CN116189885A - 一种基于移动设备终端的冠脉支架术后患者管理系统 - Google Patents

一种基于移动设备终端的冠脉支架术后患者管理系统 Download PDF

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CN116189885A
CN116189885A CN202111414961.3A CN202111414961A CN116189885A CN 116189885 A CN116189885 A CN 116189885A CN 202111414961 A CN202111414961 A CN 202111414961A CN 116189885 A CN116189885 A CN 116189885A
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方若瑄
魏艳
詹玲
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Anhui Provincial Hospital First Affiliated Hospital of USTC
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Abstract

本发明公开了一种基于移动设备终端的冠脉支架术后患者管理系统，包括健康行为管理模式和高危预警管理模式及住院管理模式，所述健康行为管理模式包括药物管理、居家自测、健康指导和门诊复查四个模块；药物管理模块按时自动推送提醒患者使用药物，居家自测模块通过日常打卡督促患者完成自测(如血压血糖等)项目水平。该管理系统，安装在每个冠脉支架术后患者的移动设备终端(手机)上，在移动设备终端利用门诊复查模块，实现定期化验和按期复诊两个部分的数据交换，动态反馈居家自测数据值和门诊化验监测值，确保医患实时交流，提高患者用药依从性，加强术后护理管理，从而实现对冠脉支架术后患者综合健康管理的效果。

Description

一种基于移动设备终端的冠脉支架术后患者管理系统
技术领域
本发明涉及信息化应用技术领域，尤其涉及一种基于移动设备终端的冠脉支架术后患者管理系统。
背景技术
冠脉支架植入术是指经心导管技术疏通狭窄甚至闭塞的冠状动脉管腔，从而改善心肌的血流灌注的治疗方法。对于慢性稳定型冠心病有较大范围心肌缺血证据的患者，介入治疗是缓解症状的有效方法之一，对于急性心肌梗死患者，治疗的关键在于及时开通梗死相关血管(IRA)，血管开通所需时间越短，越尽可能挽救濒死心肌，降低急性期死亡风险，改善患者长期预后。
冠脉支架术后患者，应当按照康复指南及相关文献指导，积极配合进行心脏康复治疗。但是研究表明，我国冠心病患者用药依从性较低，支架植入术后自我管理水平较差，因此造成部分患者术后支架内血栓形成，从而再次发生心肌梗死，严重影响患者生命安全。
目前，院方主要通过建立规范化随访管理制度，通过发放书面资料、运用多媒体宣传资料、建立病人个人信息档案、电话随访或面对面随访等方式，定期了解冠脉支架术后患者病情变化、实验室检查指标结果，进行康复指导。
但随着互联网及移动通信的普及，现有的医疗服务管理系统明显较为落后，缺乏医院-家庭信息互动交流，无法督促患者进行自我监测，从而不能及时发现异常，规范不良用药行为，提醒患者就医。
发明内容
本发明的目的是为了解决现有技术中存在的缺点，而提出的一种基于移动设备终端的冠脉支架术后患者管理系统。
为了实现上述目的，本发明采用了如下技术方案：一种基于移动设备终端的冠脉支架术后患者管理系统，包括健康行为管理模式、高危预警管理模式及住院管理模式，所述健康行为管理模式包括药物管理、居家自测和门诊复查三个模块，门诊复查包括门诊定期化验和门诊按期复诊，该系统附带预约挂号功能，与医院放号系统直接挂钩，满足患者预约挂号需求，复诊患者遵循遗嘱选择住院则开启住院管理模式，患者拒绝住院则开启高危预警管理模式。
高危预警管理模式设有疼痛管理和睡眠管理，所述疼痛管理是指患者出现胸痛＞15min，持续不可缓解，口服药物无效，这三项满足两项，开始进行疼痛自评(采用数字评分法+笑脸评分法填写或者语音录入：疼痛部位、疼痛评分、疼痛时间、疼痛频率)，得出指标值，捕捉数据，汇总后进行疼痛管理。
所述睡眠管理是指患者进行睡眠自评，评估近期是否存在中度以上睡眠障碍，是否因疼痛出现睡眠干扰，使用匹兹堡睡眠质量指数问卷，得出指标值，配对具备睡眠监测功能的智能穿戴设备，捕捉每天睡眠数据，汇总进行睡眠管理。
住院管理模式包括住院监测模式和住院救援模式，住院监测模式包括临床数据采集模块、云端数据库模块和通讯反馈模块，住院救援模式包括临床救援模块和紧急通讯模块。
优选地，所述药物管理包括每日服药打卡，系统到时间定点提醒患者所需服用的药物，并以推送图片形式进行提示，提示内容包括患者服药的剂量、频次及药物说明书。
优选地，所述居家自测包括每日血压打卡和每日血糖打卡，根据病史需要添加该模块，高血压病史添加血压模块糖尿病病史添加血糖模块。
优选地，所述门诊定期化验，患者在固定医院定期复查化验值，异常值结果与数据终端进行比较反馈，提醒患者是否需要挂号就诊，口服抗凝药物，对华法林的患者增加出血风险评估项目，针对这一项风险值高的患者增加门诊化验的频次。
优选地，所述高危预警管理模式满足特定范围开启预警呼救模块，向预先设定的紧急联系人发出短信或电话联系，保障患者得到及时救治，所述特定范围是指疼痛管理和睡眠管理的指标值超出系统设定评定范围。
优选地，所述临床数据数据采集模块包括心电信息采集、生命体征采集，检验值采集，临床检查结果采集云端数据库模块包括云端大数据储存模块、正常生理参数储存模块、对比模块和监测数据记录储存模块，将临床数据采集模块结果通过通讯反馈模块传递至数据库模块中并进行对比，即可动态反馈患者病情变化。
优选地，患者病情变化后切换住院救援模式，医护人员手机安装此系统医护端，所述临床救援模块依据于此系统医护端，值班人员手机端可直接接收患者床号及异常信息，并且，可自动切入护士站的呼叫铃系统进行呼叫，保障患者得到及时救援，所述紧急通讯模块用于通知患者家属，自动弹出紧急联系人，为急诊手术作好准备。
优选地，所述健康行为管理模式还包括健康指导模块，通过推送相关视频、音频和/或文字完善术后健康知识宣教，所述视频、音频和/或文字包括疾病宣教知识、饮食指导、血压血糖监测指导、心理指导、发病应急指导以及运动康复指导。
本发明具有以下有益效果：
1、该基于移动设备终端的冠脉支架术后患者管理系统，安装在每个冠脉支架术后患者的移动设备终端(手机)上，在移动设备终端利用门诊复查模块，实现定期化验和按期复诊的数据交换，动态反馈居家自测数据值和门诊化验监测值，确保医患实时交流，从而实现对冠脉支架术后患者综合管理，并且和医院门诊放号系统挂勾，满足患者预约挂号需求。
2、该基于移动设备终端的冠脉支架术后患者管理系统，通过每日打卡模块督促患者进行自我监测，加强患者对血压，血糖控制行为的重视；每日自动提醒患者所需服用的药物，并以推送图片形式提示，提高患者用药依从性，加强术后药物管理水平，通过健康指导模块，附带健康宣教功能，通过推送视频，音频文字等多媒体形式，培养患者发病应急处理能力，提升术后自我监测水平。
3、该基于移动设备终端的冠脉支架术后患者管理系统，通过设置住院监测模式和医院系统挂钩，且为患者的临床数据实现同步更新，及时反馈，方便就医，通过设置救援模式，能在对比模块中参数超出对比范围值及时呼叫护士站护理人员与专业医师及时救援。
附图说明
图1为本发明提出的一种基于移动设备终端的冠脉支架术后患者管理系统示意图。
具体实施方式
下面将结合本发明实施例中的附图，对本发明实施例中的技术方案进行清楚、完整地描述，显然，所描述的实施例仅仅是本发明一部分实施例，而不是全部的实施例。
在本发明的描述中，需要理解的是，术语“上”、“下”、“前”、“后”、“左”、“右”、“顶”、“底”、“内”、“外”等指示的方位或位置关系为基于附图所示的方位或位置关系，仅是为了便于描述本发明和简化描述，而不是指示或暗示所指的装置或元件必须具有特定的方位、以特定的方位构造和操作，因此不能理解为对本发明的限制。
该基于移动设备终端的冠脉支架术后患者管理系统，安装在冠脉支架植入术后患者的手机上，所需终端要求智能手机2G水准以上，可自动开启定位系统，该管理系统包括健康行为管理模式、高危预警管理模式及住院管理模式，所述健康行为管理模式包括药物管理、居家自测、门诊复查和健康指导四个模块；门诊复查包括门诊定期化验和门诊按期复诊两个部分，患者按期门诊进行复诊，若复诊医生医嘱要求患者住院，患者遵循遗嘱选择住院则开启住院管理模式，患者拒绝住院则开启高危预警管理模式。
1、药物管理:每日服药打卡，系统到时间点推送服用的药物和/或图片提示，提示内容包括患者服药的剂量、频次及药物说明书，频次：几/几，比如一天一次，那么早上，就打卡1/1；一天2次，早上那次就打卡1/2。
2、居家自测：默认包括每日血压打卡、每日血糖打卡，根据病史需要添加该模块，高血压病史添加血压模块，糖尿病病史添加血糖模块。
可根据病史需要添减该模块项目内容，记录测量值，做好数据管理，并且对比大数据正常值范围及患者既往数据值范围，如果测得结果波动范围较大，增加测量频率，并且系统提示下次复测时间，到时间自动推送提醒患者复测，动态反馈监测值。
3、门诊复查：(1)门诊定期化验，患者固定医院定期复查化验值，异常值结果进行反馈，提醒患者是否需要住院，口服抗凝药物尤其是华法林的患者，增加出血风险评估这一项，风险值高的患者，增加化验的频次；(2)门诊按期复诊，冠脉支架术后患者1、3、6、12个月定期门诊复查，根据病情，复诊时间由医生医嘱要求；患者按期门诊进行复诊，若复诊医生医嘱要求患者住院，患者遵循遗嘱选择住院则开启住院管理模式，如果患者拒绝住院则开启高危预警管理模式，该模式设有疼痛管理和睡眠管理和预警呼救三个模块。
1)、疼痛管理：患者出现胸痛＞15min，持续不可缓解，口服药物无效，这三项满足2项，开始进行疼痛自评(采用数字评分法+笑脸评分法填写或者语音录入：疼痛部位、疼痛评分、疼痛时间、疼痛频率)，数据汇总后进行疼痛管理。
2)、睡眠管理：自评近期是否存在中度以上睡眠障碍，是否因疼痛出现睡眠干扰使用匹兹堡睡眠质量指数问卷。配对具备睡眠监测功能的智能穿戴设备，捕捉每天睡眠数据，汇总进行睡眠管理。
1)和2)项指标值，系统设定评分范围，采用国际通用评定方法，语音指导，较为简单，患者可以完成自评，超过范围开启预警呼救模块，系统自动切入手机通讯录，拨打紧急联系人，呼叫家属送住院。
进入预警呼救模块后默认开启定位，发送即时位置告知家属，设置救援时间倒计时，通过定位实时反映患者位置，规定时间如90min内尚未抵达医院，系统再次发出警报，提醒患者及时住院就医。
通过推送相关视频、音频和/或文字完善术后健康知识宣教，所述视频、音频和/或文字包括疾病宣教知识、饮食指导、血压血糖监测指导、心理指导、发病应急指导以及运动康复指导，通过推送视频、音频或文字等多媒体形式，培养患者发病应急处理能力，提升术后自我监测水平。
如果患者选择住院则开启住院管理模式，和医院住院系统挂钩，自行捕捉患者复诊住院期间相关检查指标，包括患者生命体征、住院期间化验结果、检查结果，以作参考。
住院管理模式包括住院监测模式和住院救援模式，一般默认切换到住院监测模式，包括临床数据采集模块、云端数据库模块通讯反馈模块，临床数据数据采集模块，包括心电信息采集、生命体征(包括体温脉搏呼吸血压)采集，检验值采集，临床检查结果采集；云端数据库模块包括云端大数据储存模块、正常生理参数储存模块、对比模块和监测数据记录储存模块。
将临床数据采集模块结果通过通讯反馈模块，传递至数据库模块中并进行对比，即可动态反馈患者病情变化。
如遇患者病情变化，则自动切换到住院救援模式，住院救援模式包括临床救援模块和紧急通讯模块，在对比模块中参数超出对比范围值时，比如患者酶学很高，心电图显示异常的危险性心律失常，发送患者床号和异常值给值班医务人员手机端，并且自动切入护士站的呼叫铃系统，及时呼叫护士站护理人员与专业医师及时救援，此外开启紧急通讯模块，自动弹出紧急联系人，通知患者家属，以防止急诊手术需要，做好术前签字准备。
以上所述，仅为本发明较佳的具体实施方式，但本发明的保护范围并不局限于此，任何熟悉本技术领域的技术人员在本发明揭露的技术范围内，根据本发明的技术方案及其发明构思加以等同替换或改变，都应涵盖在本发明的保护范围之内。

Claims (8)

1.一种基于移动设备终端的冠脉支架术后患者管理系统，包括健康行为管理模式、高危预警管理模式及住院管理模式，其特征在于：所述健康行为管理模式包括药物管理、居家自测和门诊复查三个模块，门诊复查包括门诊定期化验和门诊按期复诊，复诊患者遵循遗嘱选择住院则开启住院管理模式，患者拒绝住院则开启高危预警管理模式；
高危预警管理模式设有疼痛管理和睡眠管理，所述疼痛管理是指患者出现胸痛＞15min，持续不可缓解，口服药物无效，这三项满足两项，开始进行疼痛自评(采用数字评分法+笑脸评分法填写或者语音录入：疼痛部位、疼痛评分、疼痛时间、疼痛频率)，得出指标值，捕捉数据，汇总进行疼痛管理；
所述睡眠管理是指患者进行睡眠自评，评估近期是否存在中度以上睡眠障碍，是否因疼痛出现睡眠干扰，使用匹兹堡睡眠质量指数问卷，得出指标值，配对具备睡眠监测功能的智能穿戴设备，捕捉每天睡眠数据，汇总进行睡眠管理；
住院管理模式包括住院监测模式和住院救援模式，患者入院后默认选择住院监测模式，住院监测模式包括临床数据采集模块、云端数据库模块和通讯反馈模块，如遇病情变化后切换住院救援模式，住院救援模式包括临床救援模块和紧急通讯模块。
2.根据权利要求1所述的一种基于移动设备终端的冠脉支架术后患者管理系统，其特征在于：所述药物管理包括每日服药打卡，系统到时间定点提醒患者所需服用的药物，并以推送图片形式进行提示，提示内容包括患者服药的剂量、频次及药物说明书。
3.根据权利要求1所述的一种基于移动设备终端的冠脉支架术后患者管理系统，其特征在于：所述居家自测默认包括每日血压打卡和每日血糖打卡，可根据病史需要添减该模块项目内容，根据测量结果提醒患者复测，并且记录异常值。
4.根据权利要求1所述的一种基于移动设备终端的冠脉支架术后患者管理系统，其特征在于：所述门诊定期化验，患者在固定医院定期复查化验值，异常值结果与数据终端进行比较反馈，提醒患者是否需要挂号就诊，口服抗凝药物，对华法林的患者增加出血风险评估项目，针对这一项风险值高的患者增加门诊化验的频次。
5.根据权利要求1所述的一种基于移动设备终端的冠脉支架术后患者管理系统，其特征在于：所述高危预警管理模式满足特定范围开启预警呼救模块，向预先设定的紧急联系人发出短信或电话联系，保障患者得到及时救治，所述特定范围是指疼痛管理和睡眠管理中的指标值超出系统设定评定范围。
6.根据权利要求1所述的一种基于移动设备终端的冠脉支架术后患者管理系统，其特征在于：所述临床数据数据采集模块包括心电信息采集、生命体征采集，检验值采集，临床检查结果采集，所述云端数据库模块包括云端大数据储存模块、正常生理参数储存模块、对比模块和监测数据记录储存模块，将临床数据采集模块结果通过通讯反馈模块传递至数据库模块中并进行对比，即可动态反馈患者病情变化。
7.根据权利要求6所述的一种基于移动设备终端的冠脉支架术后患者管理系统，其特征在于：患者病情变化后切换住院救援模式，医护人员手机安装此系统医护端，所述临床救援模块依据于此系统医护端，值班人员手机端可直接接收患者床号及异常信息，并且，可自动切入护士站的呼叫铃系统进行呼叫，保障患者得到及时救援，所述紧急通讯模块用于通知患者家属，自动弹出紧急联系人，为急诊手术作好准备。
8.根据权利要求1-7任一项所述的一种基于移动设备终端的冠脉支架术后患者管理系统，其特征在于：所述健康行为管理模式还包括健康指导模块，通过推送相关视频、音频和/或文字完善术后健康知识宣教，所述视频、音频和/或文字包括疾病宣教知识、饮食指导、血压血糖监测指导、心理指导、发病应急指导以及运动康复指导。
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CN117204901A (zh) * 2023-11-09 2023-12-12 北京大学第一医院 一种针对动脉止血的连续性减压方法及系统

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* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN117204901A (zh) * 2023-11-09 2023-12-12 北京大学第一医院 一种针对动脉止血的连续性减压方法及系统
CN117204901B (zh) * 2023-11-09 2024-02-09 北京大学第一医院 一种针对动脉止血的连续性减压方法及系统

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