Background technology
Prothrombin time, is called for short PT, refers to that add excessive tissue factor and appropriate calcium ion in the hematoblastic blood plasma of shortage after, conversion of prothrombin is fibrin ferment, causes the time needed for the clotting of plasma.The factor of prothrombin time and blood plasma, fibrinogen and AcG, VII, the level of Ⅹ is relevant.
Prothrombin time is external source blood coagulation system shaker test that is comparatively responsive and that commonly use the most, whether main reflection extrinsic coagulation is normal, its principle is in anticoagulation, add the tissue thromboplastin of q.s and appropriate calcium ion, meet extrinsic coagulation condition, be PT from the time added needed for calcium ion to the clotting of plasma.
PT is by the impact of the many factors such as tissue thromboplastin source difference, instrument and operative technique, and make result outside laboratory internal and laboratory, there is very large difference, therefore WHO started PT standardization with INR in early days the eighties.
INR international normalized ratio is from prothrombin time and the International sensitivity index (ISI measuring reagent, internationalsensitivityindex) calculate out, the PT adopting INR that different experiments room and different reagent are measured has comparability, is convenient to unified medication standard.
The situation of at present being undertaken treating by oral anticoagulation is very general, such as implement the patient of mechanical heart valve displacement technique, need after valve replacement to carry out anticoagulant therapy for a long time or all the life, therapeutic purposes prevent from forming thrombus near artificial valve, ensures the normal operation of valve.If but to take oral anticoagulation improper for patient, can cause failing to respond to any medical treatment, even cause the generation of the complication such as hemorrhage or thromboembolism, seriously jeopardize patient vitals, the detection therefore carrying out daily coagulation function is that oral anticoagulation therapy patient achieves the goal and ensures safe necessary means.
The instrument mainly laboratory equipment that current domestic coagulation function detects, equipment volume is comparatively large, and need professional to safeguard and operate, operating cost is higher.And needs of patients often arrive hospital carry out blood drawing detect, test result can not be known in time again, waste time and energy, very inconvenient, cause adjustment drug dose not prompt enough, there is potential safety hazard.
Summary of the invention
The needs of patients that the utility model mainly solves current dysfunction of blood coagulation often carries out blood drawing detection to hospital, can not know test result in time again, waste time and energy, very inconvenient, causes adjustment drug dose not prompt enough, there is the technical matters of potential safety hazard; A kind of intelligent prothrombin time supervisory system is provided, by the structure of mobile interchange system, patient is in just can detect coagulation function, automatic analysis medicining condition, provides medication dose adjustment suggestion automatically, simultaneously by testing result, medicining condition and suggestion and warning message remote transmission to doctor's monitor terminal, so that medical practitioner can understand patient status in time, provide suggestion or warning in time, time saving and energy saving, avoid the generation of risk or accident.
Above-mentioned technical matters of the present utility model is mainly solved by following technical proposals: intelligent prothrombin time supervisory system of the present utility model, comprises prothrombin time sense terminals, external treatment terminal and doctor's monitor terminal;
Prothrombin time sense terminals: for detecting prothrombin time, and testing result is sent to described external treatment terminal with wired or wireless communication modes;
External treatment terminal: the prothrombin time testing result receiving the transmission of prothrombin time sense terminals with wired or wireless communication modes, and above-mentioned information is sent to the doctor's monitor terminal be positioned at described in far-end with wired or wireless communication modes, provide Dynamic Graph directly perceived and data reference to doctor;
Doctor's monitor terminal: carry out wired or wireless communication with described external treatment terminal, for receiving the information that external treatment terminal sends, also move instruction can give described external treatment terminal;
Described prothrombin time sense terminals comprises CPU (central processing unit) and the prothrombin time detecting unit be connected with CPU (central processing unit) respectively, temperature sensor, barcode scanning terminal interface and communication interface;
CPU (central processing unit): the prothrombin time detection signal for sending here prothrombin time detecting unit processes, obtain patient information and test-strips information by barcode scanning terminal interface, connecting communication interface is to carry out data communication with described external treatment terminal;
Prothrombin time detecting unit: for gathering the reaction information in prothrombin time test-strips, obtains prothrombin time detection signal and flows to described CPU (central processing unit);
Temperature sensor: Real-time Collection environment temperature also flows to described CPU (central processing unit), is convenient to CPU (central processing unit) and carries out temperature compensation to prothrombin time testing result;
Barcode scanning terminal interface: for connecting barcode scanning instrument, described CPU (central processing unit) is flowed to by barcode scanning acquisition patient number and name, by barcode scanning automatic acquisition test-strips lot number and the parameter information obtaining this lot number from high in the clouds flows to described CPU (central processing unit), realize automatic size adjusting;
Communication interface: for realizing the data communication of CPU (central processing unit) and described external treatment terminal;
Display module, key-press module, communication module and alarm module that described external treatment terminal comprises ARM controller and is connected with ARM controller respectively;
ARM controller: carry out communication with described prothrombin time sense terminals, and above-mentioned information is sent by communication module;
Display module: for receiving, showing the data that ARM controller transports;
Key-press module: for mail message to ARM controller;
Communication module: be connected with ARM controller, realizes the data communication of ARM controller and described doctor's monitor terminal or cloud server;
Alarm module: when ARM controller judges that the prothrombin time testing result received exceedes safe range, start alarm module, give a warning information.
As preferably, described cloud server: for both carrying out wired or wireless communication with described external treatment terminal, carry out wired or wireless communication with described doctor's monitor terminal again, cloud server itself externally processing terminal and doctor's monitor terminal can also push related data.
As preferably, described prothrombin time sense terminals and external treatment terminal belong to two modules or two specific installations of same equipment.
The beneficial effects of the utility model are: by the mobile interchange system built, prothrombin time sense terminals and doctor's monitor terminal can carry out telecommunication, patient is in just can detect coagulation function, automatic analysis medicining condition, automatically medication dose adjustment suggestion is provided, simultaneously by testing result, medicining condition and the remote transmission such as suggestion and warning message are to doctor's monitor terminal, so that medical practitioner can understand Medication state and the health of be responsible for patient whenever and wherever possible in time, provide evaluation in time, suggestion or warning, avoid the trouble that client need usually travels to and fro between hospital and family, time saving and energy saving, avoid the generation of risk and accident.
Embodiment: the intelligent prothrombin time supervisory system of the present embodiment, as shown in Figure 1, comprise prothrombin time sense terminals 1, external treatment terminal 2, doctor's monitor terminal 3 and cloud server 4, external treatment terminal 2, doctor's monitor terminal 3 are all connected with cloud server with wireless communication mode, prothrombin time sense terminals 1 and external treatment terminal 2 are two specific installations, and prothrombin time sense terminals 1 is connected with wire communication mode with external treatment terminal 2.Prothrombin time detecting unit 14, temperature sensor 12, barcode scanning terminal interface 13 and communication interface 15 that prothrombin time sense terminals 1 comprises CPU (central processing unit) 11 and is connected with CPU (central processing unit) 11 respectively.Prothrombin time detecting unit 14 is for gathering the reaction information in prothrombin time test-strips, obtain prothrombin time detection signal, temperature sensor 12 Real-time Collection environment temperature, be convenient to carry out temperature compensation to testing result, barcode scanning terminal interface 13 can connect barcode scanning instrument, is obtained the information such as patient number, name and medicament test-strips lot number, control liquid lot number by barcode scanning.Display module 22, key-press module 23, communication module 24 and alarm module 25 that external treatment terminal 2 comprises ARM controller 21 and is connected with ARM controller 21 respectively, communication module 24 comprise the wire communication module of carrying out wire communication with prothrombin time sense terminals 1 and and doctor's monitor terminal 3 carry out the wireless communication module of wireless telecommunications.The data that display module 22 transports for receiving ARM controller, display prothrombin time testing result, display safety information or warning message, show the suggestion of next dosage, display patient information, information about doctor and medication information; Key-press module 23 for editing patient name, numbering, medication information, monitoring information, test-strips lot number information and physician name, account, and flows to ARM controller.External treatment terminal 2 can use portable mobile equipment popular at present, as smart mobile phone or panel computer, and is aided with corresponding prothrombin time monitoring APP software and realizes.When external treatment terminal 2 employing has smart mobile phone or the panel computer of camera function, without the need to separately joining barcode scanning terminal.
In the present embodiment, prothrombin time sense terminals also can prepare control liquid, control liquid for judge prothrombin time sense terminals and test-strips work whether normal.The Quality Control scope of every BT(batch testing) bar has difference because of its reason such as raw materials for production, process, and every BT(batch testing) bar has its specific Quality Control scope.Quality Control scope carries out barcode scanning acquisition by barcode scanning terminal to test-strips, and when carrying out Quality Control and detecting, whether prothrombin time sense terminals energy automatic decision result is within the scope of Quality Control.If not in scope, then provide warning message.In addition, regular Quality Control can be arranged to remind, as one month; New use reagent lot Quality Control is reminded.
The method for supervising of above-mentioned intelligent prothrombin time supervisory system is:
By barcode scanning equipment, barcode scanning is carried out to test-strips lot number, by barcode scanning automatic acquisition test-strips lot number, then obtained working code and the parameter of this BT(batch testing) bar by external treatment terminal 2 and cloud server 4, realize automatic size adjusting function.
Test agent Quality Control detection method, step is as follows:
1) barcode scanning device scan test agent bar code, obtains test agent lot number information and flows to external treatment terminal 2;
2) external treatment terminal 2 and cloud server 4 carry out communication, the Quality Control scope of acquisition or synchronously this lot number test agent;
3) the Quality Control scope of external treatment terminal 2 On-board test reagent lot information and acquisition;
4) prothrombin time sense terminals 1 pair of test agent carries out Quality Control detection, and testing result is sent to external treatment terminal 2;
5) testing result and the Quality Control scope that obtains before are compared by external treatment terminal 2, provide the qualified or Quality Control result over range warning of Quality Control.
Prothrombin time sense terminals 1 gathers the information in prothrombin time test-strips by test-strips reaction signal treatment circuit, through the process of internal central processing unit, external treatment terminal 2 is flowed to wire communication mode, external treatment terminal 2 is according to the prothrombin time desired value preset, by analysis and process, whether the prothrombin time value that automatic decision actual acquisition arrives is in safe range, if deviation is larger, then give a warning information, collection result and judged result are sent to cloud server 4 with wireless communication mode by external treatment terminal 2 simultaneously, doctor's monitor terminal 3 is sent to again by cloud server 4, be convenient to doctor adjust patient's dosage in time and provide handling suggestion.
The dosage of external treatment terminal 2 pairs of patient's medications every day is monitored, the medication dose that external treatment terminal 2 inputs according to user is compared, if with the medication dose of the previous day, to compare change larger, then give a warning information, remind dosage that patient takes whether correct, whether confirm through medical practitioner; If the dosage that takes confirms without doctor, belong to medication errors, then patient's medication errors information is sent to doctor's monitor terminal 3 with wireless communication mode by external treatment terminal 2, is convenient to doctor and adjusts patient's dosage in time and provide handling suggestion.
The actual dosage of patient passes through the button typing in external treatment terminal 2 by patient, actual for patient dosage and the prothrombin time value recorded present with amount effect curve by external treatment terminal 2, during amount effect curve mapping regretional analysis, only just carry out this when dosage and prothrombin time value reach ten groups of data and analyze.The amount effect curve of dosage and prothrombin time value has two kinds of the mode options, if the medicine comparatively fast presented for effect, then selects the first pattern, otherwise selects the second pattern.The first pattern is, with the prothrombin time value recorded for y value, the last dosage before the detection time of this prothrombin time value is x value, carries out mapping regretional analysis, and in the outside manage terminal 2 LCDs on show amount effect curve.The second pattern is, with the prothrombin time value recorded for y value, 5 dosages of one day before the detection time of this prothrombin time value, two days, three days, four days and five days are respectively x value, five groups of linear regression analyses are carried out in mapping respectively, automatically the suite line selecting correlativity best presents, be presented in the LCDs of external treatment terminal 2, certainly operate on button and also can artificially select to check any suite line.The regression equation of amount effect curve is INR=k × D+b, INR is the actual prothrombin time value recorded, D is dosage, k and b is the parameter drawn by the amount effect curve regretional analysis of individual patient reality, can increase along with the data of accumulation every day and some changes occur, the rear a drug dosage suggestion of patient can be extrapolated thus, that is: D '=(INR ’ – b)/k, D ' is the rear a drug dosage of suggestion, INR ' is target prothrombin time value, and the rear a drug dosage of suggestion is presented in the LCDs of external treatment terminal 2.If it is larger that the rear a drug dosage of suggestion and a front dosage compare change, then external treatment terminal 2 gives a warning information, and the rear a drug dosage of suggestion, a front dosage and warning message are sent to doctor's monitor terminal 3 with wireless communication mode by cloud server, undertaken confirming or proposing amending advice by medical practitioner.
For the patient that INR norm controlling is good, external treatment terminal 2 provides the feedback opinion of drug safety automatically; For the patient that INR norm controlling is poor, external treatment terminal 2 directly sends data to physician, and feeds back the unsafe information warning of medication to patient, reminds patient to seek medical advice as early as possible.
The workflow of intelligence prothrombin time supervisory system:
1, prothrombin time sense terminals and external treatment terminal is started.
2, manage in terminal in the outside correct time or lock in time are set, carry out duty, optimum configurations etc.
3, patient information is obtained by barcode scanning terminal or operation is manual on button inputs patient information.
4, the data management software in external treatment terminal is opened, input medication information.
5, manage in the outside and terminal insert chip or obtain the information such as test-strips lot number, working strategy by barcode scanning terminal.
6, in prothrombin time sense terminals, test-strips is inserted.
7, collection capillary blood or venous blood carry out application of sample test, obtain test result.
8, the data management software in external treatment terminal is opened, check medication information and detecting information whether correct, carry out analyzing, process and judging, correlated results teletransmission to cloud server, sent to doctor's monitor terminal of supervisor doctor again by cloud server, physician also can by the long-range transmission advisory information of cloud server to external treatment terminal.
9, detection case can be consulted at any time by the data management software in external treatment terminal, and have the analytic functions such as performance graph.
In addition, external treatment terminal software system of the present utility model comprises Quality Control and reminds, and reminding user, when system has potential risk, needs to carry out Quality Control, guarantees the accuracy of supervisory system.Quality Control reminds logic to comprise:
One, when new system just uses
External treatment terminal obtains prothrombin time sense terminals identifier information, when without the information of storage, thinks that new system uses, and provides Quality Control and reminds.
Two, system cycle Quality Control
External treatment terminal software acquiescence is reminded once January, and user also can be arranged.
When three, using the test agent of new lot
External treatment terminal can store the lot number information of last test result, and when using new lot number, barcode scanning equipment can obtain lot number information, and when inconsistent with the lot number of last test result, the Quality Control providing the test agent using new lot is reminded.
Four, when supervisory system a period of time does not use
External treatment terminal can store the test duration of last test result, when setup test next time, when prothrombin time sense terminals inserts test agent, prothrombin time sense terminals send information to external treatment terminal, external treatment terminal can check the time, as exceeded preset range (as 1 month) with the lead time of last test result, then providing not use for a long time needs Quality Control to remind.