WO2020132808A1 - 针对血流动力学的生理体征监测方法和医疗监护设备 - Google Patents

针对血流动力学的生理体征监测方法和医疗监护设备 Download PDF

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Publication number
WO2020132808A1
WO2020132808A1 PCT/CN2018/123106 CN2018123106W WO2020132808A1 WO 2020132808 A1 WO2020132808 A1 WO 2020132808A1 CN 2018123106 W CN2018123106 W CN 2018123106W WO 2020132808 A1 WO2020132808 A1 WO 2020132808A1
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Prior art keywords
hemodynamics
monitoring
interface
physiological
physiological signs
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PCT/CN2018/123106
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English (en)
French (fr)
Inventor
王澄
卿磊
秦杰
何燕德
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Shenzhen Mindray Bio Medical Electronics Co Ltd
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Shenzhen Mindray Bio Medical Electronics Co Ltd
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Priority to PCT/CN2018/123106 priority Critical patent/WO2020132808A1/zh
Priority to CN201880098459.6A priority patent/CN112911996B/zh
Publication of WO2020132808A1 publication Critical patent/WO2020132808A1/zh
Anticipated expiration legal-status Critical
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/02—Detecting, measuring or recording for evaluating the cardiovascular system, e.g. pulse, heart rate, blood pressure or blood flow
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/08—Measuring devices for evaluating the respiratory organs
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/145—Measuring characteristics of blood in vivo, e.g. gas concentration or pH-value ; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid or cerebral tissue

Definitions

  • the invention relates to the technical field of medical equipment, in particular to a method for monitoring physiological signs of hemodynamics and medical monitoring equipment.
  • the medical monitoring equipment is a device that can measure the physiological sign parameters of the monitored object, and can be compared with the known set value, and can issue an alarm if there is an over-standard. Medical monitoring equipment can monitor the patient's physiological signs parameters throughout the day, detect the changing trend, point out the critical situation, and serve as the basis for the doctor's emergency treatment and treatment.
  • the medical monitoring equipment provides various physiological parameters and waveform monitoring information of the patient on the main interface, and lists historical data of monitoring parameters in the review menu.
  • the doctor can operate on the medical monitoring equipment, which brings up the menu, and then selects the physiological parameters being evaluated from the monitoring parameters for viewing and evaluation.
  • physiological sign parameters including, for example, those related to hemodynamics, those related to the nervous system, those related to the respiratory system, and those related to the metabolic system Therefore, it often takes a lot of time and effort to find the required physiological sign parameters one by one from the medical monitoring equipment, and it is not conducive to comparing physiological sign parameters of the same type.
  • An embodiment of the present invention provides a method for monitoring physiological signs of hemodynamics, including:
  • physiological signs related to hemodynamics of the monitored object including at least blood pressure and heart rate, or the physiological signs related to hemodynamics including at least blood pressure and pulse rate;
  • Displaying a dedicated monitoring interface for hemodynamics wherein the dedicated monitoring interface for hemodynamics includes at least a first display area;
  • the waveform monitoring information corresponding to the physiological signs related to hemodynamics is displayed on the first display area.
  • An embodiment of the present invention provides a medical monitoring device, including:
  • a display configured to display information
  • Memory stores program instructions
  • a processor configured to execute the program instructions to implement the following method steps:
  • physiological signs related to hemodynamics of the monitored object including at least blood pressure and heart rate, or the physiological signs related to hemodynamics including at least blood pressure and pulse rate;
  • Displaying a dedicated monitoring interface for hemodynamics wherein the dedicated monitoring interface for hemodynamics includes at least a first display area;
  • the waveform monitoring information corresponding to the physiological signs related to hemodynamics is displayed on the first display area.
  • An embodiment of the present invention provides a computer-readable storage medium, in which instructions are stored in a computer-readable storage medium, which when executed on a computer, causes the computer to execute the methods described in the above aspects.
  • FIG. 1 is a system framework diagram of a parameter processing module in a multi-parameter monitor according to an embodiment of the present invention
  • FIG. 2 is a system framework diagram of a parameter processing module in a single-parameter monitor according to an embodiment of the present invention
  • Figure 3 is a framework diagram of a network system of monitors used in the hospital
  • FIG. 4 is a schematic flowchart of a method for monitoring physiological signs of hemodynamics
  • FIG. 5 is a schematic diagram of a dedicated monitoring interface for hemodynamics
  • FIG. 6 is a schematic diagram of the first display area in the dedicated monitoring interface for hemodynamics
  • FIG. 7 is a schematic diagram of the second display area in the dedicated monitoring interface for hemodynamics
  • FIG. 8 is a schematic diagram of a special monitoring interface for basic vital signs
  • FIG. 9 is a schematic diagram of an alarm event display area in a special monitoring interface for basic vital signs.
  • FIG. 1 provides a system frame diagram of a multi-parameter monitor.
  • the multi-parameter monitor has an independent housing with a sensor interface area on the housing panel, in which multiple sensor interfaces are integrated for connection with external physiological parameter sensor accessories 111.
  • the housing panel also includes a small LCD display area and a display 119 , Input interface circuit 122 and alarm circuit 120 (such as LED alarm area) and so on.
  • the parameter processing module is used for external communication and power interface for communicating with the host and taking power from the host.
  • the parameter processing module also supports extrapolated parameter modules.
  • the plug-in monitor host can be formed by inserting the parameter module as a part of the monitor, or connected to the host through a cable.
  • the extrapolated parameter module is used as an external accessory of the monitor.
  • the internal circuit of the parameter processing module is placed in the housing, as shown in FIG. 1, and includes at least two signal acquisition circuits 112 corresponding to physiological parameters, a front-end signal processing circuit 113, and a main processor 115.
  • the signal acquisition circuit 112 may be selected from Electrical circuits, breathing circuits, body temperature circuits, blood oxygen circuits, non-invasive blood pressure circuits, invasive blood pressure circuits, etc. These signal acquisition circuits 112 are electrically connected to corresponding sensor interfaces, respectively, for electrically connecting to sensors corresponding to different physiological parameters
  • the accessory 111 its output terminal is coupled to the front-end signal processor, the communication port of the front-end signal processor is coupled to the main processor, and the main processor is electrically connected to the external communication and power interface.
  • the front-end signal processor completes the sampling and analog-to-digital conversion of the signal acquisition circuit output signal, and outputs the control signal to control the physiological signal measurement process. These parameters include but are not limited to : ECG, respiration, body temperature, blood oxygen, noninvasive blood pressure and invasive blood pressure parameters.
  • the front-end signal processor can be implemented by a single-chip microcomputer or other semiconductor devices. For example, LHL2136 of PHLIPS, or mixed-signal single-chip microcomputers such as ADI's ADuC7021, or ASIC or FPGA can be used.
  • the front-end signal processor can be powered by an isolated power supply.
  • the sampled data is sent to the main processor through the isolated communication interface.
  • the front-end signal processor circuit can be coupled to the main processor 115 through the isolated power supply and the communication interface 114. .
  • the reason why the front-end signal processor is powered by the isolated power supply is that the DC/DC power supply isolated by the transformer plays the role of isolating the patient from the power supply equipment.
  • the main purposes are: 1. Isolating the patient, floating the application part through the isolation transformer, so that The patient leakage current is small enough; 2. Prevent the voltage or energy during the application of defibrillation or electrocautery from affecting the cards and devices of the intermediate circuit such as the main control board (guaranteed by creepage distance and electrical clearance).
  • the main processor completes the calculation of physiological parameters, and sends the calculation results and waveforms of the parameters to the host (such as a host with a display, a PC, a central station, etc.) through external communication and power interface.
  • the external communication and power interface 116 can be Ethernet (Ethernet), Token Ring (Token Ring), Token Bus (Token Bus), and one or a combination of the LAN interfaces composed of the fiber distribution data interface (FDDI) as the backbone of the three types of networks. It is one or a combination of wireless interfaces such as infrared, Bluetooth, wifi, and WMTS communication, or one or a combination of wired data connection interfaces such as RS232 and USB.
  • the external communication and power supply interface 116 may also be one or a combination of two of a wireless data transmission interface and a wired data transmission interface.
  • the host computer can be any computer equipment such as the host computer of the monitor, the electrocardiograph, the ultrasound diagnostic apparatus, and the computer. By installing the matched software, a monitor device can be formed.
  • the host can also be a communication device, such as a mobile phone, and the parameter processing module sends data to a mobile phone that supports Bluetooth communication through a Bluetooth interface to realize remote transmission of data.
  • FIG. 3 it provides a network system of monitors used in the hospital.
  • the data of the monitor can be saved as a whole, and the patient information and care information can be centrally managed. The two are stored in association to facilitate the preservation of historical data. And associated alarms.
  • a bedside monitor 212 can be provided for each bed, and the bedside monitor 212 can be the aforementioned multi-parameter monitor or a plug-in monitor.
  • each bedside monitor 212 can also be paired with a portable monitoring device 213.
  • the portable monitoring device 213 provides a simple and portable parameter processing module, but it is worn on the patient's body to carry out mobile monitoring for the patient.
  • the physiological data generated by the mobile monitoring can be transmitted to the bedside monitor 212 for display, or transmitted to the central station 211 through the bedside monitor 212 for the doctor or The nurse can view it or transmit it to the data server 215 through the bedside monitor 212 for storage.
  • the portable monitoring device 213 can also directly transmit the physiological data generated by the mobile monitoring to the central station 211 through the wireless network node 214 installed in the hospital for storage and display, or can transmit the mobile monitoring through the wireless network node 214 installed in the hospital
  • the generated physiological data is transmitted to the data server 215 for storage. It can be seen that the data corresponding to the physiological parameters displayed on the bedside monitor 212 may be derived from the sensor accessory directly connected to the monitoring, or from the portable monitoring device 213, or from the data server.
  • FIG. 4 a method for monitoring physiological signs of hemodynamics according to an embodiment of the present invention, which is applied to medical monitoring equipment It is especially suitable for medical monitoring equipment that includes a display. It can be used to display waveform monitoring information corresponding to physiological signs related to hemodynamics using the display.
  • the medical monitoring device can execute program instructions stored in a memory to implement a corresponding physiological sign monitoring method for hemodynamics.
  • the monitoring method of physiological signs for hemodynamics includes the following steps:
  • Step 301 Obtain the physiological signs of the monitored object related to hemodynamics, the physiological signs related to hemodynamics include at least blood pressure and heart rate, or the physiological signs related to hemodynamics include at least blood pressure and pulse rate;
  • the processor in the medical monitoring device may first obtain physiological signs related to hemodynamics, and the physiological signs include at least blood pressure and pulse rate, where the blood pressure may be non-invasive blood pressure, arterial pressure, and/or central vein Press and wait.
  • Hemodynamics refers to the mechanics of blood flow in the cardiovascular system. It mainly studies blood flow, blood flow resistance, blood pressure and the relationship between them. Blood is a fluid, so the basic principles of hemodynamics are the same as those of general fluid mechanics. However, because the vascular system is a relatively complicated elastic piping system, blood is a liquid containing multiple components such as blood cells and colloidal substances, rather than an ideal liquid. Therefore, hemodynamics has both the common characteristics of general hydrodynamics and its own characteristics.
  • Step 302 Obtain monitoring data corresponding to physiological signs related to hemodynamics
  • the physiological sign sensor in the medical monitoring device may acquire historical data of at least one physiological sign parameter related to hemodynamics of the monitored object within a preset time period.
  • the preset time period may be preset by the user, such as 8 hours or 24 hours, or may be set when the medical monitoring equipment is shipped from the factory, which is not limited here.
  • a sensor is a detection device that can sense the measured information and convert the sensed information into electrical signals or other required forms of information output according to a certain rule to meet the transmission, processing, storage and display of information , Recording and control requirements.
  • Step 303 Generate waveform monitoring information corresponding to the physiological signs related to hemodynamics based on the monitoring data corresponding to the physiological signs related to hemodynamics.
  • the waveform monitoring information mentioned in this application includes analog signal waveforms corresponding to physiological signs, numerical trend graphs, etc., and also includes numerical information of physiological sign parameters displayed along with the waveforms.
  • Step 304 Display a dedicated monitoring interface for hemodynamics, where the dedicated monitoring interface for hemodynamics includes at least a first display area;
  • the medical monitoring device may display a dedicated monitoring interface, where the dedicated monitoring interface includes at least a first display area.
  • FIG. 5 is a schematic diagram of an interface of hemodynamics-related information in an embodiment of the present invention.
  • the user clicks the "hemodynamics" module he can enter the Special monitoring interface related to hydrodynamics.
  • users can also select the "Vital Signs” interface, "Infection” interface, or "Craniocerebral Injury" dedicated monitoring interface for viewing.
  • Each dedicated monitoring interface will display waveform monitoring information related to the required slice. .
  • Step 305 Display waveform monitoring information corresponding to physiological signs related to hemodynamics in the first display area.
  • the display in the medical monitoring device may display waveform monitoring information corresponding to the monitoring data of the hemodynamic related physiological sign parameters based on the monitoring data of the physiological sign parameters related to hemodynamics.
  • FIG. 6 is a schematic diagram of an interface of the first display area in the embodiment of the present invention.
  • the first display area is the portion S1 indicated by the dotted frame.
  • the relevant waveform monitoring information can be displayed in.
  • the 5 waveform monitoring information in the figure is a schematic. In actual applications, it can also be other amounts of waveform monitoring information.
  • step 301 does not limit the execution order between step 301 to step 305.
  • the technical solution provided in the embodiments of the present application provides a method for monitoring physiological signs based on hemodynamics.
  • the physiological signs related to hemodynamics and the physiological signs related to hemodynamics of the monitored object are obtained. At least include blood pressure and heart rate, or physiological signs related to hemodynamics include at least blood pressure and pulse rate, and then obtain monitoring data corresponding to the physiological signs related to hemodynamics, based on the corresponding physiological signs related to hemodynamics
  • Monitoring data generates waveform monitoring information corresponding to physiological signs related to hemodynamics, and displays a dedicated monitoring interface for hemodynamics, wherein the dedicated monitoring interface for hemodynamics includes at least a first display area, and finally the first display area Display waveform monitoring information corresponding to physiological signs related to hemodynamics.
  • the medical monitoring device can directly display the waveform monitoring information related to hemodynamics according to the needs of the user, and realize the slice display of the hemodynamic physiological parameters, thereby saving the user from finding the waveforms related to hemodynamics one by one
  • the time of monitoring information improves the operability of the program.
  • the physiology related to hemodynamics also include one or more of pulse pressure variability, cardiac output, and peripheral vascular resistance index.
  • the physiological signs related to hemodynamics include: heart rate (HR), non-invasive blood pressure (non-invasive measurement of blood pressure, NIBP), arterial pressure (ART), Central venous pressure (CVP), pulse pressure variation (PPV), cardiac output (CO) (such as continuous cardiac output, continuous cardiac output, CCO), and peripheral vascular resistance index (speripheral vascular resistance index, SVRI) One or more of the parameters.
  • waveform monitoring information related to hemodynamic-related physiological signs within a period of time may be displayed, where the waveform monitoring information may be short-trend waveform information, for example, waveform information within 8 hours belongs to short-trend waveform information. Or it may be long-trend waveform information, for example, waveform monitoring information within 24 hours belongs to long-trend waveform information.
  • short-trend waveform information for example, waveform information within 8 hours belongs to short-trend waveform information.
  • long-trend waveform information for example, waveform monitoring information within 24 hours belongs to long-trend waveform information.
  • the method for monitoring physiological signs of hemodynamics further includes:
  • the switching instruction Based on the switching instruction, it is determined to display the waveform monitoring information corresponding to the physiological signs related to hemodynamics in the first time period, or to display the waveform monitoring information corresponding to the physiological signs related to hemodynamics in the second time period.
  • the current dedicated monitoring interface for hemodynamics displays waveform monitoring information (that is, short trend) within 8 hours (the first time period), and the user touches the " ⁇ " "Button, the special monitoring interface for hemodynamics is switched to display waveform monitoring information (that is, long trend) within 24 hours (second time period).
  • HR refers to the number of heartbeats per minute in a normal person in a quiet state, also known as a quiet heart rate, which is generally 60 to 100 beats per minute, which may vary individually due to age, gender or other physiological factors. Generally speaking, the younger the age, the faster the HR, the heartbeat of the elderly is slower than that of the younger, and the HR of women is faster than that of men of the same age. These are normal physiological phenomena. In a quiet state, the normal HR of an adult is 60 to 100 times per minute, and the ideal HR should be 55 to 70 times per minute.
  • NIBP can also be called an automatic noninvasive pressure measurement method, which refers to the automatic control of the cuff inflation with a special air pump, which can measure the pressure for a fixed period of time. It is the most widely used in Intensive Care Unit (ICU) and anesthesia surgery Blood pressure monitoring method.
  • ICU Intensive Care Unit
  • ART is one of the important indicators of circulatory function. If ART is too high or too low, it will affect the blood supply of various organs and the burden of the heart. If the ART is too low, it will cause a decrease in blood supply to the organs, especially the insufficient blood supply to important organs such as the brain and heart, which will cause serious consequences. If the blood pressure is too high, the heart and blood vessels are overloaded. Patients with long-term hypertension often cause compensatory cardiac hypertrophy, cardiac insufficiency, and even heart failure. The blood vessels are subject to high pressure for a long time, and the pathological changes of the blood vessel wall itself can even lead to rupture and cause serious consequences such as cerebral hemorrhage. Therefore, it is very important to maintain the relatively stable state of ART near normal.
  • CVP refers to the pressure in the right atrium and the upper and inferior vena cava thoracic segment. It can judge the comprehensive situation of the patient's blood volume, cardiac function and vascular tone, which is different from the surrounding venous pressure. The latter is affected by venous valves and other mechanical factors, so it cannot accurately reflect blood volume and cardiac function.
  • PPV is defined as the arterial blood pressure variability in patient fluid management and relies on cardiopulmonary interaction to assess infusion responsiveness during mechanical ventilation.
  • Arterial PPV derived from arterial waveform analysis and stroke volume variation derived from pulse profile analysis have been shown to be good predictors of infusion responsiveness.
  • CO refers to the amount of blood injected into the aorta or pulmonary artery by the left ventricle or right ventricle per minute.
  • the output of the left and right ventricles are basically equal.
  • the volume of blood output by each beat of the ventricle is called stroke volume.
  • the body At rest, the body is about 70 ml. If the HR averages 75 times per minute, the output of blood per minute is about 5000 ml, that is, CO per minute.
  • CO is an important indicator for evaluating the efficiency of the circulation system.
  • CO is largely compatible with the metabolism of tissue cells throughout the body.
  • CCO refers to the CO obtained in a continuous period of time.
  • the CO in this embodiment may specifically include CCO.
  • SVR peripheral vascular resistance
  • SVR is a quantitative indicator that diagnoses and reflects the level of post-load in the circulating blood flow group and the heart.
  • the resistance blood vessels increase the response to vasomotor regulation and gradually increase the blood vessel remodeling.
  • the narrowing of the radius of the blood vessel is the key factor for the increase of SVR.
  • Increased SVR increases blood pressure, which increases the heart's afterload level and oxygen consumption.
  • the waveform monitoring information includes one or more physiological sign parameters related to hemodynamics.
  • one of the parameters of heart rate, noninvasive blood pressure, arterial pressure, central venous pressure, pulse pressure variability, cardiac output (such as continuous cardiac output) and peripheral vascular resistance index can be directly displayed according to the needs of medical personnel Or more, which saves the time for medical staff to find the physiological sign parameters related to these parameters one by one, which greatly improves the application efficiency.
  • hemodynamics is dedicated
  • the monitoring interface also includes a second display area
  • the method may also include:
  • One or more of the entrance of the hemodynamic analysis interface, the entrance of the central venous pressure tool interface, and the entrance of the passive leg lift test auxiliary tool interface are displayed in the second display area.
  • a second display area is also included on the dedicated monitoring interface.
  • FIG. 7 is a schematic diagram of an interface of the second display area in the embodiment of the present invention.
  • the second display area is the S2 part indicated by the dotted frame.
  • the second display area shows the entrance of the hemodynamic analysis interface (Hemosight), the entrance of the central venous pressure tool (CVP2-5Tool), and the passive leg lift test assistance (Passive Legging Rising) guide, PLR guide) tool interface entrance.
  • Hemosight hemodynamic analysis interface
  • CVP2-5Tool central venous pressure tool
  • PLR guide Passive Legging Rising
  • one or more of the Hemosight interface entry, the CVP2-5Tool interface entry, and the PLR guide tool interface entry may be included.
  • the craniocerebral injury integrated coma index score entry port the Surviving Sepsis Campaign (SCC) treatment guide tool and the Sequential Organ Failure (Assessment, SOFA) score can also be displayed in the second display area Tool entrance etc.
  • SCC Surviving Sepsis Campaign
  • SOFA Sequential Organ Failure
  • the Hemosight interface is used to display the physiological signs and parameters related to the patient, so that multi-parameter joint decision-making can be realized.
  • the PLR guide tool interface is used to prompt and guide the operation of the PLR process, including 1. Prompt to adjust the patient to the semi-recumbent position before starting the test to obtain the baseline of the patient's observation parameters. 2. Adjust the patient's leg-lifting posture by adjusting the hospital bed, and observe and record the changes in the observed parameters. 3. Adjust the patient to return to the semi-recumbent position and check whether the observation parameters have returned to baseline.
  • the CVP2-5Tool interface entrance is used to provide real-time CVP parameter trend display in the user's rehydration project for patients. Based on the CVP2-5 principles commonly used in clinical practice, an auxiliary tool is provided to display the CVP parameter changes during the rehydration process in real time. And give an intelligent reminder of whether the fluid can be refilled, helping the doctor to conveniently and accurately complete the fluid refill.
  • a second display area is also included on the dedicated monitoring interface, where the hemodynamic analysis interface entrance, the central venous pressure tool interface entrance, and the passive leg lift test auxiliary tool interface entrance are displayed in the second display area One or more of.
  • another optional embodiment of the method for monitoring physiological signs of hemodynamics provided by the embodiment of the present invention may further include:
  • the physiological signs related to the basic vital signs include one or more of heart rate/pulse rate, blood oxygen saturation, blood pressure, body temperature and respiration rate;
  • the waveform monitoring information corresponding to the physiological signs related to the basic vital signs is displayed on the special monitoring interface for basic vital signs.
  • the user when the user needs to view another group of waveform monitoring information related to the patient, the user can also select the slice entry to be viewed on the dedicated monitoring interface of the medical monitoring device.
  • the dedicated monitoring interface of the medical monitoring device For ease of understanding, please refer to FIG. 5, when the user clicks on the “hemodynamics” module, a special monitoring interface related to hemodynamics is entered.
  • the user wishes to view at least one waveform monitoring information related to basic vital signs, he can click on the "vital signs" module to enter the interface as shown in FIG. 8, which is dedicated monitoring of basic vital signs in an embodiment of the present invention.
  • FIG. 8 is dedicated monitoring of basic vital signs in an embodiment of the present invention.
  • Vital signs are used to judge the severity and criticality of a patient's condition. There are mainly heart rate, pulse, blood pressure, blood oxygen saturation, respiration rate, pain, body temperature, changes in pupil and corneal reflex and so on. They are the mainstay for maintaining the normal activities of the body. They are indispensable. No matter which abnormality will cause serious or fatal diseases, and some diseases can also cause the changes or deterioration of these four major signs.
  • Waveform monitoring information of at least one physiological sign parameter related to basic vital signs within a period of time can be displayed on the first display area, where the waveform monitoring information may be short-trend waveform information, for example, waveform information within 8 hours belongs to short-trend waveform information . Or it may be long-trend waveform information, for example, waveform monitoring information within 24 hours belongs to long-trend waveform information.
  • short-trend waveform information for example, waveform information within 8 hours belongs to short-trend waveform information .
  • it may be long-trend waveform information, for example, waveform monitoring information within 24 hours belongs to long-trend waveform information.
  • HR refers to the number of heartbeats per minute in a normal person in a quiet state, also known as a quiet heart rate, which is generally 60 to 100 beats per minute, which may vary individually due to age, gender or other physiological factors. Generally speaking, the younger the age, the faster the HR, the heartbeat of the elderly is slower than that of the younger, and the HR of women is faster than that of men of the same age. These are normal physiological phenomena. In a quiet state, the normal HR of an adult is 60 to 100 times per minute, and the ideal HR should be 55 to 70 times per minute.
  • SpO2 is the percentage of the volume of oxygen-bound oxyhemoglobin in the blood that accounts for the volume of all bound hemoglobin, that is, the concentration of blood oxygen in the blood. It is an important physiological parameter of the respiratory cycle.
  • the metabolic process of the human body is a biological oxidation process, and the oxygen required in the metabolic process enters the human blood through the respiratory system, combines with the hemoglobin in the blood red blood cells to form oxyhemoglobin, and then transports to various tissues and cells of the human body. Blood's ability to carry and transport oxygen is measured by blood oxygen saturation.
  • ART is one of the important indicators of circulatory function. If ART is too high or too low, it will affect the blood supply of various organs and the burden of the heart. If the ART is too low, it will cause a decrease in blood supply to the organs, especially the insufficient blood supply to important organs such as the brain and heart, which will cause serious consequences. If the blood pressure is too high, the heart and blood vessels are overloaded. Patients with long-term hypertension often cause compensatory cardiac hypertrophy, cardiac insufficiency, and even lead to heart failure. The blood vessels are subject to high pressure for a long time, and the pathological changes of the blood vessel wall itself can even lead to rupture and cause serious consequences such as cerebral hemorrhage. Therefore, it is very important to maintain the relatively stable state of ART near normal.
  • BP refers to the lateral pressure that acts on the blood vessel wall per unit area when blood flows in the blood vessel. It is the driving force that promotes blood flow in the blood vessel. It is called arterial blood pressure, capillary pressure and venous blood pressure in different blood vessels.
  • the blood pressure is generally referred to as the arterial blood pressure of the systemic circulation.
  • RR is the number of milligrams of oxygen consumed or carbon dioxide released per gram of living tissue per hour.
  • the size of RR can reflect the strength of a certain organism's metabolic activity.
  • the RR per minute varies with age, gender, and physiological state.
  • the RR for adults is about 16-20 times per minute when calm, about 20 times per minute for children, and generally 1-2 times faster for women than men. It is also an important diagnosis basis for doctors in clinical diagnosis.
  • PR refers to the frequency of arterial pulse.
  • the speed of the pulse rate is affected by factors such as age, gender, exercise, and emotion.
  • Adults more than 100 times per minute are called tachycardia, and less than 60 times per minute are called bradycardia.
  • tachycardia is more than 100 times per minute
  • bradycardia is less than 60 times per minute.
  • TEMP may change slightly within the normal range, for example: TEMP is relatively higher in the afternoon than in the morning, but generally differs by less than 1°C; after eating, after working or strenuous exercise, TEMP may also increase slightly; suddenly enter a high temperature environment Factors such as emotional agitation can also slightly increase TEMP; women's TEMP is slightly higher than normal during ovulation and pregnancy. There are also slight differences in TEMP at different ages. For example, children have a higher metabolic rate and TEMP is higher than adults; elderly people have a lower metabolic rate and their TEMP is slightly lower than that of young adults.
  • the waveform monitoring information also includes one or more physiological sign parameters related to the basic vital signs.
  • one or more of heart rate, blood oxygen saturation, arterial pressure, body temperature, blood pressure, respiration rate and pulse rate can be directly displayed according to the needs of medical staff, thereby saving medical staff from looking up these parameters one by one
  • the time of the related physiological sign parameters greatly improves the application efficiency.
  • the medical monitoring device may also receive an interface switching instruction, and then switch the displayed hemodynamic dedicated monitoring interface to the dedicated monitoring interface for displaying basic vital signs according to the interface switching instruction, Then obtain the physiological signs related to the basic vital signs of the monitored object.
  • the physiological signs related to the basic vital signs include one or more of heart rate/pulse rate, blood oxygen saturation, blood pressure, body temperature, and respiration rate.
  • the monitoring data corresponding to the physiological signs related to the vital signs and then generating the waveform monitoring information corresponding to the physiological signs related to the basic vital signs based on the monitoring data corresponding to the physiological signs related to the basic vital signs. Waveform monitoring information corresponding to physiological signs related to vital signs.
  • the medical monitoring device can directly display the waveform monitoring information related to vital signs according to the user's needs, and the switching instruction can be used to realize the slice display of the physiological parameters of the vital signs, thereby saving the user from finding the waveform monitoring related to the vital signs one by one.
  • the time of information has improved the operability of the program.
  • the interface also includes an alarm event display area (S3 in FIG. 8), and the method may further include:
  • One or more of the types of historical alarm events, the number of triggers, and the trigger time are displayed in the alarm event display area.
  • the medical monitoring device also has an alarm prompt function.
  • the corresponding alarm event list and details can be opened.
  • FIG. 9 is a schematic diagram of an interface of an alarm event list and details in an embodiment of the present invention.
  • the dedicated monitoring interface for hemodynamics further includes an alarm event display area (S3 in FIG. 8), and the method may further include:
  • One or more of the types of historical alarm events, the number of triggers, and the trigger time are displayed in the alarm event display area.
  • the dedicated monitoring interface for hemodynamics may not include the alarm event display area.
  • the medical monitoring device may also display an alarm event display area, the medical monitoring device obtains historical alarm events within a preset time period, and displays the type, number of triggers, and number of historical alarm events in the alarm event display area One or more of the trigger time.
  • the user can find out whether the patient is in a dangerous state in time.
  • the medical monitoring device can monitor the patient's physiological signs in real time and review the historical information of the alarm event. When the alarm event occurs, it can also display the information related to the event. Thereby further improving the reliability and practicality of monitoring.
  • the method for monitoring physiological signs of hemodynamics further includes:
  • Acquire real-time monitoring data of at least one physiological sign of the monitoring object display the real-time monitoring data in other display areas except the dedicated monitoring interface for hemodynamics or the dedicated monitoring interface for basic vital signs on the main monitoring interface.
  • the real-time monitoring data of conventional physiological signs are displayed in the dotted frame (S4).
  • a dedicated monitoring interface for hemodynamics or a dedicated monitoring interface for basic vital signs is embedded or suspended in the main monitoring interface of a conventional medical monitoring device.
  • the real-time monitoring data includes waveform information and/or numerical information corresponding to physiological signs.
  • any tangible, non-transitory computer-readable storage medium can be used, including magnetic storage devices (hard disks, floppy disks, etc.), optical storage devices (CD-ROM, DVD, Blu-ray disks, etc.), flash memory, and/or the like .
  • These computer program instructions can be loaded onto a general purpose computer, special purpose computer, or other programmable data processing equipment to form a machine, so that these instructions executed on a computer or other programmable data processing device can generate a device that implements a specified function.
  • Computer program instructions can also be stored in a computer-readable memory, which can instruct the computer or other programmable data processing device to operate in a specific manner, so that the instructions stored in the computer-readable memory can form a piece Manufactured products, including implementation devices that implement specified functions.
  • Computer program instructions can also be loaded onto a computer or other programmable data processing device, so that a series of operating steps are performed on the computer or other programmable device to produce a computer-implemented process that allows the computer or other programmable device to execute Instructions can provide steps for implementing specified functions.
  • each of the foregoing units or modules for performing various steps may be stored in one or more of the foregoing memories, and the foregoing embodiments are respectively used to implement the foregoing medical monitoring equipment or monitoring system, in which each functional module Including each instruction set for performing the corresponding steps in the above method.
  • the above module or program ie instruction set
  • the memory may store a subset of the modules or data structures described above.

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Abstract

公开了一种针对血流动力学的生理体征监测方法及医疗监护设备，该方法包括：获取监测对象与血流动力学相关的生理体征，该与血流动力学相关的生理体征至少包括血压和心率，或者该与血流动力学相关的生理体征至少包括血压和脉率（301）；获取该与血流动力学相关的生理体征对应的监测数据（302）；基于该与血流动力学相关的生理体征对应的监测数据生成与血流动力学相关的生理体征对应的波形监护信息（303）；显示血流动力学专用监测界面，其中，该血流动力学专用监测界面至少包括第一显示区域（304）；在该第一显示区域显示该与血流动力学相关的生理体征对应的波形监护信息（305）。该医疗监护设备节省了用户逐个查找与生命体征相关的波形监护信息的时间，提升了可操作性。

Description

针对血流动力学的生理体征监测方法和医疗监护设备 技术领域
本发明涉及医疗设备技术领域，具体涉及一种针对血流动力学的生理体征监测方法和医疗监护设备。
背景技术
医疗监护设备是一种可以测量监测对象生理体征参数，并可与已知设定值进行比较，如果出现超标可发出警报的装置。医疗监护设备可以全天监测病人的生理体征参数，检测出变化趋势，指出临危情况，作为医生应急处理和进行治疗的依据。
目前，医生在对病人的病情进行综合分析时，需要按病人生理系统进行查看和评估。医疗监护设备在主界面上提供病人的各种生理参数及波形监护信息，在回顾菜单中罗列了监测参数历史数据。医生可在医疗监护设备上进行操作，由此调出菜单，然后从监护参数中选择正在评估的生理参数进行查看和评估。
然而，由于生理体征参数的类型较多，比如包括与血流动力学相关的生理体征参数、与神经系统相关的生理体征参数、与呼吸系统相关的生理体征参数以及与代谢系统相关的生理体征参数等，因此，从医疗监护设备上逐个查找所需的生理体征参数往往需要耗费较多的时间和精力，也不利于对同类型的生理体征参数进行对比。
发明内容
本发明实施例提供了一种针对血流动力学的生理体征监测方法，包括：
获取监测对象与血流动力学相关的生理体征，所述与血流动力学相关的生理体征至少包括血压和心率，或者所述与血流动力学相关的生理体征至少包括血压和脉率；
获取所述与血流动力学相关的生理体征对应的监测数据；
基于所述与血流动力学相关的生理体征对应的监测数据生成与血流动力学相关的生理体征对应的波形监护信息；
显示血流动力学专用监测界面，其中，所述血流动力学专用监测界面至少 包括第一显示区域；
在所述第一显示区域显示所述与血流动力学相关的生理体征对应的波形监护信息。
本发明实施例提供了一种医疗监护设备，包括：
显示器，所述显示器配置为显示信息；
存储器，所述存储器存储有程序指令；
处理器，所述处理器配置为执行所述程序指令以实现下面方法步骤：
获取监测对象与血流动力学相关的生理体征，所述与血流动力学相关的生理体征至少包括血压和心率，或者所述与血流动力学相关的生理体征至少包括血压和脉率；
获取所述与血流动力学相关的生理体征对应的监测数据；
基于所述与血流动力学相关的生理体征对应的监测数据生成与血流动力学相关的生理体征对应的波形监护信息；
显示血流动力学专用监测界面，其中，所述血流动力学专用监测界面至少包括第一显示区域；
在所述第一显示区域显示所述与血流动力学相关的生理体征对应的波形监护信息。
本发明实施例提供了一种计算机可读存储介质，所述计算机可读存储介质中存储有指令，当其在计算机上运行时，使得计算机执行上述各方面所述的方法。
附图说明
为了更清楚地说明本发明实施例或现有技术中的技术方案，下面将对实施例或现有技术描述中所需要使用的附图作简单地介绍，显而易见地，下面描述中的附图仅仅是本发明的一些实施例，对于本领域普通技术人员来讲，在不付出创造性劳动的前提下，还可以根据这些附图获得其他的附图。
图1为本发明实施例中多参监护仪中参数处理模块的系统框架图；
图2为本发明实施例中单参监护仪中参数处理模块的系统框架图；
图3为一种院内使用的监护仪联网系统框架图；
图4为一种针对血流动力学的生理体征监测方法的流程示意图；
图5为血流动力学专用监测界面的一种示意图；
图6为血流动力学专用监测界面中第一显示区域的一种示意图；
图7为血流动力学专用监测界面中第二显示区域的一种示意图；
图8为基本生命体征专用监测界面的一种示意图；
图9为基本生命体征专用监测界面中报警事件显示区域的一种示意图。
具体实施方式
下面将结合本申请实施例中的附图，对本申请实施例中的技术方案进行清楚、完整地描述，显然，所描述的实施例仅仅是本申请一部分实施例，而不是全部的实施例。
本申请的说明书和权利要求书及上述附图中的术语“第一”、“第二”、“第三”、“第四”等(如果存在)是用于区别类似的对象，而不必用于描述特定的顺序或先后次序。应该理解这样使用的数据在适当情况下可以互换，以便这里描述的实施例能够以除了在这里图示或描述的内容以外的顺序实施。此外，术语“包括”和“具有”以及他们的任何变形，意图在于覆盖不排他的包含，例如，包含了一系列步骤或单元的过程、方法、系统、产品或设备不必限于清楚地列出的那些步骤或单元，而是可包括没有清楚地列出的或对于这些过程、方法、产品或设备固有的其它步骤或单元。
应理解，本发明所涉及的医疗监护设备不局限于监护仪，也包括具有监护功能的有创/无创呼吸机、护士站、中央站等。本申请主要以监护仪为例进行说明。如图1所示，图1提供了一种多参监护仪的系统框架图。多参监护仪具有独立的外壳，外壳面板上具有传感器接口区，其中集成了多个传感器接口，用于与外部的各个生理参数传感器附件111连接，外壳面板上还包括小型IXD显示器区，显示器119，输入接口电路122和报警电路120(如LED报警区)等。参数处理模块用于与主机进行通讯和从主机取电的对外通讯和电源接口。参数处理模块还支持外插参数模块，可以通过插入参数模块形成插件式监护仪主机，作为监护仪的一部分，也可以通过电缆与主机连接，外插参数模块作为监护仪外置的一个配件。
参数处理模块的内部电路置于外壳内，如图1所示，包括至少两个生理参数对应的信号采集电路112、前端信号处理电路113和主处理器115，信号采集电路112可以选自于心电电路、呼吸电路、体温电路、血氧电路、无创血压电路、有创血压电路等等，这些信号采集电路112分别与相应的传感器接口电连接，用于电连接到不同的生理参数对应的传感器附件111，其输出端耦合到前端信号处理器，前端信号处理器的通讯口耦合到主处理器，主处理器与对外通讯和电源接口电连接。各种生理参数测量电路可采用现有技术中的通用电路，前端信号处理器完成信号采集电路输出信号的采样和模数转换，并输出控制信号控制生理信号的测量过程，这些参数包括但不限于：心电，呼吸，体温，血氧，无创血压和有创血压参数。前端信号处理器可采用单片机或其它半导体器件实现，例如可以选用PHLIPS公司的LPC2136，或者ADI的ADuC7021等混合信号单片机，也可以采用ASIC或FPGA实现。前端信号处理器可由隔离电源供电，采样得到的数据经过简单处理打包后，通过隔离通讯接口发送至主处理器，例如前端信号处理器电路可以通过隔离电源和通讯接口114耦合到主处理器115上。前端信号处理器由隔离电源供电的原因是通过变压器隔离的DC/DC电源，起到了隔离患者与供电设备的作用，主要目的是：1、隔离患者，通过隔离变压器，将应用部分浮地，使患者漏电流足够小；2、防止除颤或电刀应用时的电压或能量影响主控板等中间电路的板卡及器件(用爬电距离和电气间隙保证)。主处理器完成生理参数的计算，并通过对外通讯和电源接口将参数的计算结果和波形发送到主机(如带显示器的主机、PC机、中央站等等)，对外通讯和电源接口116可以是以太网(Ethernet)、令牌环(Token Ring)、令牌总线(Token Bus)以及作为这三种网的骨干网光纤分布数据接口(FDDI)构成的局域网接口中的一个或其组合，还可以是红外、蓝牙、wifi、WMTS通讯等无线接口中的一个或其组合，或者还可以是RS232、USB等有线数据连接接口中的一个或其组合。对外通讯和电源接口116也可以是无线数据传输接口和有线数据传输接口中的一种或两种的组合。主机可以是监护仪的主机、心电图机，超声诊断仪，计算机等任何一个计算机设备，安装配合的软件，就能够组成一个监护设备。主机还可以是通讯设备，例如手机，参数处理模块通过蓝牙接口将数据发送到支持蓝牙通讯的手机上，实现数据的远程传输。
如图2所示，提供的是单个生理参数的处理系统架构。相同内容可参见上述内容。
如图3所示，提供一种院内使用的监护仪联网系统，利用该系统可以将监护仪的数据进行整体保存，集中管理病人信息和看护信息，两者进行关联存储，便于进行历史数据的保存和关联报警。在图3所示的系统中，针对病床均可以提供一个床边监护仪212，该床边监护仪212可以是前述多参数监护仪或者插件式监护仪。另外，每个床边监护仪212还可以与一个便携式监护设备213进行配对传输，便携式监护设备213提供简便、可携带的参数处理模块，可是穿戴在病人身体上对应病人进行移动式监护，通过便携式监护设备213与床边监护仪212进行有线或无线通讯后可以将移动式监护产生的生理数据传输到床边监护仪212上进行显示，或通过床边监护仪212传输到中央站211供医生或护士查看，或通过床边监护仪212传输到数据服务器215进行存储。另外，便携式监护设备213还可以直接通过设置在院内的无线网络节点214将移动式监护产生的生理数据传输到中央站211进行存储和显示，或者通过设置在院内的无线网络节点214将移动式监护产生的生理数据传输到数据服务器215进行存储。可见，床边监护仪212上显示的生理参数对应的数据可以是源自直接连接到监护以上的传感器附件，或者源自便携式监护设备213，或者源自数据服务器。
下面对本发明中的针对血流动力学的生理体征监测方法进行详细描述，请参阅图4，本发明实施例提供的一种针对血流动力学的生理体征监测方法，该方法应用于医疗监护设备，特别适用于包含显示器的医疗监护设备，用于可以利用显示器来显示与血流动力学相关生理体征对应的波形监护信息。该医疗监护设备可执行存储在存储器中的程序指令以实现对应的针对血流动力学的生理体征监测方法。
针对血流动力学的生理体征监测方法包括下面步骤：
步骤301、获取监测对象与血流动力学相关的生理体征，与血流动力学相关的生理体征至少包括血压和心率，或者与血流动力学相关的生理体征至少包括血压和脉率；
本实施例中，医疗监护设备中的处理器可以先获取与血流动力学相关的生 理体征，该生理体征至少包括血压和脉率，其中，血压可以是无创血压、动脉压和/或中心静脉压等。
血流动力学是指血液在心血管系统中流动的力学，主要研究血流量、血流阻力、血压以及它们之间的相互关系。血液是一种流体，因此血流动力学基本原理与一般流体力学的原理相同。但由于血管系统是比较复杂的弹性管道系统，血液是含有血细胞和胶体物质等多种成分的液体而不是理想液体，因此血流动力学既具有一般流体力学的共性，又有其自身的特点。
步骤302、获取与血流动力学相关的生理体征对应的监测数据；
本实施例中，医疗监护设备中的生理体征传感器可以获取预设时间段内监测对象的至少一个与血流动力学相关生理体征参数的历史数据。其中，预设时间段可以是用户预先设置的，比如8个小时或者24个小时等，也可以是医疗监护设备出厂的时候就设置好的，此处不做限定。
传感器是一种检测装置，能感受到被测量的信息，并能将感受到的信息，按一定规律变换成为电信号或其他所需形式的信息输出，以满足信息的传输、处理、存储、显示、记录和控制等要求。
步骤303、基于与血流动力学相关的生理体征对应的监测数据生成与血流动力学相关的生理体征对应的波形监护信息。需要说明的是，本申请提及的波形监护信息，包括生理体征对应的模拟信号波形、数值趋势图等，同时也包括伴随波形一起显示的生理体征参数的数值信息。
步骤304、显示血流动力学专用监测界面，其中，血流动力学专用监测界面至少包括第一显示区域；
本实施例中，医疗监护设备可以显示专用监测界面，其中，该专用监测界面至少包括第一显示区域。为了便于理解，请参阅图5，图5为本发明实施例中血流动力学相关信息的一个界面示意图，如图所示，当用户点击“血流动力学”模块时，即可进入与血流动力学相关的专用监测界面。在实际应用中，用户还可以根据需求选择“生命体征”界面、“感染”界面或者“颅脑损伤”专用监测界面进行查看，每个专用监测界面上都会展示与所需切片相关的波形监护信息。
步骤305、在第一显示区域显示与血流动力学相关的生理体征对应的波形 监护信息。
本实施例中，医疗监护设备中的显示器可以基于与血流动力学相关生理体征参数的监测数据，在第一显示区域显示与血流动力学相关生理体征参数的监测数据对应的波形监护信息。
为了便于介绍，请参阅图6，图6为本发明实施例中第一显示区域的一个界面示意图，如图所示，第一显示区域即为虚线框所指示的S1部分，在第一显示区域中可以显示相关的波形监护信息，图中的5个波形监护信息为一个示意，在实际应用中，还可以是其他数量的波形监护信息。
需要说明的是，本发明不对步骤301至步骤305之间的执行顺序进行限定。
本申请实施例提供的技术方案中，提供了一种基于针对血流动力学的生理体征监测方法，首先，获取监测对象与血流动力学相关的生理体征，与血流动力学相关的生理体征至少包括血压和心率，或者与血流动力学相关的生理体征至少包括血压和脉率，然后获取与血流动力学相关的生理体征对应的监测数据，基于与血流动力学相关的生理体征对应的监测数据生成与血流动力学相关的生理体征对应的波形监护信息，显示血流动力学专用监测界面，其中，血流动力学专用监测界面至少包括第一显示区域，最后在第一显示区域显示与血流动力学相关的生理体征对应的波形监护信息。通过上述方式，医疗监护设备能够根据用户的需求直接显示与血流动力学相关的波形监护信息，实现血流动力学生理参数的切片展示，从而节省了用户逐个查找与血流动力学相关的波形监护信息的时间，提升了方案的可操作性。
可选地，在上述图4对应的实施例的基础上，本发明实施例提供的针对血流动力学的生理体征监测方法的一个可选实施例中，所述与血流动力学相关的生理体征还包括脉压变异率、心输出量和外周血管阻力指数中的一项或多项。
本实施例中，具体说明了与血流动力学相关生理体征参数包括：心率(heart rate，HR)、无创血压(non-invasive measurement of blood pressure，NIBP)、动脉压(arterial pressure，ART)、中心静脉压(central venous pressure，CVP)、脉压变异率(pulse pressure variation，PPV)、心输出量(cardiac output，CO)(例如连续心输出量，continuous cardiac output，CCO)以及外周血管阻力指数(speripheral vascular resistance index，SVRI) 参数中的一项或多项。
在第一显示区域上可以显示一段时间内与血流动力学相关生理体征的波形监护信息，其中，波形监护信息可以是短趋势波形信息，比如8小时以内的波形信息属于短趋势波形信息。或者可以是长趋势波形信息，比如24小时以内的波形监护信息属于长趋势波形信息。
在一实施例中，针对血流动力学的生理体征监测方法还包括：
在血流动力学专用监测界面中显示图形化触控按钮；
获取用户通过图形化触控按钮输入的切换指令；
基于切换指令，确定显示第一时间段内与血流动力学相关的生理体征对应的波形监护信息，或显示第二时间段内与血流动力学相关的生理体征对应的波形监护信息。
例如，如图5-7中所示的“<”按钮，目前血流动力学专用监测界面显示的是8小时(第一时间段)内的波形监护信息(即短趋势)，用户触摸“<”按钮后，血流动力学专用监测界面切换显示为24小时(第二时间段)内的波形监护信息(即长趋势)。
可以理解的是，HR是指正常人安静状态下每分钟心跳的次数，也叫安静心率，一般为60～100次/分，可因年龄、性别或其他生理因素产生个体差异。一般来说，年龄越小，HR越快，老年人心跳比年轻人慢，女性的HR比同龄男性快，这些都是正常的生理现象。安静状态下，成人正常HR为60～100次/分钟，理想HR应为55～70次/分钟。
NIBP又可称为自动化无创性测压法，是指用特别的气泵自动控制袖套充气，可定时间段测压，是重症加强护理病房(Intensive Care Unit，ICU)以及麻醉手术中使用最广泛的血压监测方法。
ART是循环功能的重要指标之一，ART过高或过低都会影响各器官的血液供应和心脏的负担。若ART过低，将引起器官血液供应减少，尤其是脑和心脏等重要器官的供血不足，将导致严重后果。若血压过高，则心脏和血管的负担过重。长期高血压患者往往引起心脏代偿性肥大、心功能不全，甚至导致心力衰竭。血管长期受到高压，血管壁本身发生病理性改变，甚至可导致破裂而引起脑溢血等严重后果，所以保持ART近于正常的相对稳定状态是十分重要的。
CVP是指右心房及上以及下腔静脉胸腔段的压力。它可判断病人血容量、心功能与血管张力的综合情况，有别于周围静脉压力。后者受静脉腔内瓣膜与其他机械因素的影响，故不能确切反映血容量与心功能等状况。
PPV在病人液体管理中定义为动脉血压变异率，在机械通气时依靠心肺相互作用评估输液反应性。源自动脉波形分析的动脉PPV和源自脉冲轮廓分析的每搏输出量变异已被证明能够很好的预测输液反应性。
CO是指每分钟左心室或者右心室射入主动脉或肺动脉的血量。左、右心室的输出量基本相等。心室每次搏动输出的血量称为每搏输出量，人体静息时约为70毫升，如果HR每分钟平均为75次，则每分钟输出的血量约为5000毫升，即每分钟CO，CO是评价循环系统效率高低的重要指标。CO很大程度上和全身组织细胞的新陈代谢相适应。CCO是指连续时间段内得到的CO。本实施例中的CO具体可以包括CCO。
SVRI与外周血管阻力(speripheral vascular resistance，SVR)相关，SVR是诊断和反映循环血流组里以及心脏后负荷水平的数量指标，阻力血管对缩血管调节反应增强和渐进性加重的血管改建引起组里血管半径缩小，是SVR增大的关键因素。SVR的增高使血压升高，加重了心脏的后负荷水平以及氧耗。
其次，本发明实施例中，波形监护信息包括一个或者多个与血流动力学相关生理体征参数。通过上述方式，能够根据医护人员的的需求直接显示心率、无创血压、动脉压、中心静脉压、脉压变异率、心输出量(例如连续心输出量)以及外周血管阻力指数参数中的一项或多项，从而节省了医护人员逐个查找与这些参数相关的生理体征参数的时间，大幅地提升了应用效率。
可选地，在上述图4以及图4对应的一个实施例的基础上，本发明实施例提供的针对血流动力学的生理体征监测方法的另一个可选实施例中，血流动力学专用监测界面还包括第二显示区域；
该方法还可以包括：
在第二显示区域显示血流动力学分析界面入口、中心静脉压工具界面入口以及被动抬腿试验辅助工具界面入口中的一项或多项。
本实施例中，在专用监测界面上还包括有第二显示区域，为了便于介绍，请参阅图7，图7为本发明实施例中第二显示区域的一个界面示意图，如图所 示，第二显示区域即为虚线框所指示的S2部分，第二显示区域显示血流动力学分析(Hemosight)界面入口、中心静脉压工具(CVP2-5Tool)界面入口以及被动抬腿试验辅助(Passive Leg Rising guide，PLR guide)工具界面入口。可以理解的是，在实际应用中，可以包括Hemosight界面入口、CVP2-5Tool界面入口以及PLR guide工具界面入口的一项或多项。
此外，在第二显示区域中还可以展示颅脑损伤整合昏迷指数评分进入口，拯救脓毒症运动(Surviving Sepsis Campaign，SCC)治疗指南工具和序贯器官衰竭(Sequential Organ Failure Assessment，SOFA)评分工具入口等。
在Hemosight界面用于展示与患者相关的生理体征参数，从而可以实现多参数联合辅助决策。
PLR guide工具界面用于对PLR过程操作提示指导，包括1、提示开始试验前调整病人为半卧位，获得病人观察参数基线。2、通过调节病床调节病人值腿抬高姿态，观察并记录观察参数变化。3、调节病人恢复半卧位，查看观察参数是否恢复基线。
CVP2-5Tool界面入口用于在用户对病人进行补液工程中提供实时的CVP参数趋势显示，基于在临床上普遍使用的CVP2-5原则，提供辅助工具，对补液过程中的CVP参数变化进行实时呈现并对是否可以补液进行智能的提示，帮助医生方便准确的完成补液。
再次，本发明实施例中，在专用监测界面上还包括第二显示区域，在第二显示区域显示血流动力学分析界面入口、中心静脉压工具界面入口以及被动抬腿试验辅助工具界面入口中的一项或多项。通过上述方式，医疗监护设备不但可以显示与血流动力学相关的波形监护信息，还可以为用户提供快捷的界面入口，直接在专用监测界面上选择所需进入的界面入口即可，从而提升操作的灵便性，可以更高效地对患者的生理状态进行分析和观察。
可选地，在上述图4对应的实施例的基础上，本发明实施例提供的针对血流动力学的生理体征监测方法的另一个可选实施例中，还可以包括：
接收界面切换指令；
根据界面切换指令将显示的血流动力学专用监测界面切换为显示基本生命体征专用监测界面；
获取监测对象与基本生命体征相关的生理体征，与基本生命体征相关的生理体征包括心率/脉率、血氧饱和度、血压、体温、呼吸率中的一种或多种；
获取与基本生命体征相关的生理体征对应的监测数据；
基于与基本生命体征相关的生理体征对应的监测数据生成与基本生命体征相关的生理体征对应的波形监护信息；
在基本生命体征专用监测界面显示与基本生命体征相关的生理体征对应的波形监护信息。
本实施例中，当用户需要查看与患者相关的另一组波形监护信息时，还可以在医疗监护设备的专用监测界面上选择所需查看的切片入口。为了便于理解，请参阅图5，在用户点选“血流动力学”模块时进入的是与血流动力学相关的专用监测界面。当用户希望查看至少一个与基本生命体征相关的波形监护信息时，可点选“生命体征”模块，由此进入如图8所示的界面，图8为本发明实施例中基本生命体征专用监测界面的一个示意图。
生命体征就是用来判断病人的病情轻重和危急程度的指征。主要有心率、脉搏、血压、血氧饱和度、呼吸率、疼痛度、体温、瞳孔和角膜反射的改变等等。它们是维持机体正常活动的支柱，缺一不可，不论哪项异常也会导致严重或致命的疾病，同时某些疾病也可导致这四大体征的变化或恶化。
在第一显示区域上可以显示一段时间内至少一个与基本生命体征相关生理体征参数的波形监护信息，其中，波形监护信息可以是短趋势波形信息，比如8小时以内的波形信息属于短趋势波形信息。或者可以是长趋势波形信息，比如24小时以内的波形监护信息属于长趋势波形信息。
可以理解的是，HR是指正常人安静状态下每分钟心跳的次数，也叫安静心率，一般为60～100次/分，可因年龄、性别或其他生理因素产生个体差异。一般来说，年龄越小，HR越快，老年人心跳比年轻人慢，女性的HR比同龄男性快，这些都是正常的生理现象。安静状态下，成人正常HR为60～100次/分钟，理想HR应为55～70次/分钟。
SpO2是血液中被氧结合的氧合血红蛋白的容量占全部可结合的血红蛋白容量的百分比，即血液中血氧的浓度，它是呼吸循环的重要生理参数。人体的新陈代谢过程是生物氧化过程，而新陈代谢过程中所需要的氧，是通过呼吸系 统进入人体血液，与血液红细胞中的血红蛋白，结合成氧合血红蛋白，再输送到人体各部分组织细胞中去。血液携带输送氧气的能力即用血氧饱和度来衡量。
ART是循环功能的重要指标之一，ART过高或过低都会影响各器官的血液供应和心脏的负担。若ART过低，将引起器官血液供应减少，尤其是脑和心脏等重要器官的供血不足，将导致严重后果。若血压过高，则心脏和血管的负担过重。长期高血压患者往往引起心脏代偿性肥大、心功能不全，甚至导致心力衰竭。血管长期受到高压，血管壁本身发生病理性改变，甚至可导致破裂而引起脑溢血等严重后果，所以保持ART近于正常的相对稳定状态是十分重要的。
BP是指血液在血管内流动时作用于单位面积血管壁的侧压力，它是推动血液在血管内流动的动力。在不同血管内被分别称为动脉血压、毛细血管压和静脉血压，通常所说的血压是指体循环的动脉血压。
RR表示每克活组织在每小时内消耗氧或释放二氧化碳的毫克数。RR的大小可反映某生物体代谢活动的强弱。每分钟的RR随年龄、性别和生理状态而异.成人平静时的RR约为每分钟16-20次，儿童约为每分钟20次，一般女性比男性快1-2次。它也是医生在临床诊断中的一项重要的诊断依据。
PR指动脉搏动的频率。脉率的快慢受年龄、性别、运动和情绪等因素的影响。成人每分钟超过100次，称为心动过速，每分钟低于60次，称为心动过缓。临床上有许多疾病，特别是心脏病可使脉率发生变化。因此，测量PR对病人来讲是一个不可缺少的检查项目。
TEMP在正常范围内可有轻度变化，例如：下午较早晨TEMP相对要高，但一般相差小于1℃；进餐后、劳动或剧烈运动后，TEMP也可有轻度升高；突然进入高温环境或情绪激动等因素也可使TEMP略有升高；妇女在排卵期和妊娠期TEMP稍高于正常。不同的年龄阶段也存在轻微的TEMP差异，如小儿因代谢率高，TEMP较成年人偏高；老年人由于代谢率低，其TEMP也比青壮年稍低。
波形监护信息还包括一个或者多个与基本生命体征相关生理体征参数。通过上述方式，能够根据医护人员的的需求直接显示心率、血氧饱和度、动脉压、体温、血压、呼吸率以及脉率中的一项或多项，从而节省了医护人员逐个查找与这些参数相关的生理体征参数的时间，大幅地提升了应用效率。
其次，本发明实施例中，在显示专用监测界面之后，医疗监护设备还可以 接收界面切换指令，然后根据界面切换指令将显示的血流动力学专用监测界面切换为显示基本生命体征专用监测界面，然后获取监测对象与基本生命体征相关的生理体征，与基本生命体征相关的生理体征包括心率/脉率、血氧饱和度、血压、体温、呼吸率中的一种或多种，获取与基本生命体征相关的生理体征对应的监测数据，再基于与基本生命体征相关的生理体征对应的监测数据生成与基本生命体征相关的生理体征对应的波形监护信息，最后在基本生命体征专用监测界面显示与基本生命体征相关的生理体征对应的波形监护信息。通过上述方式，医疗监护设备能够根据用户的需求直接显示与生命体征相关的波形监护信息，采用切换指令即可实现生命体征生理参数的切片展示，从而节省了用户逐个查找与生命体征相关的波形监护信息的时间，提升了方案的可操作性。
可选地，在上述图4对应的实施例的基础上，本发明实施例提供的针对血流动力学的生理体征监测方法的另一个可选实施例中，基本生命体征专用监测
界面还包括报警事件显示区域(图8中S3)，该方法还可以包括：
获取预设时间段内的历史报警事件；
在报警事件显示区域显示历史报警事件的类型、触发次数以及触发时间中的一项或多项。
本实施例中，医疗监护设备还具有报警提示的功能，通过响应操作者在报警事件显示区域的触摸操作，可以打开对应的报警事件列表及详情。为了便于介绍，请参阅图9，图9为本发明实施例中报警事件列表及详情的一个界面示意图。
可以理解的是，图8所示的报警事件类型、触发次数和触发时间仅为一个示意，在实际应用中，还存在不同的报警事件类型，以及报警事件类型所对应的触发次数和触发时间，此处不作限定。
在一实施例中，血流动力学专用监测界面还包括报警事件显示区域(图8中S3)，该方法还可以包括：
获取预设时间段内的历史报警事件；
在报警事件显示区域显示历史报警事件的类型、触发次数以及触发时间中的一项或多项。
具体的，通过响应操作者在报警事件显示区域的触摸操作，可以打开对应 的报警事件列表及详情。当然，在一些实施例中，血流动力学专用监测界面也可以不包括报警事件显示区域。
进一步地，本发明实施例中，医疗监护设备还可以显示报警事件显示区域，该医疗监护设备获取预设时间段内的历史报警事件，在报警事件显示区域显示历史报警事件的类型、触发次数以及触发时间中的一项或多项。通过上述方式，用户能够及时地发现患者是否处于危险状态，医疗监护设备可以对患者的生理体征参数进行实时监测以及报警事件历史信息回顾，在出现报警事件的时候还可以显示与事件相关的信息，从而进一步提升了监测的可靠性和实用性。
在另一实施例中，针对血流动力学的生理体征监测方法还包括：
获取监测对象的至少一种生理体征的实时监测数据；在主监测界面除血流动力学专用监测界面或基本生命体征专用监测界面外的其他显示区域内显示该实时监测数据。
如图9所示，虚线框内(S4)显示常规生理体征的实时监测数据。可以理解为，本申请实施例中，在常规的医疗监护设备的主监测界面内嵌入或悬浮显示血流动力学专用监测界面或基本生命体征专用监测界面。在主监测界面下显示常规实时监测数据的前提下，为医护人员提供一个了解血流动力学或基本生命体征相关信息的专门界面。当然，该实时监测数据包括对应生理体征的波形信息和/或数值信息。
另外，如本领域技术人员所理解的，本文的原理可以反映在计算机可读存储介质上的计算机程序产品中，该可读存储介质预装有计算机可读程序代码。任何有形的、非暂时性的计算机可读存储介质皆可被使用，包括磁存储设备(硬盘、软盘等)、光学存储设备(CD-ROM、DVD、Blu Ray盘等)、闪存和/或诸如此类。这些计算机程序指令可被加载到通用计算机、专用计算机或其他可编程数据处理设备上以形成机器，使得这些在计算机上或其他可编程数据处理装置上执行的指令可以生成实现指定的功能的装置。这些计算机程序指令也可以存储在计算机可读存储器中，该计算机可读存储器可以指示计算机或其他可编程数据处理设备以特定的方式运行，这样存储在计算机可读存储器中的指令就可以形成一件制造品，包括实现指定功能的实现装置。计算机程序指令也可以加载到计算机或其他可编程数据处理设备上，从而在计算机或其他可编程设备上 执行一系列操作步骤以产生一个计算机实现的进程，使得在计算机或其他可编程设备上执行的指令可以提供用于实现指定功能的步骤。
虽然在各种实施例中已经示出了本文的原理，但是许多特别适用于特定环境和操作要求的结构、布置、比例、元件、材料和部件的修改可以在不脱离本披露的原则和范围内使用。以上修改和其他改变或修正将被包含在本文的范围之内。
前述具体说明已参照各种实施例进行了描述。然而，本领域技术人员将认识到，可以在不脱离本披露的范围的情况下进行各种修正和改变。因此，对于本披露的考虑将是说明性的而非限制性的意义上的，并且所有这些修改都将被包含在其范围内。同样，有关于各种实施例的优点、其他优点和问题的解决方案已如上所述。然而，益处、优点、问题的解决方案以及任何能产生这些的要素，或使其变得更明确的解决方案都不应被解释为关键的、必需的或必要的。本文中所用的术语“包括”和其任何其他变体，皆属于非排他性包含，这样包括要素列表的过程、方法、文章或设备不仅包括这些要素，还包括未明确列出的或不属于该过程、方法、系统、文章或设备的其他要素。此外，本文中所使用的术语“耦合”和其任何其他变体都是指物理连接、电连接、磁连接、光连接、通信连接、功能连接和/或任何其他连接。
具有本领域技术的人将认识到，在不脱离本发明的基本原理的情况下，可以对上述实施例的细节进行许多改变。因此，本发明的范围应仅由以下权利要求确定。
前述用于执行各个步骤的各个单元或模块中的每一个可以存储在一个或多个前述存储器中，而上述实施例中分别用于实现前述的医疗监护设备或监护系统中，其中各个功能模块中包括每一个用于执行上述方法中相应步骤的指令集，上述模块或程序(即指令集)不需要时限为分立软件程序、过程或模块，因此，在各个实施例中可以组合或重新安排这些模块的各个子块，因此，在本发明的一些实施例中存储器可以存储如上所述的模块或数据结构的子集。
以上实施例仅表达了几种实施方式，其描述较为具体和详细，但并不能因此而理解为对本发明专利范围的限制。应当指出的是，对于本领域的普通技术人员来说，在不脱离本发明构思的前提下，还可以做出若干变形和改进，这些 都属于本发明的保护范围。因此，本发明专利的保护范围应以所附权利要求为准。

Claims (15)

  1. 一种针对血流动力学的生理体征监测方法，其特征在于，包括：
    获取监测对象与血流动力学相关的生理体征，所述与血流动力学相关的生理体征至少包括血压和心率，或者所述与血流动力学相关的生理体征至少包括血压和脉率；
    获取所述与血流动力学相关的生理体征对应的监测数据；
    基于所述与血流动力学相关的生理体征对应的监测数据生成与血流动力学相关的生理体征对应的波形监护信息；
    显示血流动力学专用监测界面，其中，所述血流动力学专用监测界面至少包括第一显示区域；
    在所述第一显示区域显示所述与血流动力学相关的生理体征对应的波形监护信息。
  2. 根据权利要求1所述的方法，其特征在于，所述与血流动力学相关的生理体征还包括脉压变异率、心输出量和外周血管阻力指数中的一项或多项。
  3. 根据权利要求1所述的方法，其特征在于，所述血流动力学专用监测界面还包括第二显示区域；
    所述方法还包括：
    在所述第二显示区域显示血流动力学分析界面入口、中心静脉压工具界面入口以及被动抬腿试验辅助工具界面入口中的一项或多项。
  4. 根据权利要求1所述的方法，其特征在于，还包括：
    接收界面切换指令；
    根据所述界面切换指令将显示的血流动力学专用监测界面切换为显示基本生命体征专用监测界面；
    获取监测对象与基本生命体征相关的生理体征，所述与基本生命体征相关的生理体征包括心率/脉率、血氧饱和度、血压、体温、呼吸率中的一种或多种；
    获取所述与基本生命体征相关的生理体征对应的监测数据；
    基于所述与基本生命体征相关的生理体征对应的监测数据生成与基本生命体征相关的生理体征对应的波形监护信息；
    在所述基本生命体征专用显示界面显示所述与基本生命体征相关的生理体征对应的波形监护信息。
  5. 根据权利要求4所述的方法，其特征在于，所述基本生命体征专用监测界面还包括报警事件显示区域，所述方法还包括：
    获取预设时间段内的历史报警事件；
    在所述报警事件显示区域显示所述历史报警事件的类型、触发次数以及触发时间中的一项或多项。
  6. 根据权利要求1所述的方法，其特征在于，所述血流动力学专用监测界面还包括报警事件显示区域，所述方法还包括：
    获取预设时间段内的历史报警事件；
    在所述报警事件显示区域显示所述历史报警事件的类型、触发次数以及触发时间中的一项或多项。
  7. 根据权利要求1所述的方法，其特征在于，还包括：
    获取所述监测对象的至少一种生理体征的实时监测数据；
    在主监测界面除所述血流动力学专用监测界面或基本生命体征专用监测界面外的其他显示区域内显示所述实时监测数据。
  8. 一种医疗监护设备，其特征在于，包括：
    显示器，所述显示器配置为显示信息；
    存储器，所述存储器存储有程序指令；
    处理器，所述处理器配置为执行所述程序指令以实现下面方法步骤：
    获取监测对象与血流动力学相关的生理体征，所述与血流动力学相关的生理体征至少包括血压和心率，或者所述与血流动力学相关的生理体征至少包括血压和脉率；
    获取所述与血流动力学相关的生理体征对应的监测数据；
    基于所述与血流动力学相关的生理体征对应的监测数据生成与血流动力学相关的生理体征对应的波形监护信息；
    显示血流动力学专用监测界面，其中，所述血流动力学专用监测界面至少包括第一显示区域；
    在所述第一显示区域显示所述与血流动力学相关的生理体征对应的波形 监护信息。
  9. 根据权利要求8所述的医疗监护设备，其特征在于，所述与血流动力学相关的生理体征还包括脉压变异率、心输出量和外周血管阻力指数中的一项或多项。
  10. 根据权利要求8所述的医疗监护设备，其特征在于，所述血流动力学专用监测界面还包括第二显示区域，所述处理器还配置为实现：
    在所述第二显示区域显示血流动力学分析界面入口、中心静脉压工具界面入口以及被动抬腿试验辅助工具界面入口中的一项或多项。
  11. 根据权利要求8所述的医疗监护设备，其特征在于，所述处理器还配置为实现：
    接收界面切换指令；
    根据所述界面切换指令将显示的血流动力学专用监测界面切换为显示基本生命体征专用监测界面；
    获取监测对象与基本生命体征相关的生理体征，所述与基本生命体征相关的生理体征包括心率/脉率、血氧饱和度、血压、体温、呼吸率中的一种或多种；
    获取所述与基本生命体征相关的生理体征对应的监测数据；
    基于所述与基本生命体征相关的生理体征对应的监测数据生成与基本生命体征相关的生理体征对应的波形监护信息；
    在所述基本生命体征专用监测界面显示所述与基本生命体征相关的生理体征对应的波形监护信息。
  12. 根据权利要求11所述的医疗监护设备，其特征在于，所述基本生命体征专用监测界面还包括报警事件显示区域，所述处理器还配置为实现：
    获取预设时间段内的历史报警事件；
    在所述报警事件显示区域显示所述历史报警事件的类型、触发次数以及触发时间中的一项或多项。
  13. 根据权利要求8所述的医疗监护设备，其特征在于，所述血流动力学专用监测界面还包括报警事件显示区域，所述处理器还配置为实现：
    获取预设时间段内的历史报警事件；
    在所述报警事件显示区域显示所述历史报警事件的类型、触发次数以及触发时间中的一项或多项。
  14. 根据权利要求8所述的医疗监护设备，其特征在于，所述处理器还配置为实现：
    获取所述监测对象的至少一种生理体征的实时监测数据；
    在主监测界面除所述血流动力学专用监测界面或基本生命体征专用监测界面外的其他显示区域内显示所述实时监测数据。
  15. 一种计算机可读存储介质，包括指令，当其在计算机上运行时，使得计算机执行如权利要求1至7中任一项所述的方法。
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