CN112366006A - Delivery pain assessment system and method - Google Patents
Delivery pain assessment system and method Download PDFInfo
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- CN112366006A CN112366006A CN202011354901.2A CN202011354901A CN112366006A CN 112366006 A CN112366006 A CN 112366006A CN 202011354901 A CN202011354901 A CN 202011354901A CN 112366006 A CN112366006 A CN 112366006A
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- 208000007914 Labor Pain Diseases 0.000 claims abstract description 94
- 208000035945 Labour pain Diseases 0.000 claims abstract description 94
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- 230000035606 childbirth Effects 0.000 claims abstract description 16
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- G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
- G16H80/00—ICT specially adapted for facilitating communication between medical practitioners or patients, e.g. for collaborative diagnosis, therapy or health monitoring
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- G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
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Abstract
The invention relates to a system and a method for evaluating childbirth pain. The system is provided with an NRS scale real object or a man-machine interaction device containing an NRS scale electronic image, and is further provided with a fetal heart monitor, a timer, a delivery pain management and judgment module, an abnormal uterine contraction pain judgment module, an alarm, a delivery pain grading display module, an input device, a storage device and a display. The method comprises the following steps: acquiring three parameters of NRS score, duration of one uterine contraction and interval time of two uterine contractions of a puerpera at intervals, and displaying the NRS score, the duration of one uterine contraction and the interval time of two uterine contractions in a two-dimensional score representation; judging the level or degree of labor pain according to the three parameters; and judging whether abnormal pain (pain caused by abnormal uterine contraction, such as uterine rupture, pubic symphysis and the like) exists according to the three parameters. The invention is helpful for reflecting the delivery pain degree of the lying-in woman more conveniently, quickly and accurately, and optimizing the pain management during individual delivery and the maternal-infant safety during delivery.
Description
Technical Field
The invention relates to the field of obstetrical labor pain management, in particular to a labor pain evaluation system and a labor pain evaluation method.
Background
From a pain nature, labor pain is an acute pain. The most internationally used scales for assessing labor pain are the Numerical pain Rating Scale (NRS) and the Visual Analogue Scale (VAS). NRS (FIG. 1) was considered by the American pain Association as the gold standard for pain assessment, requiring patients to select among 4 categories, 11 scores (0-10) in total, namely: no pain (0), mild pain (1-3), moderate pain (4-6), and severe pain (7-10). VAS (fig. 2) consists mainly of a 100mm straight line with one end representing "completely painless", the other end representing "the most intense pain that can be imagined" or "pain to extreme" etc., on which the patient will be asked to mark the corresponding position to represent the intensity of the pain they experience.
Both NRS and VAS belong to one-dimensional scales, are originally used for evaluating postoperative pain of patients, can only evaluate the intensity of pain, and objectively express subjective pain perception of patients in the form of numbers, characters, images, and the like. However, labor pain is a complex, multidimensional pain experience. There are certain limitations to using the above scale to assess labor pain. Studies have reported that the use of the multidimensional scale, McGill pain index (MPQ), to assess labor pain, allows detailed investigations into the nature, character, intensity, emotional state, and psychosensory aspects of pain. However, MPQ takes a long time (needs 5-15 min), has a complex structure, and is also influenced by factors such as the cultural degree, emotion, gender and race of a patient. Therefore, the use of MPQ to assess labor pain is not clinically practical.
Other pain assessment methods have also been reported in the patent literature. Patent document CN110321827A, published japanese 2019.10.11, discloses a pain level assessment method based on facial pain expression video, which is characterized in that: the method comprises a training stage and an identification stage; wherein the training phase comprises the steps of: (1) extracting facial pain expression videos from a facial pain expression video library, and editing according to a set time period and different pain levels to obtain video segments with a plurality of levels and different pain levels; (2) preprocessing video segments with different pain levels, training and constructing a pain level evaluation network comprising a convolutional neural network and a long-term and short-term memory network; the identification phase comprises the following steps: the method comprises the steps of collecting facial pain expression video clips of a patient in a set time period, using the facial pain expression video clips as input of a pain level evaluation network, and outputting pain level values corresponding to the facial pain expression video clips by the pain level evaluation network. Patent document CN110338777A, published japanese 2019.10.18, discloses a pain assessment method integrating heart rate variability features and facial expression features, which fuses the expression feature information and heart rate variability feature information into a pain fusion feature set, inputs the pain fusion feature set into an SVR regression classifier for training and learning, acquires an expression image sequence and heart rate data of a patient to be assessed to generate a pain fusion feature set to be assessed, and sends the pain fusion feature set to the trained SVR classifier for regression prediction to complete assessment of pain level. Patent document CN111210907A, published japanese patent No. 2020.05.29, discloses a pain intensity estimation method based on a space-time attention mechanism. Firstly, a face image is mapped to a pre-training model VGG-16 to obtain a depth feature map, the feature map is input to a space attention module to obtain a space attention map, and the space attention map is applied to the depth feature map to obtain space attention features. Then, the spatial attention feature extraction network is fixed, each image generates a corresponding spatial attention feature, the features are input into a recurrent neural network, a temporal attention module is followed to generate temporal attention features, and the features are used for estimating the pain intensity of the video sequence.
The pain assessment methods reported above are all based on big data, collecting human facial expression or heart rate characteristics, and obtaining a pain assessment model through machine learning. But is difficult to achieve in the absence of training data.
In general, there is a need for a method and apparatus that more easily, quickly and accurately identifies the level of pain associated with delivery of a parturient.
Disclosure of Invention
The invention aims to provide an individual, accurate and rapid delivery pain evaluation system aiming at the defects of the existing delivery pain evaluation method.
It is a further object of the present invention to provide a method of assessing labor pain for non-diagnostic and therapeutic purposes.
In order to achieve the first purpose, the invention adopts the technical scheme that:
a childbirth pain assessment system, comprising:
NRS scale for collecting NRS scores of delivery pain for the parturient;
the fetal heart monitor is used for collecting a uterine contraction pressure curve and a fetal heart rate change curve of a lying-in woman;
the timer is used for prompting a time point at which the NRS score of the puerpera needs to be acquired by using the NRS scale and prompting a time point at which the duration of one uterine contraction and the interval time between two adjacent uterine contractions need to be acquired;
the delivery pain management judgment module comprises a first uterine contraction duration time calculation submodule, a second uterine contraction interval time calculation submodule and a delivery pain grade judgment submodule; the childbirth pain grade judgment submodule is used for comparing the NRS score, the first uterine contraction duration time and the two uterine contraction interval time with a childbirth pain grade judgment rule and judging the degree and grade of the current childbirth pain;
the abnormal uterine contraction pain judging module comprises an NRS scoring curve generating submodule, a primary uterine contraction duration curve generating submodule, an interval curve generating submodule adjacent to the two uterine contractions and an abnormal uterine contraction threshold judging submodule, wherein the abnormal uterine contraction threshold judging submodule is used for comparing the NRS scoring, the primary uterine contraction duration and the interval time of the two uterine contractions with an abnormal uterine contraction pain judging rule, judging whether the abnormal uterine contraction pain is abnormal pain (pain caused by abnormal uterine contraction, such as uterine rupture, pubic symphysis separation and the like) or not, and if the abnormal uterine contraction pain is abnormal pain, starting an alarm;
the alarm is used for sending out an alarm signal;
the labor pain score display module is used for displaying the NRS score, the duration of one uterine contraction and the interval time between two adjacent uterine contractions, which are acquired and calculated at each time point, in a two-dimensional score mode;
an input device;
a storage device;
a display.
As a preferred embodiment of the present invention, the two-dimensional score is in particular in the form of: setting the NRS score as "S score", one contraction duration as "D seconds", and an interval between two adjacent contractions as "I minutes", the labor pain score display module displays the data as
In the form of (1).
As another preferred embodiment of the invention, the delivery pain assessment system is provided with a human-computer interaction device, and the NRS scale is an electronic image of the NRS scale in the human-computer interaction device.
As a preferred example, after the timer issues an execution command, the human-computer interaction device starts a voice device to prompt the parturient to select the NRS score for the pain of the current delivery according to the electronic image of the NRS scale in the form of a prompt.
As another preferred example, the delivery pain assessment system is provided with an image pickup device, and when the set NRS detection time is up and the image pickup device detects that the parturient is out of bed, an NRS score detection request is issued immediately after the parturient is detected to return to the bed.
More preferably, the labor pain assessment system is connected to the hospital hospitalization information system, when the hospital hospitalization information system indicates that a certain obstetrical hospital bed is occupied, the imaging device is started to start to collect information about whether a parturient on the hospital bed is in the bed, and when the parturient on the hospital bed is detected to be in the bed for the first time, the imaging device sends an instruction to the timer to start a timing program and start subsequent data collection.
As another preferred embodiment of the present invention, the labor pain level determination rule is:
a. no pain: NRS 0, uterus contraction
b. Mild pain: NRS 1-3, uterus shrinkage
c. Moderate pain: NRS 4-6, uterus shrinkage
d. Severe pain: NRS 7-10, uterus shrinkage
As another preferred embodiment of the present invention, the abnormal uterine contraction pain determination rule is:
a. uterine contraction with the uterine contraction over-strong NRS of 8-10
b. Uterine contraction overfrequency NRS 6-10
c. Uterine hypersystole or overfrequency: the occurrence of uterine hypercontractility is more than or equal to 2 times within 5 min.
As another preferred embodiment of the invention, the NRS scale is a paper, wood or plastic real object, or a picture in an electronic image format, and a mobile phone or a tablet computer is used as a carrier; the input device is used for manually inputting the collected NRS scores.
In order to achieve the second object, the invention adopts the technical scheme that:
a method of assessing labor pain for non-diagnostic and therapeutic purposes using a labor pain assessment system as claimed in any preceding claim.
The invention has the advantages that:
1. in the aassessment to the childbirth pain, select NRS mark and uterus shrinkage information for use as the aassessment foundation, and extract a uterus shrinkage duration and two times uterus shrinkage interval time as specific aassessment parameter, the selection of parameter is reasonable, the limitation of single dimension pain aassessment has been broken through, possess simultaneously and gather conveniently, easy operation's advantage, even can also accomplish whole collection process in 2 ~ 3min under NRS mark uses NRS scale real object face-to-face direct inquiry's mode, be convenient for the real-time supervision of lying-in woman's childbirth pain state, can also guarantee the accurate painful degree of lying-in woman's childbirth of reflecting.
2. The NRS score, the duration time of one uterine contraction and the interval time of two uterine contractions are displayed by a two-dimensional score representation method, so that the method is very intuitive, a doctor can conveniently and quickly know the conditions and make a decision, and a better management effect of labor pain is obtained.
3. The delivery pain assessment data are monitored and compared, the design rule is reasonable, the delivery pain can be assessed comprehensively and accurately, a more refined and individualized analgesia scheme is adopted, abnormal uterine contraction pain in the labor process is found in time, abnormal and critical delivery conditions are investigated in time, and the delivery analgesia quality and safety are improved remarkably.
4. We find that the puerperal delivery pain receives the influence of treating the work of delivery room medical personnel great, consequently, the data acquisition process is all automatic, through the painful NRS score of bedside human-computer interaction equipment regular acquisition delivery, connect the painful monitoring of delivery that the hospital in information system starts the puerperal, through camera device real-time supervision delivery bed puerperal whether in bed, thereby control entire system's data acquisition, medical personnel have been reduced and have been waited the delivery room and have walked, and then the influence to the puerperal has been reduced, the painful degree of accurate reflection delivery, thereby the management of the individualized analgesia of delivery is guided, improve puerperal delivery comfort level and mother and infant safety.
5. The system of the invention has lower economic cost and is easy to realize.
Drawings
Figure 1 is the NRS scale.
Figure 2 is a VAS scale.
Fig. 3 is a flow chart of a method of assessing labor pain in accordance with the present invention.
Figure 4 is a graph of normal uterine contraction pressure (uterine contraction pain).
Fig. 5 is a schematic of the duration of one contraction and the interval between two adjacent contractions.
Fig. 6 is a schematic diagram showing a labor pain level determination rule.
FIG. 7 is a schematic diagram of the abnormal uterine contraction pain judgment rule.
Fig. 8 is a block diagram of a labor pain assessment system according to the present invention.
Fig. 9 is a block diagram of another labor pain assessment system in accordance with the present invention.
Detailed Description
To solve the problem of lack of a rapid, simple and accurate method for assessing the level of labor pain in clinical practice, the present inventors have recognized that one-dimensional NRS has the advantage of being rapid and intuitive in assessing labor pain based on abundant obstetrical clinical work experience and research experience, and also recognized the complexity of labor pain compared to general pain, namely: labor pain in the first labor is mainly visceral pain, due to uterine contractions and cervical dilatation; the second stage of labor is mainly somatic pain, during contraction, the lowering of fetal head against pelvic floor tissue and dilation of cervix are the main causes of pain, i.e. contraction is the main cause of labor pain, therefore NRS and contraction are used in combination for labor pain assessment. And the NRS score, the duration of one uterine contraction and the interval time between two adjacent uterine contractions are displayed in a two-dimensional score form, so that medical staff can quickly and directly know the full view of the delivery pain degree of the lying-in woman. Furthermore, the inventor has recognized that the labor of the parturient is adversely affected by the movement and inquiry of the hospital staff in the delivery room, and therefore the parameter acquisition for the evaluation of the degree of labor pain is set to be automatic at regular intervals, and it is found that the degree of labor pain of the parturient can be significantly reduced. The present invention has been accomplished based on this.
The technical solutions of the present invention will be described clearly and completely below, and it should be apparent that the described embodiments are some, but not all, embodiments of the present invention.
The reference numbers and meanings in the drawings are as follows:
example 1
Referring to fig. 3, fig. 3 is a flowchart of a method for evaluating labor pain according to the present invention, including the following steps:
s1, during parturition, the woman' S own pain scores are collected at intervals using the NRS scale.
In the step, a parturient can be directly asked by an obstetrical nurse in a face-to-face manner to obtain a result, and the parturient can be asked to select a pain score by the obstetrical nurse by carrying an NRS scale real object made of paper, wood or plastic materials and the like; the device carrying the electronic image NRS scale can also be carried, such as a mobile phone, a tablet computer and the like, so that the lying-in woman can select the pain score.
The pain scoring adopts NRS scale 0-10 edition: no pain (0), mild pain (1-3), moderate pain (4-6), and severe pain (7-10). The score is denoted by S.
In the case that the detection result indicates that the parturient has no abnormality, the NRS score is usually collected once every 10 minutes.
And S2, acquiring the uterine contraction data of the lying-in woman, wherein the uterine contraction data comprise duration of one uterine contraction and interval time between two adjacent uterine contractions.
After a parturient enters a room to be parturient, the fetus heart monitor starts to monitor the electrocardiogram of the fetus, the fetus heart monitoring graph of the fetus heart monitor comprises a uterine contraction pressure curve, the normal uterine contraction pressure curve is generally in a wave shape as a whole, the intrauterine pressure value of a vertical coordinate is gradually increased and rises when uterine contraction occurs, when the uterine contraction reaches the maximum degree and starts to be relieved, the intrauterine pressure value starts to be reduced, the curve is also reduced at the same time, and the curve of a complete uterine contraction process is in a parabola shape. The intrauterine pressure value between two contractions is basically stable, so that a relatively straight line segment (figure 4) is shown between two parabolas on the uterine contraction pressure curve diagram. The duration of one uterine contraction, namely the time span of a complete parabola on the uterine contraction pressure curve, is acquired through the uterine contraction pressure curve on the fetal heart monitor, and the interval time of two adjacent uterine contractions, specifically the time difference between the starting occurrence time of one uterine contraction and the ending time of the last uterine contraction, is acquired through the uterine contraction pressure curve (fig. 5). The duration of one contraction is denoted by D and the interval between two adjacent contractions is denoted by I.
The time point of acquiring the uterine contraction data is synchronized with the time when the puerpera gives the NRS score, namely, the duration of one uterine contraction and the interval time between two adjacent uterine contractions, which are the closest to the time point when the puerpera gives the NRS score, are acquired.
S3, presenting the collected NRS scale score and duration of one contraction, time between two adjacent contractions as a two-dimensional score, as follows:
and S4, the obstetrician determines the degree and the grade of the uterine contraction pain of the parturient according to the judgment rule of the grade of the labor pain.
Generally, the obstetrician compares the result of labor pain scoring in the form of a two-dimensional score at a certain time point with the labor pain level decision rule. Based on the prior study, the labor pain level decision rule (fig. 6) was as follows:
a. no pain: NRS 0, uterus contraction
b. Mild pain: NRS 1-3, uterus shrinkage
c. Moderate pain: NRS 4-6, uterus shrinkage
d. Severe pain: NRS 7-10, uterus shrinkage
S5, in the process of evaluating the labor pain degree, the obstetrician further determines whether the uterine contraction pain of the lying-in woman is normal according to the abnormal uterine contraction pain judgment rule. Based on the previous study, the abnormal uterine contraction pain determination rule (fig. 7) was as follows:
a. uterine contraction with the uterine contraction over-strong NRS of 8-10
b. Uterine contraction overfrequency NRS 6-10
c. Uterine hypersystole or overfrequency: the occurrence of uterine hypercontractility is more than or equal to 2 times within 5 min.
When abnormal uterine contraction pain is judged, special attention is given to the puerpera, abnormal delivery and crisis conditions, such as the existence of pubic symphysis separation, uterine rupture, head basin asymmetry and the like, are timely and actively taken, and the incidence rate of adverse events of mothers and infants is reduced.
Example 2
This example provides another labor pain assessment method of the present invention, comprising the steps of:
s1, during parturition, the woman' S own pain scores are collected at intervals using the NRS scale.
In the step, each sickbed of a delivery room in a hospital is provided with a special man-machine interaction device, the man-machine interaction device is connected with a hospital hospitalization information system, when the hospital hospitalization information system inputs hospital bed information to prompt that the sickbed is occupied, the man-machine interaction device starts a query mode, an NRS scale electronic image is called out, a voice prompt is automatically sent every 3 minutes to prompt a puerpera to select pain and score, the puerpera is transacted with hospitalization procedures, and after lying on the sickbed, the operation is prompted according to the voice of the man-machine interaction device.
The pain scoring adopts NRS scale 0-10 edition: no pain (0), mild pain (1-3), moderate pain (4-6), and severe pain (7-10). The score is denoted by S.
In the case that the detection result indicates that the parturient has no abnormality, the NRS score is usually collected once every 10 minutes.
And S2, acquiring the uterine contraction data of the lying-in woman, wherein the uterine contraction data comprise duration of one uterine contraction and interval time between two adjacent uterine contractions.
After a parturient enters a room to be parturient, the fetus heart monitor starts to monitor the electrocardiogram of the fetus, the fetus heart monitoring graph of the fetus heart monitor comprises a uterine contraction pressure curve, the normal uterine contraction pressure curve is generally in a wave shape as a whole, the intrauterine pressure value of a vertical coordinate is gradually increased and rises when uterine contraction occurs, when the uterine contraction reaches the maximum degree and starts to be relieved, the intrauterine pressure value starts to be reduced, the curve is also reduced at the same time, and the curve of a complete uterine contraction process is in a parabola shape. The intrauterine pressure value between two contractions is basically stable, so that a relatively straight line segment (figure 4) is shown between two parabolas on the uterine contraction pressure curve diagram. The duration of one uterine contraction, namely the time span of a complete parabola on the uterine contraction pressure curve, is acquired through the uterine contraction pressure curve on the fetal heart monitor, and the interval time of two adjacent uterine contractions, specifically the time difference between the starting occurrence time of one uterine contraction and the ending time of the last uterine contraction, is acquired through the uterine contraction pressure curve (fig. 5). The duration of one contraction is denoted by D and the interval between two adjacent contractions is denoted by I.
The time point of acquiring the uterine contraction data is synchronized with the time when the puerpera gives the NRS score, namely, the duration of one uterine contraction and the interval time between two adjacent uterine contractions, which are the closest to the time point when the puerpera gives the NRS score, are acquired.
S3, presenting the collected NRS scale score and duration of one contraction, time between two adjacent contractions as a two-dimensional score, as follows:
and S4, the obstetrician determines the degree and the grade of the uterine contraction pain of the parturient according to the judgment rule of the grade of the labor pain.
Generally, the obstetrician compares the result of labor pain scoring in the form of a two-dimensional score at a certain time point with the labor pain level decision rule. Based on the prior study, the labor pain level decision rule (fig. 6) was as follows:
a. no pain: NRS 0, uterus contraction
b. Mild pain: NRS 1-3, uterus shrinkage
c. Moderate pain: NRS 4-6, uterus shrinkage
d. Severe pain: NRS 7-10, uterus shrinkage
S5, in the process of evaluating the labor pain degree, the obstetrician further determines whether the uterine contraction pain of the lying-in woman is normal according to the abnormal uterine contraction pain judgment rule. Based on the previous study, the abnormal uterine contraction pain determination rule (fig. 7) was as follows:
a. uterine hypersystole: 8-10% NRS uterine contraction
b. Uterine contraction and overfrequency: NRS 6-10, uterus shrinkage
c. Uterine hypersystole or overfrequency: the occurrence of uterine hypercontractility is more than or equal to 2 times within 5 min.
When abnormal uterine contraction pain is judged, special attention is given to the puerpera, abnormal delivery and crisis conditions, such as the existence of pubic symphysis separation, uterine rupture, head basin asymmetry and the like, are timely and actively taken, and the incidence rate of adverse events of mothers and infants is reduced.
Example 3
This example provides another labor pain assessment method of the present invention, comprising the steps of:
s1, during parturition, the woman' S own pain scores are collected at intervals using the NRS scale.
In the step, each sickbed of a delivery room in a hospital is provided with a special man-machine interaction device, the man-machine interaction devices are connected with a hospital hospitalization information system, when the hospital hospitalization information system records that the sickbed is occupied, the camera device is used for detecting whether a puerpera is in the bed or not, if the puerpera is detected to be in the bed for the first time, an instruction is sent to the man-machine interaction devices, the man-machine interaction devices start an inquiry mode, an NRS scale electronic image is called out, and a voice prompt is sent to prompt the puerpera to select pain scoring.
The pain scoring adopts NRS scale 0-10 edition: no pain (0), mild pain (1-3), moderate pain (4-6), and severe pain (7-10). The score is denoted by S.
In the case that the detection result indicates that the parturient has no abnormality, the NRS score is usually collected once every 10 minutes. In addition, the in-bed or out-of-bed state of the lying-in woman on the sickbed is detected through the camera device, when the NRS detection time set in the whole monitoring process is up and the camera device detects that the lying-in woman is in the out-of-bed state, an NRS scoring detection request is sent out immediately after the lying-in woman returns to the bed.
And S2, acquiring the uterine contraction data of the lying-in woman, wherein the uterine contraction data comprise duration of one uterine contraction and interval time between two adjacent uterine contractions.
After a parturient enters a room to be parturient, the fetus heart monitor starts to monitor the electrocardiogram of the fetus, the fetus heart monitoring graph of the fetus heart monitor comprises a uterine contraction pressure curve, the normal uterine contraction pressure curve is generally in a wave shape as a whole, the intrauterine pressure value of a vertical coordinate is gradually increased and rises when uterine contraction occurs, when the uterine contraction reaches the maximum degree and starts to be relieved, the intrauterine pressure value starts to be reduced, the curve is also reduced at the same time, and the curve of a complete uterine contraction process is in a parabola shape. The intrauterine pressure value between two contractions is basically stable, so that a relatively straight line segment (figure 4) is shown between two parabolas on the uterine contraction pressure curve diagram. The duration of one uterine contraction, namely the time span of a complete parabola on the uterine contraction pressure curve, is acquired through the uterine contraction pressure curve on the fetal heart monitor, and the interval time of two adjacent uterine contractions, specifically the time difference between the starting occurrence time of one uterine contraction and the ending time of the last uterine contraction, is acquired through the uterine contraction pressure curve (fig. 5). The duration of one contraction is denoted by D and the interval between two adjacent contractions is denoted by I.
The time point of acquiring the uterine contraction data is synchronized with the time when the puerpera gives the NRS score, namely, the duration of one uterine contraction and the interval time between two adjacent uterine contractions, which are the closest to the time point when the puerpera gives the NRS score, are acquired.
S3, presenting the collected NRS scale score and duration of one contraction, time between two adjacent contractions as a two-dimensional score, as follows:
and S4, the obstetrician determines the degree and the grade of the uterine contraction pain of the parturient according to the judgment rule of the grade of the labor pain.
Generally, the obstetrician compares the result of labor pain scoring in the form of a two-dimensional score at a certain time point with the labor pain level decision rule. Based on the prior study, the labor pain level decision rule (fig. 6) was as follows:
a. no pain: NRS 0, uterus contraction
b. Mild pain: NRS 1-3, uterus shrinkage
c. Moderate pain: NRS 4-6, uterus shrinkage
d. Severe pain: NRS 7-10, uterus shrinkage
S5, in the process of evaluating the labor pain degree, the obstetrician further determines whether the uterine contraction pain of the lying-in woman is normal according to the abnormal uterine contraction pain judgment rule. Based on the previous study, the abnormal uterine contraction pain determination rule (fig. 7) was as follows:
a. uterine contraction with the uterine contraction over-strong NRS of 8-10
b. Uterine contraction overfrequency NRS 6-10
c. Uterine hypersystole or overfrequency: the occurrence of uterine hypercontractility is more than or equal to 2 times within 5 min.
When abnormal uterine contraction pain is judged, special attention is given to the puerpera, abnormal delivery and crisis conditions, such as the existence of pubic symphysis separation, uterine rupture, head basin asymmetry and the like, are timely and actively taken, and the incidence rate of adverse events of mothers and infants is reduced.
Example 4
Referring to fig. 8, fig. 8 is a block diagram of a labor pain assessment system according to the present invention. The labor pain evaluation system is provided with:
The fetal heart monitor 2 is used for collecting the uterine contraction pressure curve of the lying-in woman.
And the timer 3 is used for prompting the time point of acquiring the NRS score of the puerpera by using the NRS scale 1 and prompting the time point of acquiring the duration of one uterine contraction and the time point of the interval time between two adjacent uterine contractions.
The delivery pain management decision module 4 includes a contraction duration calculation submodule 41, an interval time between adjacent contractions calculation submodule 42, and a delivery pain level decision submodule 43. The primary uterine contraction duration calculation submodule 41 is configured to calculate a primary uterine contraction duration of each time point set by the nearest timer 3 according to a uterine contraction pressure curve acquired by the fetal heart monitor 2. The adjacent two-time uterine contraction interval time calculation submodule 42 is configured to calculate an adjacent two-time uterine contraction interval time at each time point set by the nearest timer 3 according to the uterine contraction pressure curve acquired by the fetal heart monitor 2. The labor pain grade judging submodule 43 is configured to compare the NRS score collected by the NRS scale 1, the first uterine contraction duration calculated by the first uterine contraction duration calculating submodule 41, and the second uterine contraction interval calculated by the adjacent two uterine contraction interval calculating submodule 42 with a labor pain grade judging rule, if the judgment result is no pain, mild pain, or severe pain, continue to collect relevant data at the originally set time interval, if the judgment result is severe pain, start the timer 3 to adjust the time interval of data collection to 2 minutes, continuously collect the data for two times, and if the two labor pain degree evaluation results are both severe pain, start the alarm 6.
The abnormal uterine contraction pain judging module 5 comprises an NRS scoring curve generating submodule 51, a first uterine contraction duration curve generating submodule 52 and a second adjacent uterine contraction interval curve generating submodule 53, and the three modules are respectively used for drawing corresponding curves according to the NRS scoring, the first uterine contraction duration and the second adjacent uterine contraction interval time acquired at each time point so as to facilitate an obstetrician to observe the tendency of each pain parameter of a puerpera. The abnormal uterine contraction pain determination module 5 further comprises an abnormal uterine contraction threshold determination submodule 54 for comparing the NRS score, the duration of one uterine contraction and the interval time between two adjacent uterine contractions with an abnormal uterine contraction pain determination rule, wherein the abnormal uterine contraction pain determination rule is as follows: a. uterine contraction with the uterine contraction over-strong NRS of 8-10
b. Uterine contraction overfrequency NRS 6-10
c. Uterine hypersystole or overfrequency: when the uterine contraction is not less than 2 times within 5min, judging abnormal uterine contraction pain, starting alarm6。
And the alarm 6 is used for sending an alarm signal and can be a sound alarm, a light alarm or a combination of the sound alarm and the light alarm. Different alarm signals are issued for the commands of the delivery pain management decision module 4 and the abnormal uterine contraction pain decision module 5 to help the differentiation. After the alarm 6 sends out an alarm signal, the medical staff is prompted to carry out analgesia management on the lying-in woman or investigate the abnormal delivery condition and the crisis condition. The alarm 6 can also be provided with color warning, and if the uterine contraction pain is judged to be normal, the color warning is displayed as green; if abnormal pain is judged, the color is continuously red; no judgment or other conditions (no relevant determinable data, no shrinkage or over shrinkage in the detection interval, machine or system failure) are displayed in yellow.
A labor pain score display module 7 for displaying the NRS score, the duration of one contraction and the interval between two adjacent contractions collected at each time point in the form of two-dimensional scores, and assuming that the NRS score is "S score", the duration of one contraction is "D seconds", and the interval between two adjacent contractions is "I minutes", the labor pain score display module 7 displays the data as "S score", the duration of one contraction is "D seconds", and the interval between two adjacent contractions is "I minutes"
In the form of (1).
And an input device 8 for inputting the NRS score collected by the NRS scale 1 into the labor pain assessment system of the present invention, and additionally, for inputting maternal case information including name, age, gestational week, bed number, number of labor, and the like.
And the storage device 9 is used for storing the NRS scores acquired by the NRS scale 1 and the uterine contraction pressure curves acquired by the fetal heart monitor 2, and the calculated parameters comprise a detection time point, duration of one uterine contraction, interval time of two adjacent uterine contractions, a generated NRS score curve, information of puerperal cases and the like.
And a display 10 for displaying the result of the labor pain determination at each time point in the form of a two-dimensional score processed by the labor pain score display module 7, and further displaying the NRS score curve, the one-contraction duration curve, the adjacent two-contraction interval time curve, and the maternal case information.
Example 5
Referring to fig. 9, fig. 9 is a block diagram of another labor pain assessment system according to the present invention. The labor pain evaluation system is provided with:
and the man-machine interaction device 13 is internally provided with an electronic image of the NRS measuring scale, and after the timer 3 sends an execution command, a voice device is started to prompt the puerpera to select the NRS score for the pain of the current delivery according to the electronic image of the NRS measuring scale in a prompt language mode.
The fetal heart monitor 2 is used for collecting the uterine contraction pressure curve of the lying-in woman.
And the timer 3 is used for prompting a time point when the NRS score of the puerpera needs to be acquired by using the NRS scale and prompting a time point when the duration of one uterine contraction and the interval time adjacent to the two uterine contractions need to be acquired.
The delivery pain management decision module 4 includes a contraction duration calculation submodule 41, an interval time between adjacent contractions calculation submodule 42, and a delivery pain level decision submodule 43. The primary uterine contraction duration calculation submodule 41 is configured to calculate a primary uterine contraction duration of each time point set by the nearest timer 3 according to a uterine contraction pressure curve acquired by the fetal heart monitor 2. The adjacent two-time uterine contraction interval time calculation submodule 42 is configured to calculate an adjacent two-time uterine contraction interval time at each time point set by the nearest timer 3 according to the uterine contraction pressure curve acquired by the fetal heart monitor 2. The childbirth pain grade judgment submodule 43 is configured to compare the NRS score collected by the human-computer interaction device 13, the first uterine contraction duration calculated by the first uterine contraction duration calculation submodule 41, and the second uterine contraction interval calculated by the adjacent two uterine contraction interval calculation submodule 42 with the childbirth pain grade judgment rule, if the result is no pain, mild pain, or severe pain, continue to collect relevant data according to a set time interval, if the result is severe pain, start the timer 3 to adjust the time interval of data collection to 2 minutes, continuously collect the data twice, and if the two childbirth pain degree evaluation results are both severe pain, start the alarm 6.
Abnormal uterine contraction pain judging dieAnd the block 5 comprises an NRS scoring curve generation submodule 51, a first uterine contraction duration curve generation submodule 52 and a second uterine contraction interval time curve generation submodule 53 adjacent to the first uterine contraction duration curve, wherein the NRS scoring curve generation submodule 51, the first uterine contraction duration curve generation submodule 52 and the second uterine contraction interval time curve generation submodule 53 are respectively used for drawing corresponding curves according to the NRS scoring, the first uterine contraction duration and the second uterine contraction interval time collected at each time point so as to facilitate an obstetrician to observe the tendency of each pain parameter of the lying-in woman. The abnormal uterine contraction pain judgment module 5 further comprises an abnormal uterine contraction threshold judgment submodule 54 for comparing the data calculated by the submodules with an abnormal uterine contraction pain judgment rule, wherein the abnormal uterine contraction pain judgment rule is as follows: a. uterine contraction with the uterine contraction over-strong NRS of 8-10
b. Uterine contraction overfrequency NRS 6-10
c. Uterine hypersystole or overfrequency: when the uterine contraction is over-strong for more than or equal to 2 times within 5min, the alarm 6 is started when abnormal uterine contraction pain is judged.
And the alarm 6 is used for sending an alarm signal and can be a sound alarm, a light alarm or a combination of the sound alarm and the light alarm. Different alarm signals are issued for the commands of the delivery pain management decision module 4 and the abnormal uterine contraction pain decision module 5 to help the differentiation. After the alarm 6 sends out an alarm signal, the medical staff is prompted to carry out analgesia management on the lying-in woman or investigate the abnormal delivery condition and the crisis condition. The alarm 6 can also be provided with color warning, and if the uterine contraction pain is judged to be normal, the color warning is displayed as green; if abnormal pain is judged, the color is continuously red; no judgment or other conditions (no relevant determinable data, no shrinkage or over shrinkage in the detection interval, machine or system failure) are displayed in yellow.
A labor pain score display module 7 for displaying the NRS score, the duration of one contraction and the interval between two adjacent contractions collected at each time point in the form of two-dimensional scores, and assuming that the NRS score is "S score", the duration of one contraction is "D seconds", and the interval between two adjacent contractions is "I minutes", the labor pain score display module 7 displays the dataIs composed of
In the form of (1).
And the input device 8 is used for inputting the case information of the lying-in woman, including name, age, gestational week, bed position number, delivery times and the like.
The storage device 9 is used for storing the NRS score collected by the human-computer interaction device 13, the uterine contraction pressure curve collected by the fetal heart monitor 2, and the calculated parameters include time points, duration of one uterine contraction, interval time between two adjacent uterine contractions, the generated NRS score curve, the duration curve of one uterine contraction, the interval time between two adjacent uterine contractions, and the like.
And a display 10 for displaying the result of the labor pain determination at each time point in the form of a two-dimensional score processed by the labor pain score display module 7, and further displaying the NRS score curve, the one-contraction duration curve, the adjacent two-contraction interval time curve, and the maternal case information.
And the camera device 11 is used for acquiring the information whether the puerpera on the sickbed is in the bed or not. When the set NRS detection time is up and the imaging device 11 detects that the lying-in woman is in the out-of-bed state, an NRS scoring detection request is sent immediately after the lying-in woman is detected to return to the bed.
The hospital hospitalization information system 12 is used for being connected with the labor pain evaluation system, when the labor pain evaluation system of the invention receives that a certain obstetrical hospital bed of the hospital hospitalization information system 12 is occupied, the camera device 11 is started to start to collect information whether a lying-in woman is in the bed on the hospital bed, when the lying-in woman in the hospital bed is detected to be in the bed for the first time, a command is further sent to the timer 3, a timing program is started, and subsequent data collection is started.
For the above embodiments, it should be noted that in the assessment of childbirth pain, the invention selects few and precise assessment parameters, which not only breaks through the limitation of single-dimensional pain assessment, but also ensures the advantages of convenient collection and simple operation, and also ensures that the childbirth pain degree of the puerpera can be accurately reflected. On the display of the pain level, we setThe labor pain score display module 7 is used for collecting and calculating NRS scores at all time points, duration of one contraction and interval time between two adjacent contractions as two-dimensional scores
The form display is convenient for doctors to quickly and intuitively know the situation and make decisions. In the monitoring process of the labor pain degree, the labor pain degree is automatically evaluated by using rules accumulated by experience, the designed rules are reasonable, the labor pain can be comprehensively and accurately evaluated, a more refined and individualized analgesia scheme is adopted, abnormal uterine contraction pain in the labor process is timely found, and abnormal and critical conditions of labor are timely investigated. The parturient labor pain monitoring system not only realizes simple, convenient, rapid and accurate monitoring of the parturient labor process, but also finds important factors influencing the parturient labor pain degree, and completely designs the labor pain data acquisition mode into an automatic mode, thereby further remarkably reducing the clinical parturient labor pain feeling and improving the labor pain management quality.
The above description is only a preferred embodiment of the present invention, and it should be noted that, for those skilled in the art, several modifications and additions can be made without departing from the method of the present invention, and these modifications and additions should also be regarded as the protection scope of the present invention.
Claims (10)
1. A labor pain assessment system, comprising:
NRS scale for collecting NRS scores of delivery pain for the parturient;
the fetal heart monitor is used for collecting a uterine contraction pressure curve and a fetal heart rate change curve of a lying-in woman;
the timer is used for prompting a time point at which the NRS score of the puerpera needs to be acquired by using the NRS scale and prompting a time point at which the duration of one uterine contraction and the interval time between two adjacent uterine contractions need to be acquired;
the delivery pain management judgment module comprises a first uterine contraction duration time calculation submodule, a second uterine contraction interval time calculation submodule and a delivery pain grade judgment submodule; the childbirth pain grade judgment submodule is used for comparing the NRS score, the first uterine contraction duration time and the two uterine contraction interval time with a childbirth pain grade judgment rule and judging the degree and grade of the current childbirth pain;
the abnormal uterine contraction pain judging module comprises an NRS scoring curve generating submodule, a primary uterine contraction duration curve generating submodule, an adjacent two-uterine contraction interval time curve generating submodule and an abnormal uterine contraction threshold judging submodule, wherein the abnormal uterine contraction threshold judging submodule is used for comparing the NRS scoring, the primary uterine contraction duration and the two-uterine contraction interval time with an abnormal uterine contraction pain judging rule and judging whether the abnormal uterine contraction pain is abnormal pain or not, and if the abnormal uterine contraction pain is abnormal pain, an alarm is started;
the alarm is used for sending out an alarm signal;
the labor pain score display module is used for displaying the NRS score, the duration of one uterine contraction and the interval time between two adjacent uterine contractions, which are acquired and calculated at each time point, in a two-dimensional score mode;
an input device;
a storage device;
a display.
2. The labor pain assessment system of claim 1, wherein the two-dimensional score is in the form of: setting the NRS score as "S score", one contraction duration as "D seconds", and an interval between two adjacent contractions as "I minutes", the labor pain score display module displays the data as
In the form of (1).
3. The labor pain assessment system of claim 1, wherein the labor pain assessment system is provided with a human interaction device, and the NRS scale is an electronic image of the NRS scale in the human interaction device.
4. The labor pain assessment system of claim 3, wherein after the timer issues an execution command, the human-machine interaction device activates a voice device to prompt the parturient to select an NRS score for the pain at the time of labor based on the electronic image of the NRS scale in the form of a prompt.
5. The labor pain assessment system according to claim 3, wherein the labor pain assessment system is provided with an image capturing device, when the set NRS detection time is up and the image capturing device detects that the parturient is out of bed, an NRS score detection request is issued immediately after the parturient is detected to return to the bed.
6. The labor pain assessment system according to claim 5, wherein the labor pain assessment system is connected to the hospital hospitalization information system, when the hospital hospitalization information system indicates that a certain obstetric bed is occupied, the camera device is started to start to collect information about whether a parturient in the sickbed is in the bed, and when the parturient in the sickbed is detected to be in the bed for the first time, the camera device sends an instruction to the timer to start a timing program to start a subsequent data collection.
7. The labor pain assessment system of claim 1, wherein the labor pain level determination rule is:
a. no pain: NRS 0, uterus contraction
b. Mild pain: NRS 1-3, uterus shrinkage
c. Moderate pain: NRS 4-6, uterus shrinkage
d. Severe pain: NRS 7-10, uterus shrinkage
8. The labor pain assessment system of claim 1, wherein the abnormal uterine contraction pain determination rule is:
a. uterine contraction with the uterine contraction over-strong NRS of 8-10
b. Uterine contraction overfrequency NRS 6-10
c. Uterine hypersystole or overfrequency: the occurrence of uterine hypercontractility is more than or equal to 2 times within 5 min.
9. The labor pain assessment system of claim 1, wherein the NRS scale is a paper, wood or plastic real object, or a picture in electronic image format, with a cell phone or tablet computer as a carrier; the input device is used for manually inputting the collected NRS scores.
10. A method for assessing labor pain for non-diagnostic and therapeutic purposes, wherein assessment of labor pain is performed using the labor pain assessment system of any one of claims 1-9.
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