CN110152087A - A kind of monitoring method of blood dialysis - Google Patents
A kind of monitoring method of blood dialysis Download PDFInfo
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- CN110152087A CN110152087A CN201910318751.0A CN201910318751A CN110152087A CN 110152087 A CN110152087 A CN 110152087A CN 201910318751 A CN201910318751 A CN 201910318751A CN 110152087 A CN110152087 A CN 110152087A
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- hematocrit
- dialysis
- patient
- ultrafiltration
- blood
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
- A61M1/14—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis
- A61M1/16—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis with membranes
- A61M1/1601—Control or regulation
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
- A61M1/14—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis
- A61M1/16—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis with membranes
- A61M1/1601—Control or regulation
- A61M1/1603—Regulation parameters
- A61M1/1611—Weight of the patient
-
- G—PHYSICS
- G06—COMPUTING; CALCULATING OR COUNTING
- G06N—COMPUTING ARRANGEMENTS BASED ON SPECIFIC COMPUTATIONAL MODELS
- G06N3/00—Computing arrangements based on biological models
- G06N3/02—Neural networks
- G06N3/08—Learning methods
- G06N3/084—Backpropagation, e.g. using gradient descent
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M2230/00—Measuring parameters of the user
- A61M2230/20—Blood composition characteristics
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M2230/00—Measuring parameters of the user
- A61M2230/30—Blood pressure
Abstract
The present invention relates to a kind of monitoring methods of blood dialysis.The described method includes: history dialysis data of the acquisition including patient history's dialysis data are pre-processed to obtain total sample set；Total sample set is divided into training set and test set；Training set is trained using BP neural network to obtain hematocrit prediction model, prediction model is tested using test set；Before patient dialyses, weight, acquisition patient after extracting last dialysis current weight and hematocrit are input in prediction model after being pre-processed these data and are predicted the hematocrit after being dialysed；The monitoring of hematocrit is carried out to Patients Undergoing Hemodialysis process using the hematocrit of prediction as thresholding.For the present invention since hematocrit thresholding is predicted using the network BP, robustness is good, and the hematocrit thresholding based on prediction carries out the intelligent monitoring of haemodialysis, and blood dialysis patient can be effectively reduced and low blood pressure probability occur.
Description
Technical field
The present invention relates to haemodialysis fields, more particularly to a kind of monitoring method of blood dialysis.
Background technique
Haemodialysis (HD) is one of acute or chronic renal failure kidneys of patients Replacement Therapy.It is by by internal blood
Liquid is drained in vitro, through one by the dialyzer that is formed without several hollow fibres, blood electrolysis similar with concentration containing body
Matter solution (dialyzate) carries out mass exchange inside and outside hollow fibre one by one, through disperse, ultrafiltration, absorption and convective principles,
It removes intracorporal metabolic waste, maintain electrolyte and acid-base balance；Moisture excessive in vivo is removed simultaneously, and will be by purification
The whole process of blood recovery is known as haemodialysis.
That is, the task of dialysis treatment first is that moisture content extra in removing machine body is reached with keeping capacitance balance
Ideal weight, that is, " dry weight " often said.
In the prior art, doctor generally estimates dry weight according to the clinical manifestation of dialysis patient, general saturating by judgement
Whether analysis patient has the progress such as lung's moist rales, oedema, changes of weight, expiratory dyspnea.The symptom and sign of fluid overload has water
It is swollen (eyelid, lower limb, it is serious when be found in whole body), hydrothorax, distension of jugular vein, hepatomegaly etc.；And low capacity state is then shown as
Thirsty, mucocutaneous, dry elasticity attenuation, eye socket recess etc..If patient does not have above-mentioned performance, it is believed that flat in body fluid
Weighing apparatus state.The method is affected by evaluator's subjective factor, and does not have specific sign.It should be noted that only working as
Water l oad significantly increases rear patient and just shows as oedema, especially patients undergoing peritoneal dialysis.
Other than the basic methods of above-mentioned clinical manifestation, ambition ratio (whether less than 0.5), the echocardiogram (heart are often combined
Dirty size variation) it assesses whether to have reached dry weight.
Based on above-mentioned stem body reevaluating, common simple and easy method be the weight after last normal dialysis is considered as roughly it is dry
Dehydrating amount when dialysing next time is considered as weight dialyse next time before and subtracts dry weight, or carries out letter on this basis by weight
Single correction.
It is above-mentioned be relatively conventional clinical assessment method, such method sensibility is poor, and do not consider patient disease, diet,
Nutrition condition etc. influences, and patient compliance's degree is difficult to ensure, and then increases difficulty and uncertainty for the determination of dry weight.
Hypotension is one of main complication in blood dialysis, thus the reason of low blood pressure first is that thoroughly
The decline of effective circulating blood volume caused by being dehydrated during analysis.
Summary of the invention
The present invention in order to overcome at least one of the drawbacks of the prior art described above (deficiency), provides one kind and passes through intellectual monitoring
The method of dialysis procedure reduces blood dialysis patient and the monitoring method of the blood dialysis of low blood pressure probability occurs.
In order to solve the above technical problems, technical scheme is as follows:
A kind of monitoring method of blood dialysis, comprising:
The history dialysis data including patient history's dialysis data are acquired to be pre-processed to obtain total sample set；
History dialysis data include the weight value and hematocrit of Before and after dialysis；
By total sample set, random division is training sample set and test sample collection according to a certain percentage；
Training sample set is trained using BP neural network to obtain hematocrit prediction model, then utilizes test
Sample set tests prediction model；
Before patient dialyses, the current weight of weight, acquisition patient after extracting last dialysis and current red
Cell pack, the data that will be extracted and acquire are input to red after being predicted to be dialysed in prediction model after being pre-processed
Cell pack；
The monitoring of hematocrit is carried out to Patients Undergoing Hemodialysis process using the hematocrit predicted as thresholding.
In above scheme, in monitoring process, when real-time detection to hematocrit value reach or it is red higher than what is predicted
When cell pack thresholding, lower ultrafiltration volume, until hematocrit is lower than predicted hematocrit.
In above scheme, also the blood pressure of patient is monitored in monitoring process, when the blood pressure for real-time monitoring patient is inclined
Ultrafiltration volume or pause ultrafiltration are reduced when from normal range (NR).
In above scheme, monitoring process further includes danger button operating procedure, when patient malaise symptoms occurs by lower button
When, button signal is received, lowers ultrafiltration volume or suspends ultrafiltration and issue alarm signal.
In above scheme, monitoring process further include: the ultrafiltration volume governing stage of setting and time correlation, lowering ultrafiltration volume is root
It is carried out according to ultrafiltration volume governing stage, after ultrafiltration volume is adjusted there is the real value of hematocrit in certain time relevant to governing stage
The ultrafiltration volume is kept when reduction, after ultrafiltration volume is adjusted there is the real value of hematocrit in certain time relevant to governing stage
Do not change or continue then to continue to adjust to next stage ultrafiltration volume when rising.
In above scheme, the adjusting number of ultrafiltration volume is no more than three times, more than then sending a warning message and suspend super three times
Filter.
Compared with the existing technology, the invention has the advantages that with effective effect:
For the present invention in the monitoring of blood dialysis, acquisition dialysis data utilize BP as sample set and test set
Network training forms the prediction model of hematocrit thresholding, acquires its current weight, red blood cell before patient per's dialysis
Hematocrit value and the weight after obtaining last dialysis in history dialysis data carry out red blood cell pressure as the input of BP network
The prediction of product thresholding, the monitoring of blood dialysis is carried out according to the hematocrit thresholding predicted.Due to hematocrit
Thresholding is predicted using the network BP, and robustness is good, and the hematocrit thresholding obtained based on prediction carries out haemodialysis
Intelligent monitoring, blood dialysis patient can be effectively reduced and low blood pressure probability occur.
Detailed description of the invention
Fig. 1 is a kind of flow chart of the monitoring method of blood dialysis of the present invention.
Specific embodiment
The attached figures are only used for illustrative purposes and cannot be understood as limitating the patent；
In order to better illustrate this embodiment, the certain components of attached drawing have omission, zoom in or out, and do not represent actual product
Size；
To those skilled in the art, it is to be understood that certain known features and its explanation, which may be omitted, in attached drawing
's.
In the description of the present invention, it is to be understood that, in addition, term " first ", " second " are used for description purposes only, and
It cannot be understood as indicating or implying relative importance or imply the quantity of indicated technical characteristic." first " that limits as a result,
One or more of the features can be expressed or be implicitly included to the feature of " second ".In the description of the present invention, unless separately
It is described, the meaning of " plurality " is two or more.
In the description of the present invention, it should be noted that unless otherwise clearly defined and limited, term " installation " " connects
Connect " it shall be understood in a broad sense, for example, it may be being fixedly connected, it may be a detachable connection, or be integrally connected；It can be machine
Tool connection, is also possible to be electrically connected；It can be directly connected, be also possible to be indirectly connected with by intermediary, it may be said that two
Connection inside element.For the ordinary skill in the art, above-mentioned term can be understood in the present invention with concrete condition
Concrete meaning.
The following further describes the technical solution of the present invention with reference to the accompanying drawings and examples.
Embodiment 1
As shown in Figure 1, a kind of specific steps of the monitoring method of blood dialysis of the present embodiment include:
S101. the history dialysis data including patient history's dialysis data are acquired to be pre-processed to obtain total sample
Collection；History dialysis data include the weight value and hematocrit of Before and after dialysis；History dialyses data can be by building one
A database stores, for extracting and call.
In the specific implementation process, patients with hemodialysis's time is longer, and urine volume can have fewer and fewer, intracorporal level
Weighing apparatus also can be increasingly worse；Based on this, the data of acquisition can be with different from, for example the history dialysis data acquired are satisfactions one
Surely the history dialysis data of the patient for duration of dialysing.In specific implementation process, it can be established according to the patient of different dialysis durations
Different hematocrit prediction model, to provide the accuracy of prediction.
S102. by total sample set, random division is training sample set and test sample collection according to a certain percentage；Preferably,
The ratio of training sample set and test sample collection is 9:1.
S103. training sample set is trained using BP neural network to obtain hematocrit prediction model, it is then sharp
Prediction model is tested with test sample collection；The training sample set for first passing through big data carries out the training of BP neural network,
The model obtained after training passes through test sample collection again and carries out prediction adjustment and correction, and the robustness of the prediction model made is more
It is good.
S104. before patient dialyses, the current weight of weight, acquisition patient after extracting last dialysis and current
Hematocrit, will extract and the data of acquisition pre-processed after be input in prediction model and predicted to obtain dialysis after
Hematocrit；Weight after last time dialysis can be extracted from history dialysis data.
S105. the prison of hematocrit is carried out to Patients Undergoing Hemodialysis process using the hematocrit predicted as thresholding
It surveys.The hematocrit value that prediction is obtained carries out the monitoring of blood dialysis as thresholding, basis can monitor in real time
Hematocrit value be compared with thresholding.
It is now recognized that it is horizontal closer to the blood volume of dialysis patient to continue blood volume determination, and blood volume changes and red blood cell
Hematocrit is inversely proportional.Measuring velocity of blood flow by ultrasound can detecte the variation of hematocrit, pass through the monitoring of hematocrit
The variation that blood volume in patients in dialysis procedure can intuitively be understood helps avoid the generation of hypotension and is conducive to
Evaluate the dry weight of patient.In the present invention, the prediction model of hematocrit thresholding is built using the dialysis data of history,
Hematocrit thresholding is predicted using the model, and the ultrafiltration in blood dialysis is monitored according to the thresholding, it can
To provide accurate auxiliary characteristics for medical staff, in monitoring process once occur real-time hematocrit be higher than it is set red
When cell pack thresholding, continue to observe dialysis procedure by lowering ultrafiltration volume.
In the specific implementation process, in monitoring process, when the hematocrit value that real-time detection arrives reaches or be higher than institute
When the hematocrit thresholding of prediction, lower ultrafiltration volume, until hematocrit is lower than predicted hematocrit.
In above scheme, also the blood pressure of patient is monitored in monitoring process, when the blood pressure for real-time monitoring patient is inclined
Ultrafiltration volume or pause ultrafiltration are reduced when from normal range (NR).
Theoretically, blood volume declines less patient's weight higher than true dry weight in dialysis procedure, blood volume variation with
Hematocrit is inversely proportional.It is red when what is real-time monitored when carrying out the monitoring of dialysis procedure by setting hematocrit thresholding
When cell pack value increases, indicate that blood volume is declining, the true weight of patient is still not up to the level of dry weight at this time, can be with
Dialysis procedure is continued to monitor, when the real value of hematocrit rises to hematocrit thresholding, can show that blood holds roughly
Amount drops to suitable level, the true weight of patient at this time closer to dry weight, at this time can by reduce ultrafiltration volume come
Continue the process of observation ultrafiltration.In actual mechanical process, needs that the ultrafiltration volume governing stage with time correlation is arranged, lower ultrafiltration volume
To be carried out according to ultrafiltration volume governing stage, after ultrafiltration volume is adjusted in relevant to governing stage certain time hematocrit it is real-time
Value keeps the ultrafiltration volume when having reduction, after ultrafiltration volume is adjusted in relevant to governing stage certain time hematocrit it is real-time
Value either with or without change or continue rise when then continue to next stage ultrafiltration volume adjust.That is, ultrafiltration volume regulated quantity and when
Between it is related, for example, the ultrafiltration volume that reduction is centainly measured in every n second of time, after lowering ultrafiltration volume, after being separated by n seconds time
It monitors that hematocrit value has decline, then current ultrafiltration volume can be kept to continue to dialyse, after lowering ultrafiltration volume, phase
It monitored that hematocrit value does not decline or still persistently rises after n seconds time, then continues the ultrafiltration to next magnitude
Amount lowers, and so adjusts.In practical operation, the general adjusting number that ultrafiltration volume is arranged is no more than three times, more than then issuing three times
Warning message simultaneously suspends ultrafiltration.
In the specific implementation process, in order to improve the safety and intelligence of monitoring, method of the invention is also to patient's
Blood pressure is monitored, and ultrafiltration volume or pause ultrafiltration are reduced when the blood pressure for real-time monitoring patient deviates normal range (NR).Specifically
When operation, can be preset according to the dialysis data of patient history reduces ultrafiltration volume or pause ultrafiltration.
In the specific implementation process, monitoring process further includes danger button operating procedure, when patient occur malaise symptoms by
When lower button, button signal is received, lower ultrafiltration volume or suspends ultrafiltration and issues alarm signal.This mode considers patient saturating
Malaise symptoms during analysis, when the patient feels are to not in due course, such as when there is spasm, slight headache, nausea symptom, Ke Yitong
Crossing by lower button reduces ultrafiltration volume or pause ultrafiltration.Likewise, when specific operation, it can be according to the dialysis number of patient history
According to come be when presetting by lower button execute reduce ultrafiltration volume or pause ultrafiltration.
The same or similar label correspond to the same or similar components；
Described in attached drawing positional relationship for only for illustration, should not be understood as the limitation to this patent；
Obviously, the above embodiment of the present invention be only to clearly illustrate example of the present invention, and not be pair
The restriction of embodiments of the present invention.For those of ordinary skill in the art, may be used also on the basis of the above description
To make other variations or changes in different ways.There is no necessity and possibility to exhaust all the enbodiments.It is all this
Made any modifications, equivalent replacements, and improvements etc., should be included in the claims in the present invention within the spirit and principle of invention
Protection scope within.
Claims (6)
1. a kind of monitoring method of blood dialysis characterized by comprising
The history dialysis data including patient history's dialysis data are acquired to be pre-processed to obtain total sample set；
History dialysis data include the weight value and hematocrit of Before and after dialysis；
By total sample set, random division is training sample set and test sample collection according to a certain percentage；
Training sample set is trained using BP neural network to obtain hematocrit prediction model, then utilizes test sample
Collection tests prediction model；
Weight, the acquisition current weight of patient and current red blood cell before patient dialyses, after extracting last dialysis
Hematocrit, the data that will be extracted and acquire are input to after being pre-processed and are predicted the red blood cell after being dialysed in prediction model
Hematocrit；
The monitoring of hematocrit is carried out to Patients Undergoing Hemodialysis process using the hematocrit predicted as thresholding.
2. the monitoring method of blood dialysis according to claim 1, which is characterized in that in monitoring process, when real-time
The hematocrit value that detects reaches or when higher than the hematocrit thresholding predicted, lowers ultrafiltration volume, until red blood cell
Hematocrit is lower than predicted hematocrit.
3. the monitoring method of blood dialysis according to claim 1, which is characterized in that also to patient in monitoring process
Blood pressure be monitored, when real-time monitor patient blood pressure deviate normal range (NR) when reduce ultrafiltration volume or pause ultrafiltration.
4. the monitoring method of blood dialysis according to claim 1, which is characterized in that monitoring process further includes urgent
Push-botton operation step receives button signal when patient malaise symptoms occurs by lower button, lowers ultrafiltration volume or pause ultrafiltration simultaneously
Issue alarm signal.
5. the monitoring method of blood dialysis according to claim 2 or 4, which is characterized in that monitoring process further include:
It is arranged and the ultrafiltration volume governing stage of time correlation, attenuating ultrafiltration volume is carried out according to ultrafiltration volume governing stage, after ultrafiltration volume is adjusted
The ultrafiltration volume is kept when the real value of hematocrit has reduction in certain time relevant to governing stage, after ultrafiltration volume is adjusted
The real value of hematocrit then continues either with or without when changing or continue and rising to next in certain time relevant to governing stage
Grade ultrafiltration volume is adjusted.
6. the monitoring method of blood dialysis according to claim 5, which is characterized in that the adjusting number of ultrafiltration volume is not
More than three times, more than then sending a warning message three times and suspend ultrafiltration.
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| CN201910318751.0A CN110152087A (en) | 2019-04-19 | 2019-04-19 | A kind of monitoring method of blood dialysis |
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Cited By (2)
| Publication number | Priority date | Publication date | Assignee | Title |
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| CN113289098A (en) * | 2021-05-25 | 2021-08-24 | 南通市第二人民医院 | Dialysate monitoring method and device based on hemodialysis device |
| CN116682566A (en) * | 2023-08-03 | 2023-09-01 | 青岛市中医医院(青岛市海慈医院、青岛市康复医学研究所) | Hemodialysis data processing method and system |
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Application publication date: 20190823 |