CN1943505A - Realtime remote monitoring system for high risk heart disease crowd and integrated control type continuous monitoring method - Google Patents

Realtime remote monitoring system for high risk heart disease crowd and integrated control type continuous monitoring method Download PDF

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CN1943505A
CN1943505A CN 200610029899 CN200610029899A CN1943505A CN 1943505 A CN1943505 A CN 1943505A CN 200610029899 CN200610029899 CN 200610029899 CN 200610029899 A CN200610029899 A CN 200610029899A CN 1943505 A CN1943505 A CN 1943505A
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monitoring
patient
information
monitor
real
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CN 200610029899
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方祖祥
赖大坤
宋海浪
许之敏
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方祖祥
赖大坤
宋海浪
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Priority to CN 200610029899 priority Critical patent/CN1943505A/en
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Abstract

The invention belongs to supervisory technical field for distance treatment, particularly for applying far distance patient monitor system and centralized continuously monitoring process to high-risk people of heart disease. Said system comprising portable monitor carried by patients, hospital central monitor center, doctors' far distance group consultation terminal, ambulance monitor, communication net system, etc. The monitor process is, through communication network such as mobile , local, wireless and internet communication, making hospital central monitor center and portable monitor in and out of the hospital , ambulance carrying monitor and far distance group consultation real-time connecting, exchanging and transmitting information such as real-time ECG, blood pressure, etc., patient geographical location, doctor group consultation and advice, and far distance equipment remote measurement & program controlled in each terminal, realizing continuously monitor to high-risk people of heart disease, applying central remote measurements and program control of far distance mobile terminal, prior to coming on of heat disease early period proper diagnosis given and applying real-time treatment to serious patient, etc.

Description

高危心脏病人群的远程实时监护系统及集控式连续监护方法 High-risk heart disease populations of remote real-time monitoring system and centralized control continuous monitoring method

技术领域 FIELD

本发明属于远程医疗监护技术领域,具体涉及一种针对高危心脏病人群的远程实时监护系统及其相应的集控式连续监护方法。 The present invention pertains to remote health care technologies, and particularly relates to a high-risk of heart disease populations remote real-time monitoring systems and their corresponding centralized control continuous monitoring method.

背景技术 Background technique

心血管疾病发病往往十分危急,且病情严重、变化迅速,一旦发作就可能给病人带来巨大痛苦、甚至导致晕厥和猝死。 Cardiovascular disease is often very critical and serious condition, rapidly changing, once the attack can give the patient great pain and even lead to syncope and sudden death. 尤以冠心病、心肌病、有心律失常病史、心源性猝死家族史、心脏移植史等病况,具有病发突然、随机、高猝死率特点,通常在急性症状出现后1小时内就可能引起死亡,恶性的室性颤动甚至在12分钟内引起病人猝死,患有上述严重心脏病的患者即为高危心脏病人。 Especially coronary heart disease, cardiomyopathy, arrhythmia history of sudden cardiac death family history of cardiac history and other transplant conditions, have the disease sudden, random, high sudden death rate characteristics, usually it may cause within 1 hour after the acute onset of symptoms death, malignant ventricular fibrillation even in 12 minutes within a patient caused sudden death, suffering from the above-mentioned severe heart disease patients is the high risk of heart disease. 每当心脏病,尤其是高危心脏病发作时,每分每秒的时间对于患者的生命都是至关重要的。 Whenever heart disease, especially in high-risk heart attack, every minute of time for the patient's life is essential. 心电图是诊断心脏病的常规而有效的手段,高危心脏病病发前、病发时、以至恶性的病发晕厥或猝死等都存在多种高危心电图表现。 ECG is a routine and effective means of diagnosis of heart disease, the former high risk of heart disease, when the disease, as well as malignant disease syncope or there are many high-risk ECG sudden death and so on. 但由于高危心脏病的突发性及随机性,在常规心电检查中短时间(数分钟)的心电图检测常常无法捕捉到转瞬即失的危险信息。 However, due to sudden and random high risk of heart disease, a short time in the regular ECG examination (minutes) ECG detection often can not capture the risk of information end in the loss of. 利用心电图仪的连续动态监护、分析,有助于早期发现和及时诊断这类疾病。 The use of continuous dynamic monitoring ECG, analysis, contribute to early detection and timely diagnosis of these diseases.

长期以来,为了给心脏病人(尤其高危心脏病人)提供有效监护、早期诊断各种异常病征和避免病发时因得不到及时抢救而导致猝死,先后出现了的心脏病人的院内集中监护、院外Holter式动态监护和远程监护等心电监护系统。 For a long time, in order to heart disease (especially in high-risk cardiac patients) to provide effective care, early diagnosis of various abnormal symptoms and to avoid the lack of timely rescue when the disease caused sudden death, he has appeared in heart patients of the hospital centralized custody, outside the hospital Holter dynamic monitoring and remote monitoring and other ECG monitoring system. 近年来,伴随着计算机技术及微电子技术的飞速发展,尤其是现代移动通信技术的日益成熟和应用大众化,基于现代移动通信技术的远程移动心电监护系统引起了人们的极大关注。 In recent years, with the rapid development of computer technology and microelectronics technology, in particular, has become more sophisticated modern mobile communication technology and applications popular, modern mobile communication technology of remote mobile ECG monitoring system based aroused great concern. 与其它心电监护系统相比,基于移动通信技术的远程移动心电监护系统具有连续监护、远程告警、远程初诊等临床实用特点,以及通信传输可靠、病人活动自由、自我安全感高、所需医疗费用低,医疗资源利用率高等显著优点。 Compared with other ECG monitoring system, based on mobile communication technology remote mobile ECG monitoring system with continuous monitoring, remote alarm, remote diagnosed and other clinical utility characteristics, and a communication transmission reliability, patient freedom of movement, high self-security required lower health care costs, health care resource utilization, higher significant advantages. 基于移动通信技术的远程移动心电监护系统主要由病人随身携带的移动监护仪、医院监护中心和移动通信网络等部分构成。 Mainly by the patient to carry part of the mobile monitor, hospital care center and mobile communication networks and other mobile communication technology remote mobile ECG monitoring system. 移动监护仪采集病人的心电信息,通过移动通信网络上传至监护中心,医生即可在医院同时查看多名位于不同地方的受监护病人的心电信息,当出现心电异常时,系统自动告警提示病人和医生;在对病人进行远程监护的同时,医生可以通过移动通信网络下发医嘱等信息。 ECG information of the mobile monitors collect patient, uploaded via the mobile communications network to the monitoring center, the doctor can simultaneously view more than Located ECG information by monitoring patients in different parts of the hospital, when the ECG is abnormal, the system automatically alerts prompting a patient and a doctor; while the patient remote monitoring, the physician via the mobile communication network send orders and other information. 在现有的基于移动通信技术的远程移动心电监护系统中,实现医生远程监护病人的方式主要是在院外Holter式动态监护基础上扩展提供病人连续的常规心电远程监护。 Manner conventional remote mobile ECG monitoring system based on mobile communication technology, to achieve a doctor remotely monitoring a patient main extension provides consecutive patients conventional ECG remote monitoring in hospital Holter Ambulatory care basis.

现有的远程移动心电监护系统解决了传统监护系统存在的监护时间与监护范围矛盾的不足,然而却存在监护措施简单、通信传输方式单一、诊断和救助环节薄弱等不足;针对心脏病人、尤其是高危心脏病人等这一特殊人群通常病发突然、病情危急、抢救紧急,且经常发生在远离医生、远离医院、甚至病人当时周围无任何人的地方,它可能发生在病人家里、街区、公园、乡村、旅游途中,现有的这类系统不能满足随时随地的远程连续监护、早期准确诊断、病发及时救助等临床应用方面的特殊要求。 Existing remote mobile ECG monitoring system solves the problems of traditional monitoring system monitoring for less than guardianship range contradiction, however, there are guardianship measures simple, single communication transmission, diagnosis and rescue weak links and other issues; for heart disease, especially high-risk cardiac patients, etc. this special populations generally ill suddenly, in critical condition, rescue emergencies, and often occur in the doctor away, away from the hospital, and even the patient was not anyone around the place, it could happen in the patient's home, neighborhood, park , rural tourism the way, the existing system of this type can not meet anywhere, anytime remote continuous monitoring, early and accurate diagnosis, disease specific requirements of applications in clinical timely relief and so on.

发明内容 SUMMARY

本发明的目的在于提供一种能克服现有技术不足的针对高危心脏病人群的远程实时监护系统及集控式连续监护方法。 Object of the present invention is to provide a overcome deficiencies of the prior art for the risk of heart disease populations remote real-time monitoring system and a centralized control continuous monitoring method.

本发明提出的高危心脏病人群的远程实时监护系统,针对心脏病、尤其是高危心脏病在临床监护、诊断和救助方面的特殊需要,在现有的远程移动心电监护系统的基础上,通过移动网、无线局域网和Internet网等通信网络,使医院监护中心与院内外移动监护仪、急救车载监护仪及远程会诊终端实时地互连互通,交换、传输病人实时心电、血压等监护信息、病人地理位置信息、医生会诊信息和医嘱以及各远程设备遥测程控信息,实现对院内外高危心脏病人群随时随地的集中连续监护、在病发前予以早期准确诊断、恶性病发时实施及时救助及对远程移动终端设备集中遥测和程控。 Proposed by the invention of high-risk heart disease populations of remote real-time monitoring system for heart disease, especially in high-risk heart attack special needs in clinical monitoring, diagnosis and rescue aspects, based on the existing remote mobile ECG monitoring system, through mobile, wireless LAN and Internet network and other communication networks, the hospital care center and outside of the hospital mobile monitors, emergency-board monitor and remote consultation terminal in real-time interconnection, exchange, transfer of patients in real-time ECG, blood pressure and other monitoring information, patient location information, the doctor consultation information and orders as well as the remote device telemetry programmed information, centralized continuous monitoring of people anywhere outside of the hospital at high risk of heart disease, be early and accurate diagnosis before the disease, implement timely assistance when malignant disease and remote mobile terminal device centralized telemetry and program-controlled.

本发明提出的远程监护系统,包括病人随身携带的移动监护仪、医院监护中心、医生远程会诊终端、急救车载监护仪及实现各部分间信息交换的通信网络系统;其中:(1)所述的移动监护仪由高危心脏病人随身携带,作为该远程实时监护系统的病人端设备,由生理参数采集模块、主控制模块、人机界面模块和无线通信模块等基本模块和位置定位模块、电除颤急救模块等可选模块构成;生理参数采集模块通过体表心电导联线和血压袖带实时测量病人的心电信号和血压值;无线通信模块接入院外GSM/GPRS移动通信网络(或CDMA、3G网络)、院内或家内无线WiFi局域网络,将处理后的生理参数信息、地理位置信息和设备状态维护信息上传到医院监护中心,并接收来自于医院监护中心的诊断信息、医嘱和设备调控命令;人机界面模块通过声、光、文字显示等方式提示 Proposed by the present invention is the remote monitoring system, including patients carry mobile monitors, hospital care center, the doctor remote consultation terminal, emergency vehicle monitor and implement a communication network system between parts of the exchange of information; wherein: (1) moving the monitor to carry a high risk of heart disease as the patient end equipment of the remote real-time monitoring system, the basic modules physiological parameter acquisition module, a main control module, a human interface module and a wireless communication module and a position location module, defibrillation aid module optional modules; physiological parameter acquisition module cuff real-time measurements of ECG and blood pressure values ​​of the patient through a body surface ECG lead and blood pressure; external wireless communication module access hospital GSM / GPRS mobile communication network (or CDMA, 3G network), the hospital or in-home wireless WiFi local area network, the physiological parameter information, location information and device status after treatment maintenance information uploaded to hospital care center, and receive diagnostic information from hospital care center, the doctor and the device-control command ; human interface module via sound, light and character display, etc. tips 告警病人自身体征、导联电极脱落情况及所携带的设备运行状态;位置定位模块连续采集病人所在的地理位置,协助医生指导急救人员对病发于阵发性恶性心动过速急症病人实施及时救助;对于临床诊断病症显示有危重心脏疾病潜在病发可能的特殊病人,需选配电除颤急救模块,实现医生对病发于特别危重的心脏疾病(如室性扑动、室性纤颤、心跳骤停、心源性昏厥等)而得不到及时救助的病人直接行远程电复律程控刺激救助;上述模块在主控制模块的统一控制下协调工作,实现移动监护仪对高危心脏病人的远程实时监护、定位和病发时的急救治疗等功能;移动监护仪具有正常监护态和病发时的紧急监护态等两种工作状态,两种工作状态可由移动监护仪根据诊断结果自动切换或接受监护中心命令强制切换;(2)所述的医院监护中心设置于医院内,作为 Alarm patient's own signs, lead electrodes shedding and carried equipment operation; position-location module continuously collecting location the patient is located, to assist guidance of a doctor emergency personnel of the disease in paroxysmal malignant tachycardia emergency patients embodiment timely assistance ; clinical diagnosis condition display critically ill heart disease underlying disease possible particular patient, for an election distribution defibrillation aid module, doctor disease in particularly severe cardiac disease (such as ventricular flutter, ventricular fibrillation, cardiac arrest, cardiogenic syncope, etc.) and lack of patient timely assistance direct line of remote electrical cardioversion programmed electrical stimulation aid; above modules coordination under the unified control of the main control module for mobile monitor high-risk heart patients remote real-time monitoring, during positioning and disease emergency treatment function; mobile monitoring device having two operating states normal monitoring state, and when the disease hair emergency monitoring state, etc., two operating states by moving the monitor automatically switched based on the results or receiving care center command forced switching; (2) according to hospital care center is provided in a hospital, as 远程实时监护系统的信息交换、处理、存储和分发的中心,由通信服务子系统、监护与诊疗子系统、GIS地理定位子系统、数据库子系统、运行维护子系统等构成;其中,通信服务子系统是监护中心的网关,实现医院监护中心与远程移动监护仪、急救车载监护仪、医生远程会诊终端之间的院外GSM/GPRS移动通信网络(或CDMA、3G移动网络)、院内无线局域网及Internet网络的数据交换和分发,以及与医院已有兼容PACS、DICOM通信标准的诊疗系统进行互联互通;监护与诊疗子系统实时监护每个病人的动态心电信号和血压值、结合专家数据库进行自动分析、病发告警、辅助值班医生及远程会诊医生进行早期诊断,必要时医生通过该子系统发出远程电复律程控电刺激命令对病人实施远程急救;GIS地理定位子系统在电子地图上跟踪显示病人所在位置;运行维护子系统完 Center for Information Interchange remote real-time monitoring system, processing, storage and distribution, by the communication service subsystem, care and treatment sub-system, GIS geographic positioning subsystem, database subsystem, operation and maintenance of subsystems, and the like; wherein the communication service sub the system is a gateway monitoring center, to achieve hospital care center with remote mobile monitors, emergency-vehicle monitor, outside the hospital between doctors remote consultation terminal GSM / GPRS mobile communication network (or CDMA, 3G mobile networks), hospital wireless LAN and Internet data exchange and distribution networks, and it has been compatible with the hospital PACS, DICOM communication standard medical system interoperability; automatic signal real and blood pressure monitoring and treatment subsystem real-time monitoring of each patient, combined with expert database , disease alarms, auxiliary doctor on duty and remote consultation doctor for early diagnosis, doctors stimulate command on a patient remote first aid issue remote electrical cardioversion programmable power by the subsystem when necessary; GIS geographic positioning subsystem trace shows that patients on the electronic map location; operation and maintenance subsystem End 对远程各移动监护仪、急救车载监护仪进行运行监控、诊断和维护,对医院监控中心各子系统的运行状态、操作权限进行管理;(3)所述的医生远程会诊终端具有无线和有线两种通信方式与医院监护中心联络,在病发时、尤其是部分疑难杂症值班医生无法确诊时及时组成专家会诊网络,通过呈现的病人动态生理监护信息及历史病发信息由不同科室、不同医院甚至不同地区的专家实施会诊;(4)所述的急救车载监护仪安装在急救车上,作为急救监护装置通过无线移动通信与医院监护中心实时联系,接收待救病人的动态生理监护信息和地理位置信息、与医生交换救助措施。 Remote each mobile monitors, emergency-vehicle monitor conduct performance monitoring, diagnostics and maintenance, operational status of the hospital monitoring center of the subsystems, the operating authority for management; the doctor teleconsultation terminal according to (3) have both wireless and wired kind of communication with hospital care center contact, when the disease, especially in a timely manner to form an expert consultation network when part of incurable diseases doctor on duty can not be diagnosed by the patient dynamic physiological monitoring information and made history illness information presented by different departments, different hospitals even experts in different areas embodiments consultation; (4) the emergency vehicle monitor installed in the ambulance, as emergency monitoring means in real-time contact through a wireless mobile communication with hospital care center, dynamic physiological monitoring information and geographic reception to be save the patient's location information, Remedies and doctors exchange.

本发明提出的利用上述远程实时监护系统进行集控式连接续监护的方法,具体步骤如下:首先,受监护的高危心脏病人群每人随身携带一台移动监护仪,工作在正常监护态实时采集该病人的心电信号及血压信息、进行初步分析诊断,连同接收到的GPS等定位信息经压缩处理后采用脉冲式分批传送的方式上传至医院监护中心;并采用短时循环更新的方式储存在Flash存储器里,而自动诊断结果也同步在移动监护仪上予以显示;接着,设置于医院内的监护中心同时对多名病人进行实时监护,监护中心的通信服务子系统实时接收位于院外远程各地、院内各处或家内的各个病人随身携带的移动监护仪发送的数据,对其进行解压缩、通信协议转换处现后,将病人的监护信息保存到数据库子系统的监护信息库中、将移动监护仪的工作参数信息保存到数据库子系统的 The present invention provides the use of the above-mentioned remote real-time monitoring system of centralized control connection continuous monitoring method, follow these steps: First, in care of high-risk heart disease populations person to carry a mobile monitor works in normal monitoring state real-time acquisition ECG of the patient's blood pressure information, a preliminary analysis and diagnosis, along with the location information of the received GPS and uploaded by way of pulsed batch transferred to hospital care center after the compression processing; and using a short cycle update stored in a manner in the Flash memory in, and automatic diagnosis also simultaneously be displayed on the mobile monitor; then disposed care center in the hospital at the same time more than patient in real-time monitoring, monitoring center communication service subsystem receive real-time located outside the hospital around the remote data movement monitor transmitted throughout the hospital or within the family of the individual patient carry, decompresses it, the communication protocol conversion at the rear now save patient monitoring information in a database subsystem monitoring repository, will move save the parameter information monitors to the database subsystem 备信息库中、将GPS等定位信息保存到数据库子系统的地理位置信息库中;监护与诊疗子系统实时分析监护信息库中每个病人的动态心电信号和血压值、进行自动诊断和预警;每个受监护的病人的心电、血压监护信息以及其预警信息均通过监护与诊疗子系统实时显示出来,实现值班医生在一个监护中心对院内外多名高危心脏病人的集中式实时监护;其次,当某受监护的病人急性病发时,其所携带的移动监护仪对异常心电或血压信息进行初步分析诊断,告警提示病人并自动转为紧急监护状态,采用连续实时传送的方式与医院监护中心通信联络全速上传实时监护信息;监护中心对告警信息和所指示的病人的监护信息进行自动分析诊断,诊断结果为异常即产生一个告警事件,通过监护与诊疗子系统告警提示值班医生;继而,由值班医生在结合系统自动分析 Preparation repository, save the GPS and other location information to the database subsystem geographical information database; care and treatment subsystem real-time analysis Holter signal and blood pressure values ​​for each patient's care information repository, automated diagnosis and early warning ; each ECG, blood pressure monitoring information and early-warning information by monitoring patients have passed the monitoring and treatment subsystem displayed in real time, to achieve the doctor on duty at a care center over high-risk heart patients, centralized real-time monitoring on the outside of the hospital; Second, when a ward of patients with acute hair when they carry mobile monitor abnormal ECG or blood pressure information is preliminary analysis and diagnosis, alarm prompts the patient and automatically switch to the emergency ward, continuous real-time transmission of the way with the hospital care center communication contact at full speed upload real-time monitoring information; care center for alarm information and patient indicated by monitoring information for automatic analysis and diagnosis, the diagnosis result is abnormal, ie generate an alarm event, the monitoring and treatment subsystem warning prompt the doctor on duty; then automatically analyzed by the doctor on duty in conjunction with the system 诊断结果的同时对监护告警事件作及时处理,即对病发病人的监护信息深入分析和诊断、剔除系统的误报警,并对短时和对病人生命健康无危险的异常监护信息做出标志;值班医生根据病人的监护信息可通过监护中心向远程移动监护仪下发医嘱,建议和提示病人相关注意事项;然后,对于病发症状复杂值班医生不能及时确诊的告警事件,由值班医生及时组织相关专家医生,通过监护中心的通信服务子系统联络各处专家的远程会诊终端组成专家会诊网络,专家根据各自会诊需要由远程会诊终端提取和分析病人的实时监护信息和历史监护信息,专家之间诊断建议通过监护中心中转和分发,继而对该病发症状予以确诊,值班医生根据会诊意见对告警事件进行相应处理;最后,对于经值班医生确诊或经专家会诊为病发于恶性心脏疾病且需及时抢救的病人, Diagnostic results while monitoring alarm event for timely processing, namely monitoring information on disease incidence of people in-depth analysis and diagnosis, eliminate false alarms system, and the short and the patient's health without danger of abnormal care information to make a mark; the doctor on duty in accordance with the patient's care information is available through the monitoring center to remote mobile monitors issued a doctor's advice, suggestions and tips patient-related considerations; then, for the disease symptom complex doctor on duty can not be timely diagnosis of an alarm event, by the doctor on duty promptly organize relevant medical experts, through the communication service monitoring center subsystem contact remote consultation terminal throughout experts composed of expert consultation network, experts need to extract and analyze the patient's real-time monitoring and historical monitoring information from the remote consultation terminal in accordance with their consultation, diagnosis among experts recommended by the monitoring center transit and distribution, and then to be diagnosed the disease with symptoms, the doctor on duty accordingly handle the event based on consultation comments; Finally, by the doctor on duty diagnosed or with expert consultation for the disease malignant heart disease and the need for timely rescue patients, 班医生根据GIS地理定位子系统指示,及时联系病人所在地急救中心指派急救人员前往救助,急救人员通过急救车载监护仪与监护中心实时通信联络,接收监护中心救助指导、实时接收病人的心电及血压监护信息、地理位置信息和该病人的历史病例信息,前往现场对病人实施救助;而对于病发于特别危重、必须立即治疗的心脏疾病,且急救人员不能及时赶到的情况下,值班医生行远程控制电复律刺激对该病人实施远程急救。 Ban doctors subsystem indication based on GIS geographic location, promptly contact your local patient emergency center assigned emergency personnel to the rescue, emergency personnel through the emergency real-time communication on-board monitor and care center contact, receiving care center aid guidance received in real time the patient's ECG and blood pressure monitoring information, location information and historical case information of the patient, to the scene on a patient assistance; and for the disease in particular critical need immediate treatment of heart disease, case and emergency personnel can not be rushed, the doctor on duty line remote control electrical cardioversion stimulation of the patient remotely aid.

同时,病人随身携带的移动监护仪自动监测其工作运行情况,定时收集设备供电电池、Flash存储器、心电导联电极接触、GPS通信、GPRS(或CDMA、3G)通信等设备工作参数,急救车载监护仪及远程会诊终端同样自动监测和收集设备运行状态、与监护中心通信情况等工作参数;当网络通信故障,则移动监护仪自动转为Holter式动态监护方式,实时监护信息自动存入移动监护仪自带存储器中;所有的远程移动监护仪、急救车载监护仪及远程会诊终端的运行状态参数均经过统一编码处理后上传至监护中心的设备信息库中;在设备出现工作状态异常甚至故障时,移动监护仪将显示设备故障信息、自动告警提示病人,急救车载监护仪将显示设备故障信息、自动告警提示急救人员;在需要调整工作参数或可通过修改工作参数消除设备故障时,值班医生可通过监护中心的 At the same time, the patient carry mobile monitor automatically monitor its operation, the timing of collection devices powered battery, Flash memory, ECG electrode contact, GPS communication, GPRS (or CDMA, 3G) communications and other equipment operating parameters, emergency car care devices and remote consultation terminals same automatic monitoring and operating parameters of the collection device operation status, with the monitoring center communication situation and the like; when the network communication failure, the mobile monitor automatically to Holter Ambulatory monitoring mode, real-time monitoring information is automatically stored in the mobile monitor built-in memory; all remote mobile monitors, emergency-vehicle monitors, and operating parameters of remote consultation terminal are uploaded to the device repository care center in unified coding process through; abnormal working condition appears in the device or even failure, mobile monitor will display equipment failure information, automatic alarm prompts the patient, equipment failure information, automatic alarm prompts emergency personnel first aid on-board monitor will display; if necessary adjust operating parameters or eliminate equipment failure by modifying the operating parameters, the doctor on duty by care center 行维护子系统对所监测的移动监护仪或急救车载监护仪的进行在线远程调参和维护;这样监护中心在医院内实现对不同地点、不同功能的远程设备(移动监护仪、急救车载监护仪及远程会诊终端)的集中式同步实时监测、维护和管理。 Line maintenance subsystem of the monitored mobile monitor or emergency-vehicle monitors online remote parameter adjustment and maintenance; this care center at the hospital within the realization of the different locations, different functions of remote devices (mobile monitors, emergency-board monitor and remote consultation terminal) centralized simultaneous real-time monitoring, maintenance and management.

本发明利用上述方法及系统可以实现一个医院监护中心同时连续监护多个位于医院内和医院外的高危心脏病人,同时接入多名位于不同科室、不同医院甚至不同地区的会诊专家,同时与一辆或多辆急救车联络通信,满足心脏病、尤其是高危心脏病在临床监护、诊断和救助等方面的特殊需要。 The present invention utilizes the above-described method and system may implement a hospital care center while continuously monitoring the plurality is located in hospitals and outside hospitals high risk cardiac patients, simultaneous access, different hospitals and even expert consultation over in different sections of different regions, at the same time with a vehicles or ambulances contact communication, meet heart disease, especially in high-risk heart attack special needs in terms of clinical care, diagnosis and rescue, etc.

与现有的仅提供病人常规心电连续监护的远程移动监护系统相比,本发明还具有如下特点:(1)、提高远程移动监护系统对心脏病人、尤其是高危心脏病人等这一特殊人群的临床应用针对性。 Compared with the existing only routine patient ECG continuous monitoring of remote mobile monitoring system, the present invention also has the following characteristics: (1) improved remote mobile monitoring system for heart disease, especially in high-risk cardiac patients, etc. This special populations clinical relevance. 在本发明中,针对心脏病、尤其是高危心脏病通常病发突然、病情危急、变化迅速等临床病发特点,扩展了现有远程移动监护系统的在远程监护方面的功能、弥补在远程诊断和及时救助方面的不足,实现对高危心脏病人随时随地的远程连续监护、早期准确诊断和病发及时救助等方面的临床诊疗应用目的。 In the present invention, for heart disease, especially in high-risk heart attack usually ill suddenly, in critical condition, change quickly and other clinical disease characteristics, extends the functionality of existing remote mobile monitoring system in remote monitoring aspects make up the remote diagnosis and timely salvage insufficient to achieve high-risk heart patients anytime, anywhere remote continuous monitoring, early and accurate diagnosis of TB timely assistance and other aspects of clinical diagnosis and treatment application purposes.

(2)、本发明采用实时监护和动态监护两级自动监护方式,提高系统冗余可靠性,充分保证对高危心脏病人监护的连续性。 (2), the present invention uses real-time monitoring and dynamic monitoring two automatic monitoring mode, improving system redundancy reliability, fully guaranteed high-risk cardiac patients monitoring continuity. 在本发明中,一级自动监护是医院监护中心的实时监护,即监护中心实时接收远程移动监护仪采集、上传的病人心电和血压信息,经分析处理后实时显示在监护中心监视器上供值班医生查看和诊断,同时保存到监护信息数据库中;二是移动监护仪的动态监护,即当病人随身携带的移动监护仪与监护中心出现长段时间通信故障时,移动监护仪将自动转为Holter式动态监护,将实时采集的心电和血压信息存入随机附带的大容量Flash存储器里,并提示病人通信故障,在移动监护仪的有效存储监护期内(如144小时以内)需前往监护中心进行监护信息同步,实现对该病人的历史监护的连续性。 In the present invention, an automatic monitoring is real-time monitoring hospital care center, i.e. care center receive real-time remote mobile monitors the acquisition, upload patient ECG and blood pressure information, after analysis and processing real-time display at the monitoring center the monitor for reference Doctor viewing and diagnosis, while preserving to the custody of the information in the database; the second is a dynamic care mobile monitor, that is when the patient carry mobile monitor and care center appears a long period of time a communication failure, a mobile monitor will automatically be converted Holter Ambulatory care, the real-time acquisition of the ECG and blood pressure information stored in the mass Flash memory supplied in, and prompting a patient communication failure, a mobile monitor effective storage monitoring period (e.g., within 144 hours) required to care center for monitoring information synchronization, realize the continuity of the history of monitoring a patient's.

(3)、本发明采用心电自动分析及多种高危心脏病征识别方法,结合病人历史监护信息及专家信息库,行自动诊断协助医生及时、可靠、准确的做出诊断,形成多级诊断系统,降低医生工作强度、病症误判率、提高诊断准确性。 (3) The present invention employs ECG automatic analysis and a variety of high-risk heart attack signature identification methods, combined with patient history monitoring information and expert information base line automatic diagnostic assistance in a timely manner the doctor, reliable and accurate make a diagnosis, to form a multi-level diagnostic systems reduce doctors working strength, condition false positive rate, improve diagnostic accuracy. 在本发明中,首先是移动监护仪的初步分析诊断,即实时初步的分析、识别病人心电图的P波、QRS波、T波、ST段、PP间期、PR间期、ST间期,以及检测血压的收缩压、舒张压等特征参数,当诊断结果出现异常时将告警提示病人,同时将告警上传至监护中心;其次,医院监护中心的自动诊断,即处理移动监护仪上传的告警信息,全面分析病人的实时心电和血压监护信息,提取特征参数,并综合该病人的历史监护信息、比对心脏病专家诊断信息库,做出自动诊断,结果异常则告警值班医生;第三级是值班医生在监护查看病人实时监护信息同时,重点分析有告警信息病人的监护信息,及时做出现场诊断;最后对于值班医生的无法做出及时诊断的部分疑难杂症,由会诊专家远程会诊终端进行远程会诊。 In the present invention, first, preliminary analysis and diagnosis moving the monitor, i.e., real-time preliminary analysis, identifying the patient ECG P-wave, a QRS wave, T-wave, ST segment, PP period, PR interval, between ST period, and detecting systolic blood pressure, diastolic blood pressure and other characteristic parameters, when the diagnostic result is abnormal will alarm prompting a patient, while the alarm uploaded to the monitoring center; Secondly, automatic diagnosis hospital care center, i.e., processing the alarm information of the mobile monitor upload, a comprehensive analysis of the patient's real-time ECG and blood pressure monitoring information, extracting characteristic parameters, and integrated the patient's history of care information, compare cardiologist diagnostic information base to make automatic diagnosis, abnormal results are warning doctors on duty; the third level is Doctor in custody to view patient real-time monitoring information at the same time, the focus of analysis have alarms patient care information, timely on-site diagnosis; and finally for some incurable diseases can not make a timely diagnosis of the doctor on duty, by consultation of experts remote consultation terminal remote consultation.

(4)、本发明采用如下两级急救保护措施,提高对高危心脏病人在恶性病发时救助的时效性,降低病发时因得不到及时抢救而导致猝死的发生率。 (4), the present invention adopts the following two first aid measures to improve the timeliness of high-risk cardiac patients relief in the malignant disease, decrease due to lack of timely rescue when the disease caused by the occurrence of sudden death. 在本发明中,一级急救保护措施是急救人员在医生的指导下及急救车载监护仪的协助下,前往待救病人所在地对病人实施现场急救;二级是对于选配有电除颤急救模块的一类特殊高危心脏病人,当病发于特别危重的心脏疾病(如室性扑动、室性纤颤、心跳骤停、心源性昏厥等),同时急救车辆不能及时赶到的情况下,医生可行远程控制电复律刺激对该病人实施远程急救。 In the present invention, emergency protective measures a first aid personnel with the assistance of a doctor's guidance and emergency-vehicle monitors, went to be save the patient location on a patient first aid; two for optional electrical defibrillation first aid module a special kind of high-risk cardiac patients, in the case where the disease to a particular critically ill cardiac disease (such as ventricular flutter, ventricular fibrillation, cardiac arrest, cardiac syncope), while the emergency vehicle can not be rushed in doctors feasible remote control electrical cardioversion stimulation of the patient remotely aid.

(5)、本发明采用包括脉冲式分批传送、连续实时传送及监护中心主控实时通信等三种的数据传输方式,根据病人身体状况随时进行传输方式切换,有效降低移动监护仪的运行功耗、提高监护中心的远程接入通信负荷量、节约通信费用。 (5), the present invention is employed includes three data transmission pulsed batch transfer, continuous real-time transmission and the monitoring center host in real-time communications, transmission mode switching at any time according to the patients physical condition, reduce operating power movement of the monitor consumption, increase remote access communication load monitoring center, saving the communication cost. 在本发明中,移动监护仪工作在正常监护态时采用脉冲式分批传送的方式上行与医院监护中心通信,即每隔一段时间(间隔周期小于10分钟)与监护中心通信一次,将此段时间的所有监护信息压缩处理后发送给监护中心;移动监护仪工作在紧急监护态时,采用连续实时传送的方式上行与医院监护中心通信,即与监护中心进行全速实时通信,所有监护信息不经压缩发送给监护中心;如监护中心需要主动与移动监护仪通信下传医嘱或控制命令时,采用主控实时通信方式,移动监护仪监护信息暂存至此次主控通信事件完成后再合并上传给监护中心,保证监护信息完整性。 In the present invention, the mobile monitors work by way of a pulsed batch conveyed in the normal monitoring state uplink hospital care center in communication with, i.e., intervals (the interval period less than 10 minutes) a monitoring center in communication with the paragraph All monitoring information about the time of transmission after compression processing to the monitoring center; mobile monitor work in emergency care state, by way of a continuous real-time transmission of the uplink, i.e. full-speed real-time communication with the monitoring center hospital care center communicating with all the monitoring information without compression is sent to the monitoring center; such as care centers need to take the initiative and when the transfer orders mobile monitor communications under or control commands, using the master real-time communication, the mobile monitor monitoring information temporary storage to the main communication events after the completion of the merger uploaded to care centers, to ensure that monitoring information integrity.

(6)、本发明随病人和急救车所在位置和根据当地网络情况可人工或自动切换与监护中心的通信方式,保证监护信息通信传输的可靠性、降低通信运行费用、方便病人日常正常活动。 (6), according to the present invention with the patient and the location of emergency vehicles location and communication can be manually or automatically switched depending on the local network where the monitoring center to ensure the reliability of the monitoring information communication transmission, reduce the communication operation cost, convenient for patients daily normal activities. 在本发明中,当移动监护仪、急救车载监护仪位于院外时,通过GSM/GPRS移动通信网络(或CDMA、3G移动网络)与医院监护中心进行通信联络;对于接受院内或家庭实时监护的病人,其所携带的移动监护仪通过接入院内无线WiFi局域网络、或家内接入Internet的WiFi局域网络与与医院监护中心通信联络。 In the present invention, when moving the monitor, the emergency vehicle monitor located outside the hospital, (, 3G mobile network, or CDMA) communication contact hospital care center through the GSM / GPRS mobile communication network; acceptance hospital or home real-time monitoring of the patient , they carry mobile monitor and contact hospital care center communicate through access to hospital wireless WiFi local area network, or within the family access to the Internet WiFi local area network.

(7)、本发明采用以全球卫星定位系统(GPS)为主,结合移动手机定位系统和近程射频主动定位为辅的病人的联合定位方法,及时准确给出病人所在具体位置、急救车所在位置,有效调度和指挥救助人员及时到达病发现场,为抢救赢得宝贵时间。 (7), the present invention employs a global positioning system (GPS), combined with the mobile phone positioning system and a proximity radio active positioning joint positioning method, supplemented by a patient, timely and accurate given patient specific location, emergency vehicles where position, the effective scheduling and directing rescue personnel arrive disease scene, as rescue win valuable time. 在本发明中,监护中心实时接收远程移动心电监护仪上传的病人GPS位置信息、移动手机定位及近程射频主动定位信息,输入作为GIS地理定位信息;GIS系统根据输入的原始位置信息,实时定位和跟踪病人所在地区、街道、建筑物,并显示在医院监护中心和急救车载监护仪的电子地图上;其中,近程射频主动定位方式为在病发时,移动监护仪的位置定位模块主动发出一特殊频段的射频信号,急救车载监护仪在一定的近距离范围内(如小于500-1000米)可探测和定位射频信号源位置,弥补GPS盲区或GPS定位精度低不足,协助急救人员对病人的搜寻定位和现场及时救助。 Patient GPS location information in the present invention, care center receive real-time remote mobile ECG uploaded, the mobile phone location and proximity radio active positioning information inputted as GIS geographic location information; GIS system according to the original position information input in real time locate and track patient Region, streets, buildings, and displayed on the electronic map hospital care center and emergency-vehicle monitors; which, short-range radio frequency active targeting method in the disease, the mobile monitors the position-location module active radiating radio frequency signal having a specific frequency band, the emergency vehicle monitors (e.g., less than 500-1000 meters) can be detected within a short distance range and location of the RF signal source location, to compensate for GPS blind or GPS positioning accuracy is low insufficient to help emergency personnel Search positioning the patient and site and timely rescue.

本发明远程实时监护系统本身架构简单、灵活、构建方便。 Remote real-time monitoring system of the invention itself architecture is simple, flexible, build convenient. 本发明只需在现成的移动通信及GPS全球定位系统的基础之上,每个病人随身携带一台移动监护仪,再根据受监护的病人数实际情况,构建不同规模的医院监护中心,根据需要灵活扩展构建远程会诊网络和急救网络,故其可适用和满足县、市、省级医院对心脏病人、尤其是高危心脏病人的集中监护及医疗救助服务。 The present invention simply on the basis of existing mobile communications and GPS global positioning system on each patient to carry a mobile monitor, and then under under guardianship actual number of patients, build different sizes of hospital care center, if necessary flexible extension building teleconsultation network and emergency network, so it can be applied and meet the county, city, provincial hospital for heart disease, especially in high-risk heart patients centralized monitoring and Medicaid services.

附图说明 BRIEF DESCRIPTION

图1是本发明的远程实时监护系统的一种实施例拓扑结构图。 FIG 1 is a remote real-time monitoring system of the present invention topology embodiment.

图2是图1实施例中的移动监护仪的硬件模块方框图。 FIG 2 is a block diagram of the mobile monitor hardware module of FIG. 1 embodiment.

图3是图2实施例中的移动监护仪的软件结构图。 FIG 3 is a software configuration diagram of the mobile monitors the embodiment in FIG. 2.

图4是图1实施例中的医院监护中心的子系统方框图。 FIG 4 is a subsystem block diagram of the hospital care center of FIG. 1 embodiment.

图5是图1实施例在实现高危心脏病人群的集控式连续监护的工作流程总图。 FIG 5 is a workflow overall view of achieving high risk of heart disease groups centralized control continuous monitoring of FIG. 1 embodiment.

具体实施方式 Detailed ways

以下结合实施例和附图具体说明本发明的系统构成及方法。 The following Examples and the accompanying drawings illustrates a system configuration and method of the present invention.

参照图1,采用本发明的高危心脏病人群的远程实时监护系统的实施例,包括病人随身携带的移动监护仪、医院监护中心、医生远程会诊终端、急救车载监护仪,及实现各部分间信息交换的通信网络系统。 Referring to Figure 1, an embodiment of the remote real-time monitoring system of the present invention, the risk of heart disease population, including patients carry mobile monitors, hospital care center, the doctor remote consultation terminal, emergency vehicle monitors, and realization among pieces of information communication network system exchange. 通信网络系统主要包括具有远程移动通信功能的GSM/GPRS网络、家内或医院内近程无线WiFi局域网络及有线以太局域网络、Internet网络;医院监护中心通过租用宽带网络线路由院内局域网络与Internet网络连接,再与远程的GSM/GPRS移动通信网、专家医生和病人的家内无线或有线以太局域网络互联,实现监护中心与急救车载监护仪、与院内、院外及家内的受监护病人随身所携带的移动监护仪、与会诊专家医生的会诊终端进行随时随地的数据传输和通信联络。 The communication network system includes GSM having a remote mobile communication function / GPRS network, in-home or hospital proximity wireless WiFi local area network and a wired Ethernet LAN, the Internet; hospital care center via leased broadband network lines by the hospital local area network and Internet connection, and then with a remote GSM / GPRS mobile communication network, expert doctors and patients home within a wireless or wired Ethernet local area network interconnection, to achieve care center and emergency-vehicle monitor, and the hospital, outside the hospital and at home in the ward patients carry carried mobile monitors, data transmission, communication, anytime, anywhere with an expert physician consultation consultation terminal.

移动监护仪上行发送的数据包括:病人实时的心电、血压等监护信息、地理位置信息以及设备工作状态信息等,医生远程电刺激程控命令。 Data movement monitors uplink transmission comprising: a patient in real-time ECG, blood pressure monitoring information, location information, and the device operation state information, the doctor remote electrical stimulation remote command. 接收到的数据包括:医生的诊断信息、医嘱、设备调控命令。 Receiving data comprising: a doctor diagnostic information, doctor's advice, the device-control command.

医生远程会诊终端具有无线和有线两种通信方式与医院监护中心联络,在病发时、尤其是部分疑难杂症值班医生无法确诊时及时组成专家会诊网络,通过呈现的病人实时生理监护信息及历史病发信息由不同科室、不同医院甚至不同地区的专家实施会诊。 Doctors remote consultation terminal with wireless and wired two means of communication with hospital care center contact, when the disease, especially in a timely manner to form an expert consultation network when part of incurable diseases doctor on duty can not be diagnosed by the patient presented in real time physiological monitoring information and history disease information from different departments, different hospitals and even experts from different regions of the implementation of consultation.

急救车载监护仪安装在急救车上,作为急救监护装置通过无线移动通信与医院监护中心实时联系,接收待救病人的动态生理监护信息和地理位置信息、与医生交换救助信息。 Emergency car monitor installed in the ambulance as emergency care device through a wireless mobile communication with hospital monitoring center in real-time contact reception to be to save the patient's dynamic physiological monitoring information and location information, and the doctor exchanged rescue information.

参照图2,移动监护仪由高危心脏病人随身携带,作为本发明实施例的病人端设备,其硬件系统主要由生理参数采集模块、嵌入式主控制模块、人机交互模块和无线通信模块等基本模块和位置定位模块、电除颤急救模块等可选模块构成;生理参数采集模块通过体表心电导联线和血压袖带实时测量病人的心电信号和血压值,经微弱信号放大、滤波及A/D转换后形成数字信息,送入模块内的单片机做数据包封装、分包等处理,再通过IIC通信口送入嵌入式主控制模块。 Referring to FIG. 2, the mobile monitors carry a high risk of heart disease, the present invention, the patient end apparatus of this embodiment, the hardware system consists of a physiological parameter collection module, embedded main control module, interactive module and the wireless communication module substantially module and the location module, defibrillation aid module optional modules; physiological parameter acquisition module is measured by surface ECG lead and blood pressure cuff realtime ECG and blood pressure values ​​of the patient, amplifies the weak signals, filters, and a / D conversion after the formation of the digital information, into the microcontroller in the module for data packet is encapsulated, subcontracting processing, and then sent to the embedded main control module via IIC communication port. 无线通信模块采用具有PCMCIA标准接口的GPRS移动通信卡(或CDMA、3G网络)以及无线WiFi网络卡,通过PCMCIA插槽与主控制模块连接,使移动监护仪根据病人所在地网络情况自动或由病人手动选择院外GSM/GPRS移动通信网络(或CDMA、3G网络)、院内或家内无线WiFi局域网络等进行数据通信,将处理后的生理参数信息、地理位置信息和设备状态维护信息上传到医院监护中心,并接收来自于医院监护中心的诊断信息、医嘱和设备调控命令。 The wireless communication module uses GPRS mobile communications card (or CDMA, 3G network) and a wireless WiFi network card having a PCMCIA standard interface, via PCMCIA slot and a main control module, the moving monitor automatically or by the patient manually according to the patient location network where select outside the hospital GSM / GPRS mobile communication network (or CDMA, 3G networks), hospital, or in-home wireless WiFi local area network or the like in data communication, the physiological parameter information, location information and device state after the process maintenance information uploaded to the hospital care center, diagnostic information and to receive from hospital care center, the doctor and the device-control commands. 需要说明的是该移动监护仪同时配置了RJ45端口的以太网有线局域网通信端口,可方便病人选择有线方式与Internet连接,实现与监护中心的实时可靠通信;人机交互模块通过主控制模块的通用输入输出接口配置有LCD图文显示、蜂鸣器声音告警及按键输入控制方式,实现移动监护仪以声、光、图文显示等方式提示或告警病人自身体征、导联电极脱落情况及所携带的设备运行状态,方便病人查看医嘱、简单的按键功能选择和设备运行控制;位置定位模块由连接到主控制模块UART口的GPS模块以及通用输入输出接口的近程射频主动定位电路构成,连续采集病人所在的GPS地理位置,实现对病人的GPS地理位置初步跟踪和定位及救助人员对病人的射频主动探测和找寻,实现病发时在GPS定位引导下方便急救车辆及时赶到病发地,救助人员再根据探测移动监护仪发射的近 Note that the mobile monitor configure Ethernet wired local area network communication port RJ45 ports, easy patient selection wired connection to the Internet, reliable communications with the monitoring center in real time; universal human-machine interaction module via the main control module input-output interface is arranged LCD graphic display, buzzer sound alarms and key input control, for mobile monitors in sound, light, graphic display mode prompt or alert the patient's own signs, lead electrodes shedding and carried the device operation status, to facilitate the patient to see the doctor's advice, the simple key function selection and equipment operation control; position-location module by the connection to the main control module UART port of the GPS module and the proximity radio GPIO interface active locator circuit, continuous acquisition GPS location of patients where, to achieve GPS location of the patient's initial track and locate and rescue personnel RF patients take the initiative to detect and find, to achieve convenient emergency vehicles in the GPS positioning guide when the disease arrived in the disease, the rescue workers re-launch basis of the detected mobile monitor near 程射频信号,主动探测和找寻病人(尤其是地下车场、隧道、楼内等无GPS信号的地域),对病发于阵发性恶性心动过速急症病人实施及时救助;对于临床诊断病症显示有危重心脏疾病潜在病发可能的特殊病人,需选配电除颤急救模块,模块通过GPIO口与主控制模块相连,接收远程医生发出的程控电刺激命令,经放大、隔离保护后控制病人随身安装的体外电除颤器,或者经放大、调制后控制埋藏于病人体内的lCD除颤器,实施急救;对病发于特别危重的心脏疾病(如室性扑动、室性纤颤、心跳骤停、心源性昏厥等)而得不到及时救助的病人直接行远程电复律程控刺激救助;嵌入式主控制模块在ARM微处理器基础上,通过扩展SDRAM、大容量FLASH,配置必要的时钟、电源、复位和JTAG调试口,以及PCMCIA口、USB口、UART口、RJ45以太网口等通信端口构成;移动监护仪配置高 Cheng RF signal, active probing and finding patients (especially underground car parks, tunnels, building and other non-GPS signal area) of the disease in paroxysmal malignant tachycardia emergency patients implement timely assistance; for the clinical diagnosis of symptoms showed Critical heart disease underlying disease possible particular patient, for an election distribution defibrillation aid module, which is connected through the GPIO port of the main control module, programmed electrical reception remote doctor issued stimulation command, amplified, after isolation protection control patients carry installation vitro defibrillators, or the amplified, modulated control buried in the patient's body lCD defibrillators, first aid; of disease in particular severe cardiac disease (such as ventricular flutter, ventricular fibrillation, cardiac arrest stop, cardiac syncope) and lack of patient timely relief directly remotely cardioversion programmed electrical stimulation aid; embedded main control module microprocessor-based ARM, through expansion SDRAM, large capacity FLASH, configure the necessary clock, power, reset, and JTAG debug ports, and the PCMCIA port, USB ports, UART port, RJ45 Ethernet ports and other communications ports configuration; mobile monitor configured high 量锂电池,可在电池供电或市电供电方式下工作,且具有正常监护态和病发时的紧急监护态等两种工作状态,两种工作状态可由移动监护仪根据诊断结果自动切换或接受监护中心命令强制切换。 Amount of the lithium battery, can work at a battery or mains power supply, and having two operating states of emergency care state like in the normal monitoring state and a disease, two operating states by moving the monitor automatically switches or receive based on the results care center command forced switching.

参照图3,移动监护仪的软件系统采用高可靠的嵌入式系统Linux为核心、增加文件系统、网络协议及GUI库等高级抽象层功能、扩展FLASH存储器、LCD、IIC、PCMCIA等硬件驱动构成基础软件系统;移动监护仪所要完成的功能被细化为八个核心应用任务:监护信息采集及初诊、数据处理(分析、压缩、存储)、设备程控管理、人机交互任务(LCD、按键、声音报警)、GRPS通信、WiFi无线和以太网有线通信、GPS接收及射频主动定位、电除颤程控等任务,所有应用任务由Linux操作系统统一调度,宏观上实现多任务的并行执行,实现嵌入式主控制模块对各工作模块的统一控制、协调分配,最终实现移动监护仪对高危心脏病人的远程实时监护、定位和病发时的急救治疗等功能。 Referring to FIG 3, the mobile monitors the software system uses highly reliable embedded Linux core, increase the file systems, network protocols, and GUI libraries advanced abstraction layer, expanded FLASH memory, LCD, IIC, PCMCIA hardware drivers form the basis software system; mobile monitor the functions to be accomplished is subdivided into eight core application tasks: monitoring information collection and newly diagnosed, data processing (analysis, compression, storage), device programmed management, human-computer interaction tasks (LCD, buttons, sounds alarm), GRPS communication, WiFi wireless and wired Ethernet communication, GPS receivers and radio frequency active position, defibrillation program-controlled tasks, all application tasks unified by the Linux operating system, parallel execution of multiple tasks macro, embedded the main control module for unified control of the working module, coordinating distribution, and ultimately mobile monitor remote real-time monitoring of high-risk heart patients, when positioning and the disease first aid treatment and other functions.

参照图4,医院监护中心设置于医院内,作为本发明实施例的信息交换、处理、存储和分发的中心,由通信服务子系统、监护与诊疗子系统、GIS地理定位子系统、数据库子系统、运行维护子系统等构成;其中,通信服务子系统是监护中心的通信网关,实现医院监护中心与远程移动监护仪、急救车载监护仪、医生远程会诊终端之间的院外GSM/GPRS移动通信网络(或CDMA、3G移动网络)、院内无线局域网及Internet网络的数据交换和分发,以及与医院已有兼容PACS、DICOM通信标准的诊疗系统进行互联互通;数据库子系统是整个监护中心以及整个远程实时监护系统的信息中心,由通信网关统一将各类数据信息分类、更新并存入相应的数据库中;监护信息库和设备信息库分别收集和存储历史的和实时的病人监护信息及各远程设备配置及运行状态信息,受监护病人的病历信 4, hospital care center set up in hospitals within, as the embodiment of the invention information exchange, processing, storage and distribution center, by the communication service subsystem, care and treatment sub-system, GIS geographic positioning subsystem, database subsystem , operation and maintenance subsystems, and the like; wherein the communication service is communication gateway subsystem care center, hospital care center and implement remote mobile monitors, emergency-vehicle monitor, outside the hospital consultation between doctors remote terminal GSM / GPRS mobile communication network (or CDMA, 3G mobile networks), hospital wireless LAN and Internet network data exchange and distribution, as well as existing compatible PACS, DICOM communication standard medical systems and hospitals interoperability; database subsystem is the entire care centers, and the real-time remote monitoring system information Center, a communication gateway unified the various types of data classification, updated and stored in the appropriate database; monitoring information database and device information library were collected and stored historical and real-time patient monitoring information and each remote device configuration and operating status information, medical records of patients under guardianship letter 息以及专家的诊断经验信息分别存入病人的电子病历库和专家信息库中,地理信息库包括受监护病人的行踪信息和所在地区的电子地图;监护与诊疗子系统根据实时监护每个病人的动态心电信号和血压值、结合专家数据库进行自动分析、病发告警、辅助值班医生及远程会诊医生进行早期诊断,必要时医生通过该子系统发出远程电复律程控电刺激命令对病人实施远程急救;GIS地理定位子系统在电子地图上跟踪显示病人所在位置;运行维护子系统完成对远程各移动监护仪、急救车载监护仪进行运行监控、诊断和维护,对医院监控中心各子系统的运行状态、操作权限进行管理;值班医生通过监护中心主界面可实时观看每位受监护病人的心电及血压等生理信息、跟踪和定位病人地理位置、查阅历史监护信息,可远程管理和程控病人随身携带的移动监护仪、 Information and diagnostic experience information specialists are stored in the patient's electronic medical records database and expert information database, geographic information library including by electronic map whereabouts information for monitoring a patient and your region; care and treatment subsystem based on real-time monitoring of each patient Holter signal and the blood pressure values, combined with expert database for automatic analysis, disease alarm, auxiliary doctor on duty and the remote consultation physician early diagnosis performed on the patient remote doctor issued remote electrical cardioversion programmed electrical stimulation command by the subsystem when necessary first aid; GIS geographic positioning subsystem tracking on the electronic map display patient location; operation and maintenance subsystem complete remote each mobile monitors, emergency-vehicle monitor conduct performance monitoring, diagnostics and maintenance, each subsystem to run the hospital monitoring center state operating authority to manage; doctor on duty through the monitoring center of the main interface can watch each ward patient's ECG and blood pressure and other physiological information, tracking and locating patient location, access to historical monitoring information, remote management and programming of the patient players portable mobile monitor, 救车载监护仪等设备。 Save car monitors and other equipment.

参照图5,本实施例实现高危心脏病人群的集控式连续监护的工作过程如下:首先,本实施例中受监护的高危心脏病人群每人随身携带一台移动监护仪,工作在正常监护态实时采集该病人的心电信号及血压信息、进行初步分析诊断,连同接收到的GPS等定位信息经压缩处理后采用脉冲式分批传送的方式上传至医院监护中心;并采用短时循环更新的方式储存在Flash存储器里,而监护诊断也同步在移动监护仪上予以显示;接着,设置于医院内的监护中心同时对多名病人进行实时监护,监护中心通信服务子系统实时接收位于院外远程各地、院内各处或家内的各个病人随身携带的移动监护仪发送的数据,对其进行解压缩、通信协议转换处理后,将病人的监护信息保存到数据库子系统的监护信息库中、将移动监护仪的工作参数信息保存到数据库子系统的设备信息 Referring to FIG 5, the present embodiment implements centralized control type high risk of heart disease populations continuous monitoring of the process is as follows: First, the present embodiment by monitoring the risk of heart disease groups per carry a mobile monitor, operating in a normal monitoring state of real-time acquisition of ECG and blood pressure information of the patient, a preliminary analysis and diagnosis, along with positioning information received GPS or the like after the compression treatment using uploading pulsed batch transferred to hospital care center; and using short cycle update the way is stored in the Flash memory inside, while care diagnosis also simultaneously be displayed on the mobile monitor; then disposed care center in the hospital at the same time more than patient in real-time monitoring, monitoring center communication service subsystem receive real-time located outside the hospital remote country, data movement monitors throughout the hospital or sent home within individual patients carry, unpack it, after the communication protocol conversion process to save the patient's care information into the database subsystem custody repository, move save the parameter monitor information to the device information database subsystem 中、将GPS等定位信息保存到数据库子系统的地理位置信息库中;监护与诊疗子系统实时分析监护信息库中每个病人的动态心电信号和血压值、进行自动诊断和预警;每个受监护的病人的心电、血压监护信息以及其预警信息均通过监护与诊疗子系统实时显示出来,实现值班医生在一个监护中心对院内外多名高危心脏病人的集中式实时监护;其次,当某受监护的病人急性病发时,其所携带的移动监护仪对异常心电或血压信息进行初步分析诊断,告警提示病人并自动转为紧急监护态,采用连续实时传送的方式与医院监护中心通信联络全速上传实时监护信息;监护中心对告警信息和所指示的病人的监护信息进行自动分析诊断,诊断结果为异常即产生一个告警事件,通过监护与诊疗子系统告警提示值班医生;继而,由值班医生在结合系统自动分析诊断结果 , Save the GPS and other location information to the database subsystem geographical information database; care and treatment subsystem real-time analysis Holter signal and blood pressure values ​​for each patient's care information repository, automated diagnosis and early warning; each ECG ward patients, blood pressure monitoring information and early-warning information is by monitoring and treatment subsystem displayed in real time, to achieve the doctor on duty at a care center centralized real-time monitoring on the outside of the hospital more than high-risk heart patients; secondly, when a subject when monitoring patients with acute hair, they carry mobile monitor abnormal ECG or blood pressure information is preliminary analysis and diagnosis, alarm prompts the patient and automatically converted to emergency care state, the use of continuous real-time transmission and hospital care center communication Contact uploading at full speed real-time monitoring information; alarm monitoring center for information and patient care information indicated for automatic analysis and diagnosis, diagnosis is abnormal which produce an alarm event, through monitoring and alarm notification subsystem clinic doctor on duty; then, on duty doctors automatic analysis and diagnosis results in a combined system 同时对监护告警事件作及时处理,即对病发病人的监护信息深入分析和诊断、剔除系统的误报警,并对短时和对病人生命健康无危险的异常监护信息做出标志;值班医生根据病人的监护信息可通过监护中心向远程移动监护仪下发医嘱,建议和提示病人相关注意事项;然后,对于病发症状复杂值班医生不能及时确诊的告警事件,由值班医生及时组织相关专家医生,通过监护中心的通信服务子系统联络各处专家的远程会诊终端组成专家会诊网络,专家根据各自会诊需要由远程会诊终端提取和分析病人的实时监护信息和历史监护信息,专家之间诊断建议通过监护中心中转和分发,继而对该病发症状予以确诊,值班医生根据会诊意见对告警事件进行相应处理;最后,对于经值班医生确诊或经专家会诊为病发于恶性心脏疾病且需及时抢救的病人,值班医生根 While monitoring for timely processing of alarm events, that the incidence of human disease care information in-depth analysis and diagnosis, eliminate false alarms system, and make a mark on the short-term and life and health of the patient without risk of abnormal care information; according to the doctor on duty patient care information is available through the monitoring center to issue orders under remote mobile monitors, suggestions and tips patient-related considerations; then, for the disease symptom complex doctor on duty can not be timely diagnosis of an alarm event, by the doctor on duty promptly organize relevant medical experts, subsystem contact remote consultation terminal throughout experts composed of expert consultation network through communication service monitoring center, experts need to extract and analyze the patient by the remote consultation terminal in accordance with their consultation, real-time monitoring and historical monitoring information, diagnostic recommendations between experts through monitoring Center transit and distribution, and then to be the disease with symptoms diagnosed, the doctor on duty accordingly handle the event based on consultation comments; Finally, by the doctor on duty diagnosed or with expert consultation for the disease malignant heart disease and the need for timely rescue of patients , Doctor root 据GIS地理定位子系统指示,及时联系病人所在地急救中心指派急救人员前往救助,急救人员通过急救车载监护仪与监护中心实时通信联络,接收监护中心救助指导、实时接收病人的心电及血压监护信息、地理位置信息和该病人的历史病例信息,前往现场对病人实施救助;而对于病发于特别危重、必须立即治疗的心脏疾病,且急救人员不能及时赶到的情况下,值班医生行远程控制电复律刺激对该病人实施远程急救。 According to GIS geographic positioning subsystem instructions, promptly contact your local emergency center patients assigned emergency personnel to the rescue, first aid emergency personnel through real-time communication with on-board monitor contact center monitoring, monitoring center to receive aid guide, receive real-time patient ECG and blood pressure monitoring information geographical and historical case information of the patient, to the scene on a patient assistance; and for the disease in particular critical need immediate treatment of heart disease, case and emergency personnel can not be rushed, and the doctor on duty-line remote control electrical cardioversion stimulation of the patient remotely aid.

同时,病人随身携带的移动监护仪自动监测其工作运行情况,定时收集设备供电电池、Flash存储器、心电导联电极接触、GPS通信、GPRS(或CDMA、3G)通信等设备工作参数,急救车载监护仪及远程会诊终端同样自动监测和收集设备运行状态、与监护中心通信情况等工作参数;当网络通信故障,则移动监护仪自动转为Holter式动态监护方式,实时监护信息自动存入移动监护仪自带存储器中;所有的远程移动监护仪、急救车载监护仪及远程会诊终端的运行状态参数均经过统一编码处理后上传至监护中心的设备信息库中;在设备出现工作状态异常甚至故障时,移动监护仪将显示设备故障信息、自动告警提示病人,急救车载监护仪将显示设备故障信息、自动告警提示急救人员;在需要调整工作参数或可通过修改工作参数消除设备故障时,值班医生可通过监护中心的 Meanwhile, the patients carry a mobile monitor automatically monitor its operation, the timing of collection device powered by the battery, the device operating parameters Flash memory, ECG electrode contact, GPS communication, GPRS (or CDMA, 3G) communication, emergency vehicle monitoring devices and remote consultation terminals same automatic monitoring and operating parameters of the collection device operation status, with the monitoring center communication situation and the like; when the network communication failure, the mobile monitor automatically to Holter Ambulatory monitoring mode, real-time monitoring information is automatically stored in the mobile monitor built-in memory; all remote mobile monitors, emergency-vehicle monitors, and operating parameters of remote consultation terminal are uploaded to the device repository care center in unified coding process through; abnormal working condition appears in the device or even failure, mobile monitor will display equipment failure information, automatic alarm prompts the patient, equipment failure information, automatic alarm prompts emergency personnel first aid on-board monitor will display; if necessary adjust operating parameters or eliminate equipment failure by modifying the operating parameters, the doctor on duty by care center 行维护子系统对所监测的移动监护仪或急救车载监护仪的进行在线远程调参和维护;这样监护中心在医院内实现对不同地点、不同功能的远程设备(移动监护仪、急救车载监护仪及远程会诊终端)的集中式同步实时监测、维护和管理。 Line maintenance subsystem of the monitored mobile monitor or emergency-vehicle monitors online remote parameter adjustment and maintenance; such monitoring center remote device to different locations, different functions (mobile monitors in hospitals, first aid onboard monitor and remote consultation terminal) centralized simultaneous real-time monitoring, maintenance and management.

在上述实施例中,电除颤器、急救车载监护仪、远程会诊终端,移动监护仪的GPS模块、GPRS模块、生理参数采集模块、电池供电模块等硬件模块和uC/OS-II、TCP/IP协议栈、文件系统、GUI库等软件系统,监护中心的数据库管理系统、计算机系统,常规的远程心电移动监护原理、电除颤的远程程控方法以及高危心脏病的心电自动分析识别和诊断方法等为常规的,故未给出详细阐述,具体可参考相关技术资料和现有的基于移动通信系统的远程心电监护系统来实现。 In the above embodiment, defibrillators, first aid vehicle monitor, remote consultation terminal, the mobile monitors the GPS module, GPRS module, a physiological parameter acquisition module, battery module hardware modules and uC / OS-II, TCP / IP protocol stack, filesystem, GUI libraries and other software systems, monitoring center database management systems, computer systems, conventional remote ECG mobile monitoring principle, remote program control method defibrillation and ECG at high risk of heart disease automated analysis to identify and diagnosis method as conventional and not shown in detail, specifically with reference to technical information and existing mobile communication systems based remote ECG monitoring system is achieved.

Claims (11)

1.一种针对高危心脏病人群的远程实时监护系统,包括病人随身携带的移动监护仪、医院监护中心、医生远程会诊终端、急救车载监护仪及通信网络系统;该系统针对心脏病、尤其是高危心脏病在临床监护、诊断和救助等方面的特殊需要,通过通信网络,使医院监护中心与院内外移动监护仪、急救车载监护仪及远程会诊终端实时地互连互通,交换、传输病人实时心电、血压等监护信息、病人地理位置信息、医生会诊信息和医嘱以及各远程设备遥测程控信息,实现对院内外高危心脏病人群随时随地的集中连续监护、在病发前予以早期准确诊断、恶性病发时实施及时救助及对远程移动终端设备集中遥测和程控;其特征在于:(1)所述的移动监护仪由高危心脏病人随身携带,作为该远程实时监护系统的病人端设备,由基本模块:生理参数采集模块、嵌入式 A high-risk heart disease populations of remote real-time monitoring system, including patients carry mobile monitors, hospital care center, doctors remote consultation terminal, first aid onboard monitors and communication network system; the system for heart disease, especially high risk of heart disease with special needs in terms of clinical care, diagnosis and rescue, etc., through the communication network, the hospital care center and outside of the hospital mobile monitors, emergency-board monitor and remote consultation terminal in real-time interconnection, exchange, transport the patient in real time ECG, blood pressure and other monitoring information, patient location information, the doctor consultation information and orders as well as the remote device telemetry programmed information, centralized continuous monitoring of people anywhere outside of the hospital at high risk of heart disease, be early and accurate diagnosis before the disease, embodiment malignancies when sent timely assistance and remote mobile terminal device concentration telemetry and program control; characterized in that: (1) the mobile monitor from high-risk cardiac patients carry, as the patient end device of the remote real-time monitoring system, the basic modules: physiological parameter acquisition module, an embedded 控制模块、人机交互模块和无线通信模块,以及可选模块:位置定位模块、电除颤急救模块构成;其中,生理参数采集模块通过体表心电导联线和血压袖带实时测量病人的心电信号和血压值;无线通信模块接入院外GSM/GPRS移动通信网络或CDMA或3G网络、院内或家内无线WiFi局域网络,将处理后的生理参数信息、设备状态维护信息上传到医院监护中心,并接收来自于医院监护中心的医嘱,诊断信息;人机交互模块通过声、光、文字显示等方式提示或告警病人自身体征、导联电极脱落情况及所携带的设备运行状态;位置定位模块连续采集病人所在的地理位置,协助医生指导急救人员对病发于阵发性恶性心动过速急症病人实施及时救助;对于临床诊断病症显示有危重心脏疾病潜在病发可能的特殊病人,选配电除颤急救模块,实现医生对病发于特别危重的心脏 A control module, interactive module and a wireless communication module, and optional modules: a position-location module, defibrillation rescue modules; wherein the physiological parameter acquisition module measuring a patient's heart in real time by surface ECG lead and blood pressure cuff electrical and blood pressure value; external wireless communication module access hospital GSM / GPRS mobile communication network or CDMA or 3G network, hospital, or in-home wireless WiFi local area network, the physiological parameter information, the device state after the process maintenance information uploaded to the hospital care center, and receiving from the orders hospital care center, the diagnostic information; interactive module prompt or alert the patient's own signs, lead electrodes shedding and carried equipment operation via sound, light, text display mode; position location module continuously collecting geographic patient is located, to help doctors guide emergency personnel to the disease in paroxysmal malignant tachycardia emergency patients implement timely assistance; for the clinical diagnosis of symptoms showed a severe heart disease underlying disease possible special patients, selected distribution except flutter first aid module, the doctor heart of the disease in particular critical of 疾病而得不到及时救助的病人直接进行远程电复律程控刺激救助;上述模块在嵌入式主控制模块的统一控制下协调工作,实现移动监护仪对高危心脏病人的远程实时监护、定位和病发时的急救治疗的功能;(2)所述的医院监护中心设置于医院内,作为该远程实时监护系统的信息交换、处理、存储和分发的中心,由通信服务子系统、监护与诊疗子系统、GIS地理定位子系统、数据库子系统、运行维护子系统构成;其中,通信服务子系统是监护中心的网关,实现医院监护中心与远程移动监护仪、急救车载监护仪、医生远程会诊终端之间的院外GSM/GPRS移动通信网络或CDMA或3G移动网络、院内WiFi无线局域网及Internet网络的数据交换和分发,以及与医院已有兼容PACS、DICOM通信标准的诊疗信息系统进行互联互通;监护与诊疗子系统实时监护每个病人的动态心电信号和 Disease and lack of patient timely rescue of direct remote electrical cardioversion programmed electrical stimulation aid; above modules coordinate the work under the unified control of the embedded main control module for mobile monitor remote real-time monitoring of high-risk heart patients, positioning and disease function aid treatment when hair; (2) according to hospital care center is provided in a hospital, the central Examples of the remote real-time monitoring system to exchange information, processing, storage and distribution, by the communication service subsystem, monitoring and treatment sub system, GIS geographic positioning subsystem, database subsystem, operation and maintenance of subsystems; wherein the communication service subsystem is the gateway monitoring center, to achieve hospital care center with remote mobile monitors, emergency-vehicle monitor, a doctor teleconsultation terminal of outside the hospital GSM between / GPRS mobile communication network or CDMA or 3G mobile networks, data exchange and distribution of nosocomial WiFi wireless LAN and Internet networks, and has been compatible with the hospital PACS, DICOM communication standard medical information systems interoperability; monitoring and treatment subsystem real-time monitoring of each patient's Holter signal and 压值,结合专家数据库进行自动分析,并实施病发告警、辅助值班医生及远程会诊医生进行早期诊断,医生通过该子系统发出远程电除颤程控电刺激命令对病人实施远程急救;GIS地理定位子系统在电子地图上跟踪显示病人所在位置;运行维护子系统完成对远程各移动监护仪、急救车载监护仪进行运行监控、诊断和维护,对医院监控中心各子系统的运行状态、操作权限进行管理;(3)所述的医生远程会诊终端具有无线和有线两种通信方式与医院监护中心联络,在病发时、尤其是部分疑难杂症值班医生无法确诊时及时组成专家会诊网络,通过呈现的病人动态生理监护信息及历史病发信息由不同科室、不同医院甚至不同地区的专家实施会诊;(4)所述的急救车载监护仪安装在急救车上,作为急救监护装置通过无线移动通信与医院监护中心实时联系,接收待救 Pressure value, combined with expert database for automatic analysis, and implementation of disease alarms, auxiliary doctor on duty and remote consultation doctor for early diagnosis, doctors stimulate command on a patient remote first aid issue remote defibrillation program-controlled electricity through the subsystem; GIS geopositioning subsystem tracking on the electronic map display patient location; operation and maintenance subsystem complete remote each mobile monitors, emergency-vehicle monitor conduct performance monitoring, diagnostics and maintenance, operational status of the hospital monitoring center of the subsystems, the operating authority for management; doctors remote consultation terminal according to (3) with wireless and wired two means of communication with hospital care center contact, when the disease, especially in a timely manner to form an expert consultation network when part of incurable diseases doctor on duty can not be confirmed, by presenting dynamic physiological monitoring information, and send the history disease information from the different sections, the different hospitals and even experts in different areas embodiments consultation patient; according to (4) emergency vehicle monitor installed in the ambulance, as emergency monitoring device through a wireless mobile communication and hospital care center in real-time contact reception to be saved 病人的动态生理监护信息和地理位置信息、与医生交换救助措施。 Patient dynamic physiological monitoring information and location information, Remedies and doctors exchange.
2.根据权利要求1所述的远程实时监护系统,其特征在于所述的移动监护仪中,所述的生理参数采集模块将测量的心电信号和血压值,经微弱信号放大、滤波及A/D转换后形成数字信息,送入模块内的单片机做数据包封装、分包处理,再通过IIC通信口送入嵌入式主控制模块;所述无线通信模块采用具有PCMCIA标准接口的GPRS移动通信卡以及无线WiFi网络卡,通过PCMCIA插槽与主控制模块连接;所述人机交互模块通过主控制模块的通用输入输出接口配置有LCD图文显示、蜂鸣器声音告警及按键输入控制方式;所述的位置定位模块由连接到主控制模块UART口的GPS模块以及通用输入输出接口的近程射频主动定位电路构成,连续采集病人所在的GPS地理位置;所述的电除颤急救模块通过GPIO口与主控制模块相连,接收远程医生发出的程控电刺激命令,经放大、隔离保护后控制 The remote real-time monitoring system according to claim 1, characterized in that the ECG and blood pressure values ​​of the mobile monitor, the physiological parameter acquisition module to be measured, the weak signal amplification, filtering, and A after the a / D converter forming digital information into the microcontroller in the module for data packet encapsulation, sub-process, and then into the embedded main control module via IIC communication port; the wireless communication module uses GPRS mobile communication having a PCMCIA standard interface card and a wireless WiFi network card via the PCMCIA slot and a main control module; the interactive module LCD graphic display via GPIO interface configuration of the main control module, a buzzer sounds an alarm and a key input control; the position-location module active targeting by the connection to the main control module UART port of the GPS module and the proximity radio GPIO interface circuit, continuously collecting GPS location patient location; said electrical defibrillation aid module GPIO coupled port and a main control module, receives a remote doctor issued programmed electrical stimulation command, amplified, after isolation protection control 病人随身安装的体外电除颤器,或者经放大,调制后控制埋藏于病人体内的ICD除颤器,实施急救;所述嵌入式主控制模块以ARM微处理器为核心,扩展有SDRAM、大容量FLASH,并配置时钟、电源、复位和JTAG调试口,以及PCMCIA口、USB口、UART口、RJ45以太网口。 Patients carry installed vitro defibrillators, or the amplified, modulated control buried in the patient's ICD defibrillators, first aid; said embedded main control module ARM microprocessor core, extended with SDRAM, large capacity FLASH, set the clock, power, reset, and JTAG debug ports, and the PCMCIA port, USB ports, UART port, RJ45 Ethernet port.
3.一种利用权利要求1所述的高危心脏病人群的远程实时监护系统进行集控式连续监护的方法,其特征在于具体步骤如下:(1)受监护的高危心脏病人群每人随身携带一台移动监护仪,在正常监护状态时实时采集该病人的心电信号及血压信息、进行初步分析诊断,连同接收到的GPS定位信息经压缩处理后采用脉冲式分批传送的方式上传至医院监护中心;并采用短时循环更新的方式将上述信息储存在Flash存储器里,自动诊断结果也同步在移动监护仪上予以显示;(2)设置于医院内的监护中心同时对多名病人进行实时监护,监护中心的通信服务子系统实时地接收位于院外远程各地、院内各处或家内的各个病人随身携带的移动监护仪发送的数据,对其进行解压缩、通信协议转换处理,然后将病人的监护信息保存到数据库子系统的监护信息库中、将移动监护仪的工 A use as claimed in claim risk of heart disease groups real-time remote monitoring system of claim 1 for centralized control continuous monitoring process, characterized by the following steps: (1) by monitoring the risk of heart disease groups per carry a mobile monitor, in the normal monitoring status in real time acquisition of ECG and blood pressure information of the patient, a preliminary analysis and diagnosis, uploaded to the hospital, together with mode after receiving the GPS location information by the compression processing using pulsed batch transfer care center; and adopting a short-cycle update of the above information is stored in Flash memory, the automatic diagnosis also simultaneously be displayed on the mobile monitor; (2) provided in the care center in the hospital at the same time more than patient in real time guardianship, care center communication service subsystem received in real time located outside the hospital around the remote data throughout the hospital or the individual patient in the home portable mobile monitors sent, decompresses it, the communication protocol conversion process, and then the patient save monitoring information to the database subsystem custody repository, move the monitor's work 参数信息保存到数据库子系统的设备信息库中、将GPS定位信息保存到数据库子系统的地理位置信息库中,监护与诊疗子系统实时分析监护信息库中每个病人的动态心电信号和血压值、进行自动诊断和预警;每个受监护的病人的心电、血压监护信息以及其预警信息均通过监护与诊疗子系统实时显示出来,使值班医生在一个监护中心对院内外多名高危心脏病人的集中式实时监护;(3)当某受监护的病人急性病发时,其所携带的移动监护仪对异常心电或血压信息进行初步分析诊断,告警提示病人并自动转为紧急监护状态,采用连续实时传送的方式与医院监护中心通信联络全速上传实时监护信息;监护中心对告警信息和所指示的病人的监护信息进行自动分析诊断,诊断结果为异常即产生一个告警事件,通过监护与诊疗子系统告警提示值班医生;然后,由值班 Save parameter information to the database subsystem device information library, save the GPS location information to a database subsystem geographic information database, monitoring and treatment subsystem real-time analysis Holter signal and blood pressure monitors repository for each patient value, the automatic diagnosis and early warning; ECG each ward of the patient's blood pressure monitoring information and early-warning information is by monitoring and treatment subsystem is displayed in real time, the doctor on duty at a care center for more than outside of the hospital in high-risk heart patients centralized real-time monitoring; (3) when monitoring patients with acute hair of a subject, they carry mobile monitor abnormal ECG or blood pressure information is preliminary analysis and diagnosis, alarm prompts the patient and automatically switch to the emergency ward, continuous real-time transmission of the way hospital care center communication contact at full speed upload real-time monitoring information; care center for alarm information and patient indicated by monitoring information for automatic analysis and diagnosis, the diagnosis result is abnormal, ie generate an alarm event, the monitoring and treatment subsystem alarm prompts the doctor on duty; then, on duty 医生在结合系统自动分析诊断结果的同时对监护告警事件作及时处理,包括对病发病人的监护信息深入分析和诊断、剔出系统的误报警,并对短时和对病人生命健康无危险的异常监护信息做出标志;值班医生根据病人的监护信息通过监护中心向远程移动监护仪下发医嘱,建议和提示病人相关注意事项;(4)对于病发症状复杂,值班医生不能及时确诊的告警事件,由值班医生及时组织相关专家医生,通过监护中心的通信服务子系统联络各处专家的远程会诊终端组成专家会诊网络,专家根据各自会诊需要由远程会诊终端提取和分析病人的实时监护信息和历史监护信息,专家之间诊断建议通过监护中心中转和分发,继而对该病发症状予以确诊,值班医生根据会诊意见对告警事件进行相应处理;(5)对于经值班医生确诊或经专家会诊为病发于恶性心脏疾病且需 Doctors in combined automatic analysis diagnosis system for monitoring alarm event for timely processing, including monitoring information on disease incidence of people in-depth analysis and diagnosis, bound by the system of false alarms, and the short-term and patient life and health of non-hazardous alarm (4) for the disease symptom complex, Doctor not promptly diagnosed; abnormal monitoring information to make signs; the doctor on duty in accordance with the patient's care information through the care center to issue orders under remote mobile monitors, suggestions and tips patient-related considerations event, by the doctor on duty promptly organize relevant medical experts, through the communication service monitoring center subsystem contact remote consultation terminal throughout experts composed of expert consultation network, experts need to extract and analyze the patient by the remote consultation terminal in accordance with their consultation, real-time monitoring information and historical monitoring information, diagnostic recommendations between experts through monitoring center transit and distribution, and then to be diagnosed the disease with symptoms, the doctor on duty accordingly handle the event based on consultation comments; (5) for by the doctor on duty diagnosed or with expert consultation to disease malignant heart disease and the need 时抢救的病人,值班医生根据GIS地理定位子系统指示,及时联系病人所在地急救中心指派急救人员前往救助,急救人员通过急救车载监护仪与监护中心实时通信联络,接收监护中心救助指导、实时接收病人的心电及血压监护信息、地理位置信息和该病人的历史病例信息,前往现场对病人实施救助;而对于病发于特别危重、必须立即治疗的心脏疾病,且急救人员不能及时赶到的情况下,值班医生行远程控制电复律刺激对该病人实施远程急救;同时,病人随身携带的移动监护仪自动监测其工作运行情况,定时收集设备供电电池、Flash存储器、心电导联电极接触、GPS通信、GPRS或CDMA或3G通信设备工作参数,急救车载监护仪及远程会诊终端同样自动监测和收集设备运行状态、与监护中心通信情况这些工作参数;所有的远程移动监护仪、急救车载监护仪及远 Patient rescue, the doctor on duty subsystem indication based on GIS geographic location, promptly contact your local patient emergency center assigned emergency personnel to the rescue, emergency personnel through the emergency real-time communication on-board monitor and care center contact, receiving care center aid guide, receive real-time patient ECG and blood pressure monitoring information, location information and historical case information of the patient, to the scene on a patient assistance; and for the disease in particular critical need immediate treatment of heart disease, and emergency personnel can not be timely arrived , the doctor on duty remotely control electrical cardioversion stimulation of the patient remotely aid; Meanwhile, patients carrying a mobile monitor automatically monitor its operation, the timing of collection device powered by the battery, Flash memory, ECG electrode contact, GPS communications, GPRS or CDMA or 3G communication device operating parameters, and emergency vehicle monitor and remote consultation terminals same automatic monitoring and operating state, and the care center communicating these operating parameters the collection device; all remote mobile monitoring device, emergency vehicle monitor and far 会诊终端的运行状态参数均经过统一编码处理后上传至监护中心的设备信息库中;在设备出现工作状态异常甚至故障时,移动监护仪将显示设备故障信息、自动告警提示病人,急救车载监护仪将显示设备故障信息、自动告警提示急救人员;在需要调整工作参数或可通过修改工作参数消除设备故障时,值班医生通过监护中心的运行维护子系统对所监测的移动监护仪或急救车载监护仪的进行在线远程调参和维护;这样监护中心在医院内实现对不同地点、不同功能的远程设备包括移动监护仪、急救车载监护仪及远程会诊终端的集中式同步实时监测、维护和管理。 Running parameters consultation terminal are unified coding process after upload to the device repository care center in; work condition occurs in equipment malfunction even when a fault, move the monitor will display the equipment failure information, automatic alarm prompts the patient, first aid onboard monitor equipment failure information, automatic alarm prompts emergency personnel will be displayed; when you need to adjust operating parameters or eliminate equipment failure by modifying the operating parameters, Doctor maintenance subsystem of the monitored mobile monitor or emergency car monitor by running the care center the online remote parameter adjustment and maintenance; such monitoring center remote device to different locations, different functions including mobile monitors, emergency-board monitor and centralized simultaneous real-time monitoring of remote consultation terminal, maintenance and management in hospitals.
4.根据权利要求3所述的集控式连续监护方法,其特征在于采用实时监护和动态监护两级自动监护方法保证对高危心脏病人的连续监护,一是医院监护中心的实时监护:监护中心实时接收远程移动监护仪采集、上传的病人心电和血压信息,经分析处理后实时显示在监护中心监视器上供值班医生查看和诊断,同时保存到监护信息数据库中;二是移动监护仪的动态监护:当病人随身携带的移动监护仪与监护中心出现长段时间通信故障时,移动监护仪将自动转为Holter式动态监护,将实时采集的心电和血压信息存入随机附带的大容量Flash存储器里,并提示病人通信故障,在移动监护仪的有效存储监护期内需前往监护中心。 4. The centralized control continuous monitoring method according to claim 3, characterized in that a real-time monitoring and dynamic monitoring two automatic monitoring method to ensure a continuous monitoring of high-risk cardiac patients, one real-time monitoring hospital care center: the monitoring center receive real-time remote mobile monitor collection, upload patient ECG and blood pressure information, after analysis and processing real-time display on duty doctors to see and diagnose the monitoring center monitor altar, save to the custody of the information in the database at the same time; the second is to move the monitor dynamic monitoring: when a patient carry mobile monitor and care center appears a long period of time a communication failure, a mobile monitor will automatically be converted to Holter Ambulatory care, the real-time collection of ECG and blood pressure information into the supplied high-capacity Flash memory inside, and prompts the patient communication failure, a mobile monitor effective storage monitoring period need to go to the monitoring center.
5.根据权利要求3所述的集控式连续监护方法,其特征在于采用多级诊断预防措施,包括:(1)移动监护仪的初步分析诊断:实时初步的分析、识别病人心电图的P波、QRS波、T波、ST段、PP间期、PR间期、ST间期,以及检测血压的收缩压、舒张压等特征参数,当诊断结果出现异常时将告警提示病人,同时将告警上传至监护中心;(2)医院监护中心的自动诊断:处理移动监护仪上传的告警信息,全面分析病人的实时心电和血压监护信息,提取特征参数,并综合该病人的历史监护信息、比对心脏病专家诊断信息库,做出自动诊断,结果异常则告警值班医生;(3)第三级是值班医生在监护查看病人实时监护信息同时,重点分析有告警信息病人的监护信息,及时做出现场诊断;(4)对于值班医生的无法做出及时诊断的部分疑难杂症,由会诊专家远程会诊终端进行远程会诊 The centralized control continuous monitoring method according to claim 3, characterized in that the multi-level diagnosis prevention, comprising: a preliminary analysis and diagnosis (1) moving the monitor: real-time preliminary analysis, identifying the patient ECG P-wave , a QRS wave, T-wave, ST segment, PP period, PR interval, between ST period, and detecting a systolic blood pressure, diastolic blood pressure and other characteristic parameters, when the diagnostic result is abnormal will alarm prompting a patient while the alarm upload to the care center; automatic diagnostics (2) hospital care center: the process alarms mobile monitor uploaded a comprehensive analysis of the patient's real-time ECG and blood pressure monitoring information, extracting characteristic parameters, and integrated the patient's history of care information, comparison cardiologist diagnostic information base to make automatic diagnosis, abnormal results are warning doctors on duty; (3) the third level is the doctor on duty in the custody viewing patient real-time monitoring information at the same time, the focus of analysis have alarms patient care information in a timely manner site diagnosis; (4) for some incurable diseases can not make a timely diagnosis of the doctor on duty, remote consultation by the consultation of experts remote consultation terminal .
6.根据权利要求3所述的集控式连续监护方法,其特征在于采用如下两级高危心脏病人在病发时的急救保护措施:一级是急救人员在医生的指导下及急救车载监护仪的协助下,前往待救病人所在地对病人实施现场急救;二级是对于选配有电除颤急救模块的一类特殊高危心脏病人,当病发于特别危重的心脏疾病,同时急救车辆不能及时赶到的情况下,医生进行行远程控制电复律刺激对该病人实施远程急救。 The centralized control continuous monitoring method according to claim 3, wherein follows two high-risk cardiac patients emergency protection at onset of: a first aid personnel under the guidance of a doctor and emergency vehicle monitor under the assistance, go to be save the patient location on a patient first aid; two for a special high-risk heart patients optional electrical defibrillation first aid module, when the disease occurs in particular severe heart disease, while emergency vehicles can not be timely the case went to the doctor performed remotely control electrical cardioversion stimulation of the patient remotely aid.
7.根据权利要求3所述的集控式连续监护方法,其特征在于所述的移动监护仪采用正常监护态和病发时的紧急监护态两种工作状态,两种工作状态由移动监护仪根据诊断结果自动切换或接受监护中心命令强制切换。 The centralized control continuous monitoring method according to claim 3, characterized in that said mobile monitor using emergency care state two operating states in the normal monitoring state and a disease, two operating states of the mobile monitor automatic switching or accept care center command to force the switch based on the results.
8.根据权利要求3所述的集控式连续监护方法,其特征在于所述的移动监护仪与监护中心采用如下几种数据传输方式:移动监护仪工作在正常监护态时,采用脉冲式分批传送的方式上行与医院监护中心通信,即每隔一段时间与监护中心通信一次,将此段时间的所有监护信息压缩处理后发送给监护中心;移动监护仪工作在紧急监护态时,采用连续实时传送的方式上行与医院监护中心通信,当监护中心进行全速实时通信,所有监护信息不经压缩发送给监护中心;如监护中心需要主动与移动监护仪通信下传医嘱或控制命令时,采用主控实时通信方式,移动监护仪监护信息暂存,至此次主控通信事件完成后再合并上传给监护中心,保证监护信息完整性。 The centralized control continuous monitoring method according to claim 3, characterized in that said mobile monitor and the monitoring center follows several data transmission: moving the monitor is operating in the normal monitoring state using the pulse division way batch transfer uplink hospital care center in communication with, i.e. intervals and care center communication once, all the monitoring information of this period is compressed to a post-treatment monitoring center; mobile monitor work in emergency care state, continuous real time transmission of the uplink center communication hospital care and, when the monitoring center at full speed real-time communication, all the monitoring information is not compressed to a monitoring center; the care center requires active when pass orders the mobile monitors the communication in or control commands, using principal control real-time communication, the mobile monitor monitoring information is temporarily stored to the main communication events after the completion of the merger uploaded to the monitoring center, to ensure the monitoring information integrity.
9.根据权利要求3所述的集控式连续监护方法,其特征在于所述的移动监护仪、急救车载监护仪位于院外时,通过GSM/GPRS移动通信网络或CDMA或3G移动网络与医院监护中心进行通信联络;对于接受院内或家庭实时监护的病人,其所携带的移动监护仪通过接入院内无线WiFi局域网络、或家内接入Internet的WiFi局域网络与与医院监护中心通信联络。 9. A centralized control continuous monitoring method according to claim 3, wherein said mobile monitor, the emergency-vehicle monitor located outside the hospital, through the GSM / GPRS mobile communication network or CDMA or 3G mobile networks and Hospital Care center for communications and liaison; for patients receiving hospital or home real-time monitoring, and they carry a mobile monitor via an access hospital wireless WiFi local area networks, or access the Internet WiFi local area network within the home and contact hospital care center to communicate with.
10.根据权利要求3所述的集控式连续监护方法,其特征在于采用以GPS为主,结合移动手机定位系统和近程射频主动定位为辅的病人的定位方式;其中,近程射频主动定位方式为在病发时,移动监护仪的位置定位模块主动发出一特殊频段的射频信号,急救车载监护仪在500-1000米距离范围内探测和定位射频信号源位置,弥补GPS盲区或GPS定位精度低不足,协助急救人员对病人的搜寻定位和现场及时救助。 10. A centralized control continuous monitoring method according to claim 3, characterized in that a GPS-based, with the mobile phone positioning system and a proximity radio active targeting targeting supplemented patient; wherein proximity radio active positioning mode is when the disease, the mobile monitors the position-location module actively sends a radio frequency signal a particular frequency band, emergency vehicle monitor probe within 500-1000 meters distance and positioning of the RF signal source location, to compensate for GPS blind or GPS positioning precision low shortcomings, to assist emergency personnel to search for positioning the patient and site and timely rescue.
11.根据权利要求3所述的集控式连续监护方法,其特征在于病人GPS位置信息、移动手机定位及近程射频主动定位信息作为GIS地理定位信息输入;GIS系统根据输入的原始位置信息,实时定位和跟踪病人所在地区、街道、建筑物,并显示在医院监护中心和急救车载监护仪的电子地图上。 11. A centralized control method of continuous monitoring according to claim 3, characterized in that the patient GPS location information, the mobile phone and the positioning location information as the proximity radio active GIS geographic location information input; GIS system in accordance with the position of the original information input, Real-time locating and tracking area where the patient, streets, buildings, and displayed on the electronic map hospital care center and emergency-vehicle monitors.
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