JP7257127B2 - Medical image display method and program - Google Patents

Description

The present invention relates to a medical image display method and program for forming and displaying a medical image based on data of an anesthesia machine.

Generally, an anesthesia machine is used for surgery. The anesthesia machine mixes oxygen, nitrous oxide, and air supplied from pipes or cylinders with volatile inhalation anesthetics such as sevoflurane and desflurane vaporized by a vaporizer, adjusts the flow rate, and supplies it to the breathing circuit as anesthetic gas. supply. The anesthesia machine delivers anesthetic gas through the breathing circuit to the patient as inspiration. The anesthesia machine circulates the patient's exhaled breath through a carbon dioxide absorber (canister) back into the inspiratory air and exhausts excess gas through a semi-closed valve (APL valve). Such an anesthesia machine is disclosed, for example, in US Pat.

On the other hand, the anesthesia machine monitors the patient's respiratory status and depth of anesthesia and displays it on the display. For example, the exhaled carbon dioxide partial pressure, the volatile inhalation anesthetic concentration, the inhaled oxygen concentration, the ventilation volume, and the like are displayed on the display along with the target values (set values).

Japanese Patent Application Laid-Open No. 2004-041247

In recent years, anesthesia machines having an automatic gas control (AGC) function have been realized. Therefore, anesthesia machines with both automatic gas control and manual gas control (MGC) modes have also appeared.

Here, in the manual gas control mode, a person manually adjusts the flow rate of oxygen and air so as to obtain the target oxygen concentration. On the other hand, in the automatic gas control mode, the anesthesia machine automatically adjusts the flow rate of oxygen and air so that the oxygen concentration is set by the person.

A medical worker such as a doctor or a nurse performs anesthesia management suitable for the patient's situation while comparing the patient's exhalation and inhalation data displayed on the display with the set values.

By the way, in the manual gas control mode and the automatic gas control mode, even the same kind of data has different meanings between the modes. For example, regarding the oxygen concentration, the oxygen concentration in the manual gas control mode is the actual value obtained by manually adjusting the flow rate by the medical staff, and the oxygen concentration in the automatic gas control mode is the actual value obtained by adjusting the anesthesia machine automatically. value. Thus, deviations in oxygen concentration from target in manual gas control mode are attributed to medical personnel flow adjustments, whereas deviations in oxygen concentration from target in automatic gas control mode are attributed to the anesthesia machine. may be caused by the failure of the

However, with conventional anesthesia charts, for example, when there is a problem with anesthesia management, it is difficult for medical staff to determine whether it is caused by something artificial or mechanical (anesthesia machine). users are difficult to grasp.

The present invention has been made in consideration of the above points, and enables the user to perform accurate anesthesia management when an anesthesia machine having both manual gas control mode and automatic gas control mode is used. To provide a medical image display method and a program capable of displaying such medical images.

One aspect of the medical image display method of the present invention is
forming a graph representing the temporal transition of the patient's inspiratory data and expiratory data obtained by the anesthesia machine;
displaying, in addition to the graph, an identification image capable of identifying whether the anesthesia machine was in the manual gas control mode period or the automatic gas control mode period;
including.

According to the present invention, it becomes possible to clearly recognize whether the graph one is looking at shows the behavior under manual gas control or the behavior under automatic gas control. Accurate anesthesia management can be performed when an anesthesia machine having both gas control modes is used.

1 is a diagram showing an outline of a hospital information system to which a medical image display method according to an embodiment is applied; FIG. 4A and 4B are diagrams showing examples of medical images according to the embodiment; FIG. 10 is a diagram showing an example of a medical image according to another embodiment; FIG. 10 is a diagram showing an example of a medical image according to another embodiment;

BEST MODE FOR CARRYING OUT THE INVENTION Hereinafter, embodiments of the present invention will be described with reference to the drawings.

<System configuration>
FIG. 1 is a diagram showing an overview of a hospital information system (HIS) to which a medical image display method according to an embodiment of the present invention is applied. The hospital information system in FIG. 1 has an electronic chart system as a host system, and a medical accounting system, radiation system, central examination system, ordering system, physical distribution management system, and acute department system 1 are connected online.

The acute department system 1 has a database server 100 . The database server 100 is communicably connected to other systems included in the hospital information system, such as the above-described electronic chart system and ordering system, via a gateway server 101 as a data exchanger.

The database server 100 centrally manages data of an operating room, an intensive care unit (ICU), and an emergency room (ER). In the following, the intensive care unit and emergency room are abbreviated as intensive care unit or ICU-ER.

The operating room is equipped with an anesthesia machine 200 and a biological information monitor 210 , which are online-connected to the database server 100 via a conversion module 220 . The ICU-ER is equipped with a ventilator, an aortic balloon pump, a biological information monitor, etc. (not shown), which are connected online to the database server 100 via a conversion module (not shown).

The database server 100 collects online data from the anesthesia machine 200, biological information monitor 210, ventilator (not shown), blood gas analyzer (not shown), etc. installed in the operating room or ICU-ER. centrally managed. In addition, the database server 100 can acquire data such as patient attributes, various examination data, drug orders, and surgical orders from an electronic medical chart system, an ordering system, a central examination system, and the like via the gateway server 101 . Furthermore, it is also possible to send data from the acute department system 1 to other systems included in the hospital information system.

The database server 100 can centrally manage the perioperative period, from preoperative surgical reservations to scheduling and postoperative anesthesia record summaries.

The database server 100 is also connected to an operating room terminal 103 and an ICU-ER terminal 104 . The terminals 103 and 104 have a function of receiving data from the database server 100 and creating medical images such as anesthesia charts and anesthesia machine state transition images, which will be described later. Specifically, the terminals 103 and 104 have a ROM (Read Only Memory), a RAM (Random Access Memory), a CPU (Central Processing Unit), etc., and the CPU executes a program held in the ROM, Generate and display medical images such as anesthesia charts and anesthesia machine state transition images.

Specifically, the terminals 103 and 104 receive information such as various online data, process events from entering the room, anesthesia machine information, vital information, drug information, and infusion information from the database server 100, and based on this information, anesthesia charts are generated. and a medical image such as an anesthesia machine state transition image. Furthermore, the terminals 103 and 104 can register information such as the start/end of anesthesia in the anesthesia chart.

The terminals 103 and 104 then display medical images such as anesthesia charts and anesthesia machine state transition images on their display units.

Medical images such as anesthesia charts and anesthesia machine state transition images formed by the terminals 103 and 104 are recorded by the database server 100 . Medical images such as the anesthesia chart and the anesthesia machine state transition image can also be referred to via the web server 102 at an in-hospital or external terminal.

<Display of medical images according to the embodiment>
Next, a medical image formed and displayed according to this embodiment will be described with reference to FIG.

The medical image 10 of FIG. 2 is formed and displayed by the terminal 103 based on the data output from the anesthesia machine 200 . As mentioned above, the output data of the anesthesia machine 200 can be received at the terminal 103 via the database server 100 . The medical image 10 in FIG. 2 can be called, for example, an anesthesia machine state transition image. Therefore, hereinafter, the medical image 10 may also be referred to as an anesthesia machine state transition image 10 .

In addition to the anesthesia machine state transition image 10 shown in FIG. 2, the terminal 103 also creates an anesthesia chart including the vital graph obtained by the biological information monitor 210 and the anesthesia information obtained by the anesthesia machine 200. It is possible to display. Which image to create and display can be selected by operating the terminal 103 by a medical worker who is the user of the terminal 103 .

The anesthesia machine state transition image 10 shown in FIG. 2 expresses the temporal transition of the patient's inspiratory data and expiratory data obtained by the anesthesia machine 200 . The anesthesia machine state transition image 10 includes the inspired oxygen concentration (InspO2) measured by the anesthesia machine 200 and the exhaled anesthetic agent concentration (EtAA) such as the exhaled Sevo concentration measured by the anesthesia machine 200 . The anesthesia machine state transition image 10 also includes a target inspiratory oxygen concentration (target InspO2) and a target expiratory anesthetic agent concentration (target EtAA) preset in the anesthesia machine 200 .

In the medical image display method presented in this embodiment, in addition to this, depending on whether the anesthesia machine 200 was in the manual gas control mode period or the automatic gas control mode period (AGC period), The background color of the graph representing the temporal transition of the inspiratory data and the expiratory data is changed. That is, the background color of the manual gas control mode period and the background color of the automatic gas control mode period (AGC period) are set to different colors. Note that making the background colors different includes processing to color one background and not color the other background.

In the example of FIG. 2, the background color of the automatic gas control mode period (AGC period) is shaded for convenience. From this anesthesia machine state transition image 10, the medical staff can see that the period from 9:05 to 10:10 is the automatic gas control mode period (AGC period), and the other period is the manual gas control mode period. recognizable.

As a result, according to the anesthesia machine state transition image 10 of the present embodiment, the medical staff can determine whether the behavior of the anesthesia machine 200 during the period he or she is viewing is due to manual gas control or due to automatic gas control. can be clearly recognized. As a result, for example, if there is a problem with the behavior of the anesthesia machine, the medical staff should know whether it is due to something human (i.e. due to manual gas control) or mechanical (the anesthesia machine). ) (that is, whether it is caused by the automatic gas control of the anesthesia machine).

<effect>
As described above, according to the present embodiment, a graph representing the temporal transition of the patient's inspiratory data (InspO2) and expiratory data (EtAA) obtained by the anesthesia machine 200 is formed, and the graph is manually generated. By adding background images with different colors during the gas control mode period and during the automatic gas control mode period, the medical staff can see whether the graph they are looking at shows the behavior due to manual gas control or the automatic gas control mode. It is possible to clearly recognize whether the behavior is due to gas control. As a result, accurate anesthesia management can be performed when an anesthesia machine having both manual gas control mode and automatic gas control mode is used.

<Other embodiments>
The above-described embodiments are merely examples of specific implementations of the present invention, and the technical scope of the present invention should not be construed to be limited by these. That is, the present invention can be embodied in various forms without departing from its spirit or essential characteristics.

(i) In the above-described embodiment, the background color of the graph is set to different colors during the manual gas control mode period and the automatic gas control mode period, thereby indicating whether the anesthesia machine was in the manual gas control mode period or the automatic gas control mode period. A case has been described in which it is possible to identify whether it was the gas control mode period, but this is not the only option. For example, as shown in FIG. The mode (AGC mode) period may be identifiably displayed by an arrow, characters, or the like.

As can be seen from FIGS. 2 and 3, in the anesthesia machine state transition image 10 of the above-described embodiment, the target inspiratory oxygen concentration (target InspO2) and the target expiratory anesthetic agent Concentrations (target EtAA) are displayed and are not displayed during manual gas control mode (MGC mode), allowing the healthcare professional to determine the presence or absence of target inspiratory oxygen concentration (target InspO2) and target expiratory anesthetic agent concentration (target EtAA). , it is possible to recognize which period of the anesthesia machine state transition image 10 is the automatic gas control mode (AGC mode) period and which period is the manual gas control mode (MGC mode) period. That is, the displayed target inspiratory oxygen concentration (target InspO2) graph and the displayed target expiratory anesthetic agent concentration (target EtAA) graph show whether the anesthesia machine 200 was in the manual gas control mode or during the automatic gas control mode. It can also be said that it is an identification image for identifying whether it was during the control mode period. In the example of FIG. 2 and the example of FIG. 3, it is difficult to identify the mode only with the graph of the target inspiratory oxygen concentration (target InspO2) and the graph of the target expiratory anesthetic agent concentration (target EtAA). makes it easier to distinguish between modes.

(ii) As shown in FIG. 4, in addition to the display of FIG. 2, there is a first difference allowable graph 11 showing the difference allowable range between the measured intake oxygen concentration graph (InspO2) and the target intake oxygen concentration graph (target InspO2). and a second difference allowable graph 12 showing the difference allowable range of the actually measured expiratory anesthetic concentration graph (EtAA) from the target expiratory anesthetic concentration graph (target EtAA). The first allowable difference graph 11 and the second allowable difference graph 12 each have a lower limit value and an upper limit value.

The first and second allowable difference graphs 11 and 12 are preset by a user such as a medical worker. The first and second allowable difference graphs 11 and 12 are preferably set for each patient.

If the measured inspiratory oxygen concentration graph (InspO2) falls within the allowable range shown between the lower limit value and the upper limit value of the first difference allowable graph 11, the medical staff can confirm that the automatic gas control operates normally. It can be inferred that Similarly, the health care professional can indicate that if the measured expiratory anesthetic agent concentration graph (EtAA) falls within the tolerance shown between the lower and upper limits of the second differential tolerance graph 12, automatic gas control is enabled. I can assume that it is working properly.

In addition, in the example of FIG. 4, the measured inspiratory oxygen concentration graph (InspO2) and/or the measured expiratory anesthetic concentration graph (EtAA) are out of the range of the first difference allowable graph 11 and/or the second difference allowable graph 12. When this happens, an image indicating this ("!" in the example in the figure) is displayed. This enables medical personnel to reliably and quickly recognize that an abnormality has occurred in the automatic gas control.

Here, it is preferable that the allowable ranges indicated by the first difference allowable graph 11 and the second difference allowable graph 12 are different immediately after the start of the automatic gas control mode period and thereafter. Specifically, as can be seen from FIG. 4, it is preferable to increase the allowable range immediately after the start of the automatic gas control mode period and narrow the allowable range thereafter. By doing so, the degree of tolerance is relaxed immediately after the start of the automatic gas control mode when the effect of the automatic gas control does not fully appear, and the degree of tolerance is increased after a predetermined time when the effect of the automatic gas control should fully appear. can be tightened, allowing reasonable comparisons to be made.

(iii) A graph of breath oxygen concentration may be added to the graph of FIG. In this way, the patient's metabolic status can be estimated from the difference between the patient's inspiratory oxygen concentration and expiratory oxygen concentration. Also, a graph of exhaled carbon dioxide concentration may be added to the graph of FIG. In this way, it becomes possible to estimate the situation of the patient's ventilation capacity.

(iv) In the above-described embodiment, a case has been described in which the terminals 103 and 104 create and display the medical image (anesthesia machine state transition image) 10 according to the present invention, but the present invention is not limited to this. For example, the database server 100 performs the process of creating the medical image (anesthesia machine state transition image) 10, and the terminal 103, 104 performs the display process of the created medical image (anesthesia machine state transition image) 10. good too.

In the above-described embodiment, the case where the graph-displayed inspiratory data is the measured inspiratory oxygen concentration graph (InspO2) and the graph-displayed expiratory data is the measured expiratory anesthetic concentration graph (EtAA) has been described. The inspiratory data and expiratory data are not limited to these, and in short, other data may be used as long as they are inspiratory data and expiratory data controlled by the anesthesia machine 200 .

INDUSTRIAL APPLICABILITY The present invention is useful as a medical image display method and program for forming and displaying a medical image based on data of an anesthesia machine.

1 Acute department system 10 Medical image (anesthesia machine state transition image)
11 first difference tolerance graph 12 second difference tolerance graph 100 database server 101 gateway server 102 web server 103, 104 terminal 200 anesthesia machine 210 biological information monitor 220 conversion module

Claims (7)

the computer forming a graph representing the temporal evolution of the patient's inspiratory and expiratory data obtained by the anesthesia machine;
The computer displays on the display unit an identification image capable of distinguishing between the time region during which the anesthesia machine is in the manual gas control mode period and the time region during which the anesthesia machine is in the automatic gas control mode, to the graph. and
A medical image display method comprising: wherein the identification image is a background image that differs between the manual gas control mode period and the automatic gas control mode period;
The medical image display method according to claim 1. wherein the identification image is a graph of target inspiratory oxygen concentration and/or target expiratory anesthetic agent concentration;
The medical image display method according to claim 1. The graph is at least
an actual measurement intake oxygen concentration graph, a target intake oxygen concentration graph, and a first difference allowable graph showing an allowable difference range of the measured intake oxygen concentration graph from the target intake oxygen concentration graph during the automatic gas control mode period;
A measured expiratory anesthetic concentration graph, a target expiratory anesthetic concentration graph, and a second difference indicating an allowable difference range of the measured expiratory anesthetic concentration graph from the target expiratory anesthetic concentration graph during the automatic gas control mode period. a tolerance graph;
The medical image display method according to claim 1 or 2, comprising: The allowable range indicated by the first difference allowable graph and/or the second difference allowable graph is different immediately after the start of the automatic gas control mode period and after that,
The medical image display method according to claim 4. When the measured inspiratory oxygen concentration graph and/or the measured expiratory anesthetic agent concentration graph are outside the range of the first difference allowable graph and/or the second difference allowable graph, an image indicating this is displayed. ,
The medical image display method according to claim 4 or 5. to the computer,
a process of forming a graph representing the temporal transition of the patient's inspiratory data and expiratory data obtained by the anesthesia machine;
a process of adding an identification image capable of distinguishing a time region during which the anesthesia machine is in the manual gas control mode period and a time region during the automatic gas control mode period to the graph, and displaying the graph on a display unit; ,
program to run.

Images