JPH02154736A - Simple centralized treatment device - Google Patents

Abstract

PURPOSE: To inexpensively produce a simplified intensive care device by composing it in that a producing means produces a biological information based on a biological signal detected by a detecting method and a controling means controls a medical treatment method based on the biological information and the medical treatment information inherent to a corresponding patient. CONSTITUTION: Based on a biological signal detected by a detecting means M2, a producing means M4 produces the first medical treatment information to store it in a first storing means M3. Subsequently a controling means M6 controls a medical treatment means M1 based on both the first medical treatment information which is stored in the first storing means M3 and the second medical treatment information inherent to a corresponding therapeutic object which is stored in a second storing means M5. The producing means M4, the first storing means M3, the second storing means M5 and the controling means M6 are integrally and detachably formed into a simplified intensive care device, the device is provided to an individual patient and used exclusively for the patient.

Description

DETAILED DESCRIPTION OF THE INVENTION [Field of Industrial Application] The present invention relates to a simple intensive treatment device for supporting the life of a patient and treating an affected area.

[Prior Art] Intensive treatment devices are known for supporting the life of a person to be treated (hereinafter referred to as a patient), particularly a critically ill patient, or for treating an affected area. This type of intensive treatment equipment consists of a large number of sensors and various measuring instruments that detect implant signals, various treatment devices that treat the affected area of the patient based on various information from the sensors and measuring instruments, storage devices, and displays. It is a device complex that is equipped with devices and is centrally controlled by a computer.
tensiνeCare Unit) or CCU
(Coronary Care Unit).

[Problems to be Solved by the Invention] However, the above-mentioned intensive care device is large and complicated, and requires a huge amount of cost to manufacture. In addition, doctors and nurses who are proficient in its operation are required. Therefore, it is extremely difficult to introduce the above-mentioned devices in small-scale hospitals and clinics, and it is almost impossible to install an intensive treatment device for each patient.

In addition, although the advanced intensive care equipment described above is not required to any extent, it is necessary to have a simple intensive care equipment that can be installed for each patient and monitor the patient at any given time, as well as provide a certain level of treatment to the patient. It is often done. This is especially necessary at night when there are fewer doctors and nurses. For this reason, simple concentration f5. Place B was needed.

The present invention has been made with the object of providing a simple concentration device that can be installed for each patient and manufactured at low cost.

[Means for Solving the Problems] The gist of the present invention, as illustrated in FIG. a detection means M2 that detects biological signals necessary for the detection, and a creation means M4 that creates first treatment information based on the detected biological signals and stores the first treatment information in the first storage means M3. and a second storage means M5 in which second treatment information specific to the treatment subject is stored in advance; and controlling the treatment means M1 based on the first treatment information and the second treatment information. A simple centralized control unit comprising a control means M6 and f5. The apparatus comprises the creation means M4, the first storage means M3, the second storage means M5, and the control means M6, which are removably formed integrally with the intensive care device. A simple intensive treatment device characterized by Treatment information is created and stored in the first storage means M3. Then, the control means M6 controls the treatment means M1 based on the first treatment information stored in the first storage means M3 and the second treatment information stored in the second storage means M5. Further, since the creation means M4, the first storage means M3, the second storage means M5, and the control means M6 are removably integrally formed in the simple intensive care device, they are provided for each patient and used exclusively for that patient. be able to.

[Example] An embodiment of the present invention will be described based on the drawings.

As shown in FIG. 2, the simple intensive treatment device 1 is composed of detection equipment 2 as a detection means, a signal processing device 4, an electronic control device 6, and an insulin injection device 8 as a treatment means. There is.

As the detection equipment 2, a glucose sensor 10, a well-known electrocardiogram body surface electrode 12, and a blood pressure monitor 14 are provided.

The glucose sensor 10 is formed by fixing glucose oxidase in two cuprophan membranes and coating the electrode surface with the cuprophan membranes. It is configured to generate a potential difference across the electrodes depending on the amount of hydrogen.

As shown in FIG. 3, the signal processing device 4 includes a human power processing system processor 20, a well-known human power output boat 22, blood sugar level,
An alarm device 24 that generates a warning sound in response to a command signal from the electronic control device 6 when there is an abnormality in the electrocardiogram or blood pressure, and a non-volatile memory (hereinafter referred to as EEPROM) 26 that stores a patient identification number and can be rewritten at any time. and a well-known uninterruptible power supply.

The human processing system block 20 includes an amplification circuit 40a that amplifies the electrical signal manually input from the detection equipment 2 to a predetermined level.
, 40b, 40c, sample and hold circuits (hereinafter referred to as S/H circuits) 42a, 42b, 42c that hold the amplified electrical signals at a constant cycle, a well-known A/D converter 44, and a clock signal generation circuit 46. and the respective S/H circuits 42a, 42b, 42 from the clock signal.
A/D converter circuit 48 that creates a timing signal that determines the hold timing of c
The multiplexer 50 is connected to the converter 44.

Note that in order to ensure patient safety, the amplifier circuit 40a,
The input end and output side of 40b and 40c are insulated.

Furthermore, this signal processing device 4 includes connectors 50a, 50.
b, so that the electronic control device 6 can be attached and detached from the signal processing device 4, and the connection cable (not shown) of the insulin injection device 8 can be attached and detached.

Note that the signal processing device 4 also corresponds to the detection means.

The electronic 'I'a device 6 is a well-known (7) CPU 60, RO
It is composed of an M62, a RAM 64, an EEPROM 66, and a bus 68 that interconnects each element.

This electronic control device 6 is integrally molded in the shape of a card, and terminals are arranged in clusters at the detachable part (not shown in the figure).
, can be attached to and detached from the signal processing device 4.

The RArVI 64 includes areas such as a buffer 64a for temporarily storing various biological information manually input from the signal processing device 4, a work area 64b for storing various data, and an accumulation area 64c for storing various biological information. The data stored in each area is protected by the backup battery 70 even if the electronic control device 6 is removed from the signal processing device 4.

The EEPROM 66 stores treatment information unique to the patient set based on the doctor's diagnosis, such as various constants that determine the amount of insulin to be injected into the diabetic patient and the patient's registration number.

The above-mentioned treatment information is rewritten for each patient and at any time according to the patient's medical condition.

Note that the electronic control device 6 corresponds to a creation means and a control means, the RAM 64 corresponds to a first storage means, and the EEPROM
66 corresponds to second storage means.

The insulin injection device 8 injects insulin into a patient based on the injection amount data from the signal processing device 4. The injection amount data is converted into a voltage signal at a predetermined level by a D/A converter 80 and an amplifier circuit 82 provided in the insulin injection device 8, and outputted to an injection pump 84 that injects insulin.

Next, an example of patient monitoring and treatment processing executed in the intensive care apparatus 1 having the above-described configuration will be described based on the flowcharts shown in FIGS. 4, 5, and 6.

First, when the electronic control device 6 is set in the signal processing device 4, the CPU 60 executes the initial value setting process shown in FIG.

That is, the CPU 60 reads the identification number from the EEPROM 26 (S1), checks it with the registration number stored in the EEPROM 66, and if it matches (S2-'l').
Es), various initial values are set (S3), and the process ends.

On the other hand, if the identification number and registration number do not match (S
2-NO), output the alarm command to the notification device 24 (S4)
, enters the CPU halt state. That is, unless it is confirmed that the electronic control device 6 is for the patient, monitoring and treatment cannot proceed. Further, the CPU 60 cannot resume operation unless the CPU 60 is released from the halt state by power reset and returns to the initial state.

When the initial settings are completed, the CPU 60 executes an interrupt process for inputting biological information and a treatment process shown in the flowcharts of FIGS. 5 and 6.

First, the CPU 60 receives timing signals Tim1, Tim2 . Interrupt request signal 1ntl synchronized with Tim3, Int2. When Int3 is input manually, the interrupt processing shown in the flowchart of FIG. 5 is executed.

That is, data related to biometric information is read from the A/D converter (S10), and stored in the buffer 764a in order from the start address of the designated area (Sll), and the process ends.

When the above-described interrupt processing is executed in sequence, biological information corresponding to biological signals detected by the glucose sensor 10, body surface electrode 12, and blood pressure monitor 14 is stored in the buffer 64a.

When the CPU 60 starts the interrupt processing, it also executes the treatment processing shown in the flowchart of FIG. 6 in a time-sharing manner.

First, when the clinically confirmed delay time T of blood sugar level change with respect to insulin injection has elapsed (S20-YES),
The blood sugar level data read so far is stored in the buffer 64a.
to the work area (521), buffer 64a
is cleared (S22).

Next, the blood sugar level data is read out from the work area 64b (923), and it is determined whether the detected blood sugar level data is equal to or higher than the allowable minimum blood sugar level (S24).

If the blood sugar level is less than the minimum allowable blood sugar level (S24-N
O), a hypoglycemic state is assumed and a danger warning command is output to the notification device 24 (536), and the process ends.

On the other hand, if the blood sugar level is above the allowable minimum value (S24
-YES), it is determined whether the blood sugar level is equal to or higher than a predetermined appropriate blood sugar level (S25). If the determination in S25 is negative, a command to notify that the insulin injection has ended is output to the notification device 24 (S37), and the process ends. If the determination is affirmative, the difference between the data at the address and the data at the next address in order from the first address of the work area 64b, that is, the blood glucose 1 direct change rate is determined (S26), and the process proceeds to 527.

In S27, the amount of insulin injected per predetermined time (for example, in minutes) is calculated based on the blood sugar level and its rate of change. That is, the insulin injection amount is determined based on the following equation.

I I R(t)=Kp-BG(t)+Kd-dB
G(t)/d t+Kc ・・・・・・(1) IIR(t) is insulin injection rate (Jl, U/m1n)
, BG(1) is the blood glucose level, Kp is the proportional action coefficient (μU/m
g), K (l is the differential operating coefficient (u, U-min/mg
), Kc is the basal insulin infusion constant.

Since the blood sugar level is sampled at a predetermined period, the difference value of the blood sugar level data can be regarded as the value for one edition. That is, dBG(t)/dt is the difference (directly equal to). Therefore, the detected blood sugar level and the difference value are substituted into equation (1) to find the amount of insulin injected per minute.

Next, referring to the conversion table stored in the ROM 62, the insulin injection amount data is converted into voltage data and output to the insulin injection device 8 (828). Then, the insulin injection device 8 injects the above injection amount of insulin into the patient. Next, the system waits for a predetermined time (for example, one minute) to elapse after the previous insulin injection command was output (829), and reads and injects the next insulin injection amount (S30). Then, a predetermined number of times (work area 66b
After injecting insulin (the number of blood sugar level data read in) (S31-YES), the insulin injection amount data is stored in the storage area 64c (532), and the work area 6
4b is cleared (S33), and the process proceeds to S34.

In S34, the total injection amount up to that point is integrated and it is determined whether the total injection amount is less than or equal to the predetermined maximum allowable total injection amount,
If the judgment is affirmative, return to S21 and continue insulin injection.
If the determination is negative, a caution warning command to the effect that the maximum amount has been exceeded is output to the notification device 24 (S35) and the process is terminated.

By executing the above-described treatment process, the calculated insulin injection amount is injected into the patient at predetermined time intervals starting from the time when the delay time T has elapsed from the start of blood glucose (direct measurement).

The above-mentioned proportional action coefficient Kp, tfi action coefficient Kd, delay time T, minimum allowable blood sugar level, and appropriate blood sugar level can be rewritten for each patient and according to the patient's medical condition so that optimal insulin injection processing can be executed. do.

The details of the algorithm for insulin injection are described in the paper "Glucose Regulatory Mechanism and Treatment Control System" published in the Journal of the Japan Society of System Control and Information Science (VOL, 30.N08), so a detailed explanation will be omitted.

As described in detail above, the simple intensive care device 1 of this embodiment has the following features:
Treatment information created for each patient can be written into the electronic control device 6 dedicated to that patient, and can be rewritten according to the patient's medical condition, so based on the treatment information, the most appropriate Treatment with insulin injections can be administered.

Further, the stored blood sugar level and InkSwan injection amount can be read out at any time and used as material for determining the progress or recovery of the patient's condition. Alternatively, since changes in blood sugar level during insulin injection are recorded in the RAM 64, this can be used as a basis for determining the progression or recovery of a disease.

Since the electronic control device 6 is integrally formed in the shape of a card and can be attached to and detached from the insulin injection device 8, even if the patient changes, the patient can receive appropriate treatment by simply setting the electronic control device for that patient. can be applied. In addition, it is equipped with a safety lock function that prevents treatment from starting unless the identification number and registration number match, and a function that alerts you when a hypoglycemic state is detected, ensuring patient safety. be done.

Furthermore, the simple intensive care device 1 has an extremely simple configuration compared to an ICU or CCU, so it can be manufactured at low cost.
It can also be introduced in small hospitals and private clinics.

Furthermore, once the simple intensive care device 1 is installed, medical staff only need to monitor the warning sound, which helps solve the shortage of medical staff and is effective in treating and monitoring patients at night.

Furthermore, the EEPROM 66 is filled with data related to predicted electrocardiogram waveform abnormalities and blood pressure abnormalities specific to the thought, and these data are compared with the created biological information to determine whether or not there is an abnormality. Programming the process of outputting alarm commands is effective for treatment and monitoring of patients in the -layer.

In addition, in order to add a data communication function to this simple intensive care device 1, multiple simple treatment devices and a central information processing device installed at a nurse center etc. can be connected through a communication line, and all patients can be handled at the nurse center etc. It is possible to monitor all at once.

Alternatively, the glucose sensor 10 and the insulin injection device 8 may be replaced with another sensor (for example, a breath sensor or an electronic thermometer) or another treatment device (for example, a respirator or a dropper), and treatment information specific to the person being treated can be transmitted. By writing in the EEPROM 66 and programming the control of the treatment device, it can be used to monitor the growth of newborns, especially premature babies, and to control and monitor infusions for so-called bedridden elderly people.

Next, a second embodiment of the present invention will be described.

The basic configuration of the simple intensive care device 90 of the second embodiment is the same as that of the first embodiment, but as shown in FIG. A sensor 92 is used, and a well-known artificial dialysis device 94 and an automatic dialysis blood collection device 96 are used instead of the insulin injection device 8 as treatment means.

The artificial dialysis device 94 is controlled to start and stop dialysis by commands from the simple intensive care device 90.

The automatic dialysis blood collection device 96 performs blood collection in response to a command from the simple intensive care device 90 after the artificial dialysis device 94 stops dialysis, and automatically stops when the dialysis is completed.

In the EEPROM 66 of the electronic control device 6, data regarding the appropriate value of the blood waste product concentration specific to the dialysis subject and the basic dialysis time are written in advance. These data are rewritten according to the patient's medical condition and physical condition.

Similarly to the first embodiment, the electronic control unit 6 executes the initial value setting process shown in FIG. 4 and then executes the interrupt process shown in FIG. The waste product concentration is detected and sequentially stored in a predetermined area of the buffer 64a. Then, along with the interrupt processing, the treatment processing shown in FIG. 8 is executed in a time-sharing manner.

That is, after the basic dialysis time has elapsed by measuring time using a well-known software timer (S40-YES), it is determined whether the detected waste product concentration has fallen below a predetermined appropriate concentration (S41). ). If the waste concentration exceeds the specified agricultural rate (S41-NO),
The temperature determination is continued (return to S41).

If the concentration of waste products falls below the predetermined agricultural level (S
41-'i'ES), after a predetermined time (S42-YE
S), it is determined whether the concentrations of all waste products detected after the concentration becomes equal to or less than a predetermined appropriate concentration are equal to or less than a predetermined concentration (S43). If a negative determination is made in S43, the process returns to S41.

On the other hand, if the determination in 943 is affirmative, the artificial dialysis device 94
At the same time, a command to notify the end of dialysis is output to the notification device 24 (S44). Next, output a collection command to the automatic dialysis blood collection device 96 (945),
Finish the process.

As explained above, the simple centralized steam treatment apparatus 9 of the second embodiment
0 allows dialysis treatment to be given according to the patient's medical condition, and the dialysis time that has been determined empirically and uniformly performed for a predetermined time is the most suitable for the patient's medical condition and physical condition. can do.

Furthermore, the same effects as in the first embodiment are achieved.

Furthermore, if a process is programmed to monitor the elapse of a predetermined heparin (anticoagulant) injection time and output a command to notify the time elapse to the notification device 24 when it has elapsed, heparin injection can be performed. The time will be reliably announced, so
Heparin injection treatment by medical staff can be ensured.

In particular, when nursing a large number of dialysis patients, medical staff are extremely busy because the dialysis time and heparin injection time differ for each patient, but this is effective in improving the treatment conditions.

[Effects of the Invention] As explained above, according to the present invention, the creation means creates biological information based on the raw $ signal detected by the detection means, and the control means generates biological information and treatment specific to the patient. Since the treatment means are controlled based on the information, it is possible to provide comprehensive treatment for each patient according to the patient's condition, and it also has the effect of resolving the shortage of medical staff. Furthermore, since the creation means, the first storage means, the second storage means, and the control means are removably integrated into the simple intensive care device, for example,
The card can be personalized to an individual patient. Furthermore, since the device has a simple configuration, it can be manufactured at low cost.

[Brief explanation of the drawing]

FIG. 1 is a basic configuration diagram illustrating the present invention, FIG. 2 is a schematic configuration diagram showing a simple intensive care device according to an embodiment, FIG. 3 is a block diagram of a signal processing device, and FIG. 4 is a block diagram of an electronic control device. FIG. 5 is a flowchart showing the initial value setting process executed, FIG. 5 is a flowchart showing the interrupt process executed in the electronic control device, FIG. 6 is a flowchart showing the treatment process executed in the electronic control device, and FIG. FIG. 8 is a schematic configuration diagram showing the simple intensive treatment device of the second embodiment, and a flowchart showing the treatment processing executed in the electronic control device. Ml...Treatment means (insulin injection device 89, artificial dialysis machine 94) M2...Detection means (detection equipment 2. Signal processing device 4° glucose sensor 10. Biosensor 92) M3... First storage means (RAM64) M4... Creation means (signal processing device 4. Electronic control device M5... second storage means (
EEPROM66) M6... Control means (electronic control device 6) 1.90... Simple intensive treatment device 14 Figure 5

Claims (1)

[Scope of Claims] A treatment means for treating an affected part of a person to be treated, a detection means for detecting biological signals necessary for treatment from each body part of the person to be treated, and a detection means for detecting biological signals necessary for treatment from various parts of the body of the person to be treated, and a creation means for creating one treatment information and storing the first treatment information in a first storage means; a second storage means in which second treatment information specific to the person to be treated is stored in advance; A simple intensive treatment device comprising: a control means for controlling the treatment means based on the first treatment information and the second treatment information, the creation means; the first storage means; A simple intensive treatment device, characterized in that the second storage means and the control means are integrally formed in a removably attachable manner to the simple intensive treatment device.