Treatment guidance system for diabetic ketoacidosis patient

Abstract

The invention discloses a treatment guidance system for a diabetic ketoacidosis patient. According to the system, a data detection unit is used for acquiring symptom related data of a target patient; the decision analysis unit is used for generating a corresponding first treatment scheme based on the symptom related data in combination with a stored treatment guide; the scheme recommendation unit is used for generating a second treatment scheme based on the first treatment scheme in response to an auditing result of the auditing terminal on the first treatment scheme, and then sending the second treatment scheme to the execution terminal; and the infusion monitoring unit is used for responding to the instruction of the execution end, automatically controlling infusion treatment on the target patient based on the second treatment scheme and automatically adjusting the dosage in combination with the detection index. According to the invention, the treatment success rate of DKA patients is effectively improved, and the incidence rate of adverse events such as hypoglycemia and prolonged uridone body negative conversion time is reduced.

Description

Technical Field

[0001] The present invention relates to the field of intelligent medical technology, and more specifically, to a treatment guidance system for patients with diabetic ketoacidosis. Background Art

[0002] Diabetic ketoacidosis (DKA) is a common acute complication in patients with diabetes. In the process of treating ketoacidosis, more details need to be paid attention to, such as when to supplement potassium, when to start to supplement sugar water, when to start to use insulin and the adjustment of insulin dosage, whether the amount of fluid replacement is sufficient, whether alkali supplementation treatment should be performed, whether to pay attention to and deal with the causes of the disease, etc. These ignored details are precisely the key to successful treatment. In addition, due to the complex and diverse clinical manifestations of DKA, it is necessary to closely monitor multiple indicators during the treatment process, adjust the dosage and speed of multiple drugs and fluids, and pay attention to the prevention and treatment of various complications. Therefore, higher requirements are placed on the professional skills of nursing staff. Often, the rescue effect is poor because medical staff are not familiar with the key points of the ketoacidosis treatment process or fail to monitor the various indicators of ketoacidosis patients in time, and adjust the dosage and speed of drugs and fluids.

[0003] In the existing technology, the details that are often overlooked in the treatment of DKA patients mainly include the following aspects:

[0004] 1) Failure to replenish potassium in time: Treatment measures for ketoacidosis, such as large amounts of fluids and the use of insulin, will lead to further hypokalemia, and patients with ketoacidosis will have a certain degree of potassium loss. Hypokalemia can lead to various complications in patients, and in severe cases, malignant arrhythmias in patients. Therefore, it is very important for patients with ketoacidosis to replenish potassium in time.

[0005] 2) Incorrect insulin dosage: For ketoacidosis, excessive insulin dosage or failure to reduce the dosage in time can easily cause hypoglycemia in patients. Insufficient insulin dosage cannot lower the patient's blood sugar and cannot correct the patient's ketoacidosis.

[0006] 3) Insufficient fluid replacement: Ketoacidosis patients all have varying degrees of hypovolemia. If insulin is used without adequate fluid replacement, as blood sugar levels drop, water enters cells, causing the patient's blood volume to further decrease, causing shock. Only by giving patients adequate fluid replacement can hypovolemia be corrected, tissue blood perfusion can be improved, and insulin can fully exert its efficacy.

[0007] 4) Blind alkali supplementation: After adequate fluid replacement and insulin use, the acidosis of patients with ketoacidosis can often return to normal on their own. Blind alkali supplementation may cause acidosis of the patient's brain cells, aggravate tissue hypoxia, and induce cerebral edema.

[0008] 5) Failure to replenish sugar water in time: A large amount of saline solution is required in the initial stage of treatment of ketoacidosis, but when the patient's blood sugar drops to 13.9mmol / L, the patient should be given 5% glucose injection to reduce the decomposition of the patient's fat and thereby reduce the production of ketone bodies.

[0009] 6) Failure to control triggering factors such as infection: A common trigger for ketoacidosis is infection. If this trigger is not removed, ketoacidosis is often difficult to correct. Summary of the invention

[0010] The purpose of the present invention is to overcome the defects of the prior art and provide a treatment guidance system for patients with diabetic ketoacidosis. The system comprises:

[0011] Data detection unit: used to obtain symptom-related data of target patients;

[0012] A decision analysis unit: used to generate a corresponding first treatment plan based on the symptom-related data and in combination with rules set according to the treatment guideline;

[0013] A plan recommendation unit: used to generate a second treatment plan based on the first treatment plan and in response to the review result of the first treatment plan by the review end, and then send the second treatment plan to the execution end, wherein the second treatment plan is the same as or different from the first treatment plan;

[0014] Infusion monitoring unit: used to respond to the instructions of the execution end, automatically control the infusion treatment of the target patient based on the second treatment plan, and automatically adjust the dosage in combination with the detection indicators.

[0015] The present invention also provides a device for guiding the treatment of patients with diabetic ketoacidosis, comprising:

[0016] Data detection module: used to obtain symptom-related data of target patients; this module connects to the hospital HIS system and LIS system through the hospital's reserved interface, and cleans and organizes the obtained patient ketoacidosis poisoning data to obtain structured data, and sends it to the decision analysis module.

[0017] Decision analysis module: storing a rule base extracted based on various guidelines, expert consensus, etc., for generating a corresponding first treatment plan based on the symptom-related data and comparing it with the stored rule base;

[0018] A plan recommendation module: used to generate a second treatment plan based on the first treatment plan and in response to the review result of the first treatment plan by the review end, and then send the second treatment plan to the execution end, wherein the second treatment plan is the same as or different from the first treatment plan;

[0019] Infusion monitoring unit: includes an infusion pump, a micro-injection pump and a pump control module box. The pump control module box is connected to the infusion pump and the micro-injection pump, and is connected to the scheme recommendation module through a wired or wireless network. It is used to respond to the instructions of the scheme recommendation module and automatically control the infusion treatment of the target patient based on the second treatment plan.

[0020] In one embodiment, the data detection unit obtains the symptom-related data, including one or more of vital signs, positive signs and test results, by interconnecting with a hospital information system and a laboratory information system.

[0021] In one embodiment, the first treatment plan generated by the decision analysis unit is determined based on blood ketones, blood sugar, arterial blood gas results, blood urea nitrogen, creatinine, electrolytes, blood gas analysis, heart rate, blood pressure, dryness of the patient's skin and mucous membranes, past medical history, and current medical history.

[0022] In one embodiment, the infusion monitoring unit automatically controls the treatment of the target patient based on the second treatment plan in response to the input instruction of the nurse, and automatically adjusts the infusion dosage in combination with the detection index.

[0023] In one embodiment, the infusion monitoring unit automatically calculates and controls the infusion speed of the infusion pump or micro pump based on the second treatment plan, so that the target patient receives the preset treatment within a specified time.

[0024] In one embodiment, the system further includes a reminder unit for prompting the audit end or the execution end to perform set operations or inspections, including one or more of reminders to monitor the patient's blood sugar, reminders to replace infusion bags, reminders to change the type of infusion fluid, reminders to change the insulin usage speed, reminders to change the fluid replenishment speed, reminders to replenish sugar water, reminders to replenish potassium, and reminders to replenish alkali.

[0025] In one embodiment, the system can automatically update the treatment plan based on the patient's real-time data and synchronize the updated plan to the doctor and nurse.

[0026] In one embodiment, the second treatment regimen includes one or more of the amount and time of insulin injection, the amount of potassium supplementation and the time interval for monitoring blood potassium, the amount of alkali supplementation and the time interval for monitoring acid-base balance, and the amount of sodium bicarbonate supplementation.

[0027] In one embodiment, the vital signs include body temperature, pulse, respiratory rate, respiratory depth, blood pressure, heart rate or central venous pressure; the positive signs include fever, pain, vomiting, diarrhea, fatigue, skin elasticity, dry skin, whether the eye sockets are collapsed, thirst, increased urine volume or whether there is a ketone odor in the breath; the test results include blood sugar, arterial blood gas results or blood ketonuria ketones.

[0028] Compared with the existing technology, the advantage of the present invention is that it combines cutting-edge scientific and technological means such as automated detection, intelligent decision-making, and personalized medical solutions to provide ketoacidosis patients and medical staff with an efficient, timely, and intelligent comprehensive disease management system.

[0029] Further features and advantages of the present invention will become apparent from the following detailed description of exemplary embodiments of the present invention with reference to the attached drawings. BRIEF DESCRIPTION OF THE DRAWINGS

[0030] The accompanying drawings, which are incorporated in and constitute a part of the specification, illustrate embodiments of the invention and, together with the description, serve to explain the principles of the invention.

[0031] Figure 1 is an architectural diagram of a treatment guidance system for patients with diabetic ketoacidosis according to an embodiment of the present invention;

[0032] Figure 2 is a schematic diagram of automatic fluid replenishment according to symptoms and dehydration degree according to one embodiment of the present invention;

[0033] Figure 3 is a schematic diagram of pushing a solution based on blood sugar data according to an embodiment of the present invention;

[0034] Figure 4 is a schematic diagram of pushing a plan based on blood potassium data according to an embodiment of the present invention;

[0035] Figure 5 is a schematic diagram of pushing a plan according to an acid-base imbalance situation according to an embodiment of the present invention;

[0036] Figure 6 It is a schematic diagram of pushing a plan according to the acid-base imbalance situation according to another embodiment of the present invention. DETAILED DESCRIPTION

[0037] Various exemplary embodiments of the present invention will now be described in detail with reference to the accompanying drawings. It should be noted that the relative arrangement of components and steps, numerical expressions and numerical values ​​set forth in these embodiments do not limit the scope of the present invention unless otherwise specifically stated.

[0038] The following description of at least one exemplary embodiment is merely illustrative in nature and is in no way intended to limit the invention, its application, or uses.

[0039] Technologies, methods, and equipment known to ordinary technicians in the relevant art may not be discussed in detail, but where appropriate, the technologies, methods, and equipment should be considered as part of the specification.

[0040] In all examples shown and discussed herein, any specific values ​​should be interpreted as merely exemplary and not as limiting. Therefore, other examples of the exemplary embodiments may have different values.

[0041] It should be noted that like reference numerals and letters refer to similar items in the following figures, and therefore, once an item is defined in one figure, it need not be further discussed in subsequent figures.

[0042] The present invention proposes a treatment system for patients with ketoacidosis, which can generate comprehensive, systematic and continuous intervention measures according to individual differences of patients, including blood sugar monitoring, fluid resuscitation, insulin therapy, electrolyte balance, etc. The system can make the treatment of patients with ketoacidosis more standardized and timely, and avoid the prolongation or even deterioration of the course of ketoacidosis patients due to doctors and nurses neglecting some details. In short, the treatment guidance system for patients with ketoacidosis (DKA) provided integrates multiple units such as data detection, intelligent decision-making, program recommendation and infusion monitoring, and can achieve efficient, timely and intelligent treatment of DKA patients.

[0043] Specifically, see Figure 1 As shown, the provided treatment guidance system for patients with diabetic ketoacidosis mainly includes a data detection unit, a decision analysis unit, a plan recommendation unit and an infusion monitoring unit.

[0044] The data detection unit obtains various data related to the patient's ketoacidosis: the data detection unit automatically extracts the patient's relevant data by interconnecting with the hospital's HIS (hospital information system) and LIS (laboratory information system), cleans and organizes the data to obtain structured data, and sends it to the decision analysis unit. The extracted data includes but is not limited to the patient's relevant clinical manifestations, chief complaints, symptoms and signs, test indicators, etc., such as the patient's vital signs (such as body temperature, pulse, respiratory rate, blood pressure, etc.), positive signs (such as fever, vomiting, whether there is ketone odor in the breath, etc.) and specific test results (such as blood sugar, blood ketones, urine ketones, arterial blood gas results, electrolytes, blood gas analysis, etc.).

[0045] Decision analysis module: compares the above sorted data with the stored rule base to generate the corresponding first treatment plan;

[0046] The rule base of the present invention is a rule base obtained after mining and analyzing various guidelines, clinical treatment pathways, expert consensus, teaching materials, papers, works, scientific inferences, experimental reports, test reports, relevant laws and regulations, and relevant literature and materials on diabetic ketoacidosis.

[0047] The decision analysis module is used to receive the data sent by the data detection module, and compare it with the rule base stored in the system, intelligently generate a treatment plan based on the comparison results, and then send the treatment plan to the doctor's HIS (or review end) for review. The doctor can further modify the treatment plan as needed. The treatment plan includes key treatment parameters such as the amount of fluid replacement, insulin dosage, potassium supplementation strategy, and whether to supplement alkali. The decision analysis unit can also reconfirm whether the patient has DKA and evaluate the degree of dehydration, electrolytes, and acid-base balance. Combined with Figures 2 to 6 As shown, the decision analysis unit can determine the amount of fluid replacement, insulin dosage, potassium supplementation strategy, whether to supplement alkali, infusion time interval, and timing of monitoring blood sugar, blood potassium and acid-base balance according to symptoms, degree of dehydration, blood sugar monitoring values, blood potassium monitoring values, and acid-base imbalance.

[0048] After the treatment plan is reviewed by the doctor, the plan recommendation unit will issue the treatment plan to the nurse (or execution end). The nurse will display the medication, test and examination measures that need to be completed for the patient in each time period to ensure the accurate implementation of the treatment plan.

[0049] The infusion monitoring unit is connected to the regimen recommendation unit for automatic control of the infusion pump or micro pump to provide infusion therapy to the patient according to the treatment plan. The infusion monitoring unit can automatically calculate and control the infusion speed to ensure that the patient receives adequate treatment within the prescribed time. At the same time, the infusion monitoring unit can also automatically adjust the infusion volume and insulin infusion speed according to the patient's real-time data. For example, when the patient's blood sugar, blood potassium and other indicators change, the infusion volume and insulin infusion speed are automatically adjusted.

[0050] For example, the infusion monitoring unit is an infusion pump or a micro pump. Figure 3 As shown, the infusion monitoring unit is controlled by the decision analysis unit. When the decision analysis unit gives the patient an intravenous push of 10-20U short-acting insulin and a maintenance order of 0.1U / kg / h of short-acting insulin, the nurse connects the liquid line and clicks start. The micro pump automatically calculates the infusion rate according to the patient's weight and infuses. When the data detection unit detects that the patient's blood sugar has dropped to 13.9mmol / L, the data detection unit sends the patient's blood sugar data to the decision analysis unit. The decision analysis unit makes a new treatment plan and sends the treatment plan to the plan recommendation unit. The plan recommendation unit can then pop up a box to remind: The patient's blood sugar has dropped to 13.9mmol / L or below. Please use 5% glucose injection for fluid therapy and reduce the insulin input to 0.02-0.05U / kg / h, and maintain the patient's blood sugar at 8.3-11.1mmol / L. Please confirm. After the medical staff confirms, the plan recommendation unit sends it to the infusion monitoring unit, and the system will control the insulin pump to automatically perform the above tasks.

[0051] It should be noted that the data detection unit can continuously monitor the patient's real-time data, including blood sugar, blood ketones, electrolytes, etc. When new test results come out, the system automatically obtains them and sends them to the decision analysis unit, which updates the treatment plan. The updated treatment plan is synchronized to the doctor and nurse ends, and the system can continue to remind the nurse to implement new treatment measures.

[0052] The treatment guidance system for diabetic ketoacidosis patients of the present invention is a system that is mutually called with other systems (such as HIS, LIS, infusion pump and micro-injection pump management platform, etc.) through a data interface. The data and information transmission mode between the various modules of the present invention can be through a data line mode, a wireless transmission mode, a wired network transmission mode, etc. The wireless transmission mode includes: infrared, Bluetooth, wifi, wireless power, etc.

[0053] To further understand the present invention, the concept of the present invention is described below with reference to specific embodiments.

[0054] Assume that a hospital has admitted a patient suspected of DKA. The following is the treatment process of the patient using the system of the present invention:

[0055] The data detection unit automatically extracts all the patient's data, including vital signs, positive signs, and test results, by interconnecting with the hospital's HIS and LIS systems, and cleans and organizes the data before sending it to the decision analysis unit.

[0056] The decision analysis unit compares the patient data with the stored rule base. For example, if the patient's breath has a ketone smell, is in a coma, and the arterial blood gas shows: pH: 7.2HCO3-: 19mmol / L, and blood pressure: 90 / 50mmHg, it is judged that the patient may have ketoacidosis, and the data is sent to the scheme recommendation unit, which sends it to the HIS and other systems, and a pop-up box reminds: The patient may have ketoacidosis, please immediately test peripheral blood sugar, blood ketones, urine ketones, urea nitrogen, creatinine, electrolytes, blood gas analysis, etc. to confirm or exclude this disease. Please send blood routine, C-reactive protein, procalcitonin determination, interleukin 6, etc. to clarify the cause of the patient's DKA. At the same time, the decision analysis unit found that the patient's skin was dry, the eye sockets were obviously sunken, the CVP was low, and the blood pressure was low, and the patient's dehydration was judged to be severe dehydration. At the same time, the decision analysis unit analyzed the patient's blood sugar: 23mmol / L, and insulin injection was required. At the same time, the decision analysis unit analyzes the patient's blood potassium: 3.5mmol / L, requiring potassium supplementation. The decision analysis unit sends the above treatment plan to the doctor.

[0057] The doctor can pop up a box to remind the following points:

[0058] 1) The patient may have ketoacidosis. Please immediately test peripheral blood glucose, blood ketones, urine ketones, urea nitrogen, creatinine, electrolytes, blood gas analysis, etc. to confirm or exclude this disease. Please send blood routine, C-reactive protein, procalcitonin determination, interleukin 6, etc. for testing to clarify the cause of the patient's DKA.

[0059] 2) If the patient's skin is very dry, eye sockets are obviously sunken, CVP and blood pressure are poor, and the patient is severely dehydrated, please inject 1000-2000ml of 0.9% sodium chloride injection within 1-2 hours, and inject 1 / 3 of the patient's water loss within 4 hours (the principle of fluid replacement: fast first, then slow, salt first, then sugar).

[0060] 3) If the patient's blood sugar is >13.9mmol / L, please give the patient 10-20U of short-acting insulin intravenously, and give 0.1U / kg / h of short-acting insulin for maintenance, and check the blood sugar every 1-2 hours.

[0061] 4) Patient's blood potassium: 3.5mmol / L. Please start potassium supplementation immediately while starting insulin and fluid therapy (1.5-3g potassium chloride can be added to each liter of fluid), and recheck blood potassium after 2 hours.

[0062] After the decision analysis unit sends the above treatment plan to the plan recommendation unit, the plan recommendation unit sends it to the doctor side. After the doctor reviews it, the plan recommendation unit pushes the treatment plan to the nurse side. The nurse side displays the above content.

[0063] Treatment plan implementation:

[0064] The infusion pump displays: Please connect 0.9% sodium chloride injection 1000-2000ml. After the nurse connects the normal saline to the infusion pump, click to start infusion. The infusion pump automatically infuses the patient at a rate of 1000ml per hour according to the treatment plan.

[0065] The micro pump shows: the patient's blood sugar is >13.9mmol / L, please connect 1U / ml insulin injection. After the nurse connects the insulin injection to the micro pump, click to start infusion. The infusion pump automatically gives the patient 10-20U short-acting insulin intravenous push according to the treatment plan, and gives 6U / h (patient weight 60kg) of short-acting insulin infusion.

[0066] 50 minutes after the above measures were started, the program recommendation unit prompted: The infusion or insulin injection pump will be infused for about 1 hour, please recheck the patient's blood sugar and blood potassium levels.

[0067] The data detection unit continuously monitors the patient's real-time data. When it is detected that the patient's blood sugar has dropped to 13.9mmol / L, the data detection unit sends it to the decision analysis unit, and the decision analysis unit automatically updates the treatment plan: the patient's blood sugar has dropped to 13.9mmol / L, please use 5% glucose injection for fluid rehydration and reduce the insulin input to 3U / h, and maintain the patient's blood sugar at 8.3-11.1mmol / L. The updated treatment plan is pushed to the plan recommendation unit, which sends it to the doctor's side. After the doctor reviews it, the plan recommendation unit pushes the treatment plan to the nurse's side. The nurse's side displays the above content.

[0068] After the nurse confirms, the infusion pump displays: Please connect 1000ml of 5% glucose injection. After the nurse connects the glucose injection to the infusion pump, click to start infusion. The infusion pump automatically infuses the patient at a rate of 1000ml per hour according to the treatment plan.

[0069] The micro pump shows: patient blood sugar: 13.9mmol / L, the insulin input has been reduced to 3U / h, and the patient's blood sugar is maintained at 8.3-11.1mmol / L. Please confirm. After the nurse confirms, the micro pump automatically infuses at a rate of 3U / h.

[0070] The above infusion monitoring unit automatically controls the infusion pump to perform infusion therapy according to the updated treatment plan. The system can automatically calculate and control the infusion speed to ensure that the patient receives adequate treatment within the specified time. At the same time, the system can also automatically adjust the infusion volume and insulin infusion speed according to the patient's real-time data, and only start infusion with the automatically adjusted data after the nurse confirms, to ensure the safety of the patient again.

[0071] Accordingly, based on the above system, the present invention provides a method for treating patients with ketoacidosis, comprising the following steps:

[0072] S1: This system automatically extracts all patient data by connecting with the hospital's HIS system and LIS system, including but not limited to the patient's relevant clinical manifestations, symptoms and signs, and test indicators, and automatically analyzes the patient's condition.

[0073] S2: Generate a treatment plan for the patient based on the comparison of the patient's condition data and the rule base. The plan is pushed to the doctor's HIS for review, and the doctor can modify the treatment plan.

[0074] S3: After the treatment plan is reviewed by the doctor, the system sends it to the nurse.

[0075] S4: Based on the treatment plan, the system starts to remind the nurse what treatments and examinations the nurse should complete for the patient at each time point and time period.

[0076] S5: When new test results come out, the system will automatically obtain them, update the treatment plan based on the patient's new test results, and synchronize them to the doctor and nurse ends, and then start to remind the nurses which treatments and examinations for the patients should be completed at each time point and time period.

[0077] In one embodiment, in step S1, the system automatically extracts all patient data by connecting with the hospital medical record system, including: patient vital signs: body temperature, pulse, respiratory rate, respiratory depth, blood pressure, heart rate, central venous pressure; patient positive signs: fever, pain, vomiting, diarrhea, fatigue, skin elasticity, dry skin, sunken eye sockets, thirst, increased urine volume, and ketone odor (rotten apple odor) in the breath; test results: blood sugar, arterial blood gas results, blood ketones, urine ketones, etc. The system cleans and organizes the acquired data and pushes it to the decision analysis unit

[0078] In one embodiment, in step S2, the decision analysis unit compares the patient data with the stored rule base. When the patient has unexplained nausea, vomiting, acidosis, dehydration, shock, coma, especially ketones (rotten apple smell) on the breath, low blood pressure and high urine volume, regardless of whether there is a history of diabetes. The decision analysis unit determines that the patient may have ketoacidosis and sends the data to the scheme recommendation unit, which sends it to the HIS system, etc., and a pop-up box reminds: The patient may have ketoacidosis. Please immediately test peripheral blood sugar, blood ketones, urine ketones, urea nitrogen, creatinine, electrolytes, blood gas analysis, etc. to confirm or rule out this disease. Please send for routine blood tests, C-reactive protein, procalcitonin determination, interleukin 6, etc. to clarify the cause of the patient's DKA.

[0079] When the patient has the above test results, the data detection unit will push the data to the decision analysis unit, which will compare: when blood ketones ≥ 3mmol / L or urine ketones are positive, blood sugar > 13.9mmol / L or is known to be a diabetic patient, serum HCO3 - >18mmol / L and (or) arterial blood pH>7.3, it can be diagnosed as diabetic ketoacidosis, while HCO3 - <18mmol / L and / or arterial blood pH <7.3 can be diagnosed as DKA. Pop-up reminder: patient blood ketone: A mmol / L, blood sugar: B mmol / L, pH: C, HCO3 - :D mmol / L, consistent with the diagnosis of diabetic ketoacidosis / DKA. When the patient's white blood cell count, C-reactive protein, procalcitonin assay, interleukin 6 and other results exceed normal values, the system pops up a box to remind: The patient's white blood cell count, C-reactive protein, procalcitonin assay, interleukin 6 and other results exceed normal values. Consider that the patient has an infection. Please give appropriate antibiotics to remove the cause of DKA.

[0080] At the same time, the decision analysis unit compares the patient data to determine the degree of dehydration of the patient, see Figure 2 As shown:

[0081] Mild dehydration without acidosis, pop-up box reminder: The patient is mildly dehydrated without acidosis and can be given oral rehydration;

[0082] For moderate or above dehydration, a pop-up box will remind you: The patient is severely dehydrated. Please infuse 1000-2000ml of 0.9% sodium chloride injection within 1-2 hours, and infuse 1 / 3 of the patient's water loss within 4 hours (rehydration principle: fast first, then slow, salt first, then sugar). At the same time, the decision-making unit sends the infusion plan to the infusion monitoring unit, and the infusion pump prompts the nurse to connect the corresponding liquid. After the connection is completed, the system automatically controls the speed of the infusion pump, and at the end of each bag of liquid infusion, it will sound to remind the nurse to change it to ensure that the patient is given enough liquid within the specified time.

[0083] At the same time, the data detection unit continuously monitors the patient's blood sugar level and sends it to the decision analysis unit, see Figure 3 As shown in the figure, when the patient's blood sugar is >13.9mmol / L, a pop-up box reminds: If the patient's blood sugar is >13.9mmol / L, please give the patient 10-20U short-acting insulin intravenous push, and give 0.1U / kg / h short-acting insulin for maintenance, and check blood sugar every 1-2 hours. At the same time, the decision-making unit sends the infusion plan to the infusion monitoring unit, and the micro pump prompts the nurse to connect the corresponding concentration of insulin injection. After the connection is completed, the system automatically controls the speed of the micro pump, and at the end of each pump of insulin injection, it sounds to remind the nurse to change.

[0084] When it is monitored that the patient's blood sugar drops less than 10% in the first hour, a pop-up window will appear: The patient's blood sugar drops less than 10%. The system will push 0.14U / kg and then continue with 0.1U / kg / h of short-acting insulin for maintenance. Please confirm. After the doctor or nurse confirms, the system will control the insulin pump to automatically perform the above tasks.

[0085] When the patient's blood sugar is monitored to drop to 13.9mmol / L, a pop-up box will remind you: The patient's blood sugar has dropped to 13.9mmol / L and below. Please use 5% glucose injection for fluid replacement therapy and reduce the insulin input to 0.02-0.05U / kg / h, and maintain the patient's blood sugar at 8.3-11.1mmol / L. Please confirm; after the doctor or nurse confirms, the system will control the insulin pump to automatically perform the above tasks.

[0086] At the same time, the decision analysis unit analyzes the patient's electrolyte and acid-base balance, see Figure 4 , Figure 5 and Figure 6 As shown:

[0087] When the patient's blood potassium is monitored to be lower than 5.5mmol / L and the patient's urine volume is >40ml / h, the system will prompt a reminder: Please start potassium supplementation immediately while starting insulin and fluid therapy (1.5-3g potassium chloride can be added to each liter of fluid)

[0088] When the patient's blood potassium is monitored to be lower than 3.5mmol / L, potassium supplementation should be given priority.

[0089] When the patient's pH is <7.1, HCO3 - <5mmol / L, the system will remind you to use isotonic sodium bicarbonate injection (1.25%-1.4%) to slowly replenish fluids.

[0090] At the same time, the data detection unit detects whether there is a new blood sugar value every hour. If not detected, the system will pop up a box to remind you: Please monitor the patient's blood sugar in time.

[0091] At the same time, the data monitoring unit continuously monitors the patient's test results: blood ketones and blood sugar are required to be tested every hour for the first 6 hours, and electrolytes and acid-base balance are tested every 2 hours. When there is no new test result within the time limit, the system will pop up a reminder.

[0092] In summary, compared with the prior art, the present invention has the following advantages:

[0093] 1) The system provided by the present invention can generate a treatment plan suitable for the patient according to the patient's various indicators, and remind the nurse to complete various treatment measures for ketoacidosis patients in a timely manner, and the system controls the infusion pump and the micro pump to automatically complete the relevant settings. For example, according to the treatment plan, the nurse is prompted at each time point and time period to complete the treatment and examination for the patient; and the system controls the infusion pump and the micro pump to automatically complete the relevant settings; when the new test results come out, the system will automatically obtain them, and update the treatment plan according to the patient's new test results, and synchronize them to the nurse side, and start to remind the nurse at each time point and time period to complete the treatment and examination for the patient.

[0094] 2) The present invention provides guidance for the treatment of patients with ketoacidosis, and effectively solves the problems of decreased rescue success rate, hypoglycemia, prolonged urine ketone body conversion time, etc. due to untimely treatment measures, wrong sequence, and neglect of treatment details when treating patients with ketoacidosis.

[0095] 3) The infusion monitoring unit of the present invention can automatically control the infusion pump or micro pump to perform infusion therapy according to the treatment plan. The system can automatically calculate and control the infusion speed to ensure that the patient receives adequate treatment within the specified time. When the patient's blood sugar, blood potassium and other indicators change, the system can automatically adjust the infusion volume and insulin infusion speed. In short, the present invention provides an efficient, timely and intelligent DKA patient rescue guidance system, which effectively improves the success rate of DKA patients and reduces the incidence of adverse events such as hypoglycemia and prolonged urine ketone body conversion time.

[0096] The present invention may be a system, a method and / or a computer program product. The computer program product may include a computer-readable storage medium carrying computer-readable program instructions for causing a processor to implement various aspects of the present invention.

[0097] Computer readable storage medium can be a tangible device that can hold and store instructions used by an instruction execution device. Computer readable storage medium can be, for example, but not limited to, an electrical storage device, a magnetic storage device, an optical storage device, an electromagnetic storage device, a semiconductor storage device, or any suitable combination thereof. More specific examples (non-exhaustive list) of computer readable storage medium include: a portable computer disk, a hard disk, a random access memory (RAM), a read-only memory (ROM), an erasable programmable read-only memory (EPROM or flash memory), a static random access memory (SRAM), a portable compact disk read-only memory (CD-ROM), a digital versatile disk (DVD), a memory stick, a floppy disk, a mechanical encoding device, for example, a punch card or a convex structure in a groove on which instructions are stored, and any suitable combination thereof. The computer readable storage medium used here is not interpreted as a transient signal itself, such as a radio wave or other freely propagating electromagnetic wave, an electromagnetic wave propagated by a waveguide or other transmission medium (for example, a light pulse by an optical fiber cable), or an electrical signal transmitted by a wire.

[0098] The computer-readable program instructions described herein can be downloaded from a computer-readable storage medium to each computing / processing device, or downloaded to an external computer or external storage device via a network, such as the Internet, a local area network, a wide area network, and / or a wireless network. The network can include copper transmission cables, optical fiber transmissions, wireless transmissions, routers, firewalls, switches, gateway computers, and / or edge servers. The network adapter card or network interface in each computing / processing device receives the computer-readable program instructions from the network and forwards the computer-readable program instructions for storage in the computer-readable storage medium in each computing / processing device.

[0099] The computer program instructions for performing the operation of the present invention may be assembly instructions, instruction set architecture (ISA) instructions, machine instructions, machine-dependent instructions, microcode, firmware instructions, state setting data, or source code or object code written in any combination of one or more programming languages, including object-oriented programming languages, such as Smalltalk, C++, Python, etc., and conventional procedural programming languages, such as "C" language or similar programming languages. Computer-readable program instructions may be executed entirely on a user's computer, partially on a user's computer, as an independent software package, partially on a user's computer, partially on a remote computer, or entirely on a remote computer or server. In the case of a remote computer, the remote computer may be connected to the user's computer via any type of network, including a local area network (LAN) or a wide area network (WAN), or may be connected to an external computer (e.g., using an Internet service provider to connect via the Internet). In some embodiments, an electronic circuit, such as a programmable logic circuit, a field programmable gate array (FPGA), or a programmable logic array (PLA), may be personalized by utilizing the state information of the computer-readable program instructions, and the electronic circuit may execute the computer-readable program instructions, thereby realizing various aspects of the present invention.

[0100] Various aspects of the present invention are described herein with reference to the flow charts and / or block diagrams of the methods, devices (systems) and computer program products according to embodiments of the present invention. It should be understood that each box of the flow chart and / or block diagram and the combination of each box in the flow chart and / or block diagram can be implemented by computer-readable program instructions.

[0101] These computer-readable program instructions can be provided to a processor of a general-purpose computer, a special-purpose computer, or other programmable data processing device, thereby producing a machine, so that when these instructions are executed by the processor of the computer or other programmable data processing device, a device that implements the functions / actions specified in one or more boxes in the flowchart and / or block diagram is generated. These computer-readable program instructions can also be stored in a computer-readable storage medium, and these instructions cause the computer, programmable data processing device, and / or other equipment to work in a specific manner, so that the computer-readable medium storing the instructions includes a manufactured product, which includes instructions for implementing various aspects of the functions / actions specified in one or more boxes in the flowchart and / or block diagram.

[0102] Computer-readable program instructions may also be loaded onto a computer, other programmable data processing apparatus, or other device so that a series of operating steps are performed on the computer, other programmable data processing apparatus, or other device to produce a computer-implemented process, thereby causing the instructions executed on the computer, other programmable data processing apparatus, or other device to implement the functions / actions specified in one or more boxes in the flowchart and / or block diagram.

[0103] The flow charts and block diagrams in the accompanying drawings show the possible architecture, functions and operations of the systems, methods and computer program products according to multiple embodiments of the present invention. In this regard, each box in the flow chart or block diagram can represent a part of a module, a program segment or an instruction, and a part of the module, a program segment or an instruction contains one or more executable instructions for realizing the specified logical function. In some alternative implementations, the functions marked in the box can also occur in a different order from the order marked in the accompanying drawings. For example, two consecutive boxes can actually be executed substantially in parallel, and they can sometimes be executed in the opposite order, depending on the functions involved. It should also be noted that each box in the block diagram and / or flow chart, and the combination of the boxes in the block diagram and / or flow chart can be implemented by a dedicated hardware-based system that performs the specified function or action, or can be implemented by a combination of dedicated hardware and computer instructions. It is well known to those skilled in the art that it is equivalent to implement it by hardware, implement it by software, and implement it by combining software and hardware.

[0104] Embodiments of the present invention have been described above, and the above description is exemplary, not exhaustive, and is not limited to the disclosed embodiments. Many modifications and variations will be apparent to those of ordinary skill in the art without departing from the scope and spirit of the described embodiments. The selection of terms used herein is intended to best explain the principles of the embodiments, practical applications, or technical improvements in the marketplace, or to enable other persons of ordinary skill in the art to understand the embodiments disclosed herein. The scope of the present invention is defined by the appended claims.

Claims

1. A treatment guidance system for patients with diabetic ketoacidosis, comprising: Data detection unit: used to obtain symptom-related data of target patients; A decision analysis unit: used to generate a corresponding first treatment plan based on the symptom-related data and in combination with the stored treatment guidelines; A plan recommendation unit is used to generate a second treatment plan based on the first treatment plan and in response to the review result of the first treatment plan by the review end, and then send the second treatment plan to the execution end, wherein the second treatment plan is the same as or different from the first treatment plan, and the second treatment plan includes one or more of the following: fluid replenishment amount, fluid replenishment speed, insulin dosage and speed, potassium replenishment strategy, and whether to replenish alkali; Infusion monitoring unit: used to respond to the instructions of the execution end, automatically control the infusion treatment of the target patient based on the second treatment plan, and automatically adjust the dosage in combination with the detection indicators.

2. The system according to claim 1, characterized in that The data detection unit obtains the symptom-related data, including one or more of vital signs, positive signs and test results, by interconnecting with the hospital information system and the laboratory information system, and cleans and organizes the data to obtain structured data.

3. The system according to claim 1, characterized in that The first treatment plan generated by the decision analysis unit is determined based on blood ketones, blood sugar, arterial blood gas results, blood urea nitrogen, creatinine, electrolytes, blood gas analysis results, heart rate, blood pressure, dryness of the patient's skin and mucous membranes, past medical history, and current medical history.

4. The system according to claim 1, characterized in that The infusion monitoring unit responds to the input instruction of the nurse end, automatically controls the treatment of the target patient based on the second treatment plan, and automatically adjusts the infusion dosage in combination with the detection index.

5. The system according to claim 1, characterized in that The infusion monitoring unit automatically calculates and controls the infusion speed of the infusion pump or micro pump based on the second treatment plan, so that the target patient receives the preset treatment within a specified time.

6. The system according to claim 1, characterized in that The system also includes a reminder unit, which is used to prompt the audit end or the execution end to perform set operations or inspections, including one or more of reminders to monitor patient blood sugar, reminders to replace infusion bags, reminders to change the type of infusion fluid, reminders to change insulin usage speed, reminders to change fluid replenishment speed, reminders to check patient infection indicators, reminders to supplement potassium, and reminders to supplement alkali.

7. The system according to claim 1, characterized in that The system can automatically update the treatment plan based on the patient's real-time data and synchronize the updated plan to the doctors and nurses.

8. The system according to claim 1, characterized in that The second treatment plan includes one or more of the amount and speed of insulin injection, the amount and speed of fluid replacement, the time of blood glucose monitoring, the amount of potassium replacement and the time interval for monitoring blood potassium, the amount of alkali replacement and the time interval for monitoring acid-base balance, and the amount of sodium bicarbonate supplementation.

9. The system according to claim 2, characterized in that The vital signs include body temperature, pulse, respiratory rate, respiratory depth, blood pressure, heart rate or central venous pressure, etc.; the positive signs include fever, pain, vomiting, diarrhea, fatigue, skin elasticity, dry skin, whether the eye sockets are collapsed, thirst, increased urine volume or whether there is a ketone odor in the breath; the test results include blood sugar, arterial blood gas results or blood ketonuria ketones.

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