Nutrition prescription recommendation method and device based on patient medical record information

Abstract

The invention relates to the technical field of intelligent medical treatment, in particular to a nutrition prescription recommendation method and device based on patient medical record information. The method comprises the following steps: S1, calculating a target amount of total energy required by a patient every day; s2, calculating the total protein target amount required by the patient every day; s3, determining a nutrition support approach of the patient; the method specifically comprises the steps that the latest diet medical advice of a patient is obtained, and the nutrition support way of the patient without the diet medical advice is the combination of diet and enteral nutrition; the diet medical advice is a fasting patient, and the nutrition support way is whole parenteral nutrition; the diet doctor advice is a patient with general diet or semi-liquid diet, and the nutrition support way is the combination of diet and enteral nutrition; the diet medical advice is a patient with clear flow, and the nutrition support way is the combination of diet, enteral nutrition and parenteral nutrition; and S4, giving a nutrition prescription. The nutrition prescription recommendation method provided by the invention is more in line with the actual situation, is more beneficial to nutrition supplement of the patient, improves the nutrition utilization rate, and is high in execution degree.

Description

Technical Field

[0001] The present invention relates to the field of smart medical technology, and in particular to a method and device for recommending nutritional prescriptions based on patient medical record information. Background Art

[0002] In medical practice, in addition to drug treatment, some patients also need to pay attention to their nutritional supplements, and some patients have a higher probability of malnutrition due to their diseases. It is necessary to provide patients with appropriate nutritional prescriptions. Reasonable nutrition can not only alleviate the condition and prevent complications, but also shorten the course of the disease.

[0003] Nutritional prescriptions can be formulated based on the patient's specific nutritional needs, including personalized diets and nutritional supplement plans. Among them, the ways of nutritional supplementation include diet, enteral nutrition and parenteral nutrition. Diet is the most basic and traditional way of nutritional supplementation. Enteral nutrition refers to the method of injecting some nutrient solutions that only need chemical digestion or can be absorbed without digestion into the patient's gastrointestinal tract to provide patients with the required nutrients. The injection method includes oral or tube feeding. Enteral nutrition preparations mainly include elemental enteral nutrition preparations, non-elemental enteral nutrition preparations, component enteral nutrition preparations, and special application enteral nutrition preparations. Parenteral nutrition is a way of providing patients with nutrients by intravenous injection into the patient's body. Even if the patient cannot eat or has a high metabolism, he or she can still maintain a good nutritional status.

[0004] The traditional way of recommending nutrition prescriptions mainly relies on human experience, and the nutrition prescriptions issued are relatively general, such as low sugar and low salt, increased protein supplementation, etc., which patients cannot execute. Later, people realized the automatic prescription equipment of nutrition prescriptions based on smart medical technology, such as the method and device for pushing a diet management plan for chronic disease patients disclosed in the prior art CN107644670A, wherein the method includes: obtaining the patient's physical condition data, wherein the physical condition data includes height, weight and physical labor intensity; determining the patient's daily calorie requirement according to the physical condition data; obtaining the patient's basic disease; determining the patient's diet plan according to the patient's daily calorie requirement and the basic disease, wherein the diet plan includes the types of ingredients required by the patient daily and the weight of the ingredients corresponding to each type of ingredients; outputting the patient's diet plan to the patient's terminal device. Through this technical solution, a diet plan with reasonable calories, balanced nutrition, multiple combinations, and free exchange can be automatically matched for the patient, which is convenient for the patient's daily implementation and long-term persistence, thereby contributing to good control of the disease.

[0005] The prior art CN118430747A discloses a method for recommending enteral nutrition preparations for surgical patients, comprising the following steps: (1) calculating the patient's BMI; (2) calculating the basal energy expenditure BEE; (3) calculating the energy expenditure TEE of trauma and stress state; (4) calculating the patient's daily non-protein calories NPC and nitrogen requirement N; and (5) calculating the patient's heat-nitrogen ratio NPC / N, and selecting an enteral nutrition preparation.

[0006] Although the above-mentioned existing technologies can all give nutritional supplement prescriptions, they all recommend a single nutritional supplement method. In actual situations, patients can combine multiple nutritional supplement methods to improve the utilization rate of nutrition. Summary of the invention

[0007] In order to solve the above technical problems existing in the prior art, the present invention provides a method and device for recommending nutritional prescriptions based on patient medical record information.

[0008] To achieve the above object, the technical solution of the present invention is as follows:

[0009] In a first aspect, the present invention provides a method for recommending a nutritional prescription based on a patient's medical record information, comprising:

[0010] S1. Calculate the total daily energy target required by the patient;

[0011] S2. Calculate the patient's daily target total protein requirement;

[0012] S3. Determine the nutritional support approach for the patient; specifically include:

[0013] Obtain the patient's latest dietary instructions. For patients without dietary instructions, nutritional support is a combination of diet and enteral nutrition;

[0014] For patients whose dietary instructions are to fast, the nutritional support route is total parenteral nutrition;

[0015] For patients who are prescribed a normal or semi-liquid diet, nutritional support is provided by a combination of dietary and enteral nutrition.

[0016] For patients whose dietary instructions are clear flow, the nutritional support route is a combination of diet, enteral nutrition and parenteral nutrition;

[0017] S4. Give a nutritional prescription based on the results of steps S1-S3.

[0018] Furthermore, in step S4, a nutritional prescription is given, and the specific method includes:

[0019] Set the patient's daily total energy target as Q, and the patient's daily total protein target as S, then,

[0020] For patients without dietary instructions or with general dietary instructions, nutritional support is provided by a combination of dietary and enteral nutrition, where the energy supplemented by the diet is Q1 and the protein is S1, and the energy supplemented by the enteral nutrition is Q2 and the protein supplemented is S2.

[0021] Q2=-Q1

[0022] S2=-S1

[0023] In the above formula, when the patient is male, Q1 is 1200Kcal and S1 is 55g; when the patient is female, Q1 is 1000Kcal and S1 is 50g;

[0024] For patients who are prescribed a semi-liquid diet, the nutritional support is a combination of dietary and enteral nutrition. The dietary supplement is 500 energy and 15 protein, while the enteral nutrition supplement is Q3 energy and S3 protein.

[0025] Q3=Q-500

[0026] S3=-15

[0027] For patients whose diet is clear, the nutritional support is a combination of diet, enteral nutrition and parenteral nutrition; the energy supplement of diet is 200 and the protein is 10, the energy supplement of enteral nutrition is Q3 and the protein supplement is S3, the energy supplement of parenteral nutrition is Q4 and the protein supplement is S4.

[0028] Q3=0.5×(Q-200)

[0029] S3=0.5×(S-10)

[0030] Q4=0.5×(Q-200)

[0031] S4=0.5×(S-10).

[0032] Furthermore, the nutritional prescription given in step S4 also includes confirmation of the type of enteral nutrition preparation, specifically:

[0033] Obtain the patient's confirmed disease information, and determine the patient type based on the disease information. If the patient is a tumor patient, the enteral nutrition preparation is a tumor-type preparation;

[0034] If the patient is on dialysis, the enteral nutrition preparation is a nephrotic preparation;

[0035] If the patient has a disease in the gastrointestinal, hepatobiliary and pancreatic regions, the enteral nutrition preparation is a short peptide preparation;

[0036] If the patient is diabetic, the enteral nutrition preparation is a diabetic-type preparation;

[0037] If the patient is suffering from a disease other than cancer, dialysis, gastrointestinal, hepatobiliary and pancreatic disease, or diabetes, the enteral nutrition preparation shall be a common preparation;

[0038] In addition, the biochemical data of the patient is obtained, and the patient type is determined according to the biochemical data of the patient. If the patient is a hyperglycemic patient, the enteral nutrition preparation is a diabetic preparation;

[0039] If the patient has impaired liver function, the enteral nutrition preparation is a liver-type preparation;

[0040] If the patient has impaired renal function, the enteral nutrition preparation is a nephrotic preparation;

[0041] Among them, all enteral nutrition preparations are selected in order of priority from high to low, and the priority from high to low is: short peptide preparations, liver type preparations, kidney disease type preparations, ordinary type preparations, diabetes type preparations, and tumor type preparations.

[0042] Furthermore, the nutritional prescription given in step S4 also includes the selection of enteral nutrition preparation products, specifically:

[0043] Calculate basic energy consumption BEE:

[0044] Male BEE=66+(13.75×W)+(5×H)-(6.76×A);

[0045] Female BEE=665.1+(9.56×W)+(1.7×H)-(4.67×A);

[0046] Among them, W is weight, H is height, and A is age;

[0047] Calculation of TEE for trauma and stress:

[0048] TEE = BEE × (activity coefficient × stress coefficient + correction coefficient);

[0049] Calculate the patient's daily non-protein calories NPC and nitrogen requirement N:

[0050] Patients with mild malnutrition: NPC = (BEE + TEE) × w / 2; N = βgN / kg / d × W;

[0051] Patients with moderate malnutrition: NPC = (BEE + TEE) / 2; N = βgN / kg / d × W;

[0052] For patients with severe malnutrition: NPC = BEE × 0.9, N = βgN / kg / d × W;

[0053] Wherein, w is a coefficient, and the value of w is a number between 0.6 and 1; gN / kg / d is the daily dosage per kilogram of body weight;

[0054] β is a coefficient, and β takes a value between 0.1 and 0.3;

[0055] Calculate the patient's heat-nitrogen ratio NPC / N and select enteral nutrition preparation products based on the heat-nitrogen ratio.

[0056] Furthermore, the weight W is selected as follows: when the patient's BMI is greater than 25 kg / m 2 , using ideal body weight, when the patient's BMI ≤ 25 kg / m 2 , actual weight is used; the ideal weight = height - 105;

[0057] When the patient is bedridden, the activity coefficient is 1.2;

[0058] When the patient is ambulatory, the activity coefficient is 1.3-1.5;

[0059] When the patient is a tumor patient, the stress coefficient is 1.1;

[0060] When the patient is a non-tumor patient, the stress coefficient is 1;

[0061] The correction factor includes three cumulative items: body temperature>37°C, every 1°C increase, +10%; malnourished patients, +10%; age>70 years old, -10%;

[0062] Patients with mild malnutrition: β = 0.1-0.25;

[0063] Moderately malnourished patients: β = 0.2-0.3;

[0064] Patients with severe malnutrition: β = 0.1-0.25.

[0065] Furthermore, in step S1, the total daily energy target required by the patient is calculated by:

[0066] If the patient's BMI is ≥ 24, the initial target amount Q0 is calculated as:

[0067] Q0=W 校 ×30

[0068] W 校 =0.5×(W 实 -W 理 )+ 理

[0069] Among them, W 校 is the calibration weight, in kg; W 实 is the actual body weight, in kg; W理 is the ideal body weight, in kg; W 理 =H-105, H represents the patient's height, in cm;

[0070] If the patient's BMI is less than 24, the initial target amount Q0 is calculated as:

[0071] Q0=W 实 ×30

[0072] Then, the patient's age and doctor's advice information are obtained, and the total energy target Q is determined based on the patient's age and doctor's advice information:

[0073] Q=b×Q0

[0074] In the above formula, b is the correction coefficient.

[0075] Furthermore, if the age is ≥70 and the doctor's order is not fasting, the correction factor b is 0.9;

[0076] If the age is less than 70 and the doctor's order is fasting, the correction factor b is 0.7;

[0077] If the patient is ≥70 years old and the doctor's order is fasting, the correction factor b is 0.65;

[0078] If the patient is younger than 70 years old and the doctor's order is not fasting, the correction factor b is 1.

[0079] Furthermore, in step S2, the target amount of total protein required by the patient per day is calculated by:

[0080] S=f×W 实

[0081] In the above formula, f represents the correction factor.

[0082] Furthermore, the latest biochemical data and disease diagnosis information of the patient are obtained to determine whether the patient's liver or kidney function is abnormal.

[0083] If the patient has abnormal liver function or abnormal kidney function, it is determined whether the patient is a dialysis patient.

[0084] If the patient is a dialysis patient, the correction factor f is taken as 0.8;

[0085] If the patient is a non-dialysis patient, the correction factor f takes the value of 1;

[0086] If the patient's liver function is normal and the kidney function is normal, then determine whether the patient's prealbumin data is abnormal.

[0087] If prealbumin is normal, the correction factor f is 1.2;

[0088] If the prealbumin is lower than the lower limit of prealbumin and higher than the abnormal value, the correction factor f is 1.5;

[0089] If the prealbumin level is below the lower limit, the correction factor f is set to 1.6.

[0090] Furthermore, if the patient has abnormal liver function or abnormal kidney function, the determined correction coefficient is corrected twice, and the specific method is as follows:

[0091] Obtain the patient's biochemical data and form a vector R in the order of alanine aminotransferase, aspartate aminotransferase, alkaline aminotransferase, glutamyl transpeptidase, total protein, albumin, globulin, albumin-globulin ratio, total bilirubin, indirect bilirubin, direct bilirubin, and alpha-fetoprotein. The vector R = r1, r2, ... r i ……, r 12 ], where r i Represents biochemical data; judge r i Whether it is within the normal range of the corresponding biochemical index, generate the directional value k of the biochemical index i ;

[0092] If r i If the value is lower than the lower limit of the corresponding biochemical index, k i is 0.5;

[0093] If r i If it is higher than the upper limit of the corresponding biochemical index, then k i is 1;

[0094] If r i If the corresponding biochemical index is within the normal range, then k i is 0;

[0095] Finally, the patient's pointing vector K is formed, K = k1, k2, ... k i ..., k 12 ], find the modulus |K| of vector K, then the quadratic correction coefficient t is

[0096]

[0097] If the pointing vector K is a zero vector, then t takes the value 1;

[0098] The total protein target required by the patient every day is as follows:

[0099] S=t×f×W 实 .

[0100] In a second aspect, the present invention provides a nutrition prescription recommendation device based on patient medical record information, which is used to execute the above-mentioned nutrition prescription recommendation method based on patient medical record information, and the nutrition prescription recommendation device includes:

[0101] A data reading module, which is connected to the hospital's medical system and is used to obtain the patient's basic information, disease diagnosis information, and biochemical data;

[0102] A calculation module, which can receive data sent by the data reading module and is used to calculate the total energy target amount and total protein target amount required by the patient every day;

[0103] A prescription issuing module, which issues a nutritional prescription based on the patient's daily target total energy and total protein, as well as the patient's basic information, disease diagnosis information, and biochemical data.

[0104] Compared with the prior art, the present invention has the following beneficial effects:

[0105] The nutritional prescription recommendation method based on the patient's medical record information provided by the present invention includes three nutritional supplementation methods: diet, enteral nutrition, and parenteral nutrition. It is more in line with the actual situation, and is more conducive to the patient's nutritional supplementation and improves the nutritional utilization rate.

[0106] In addition, the nutritional prescription recommended by the present invention not only includes three nutritional supplementation methods, but also provides the specific energy and protein supplementation amounts of each nutritional supplementation method, and also includes the types of enteral nutrition preparations and specific products, etc. Patients can effectively implement them according to the nutritional prescription, and the executability is high. BRIEF DESCRIPTION OF THE DRAWINGS

[0107] Figure 1 It is a logic diagram of the method of the present invention. DETAILED DESCRIPTION

[0108] The technical solution of the present invention will be clearly described below in conjunction with the accompanying drawings. Obviously, the described embodiments are not all embodiments of the present invention, and all other embodiments obtained by ordinary technicians in the field without making creative work are within the protection scope of the present invention.

[0109] It should be noted that, unless otherwise specifically stated, the relative arrangements of components and steps, and numerical expressions set forth in these embodiments should not be construed as limiting the scope of the present invention.

[0110] The following description of the exemplary embodiments is merely illustrative and is not intended to limit the present invention and its application or use in any sense. Techniques, methods and devices known to ordinary technicians in the relevant field may not be discussed in detail here, but where applicable, these techniques, methods and devices should be considered as part of this specification.

[0111] The present invention provides a method for recommending nutritional prescriptions based on patient medical record information. Figure 1 Shown is the logic diagram of the method, including:

[0112] S1. Calculate the total daily energy target required by the patient; the specific method is:

[0113] If the patient's BMI is ≥ 24, the initial target amount Q0 is calculated as:

[0114] Q0=W 校 ×30

[0115] W 校 =0.5×(W 实 -W 理 )+W 理

[0116] Among them, W 校 is the calibration weight, in kg; W 实 is the actual body weight, in kg; W 理 is the ideal body weight, in kg; W 理 =H-105, H represents the patient's height in cm; the initial target amount Q0 is in Kcal / d, which represents the daily energy required;

[0117] If the patient's BMI is less than 24, the initial target amount Q0 is calculated as:

[0118] Q0= 实 ×30

[0119] Then, the patient's age and doctor's advice information are obtained, and the total energy target Q is determined based on the patient's age and doctor's advice information:

[0120] Q=b×Q0

[0121] In the above formula, b is the correction coefficient.

[0122] The correction factor is determined according to age and doctor's orders. If the age is ≥70 and the doctor's orders are not fasting, the correction factor b is 0.9;

[0123] If the age is less than 70 and the doctor's order is fasting, the correction factor b is 0.7;

[0124] If the patient is ≥70 years old and the doctor's order is fasting, the correction factor b is 0.65;

[0125] If the patient is younger than 70 years old and the doctor's order is not fasting, the correction factor b is 1.

[0126] S2. Calculate the total protein target required by the patient daily; the specific method is:

[0127] S=f×W 实

[0128] In the above formula, f represents the correction factor.

[0129] Obtain the patient's latest biochemical data and disease diagnosis information to determine whether the patient's liver or kidney function is abnormal.

[0130] If the patient has abnormal liver function or abnormal kidney function, it is determined whether the patient is a dialysis patient.

[0131] If the patient is a dialysis patient, the correction factor f is taken as 0.8;

[0132] If the patient is a non-dialysis patient, the correction factor f takes the value of 1;

[0133] If the patient's liver function is normal and the kidney function is normal, then determine whether the patient's prealbumin data is abnormal.

[0134] If prealbumin is normal, the correction factor f is 1.2;

[0135] If the prealbumin is lower than the lower limit of prealbumin and higher than the abnormal value, the correction factor f is 1.5;

[0136] If the prealbumin level is below the lower limit, the correction factor f is set to 1.6.

[0137] Among them, the lower limit of prealbumin is determined by the detection equipment, and the abnormal value of the lower limit is set as needed, preferably set to 0.8 times the lower limit. If the prealbumin is lower than the lower limit of prealbumin and higher than the abnormal value, it indicates that the degree of prealbumin deficiency is relatively mild; if the prealbumin is lower than the abnormal value of the lower limit, it indicates that the degree of prealbumin deficiency is relatively serious. For example, the normal range of prealbumin in adults is 280-360 mg / L. Some detection equipment uses 280 as the lower limit, then the abnormal value can be set to 224 mg / L. If the prealbumin is lower than 280 and higher than 224, the correction coefficient f takes a value of 1.5; if the prealbumin is lower than 224, the correction coefficient f takes a value of 1.6.

[0138] Since the degree of abnormal liver function or abnormal renal function of patients is different, if the patient has abnormal liver function or abnormal renal function, the determined correction coefficient is corrected twice. The specific method is as follows:

[0139] Obtain the patient's biochemical data and form a vector R in the order of alanine aminotransferase, aspartate aminotransferase, alkaline aminotransferase, glutamyl transpeptidase, total protein, albumin, globulin, albumin-globulin ratio, total bilirubin, indirect bilirubin, direct bilirubin, and alpha-fetoprotein. The vector R = r1, r2, ... r i ……, r 12 ], where r i Represents biochemical data; judge r iWhether it is within the normal range of the corresponding biochemical index, generate the directional value k of the biochemical index i ;

[0140] If r i If the value is lower than the lower limit of the corresponding biochemical index, k i is 0.5;

[0141] If r i If it is higher than the upper limit of the corresponding biochemical index, then k i is 1;

[0142] If r i If the corresponding biochemical index is within the normal range, then k i is 0;

[0143] Finally, the patient's pointing vector K is formed, K = k1, k2, ... k i ..., k 12 ], find the modulus |K| of vector K, then the quadratic correction coefficient t is

[0144]

[0145] If the pointing vector K is a zero vector, then t takes the value 1.

[0146] The total protein target required by the patient every day is as follows:

[0147] S=t×f×W 实 .

[0148] S3. Determine the nutritional support approach for the patient; specifically include:

[0149] Obtain the patient's latest dietary instructions. For patients without dietary instructions, nutritional support is a combination of diet and enteral nutrition;

[0150] For patients whose dietary instructions are to fast, the nutritional support route is total parenteral nutrition;

[0151] For patients who are prescribed a normal or semi-liquid diet, nutritional support is provided by a combination of dietary and enteral nutrition.

[0152] For patients whose dietary instructions are clear flow, the nutritional support route is a combination of diet, enteral nutrition and parenteral nutrition;

[0153] S4, according to the results of steps S1-S3, give a nutritional prescription. The specific method includes:

[0154] Set the patient's daily total energy target as Q, and the patient's daily total protein target as S, then,

[0155] For patients whose dietary instructions are to fast, the nutritional support route is total parenteral nutrition, and the energy and protein supplements are supplemented according to Q and S;

[0156] For patients without dietary instructions or with general dietary instructions, nutritional support is provided by a combination of dietary and enteral nutrition, where the energy supplemented by the diet is Q1 and the protein is S1, and the energy supplemented by the enteral nutrition is Q2 and the protein supplemented is S2.

[0157] Q2=-Q1

[0158] S2=-S1

[0159] In the above formula, when the patient is male, Q1 is 1200Kcal and S1 is 55g; when the patient is female, Q1 is 1000Kcal and S1 is 50g;

[0160] For patients who are prescribed a semi-liquid diet, the nutritional support is a combination of dietary and enteral nutrition. The dietary supplement is 500 energy and 15 protein, while the enteral nutrition supplement is Q3 energy and S3 protein.

[0161] Q3=Q-500

[0162] S3=-15

[0163] For patients whose diet is clear, the nutritional support is a combination of diet, enteral nutrition and parenteral nutrition; the energy supplement of diet is 200 and the protein is 10, the energy supplement of enteral nutrition is Q3 and the protein supplement is S3, the energy supplement of parenteral nutrition is Q4 and the protein supplement is S4.

[0164] Q3=0.5×(Q-200)

[0165] S3=0.5×(S-10)

[0166] Q4=0.5×(Q-200)

[0167] S4=0.5×(S-10).

[0168] The nutritional prescription given also includes confirmation of the type of enteral nutrition preparation, specifically:

[0169] Obtain the patient's confirmed disease information, and determine the patient type based on the disease information. If the patient is a tumor patient, the enteral nutrition preparation is a tumor-type preparation;

[0170] If the patient is on dialysis, the enteral nutrition preparation is a nephrotic preparation;

[0171] If the patient has a disease in the gastrointestinal, hepatobiliary and pancreatic regions, the enteral nutrition preparation is a short peptide preparation;

[0172] If the patient is diabetic, the enteral nutrition preparation is a diabetic-type preparation;

[0173] If the patient is suffering from a disease other than cancer, dialysis, gastrointestinal, hepatobiliary and pancreatic disease, or diabetes, the enteral nutrition preparation shall be a common preparation;

[0174] In addition, the biochemical data of the patient is obtained, and the patient type is determined according to the biochemical data of the patient. If the patient is a hyperglycemic patient, the enteral nutrition preparation is a diabetic preparation;

[0175] If the patient has impaired liver function, the enteral nutrition preparation is a liver-type preparation;

[0176] If the patient has impaired renal function, the enteral nutrition preparation is a nephrotic preparation;

[0177] Among them, all enteral nutrition preparations are selected in order of priority from high to low, and the priority from high to low is: short peptide preparations, liver preparations, kidney preparations, common preparations, diabetes preparations, and tumor preparations. That is, if the patient meets multiple conditions of the above enteral nutrition preparations at the same time, the enteral nutrition preparation with the highest level of priority will be selected for supplementation.

[0178] The nutritional prescription given also includes the selection of enteral nutrition preparation products, specifically:

[0179] Calculate basic energy consumption BEE:

[0180] Male BEE=66+(13.75×W)+(5×H)-(6.76×A);

[0181] Female BEE=665.1+(9.56×W)+(1.7×H)-(4.67×A);

[0182] Where W is weight, in kg; H is height, in cm; A is age;

[0183] Calculation of TEE for trauma and stress:

[0184] TEE = BEE × (activity coefficient × stress coefficient + correction coefficient);

[0185] Calculate the patient's daily non-protein calories NPC and nitrogen requirement N:

[0186] Patients with mild malnutrition: NPC = (BEE + TEE) × w / 2; N = βgN / kg / d × W;

[0187] Patients with moderate malnutrition: NPC = (BEE + TEE) / 2; N = βgN / kg / d × W;

[0188] For patients with severe malnutrition: NPC = BEE × 0.9, N = βgN / kg / d × W;

[0189] Wherein, w is a coefficient, and the value of w is a number between 0.6 and 1; gN / kg / d is the daily dosage per kilogram of body weight;

[0190] β is a coefficient, and β takes a value between 0.1 and 0.3;

[0191] Calculate the patient's NPC / N ratio and select an enteral nutrition product based on the NPC / N ratio. Select an enteral nutrition product with a NPC / N ratio that is closest to the patient's NPC / N ratio.

[0192] The weight W is selected as follows: when the patient's BMI is greater than 25 kg / m 2 , using ideal body weight, when the patient's BMI ≤ 25 kg / m 2 , actual weight is used; the ideal weight = height - 105;

[0193] When the patient is bedridden, the activity coefficient is 1.2;

[0194] When the patient is ambulatory, the activity coefficient is 1.3-1.5;

[0195] When the patient is a tumor patient, the stress coefficient is 1.1;

[0196] When the patient is a non-tumor patient, the stress coefficient is 1;

[0197] The correction factor includes three cumulative items: body temperature>37°C, every 1°C increase, +10%; malnourished patients, +10%; age>70 years old, -10%;

[0198] Patients with mild malnutrition: β = 0.1-0.25;

[0199] Moderately malnourished patients: β = 0.2-0.3;

[0200] Patients with severe malnutrition: β = 0.1-0.25.

[0201] The nutritional prescription given also includes the determination of the quantity of enteral nutrition preparation products, including:

[0202] The quantity of the product is calculated based on the minimum specification of g or ml, and then determined according to the sales unit. If it is less than an integer sales unit, it will be calculated as 0.5 sales unit if it is less than 0.5 sales unit, and it will be calculated as 1 sales unit if it is more than 0.5 sales unit.

[0203] The minimum specification quantity required for energy = energy supplemented by enteral nutrition / energy contained in every 100 grams or 100 milliliters of the product, where the energy supplemented by enteral nutrition is Q2 or Q3.

[0204] Product protein = minimum specification quantity required for energy × protein content of the product per 100 grams or per 100 milliliters. Then calculate the sum of product protein, dietary recommended protein and parenteral protein. If the patient's daily total protein target is greater than the total, additional protein preparations are recommended according to the difference. It can be a dietary supplement, or it can be an enteral nutrition preparation or a parenteral nutrition preparation.

[0205] In a second aspect, the present invention provides a nutrition prescription recommendation device based on patient medical record information, which is used to execute the above-mentioned nutrition prescription recommendation method based on patient medical record information, and the nutrition prescription recommendation device includes:

[0206] A data reading module, which is connected to the hospital's medical system and is used to obtain the patient's basic information, disease diagnosis information, and biochemical data;

[0207] A calculation module, which can receive data sent by the data reading module and is used to calculate the total energy target amount and total protein target amount required by the patient every day;

[0208] A prescription issuing module, which issues a nutritional prescription based on the patient's daily target total energy and total protein, as well as the patient's basic information, disease diagnosis information, and biochemical data.

[0209] Embodiment 1

[0210] Patient information: male, height 172cm, weight 62.5kg, BMI 21.13kg / m 2 , 60 years old, intestinal cancer, ambulatory, body temperature 36.4℃, moderate malnutrition, biochemical data showed that high transaminase and total bilirubin led to abnormal liver and kidney function, no underlying diabetes, and the diet prescribed by the doctor was normal food.

[0211] The total daily energy target required by the patient is calculated as Q = 62.5 × 30 = 1875.

[0212] The total protein target required by the patient per day is calculated as S = 0.84 × 62.5 = 52.56.

[0213] Confirm the support route required by the patient. If the patient's doctor's order is general diet, the nutritional support route is a combination of dietary and enteral nutrition.

[0214] Among them, the daily dietary energy supplement is 1200Kcal, protein 55g, and the daily enteral nutrition energy supplement is 1875-1200=675Kcal. No protein supplement is required for enteral nutrition.

[0215] Confirm the type of enteral preparation for the patient. If the patient has intestinal cancer, the enteral nutrition preparation is a short peptide preparation. If the liver function is abnormal and the patient meets the liver-type preparation requirements, it will be determined as a short peptide preparation according to priority.

[0216] Determine the enteral nutrition product the patient needs

[0217] According to the formula, the patient's thermal nitrogen ratio NPC / N is calculated to be 1745.4155 / 15.625≈112 / 1. Among the known short peptide preparation product library, the product closest to 112 is Weiyuanjia (thermal nitrogen ratio is 108), so Weiyuanjia is recommended.

[0218] Confirm the quantity of enteral preparation products for the patient, Weiyuanjia 400g / box, energy 404.5Kcal per 100g, protein 16g per 100g.

[0219] Minimum quantity required for energy = enteral nutrition energy / product energy per 100g = 675 / 4.045 = 167g;

[0220] Quantity sold = 167 / 400 ≈ 0.5 boxes;

[0221] Protein supplement amount = 200g × 0.16g = 32g. At the same time, it can also supplement the amount of protein needed in the intestine, but enteral nutrition does not require protein supplementation. Therefore, the protein supplemented here may not be absorbed.

[0222] Embodiment 2

[0223] Patient information: female, height 165cm, weight 70kg, BMI 25.71kg / m 2 , 75 years old, hemodialysis patient, ambulatory, body temperature 36.6℃, mild malnutrition, biochemical data showed abnormal renal function due to high creatinine, no underlying diabetes, and the dietary advice was normal food.

[0224] Ideal body weight is 60kg, calibrated body weight = (70-60) / 2+60 = 65kg;

[0225] The total daily energy target required by the patient is calculated as Q = 0.9 × 65 × 30 = 1755.

[0226] The total protein target required by the patient per day is calculated as S = 0.8 × 70 = 56.

[0227] Confirm the support route required by the patient. If the patient's doctor's order is general diet, the nutritional support route is a combination of dietary and enteral nutrition.

[0228] Among them, the daily dietary energy supplement is 1000Kcal and protein is 50g, the daily enteral nutrition energy supplement is 1755-1000=755Kcal, and the enteral nutrition protein supplement is 6g.

[0229] Confirm the type of enteral preparation for the patient. If the patient is on dialysis, the enteral nutrition preparation should be a nephrotic type preparation.

[0230] Determine the enteral nutrition product the patient needs

[0231] According to the formula, the patient's heat-nitrogen ratio NPC / N is calculated to be 1402.74 / 12≈117 / 1. Among the known kidney-type preparation product library, the one closest to 117 is Yangletuo Protein Energy Nutrition Powder (heat-nitrogen ratio is 119), so it is recommended to use Yangletuo Protein Energy Nutrition Powder.

[0232] Confirm the quantity of enteral preparation products for the patient, Yangletou protein energy nutritional powder 23.5g / bag, 12 bags / box, energy 498Kcal per 100g, protein 16g per 100g.

[0233] Minimum quantity required for energy = enteral nutrition energy / product energy per 100g = 755 / 4.98 = 151.6g;

[0234] Quantity sold = 151.6 / 23.5≈6.45 bags, confirmed as 1 box;

[0235] Protein supplement amount = 151.6 × 0.16g = 24.256g, which is 6g greater than the amount of protein supplement required in the intestine, and therefore can meet the patient's daily protein supplement requirement.

[0236] The above specific implementation methods are only used to illustrate the technical solution of the present invention rather than to limit it. Although the present invention has been described in detail with reference to examples, a person skilled in the art should understand that the technical solution of the present invention can be modified or replaced by equivalents without departing from the scope of the technical solution of the present invention, which should be included in the scope of the claims of the present invention.

Claims

1. A method for recommending nutritional prescriptions based on patient medical record information, characterized in that: include: S1. Calculate the total daily energy target required by the patient; S2. Calculate the patient's daily target total protein requirement; S3. Determine the nutritional support approach for the patient; Specifically include: Obtain the patient's latest dietary instructions. For patients without dietary instructions, nutritional support is a combination of diet and enteral nutrition; For patients whose dietary instructions are to fast, the nutritional support route is total parenteral nutrition; For patients who are prescribed a normal or semi-liquid diet, nutritional support is provided by a combination of dietary and enteral nutrition. For patients whose dietary instructions are clear flow, the nutritional support route is a combination of diet, enteral nutrition and parenteral nutrition; S4. Give a nutritional prescription based on the results of steps S1-S3.

2. The method for recommending nutritional prescriptions according to claim 1, characterized in that: In step S4, a nutritional prescription is given, and the specific method includes: Set the patient's daily total energy target as Q, and the patient's daily total protein target as S, then, For patients without dietary instructions or with general dietary instructions, nutritional support is provided by a combination of dietary and enteral nutrition, where the energy supplemented by the diet is Q1 and the protein is S1, and the energy supplemented by the enteral nutrition is Q2 and the protein supplemented is S2. Q2=Q-Q1 S2=S-S1 In the above formula, when the patient is male, Q1 is 1200Kcal and S1 is 55g; when the patient is female, Q1 is 1000Kcal and S1 is 50g; For patients who are prescribed a semi-liquid diet, the nutritional support is a combination of dietary and enteral nutrition. The dietary supplement is 500 energy and 15 protein, while the enteral nutrition supplement is Q3 energy and S3 protein. Q3=Q-500 S3=S-15 For patients whose diet is clear, the nutritional support is a combination of diet, enteral nutrition and parenteral nutrition; the energy supplement of diet is 200 and the protein is 10, the energy supplement of enteral nutrition is Q3 and the protein supplement is S3, the energy supplement of parenteral nutrition is Q4 and the protein supplement is S4. Q3=0.5×(Q-200) S3=0.5×(S-10) Q4=0.5×(Q-200) S4=0.5×(S-10).

3. The method for recommending nutritional prescriptions according to claim 2, characterized in that: The nutritional prescription is given in step S4, and also includes confirmation of the type of enteral nutrition preparation, specifically: Obtain the patient's confirmed disease information, and determine the patient type based on the disease information. If the patient is a tumor patient, the enteral nutrition preparation is a tumor-type preparation; If the patient is on dialysis, the enteral nutrition preparation is a nephrotic preparation; If the patient has a disease in the gastrointestinal, hepatobiliary and pancreatic regions, the enteral nutrition preparation is a short peptide preparation; If the patient is diabetic, the enteral nutrition preparation is a diabetic-type preparation; If the patient is suffering from a disease other than cancer, dialysis, gastrointestinal, hepatobiliary and pancreatic disease, or diabetes, the enteral nutrition preparation shall be a common preparation; In addition, the biochemical data of the patient is obtained, and the patient type is determined according to the biochemical data of the patient. If the patient is a hyperglycemic patient, the enteral nutrition preparation is a diabetic preparation; If the patient has impaired liver function, the enteral nutrition preparation is a liver-type preparation; If the patient has impaired renal function, the enteral nutrition preparation is a nephrotic preparation; Among them, all enteral nutrition preparations are selected in order of priority from high to low, and the priority from high to low is: short peptide preparations, liver type preparations, kidney disease type preparations, ordinary type preparations, diabetes type preparations, and tumor type preparations.

4. The method for recommending nutritional prescriptions according to claim 3, characterized in that: In step S4, a nutritional prescription is given, which also includes the selection of enteral nutrition preparation products, specifically: Calculate basic energy consumption BEE: Male BEE=66+(13.75×W)+(5×H)-(6.76×A); Female BEE=665.1+(9.56×W)+(1.7×H)-(4.67×A); Among them, W is weight, H is height, and A is age; Calculation of TEE for trauma and stress: TEE = BEE × (activity coefficient × stress coefficient + correction coefficient); Calculate the patient's daily non-protein calories NPC and nitrogen requirement N: Patients with mild malnutrition: NPC = (BEE + TEE) × w / 2; N = βgN / kg / d × W; Moderately malnourished patients: NPC = (BEE + TEE) / 2; N = βgN / kg / d × W; For patients with severe malnutrition: NPC = BEE × 0.9, N = βgN / kg / d × W; Wherein, w is a coefficient, and the value of w is a number between 0.6 and 1; gN / kg / d is the daily dosage per kilogram of body weight; β is a coefficient, and β takes a value between 0.1 and 0.3; Calculate the patient's heat-nitrogen ratio NPC / N and select enteral nutrition preparation products based on the heat-nitrogen ratio.

5. The method for recommending nutritional prescriptions according to claim 4, characterized in that: The method for selecting the weight W is: when the patient's BMI is greater than 25 kg / m 2 , using ideal body weight, when the patient's BMI ≤ 25 kg / m 2 , actual weight is used; the ideal weight = height - 105; When the patient is bedridden, the activity coefficient is 1.2; When the patient is ambulatory, the activity coefficient is 1.3-1.5; When the patient is a tumor patient, the stress coefficient is 1.1; When the patient is a non-tumor patient, the stress coefficient is 1; The correction factor includes three cumulative items: for body temperature > 37°C, +10% for every 1°C increase; for malnourished patients, +10%; Age > 70 years, -10%; Patients with mild malnutrition: β = 0.1-0.25; Moderately malnourished patients: β = 0.2-0.3; Patients with severe malnutrition: β = 0.1-0.

25.

6. The method for recommending nutritional prescriptions according to claim 1, characterized in that: In step S1, the total daily energy target required by the patient is calculated by: If the patient's BMI is ≥ 24, the initial target amount Q0 is calculated as: Q0=W 校 ×30 IN 校 =0.5×(W 实 -IN 理 )+W 理 Wherein, Wcalibration is the calibration weight, in kg; Wactual is the actual weight, in kg; Wrational is the ideal weight, in kg; W 理 =H-105, H represents the patient's height, in cm; If the patient's BMI is less than 24, the initial target amount Q0 is calculated as: Q0=W 实 ×30 Then, the patient's age and doctor's advice information are obtained, and the total energy target Q is determined based on the patient's age and doctor's advice information: Q=b×Q0 In the above formula, b is the correction coefficient; If the age is ≥70 and the doctor's order is not fasting, the correction factor b is 0.9; If the age is less than 70 and the doctor's order is fasting, the correction factor b is 0.7; If the patient is ≥70 years old and the doctor's order is fasting, the correction factor b is 0.65; If the patient is younger than 70 years old and the doctor's order is not fasting, the correction factor b is 1.

7. The method for recommending nutritional prescriptions according to claim 1, characterized in that: In step S2, the target amount of total protein required by the patient per day is calculated as follows: S=f×W 实 In the above formula, f represents the correction factor.

8. The method for recommending nutritional prescriptions according to claim 7, characterized in that: Obtain the patient's latest biochemical data and disease diagnosis information to determine whether the patient's liver or kidney function is abnormal. If the patient has abnormal liver function or abnormal kidney function, it is determined whether the patient is a dialysis patient. If the patient is a dialysis patient, the correction factor f is taken as 0.8; If the patient is a non-dialysis patient, the correction factor f takes the value of 1; If the patient's liver function is normal and the kidney function is normal, then determine whether the patient's prealbumin data is abnormal. If prealbumin is normal, the correction factor f is 1.2; If the prealbumin is lower than the lower limit of prealbumin and higher than the abnormal value, the correction factor f is 1.5; If the prealbumin level is below the lower limit, the correction factor f is set to 1.

6.

9. The method for recommending nutritional prescriptions according to claim 8, characterized in that: If the patient has abnormal liver function or abnormal kidney function, the determined correction coefficient shall be corrected twice. The specific method is as follows: Obtain the patient's biochemical data and form a vector R in the order of alanine aminotransferase, aspartate aminotransferase, alkaline aminotransferase, glutamyl transpeptidase, total protein, albumin, globulin, albumin-globulin ratio, total bilirubin, indirect bilirubin, direct bilirubin, and alpha-fetoprotein. The vector R = [r1, r2, ... r i ……, r 12 ], where r i Represents biochemical data; judge r i Whether it is within the normal range of the corresponding biochemical index, generate the directional value k of the biochemical index i ; If r i If the value is lower than the lower limit of the corresponding biochemical index, k i is 0.5; If r i If it is higher than the upper limit of the corresponding biochemical index, then k i is 1; If r i If the corresponding biochemical index is within the normal range, then k i is 0; Finally, the patient's pointing vector K is formed, K = [k1, k2, ... k i ..., k 12 ], find the modulus |K| of vector K, then the quadratic correction coefficient t is If the pointing vector K is a zero vector, then t takes the value 1; The total protein target required by the patient every day is as follows: S=t×f×W 实 。 10. A nutritional prescription recommendation device based on patient medical record information, used to execute the nutritional prescription recommendation method based on patient medical record information according to any one of claims 1 to 9, characterized in that: The nutrition prescription recommendation device comprises: A data reading module, which is connected to the hospital's medical system and is used to obtain the patient's basic information, disease diagnosis information, and biochemical data; A calculation module, which can receive data sent by the data reading module and is used to calculate the total energy target amount and total protein target amount required by the patient every day; A prescription issuing module, which issues a nutritional prescription based on the patient's daily target total energy and total protein, as well as the patient's basic information, disease diagnosis information, and biochemical data.

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