4,m/4+1/4,m/4,m/4,m/4；

P(m_4)＝m/4+1/4,m/4，m/4；

P(m_5)＝m/4+1/4,m/4,m/4+1/4,m/4，m/4；

P(m_6)＝m/4+1/4,m/4,m/4+1/4,m/4，m/4+1/4,m/4，m/4；

P(m_7)＝m/4+1/4,m/4；

P(m_8)＝m/4+1/4,m/4+1/4,m/4,m/4+1/4,m/4,m/4+1/4,m/4；

P(m_9)＝m/4+1/4,m/4+1/4,m/4,m/4+1/4,m/4；

P(m_10)＝m/4+1/4,m/4+1/4,m/4；

P(m_11)＝m/4+1/4,m/4+1/4,m/4+1/4,m/4,m/4+1/4,m/4+1/4,m/4；

P(m_12)＝m/4+1/4,m/4+1/4,m/4+1/4，m/4；

p ((m +1) _1) ═ m +1)/4, 1/4 tablets were added daily compared to P (m _ 1); (2)

wherein m > is 0; m is a natural number.

The formula 2 is characterized in that the problem of difficulty in medicine distribution of patients is solved by adopting a method that the daily doses are different from each other and the daily doses are multiples of 1/4.

In formula 2, P (m _ n) represents an array, the number of elements in the array is 1 to 7, and 1< ═ n < ═ 12 natural numbers. The range of n can take other values to meet the requirements according to the precise requirements of the division.

If the number of array elements is 1, the number of tablets taken per day is the same. If 2, it means that 2 days is a cycle, for example: p (m _ n) ═ 1,

the oral administration of 1 tablet on the first day and the oral administration on the second day are shown

Tablets, 1 additional tablet … on the third day, and the circulation was repeated. Similarly, if P (m _ n) is 1,

it represents a 3 day cycle and so on. Obviously, the cycle period, the number of m/4 and 1/4+ m/4 and the arrangement order of each array are not necessarily the same.

If m is constant, n increases, for any value of m, P (m _1) to P (m _12), the average daily warfarin dose is gradually increased, and P (m _ n) when m is 0 is arranged as follows:

P(m_1)＝m/4；

p (m _2) ═ m/4+1/4, m/4, m/4, m/4, increased daily 1/4 ÷ 4 over P (m _1) i.e. average daily dose of 1/16 tablets, i.e. 0.0625 tablets;

p (m _3) ═ m/4+1/4, m/4, m/4, m/4+1/4, m/4, m/4, m/4, and 1/14 tablets, i.e. 0.0714 tablets, were added per day compared to P (m _ 1);

p (m _4) ═ m/4+1/4, m/4, m/4, 1/12 more tablets per day than P (m _1), i.e. 0.0833;

p (m _5) ═ m/4+1/4, m/4, m/4+1/4, m/4, m/4, and 1/10 tablets, i.e. 0.1 tablets, are added daily compared with P (m _ 1);

p (m _6) ═ m/4+1/4, m/4, m/4+1/4, m/4, m/4+1/4, m/4, m/4, and 3/28 tablets, i.e. 0.1071 tablets, were added daily compared with P (m _ 1);

p (m _7) ═ m/4+1/4, m/4, 1/8 tablets, i.e. 0.125 tablets, were added daily compared to P (m _ 1);

p (m _8) ═ m/4+1/4, m/4+1/4, m/4, m/4+1/4, m/4, m/4+1/4, m/4, 1/7 more than P (m _1) daily, i.e. 0.1429;

p (m _9) ═ m/4+1/4, m/4+1/4, m/4, m/4+1/4, m/4, 3/20 tablets, i.e. 0.15 tablets, more than P (m _1) per day;

p (m _10) ═ m/4+1/4, m/4+1/4, m/4, 1/6 tablets, i.e. 0.1667 tablets per day than P (m _ 1);

p (m _11) ═ m/4+1/4, m/4+1/4, m/4+1/4, m/4, m/4+1/4, m/4+1/4, m/4, 5/28 tablets, namely 0.1786 tablets are added daily compared with P (m _ 1);

p (m _12) ═ m/4+1/4, m/4+1/4, m/4+1/4, m/4, 3/16 tablets, i.e. 0.1875 tablets, are added daily compared with P (m _ 1);

p ((m +1) _ is (m +1)/4, m values are the same value for easy distinction, and P ((m +1) _1) represents that m is 1, and 1/4 pieces, namely 0.25 pieces are added per day compared with P (m _ 1);

p ((m +1) _2) ═ m +1)/4+1/4, (m +1)/4, (m +1)/4, (m +1)/4, and 1/16, i.e., 0.0625, tablets were added daily compared to P ((m +1) _ 1);

p ((m +1) _3) ═ m +1)/4+1/4, (m +1)/4, (m +1)/4, (m +1)/4+1/4, (m +1)/4, (m + 1)/4) was added by 1/14 tablets per day, i.e., 0.0714 tablets, as compared to P ((m +1) _ 1);

…

it can be seen that each array corresponds to an average daily dose and that the value of P (m _ n) increases as m and n increase. Specifically, the average daily dose of warfarin was gradually increased when all P (m _ n) were ranked from 0 to 1, 2, 3, 4, 5, 6, … in m, and n was from 1 to 12. If n does not change and m increases to m ', the daily average warfarin dose increases by (m' -m)/4. P ((m +1) _ n) is increased by 1/4 tablets compared with the average daily dose of P (m _ n), and is divided into 12 steps to be gradually increased.

The warfarin recommended dose D2 calculated by equation 1 is compared with the average daily dose of the P (m _ n) array, which is the dose of the patient, to find the P (m '_ n') whose average daily dose is closest to D2 among the P (m _ n) arrays arranged from small to large.

Specifically, if the warfarin recommended amount D2 calculated by equation 1 is 1.149, 1.149 tablets are orally taken daily. It is difficult for the patient to divide the tablet according to this dose. This problem can be solved using equation 2: by comparison, among P (m _ n) arranged from small to large, P (m '_ n') whose average daily dose is closest to 1.149 is found, resulting in P (m '_ n') ═ P (4_ 9). The P (4_9) group is the administration mode of the patient, i.e.

The sheet is a sheet of a plastic material,

the number of the tablets, 1 tablet,

tablet, 1 tablet is taken orally in sequence, 5 days is a cycle period, the array elements are arranged in the sequence of taking medicine, and the average daily dose is 1.15 tablets.

According to the dose of formula 2, the patient may take the same dose orally for d consecutive days, with the dose increasing or decreasing for d +1 days. Since warfarin half-life is 36-42 hours, d +1 can be set to a maximum of 4, i.e., d is a maximum of 3. Ensuring that the increasing or decreasing dosage efficacy of d +1 day is maintained until the next d +1 day. In addition, in equation 2, when m is 0, the patient may take the drug once several days, and set the maximum value of d +1 to 4, ensuring that the patient takes the drug at least once within 4 days.

When the warfarin dosage changes in a small range, the average dosage can be calculated for several days (less than one week) or every week, and the relative adjustment of the daily dosage is more accurate. In order to calculate the average dose and ensure the concentration of the drug in the patient to be stable, the maximum cycle period is set to be 7 days.

Preferably, when INR2 ≦ 1.2 and D1<1/2, the calculation formula for warfarin dosage for the day is adjusted to: d2 ═ 1/2.

Warfarin doses from the next day were calculated according to equation 1 as follows:

D2＝(D1+0.2D1×(INRtarget-INR2)×ABS(INRtarget-INR2))× F1/F2。

in some preferred embodiments, when INR2<1.5 and D1 ═ 1/4, the dosing group for warfarin is: 1/2,1/4,1/4,1/4.

In application, after the formula 2 is introduced, the problem that the dosage of 1/4 tablet units corresponding to the dosage given by the formula 1 has no change in dosage under some specific conditions is found.

The average daily dose difference between P (m _1) and P (m _2) was 0.0625 pieces, with 0.0625 pieces being the maximum average daily dose difference. When the warfarin dosage is small, if the difference between the dosage D2 calculated by the formula 1 and the last dosage D1 is less than half of 0.0625, namely 0.03125, the dosage which is closest to D2 and is obtained in the formula 2 is the last dosage, so that the dosage of warfarin is not changed.

For another example, when m is 0, the average daily dose of P (0_12) is 3/16(0.1875) tablets, the average daily dose of P (1_1) is 1/4(0.25) tablets, and the average daily dose of P (1_2) is 5/16(0.3125) tablets. When the INR value of the patient's review deviates from the target INR value by 0.75, the patient took the medicine in the administration mode of P (0_12), P (1_1) and P (1_2), respectively, the dose change calculated according to formula 1 was 0.02109 tablets, 0.02813 tablets and 0.03516 tablets (in the case of the same dosage form), and the dose change width was less than 0.03125 tablets when the patient took the medicine in the past according to P (0_12) and P (1_ 1). The dosage given in equation 2 is still the last dosage. Whereas the target INR value deviates from the target INR value by 0.75, the risk of bleeding or embolism is high and the dosage must be reduced or increased appropriately. Therefore, the above-described processing scheme in the case where the current INR value is small is given.

In addition, it is extremely rare that the amount of warfarin taken orally by a patient per day is 1/4 tablets or less, and the following reasons are generally given: 1. patients with warfarin-related gene abnormalities who can maintain satisfactory INR with a small dose of warfarin for a long period of time; 2. simultaneously taking other medicines; 3. certain specific disease states. For the latter two cases, a professional physician is typically required to guide and find the cause.

For the above case, the proposed solution of the present application is as follows: 1. when the warfarin dosage calculated by the anticoagulation management software is less than or equal to 1/4 tablets (including 0 tablet), a mode of changing the doctor right can be adopted, the anticoagulation management software does not provide a calculation result, and a doctor needs to give an anticoagulation suggestion autonomously; anticoagulation management software may still calculate the dose in the background and give the dosing method, but not visible to the doctor and patient. The dosing regimen at the small dose calculated at this time was used for study reference only. So as to solve the problem that the warfarin dosage given by the warfarin anticoagulation management software is not suitable when the dosage of the warfarin is small and the INR2 is too low.

Preferably, the method further comprises an anticoagulation reminder, the anticoagulation reminder comprising at least one of: timing medicine taking reminding, dosage reminding, review reminding and alarm reminding.

Wherein, in the regular medicine taking reminding, the medicine taking time and the reminding ring tone can be set.

At the set time point, the ring sounds to remind the patient to take the medicine. Displaying the dose of the current day when ringing, and selecting the current day not to remind quit; optionally reminding after setting the time length.

The dose reminder may be given according to the dose of formula 1 or the dose of formula 2 and graphically displays the dividing method and number of tablets.

The review reminder may remind the patient to review by ringing the bell daily from the suggested review time point. The specific ring time patient can set, but not change the date. At the set time point, a bell sounds to remind the patient to review.

According to the difference of the current international standardized ratio, the review time comprises the following steps:

when INR2< ═ 1.2, review time: after 3 days;

when 1.5 ═ INR2 ═ 3.0, the last review interval is now w weeks + d days (0 ═ d <7), then review after w +1 weeks. No more than 4 weeks maximum, where w is an integer greater than or equal to zero;

when 1.2< INR2<1.5 or 3.0< INR2< ═ 4.0, review after 1 week;

when INR2>4.0, review the day;

wherein INR2 is the current international normalized ratio.

Generally, inpatients begin monitoring INR daily or every other day after 2-3 days of oral warfarin administration until the INR reaches a target INR value and is maintained for at least 2 days. Then, the detection time is prolonged from 2-3 times per week to 1-2 times per week according to the stability of INR results, and the detection time is continuously prolonged according to the stable condition after discharge, and the detection time can be 1 time per 4 weeks. The outpatient dose should be monitored 1 time a day or 1 time a week as appropriate before the stabilization, and once INR is stabilized, it can be monitored 1 time every 4 weeks. If the dose needs to be adjusted, the previous monitoring frequency should be repeated until the INR stabilizes again.

The review time is generally determined by two parameters: 1. the INR value of the current review; 2. the time interval between the last recheck and the current recheck.

When INR is greater than 4.0, the patient's risk of bleeding increases. Require physician intervention such as withholding warfarin, using vitamin K, transfusing plasma or clotting factors, and look for the cause of INR overdose such as whether other medications are used concurrently, whether there is a drastic change in diet, whether other illnesses are being combined, and whether there is heavy drinking. Therefore, when INR2>4.0, a daily review is required and physician assistance is sought.

When INR is too low, the risk of embolism increases. The warfarin dosage needs to be increased, the efficacy is generally shown after three days, and therefore, 3 days later for review are required, namely when INR2 is less than 1.2, the review time is as follows: after 3 days.

When INR is within an acceptable range, the review time is gradually extended, but at best, it cannot exceed 4 weeks. How to extend the time is determined by the time interval between the current review and the last review. If the time interval of the last rechecking is within 1 week, namely more than or equal to 0 day and less than 7 days, the next rechecking time is 1 week later; if the time interval of the last rechecking is more than or equal to 1 week and less than 2 weeks, the next rechecking time is 2 weeks later; if the time interval of the last rechecking is more than or equal to 2 weeks and less than 3 weeks, the next rechecking time is 3 weeks later; if the time interval of the last rechecking is more than or equal to 3 weeks and less than 4 weeks, the next rechecking time is 4 weeks later; if the time interval of the last review is 4 weeks and more than 4 weeks, the time interval of the next review is 4 weeks later. That is, when 1.5 ═ INR2 ═ 3.0, the time interval of the previous review is now n weeks + m days (m and n are natural numbers, 0 ═ m <7), and the review is performed after n +1 week. The maximum is not more than 4 weeks.

When the INR deviates slightly from the target range (approximately from target INR0.5-1.0), the dose adjustment range is approximately 5-20%, and the patient can be reviewed after one week to see whether the dose adjustment is appropriate. I.e. when 1.2< INR2<1.5, or 3.0< INR2< ═ 4.0, the examination was repeated after 1 week.

Preferably, the alert prompt includes at least one of:

when the detected international standard ratio is INR <1.5 or INR >3.0, prompting periodic review;

displaying a link to the related health education content.

Specifically, when INR <1.5 for the review, daily prompts: if the INR value is too low, the physician is advised to review the INR value regularly and to read the INR value, factors influencing the warfarin curative effect and common anticoagulation complications. Clicking on the relevant link reads the relevant section health education content.

Alternatively, when the INR of the review >3.0, daily prompts: if the INR value is too high, the doctor is required to review the INR regularly, and the doctor is required to read the INR, factors influencing the curative effect of warfarin and common anti-coagulation complications. Clicking on the relevant connection may read the relevant section health education content.

The two situations are only enumeration, and corresponding alarm prompt contents can be added or deleted according to actual situations when the alarm prompt device is applied.

In some preferred embodiments, further comprising: uploading the international standardized ratio, warfarin dosage, dosage and rechecking time to medical auxiliary back-end equipment to realize anticoagulation management.

Fig. 4 shows an exemplary flow diagram of an anticoagulation management method for a medical auxiliary backend device according to an embodiment of the application, the anticoagulation management method comprising:

step S21: receiving patient information, the patient information including condition information;

step S22: according to the disease information, calculating a corresponding target international standardized ratio for the medical auxiliary terminal equipment to calculate the warfarin dosage according to the past warfarin dosage, the current international standardized ratio and the target international standardized ratio, wherein the target international standardized ratio is read from the medical auxiliary rear-end equipment; and calculating the dosage of the 1/4 tablets according to the warfarin dosage, and displaying the dosage.

The patient information includes patient personal information: the medical treatment system comprises a hospital number, a sex, a birth date, a ethnic group, a place of residence, an occupation, an education age, a contact way, and also comprises diseases and operation related information, wherein the information comprises operation time, an operation way, whether atrial fibrillation exists, cardiac function grading, past embolism history or not and the like. Which may be entered by a manager upon patient authorization. This information is stored at the back-end server, can be modified, and can be exported in batches for analysis and statistics.

In step S22, a target INR value is determined from the condition information in the patient information, as follows:

pure aortic valve mechanical valve replacement with INR target value of 2.0;

pure aortic valve replacement, INR target value 2.0;

simple mitral valve replacement, INR target value 2.0;

mitral mechanical valve replacement, INR target 2.25;

atrial fibrillation, INR target 2.25;

the history of embolism and thrombosis: INR target value 2.25;

tricuspid or mitral valve annuloplasty: INR target value 2.0;

tricuspid valve mechanical valve replacement, INR target value 2.5;

tricuspid valve biological valve replacement, INR target value 2.5.

When there are multiple conditions, the highest INR value is taken. Such as tricuspid mechanical valve replacement, mitral valve prosthetic annuloplasty patients, the target INR value takes the high value of 2.5 and 2.0, 2.5. In the present application, a corresponding target INR value may be determined by querying the corresponding target INR value according to the disease information, and when there are a plurality of diseases, a high value is selected after comparison.

Preferably, the method further comprises the following steps: and calculating Time in The Therapeutic Range (TTR) according to the international standardized ratio of a period of Time, the target international standardized ratio and the historical data of the review Time so as to evaluate the anticoagulation treatment effect, wherein the international standardized ratio and the review Time are uploaded by the medical auxiliary terminal equipment.

TTR is an important index for evaluating the anticoagulation effect within a treatment range, and the patient has high TTR which is often used for indicating lower bleeding and embolism risks; while lower TTR is closely related to higher bleeding, tamponade. The TTR is very complicated and time-consuming to calculate, and the TTR value of each patient can be calculated by adopting a Rosendal linear interpolation method according to the patient anticoagulation records uploaded by the medical auxiliary terminal equipment.

According to Rosendal Linear interpolation, TTR is calculated in the following steps: 1. collecting anticoagulation records (review time and INR values) for each review of the patient; 2. calculating the time interval between the front and the back of each time point of the reexamination; 3. half the time interval between the front and the back of each time point is added, and the time is taken as the time occupied by the INR value obtained by the rechecking; 4. finding out all anticoagulation records which meet the target INR range; 5. the percentage of the sum of the time taken for all target INR ranges to the total treatment time is calculated.

If manual calculation is adopted, a large amount of time is consumed for collecting anticoagulation information of a large number of patients and complicated calculation, and great inconvenience is brought to clinical research.

The individual patient TTR calculation method is as follows:

TTR is based on the target INR value, and the time percentage of each INR in the target treatment range is calculated, and the formula is as follows:

TTR ═ ABS (actual INR-target INR) < ═ treatment time in the range of 0.5/time from first to last review (i.e. total treatment time) within a selected time period; where ABS () is the absolute value.

Specifically, the first step: determining a target INR value according to the patient information, and further determining a target INR range from target INR-0.5 to target INR + 0.5;

the second step is that: the number of days between the first and last review was set to K1.

Then K1 is DATEDIF (T)₁,T_nAnd "D"), wherein D represents days.

Third, calculating the number of days d for each treatment period_i(ii) a Let the time point of each review be T_iThe corresponding INR value is INR_i(ii) a The number of days per review time point is d_iI is the number of rechecks; the first time of the review is 1, the last time of the review is n, and the time point of the first review is T₁The last time point of review is T_nThe INR value is checked to be INR for the first time₁The INR value is checked to be INR in the last time_n。

Days d at first review time Point₁＝0.5*DATEDIF(T₁,T₂And "D"), which is half the number of days between the first and second review time points.

Days d at last review time point_n＝0.5*DATEDIF(T_n,T_n-1And "D"), which is half the number of days between the last and the penultimate review time points.

Days d at any time point from second to last review_i＝0.5*DATEDIF(T_i+1,T_i-1D), i.e. the point in time T_iLast time of reexamination time point T_i-1And the next time of reexamination time point T_i+1Half of the days apart.

Fourthly, all INR values are within the range d of the target INR_iThe sum is added, and the number of days in the treatment range from the first to the last review of the patient is calculated and is set as K2.

Finding out the time point T of each re-check_iCorresponding INR value INR_iIf target INR-0.5<＝INR_i<Target INR +0.5, then the INR_iWithin the therapeutic range, this time point d_iA total of a number of reviews were set within the treatment range, classified as days within the treatment range at that time point.

Then

The fifth step, calculating TTR, expressed as a percentage

TABLE 1 anticoagulation record for a patient

Time (year, month and day)	Review of INR values	Target INR-0.5	Target INR +0.5	Days d
					2016.4.7	1.8	1.75	2.75	24.5
2016.5.26	3	1.75	2.75	46
					2016.7.8	3.5	1.75	2.75	50
2016.9.3	2.1	1.75	2.75	45.5
					2016.10.7	2.4	1.75	2.75	44
2016.11.30	1.3	1.75	2.75	31.5
					2016.12.9	2.3	1.75	2.75	4.5

Table 1 gives the anticoagulation record for a patient, and the process of calculating TTR is exemplified below for that patient.

The first step is as follows: based on the patient information, the target INR is 2.25, the lower limit target INR-0.5 is 1.75, and the upper limit target INR +0.5 is 2.75.

The second step is that: 2016/4/7 to 2016/12/9 total days:

K1＝DATEDIF(2016/4/7,2016/12/9,"D")＝246。

the third step: calculating di in each time period, and accurately obtaining the last two decimal points:

first-time review:

d₁＝0.5*DATEDIF(T₁,T₂,"D")＝0.5*DATEDIF(2016/4/7,2016/5/26,"D")＝ 24.5

and (3) final rechecking: 0.5 DATEDIF (T)_n,T_n-1,"D")＝d7＝0.5*DATEDIF(T₇, T₆,"D")＝4.5

Second to sixth review:

d2＝＝0.5*DATEDIF(T₃,T₁,"D")＝46

d3＝＝0.5*DATEDIF(T₄,T₂,"D")＝50

d4＝0.5*DATEDIF(T₅,T₃,"D")＝45.5

d5＝0.5*DATEDIF(T₆,T₄,"D")＝44

d6＝0.5*DATEDIF(T₇,T₅,"D")＝31.5

the fourth step: wherein INR₁，INR₄，INR₅，INR₇Within the target INR range, d₁， d₄，d₅，d₇Summing up

Then K2 ═ d1+ d4+ d5+ d7 ═ 24.5+45.5+44+4.5 ═ 118.5

The fifth step: calculating TTR

TTR＝K2/K1＝118.5/246＝0.4817＝48.17％。

The calculation of TTR may set a calculated time period. When the TTR is known from the first to the last review of a patient, the TTR is calculated according to a selected time period, and the selected time period can be inputted or selected.

In yet another aspect, the application discloses an anticoagulation management device for medical auxiliary terminal equipment.

Fig. 5 shows an exemplary structural block diagram of an anticoagulation management device 200 for medical auxiliary terminal equipment according to an embodiment of the present application. The anticoagulation management device 200 for medical auxiliary terminal equipment shown in fig. 5 may correspondingly execute the anticoagulation management method for medical auxiliary terminal equipment shown in fig. 2.

The anticoagulation management device 200 for medical auxiliary terminal equipment includes:

the receiving unit 210: a current international normalized ratio configured to receive plasma;

warfarin dose calculation unit 220: configured to calculate a warfarin dose based on a past warfarin dose, a current international normalized ratio, and a target international normalized ratio, the target international normalized ratio read from the medical assistance backend device; and

the dose amount calculation unit 230: configured to calculate 1/4 tablets based on warfarin dosage

The dosage is unit;

the display unit 240: is configured to display the dosage.

Preferably, when the current international normalized ratio is less than 3.5, the warfarin dose is calculated according to the formula:

D2＝(D1+0.2D1×(INRtarget-INR2)×ABS(INRtarget-INR2))× F1/F2。

wherein D2 is warfarin dosage, D1 is former warfarin dosage, INRtarget is target international standardized ratio, INR2 is current international standardized ratio, INR2<3.5, F1 is former warfarin dosage form, and F2 is current warfarin dosage form.

D2＝(D1+0.2D1×(INRtarget-INR2)×ABS(INRtarget-INR2))× F1/F2。

preferably, when INR2>4.0, the warfarin dose is calculated as: d2 ═ 0;

the warfarin dose calculation unit further comprises:

a prompt unit: configured to prompt the patient for physician guidance.

The principle of anticoagulation management shown in fig. 5 refers to the anticoagulation management method shown in fig. 2, and is not described herein again.

Preferably, the medicine taking amount calculating unit 230 includes:

the medicine taking array construction unit 231: the medicine taking device is configured and used for dividing the interval dose into a plurality of medicine taking arrays in a sequence from small to large by taking 1/4 tablet doses as an interval dose according to the principle that 7 days are the maximum cycle period and at least 4 days take medicine once, wherein the elements of each medicine taking array consist of m/4 and 1/4+ m/4, m is a natural number, the value of an array element is the medicine taking amount of one day, the arrangement sequence of the array elements is the medicine taking sequence, and the number of the elements in each array is a cycle period;

the dose amount determination unit 232: and (3) comparing the warfarin dose with the average daily dose of each administration array, and taking the administration array corresponding to the closest average daily dose as the administration amount of the warfarin dose so as to convert the warfarin dose into integral multiple of 1/4 tablets.

The medicine dosage calculation unit 230 shown in fig. 5 described above may correspond to the medicine dosage calculation method of step S13 shown in fig. 3.

Preferably, the device further comprises an anticoagulation reminding unit 250, which comprises at least one of: the device comprises a regular medicine taking reminding unit, a dose reminding unit, a review reminding unit and an alarm reminding unit.

In some preferred embodiments, the alert prompt unit 250 includes at least one of:

displaying a link to the related health education content.

Preferably, the method further comprises the following steps: the upload unit 260: the equipment is configured to upload the international standardized ratio, warfarin dosage, dosage and rechecking time to medical auxiliary back-end equipment so as to realize anticoagulation management.

In another aspect, the present application discloses an anticoagulation management apparatus for a medical assistance backend device.

Fig. 6 shows an exemplary structural block diagram of an anticoagulation management device for medical auxiliary backend equipment according to an embodiment of the present application, and the anticoagulation management device 300 for medical auxiliary backend equipment shown in fig. 6 may correspondingly execute the anticoagulation management method for medical auxiliary backend equipment shown in fig. 4.

The anticoagulation management device 300 for medical auxiliary backend equipment includes:

the patient information receiving unit 310: configured to receive patient information, the patient information including condition information;

target international normalized ratio calculation unit 320: the medical auxiliary terminal equipment is configured and used for calculating a corresponding target international standardized ratio according to the disease information so as to calculate the warfarin dosage according to the previous warfarin dosage, the current international standardized ratio and the target international standardized ratio, and the target international standardized ratio is read from the medical auxiliary back-end equipment; and calculating the dosage of 1/4 tablets according to the warfarin dosage, and displaying the dosage.

Preferably, the method further comprises the following steps:

the treatment-in-range time calculation unit 330: the medical auxiliary terminal device is configured for calculating time within a treatment range according to the international standardized ratio of a period of time, the target international standardized ratio and historical data of the review time so as to evaluate the effect of anticoagulation treatment, and the international standardized ratio and the review time are uploaded by the medical auxiliary terminal device.

Next, fig. 7 shows an exemplary structural block diagram of a medical assistance apparatus according to an embodiment of the present application.

As shown in fig. 7, as another aspect, the present application also provides a medical assistance apparatus 400 adapted to be used to implement the terminal apparatus or backend apparatus of the embodiments of the present application, including one or more Central Processing Units (CPUs) 401 that can perform various appropriate actions and processes according to a program stored in a Read Only Memory (ROM) 402 or a program loaded from a storage section 408 into a Random Access Memory (RAM) 403. In the RAM 403, various programs and data necessary for the operation of the system 400 are also stored. The CPU 401, ROM 402, and RAM 403 are connected to each other via a bus 404. An input/output (I/O) interface 405 is also connected to bus 404.

The following components are connected to the I/O interface 1005: an input section 406 including a keyboard, a mouse, and the like; an output section 407 including a display device such as a Cathode Ray Tube (CRT), a Liquid Crystal Display (LCD), and the like, and a speaker; a storage section 408 including a hard disk and the like; and a communication section 409 including a network interface card such as a LAN card, a modem, or the like. The communication section 409 performs communication processing via a network such as the internet. A driver 410 is also connected to the I/O interface 405 as needed. A removable medium 411 such as a magnetic disk, an optical disk, a magneto-optical disk, a semiconductor memory, or the like is mounted on the drive 410 as necessary, so that a computer program read out therefrom is mounted into the storage section 408 as necessary.

In particular, the processes described above with reference to fig. 2-4 may be implemented as computer software programs, according to embodiments of the present disclosure. For example, embodiments of the present disclosure include a computer program product comprising a computer program tangibly embodied on a machine-readable medium, the computer program comprising program code for performing an anticoagulation management method for a medical assistance terminal device provided by the embodiments of the present application or for a medical assistance backend device provided by the embodiments of the present application. In such an embodiment, the computer program may be downloaded and installed from a network through the communication section 409, and/or installed from the removable medium 411.

The flowchart and block diagrams in the figures illustrate the architecture, functionality, and operation of possible implementations of systems, methods and computer program products according to various embodiments of the present invention. In this regard, each block in the flowchart or block diagrams may represent a module, segment, or portion of code, which comprises one or more executable instructions for implementing the specified logical function(s). It should also be noted that, in some alternative implementations, the functions noted in the block may occur out of the order noted in the figures. For example, two blocks shown in succession may, in fact, be executed substantially concurrently, or the blocks may sometimes be executed in the reverse order, depending upon the functionality involved. It will also be noted that each block of the block diagrams and/or flowchart illustration, and combinations of blocks in the block diagrams and/or flowchart illustration, can be implemented by special purpose hardware-based systems which perform the specified functions or acts, or combinations of special purpose hardware and computer instructions.

As yet another aspect, the present application also provides a computer-readable storage medium, which may be the computer-readable storage medium included in the apparatus in the above-described embodiments; or it may be a separate computer readable storage medium not incorporated into the device. The computer readable storage medium stores one or more programs for use by one or more processors in performing the anticoagulation management methods described herein for performing the medical assistance terminal devices provided in the embodiments of the present application or the anticoagulation management methods for the medical assistance backend devices provided in the embodiments of the present application.

The units or modules described in the embodiments of the present application may be implemented by software or hardware. The described units or modules may also be provided in a processor, for example, each of the described units may be a software program provided in a computer or a mobile intelligent device, or may be a separately configured hardware device. Wherein the designation of a unit or module does not in some way constitute a limitation of the unit or module itself.

The above description is only a preferred embodiment of the application and is illustrative of the principles of the technology employed. It will be appreciated by a person skilled in the art that the scope of the invention as referred to in the present application is not limited to the embodiments with a specific combination of the above-mentioned features, but also covers other embodiments with any combination of the above-mentioned features or their equivalents without departing from the inventive concept. For example, the above features may be replaced with (but not limited to) features having similar functions disclosed in the present application.

Claims

1. An anticoagulation management device for medical auxiliary terminal equipment, characterized in that the anticoagulation management device comprises:

warfarin dose calculation unit: configured to calculate a warfarin dose according to a past warfarin dose, the current international normalized ratio, and a target international normalized ratio, wherein when the current international normalized ratio is less than 3.5, the warfarin dose has a calculation formula of:

D2＝(D1+0.2D1×(INRtarget-INR2)×ABS(INRtarget-INR2))×F1/F2

wherein D2 is the current warfarin dose, D1 is the previous warfarin dose, INRtarget is the target international standardized ratio, INR2 is the current international standardized ratio, INR2<3.5, F1 is the previous warfarin dosage form, F2 is the current warfarin dosage form, and the target international standardized ratio is read from the medical auxiliary backend equipment; and

a dose calculation unit: configured to calculate a dosage of 1/4 tablets based on the warfarin dosage;

a display unit: is configured to display the dosage.

2. The anticoagulation management device according to claim 1,

when INR2 is not less than 3.5 and not more than 4.0, the warfarin dosage on the day and the next day is calculated by the formula: d2 ═ 0; the formula for warfarin dosage from the third day is:

D2＝(D1+0.2D1×(INRtarget-INR2)×ABS(INRtarget-INR2))×F1/F2。

3. the anticoagulation management device according to claim 2, wherein when INR2>4.0, the warfarin dosage calculation formula is: d2 ═ 0;

the warfarin dose calculation unit further comprises:

a prompt unit: configured to prompt the patient for physician guidance.

4. The anticoagulation management device according to any one of claims 1 to 3, wherein the administration amount calculation unit comprises:

medicine taking array construction unit: the medicine taking device is configured and used for dividing the interval dose into a plurality of medicine taking arrays in a sequence from small to large by taking 1/4 tablet doses as an interval dose according to the principle that 7 days are the maximum cycle period and at least 4 days take medicine once, wherein the elements of each medicine taking array consist of m/4 and 1/4+ m/4, m is a natural number, the value of an array element is the medicine taking amount of one day, the arrangement sequence of the array elements is the medicine taking sequence, and the number of the elements in each array is a cycle period;

a dose determining unit: and comparing the warfarin dose with the average daily dose of each medicine taking array, and taking the medicine taking array corresponding to the closest average daily dose as the medicine taking amount of the warfarin dose so as to convert the warfarin dose into integral multiple of 1/4 tablets.

5. The anticoagulation management device according to claim 4,

when INR2 is less than or equal to 1.2 and D1 is less than 1/2, the calculation formula of warfarin dosage on the day is adjusted as follows: d2 ═ 1/2.

6. The anticoagulation management device according to claim 5, wherein when INR2<1.5 and D1 ═ 1/4, the dosing set for warfarin is: 1/2,1/4,1/4,1/4.

7. The anticoagulation management device according to claim 1, wherein said device further comprises an anticoagulation reminding unit comprising at least one of: the device comprises a regular medicine taking reminding unit, a dose reminding unit, a review reminding unit and an alarm reminding unit.

8. The anticoagulation management device according to claim 7, wherein said alarm prompting unit comprises at least one of:

displaying a link to the related health education content.

9. The anticoagulation management device according to claim 7, further comprising:

an uploading unit: and the system is configured and used for uploading the international standardized ratio, the warfarin dosage, the dosage and the rechecking time to the medical auxiliary back-end equipment so as to realize anticoagulation management.