Individualized parenteral nutrition configuration method and system and computer program

Abstract

The invention discloses an individualized parenteral nutrition configuration method and system and a computer program, and belongs to the technical field of nutrient solution configuration, and the method comprises the following steps: obtaining personal basic information of a patient; calculating to obtain nutritional requirement data of the patient; obtaining types and dosage forms of parenteral nutrition preparations; performing initial individualized parenteral nutrition configuration to obtain an initial individual parenteral nutrition configuration result; and according to the personal basic information of the patient, the nutritional demand data of the patient and the initial personal parenteral nutrition configuration result, performing supplement configuration of electrolyte, trace elements, insulin and vitamins, and calculating to obtain an actual nutrition supplement result, thereby completing the personal parenteral nutrition configuration. The system is used for achieving the individualized parenteral nutrition configuration method, the computer program can be executed by a computer to achieve individualized parenteral nutrition configuration, and the problem that it is difficult to rapidly, efficiently and correspondingly configure parenteral nutrition according to the nutritional requirements of different patients is solved.

Description

Technical Field

[0001] The present invention belongs to the technical field of nutrient solution configuration, and in particular, relates to an individualized parenteral nutrition configuration method, system and computer program. Background Art

[0002] Parenteral nutrition refers to the method of providing nutritional support through intravenous means. It is suitable for special groups of people who cannot eat normally, such as malignant tumor patients with severe malnutrition and emaciation, and patients after gastrointestinal tumor surgery.

[0003] With the increasing application of parenteral nutrition, the existing parenteral nutrition configuration usually adopts two methods. One is that after the physician formulates the prescription, the internal configuration of the medical institution is completed in the intravenous drug configuration center, and the other is the industrially produced multi-chamber bag. The composition ratio of the multi-chamber bag parenteral nutrition solution is fixed, and it cannot be adjusted individually according to the specific situation of the patient; and the internal configuration of the medical institution is usually due to the serious shortage of corresponding medical staff and nutritionists, the complex calculation process of parenteral nutrition configuration, etc., and currently cannot meet the needs of individualized parenteral nutrition configuration. Summary of the invention

[0004] In view of the above-mentioned deficiencies in the prior art, the present invention provides a method, system and computer program for individualized parenteral nutrition configuration, which solves the problem that it is difficult to quickly and efficiently configure parenteral nutrition according to the nutritional needs of different patients.

[0005] In order to achieve the above-mentioned object of the invention, the technical solution adopted by the present invention is:

[0006] In one aspect, the present invention provides a method for preparing individualized parenteral nutrition, comprising the following steps:

[0007] S1. Obtain the patient's basic personal information;

[0008] S2. Calculate the patient's nutritional needs data based on the patient's personal basic information;

[0009] S3. Obtain the types and dosage forms of parenteral nutrition preparations;

[0010] S4. Initialize individualized parenteral nutrition configuration based on the patient's nutritional demand data and the type and dosage form of parenteral nutrition preparations to obtain an initial individual parenteral nutrition configuration result;

[0011] S5. Based on the patient's personal basic information, the patient's nutritional needs data and the initial personal parenteral nutrition configuration results, electrolytes, trace elements, insulin and vitamins are supplemented and configured, and the actual nutritional supplement results are calculated to complete the personal parenteral nutrition configuration.

[0012] The beneficial effects of the present invention are as follows: the present invention provides a personalized parenteral nutrition configuration method, which obtains the patient's personal basic information, calculates the patient's nutritional demand data, and performs preliminary parenteral nutrition configuration according to the patient's nutritional demand and the type and dosage form of parenteral nutrition preparations, thereby ensuring the accuracy of the patient's energy supply, and also performs supplementary configuration of electrolytes, trace elements and vitamins on the basis of the preliminary configuration, and performs supplementary configuration based on the patient's insulin demand determination according to the patient's condition, fully considering the patient's condition and the patient's daily fluid demand, thereby ensuring that targeted, accurate and healthy nutritional supplements can be provided to different patients; the configuration idea of ​​the method of the present invention is clear and simple, the calculation method is clear and convenient, and it can realize rapid personalized parenteral nutrition configuration according to the individual characteristics of the patient, so as to improve the patient's recovery speed and quality of life.

[0013] Furthermore, the patient's basic personal information includes the patient's age, weight, height, gender, body temperature and condition.

[0014] The beneficial effect of adopting the above further scheme is that the present invention provides basic personal information of the patient, so as to fully consider the individual nutritional needs of the patient from the perspective of the patient's age, weight, height, gender, body temperature and condition, and provide a basis for calculating the patient's daily energy requirement, fluid requirement, protein requirement, glucose requirement, fat requirement and heat-nitrogen ratio.

[0015] Furthermore, S2 comprises the following steps:

[0016] S21. Calculate the patient's daily basal energy expenditure using a basal energy expenditure model based on the patient's weight, height, age and gender;

[0017] The calculation expression of the basic energy consumption model is as follows:

[0018] BEE M =66.47+13.75W+5H-6.76A,

[0019] BEE WM =655.10+9.56W+1.85H-4.6A,

[0020] Among them, BEE M represents the daily basic energy expenditure of male patients, W represents the patient's weight, H represents the patient's height, A represents the patient's age, and BEE WM It represents the daily basal energy expenditure of female patients;

[0021] S22. Calculating the patient's daily energy requirement using an energy requirement model based on the patient's daily basal energy consumption;

[0022] The calculation expression of the energy demand model is as follows:

[0023] E rdM =BEE M ×f 1 ×f 2 ,

[0024] E rdWM =BEE WM ×f 1 ×f 2 ,

[0025] Among them, E rdM represents the daily energy requirement of male patients, f 1 represents the activity coefficient, f 2 Represents the energy demand stress coefficient, E rdWM It represents the daily energy requirement of female patients, among which the energy requirement stress coefficient is related to the patient's body temperature and condition;

[0026] S23, calculating the patient's daily fluid requirement using a fluid requirement model based on the patient's weight, age and condition;

[0027] The calculation expression of the liquid demand model is as follows:

[0028]

[0029] Among them, L rd Indicates the patient's daily fluid requirement, L rad represents the daily fluid requirement per unit body weight of an adult patient, f 3 Indicates the fluid demand stress coefficient, Lm ch It indicates the daily fluid requirement per unit body weight of underage patients, where the fluid requirement stress coefficient is related to the patient's condition;

[0030] S24. Calculate the patient's daily protein requirement based on the patient's weight and condition and the protein requirement model;

[0031] P rd =W×p bmr ,

[0032] Among them, P rd represents the patient's daily protein requirement, p mr It represents protein metabolism rate, wherein the protein metabolism rate is related to the patient's condition;

[0033] S25, according to the patient's weight, the calories and protein mass corresponding to each unit weight, and the glucose-to-fat energy supply ratio, respectively, calculate the patient's daily glucose requirement, fat requirement, and heat-nitrogen ratio;

[0034] The calculation expressions of the patient's daily glucose requirement, fat requirement and heat-nitrogen ratio are as follows:

[0035] G rd =(C pw ×WP pw ×W×4)×P og / 10 / 4,

[0036] F rd =(C pw ×WP pw ×W×4)×F og / 10 / 9,

[0037] Tnr=(C pw ×WP pw ×W×4) / (P pw ×W / 6.5):1

[0038] Among them, G rd represents the patient's daily glucose requirement, C pw Indicates the calories per unit body weight, P pw Indicates the amount of protein per unit body weight, P og Indicates the energy supply ratio of glucose, F rd Indicates the patient's daily fat requirement, F og It represents the energy supply ratio of fat, and Tnr represents the heat nitrogen ratio;

[0039] S26. The patient's daily energy requirement, fluid requirement, protein requirement, fat requirement, glucose requirement and heat-nitrogen ratio are used as the patient's nutritional requirement data.

[0040] The beneficial effect of adopting the above further scheme is: the present invention provides a method for calculating the patient's nutritional requirement data based on the patient's personal basic information. Based on the patient's personal basic information, the corresponding energy, liquid and nutritional requirements can be accurately calculated for the individual patient, thereby providing a basis for the actual parenteral nutrition configuration of accurate dosage.

[0041] Furthermore, S3 comprises the following steps:

[0042] S31. Obtaining the types of parenteral nutrition preparations, wherein the types of parenteral nutrition preparations include glucose preparations, fat preparations and amino acid preparations;

[0043] S32, obtaining a dosage form of a glucose preparation, wherein the dosage form of the glucose preparation includes a 5% glucose solution, a 10% glucose solution, and a 50% glucose solution;

[0044] S33, obtaining the dosage form of the fat preparation, wherein the dosage form of the fat preparation includes medium-chain fat emulsion MCT, long-chain fat emulsion LCT, medium- and long-chain fat emulsion MCT / LCT, structured fat emulsion and W-3 ​​fish oil fat emulsion;

[0045] S34. Obtain dosage forms of amino acid preparations, wherein the dosage forms of amino acid preparations include ordinary amino acids, Gan'an, Shen'an and Litai.

[0046] The beneficial effect of adopting the above further scheme is that the present invention provides types and dosage forms of parenteral nutrition preparations, which are easy to prepare from common preparations, providing a basis for fast, accurate and convenient parenteral nutrition preparation.

[0047] Furthermore, the S4 comprises the following steps:

[0048] S41. According to the patient's daily protein requirement, configure the protein based on the dosage form of the amino acid preparation to obtain a protein configuration amount;

[0049] The calculation expression of the protein configuration amount is as follows:

[0050] Q p =(P pw ×W-20) / 20.65×200+100

[0051] Among them, Q p Indicates the amount of protein configuration;

[0052] S42, configuring fat based on the dosage form of the fat preparation according to the daily fat requirement of the patient to obtain a configured fat amount;

[0053] The calculation expression of the fat configuration amount is as follows:

[0054] Q f =(F rd -10) / 0.2+100,

[0055] Among them, Q f Indicates the amount of fat;

[0056] S43, preparing glucose based on the dosage form of the glucose preparation according to the patient's daily glucose requirement to obtain a prepared amount of glucose;

[0057] The calculation expression of the glucose configuration amount is as follows:

[0058] Q g =500+((F rd -50) / 0.5)

[0059] Among them, Q g Indicates the amount of glucose configuration;

[0060] S44. Use the protein configuration amount, fat configuration amount and glucose configuration amount as the initial individual parenteral nutrition configuration result.

[0061] The beneficial effects of adopting the above further scheme are as follows: the present invention provides a method for initial individual parenteral nutrition configuration for patients, realizes accurate calculation of the amount of protein, fat and glucose configured for patients, and ensures differentiated parenteral nutrition configuration for patients and appropriate energy supplementation.

[0062] Furthermore, the S5 comprises the following steps:

[0063] S51. Prepare electrolytes and trace elements according to the patient's daily fluid requirements;

[0064] S52. Obtaining a determination result of the patient's insulin configuration requirement based on the patient's personal basic information and the patient's condition;

[0065] S53. If the insulin configuration requirement judgment result is that configuration is required, the configuration amount of insulin is set to (C pw ×WP pw ×W×4)×F og / 10 / 4 / 10U, otherwise no insulin supplementation;

[0066] S54. Supplement water-soluble vitamins, fat-soluble vitamins and multivitamins, 1 bottle each per day;

[0067] S55, according to the protein configuration amount, the fat configuration amount and the glucose configuration amount, obtaining the actual calorie of nutritional supplementation, the protein energy supply ratio, the fat energy supply ratio, the glucose energy supply ratio and the heat-nitrogen ratio;

[0068] The calculation expressions of the actual nutritional supplementation calories, protein energy supply ratio, fat energy supply ratio, glucose energy supply ratio and heat nitrogen ratio are as follows:

[0069]

[0070] R ap =((Q p -100) / 200×20.65+20)×4 / C ar ,

[0071] R af =((Q f -100)×0.2+10)×9 / C ar ,

[0072] R ag =((Q g -500)×0.5+50)×4 / C ar ,

[0073]

[0074] Among them, C ar Indicates the actual nutritional supplement calories, R ap Indicates the protein energy supply ratio of actual nutritional supplementation, R af Indicates the fat energy supply ratio of actual nutritional supplementation, R ag Indicates the glucose energy supply ratio of actual nutritional supplementation, R at-n The heat-nitrogen ratio indicating actual nutrient supplementation;

[0075] S56. Take the actual nutritional supplement calories, protein energy supply ratio, fat energy supply ratio, glucose energy supply ratio and heat-nitrogen ratio as the actual nutritional supplement results to complete the personal parenteral nutrition configuration.

[0076] The beneficial effects of adopting the above further scheme are as follows: the present invention provides a method for configuring nutritional supplements for patients and calculating actual nutritional supplement results, and provides supplementary configuration of other necessary nutritional elements in the case of differential energy supplementation for patients, fully guaranteeing the patient's parenteral nutritional supplementation, and the energy supply ratio and heat-nitrogen ratio of the actual nutritional supplementation can reflect the patient's individual-specific parenteral nutritional configuration characteristics, thereby providing a data basis for further optimization of individualized parenteral nutritional configuration.

[0077] Furthermore, the electrolytes and trace elements in S51 include 60 mL of 10% sodium chloride solution, 20 mL of 15% potassium chloride solution, 10 mL of sodium glycerophosphate solution, 10 mL of 25% magnesium sulfate solution, 10 mL of 10% calcium gluconate solution and 40 mL of trace element solution.

[0078] The beneficial effect of adopting the above further scheme is that the present invention provides a supplementary configuration dosage of electrolytes and trace elements so as to facilitate adaptation according to the patient's daily fluid requirement and improve the patient's nutritional supply.

[0079] In a second aspect, the present invention further provides a system based on a personalized parenteral nutrition configuration method, comprising:

[0080] The first module is used to obtain basic personal information of patients;

[0081] The second module is used to calculate the patient's nutritional needs data based on the patient's personal basic information;

[0082] The third module is used to obtain the types and dosage forms of parenteral nutrition preparations;

[0083] The fourth module is used to initialize individualized parenteral nutrition configuration based on the patient's nutritional demand data and the type and dosage form of parenteral nutrition preparations to obtain the initial individual parenteral nutrition configuration result;

[0084] The fifth module is used to supplement electrolytes, trace elements, insulin and vitamins according to the patient's personal basic information, patient nutritional needs data and initial personal parenteral nutrition configuration results, and calculate the actual nutritional supplement results to complete personal parenteral nutrition configuration.

[0085] The beneficial effects of the present invention are as follows: a system based on an individualized parenteral nutrition configuration method provided by the present invention is a system corresponding to the above-mentioned individualized parenteral nutrition configuration method, which is used to implement the individualized parenteral nutrition configuration method, so as to realize rapid individualized parenteral nutrition configuration according to the individual characteristics of the patient, thereby improving the patient's recovery speed and quality of life.

[0086] In a third aspect, the present invention provides a computer program comprising instructions, which, when implemented by a computer, cause the computer to execute the steps of the method for configuring personalized parenteral nutrition.

[0087] Other advantages of the present invention will be analyzed in more detail in subsequent embodiments. BRIEF DESCRIPTION OF THE DRAWINGS

[0088] In order to more clearly illustrate the technical solutions of the embodiments of the present invention, the drawings required for use in the embodiments are briefly introduced below. It should be understood that the following drawings only show certain embodiments of the present invention and therefore should not be regarded as limiting the scope. For ordinary technicians in this field, other related drawings can be obtained based on these drawings without creative work.

[0089] Figure 1 This is a flowchart of the steps of a method for configuring individualized parenteral nutrition in Example 1 of the present invention.

[0090] Figure 2 This is a block diagram of a system based on an individualized parenteral nutrition configuration method in Example 2 of the present invention. DETAILED DESCRIPTION

[0091] The technical solutions in the embodiments of the present invention will be clearly and completely described below in conjunction with the drawings in the embodiments of the present invention. Obviously, the described embodiments are only a part of the embodiments of the present invention, rather than all the embodiments. The components of the embodiments of the present invention generally described and shown in the drawings here can be arranged and designed in various different configurations. Therefore, the following detailed description of the embodiments of the present invention provided in the drawings is not intended to limit the scope of the claimed invention, but merely represents the selected embodiments of the present invention. Based on the embodiments of the present invention, all other embodiments obtained by those skilled in the art without making creative work belong to the scope of protection of the present invention.

[0092] Example 1: Figure 1 As shown, in one embodiment of the present invention, the present invention provides a method for configuring individualized parenteral nutrition, comprising the following steps:

[0093] S1. Obtain the patient's basic personal information;

[0094] The patient's basic personal information includes the patient's age, weight, height, gender, body temperature and condition.

[0095] In this embodiment, the patient's condition includes mild infection, moderate infection, severe infection, surgical operation, tumor, fracture, crush, blunt force trauma, complex injury, heart failure, craniocerebral injury, burns 20%, burns 20% to 40%, burns more than 40%, nasogastric tube drainage, diarrhea, burns, trauma, liver disease, kidney disease, cardiopulmonary disease, closed brain trauma, azotemia, islet damage, high blood lipids, abnormal lipid metabolism, shock, and acute pancreatitis.

[0096] S2. Calculate the patient's nutritional needs data based on the patient's personal basic information;

[0097] The S2 comprises the following steps:

[0098] S21. Calculate the patient's daily basal energy expenditure using a basal energy expenditure model based on the patient's weight, height, age and gender;

[0099] The calculation expression of the basic energy consumption model is as follows:

[0100] BEE M =66.47+13.75W+5H-6.76A,

[0101] BEE WM =655.10+9.56W+1.85H-4.6A,

[0102] Among them, BEE M represents the daily basic energy expenditure of male patients, W represents the patient's weight, H represents the patient's height, A represents the patient's age, and BEE WM It represents the daily basal energy expenditure of female patients;

[0103] S22. Calculating the patient's daily energy requirement using an energy requirement model based on the patient's daily basal energy consumption;

[0104] The calculation expression of the energy demand model is as follows:

[0105] E rdM =BEE M ×f 1 ×f 2 ,

[0106] E rdWM =BEE WM ×f 1 ×f 2 ,

[0107] Among them, E rdM represents the daily energy requirement of male patients, f 1 represents the activity coefficient, f 2 Represents the energy demand stress coefficient, E rdWM It represents the daily energy requirement of female patients, among which the energy requirement stress coefficient is related to the patient's body temperature and condition;

[0108] In this embodiment, the activity coefficient can be divided according to the patient's action state. The activity coefficient corresponding to the bedridden state is set to 1.2, the activity coefficient corresponding to the state of getting out of bed and doing a small amount of activity is set to 1.25, and the activity coefficient corresponding to the normal activity state is set to 1.3; when the patient's condition is not a disease, the energy demand stress coefficient corresponds to the patient's body temperature state. When the patient's body temperature is lower than 38 degrees, the corresponding stress coefficient is 1, when the patient's body temperature is greater than or equal to 38 degrees and lower than 39 degrees, the corresponding energy demand stress coefficient is 1.1, when the patient's body temperature is greater than or equal to 39 degrees and lower than 40 degrees, the corresponding energy demand stress coefficient is 1.2; when the patient's body temperature is greater than or equal to 40 degrees, the corresponding energy demand stress coefficient is 1.3. In addition, in some scenarios, if the patient's condition is a disease, the energy demand stress coefficients corresponding to different disease conditions are shown in Table 1:

[0109] Table 1

[0110]

[0111] S23, calculating the patient's daily fluid requirement using a fluid requirement model based on the patient's weight, age and condition;

[0112] The calculation expression of the liquid demand model is as follows:

[0113]

[0114] Among them, L rd Indicates the patient's daily fluid requirement, L rad represents the daily fluid requirement per unit body weight of an adult patient, f 3 Indicates the fluid demand stress coefficient, Lm ch It indicates the daily fluid requirement per unit body weight of underage patients, where the fluid requirement stress coefficient is related to the patient's condition;

[0115] In this embodiment, the daily fluid requirement per unit body weight of an adult patient is 30 to 40 mL / kg·d, and the daily fluid requirement per unit body weight of a minor patient is 50 to 100 mL / kg·d.

[0116] If the patient's condition is non-disease, the fluid requirement stress coefficient is 1. In addition, in the medical scenario, if the patient's condition is disease, the corresponding fluid requirement stress coefficients under different disease conditions are shown in Table 2;

[0117] Table 2

[0118]

[0119] S24. Calculate the patient's daily protein requirement based on the patient's weight and condition and the protein requirement model;

[0120] P rd =W×p bmr ,

[0121] Among them, P rd represents the patient's daily protein requirement, p mr It represents protein metabolism rate, wherein the protein metabolism rate is related to the patient's condition;

[0122] In this embodiment, when the patient's condition is non-disease, the protein metabolism rate is 0.8g / kg·d, that is, the protein metabolism requirement per kilogram of body weight per day is 0.8g, when the condition is mild infection, the protein metabolism rate is 1-1.2g / kg·d, when the condition is moderate infection, the protein metabolism rate is 1.2-1.5g / kg·d, and when the condition is severe infection, the protein metabolism rate is 1.5-2.0g / kg·d; in actual conditions, the ratio of non-protein calories to amino acid nitrogen is 100-200Kcal:1g. When the patient's condition is infection, the nitrogen amount should be increased and the non-protein calories should be reduced. The non-protein calories should be as much as possible 100Kcal:1g. When the patient's condition is nephropathy and / or azotemia, the nitrogen amount should be reduced and the non-protein calories should be increased to reach 300-400Kcal / g, wherein the ratio of nitrogen to protein is: 1g nitrogen = 6.25g protein;

[0123] Non-protein calories are provided by glucose and fat. The amount of calories depends on the patient's basal metabolism and condition, usually between 1800 and 4000 Kcal. The recommended daily energy supply is 20 to 30 Kcal / kg / d, and is generally estimated based on body weight in clinical practice. Sugar accounts for 50% to 70% of non-protein calories, and fat accounts for 30% to 50%, usually in a ratio of 2:1. When the patient's condition is a tumor, the ratio of sugar to fat energy supply is 1:1, or even 1:2; high glucose metabolism will increase fat energy supply. When the patient's condition is pancreatic islet damage or cardiopulmonary disease, the glucose calories ratio should be reduced; when the patient's condition is high blood lipids, the fat calories ratio should be appropriately reduced; patients with abnormal lipid metabolism, shock, and acute pancreatitis need to prohibit the use of fat; every 1g of glucose can provide 4Kcal energy, and every 1g of fat can provide 9Kcal;

[0124] S25, according to the patient's weight, the calories and protein mass corresponding to each unit weight, and the glucose-to-fat energy supply ratio, respectively, calculate the patient's daily glucose requirement, fat requirement, and heat-nitrogen ratio;

[0125] The calculation expressions of the patient's daily glucose requirement, fat requirement and heat-nitrogen ratio are as follows:

[0126] G rd =(C pw ×WP pw ×W×4)×P og / 10 / 4,

[0127] F rd =(C pw ×WP pw ×W×4)×F og / 10 / 9,

[0128] Tnr=(C pw ×WP pw ×W×4) / (P pw ×W / 6.5):1

[0129] Among them, G rd represents the patient's daily glucose requirement, C pw Indicates the calories per unit body weight, P pw Indicates the amount of protein per unit body weight, P og Indicates the energy supply ratio of glucose, F rd Indicates the patient's daily fat requirement, F og It represents the energy supply ratio of fat, and Tnr represents the heat nitrogen ratio;

[0130] S26. The patient's daily energy requirement, fluid requirement, protein requirement, fat requirement, glucose requirement and heat-nitrogen ratio are used as the patient's nutritional requirement data.

[0131] S3. Obtain the types and dosage forms of parenteral nutrition preparations;

[0132] The S3 comprises the following steps:

[0133] S31. Obtaining the types of parenteral nutrition preparations, wherein the types of parenteral nutrition preparations include glucose preparations, fat preparations and amino acid preparations;

[0134] S32, obtaining a dosage form of a glucose preparation, wherein the dosage form of the glucose preparation includes a 5% glucose solution, a 10% glucose solution, and a 50% glucose solution;

[0135] In this embodiment, the pH value of the glucose preparation is between 3.5 and 5.5. The glucose preparation dosage form for central vein should generally be less than 23%, preferably less than 15%, and the glucose preparation dosage form for peripheral vein should generally be less than 10%.

[0136] S33, obtaining the dosage form of the fat preparation, wherein the dosage form of the fat preparation includes medium-chain fat emulsion MCT, long-chain fat emulsion LCT, medium- and long-chain fat emulsion MCT / LCT, structured fat emulsion and W-3 ​​fish oil fat emulsion;

[0137] In this embodiment, the substances in the fat preparation are mainly fatty acids, which exist in the form of triglycerides of various carbon chain lengths. According to the carbon chain length, long-chain fat emulsions are C14-24, medium-chain fat emulsions are C6-14, and short-chain fat emulsions are not used for parenteral nutrition configuration due to their certain toxicity. 10g·100ml of Juve is also included; in this embodiment, the pH value of the fat preparation is 8, and the average diameter of the fatty acids is 0.25-0.5μm. When the pH value is less than 5, the stability of the fat emulsion will be destroyed, and when the diameter of the fatty acid is greater than 6μm, the possibility of pulmonary embolism will potentially increase.

[0138] S34. Obtain dosage forms of amino acid preparations, wherein the dosage forms of amino acid preparations include ordinary amino acids, Gan'an, Shen'an and Litai.

[0139] In this embodiment, when preparing parenteral nutrition, different dosage forms of amino acids are selected according to the patient's disease state; if the patient's condition is liver disease, such as cirrhosis, abnormal liver function, etc., then the liver-an composed of branched-chain amino acids is selected; if the patient's condition is kidney disease, such as nephritis, renal failure, etc., then the kidney-an composed of essential amino acids is selected; Litai, i.e. alanyl-glutamine, should be used in combination with other amino acids, and 1 part of Litai should be diluted in at least 5 parts of other amino acid liquid. Ordinary amino acids include type II compound amino acids (18AA-Ⅱ) 8.5% 14gN / L (each 250mL contains 3.5gN), type III compound amino acids (18AA-Ⅲ) 10.36% 15.2gN / L (each 250mL contains 3.8gN), and green branch an (each 200mL contains 20.65gN); liver an includes green glycine (17AA-H) 13.2gN / L (each 500mL contains 6.6gN), Anping (20AA-H) 10% 15.3gN / L (each 500mL contains 7.7gN); kidney an (9R) 5.33% 8.8gN / L (each 250mL contains 2.2gN); Li Tai 32gN / L (each 100mL contains 3.2gN).

[0140] S4. Initialize individualized parenteral nutrition configuration based on the patient's nutritional demand data and the type and dosage form of parenteral nutrition preparations to obtain an initial individual parenteral nutrition configuration result;

[0141] The S4 comprises the following steps:

[0142] S41. According to the patient's daily protein requirement, configure the protein based on the dosage form of the amino acid preparation to obtain a protein configuration amount;

[0143] The calculation expression of the protein configuration amount is as follows:

[0144] Q p =(P pw ×W-20) / 20.65×200+100

[0145] Among them, Q p Indicates the amount of protein configuration;

[0146] In this embodiment, as a preferred solution, the protein is prepared using 20.65g·200ml of Luzhian and 20g·100ml of Litai, and the amount of Luzhian is (P pw ×W-20) / 20.65*200, the configuration volume of Litai is 100ml, among which Luzhian and Litai can effectively meet the protein needs of patients while having little impact on the fluctuation of the overall body fluid volume. According to the actual situation and the patient's condition, the dosage form of amino acid preparations can be equivalently replaced.

[0147] S42, configuring fat based on the dosage form of the fat preparation according to the daily fat requirement of the patient to obtain a configured fat amount;

[0148] The calculation expression of the fat configuration amount is as follows:

[0149] Q f =(F rd -10) / 0.2+100,

[0150] Among them, Q f Indicates the amount of fat;

[0151] In this embodiment, as a preferred solution, the fat is configured using a medium-chain fat emulsion with a specification of 20% and 10g·100ml of Juve, and the configuration amount of the 20% medium-chain fat emulsion is (F rd -10) / 0.2, the configuration amount of Juve is 100ml, of which 20% of medium- and long-chain fat emulsion and Juve can effectively meet the patient's fat needs while having little effect on the fluctuation of the overall body fluid volume. According to the actual situation and the patient's condition, the dosage form of the fat preparation can be equivalently replaced.

[0152] S43, preparing glucose based on the dosage form of the glucose preparation according to the patient's daily glucose requirement to obtain a prepared amount of glucose;

[0153] The calculation expression of the glucose configuration amount is as follows:

[0154] Q g =500+((F rd -50) / 0.5)

[0155] Among them, Q g Indicates the amount of glucose configuration;

[0156] In this embodiment, as a preferred solution, the glucose is prepared using 10% glucose and 50% glucose, the preparation amount of 10% glucose is 500ml, and the preparation amount of 50% glucose is ((F rd -50) / 0.5), wherein 10% glucose and 50% glucose can effectively meet the glucose needs of patients while having little effect on the fluctuation of the overall body fluid volume. Depending on the actual situation and the patient's condition, the dosage forms of glucose preparations can be equivalently replaced.

[0157] S44. Use the protein configuration amount, fat configuration amount and glucose configuration amount as the initial individual parenteral nutrition configuration result.

[0158] S5. Based on the patient's personal basic information, the patient's nutritional needs data and the initial personal parenteral nutrition configuration results, electrolytes, trace elements, insulin and vitamins are supplemented and configured, and the actual nutritional supplement results are calculated to complete the personal parenteral nutrition configuration.

[0159] The S5 comprises the following steps:

[0160] S51. Prepare electrolytes and trace elements according to the patient's daily fluid requirements;

[0161] In this embodiment, as a preferred solution, the composition of electrolytes and trace elements consists of 10% NaCl, 10% KCl, 25% M glucose solution O4, sodium glycerophosphate injection and 10% calcium gluconate; taking the configuration amount of 1500mL-2000mL as an example, the safe dose should be: sodium ions are added to 80-100mmol of 10% sodium chloride solution 45-60mL, potassium ions are added to 40-60mmol of 10% potassium chloride solution 30-45mL, magnesium ions are added to 40-60mmol of 10% magnesium sulfate solution 30-45mL, phosphorus is added to 10mmol of sodium glycerophosphate solution 10mL or double hydrogen phosphate solution 2.5mL / 1000Cal, calcium ions are added to 2.5-5mmol of 10% calcium gluconate 10-20mL;

[0162] The electrolyte and trace element configuration in the S51 includes 60 mL of 10% sodium chloride solution, 20 mL of 15% potassium chloride solution, 10 mL of sodium glycerophosphate solution, 10 mL of 25% magnesium sulfate solution, 10 mL of 10% calcium gluconate solution and 40 mL of trace element solution.

[0163] S52. Obtaining a determination result of the patient's insulin configuration requirement based on the patient's personal basic information and the patient's condition;

[0164] In this embodiment, if the patient's condition is diabetes or pancreatitis, the insulin configuration requirement judgment result is that configuration is required, otherwise the insulin configuration requirement judgment result is that configuration is not required;

[0165] S53. If the insulin configuration requirement judgment result is that configuration is required, the configuration amount of insulin is set to (C pw ×WP pw ×W×4)×F og / 10 / 4 / 10U, otherwise no insulin supplementation;

[0166] When supplementing individual parenteral nutrition, regarding the supplementation of insulin, the ratio of glucose to insulin should be calculated based on the patient's blood sugar index, and the insulin should be prepared at a ratio of glucose: insulin equal to 4-20g: 1U; if the patient does not have diabetes, the ratio of glucose: insulin should be prepared from 8-10g: 1U, and if the patient has diabetes, the ratio of glucose: insulin should be prepared from 4g: 1U. In this embodiment, U is the international unit of insulin, and the bottled dosage form is generally 400U, with 40U per milliliter.

[0167] S54. Supplement water-soluble vitamins, fat-soluble vitamins and multivitamins, 1 bottle each per day;

[0168] When supplementing individual parenteral nutrition, vitamins include fat-soluble vitamins, water-soluble vitamins and multivitamins; water-soluble vitamins include B vitamins, C and biotin, and there is no reserve of water-soluble vitamins in the body, so they need to be provided regularly during long-term parenteral nutrition to prevent patients from being deficient; fat-soluble vitamins include vitamins A, D, E and K, and there is a certain reserve of fat-soluble vitamins in the body, so lack of intake within 2-3 weeks will not cause deficiency; patients need to increase the amount of some water-soluble vitamins such as vitamin C and B6 under stress. Only one bottle of water-soluble vitamins, fat-soluble vitamins and multivitamins is needed per day.

[0169] S55, according to the protein configuration amount, the fat configuration amount and the glucose configuration amount, obtaining the actual calorie of nutritional supplementation, the protein energy supply ratio, the fat energy supply ratio, the glucose energy supply ratio and the heat-nitrogen ratio;

[0170] The calculation expressions of the actual nutritional supplementation calories, protein energy supply ratio, fat energy supply ratio, glucose energy supply ratio and heat nitrogen ratio are as follows:

[0171]

[0172] R ap =((Q p -100) / 200×20.65+20)×4 / C ar ,

[0173] R af =((Q f -100)×0.2+10)×9 / C ar ,

[0174] R ag =((Q g -500)×0.5+50)×4 / C ar ,

[0175]

[0176] Among them, C ar Indicates the actual nutritional supplement calories, R ap Indicates the protein energy supply ratio of actual nutritional supplementation, R af Indicates the fat energy supply ratio of actual nutritional supplementation, R ag Indicates the glucose energy supply ratio of actual nutritional supplementation, R at-n The heat-nitrogen ratio indicating actual nutrient supplementation;

[0177] S56. Take the actual nutritional supplement calories, protein energy supply ratio, fat energy supply ratio, glucose energy supply ratio and heat-nitrogen ratio as the actual nutritional supplement results to complete the personal parenteral nutrition configuration.

[0178] The method of the present invention can realize rapid and accurate individualized parenteral nutrition configuration according to the individual characteristics of the patient, so as to improve the patient's recovery speed and quality of life.

[0179] Example 2: Figure 2 As shown, based on Example 1, in another embodiment of the present invention, the present invention provides a system based on an individualized parenteral nutrition configuration method, comprising:

[0180] The first module is used to obtain basic personal information of patients;

[0181] The second module is used to calculate the patient's nutritional needs data based on the patient's personal basic information;

[0182] The third module is used to obtain the types and dosage forms of parenteral nutrition preparations;

[0183] The fourth module is used to initialize individualized parenteral nutrition configuration based on the patient's nutritional demand data and the type and dosage form of parenteral nutrition preparations to obtain the initial individual parenteral nutrition configuration result;

[0184] The fifth module is used to supplement electrolytes, trace elements, insulin and vitamins according to the patient's personal basic information, patient nutritional needs data and initial personal parenteral nutrition configuration results, and calculate the actual nutritional supplement results to complete personal parenteral nutrition configuration.

[0185] The present invention provides a system based on an individualized parenteral nutrition configuration method, which is a system corresponding to the above-mentioned individualized parenteral nutrition configuration method, and is used to implement the individualized parenteral nutrition configuration method, so as to achieve rapid individualized parenteral nutrition configuration according to the individual characteristics of the patient, thereby improving the patient's recovery speed and quality of life.

[0186] In the embodiment of the present invention, the system based on the personalized parenteral nutrition configuration method includes hardware structures and / or software modules corresponding to the execution of each function in order to realize the principles and beneficial effects of the personalized parenteral nutrition configuration method. It should be easily appreciated by those skilled in the art that, in combination with the schematic modules and method steps described in the embodiments disclosed in the present invention, the present invention can be implemented in the form of hardware and / or a combination of hardware and computer software. Whether a function is executed in a hardware or computer software driven manner depends on the specific application and design constraints of the technical solution. Different methods can be used for each specific application to implement the described function, but such implementation should not be considered to exceed the scope of the present application.

[0187] Embodiment 3: The embodiment of the present invention provides a computer program including instructions, which, when implemented by a computer, enables the computer to execute any step of the method for configuring individualized parenteral nutrition described in Embodiment 1. For example, when the computer executes the program, the following contents may be implemented:

[0188] S1. Obtain the patient's basic personal information;

[0189] S2. Calculate the patient's nutritional needs data based on the patient's personal basic information;

[0190] S3. Obtain the types and dosage forms of parenteral nutrition preparations;

[0191] S4. Initialize individualized parenteral nutrition configuration based on the patient's nutritional demand data and the type and dosage form of parenteral nutrition preparations to obtain an initial individual parenteral nutrition configuration result;

[0192] S5. Based on the patient's personal basic information, the patient's nutritional needs data and the initial personal parenteral nutrition configuration results, electrolytes, trace elements, insulin and vitamins are supplemented and configured, and the actual nutritional supplement results are calculated to complete the personal parenteral nutrition configuration.

[0193] In summary, the computer program including instructions in the embodiment of the present invention obtains the patient's personal basic information, calculates the patient's nutritional requirement data, and performs preliminary configuration of parenteral nutrition according to the patient's nutritional needs and the type and dosage form of parenteral nutrition preparations, thereby ensuring the accuracy of the patient's energy supply. It also supplements electrolytes, trace elements and vitamins on the basis of the preliminary configuration, and determines and supplements insulin needs based on the patient's condition, fully considering the patient's condition and the patient's daily fluid requirement, to ensure that targeted, accurate and healthy nutritional supplements can be provided to different patients.

[0194] The above description is only a specific implementation mode of the present invention, but the protection scope of the present invention is not limited thereto. Any technician familiar with the technical field can easily think of changes or substitutions within the technical scope disclosed by the present invention, which should be covered by the protection scope of the present invention.

Claims

1. A method for preparing individualized parenteral nutrition, characterized in that: The steps include: S1. Obtain the patient's basic personal information; S2. Calculate the patient's nutritional needs data based on the patient's personal basic information; S3. Obtain the types and dosage forms of parenteral nutrition preparations; S4. Initialize individualized parenteral nutrition configuration based on the patient's nutritional demand data and the type and dosage form of parenteral nutrition preparations to obtain an initial individual parenteral nutrition configuration result; S5. Based on the patient's personal basic information, the patient's nutritional needs data and the initial personal parenteral nutrition configuration results, electrolytes, trace elements, insulin and vitamins are supplemented and configured, and the actual nutritional supplement results are calculated to complete the personal parenteral nutrition configuration.

2. The method for preparing individualized parenteral nutrition according to claim 1, characterized in that: The patient's basic personal information includes the patient's age, weight, height, gender, body temperature and condition.

3. The method for configuring individualized parenteral nutrition according to claim 2, characterized in that: The S2 comprises the following steps: S21. Calculate the patient's daily basal energy expenditure using a basal energy expenditure model based on the patient's weight, height, age and gender; The calculation expression of the basic energy consumption model is as follows: <h2 style=";text-align:left;direction:ltr">BEE<h2 style=";text-align:left;direction:ltr"> M <h2 style=";text-align:left;direction:ltr"> =66.47+13.75W+5H-6.76A, BEE WM =655.10+9.56W+1.85H-4.6A, Among them, BEE M represents the daily basic energy expenditure of male patients, W represents the patient's weight, H represents the patient's height, A represents the patient's age, and BEE WM It represents the daily basal energy expenditure of female patients; S22. Calculating the patient's daily energy requirement using an energy requirement model based on the patient's daily basal energy consumption; The calculation expression of the energy demand model is as follows: E rdM =BEE M ×f1×f2, E rdWM =BEE WM ×f1×f2, Among them, E rdM represents the daily energy requirement of male patients, f1 represents the activity coefficient, f2 represents the energy requirement stress coefficient, E rdWM It represents the daily energy requirement of female patients, among which the energy requirement stress coefficient is related to the patient's body temperature and condition; S23, calculating the patient's daily fluid requirement using a fluid requirement model based on the patient's weight, age and condition; The calculation expression of the liquid demand model is as follows: Among them, L rd Indicates the patient's daily fluid requirement, L rad represents the daily fluid requirement per unit body weight of an adult patient, f3 represents the fluid requirement stress factor, Lm ch It indicates the daily fluid requirement per unit body weight of underage patients, where the fluid requirement stress coefficient is related to the patient's condition; S24. Calculate the patient's daily protein requirement based on the patient's weight and condition and the protein requirement model; P rd =W×p bmr , Among them, P rd represents the patient's daily protein requirement, p mr It represents protein metabolism rate, wherein the protein metabolism rate is related to the patient's condition; S25, according to the patient's weight, the calories and protein mass corresponding to each unit weight, and the glucose-to-fat energy supply ratio, respectively, calculate the patient's daily glucose requirement, fat requirement, and heat-nitrogen ratio; The calculation expressions of the patient's daily glucose requirement, fat requirement and heat-nitrogen ratio are as follows: G rd =(C pw ×W-P pw ×W×4)×P og / 10 / 4, F rd =(C pw ×W-P pw ×W×4)×F og / 10 / 9, Tnr=(C pw ×W-P pw ×W×4) / (P pw ×W / 6.5):1 Among them, G rd represents the patient's daily glucose requirement, C pw Indicates the calories per unit body weight, P pw Indicates the amount of protein per unit body weight, P og Indicates the energy supply ratio of glucose, F rd Indicates the patient's daily fat requirement, F og It represents the energy supply ratio of fat, and Tnr represents the heat nitrogen ratio; S26. The patient's daily energy requirement, fluid requirement, protein requirement, fat requirement, glucose requirement and heat-nitrogen ratio are used as the patient's nutritional requirement data.

4. The method for configuring individualized parenteral nutrition according to claim 3, characterized in that: The S3 comprises the following steps: S31. Obtaining the types of parenteral nutrition preparations, wherein the types of parenteral nutrition preparations include glucose preparations, fat preparations and amino acid preparations; S32, obtaining a dosage form of a glucose preparation, wherein the dosage form of the glucose preparation includes a 5% glucose solution, a 10% glucose solution, and a 50% glucose solution; S33, obtaining the dosage form of the fat preparation, wherein the dosage form of the fat preparation includes medium-chain fat emulsion MCT, long-chain fat emulsion LCT, medium- and long-chain fat emulsion MCT / LCT, structured fat emulsion and W-3 ​​fish oil fat emulsion; S34. Obtain dosage forms of amino acid preparations, wherein the dosage forms of amino acid preparations include ordinary amino acids, Gan'an, Shen'an and Litai.

5. The method for configuring individualized parenteral nutrition according to claim 4, characterized in that: The S4 comprises the following steps: S41. According to the patient's daily protein requirement, configure the protein based on the dosage form of the amino acid preparation to obtain a protein configuration amount; The calculation expression of the protein configuration amount is as follows: Q p =(P pw ×W-20) / 20.65×200+100 Among them, Q p Indicates the amount of protein configuration; S42, configuring fat based on the dosage form of the fat preparation according to the daily fat requirement of the patient to obtain a configured fat amount; The calculation expression of the fat configuration amount is as follows: Q f =(F rd -10) / 0.2+100, Among them, Q f Indicates the amount of fat; S43, preparing glucose based on the dosage form of the glucose preparation according to the patient's daily glucose requirement to obtain a prepared amount of glucose; The calculation expression of the glucose configuration amount is as follows: Q g =500+((F rd -50) / 0.5) Among them, Q g Indicates the amount of glucose configuration; S44. Use the protein configuration amount, fat configuration amount and glucose configuration amount as the initial individual parenteral nutrition configuration result.

6. The method for configuring individualized parenteral nutrition according to claim 5, characterized in that: The S5 comprises the following steps: S51. Prepare electrolytes and trace elements according to the patient's daily fluid requirements; S52. Obtaining a determination result of the patient's insulin configuration requirement based on the patient's personal basic information and the patient's condition; S53. If the insulin configuration requirement judgment result is that configuration is required, the configuration amount of insulin is set to (C pw ×WP pw ×W×4)×F og / 10 / 4 / 10U, otherwise no insulin supplementation; S54. Supplement water-soluble vitamins, fat-soluble vitamins and multivitamins, 1 bottle each per day; S55, according to the protein configuration amount, the fat configuration amount and the glucose configuration amount, obtaining the actual calorie of nutritional supplementation, the protein energy supply ratio, the fat energy supply ratio, the glucose energy supply ratio and the heat-nitrogen ratio; The calculation expressions of the actual nutritional supplementation calories, protein energy supply ratio, fat energy supply ratio, glucose energy supply ratio and heat nitrogen ratio are as follows: R ap =((Q p -100) / 200×20.65+20)×4 / C ar , R af =((Q f -100)×0.2+10)×9 / C ar , R ag =((Q g -500)×0.5+50)×4 / C ar , Among them, C ar Indicates the actual nutritional supplement calories, R ap Indicates the protein energy supply ratio of actual nutritional supplementation, R af Indicates the fat energy supply ratio of actual nutritional supplementation, R ag Indicates the glucose energy supply ratio of actual nutritional supplementation, R at-n The heat-nitrogen ratio indicating actual nutrient supplementation; S56. Take the actual nutritional supplement calories, protein energy supply ratio, fat energy supply ratio, glucose energy supply ratio and heat-nitrogen ratio as the actual nutritional supplement results to complete the personal parenteral nutrition configuration.

7. The method for configuring individualized parenteral nutrition according to claim 6, characterized in that: The electrolyte and trace element configuration in the S51 includes 60 mL of 10% sodium chloride solution, 20 mL of 15% potassium chloride solution, 10 mL of sodium glycerophosphate solution, 10 mL of 25% magnesium sulfate solution, 10 mL of 10% calcium gluconate solution and 40 mL of trace element solution.

8. A system based on the method for configuring individualized parenteral nutrition according to any one of claims 1 to 7, characterized in that: include: The first module is used to obtain basic personal information of patients; The second module is used to calculate the patient's nutritional needs data based on the patient's personal basic information; The third module is used to obtain the types and dosage forms of parenteral nutrition preparations; The fourth module is used to initialize individualized parenteral nutrition configuration based on the patient's nutritional demand data and the type and dosage form of parenteral nutrition preparations to obtain the initial individual parenteral nutrition configuration result; The fifth module is used to supplement electrolytes, trace elements, insulin and vitamins according to the patient's personal basic information, patient nutritional needs data and initial personal parenteral nutrition configuration results, and calculate the actual nutritional supplement results to complete personal parenteral nutrition configuration.

9. A computer program comprising instructions, characterized in that When the instructions are implemented by a computer, the computer executes the steps of the personalized parenteral nutrition configuration method according to any one of claims 1 to 7.

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