JP2012106004A - Electrocardiogram analysis result report - Google Patents

Abstract

PROBLEM TO BE SOLVED: To obtain an electrocardiogram analysis report which allows even a person to be examined who is not a medical personnel to easily understand required information.SOLUTION: A result domain 62, in which the heart rate as well as the degree of disorder in waveform and pulse are indicated with marks so that the outline of an analysis result is easy to understand, is provided. Also, as the information for a doctor to determine the disorder in the waveform and pulse, a representative waveform domain 63 which indicates the representative waveform for every induction and an entire interval waveform domain 65 which indicates the entire interval waveform for one induction are provided. Further, by arranging illustrations showing an outer appearance or cross-section of the heart, explanation by a doctor and understanding of a subject can be made easy.

Description

The present invention relates to an electrocardiogram analysis result report , and more particularly to an electrocardiogram analysis report for a subject .

  An electrocardiogram (ECG) has long been widely used for the diagnosis of the presence or absence of heart disease and symptoms. In recent years, due to advances in signal processing technology, various biological information has been obtained from electrocardiograms as well as improved measurement accuracy.

  The electrocardiograph, which is an electrocardiogram measurement device, has been continuously improved, not only by measuring the electrocardiogram, but also by storing the measurement results as digital data and enabling comparison with the electrocardiogram measured in the past. Some of them have simple evaluation functions such as the presence or absence of abnormalities and possible diseases by analyzing electrocardiograms.

  Such an electrocardiograph having an automatic analysis function can output analysis results as a report in a predetermined format in addition to direct recording (real-time waveform recording) (see, for example, Patent Document 1).

JP 2002-224067 A

  However, the conventional electrocardiogram analysis result report is a report with specialized contents assuming the use of medical personnel represented by doctors, particularly those who can understand the meaning of electrocardiograms and various numerical values. Therefore, in general, subjects who are not medical personnel cannot understand even if they see the report.

  In recent years, informed consent has been regarded as important, and the provision of sufficient and easy-to-understand information to the subject is required. For this reason, it is thought that the opportunity for doctors to explain the contents of reports to subjects has increased, but since reports have not been prepared for subjects, doctors can explain the information by crushing information. There is a problem that you have to use the materials.

  In addition, even if subjects understood or intended to understand when they received verbal explanations, when they looked back at the report at a later date, they forgot to explain or found parts that they did not understand. It is not unusual to come and go. In such a case, the doctor will be contacted again, which is complicated for both the doctor and the subject.

The present invention has been made in view of such problems of the prior art, and to realize the electrocardiogram analysis report was easier to understand the necessary information in subjects who are not medical professionals.

  That is, the gist of the present invention is an electrocardiogram analysis result report for a subject, in which a bibliographic area in which bibliographic information is shown and a mark that expresses at least the degree of waveform disturbance and pulse disturbance are arranged. A result region, a representative waveform region indicating the representative waveform of the analyzed electrocardiogram waveform for each induction, and an all-interval waveform region indicating the waveform of all the sections analyzed for one preset of the analyzed electrocardiogram waveforms; An electrocardiogram analysis result report is characterized in that an illustration region showing an illustration showing the appearance or cross section of the heart according to a disease suspected as a result of analysis is arranged on the same sheet.

With this arrangement, according to the present invention, electrocardiogram analysis report was easier to understand the necessary information in subjects who are not medical professionals can be realized.

It is a block diagram which shows the structural example of the electrocardiograph which concerns on embodiment of this invention. It is the flowchart which showed the flow of the whole operation | movement of the electrocardiograph of this embodiment. It is a figure which shows the example of the real-time screen display in the electrocardiograph of this embodiment. It is a flowchart which shows the buffering process operation | movement in the electrocardiograph of this embodiment. It is a flowchart which shows the automatic analysis recording processing operation in the electrocardiograph of this embodiment. , It is a figure which shows the specific example of the report for subjects which the electrocardiograph of this embodiment can produce | generate and output. It is a flowchart which shows the freeze process operation | movement in the electrocardiograph of this embodiment. It is a figure which shows the example of the freeze screen display in the electrocardiograph of this embodiment. It is a figure explaining the freeze compression waveform part 91 in a freeze screen. It is a figure explaining the buffer image 93 in a freeze screen. It is a figure which shows the example of the freeze compression rhythm waveform display screen in the electrocardiograph of this embodiment.

Hereinafter, the present invention will be described in detail based on preferred embodiments with reference to the drawings.
(Configuration of electrocardiograph)
FIG. 1 is a block diagram showing a configuration example of an electrocardiograph as an example of an electrocardiogram analyzer according to an embodiment of the present invention.
The electrocardiogram electrode 110 is an electrode group that is worn on the chest and limbs of a subject. Usually, it is composed of an electrode group capable of standard 12-lead measurement.

  The signal processing unit 120 performs A / D conversion on the electrocardiogram signal detected by the electrocardiogram electrode 110 to convert it into digital data, and further performs filter processing typified by waveform shaping processing such as noise removal and baseline fluctuation removal. Do. Then, the processed electrocardiogram waveform data is written into the temporary storage unit 130. At this time, the signal processing unit 120 writes data in at least one of the first and second buffers 130 a and 130 b of the temporary storage unit 130 according to the control of the control unit 170.

  The temporary storage unit 130 includes first and second buffers 130a and 130b. Each buffer is realized by a storage device such as a semiconductor memory or a hard disk drive. In the present embodiment, each of the first and second buffers has a capacity capable of storing an electrocardiogram waveform for 10 minutes. The specific capacity can be determined by the sampling frequency of the A / D conversion in the signal processing unit 120, the number of bits per sample, the number of bits of additional information to be added to each heartbeat waveform, and the like.

  The electrocardiograph of this embodiment can hold the latest 10 minutes of electrocardiogram waveform data in the temporary storage unit 130 by a recording process described later. The user can call up the electrocardiogram waveform data held in the temporary storage unit 130 to perform analysis, report generation, redisplay and recording of an arbitrary section, and the like.

  The waveform memory 140 is a memory for storing a plurality of types of waveform-related information (template waveform information) to be used as a template in waveform analysis, and a part of the file storage unit 160 described later can also be used. . The waveform memory 140 may store the template waveform itself, but may store other types of data such as feature points of individual template waveforms instead.

  The classification analysis unit 150 cuts out waveform data for one beat (heartbeat waveform data) from the electrocardiogram waveform data stored in the temporary storage unit 130, and uses the template waveform information stored in the waveform memory 140 for each heartbeat waveform data. Use to determine the presence or absence of abnormality. Then, information indicating the determination result is added as additional information of each heartbeat waveform data, and is written back to the temporary storage unit 130. Note that the signal processing unit 120 may perform the process of cutting out waveform data for one beat from the electrocardiogram data. In this case, the classification analysis unit 150 may simply add the determination result as additional information.

  The classification analysis unit 150 also performs more detailed analysis processing performed on a plurality of heartbeat waveform data included in an analysis period (for example, 24 seconds) in addition to waveform analysis in units of heartbeats performed at the time of recording. The analysis performed using a plurality of heartbeat waveform data includes, for example, an analysis based on the absolute value of the RR interval and its variation.

  The file storage unit 160 is a storage device realized by, for example, a hard disk drive or a combination of a memory card and a reader / writer. The file storage unit 160 stores the measured electrocardiogram waveform data and the analysis result thereof for each subject. The file storage unit 160 also stores charts and commentary necessary for report creation, subject-specific data, and the like. Note that the file storage unit 160 may include a plurality of storage devices, for example, a storage device using a removable medium, and a storage device built in the device.

  The control unit 170 is, for example, a CPU, and controls the overall operation of the electrocardiograph of the present embodiment by executing a control program recorded in the file storage unit 160, for example. The input unit 180 is at least one input device represented by a button, switch, keyboard, mouse, joystick, touch panel, and the like, and is used when the user performs various settings and instructions. The display unit 190 is a display device such as an LCD or a CRT, and displays various information including an electrocardiogram under the control of the control unit 170. In order to realize intuitive use, in this embodiment, it is assumed that the display unit 190 is provided with a touch panel that constitutes a part of the input unit 180. The printer 200 is a thermal recording type printer that is generally used in an electrocardiograph, for example, and prints out an electrocardiogram waveform and various reports in accordance with instructions from the control unit 170. For color report output, it is also possible to separately connect a color printer usually sold as a peripheral device of a personal computer.

  The electrocardiogram analyzer of the present embodiment having such a configuration can be realized by using a general-purpose computer device that is commercially available as a personal computer, for example. The signal processing unit 120 and the waveform analysis unit 150 may be realized by individual hardware, or may be realized by software by a CPU executing a program that realizes the function of each unit.

(Overall processing)
FIG. 2 is a flowchart showing the overall operation flow of the electrocardiograph of the present embodiment.
Although not specifically described here, it is assumed that information (ID, age, gender, etc.) relating to the subject to be measured in advance is already input or read from the file storage unit 160 and set. In addition, other electrocardiograph operation settings are made as necessary.

  First, in step S201, real-time screen display is performed. FIG. 3 is a diagram showing an example of real-time screen display in the electrocardiograph of the present embodiment. On the real-time screen, the state of the examination, the electrocardiogram waveform (real time), the subject information, the state of the electrocardiograph, and the like are displayed.

The inspection mode display unit 31 displays the currently selected inspection mode.
The timer display unit 32 normally displays the current time. During exercise load, the remaining time and elapsed time are displayed as a timer.
The subject information display unit 33 displays subject information such as an ID number, sex, and age.

  The waveform display unit 34 displays the currently detected electrocardiogram waveform in real time. The waveform displayed here can be changed by setting. In the example of FIG. 3, each standard 12-lead waveform and one lead waveform (here, the second lead waveform) selected in advance as a rhythm waveform are displayed.

The heart rate display unit 35 displays the heart rate.
The device status display unit 36 displays various information related to the electrocardiograph status. In the present embodiment, the state of the electrocardiograph is displayed by icon display and character display. The display status includes electrode disconnection, battery status (remaining amount), battery status, printer status, recording paper status (recording paper exhausted, paper jam, etc.), PC card status, LAN connection status (above icon display), currently enabled Filter type, recording selection, recording speed, sensitivity (character display).

  In the function key display section 37, functions available on the currently displayed screen are displayed imitating the function keys of the keyboard of the personal computer. When the icon portion is touched, it is detected by a touch panel provided on the screen, and an operation feeling equivalent to pressing a function key is obtained.

  Returning to FIG. 2, buffering processing is started in step S203. The buffering process is a process of writing electrocardiogram waveform data in the temporary storage unit 130, and is started when a state in which at least one or more induced waveforms can be detected is detected. The buffering process is automatically started and continued regardless of the user instruction. Details of the buffering process will be described later.

  In step S <b> 205, it is detected whether or not there has been an instruction to perform automatic analysis recording through the input unit 180. If there is an instruction for automatic analysis recording, automatic analysis recording processing, which will be described later, is performed in step S207. If there is no instruction, the process proceeds to step S209.

  In step S209, it is detected whether or not there is a freeze instruction from the user through the input unit 180 (pressing the “freeze” function key in FIG. 3). If there is a freeze instruction, a freeze process, which will be described later, is performed in step S211, and the display is again returned to the real-time screen display by the freeze release instruction (step S213). If there is no freeze instruction in step S209, the process proceeds to step S215.

  In step S215, it is detected whether or not there is an end instruction (for example, a power-off instruction) from the user through the input unit 180. When there is an end instruction, the buffering process is started and the entire electrocardiograph process is ended. If there is no end instruction, the process returns to step S205.

(Buffering processing)
Next, the buffering processing operation in the electrocardiograph of this embodiment will be described using the flowchart shown in FIG. Once started, the buffering process is continued until the entire process of the electrocardiograph is completed and executed in parallel with other processes.

  First, in step S301, it is checked whether an electrode is attached. Here, when at least one channel of the induction waveform can be acquired from the state where all the electrodes are detached, it is determined that the electrodes are attached. Determination of electrode mounting is performed by the signal processing unit 120. If it is determined that all electrodes are disconnected, the detection process in step S301 is repeated.

  If it is determined that the electrodes are attached, signal processing is performed on the obtainable induced waveform and writing (buffering) to the temporary storage unit 130 is started (step S303). At the same time, the waveform analysis processing by the waveform analysis unit 150 described above is also started. Here, the buffering is performed on one of the first and second buffers 130a and 130b.

  In step S305, it is checked whether or not electrode separation has occurred. Here, it is assumed that electrode separation occurs when the number of channels that can be detected decreases after a predetermined number of induction waveforms (for example, all channels of 12 standard leads) can be detected. It shall be determined. This determination is also performed by the signal processing unit 120. If no electrode removal is detected, the process proceeds to step S315.

  If electrode disconnection is detected, it is checked in step S307 whether all electrodes have been disconnected. If it is detected that all the electrodes are disconnected, buffering is stopped in step S329. In step S331, the process waits until electrode mounting is detected under the same conditions as in step S301. When electrode mounting is detected in step S331, it is determined that measurement for a new subject has started, and in step S333, the first and second buffers 130a and 130b of the temporary storage unit 130 are cleared, and the process proceeds to step S303. Return.

  It should be noted that at any timing after the buffering process is stopped in step S329 until the buffer is cleared in step S333, at least a part of the ECG waveform data buffered up to that point and the automatic analysis result (if any). Or the like can be automatically recorded in the file storage unit 160 in association with the subject.

  If it is determined in step S307 that not all electrodes have been removed yet and at least one channel of induction waveform can be acquired, buffering of the acquisitionable waveform is continued (step S309). When the buffer is filled with data in the process of buffering, new data is written while deleting the old data in order, so that the data for the latest 10 minutes is always secured in the buffer.

  In step S315, it is checked whether or not there has been a freeze instruction. If there is a freeze instruction, the buffer for buffering is switched (step S317), and the process returns to step S305 to continue buffering. As a result, the electrocardiogram waveform data for the past maximum 10 minutes from the time when the freeze instruction is given is fixed (frozen) in the buffer that has been buffered until then. Therefore, the user can perform desired processing such as redisplay, recording processing, and analysis processing using the frozen past ECG waveform data.

  In the present embodiment, since there are two buffers, the buffer that is buffered in step S317 is detected while the user is performing work using the frozen ECG waveform data (freeze data). Thus, buffering can be continuously performed without missing the electrocardiogram waveform data.

  Of course, if the work using freeze data exceeds the maximum time that can be recorded in the buffer (here 10 minutes), only the last 10 minutes will continue to be buffered, and continuity with the freeze data will be lost. However, in any case, at least the latest 10 minutes of ECG waveform data is surely temporarily stored.

  If no freeze instruction is detected in step S315, it is checked in step S319 whether an automatic analysis recording instruction has been issued. If there is an automatic analysis recording instruction, it is confirmed in step S321 whether or not it is currently frozen. This is because the electrocardiograph of the present embodiment performs different operations in the frozen state and the non-frozen state (real-time screen display state). Specifically, when an automatic analysis recording instruction is given in the frozen state, an automatic analysis recording process is performed for a specified section in the freeze data, whereas an automatic analysis recording instruction is issued in the non-frozen state. The automatic analysis recording process is performed on the electrocardiogram waveform data measured for a predetermined period from that point.

  Therefore, if it is an automatic analysis recording instruction in the frozen state, the process returns to step S305 without any particular action. On the other hand, if the automatic analysis recording instruction is in a non-frozen state, the ECG waveform data measured for a predetermined period from the time when the automatic analysis recording instruction is given to the other buffer not used for buffering. Buffering is performed (step S323). That is, the electrocardiogram waveform data during the period for automatic analysis is buffered in both buffers 130a and 130b. Although not shown in FIG. 4, the buffering for automatic analysis recording is automatically stopped after a predetermined time has elapsed, and thereafter returns to buffering for only one buffer.

  If no automatic analysis recording instruction is detected in step S319, it is checked in step S325 whether or not a freeze release instruction has been issued. If there is a freeze release instruction, data integration processing is performed in step S327. This is a process for securing ECG waveform data for the last 10 minutes. For example, if the freeze data has a length of less than 10 minutes, the data buffered in the other buffer in parallel during the freeze This is done by moving or copying the required amount of freeze data before.

  If a freeze release instruction is not detected in step S325, the process returns to step S305 to continue buffering.

  With the recording operation as described above, the electrocardiograph according to the present embodiment can perform work using freeze data for a long time and can always ensure past electrocardiogram waveform data for a predetermined time. .

(Automatic analysis recording process)
Next, the automatic analysis recording processing operation in the electrocardiograph of this embodiment will be described using the flowchart shown in FIG.
As described in the description of the buffering process, in the electrocardiograph of this embodiment, the electrocardiogram waveform data to be analyzed is different between the freeze state and the non-freeze state, but the contents of the analysis recording process are common.

  In step S401, the waveform analysis unit 105 acquires electrocardiogram waveform data for a preset time interval used for analysis. In the frozen state, if there is no specific designation, the electrocardiogram waveform data of the designated section is read out from the frozen buffer if there is designation of the latest predetermined time section or section. On the other hand, in the non-freezing state, the electrocardiogram waveform data for a predetermined time that is buffered for automatic analysis is read from the buffer when the automatic analysis recording instruction is given. In the electrocardiograph of the present embodiment, for example, the length of the ECG waveform data used for automatic analysis can be set within 10 to 24 seconds, and any section in the freeze data is automatically analyzed in the freeze state. Can be set as

  In step S <b> 403, the waveform analysis unit 105 performs waveform analysis processing using information in the waveform memory 104 and information for analysis stored in the file storage unit 160. In step S405, necessary information (report creation data) is read from the file storage unit 160 in accordance with the analysis result and a preset report format.

  In step S407, a report of a specified format is created using the electrocardiogram waveform data read in step S401 and the report creation data read in step S406. The created report is output from the printer 200 in step S409. As described above, when a separate printer is connected for outputting the color report, the printer may output the color report. Also, it can be output as electronic data such as PDF format. In this case, the report can be displayed on the display unit 190 or can be stored in the file storage unit 160 in association with the subject together with the electrocardiogram waveform data and determination results used for automatic analysis.

  Here, the analysis processing performed in step S403 is a waveform abnormality, an RR interval abnormality, and ST rise as conventionally realized by an electrocardiograph having an electrocardiogram analysis function, an electrocardiogram analyzer, or the like. It may be a process of detecting the presence or absence of a predetermined abnormal state such as, and determining an assumed disease according to the result.

  However, the conventional apparatus, as a rule, generates a specialized report for medical personnel represented by doctors, whereas the electrocardiograph of this embodiment has such a specialized report. In addition to a simple report, a report for a subject can be generated.

(Report for examinees)
6 and 7 are diagrams showing specific examples of reports for subjects that can be generated and output by the electrocardiograph of the present embodiment.
In this embodiment, the subject report is a two-page report. FIG. 6 shows an example of the first page, and FIG. 7 shows an example of the second page. As shown in FIG. 6A, the first page includes a bibliographic area 61 indicating bibliographic items, a result area 62 indicating a summary of measurement results, and a representative waveform area indicating representative waveforms in each lead of the measured electrocardiogram waveform. 63, an illustration area 64 in which an illustration of the heart selected according to the determination result is arranged, an all-section waveform area 65 showing a waveform diagram (a pre-selected one lead) of the entire automatic analysis period, and a comment area 66 Have.

  Bibliographic information shown in the bibliographic area 61 includes, for example, personal information (ID, name, sex, age, date of birth, height, weight, body fat percentage, hospital ward, blood pressure value, etc.), measurement date, measurement The state of time (rest or load) can be exemplified. Such bibliographic information can be acquired by reading a value registered in advance in the file storage unit 160 for each subject or using a value set or acquired at the time of measurement.

  The result area 62 is information for the subject, and is determined from the heart rate 62a as an example of information that can be understood without special knowledge among important values obtained from the analysis result, and an electrocardiogram. As the types of abnormality, the degree of waveform disturbance 62b and pulse disturbance 62c are shown. Here, an actual numerical value is shown for the heart rate 62a, while a slightly specialized waveform or pulse disturbance is schematically shown step by step using marks.

  Here, a mark imitating the facial expression is used, and the level is expressed in three levels depending on the facial expression. In addition to the difference in color and size, any expression that can recognize the difference in degree is used. It is possible to use.

  The heart rate 62a is not necessarily included. Further, general biological information other than the heart rate, for example, the blood pressure value may be included, or both the heart rate and the blood pressure value may be included. Furthermore, information represented by numerical values, such as heart rate and blood pressure values, may be represented by marks in the same way as waveforms and pulse disturbances depending on the standard value or the magnitude of deviation from the past measured values of the same subject. Anyway.

  In the example of FIG. 6, since it is assumed that the doctor uses the output report to explain the findings while showing the subject, the waveform disturbance and the pulse disturbance 62b and 62c correspond to all stages. The mark to be shown is shown. Therefore, in practice, the doctor determines the waveform disturbance based on the representative waveform area 63 and the pulse disturbance based on the whole section waveform area 65, and here, three types corresponding to normal, slightly abnormal and abnormal The mark is presented to the subject, for example, with a circle. However, according to the result of the automatic analysis process, it is possible to select any one of the marks representing the steps and output only the selected mark.

In this way, for the subject, it is not a numerical value such as blood pressure value or heart rate, such as waveform and pulse disturbance, but items that are difficult to understand absolute standards , So that you can get a rough idea.
Of course, as described above, the blood pressure value and the heart rate may be expressed using marks instead of the numerical values or together with the numerical values.

  The representative waveform area 63 is mainly information for medical personnel. Among the electrocardiogram waveforms acquired in the automatic analysis section, one heart rate that is less affected by noise or the like and has a clean waveform is selected and displayed for each lead. Here, the fact that the waveform is clean is an event that is independent from the medically normal waveform, and simply means that the waveform has high measurement accuracy and is suitable for diagnosis.

  In the illustration area 64, a heart illustration is arranged as information for the subject. By having an illustration, it can be used when a doctor explains, and the subject can easily understand the explanation. In the present embodiment, when a disease is suspected as a result of analysis, an illustration suitable for explaining the disease is selected. For example, FIG. 6A shows a case in which myocardial infarction is suspected, and an illustration having an appearance suitable for explaining the coronary artery occlusion causing the myocardial infarction is selected. On the other hand, FIG. 6B shows a case in which premature ventricular contraction is suspected, and an illustration of a heart cross section suitable for explaining the original sinus node position and the electrical flow is selected. The illustrations arranged in the illustration area 64 are also stored in advance in the file storage unit 160 in association with the suspected disease and the report format, as in the explanation document included in the finding report described later.

In the entire section waveform area 65, the waveform of all automatic analysis sections is shown for a predetermined one-lead waveform. Here, the second induction waveform is shown. This waveform is also mainly information for medical personnel.
The comment area 66 is a memo field, and is an area that can be used for the purpose of a doctor or subject taking notes.

FIG. 7A and FIG. 7B show examples of the second page of the report for the subject according to the present embodiment, which are pages that are paired with FIG. 6A and FIG. 6B, respectively. It is.
As shown in FIG. 7, the second page of the report for the subject is a description explanation page, an illustration area 64 showing the same illustration as the illustration on the first page, and an explanation area showing a concrete explanation of the findings 71.

  In the explanation area 71, the disease explanation area which is the first item shows an explanation of a disease suspected as a result of the electrocardiogram analysis. In the second <pathological significance> item, possible causes, symptoms and precautions are shown. The third <cardiac electrocardiogram diagnosis> shows the measurement results and explanations that have become suspected materials.

For example, in <Electrocardiogram diagnosis> in FIG. 7A, which is a report when myocardial infarction is suspected, as a measurement result that is the basis of diagnosis,
・ Abnormal Q waves were measured by V2 and V3 guidance,
It is shown that negative T waves were measured for leads V2, V3 and V4.
A corresponding explanation is given as to what these events are and what they mean.

  These commentary explanation texts and drawings are also stored in advance in the file storage unit 160 in association with the type of suspected disease or abnormal waveform and the report format, and the corresponding commentary data is acquired based on the determination result. To do. Also in FIG. 7B, since the suspected disease is different, the contents of the illustrations and explanations are different, but the appearance of the report is the same as in FIG. 7A.

  Thus, according to the electrocardiograph of the present embodiment, it is possible to generate a report for the subject, which is useful when the doctor uses it for informed consent, It is possible to improve understanding of the disease.

  In the present embodiment, the case where the commentary is added as the second page of the report for the subject has been described. However, the commentary is not essential, and the object of the present invention is achieved by the report of at least the first page. The

  Further, the report for the subject according to the present embodiment is not limited to the application to the analysis result report by the electrocardiograph, and any device having a function of analyzing the electrocardiogram waveform data acquired by an arbitrary method. Applicable to reports in That is, the electrocardiograph of the present embodiment can be considered as one form of an electrocardiogram waveform data automatic analyzer.

(Freeze processing)
Next, the freeze processing operation in the electrocardiograph of this embodiment, which is performed in step S211 of FIG. 2, will be described using the flowchart shown in FIG.
In the real-time screen display of FIG. 3, when “Freeze” on the function key display unit 37 is pressed, the freeze process is started.

First, in step S501, all data is read from the frozen buffer (data is fixed). In step S503, a buffer image is created based on the read data. At this time, for example, a section where the recorded number of inductions is smaller than the number of measurement channels is set as an electrode disconnection section, an empty section of the buffer is detected, or an event such as an abnormal waveform is detected. The buffer image will be described in detail later.
Next, in step S505, freeze screen display is performed. Details of the freeze screen will be described later.

  In step S507, it is checked whether an automatic analysis recording instruction has been issued. If there is an instruction, the automatic analysis recording process described with reference to FIG. 5 is performed for the section manually designated on the freeze screen or the section set by default (step S509), and the process proceeds to step S511. If an instruction cannot be detected in step S507, the process proceeds directly to step S511.

  In step S511, it is checked whether a manual recording instruction has been issued. If there is an instruction, an output process is performed on the freeze data in the manually designated section on the freeze screen (step S513). In the output process, it may be printed out to the printer 200 as described above or stored in the file storage unit 160 as electronic data. It is also possible to do both. When the output process ends, the process proceeds to step S515. If the instruction cannot be detected in step S511, the process proceeds directly to step S515.

  In step S515, the presence / absence of a freeze release instruction is confirmed. Specifically, it is detected whether or not the freeze release button included in the function key display section 37 of the freeze screen is pressed. If a freeze release instruction is given, the process returns to step S213 to display a real-time screen.

  If there is no freeze release instruction, it is confirmed whether or not an operation that requires updating the freeze screen has been performed, such as manually changing the recording range, analysis target section, or display section (step S517). If an operation that requires updating the freeze screen is performed, the process returns to step S501 to read the buffer data, update the buffer image, etc., and update the freeze screen. If an operation that requires updating the freeze screen has not been performed, the process returns to step S507.

(Freeze screen)
FIG. 9 is a diagram showing an example of a freeze screen display in the electrocardiograph of the present embodiment. The same reference numerals are assigned to areas where the same content as the real-time screen display in FIG. Is okay.

  Similar to FIG. 3, the waveform display unit 94 displays a preset induction waveform (in FIG. 9, a 6-channel induction waveform, but it is also possible to display 12 inductions as in FIG. 3). However, the display waveform changes in real time in FIG. 3, but the fixed section is displayed on the freeze screen unless the user changes the display range. The initial display section can be arbitrarily set, but here, it is set to the predetermined section closest to the input of the freeze instruction.

  A waveform recording range mark 92 that is a horizontal straight line is shown at the bottom of the waveform display portion 94. The waveform recording range mark 92 represents a range recorded when automatic analysis recording is instructed in a frozen state. In the example of FIG. 9, the waveform displayed on the waveform display unit 94 is 10 seconds, and the waveform recording range mark 92 is shown in all the sections from the left end to the right end of the screen in order to show a case where the entire section is the automatic recording range. Has been. When the recording range or section is changed by the operation of the setting and input unit 108, the mark length and the display position are also changed correspondingly.

  Below the waveform display section 94, a freeze compression waveform section 91 is provided. Here, a compressed waveform of a preset rhythm induction waveform (the second induction waveform in this embodiment) is displayed. The freeze compression waveform section 91 compresses and displays a waveform of a longer period than the waveform display section 94 in the time axis direction, and displays the section displayed in the waveform display section 94 and the recording range at the time of automatic analysis recording. Is configured to do. This point will be described later.

  The buffer image 93 generated in step S503 is displayed at the right end of the freeze compression waveform section 91. Details of the buffer image 93 will be described later.

  The real-time rhythm waveform display unit 95 displays in real time one induction waveform (here, the second induction waveform) selected in advance as a rhythm waveform, similarly to the lowest stage of the waveform display unit 34 in FIG. Therefore, the user can check the electrocardiogram waveform measured in real time while working with the freeze data, and can release the freeze immediately if necessary.

FIG. 10 is a diagram for explaining the freeze compression waveform unit 91.
FIG. 10A is an enlarged view of the freeze compression waveform section 91. In addition to the compressed waveform, the freeze compressed waveform portion 91 includes a frame 91 a indicating a waveform recording range and a waveform display range mark 91 b indicating a section displayed on the waveform display portion 94. Further, a left movement button 91L and a right movement button 91R are provided at the left and right ends, and the waveform display range can be moved when these buttons are pressed.

FIG. 10B is a diagram for explaining the relationship between the pressing of the left movement button 91L and the right movement button 91R and the movement of the waveform display range 91b.
The move buttons 91L and 91R are auto-repeat keys, and when pressed once, the waveform display area is moved left and right in units of one beat. When the state of being continuously pressed continues, movement is performed in units of 5 seconds. When the state is further pressed, movement is performed in units of 10 seconds.

  The waveform display area is moved independently of the recording range within the recording range. However, when movement beyond the left and right ends of the recording range is instructed, the recording range also moves to the left and right in conjunction with the waveform display area. It shall be.

  FIG. 10B shows the case where the waveform display area 91b <the automatic recording range 91a. However, when the size is reversed, the automatic recording range 91a is moved by pressing the left / right movement button. That is, the display waveform range and the recording range are moved based on a short section.

  As described above, by moving the waveform display area and the recording range to a desired position, it is possible to freely perform display, recording, automatic analysis, and the like on the waveform data in a desired time interval.

FIG. 11 is a diagram for explaining the buffer image 93.
The buffer image has a basic form in which a drawing area simulating the size of the storage area of the buffers 130a and 130b is drawn by visually differentiating a portion where the ECG waveform data exists in the buffer and a portion where the ECG waveform data does not exist. To do. This makes it possible to intuitively grasp the buffer usage status. In addition to this basic form, the expression of the part where the ECG waveform data exists is visually differentiated, so that the waveform data status (existence of events such as electrode detachment and abnormal waveforms), the section being displayed, and the recording target It is also possible to grasp the sections that become.

When there is a large amount of data that can be buffered, as in the electrocardiograph of this embodiment, it is often impossible to display all sections in one screen. It is important to be able to easily grasp the relationship between the existing waveform and the whole.
In this embodiment, since the waveform data for a maximum of 10 minutes is stored in the buffer, the rectangular drawing area is divided into 10 line areas each representing one minute, and the time corresponding to the oldest data is in the upper left. It is expressed in association with.

  When there is an empty space in the buffer, that is, when data of less than 10 minutes is buffered at the time of freezing, the empty area is indicated by white, for example. Therefore, the empty area extends from the lower right corner to the left.

Further, (1) a section in which the number of measurement channels is correctly buffered, (2) a section in which an electrode disconnection occurs and a number of channels less than the number of measurement channels is buffered, and (3) a waveform display area The section (the section indicated by the waveform display range 91b of the freeze compression waveform section 91) is also displayed visually differently.
The buffer image 93 also functions as a toggle switch, and when pressed, the freeze screen in FIG. 9 and the freeze compressed rhythm waveform display (details will be described later) shown in FIG. 12 are switched.

  FIGS. 11B and 11C are diagrams illustrating the correspondence between the operation of moving the display waveform range 91b in the freeze compression waveform unit 91 and the buffer image described with reference to FIG. 10B. That is, in the state shown in FIG. 11A, that is, in the state where the display waveform range exists at the left end portion of the second row from the bottom, the left movement button 91L is pressed as shown in FIG. It is assumed that the range 91b has been moved in the past. In this case, as shown in FIG. 11C, the display waveform range display in the buffer image 93 also moves in the same manner.

  FIG. 12 is a diagram illustrating an example of a freeze-compressed rhythm waveform display screen that is switched and displayed when the buffer image 93 is pressed. In FIG. 12, the same reference numerals are assigned to the areas where the display equivalent to that in FIG. 9 or FIG. 3 is performed, and redundant description is omitted.

  In the waveform display area 94 ′, one induction waveform (here, a rhythm waveform, ie, the second induction in this embodiment) is displayed as a compressed waveform. In the present embodiment, a waveform for a maximum of 10 minutes in one line 20 seconds is displayed in time series from top to bottom. When the display does not fit on one screen, it can be scrolled with a scroll bar on the right side of the screen.

  At this time, the abnormal waveform, the electrode misalignment section, the automatic recording range, and the range corresponding to the manual recording range are displayed by changing the color of the waveform or the background.

  For example, in the example of FIG. 12, since the heartbeat waveform surrounded by a dotted line frame indicated by 97 is an abnormal waveform, the color is displayed differently. Also in the buffer image 93 ', the portion corresponding to this abnormal waveform is represented by a different color. In the example of FIG. 12, since an abnormal waveform appears regularly, the buffer image 93 'looks like a vertical line. In the buffer image 93 ', the waveform display range 91b and the like are displayed in the same manner as the freeze screen as described with reference to FIG.

  The display range can be moved in units of events such as abnormal waveforms. Specifically, the display range jumps by pressing an event ← button or event → button provided in the function key display unit 37.

Also in the waveform display area 94 ′, an automatic recording range 91a is shown, and the section 96 designated as the manual recording range is displayed with a different background color. The manual recording range can be designated by directly touching the start point and end point in the waveform display area 94 ′.
When the buffer image 93 'is pressed on the freeze compressed rhythm waveform display screen, the screen returns to the freeze screen of FIG.

  As described above, according to the present embodiment, by displaying the buffer image 93 together with the frozen waveform data, it is possible to perform buffering for a long time like the electrocardiograph of the present embodiment. However, it is possible to instantly grasp which part of the entire freeze data is displayed on the screen. It is also possible to grasp how much the buffer is free, and it is easy to perform analysis processing while avoiding the portion where the electrode is detached. Furthermore, since it is possible to grasp events as well, various information about the entire freeze data can be clearly grasped at once, which is very convenient.

Claims (3)

An electrocardiogram analysis result report for the subject,
A bibliographic area where bibliographic information is shown;
A result area where at least marks representing the degree of waveform disturbance and pulse disturbance are arranged;
A representative waveform area showing the representative waveforms of the analyzed electrocardiogram waveforms by induction,
Among the analyzed electrocardiogram waveforms, for one pre-set lead, the entire section waveform area indicating the waveform of the entire section analyzed,
An electrocardiogram analysis result report characterized in that an illustration region showing an illustration of the appearance or cross section of the heart corresponding to a disease suspected as a result of the analysis is arranged on the same sheet.   2. The electrocardiogram analysis result report according to claim 1, further comprising, as a separate sheet, an explanation of findings regarding a disease suspected of the analysis as well as an illustration identical to the illustration shown in the illustration area.   The electrocardiogram analysis result report according to claim 1 or 2, wherein a plurality of marks corresponding to the plurality of stages of the degree are arranged in the result area.