Quantitative Assessment and Feeding Regulation Recommendation System for Postoperative Enteral Nutrition Tolerance in General Surgery

Abstract

This invention discloses a quantitative assessment and feeding regulation recommendation system for postoperative enteral nutrition tolerance in general surgery, relating to the field of clinical nutritional support. It includes a data acquisition module, a quantitative scoring module, a trend analysis module, a status determination module, a recommendation output module, and a periodic recording module. The data acquisition module determines the assessment frequency according to postoperative time stages and forms the current assessment cycle. The quantitative scoring module obtains nutritional tolerance scores and dominant abnormal indicators based on gastric residual volume, degree of abdominal distension, frequency of diarrhea, vomiting and regurgitation, and abdominal signs. The trend analysis module determines the current tolerance trend. The status determination module determines the current feeding status. The recommendation output module outputs feeding regulation recommendations. The periodic recording module is used to maintain or switch subsequent recommendations. This invention can improve the continuity, relevance, and stability of feeding regulation recommendation generation.

Description

Technical Field

[0001] This invention relates to the field of clinical nutritional support, and more specifically, to a system for quantitative assessment of postoperative enteral nutrition tolerance and feeding regulation recommendations in general surgery. Background Technology

[0002] During enteral nutrition support after general surgery, tolerance levels such as gastric residual volume, abdominal distension, diarrhea, vomiting and regurgitation, and abdominal signs continuously change with the postoperative recovery stage and the progress of feeding. Clinically, it is usually necessary to determine whether to maintain, increase, reduce, or suspend feeding based on these manifestations. Current management methods mostly rely on nurses' judgment of individual symptoms, single records, or experience thresholds. Although this can form some observation results, there is a lack of uniform division of assessment frequency at different postoperative stages, a lack of quantitative integration of multiple tolerance indicators within the same assessment cycle, a lack of clear distinction between the source of abnormality and the overall tolerance level, and a lack of a continuous comparison mechanism between pre- and post-assessment results to determine improvement, stabilization, or deterioration. Under these circumstances, even if data such as gastric residual volume and the number of diarrhea episodes can be recorded, it is difficult to consistently generate feeding rate adjustment suggestions, nutrient solution concentration adjustment suggestions, nutrient solution temperature control suggestions, and nursing intervention prompts that match the current tolerance status. This can easily lead to scattered suggestions, delayed suggestion switching, or inconsistent output from different personnel.

[0003] The current technical problem to be solved is how to establish a quantitative assessment and feeding regulation suggestion generation mechanism for postoperative enteral nutrition support in general surgery, so that the system can continuously and stably output feeding regulation suggestions based on multiple tolerance indicators, changes in the previous and subsequent cycles and the main sources of abnormalities within the same assessment period. Summary of the Invention

[0004] To overcome the aforementioned deficiencies of the prior art, embodiments of the present invention provide a quantitative assessment and feeding regulation recommendation system for postoperative enteral nutrition tolerance in general surgery, in order to solve the problems of inconsistent tolerance assessment standards, unclear identification of abnormal sources, insufficient connection between pre- and post-assessment results, and scattered basis for feeding regulation recommendation output in the process of postoperative enteral nutrition support in general surgery.

[0005] To achieve the above objectives, the present invention provides the following technical solution: A quantitative assessment and feeding regulation recommendation system for postoperative enteral nutrition tolerance in general surgery, including: The data acquisition module acquires the tolerance assessment data of the subject within the current assessment cycle, determines the assessment frequency based on the different time stages of the subject after surgery, and divides the current assessment cycle according to the determined assessment frequency. The tolerance assessment data includes gastric residual volume, degree of abdominal distension, frequency of diarrhea, vomiting and reflux, and abdominal signs. The quantitative scoring module assigns scores based on gastric residual volume, degree of abdominal distension, frequency of diarrhea, vomiting and reflux, and abdominal signs to obtain the nutritional tolerance score for the current assessment period. The dominant abnormal indicators for the current assessment period are determined based on the scores of each indicator. The trend analysis module continuously acquires the nutritional tolerance score and dominant abnormal indicators for each assessment period, forming a scoring sequence arranged in chronological order. Based on the changes in nutritional tolerance score between the current assessment period and the adjacent previous assessment period in the scoring sequence, the current tolerance change trend is determined. The status determination module determines the current feeding status as incremental maintenance, restricted maintenance, reduced intervention, or pause recovery based on the nutritional tolerance score, dominant abnormal indicators, and tolerance change trend of the current assessment period. The output module suggests feeding control recommendations based on the current feeding status. These recommendations include suggestions for adjusting feeding speed, adjusting nutrient solution concentration, controlling nutrient solution temperature, and providing nursing intervention prompts. In subsequent evaluation cycles, the module also provides maintenance or switching recommendations for the feeding control recommendations based on the updated nutritional tolerance score, dominant abnormal indicators, and tolerance change trends.

[0006] Preferably, the data acquisition module includes: The phase division unit obtains the postoperative duration corresponding to the current assessment time of the subject and divides the subject into the initial feeding period of 6-24 hours after surgery, the feeding incremental period of 24-72 hours after surgery, or the stable feeding period after 72 hours after surgery based on the postoperative duration. The frequency determination unit determines the assessment frequency as follows: once every 4 hours when the subject is in the initial feeding period, once every 6 hours when the subject is in the feeding increment period, and once every 12 hours when the subject is in the stable feeding period. The cycle is divided into units, with the current assessment time as the end point. The current assessment cycle is formed by backtracking according to the determined assessment frequency. The gastric residual volume, degree of abdominal distension, number of diarrhea, vomiting and reflux, and abdominal signs in the current assessment cycle are marked as tolerance assessment data of the same current assessment cycle.

[0007] Preferably, the quantitative scoring module includes: The single-item scoring unit reads the gastric residual volume, degree of abdominal distension, frequency of diarrhea, vomiting and reflux, and abdominal signs within the current assessment period, and assigns scores according to the four-level grading standard corresponding to each indicator. The four-level scores for each indicator are 0, 2, 4, and 6 points, respectively. The summation scoring unit sums the scores for gastric residual volume, abdominal distension, frequency of diarrhea, vomiting and regurgitation, and abdominal signs to obtain the nutritional tolerance score for the current assessment period.

[0008] Preferably, the quantitative scoring module further includes: The scoring comparison unit obtains the scores for gastric residual volume, abdominal distension, frequency of diarrhea, vomiting and regurgitation, and abdominal signs within the current assessment period, and compares the scores for gastric residual volume, abdominal distension, frequency of diarrhea, vomiting and regurgitation, and abdominal signs. The dominant abnormal indicator determination unit identifies the indicator with the highest score as the dominant abnormal indicator for the current assessment period. When two or more indicators have the same score, the dominant abnormal indicator for the current assessment period is determined in the following priority order: vomiting and regurgitation, gastric residual volume, abdominal signs, frequency of diarrhea, and degree of abdominal distension.

[0009] Preferably, the trend analysis module includes: The sequence forming unit acquires the nutritional tolerance score and dominant abnormal indicators for the current assessment period, and arranges them in chronological order with the nutritional tolerance scores and dominant abnormal indicators for the previous assessment period to form a scoring sequence. The difference calculation unit extracts the nutritional tolerance score of the current assessment period and the nutritional tolerance score of the adjacent previous assessment period in the scoring sequence, and calculates the difference between the two scores. The trend determination unit determines the current tolerance change trend as an improving trend when the score difference is less than zero, as a stable trend when the score difference is equal to zero, and as a deteriorating trend when the score difference is greater than zero.

[0010] Preferably, the state determination module includes: The tolerance level determination unit obtains the nutritional tolerance score, dominant abnormal indicators, and current tolerance change trend for the current assessment period. When the nutritional tolerance score is in the range of 0-6, it is determined as the first tolerance level; when the nutritional tolerance score is in the range of 7-12, it is determined as the second tolerance level; when the nutritional tolerance score is in the range of 13-18, it is determined as the third tolerance level; and when the nutritional tolerance score is 19 or above, it is determined as the fourth tolerance level. The feeding status assessment unit determines the current feeding status as follows: when the nutritional tolerance score is 0-6 and the current tolerance trend is improving or stable, the current feeding status is classified as increasing maintenance; when the nutritional tolerance score is 0-6 and the current tolerance trend is worsening, the current feeding status is classified as restrictive maintenance; when the nutritional tolerance score is 7-12 and the current tolerance trend is improving, the current feeding status is classified as increasing maintenance; when the nutritional tolerance score is 7-12 and the current tolerance trend is stable, the current feeding status is classified as restrictive maintenance; when the nutritional tolerance score is 7-12 and... When the previous tolerance trend is deteriorating, the current feeding status is determined to be a reduced feeding intervention status; when the nutritional tolerance score is 13-18 and the current tolerance trend is improving, the current feeding status is determined to be a restricted maintenance status; when the nutritional tolerance score is 13-18 and the current tolerance trend is stable or deteriorating, the current feeding status is determined to be a reduced feeding intervention status; when the nutritional tolerance score is 19 or above, the current feeding status is determined to be a paused recovery status; when the dominant abnormal indicator is vomiting and regurgitation and the current tolerance trend is deteriorating, the current feeding status is determined to be a paused recovery status.

[0011] Preferably, the suggestion output module includes: The suggestion type determination unit outputs an incremental maintenance suggestion when the current feeding state is an incremental maintenance state, a restricted maintenance suggestion when the current feeding state is a restricted maintenance state, a reduced intervention suggestion when the current feeding state is a reduced intervention state, and a pause recovery suggestion when the current feeding state is a pause recovery state. The suggestion content generation unit generates suggestions for adjusting feeding rate, adjusting nutrient solution concentration, controlling nutrient solution temperature, and nursing intervention prompts based on incremental maintenance suggestions, restricted maintenance suggestions, reduced intervention suggestions, or pause and recovery suggestions. The output unit suggests that suggestions for adjusting feeding rate, adjusting nutrient solution concentration, controlling nutrient solution temperature, and nursing intervention prompts be output as feeding control suggestions for the current assessment period.

[0012] Preferably, the suggestion output module further includes: The subsequent status acquisition unit acquires the nutritional tolerance score, dominant abnormal indicators, and current tolerance change trend for the subsequent assessment period, and determines the current feeding status for the subsequent assessment period based on the nutritional tolerance score, dominant abnormal indicators, and current tolerance change trend for the subsequent assessment period. The unit suggests switching to a feeding regulation suggestion that is consistent with the current feeding status of the subsequent evaluation cycle when the current feeding status of the subsequent evaluation cycle is inconsistent with the current feeding status of the previous evaluation cycle. The maintenance unit recommends maintaining the feeding control recommendations from the previous assessment period if the current feeding status in the subsequent assessment period is consistent with the current feeding status in the previous assessment period, the dominant abnormal indicators have not changed, and the current tolerance trend is stable.

[0013] Preferably, the suggestion output module further includes: The first priority recommendation unit prioritizes feeding rate adjustment recommendations when the dominant abnormal indicator is vomiting and regurgitation or gastric residual volume, and the current tolerance trend is deteriorating. The second priority recommendation unit prioritizes the output of recommendations on adjusting nutrient solution concentration and controlling nutrient solution temperature when the dominant abnormal indicator is the number of diarrhea episodes and the current tolerance trend is deteriorating. The third priority suggestion unit prioritizes nursing intervention prompts when the dominant abnormal indicator is the degree of abdominal distension or abdominal signs. It also outputs corresponding feeding control suggestions based on the nutritional tolerance score range, the current tolerance trend, and the current feeding status.

[0014] Preferably, it also includes a periodic recording module: Write the nutritional tolerance score, dominant abnormal indicators, current tolerance trend, current feeding status, and feeding control recommendations for the current assessment period into the current period record. In subsequent evaluation cycles, the records from the previous cycle are retrieved, and the nutritional tolerance data from the previous cycle are used in the trend analysis module to determine the current tolerance change trend. The current feeding status and feeding regulation suggestions from the previous cycle are used in the suggestion output module to generate maintenance or switching suggestions for feeding regulation.

[0015] The technical effects and advantages of this invention are as follows: 1. Divide the current assessment cycle according to the postoperative stage, and collect five tolerance assessment data within the same cycle to ensure that the time boundary of the score input is consistent, so that the system can continuously and stably output feeding regulation suggestions and solve the problem of scattered assessment and suggestion generation basis; 2. Assign scores to gastric residual volume, degree of abdominal distension, frequency of diarrhea, vomiting and regurgitation, and abdominal signs, and sum them to form a nutritional tolerance score. This will transform different tolerance manifestations into comparable results and improve the consistency of quantitative assessment of tolerance status. 3. Compare the nutritional tolerance scores of the current assessment period with those of the adjacent previous assessment periods to determine the current trend of tolerance changes, whether it is improving, stabilizing or worsening, so that the recommendations can take into account the direction of changes between previous and subsequent periods and reduce the limitation of relying on a single score. 4. In addition to the nutritional tolerance score, identify the dominant abnormal indicators and output a unique result in order of priority when there is a tie for the highest score. This enables the system to identify the main source of abnormality and improve the matching degree between feeding regulation recommendations and abnormality types. 5. Use nutritional tolerance score, dominant abnormal indicators and current tolerance change trend together to determine the current feeding status, and then convert them into corresponding feeding regulation suggestions. This will give the suggestions a unified decision-making entry point and improve the continuity of suggestion generation and the consistency of implementation. 6. The periodic recording module saves scores, trends, status, and recommendations, and recalls the previous period's records in subsequent evaluation periods to generate maintenance or switching recommendations. This allows feeding regulation recommendations to be continuously updated as tolerance status changes, improving the traceability and stability of recommendation adjustments. Attached Figure Description

[0016] Figure 1 This is a block diagram of the present invention. Detailed Implementation

[0017] The technical solutions of the embodiments of the present invention will be clearly and completely described below with reference to the accompanying drawings. Obviously, the described embodiments are only some embodiments of the present invention, and not all embodiments. Based on the embodiments of the present invention, all other embodiments obtained by those skilled in the art without creative effort are within the scope of protection of the present invention.

[0018] Refer to the instruction manual appendix Figure 1 A quantitative assessment and feeding recommendation system for postoperative enteral nutrition tolerance in general surgery, including: The data acquisition module acquires the tolerance assessment data of the subject within the current assessment cycle, determines the assessment frequency based on the different time stages of the subject after surgery, and divides the current assessment cycle according to the determined assessment frequency. The tolerance assessment data includes gastric residual volume, degree of abdominal distension, frequency of diarrhea, vomiting and reflux, and abdominal signs. This data acquisition module provides tolerance assessment data with consistent time boundaries and clear sources for the subsequent quantitative scoring module. The system first calculates the postoperative duration based on the current assessment time and the end of the surgery, then determines the postoperative stage and assessment frequency accordingly. Subsequently, it traces back from the current assessment time to form the current assessment cycle, and aggregates the gastric residual volume, degree of abdominal distension, frequency of diarrhea, vomiting and regurgitation, and abdominal signs within this cycle into the tolerance assessment data for the same current assessment cycle. This process includes: When the phase division unit is executed, it first reads the end time of the surgery and the current assessment time of the person being assessed. The end time of the surgery can be determined by the time of surgery completion recorded in the surgical record, anesthesia record, or postoperative record. The current assessment time is the time when the system receives the assessment data or when the nursing staff initiates the assessment entry. The phase division unit subtracts the end time of the surgery from the current assessment time to obtain the postoperative duration corresponding to the current assessment time of the person being assessed. The postoperative duration is recorded in hours. When the calculation result is between 6h and 24h, the person being assessed is classified as the initial feeding period. When the calculation result is greater than 24h but not more than 72h, the person being assessed is classified as the feeding incremental period. When the calculation result is greater than 72h, the person being assessed is classified as the stable feeding period. If the current assessment time is earlier than 6h postoperatively, the system can mark this record as a pre-assessment observation record and not enter the formal scoring process of the current assessment cycle, thereby avoiding the influence of data that has not yet entered the enteral nutrition tolerance assessment window in the early postoperative period on subsequent scoring. After receiving the postoperative stage results output by the stage division unit, the frequency determination unit determines the assessment frequency according to the fixed correspondence between the stage and the assessment frequency. When the subject is in the initial feeding period, the frequency determination unit determines the assessment frequency to be once every 4 hours; when the subject is in the feeding increment period, the frequency determination unit determines the assessment frequency to be once every 6 hours; when the subject is in the stable feeding period, the frequency determination unit determines the assessment frequency to be once every 12 hours. After determining the assessment frequency, the system writes the assessment frequency into the cycle configuration record of the current assessment cycle to limit the length of the time window corresponding to this assessment. If the subject crosses the postoperative stage boundary, for example, from the initial feeding period to the feeding increment period, the assessment frequency corresponding to the new stage will be used from the next assessment after entering the new stage, and subsequent assessment cycles will be generated with the new assessment frequency. After obtaining the current assessment time and assessment frequency, the cycle division unit uses the current assessment time as the end point of the current assessment cycle and traces back according to the determined assessment frequency to form the current assessment cycle. When the assessment frequency is once every 4 hours, the current assessment cycle is a continuous 4-hour time interval before the current assessment time; when the assessment frequency is once every 6 hours, the current assessment cycle is a continuous 6-hour time interval before the current assessment time; when the assessment frequency is once every 12 hours, the current assessment cycle is a continuous 12-hour time interval before the current assessment time. The cycle division unit then reads the gastric residual volume, degree of abdominal distension, number of diarrhea episodes, vomiting and reflux, and abdominal signs falling within this time interval. Among them, the gastric residual volume, degree of abdominal distension, and abdominal signs are the examination or record results of the current assessment time, and the number of diarrhea episodes and vomiting and reflux are the cumulative results within the current assessment cycle. The above five data are marked as tolerance assessment data of the same current assessment cycle and saved together with the current assessment cycle number, assessment end point, and assessment frequency for direct use by the subsequent quantitative scoring module. Through the above implementation process, the data acquisition module can aggregate postoperative time stages, assessment frequency, and tolerance assessment data into the same time frame, so that subsequent nutritional tolerance score calculations no longer use data from different time windows, and provide a unified input basis for determining the dominant abnormal indicators, judging the current tolerance change trend, and outputting feeding control suggestions. In practical application: if the patient's surgery ends at 8:00 am on the same day, and the nursing staff initiates the assessment at 8:00 pm on the same day, the postoperative duration is 12 hours. The stage division unit divides it into the initial feeding period, the frequency determination unit determines the assessment frequency to be once every 4 hours, and the cycle division unit backtracks from 8:00 pm to 4:00 pm to form the current assessment cycle from 4:00 pm to 8:00 pm. The cumulative number of diarrheas, vomiting and regurgitation during this time interval, as well as the gastric residual volume, degree of abdominal distension, and abdominal signs obtained at 8:00 pm are uniformly marked as the tolerance assessment data of the current assessment cycle, and then sent to the quantitative scoring module for scoring.

[0019] The quantitative scoring module assigns scores based on gastric residual volume, degree of abdominal distension, frequency of diarrhea, vomiting and reflux, and abdominal signs to obtain the nutritional tolerance score for the current assessment period. The dominant abnormal indicators for the current assessment period are determined based on the scores of each indicator. The quantitative scoring module runs after the data acquisition module generates the tolerance assessment data for the current assessment period. Its function is to convert gastric residual volume, degree of abdominal distension, frequency of diarrhea, vomiting and reflux, and abdominal signs into individual scores under the same scoring system. These individual scores are then summed to obtain the nutritional tolerance score for the current assessment period. From each individual score, the dominant abnormality indicator representing the main source of current abnormality is identified. The nutritional tolerance score reflects the overall tolerance level within the current assessment period, while the dominant abnormality indicator reflects the abnormal item that has the most significant impact on feeding tolerance within the current assessment period. Both are then fed into the subsequent trend analysis module and status determination module. This implementation process includes: When executing the individual scoring unit, the system first retrieves the gastric residual volume, degree of abdominal distension, frequency of diarrhea, vomiting and regurgitation, and abdominal signs from the tolerance assessment data of the current assessment period, and verifies that all five data items are associated with the same current assessment period number. If any data item is missing, the individual scoring unit generates a supplementary entry prompt, and the scoring process continues only after the missing item is completed. During scoring, each indicator uses a four-level score system of 0, 2, 4, and 6 points, but the criteria for different indicator levels are determined separately. For gastric residual volume less than 100 ml... A score of 0 is given for L (volume), 2 for 100mL to less than 200mL, 4 for 200mL to less than 300mL, and 6 for 300mL or more. If the abdomen is soft and flat with no complaints of abdominal distension, the degree of abdominal distension is recorded as 0. 2 points are given for mild abdominal distension, mild abdominal bulging, or complaints of mild abdominal discomfort. 4 points are given for significant abdominal bulging, increased tension on palpation, or significant complaints of abdominal distension. 6 points are given for significant abdominal bulging, significantly increased abdominal wall tension, and persistent discomfort. Current assessment period. If no diarrhea occurs, the number of diarrhea episodes is scored as 0; 1 to 2 episodes are scored as 2; 3 to 4 episodes are scored as 4; and 5 or more episodes are scored as 6. If no vomiting or regurgitation occurs during the current assessment period, the vomiting or regurgitation situation is scored as 0; one mild regurgitation episode that does not affect continued feeding is scored as 2; vomiting or regurgitation that affects current feeding tolerance is scored as 4; and repeated vomiting or regurgitation or a high risk of aspiration is scored as 6. The abdomen is free of tenderness, abdominal muscle rigidity, and bowel sounds are present. When there are no obvious abnormalities, abdominal signs are scored as 0 points; when there is mild tenderness, mild abdominal muscle tension, or mild abnormal bowel sounds, it is scored as 2 points; when there is significant tenderness, abdominal muscle tension, or significantly weakened or enhanced bowel sounds, it is scored as 4 points; when there are significant abnormal abdominal signs indicating a significant decrease in abdominal tolerance, it is scored as 6 points. After scoring is completed, the individual scoring unit outputs the gastric residual volume score, abdominal distension score, frequency of diarrhea score, vomiting and regurgitation score, and abdominal sign score, and binds the five scores to the current assessment cycle number for saving. After receiving the five scores from the individual scoring unit, the summation scoring unit first confirms that each of the five scores is a value of 0, 2, 4, or 6. Then, it sums the scores for gastric residual volume, abdominal distension, frequency of diarrhea, vomiting and reflux, and abdominal signs to obtain the nutritional tolerance score for the current assessment period. The calculation method is: Nutritional tolerance score = Gastric residual volume score + Abdominal distension score + Frequency of diarrhea score + Vomiting and reflux score + Abdominal signs score. The higher the nutritional tolerance score, the worse the enteral nutrition tolerance performance in the current assessment period. The summation scoring unit writes the nutritional tolerance score, the current assessment period number, the end point of the assessment, and the five individual scores into the scoring record, so that the subsequent trend analysis module can directly call the nutritional tolerance score of the current assessment period and compare it with the nutritional tolerance scores of adjacent previous assessment periods. After the nutritional tolerance score is generated, the scoring comparison unit reads the gastric residual volume score, abdominal distension score, diarrhea frequency score, vomiting and regurgitation score, and abdominal signs score for the current assessment period, and compares the five scores. During the comparison, the scoring comparison unit first determines the highest score among the five scores, and then retrieves the indicators that reach the highest score. If the highest score corresponds to only one indicator, then that indicator enters the dominant abnormal indicator determination unit as the sole candidate. If the highest score corresponds to two or more indicators, the scoring comparison unit forms these parallel indicators into a set of parallel highest indicators, and sends this set of parallel highest indicators to the dominant abnormal indicator determination unit for priority determination. Through this process, the subsequent determination of dominant abnormal indicators is based on the quantified scoring results, rather than returning to the original observation values ​​for subjective judgment. The dominant abnormal indicator determination unit determines the dominant abnormal indicator for the current assessment period based on the output of the scoring comparison unit. When the highest-scoring indicator is the only indicator, it is directly determined as the dominant abnormal indicator for the current assessment period. When two or more indicators have the same score, the dominant abnormal indicator for the current assessment period is determined according to the priority order of vomiting and regurgitation, gastric residual volume, abdominal signs, frequency of diarrhea, and degree of abdominal distension. Specifically, if vomiting and regurgitation is included in the set of tied highest-scoring indicators, then vomiting and regurgitation is determined as the dominant abnormal indicator; if gastric residual volume is included but not vomiting and regurgitation, then gastric residual volume is determined as the dominant abnormal indicator; if abdominal signs are included but not vomiting and regurgitation, then... If the abdominal signs are the highest score, then the other signs are determined as the dominant abnormal indicator; the remaining signs are determined in order of frequency of diarrhea and degree of abdominal distension. This priority order is used to solve the problem of the only output when there are ties for the highest score, and to prioritize abnormal items that are more directly related to feeding safety risks and feeding rate adjustments in the subsequent suggestion generation process. For example, if the gastric residual volume score and the degree of abdominal distension score are both the highest scores in the current assessment period, the dominant abnormal indicator is determined to be the gastric residual volume; if the vomiting and regurgitation score and the gastric residual volume score are both the highest scores, the dominant abnormal indicator is determined to be the vomiting and regurgitation. After determination, the dominant abnormal indicator, along with the nutritional tolerance score, the five individual scores, and the current assessment period number, are saved together and output to the trend analysis module and the status determination module. Through the above implementation process, the quantitative scoring module converts the five tolerance assessment data within the same current assessment period into calculable and comparable scoring results, and simultaneously outputs the nutritional tolerance score and the dominant abnormality indicator. The nutritional tolerance score represents the overall tolerance level, and the dominant abnormality indicator represents the most significant source of abnormality. The combination of the two allows subsequent current tolerance trends, current feeding status, and feeding control recommendations to be based on the same scoring caliber, reducing the problem of incomparability between different observation items. In practical application: if the gastric residual volume is 180mL, the degree of abdominal distension is mild, the number of diarrhea episodes is 0, no vomiting or reflux occurs, and there are no obvious abnormalities in abdominal signs within a certain current assessment period, then the gastric residual volume score is 2 points, the degree of abdominal distension score is 2 points, the number of diarrhea episodes is 0 points, the vomiting and reflux score is 0 points, the abdominal signs score is 0 points, and the nutritional tolerance score is 4 points. Since the gastric residual volume score and the degree of abdominal distension score are tied for the highest, the dominant abnormality indicator determination unit determines the gastric residual volume as the dominant abnormality indicator according to the priority order. Subsequently, the system outputs the nutritional tolerance score of 4 points and the dominant abnormality indicator gastric residual volume to the subsequent modules.

[0020] The trend analysis module continuously acquires the nutritional tolerance score and dominant abnormal indicators for each assessment period, forming a scoring sequence arranged in chronological order. Based on the changes in nutritional tolerance score between the current assessment period and the adjacent previous assessment period in the scoring sequence, the current tolerance change trend is determined. The trend analysis module runs after the quantitative scoring module outputs the nutritional tolerance score and dominant abnormality index for the current assessment period. Its purpose is to incorporate the quantitative results generated within a single assessment period into a continuous time series and determine the current tolerance trend by analyzing the score changes between the current assessment period and adjacent previous assessment periods. This trend result, along with the nutritional tolerance score and dominant abnormality index, is then input into the status determination module, enabling the system to determine whether the assessed individual's current tolerance is improving, stable, or deteriorating, rather than making feeding adjustment recommendations based solely on a single score. This implementation process includes: When the sequence forming unit executes, it first acquires the nutritional tolerance score and dominant abnormality index for the current assessment period. The nutritional tolerance score for the current assessment period is output by the summation scoring unit, and the dominant abnormality index for the current assessment period is output by the dominant abnormality index determination unit. Subsequently, the sequence forming unit reads the nutritional tolerance score and dominant abnormality index already saved in the previous assessment period and arranges the records of the current assessment period and the previous assessment period in chronological order of assessment time. Each assessment period record includes at least the assessment period number, assessment end time, nutritional tolerance score, and dominant abnormality index. The sorting is based on the assessment end time, with records of earlier end times placed first and records of later end times placed last. Once sorting is complete, a scoring sequence is formed. In this implementation, the scoring sequence includes at least the current assessment period record and the records of adjacent previous assessment periods. When earlier historical assessment period records exist in the system, they are retained in the scoring sequence, but the direct calculation of the current tolerance change trend is based on the current assessment period and the adjacent previous assessment period. This ensures that trend judgment is established between adjacent periods, avoiding distortion of the change direction caused by spanning multiple periods. After receiving the scoring sequence, the difference calculation unit extracts the nutritional tolerance score for the current assessment period and the nutritional tolerance score for the adjacent previous assessment period from the scoring sequence. The adjacent previous assessment period refers to the assessment period in the scoring sequence that is before the current assessment period and is the closest in time to the current assessment period. The difference calculation unit calculates the score difference by subtracting the nutritional tolerance score of the adjacent previous assessment period from the nutritional tolerance score of the current assessment period. If the nutritional tolerance score of the current assessment period is A and the nutritional tolerance score of the adjacent previous assessment period is B, then the score difference is AB. This score difference is used to characterize the direction of change in the overall tolerance level between two adjacent assessment periods. Since the nutritional tolerance score is obtained by summing the same five indicators according to the same four-level scoring rules, the current assessment period and the adjacent previous assessment period can be directly compared in score, without the need to set additional conversion coefficients for gastric residual volume, degree of abdominal distension, frequency of diarrhea, vomiting and reflux, and abdominal signs. The trend determination unit determines the current tolerance change trend based on the score difference output by the difference calculation unit. When the score difference is less than zero, it indicates that the nutritional tolerance score of the current assessment period is lower than that of the adjacent previous assessment period, and the trend determination unit determines the current tolerance change trend as an improving trend. When the score difference is equal to zero, it indicates that the nutritional tolerance score of the current assessment period is the same as that of the adjacent previous assessment period, and the trend determination unit determines the current tolerance change trend as a stable trend. When the score difference is greater than zero, it indicates that the nutritional tolerance score of the current assessment period is higher than that of the adjacent previous assessment period, and the trend determination unit determines the current tolerance change trend as a worsening trend. After determination, the trend determination unit writes the current tolerance change trend into the current assessment period record and outputs it to the status judgment module along with the nutritional tolerance score and dominant abnormal indicators of the current assessment period. If the current assessment period is the first formal assessment period and there is no adjacent previous assessment period, the trend determination unit records this period as the baseline period, does not output the improving or worsening trend temporarily, and calculates the current tolerance change trend based on the nutritional tolerance scores of the two adjacent periods after the next assessment period is formed. Through the above implementation process, the trend analysis module transforms the scattered single-cycle scoring results into a scoring sequence arranged continuously over time, and uses the difference in nutritional tolerance scores between two adjacent assessment cycles to determine the current tolerance change trend. This allows the status determination module to simultaneously obtain the current nutritional tolerance level, the main source of abnormality, and the direction of change before and after. In practical applications: if the nutritional tolerance score in the current assessment cycle is 10 points and the nutritional tolerance score in the adjacent previous assessment cycle is 15 points, the score difference is -5, and the trend determination unit outputs an improving trend; if the nutritional tolerance score in the current assessment cycle is 10 points and the nutritional tolerance score in the adjacent previous assessment cycle is also 10 points, the output is a stable trend; if the nutritional tolerance score in the current assessment cycle is 15 points and the nutritional tolerance score in the adjacent previous assessment cycle is 8 points, the score difference is 7, and the output is a deteriorating trend. Subsequently, the system sends the current tolerance change trend, along with the nutritional tolerance score and the dominant abnormal indicator in the current assessment cycle, to the status determination module to determine the increasing maintenance state, the limited maintenance state, the reduced intervention state, or the paused recovery state.

[0021] The status determination module determines the current feeding status as incremental maintenance, restricted maintenance, reduced intervention, or pause recovery based on the nutritional tolerance score, dominant abnormal indicators, and tolerance change trend of the current assessment period. The status determination module runs after the trend analysis module outputs the current tolerance change trend. Its function is to combine the nutritional tolerance score, dominant abnormality index, and current tolerance change trend of the current assessment period into a unified determination criterion. The nutritional tolerance score represents the current overall tolerance level, the dominant abnormality index represents the current main source of abnormality, and the current tolerance change trend represents the direction of change between adjacent assessment periods. The system first determines the tolerance level based on the nutritional tolerance score, then combines the tolerance level, current tolerance change trend, and dominant abnormality index to determine the current feeding status, and outputs the current feeding status to the suggestion output module to generate feeding regulation suggestions. This implementation process includes: When the tolerance level determination unit executes, it first reads the nutritional tolerance score for the current assessment period from the quantitative scoring module, the dominant abnormal indicator for the current assessment period from the dominant abnormal indicator determination unit, and the current tolerance change trend from the trend analysis module. After reading, the tolerance level determination unit judges the score range to which the nutritional tolerance score belongs. When the nutritional tolerance score is in the range of 0 to 6, it is determined as the first tolerance level; when the nutritional tolerance score is in the range of 7 to 12, it is determined as the second tolerance level; when the nutritional tolerance score is in the range of 13 to 18, it is determined as the third tolerance level; when the nutritional tolerance score is in the range of 19 or above, it is determined as the fourth tolerance level. Among them, the first tolerance level indicates that the overall tolerance performance is good in the current assessment period, the second tolerance level indicates that there is mild to moderate tolerance fluctuation, the third tolerance level indicates that the overall tolerance has decreased significantly, and the fourth tolerance level indicates that the overall tolerance is poor. The tolerance level determination unit sends the tolerance level, nutritional tolerance score, dominant abnormal indicator, and current tolerance change trend to the feeding status judgment unit. After receiving the data output by the tolerance level determination unit, the feeding status determination unit outputs a unique current feeding status according to the status determination rules. Specifically, when the nutritional tolerance score is between 0 and 6 and the current tolerance trend is improving or stable, the current feeding status is determined to be an increasing maintenance status, indicating that the overall tolerance level is good within the current assessment period and there has been no worsening between previous and subsequent periods, so the increasing progress recommendation can continue. When the nutritional tolerance score is between 0 and 6 and the current tolerance trend is worsening, the current feeding status is determined to be a restricted maintenance status, indicating that although the current overall score is still relatively low... If the tolerance score is in the low range, but there has been a worsening compared to the previous assessment period, the incremental increase should be stopped and the current parameters maintained for observation. If the nutritional tolerance score is between 7 and 12 and the current tolerance trend is improving, the current feeding status is determined to be an incremental maintenance status, indicating that the current assessment period is at the second tolerance level but has improved compared to the previous period, and incremental progress can be resumed based on observation. If the nutritional tolerance score is between 7 and 12 and the current tolerance trend is stable, the current feeding status is determined to be a restricted maintenance status, indicating that there is mild to moderate tolerance fluctuation but no further deterioration, and the current feeding should be maintained. Nutritional parameters: When the nutritional tolerance score is between 7 and 12 and the current tolerance trend is worsening, the current feeding status is determined to be a reduction intervention status, indicating that although the current score has not reached the high range, it has shown an aggravating trend, and the feeding load should be reduced and the intervention strengthened; when the nutritional tolerance score is between 13 and 18 and the current tolerance trend is improving, the current feeding status is determined to be a restricted maintenance status, indicating that the current score is still in the high range, but it has improved compared to the previous cycle. The system does not recommend further reduction or escalation, but rather to maintain the restricted status for observation; when the nutritional tolerance score is between 13 and 18 and the current tolerance... When the trend of change is stable or deteriorating, the current feeding status is determined to be a reduction intervention status, indicating that the current overall tolerance has declined significantly and the reduction treatment needs to be maintained. When the nutritional tolerance score is 19 points or above, the current feeding status is directly determined to be a pause and recovery status, indicating that the current overall tolerance level is in the highest risk range. In addition, when the dominant abnormal indicator is vomiting and regurgitation and the current tolerance change trend is deteriorating, even if the nutritional tolerance score does not reach 19 points, the current feeding status is given priority to be a pause and recovery status to improve the response priority to the risk of aspiration and continuous regurgitation. When executing the above determination, the feeding status determination unit outputs a unique result in the order of "pause and recovery status - reduction intervention status - restriction maintenance status - incremental maintenance status". That is, it first determines whether the conditions for the pause and recovery status are met. If they are met, the pause and recovery status is output directly. If not, it then determines whether the conditions for the reduction intervention status are met. If still not met, it then determines whether the conditions for the restriction maintenance status are met. Finally, it determines whether the conditions for the incremental maintenance status are met. This sequential constraint can prevent multiple rules from being hit simultaneously in the same current assessment period, resulting in more than two current feeding statuses. For example, if the nutritional tolerance score for the current assessment period is 6 points, the dominant abnormal indicator is vomiting and regurgitation, and the current tolerance trend is deteriorating, although it is in the second tolerance level according to the score range, the system directly outputs the pause and recovery status because it meets the priority rule of "dominant abnormal indicator is vomiting and regurgitation and current tolerance trend is deteriorating". If the nutritional tolerance score for the current assessment period is 8 points, and the current tolerance trend is improving, the system outputs the restriction maintenance status instead of processing it as a reduction intervention status.

[0022] Through the above implementation process, the status determination module expands the judgment of a single nutritional tolerance score to a combined judgment of nutritional tolerance score, dominant abnormal indicators, and current tolerance change trend. This allows the current feeding status to simultaneously reflect the overall tolerance level, the source of the abnormality, and the direction of change over time. This processing enables the suggestion output module to generate incremental maintenance suggestions, restricted maintenance suggestions, reduced feeding intervention suggestions, or pause and recovery suggestions based on a clear current feeding status, reducing inconsistencies caused by generating suggestions based solely on a single score or a single abnormality. In practical application: if the nutritional tolerance score for the current assessment period is 4 points, the dominant abnormal indicator is the degree of abdominal distension, and the current tolerance change trend is a stable trend, then the system determines the first tolerance level and classifies the current feeding status as an incremental maintenance state. If the nutritional tolerance score is 15 points, the dominant abnormal indicator is gastric residual volume, and the current tolerance change trend is a worsening trend, then the system determines the third tolerance level and classifies the current feeding status as a reduced feeding intervention state. If the nutritional tolerance score is 10 points, the dominant abnormal indicator is vomiting and regurgitation, and the current tolerance change trend is a worsening trend, then the system, based on the safety priority rule of vomiting and regurgitation, classifies the current feeding status as a pause and recovery state and outputs this status to the suggestion output module to generate corresponding feeding regulation suggestions.

[0023] The output module suggests that it outputs feeding control suggestions based on the current feeding status. These suggestions include suggestions for adjusting feeding speed, adjusting nutrient solution concentration, controlling nutrient solution temperature, and providing nursing intervention prompts. In subsequent evaluation cycles, it outputs suggestions for maintaining or switching the feeding control suggestions based on the updated nutritional tolerance score, dominant abnormal indicators, and tolerance change trends. The suggestion output module runs after the status determination module outputs the current feeding status. Its function is not to directly implement clinical feeding operations, but rather to convert the incremental maintenance status, restricted maintenance status, reduced intervention status, or pause / recovery status into structured feeding regulation suggestions. In subsequent evaluation cycles, the system determines whether to maintain or switch the suggestions based on the new nutritional tolerance score, dominant abnormal indicators, and current tolerance trends. During this process, the system also determines priority output content based on the dominant abnormal indicators, allowing suggestions under the same feeding status to further reflect differences in the source of abnormalities. This implementation process includes: When the suggestion type determination unit executes, it first receives the current feeding status output by the status determination module and matches the current feeding status with the pre-established suggestion type correspondence. If the current feeding status is an incremental maintenance state, the suggestion type determination unit outputs an incremental maintenance suggestion; if the current feeding status is a restricted maintenance state, it outputs a restricted maintenance suggestion; if the current feeding status is a reduction intervention state, it outputs a reduction intervention suggestion; and if the current feeding status is a pause recovery state, it outputs a pause recovery suggestion. This suggestion type, along with the current assessment cycle number, nutritional tolerance score, dominant abnormal indicators, and current tolerance change trend, is temporarily stored as an index for generating specific suggestion content later. Through this process, the system first converts the status determination result into a suggestion category, avoiding inconsistencies between the suggestion type and the current feeding status when generating suggestions for adjusting feeding speed, adjusting nutrient solution concentration, controlling nutrient solution temperature, and providing nursing intervention prompts.

[0024] The suggestion content generation unit receives the incremental maintenance suggestion, restricted maintenance suggestion, reduced intervention suggestion, or pause / recovery suggestion output by the suggestion type determination unit, and generates corresponding suggestion content according to the suggestion type. Under the incremental maintenance suggestion, the suggestion content generation unit generates suggestions to gradually increase the feeding rate, gradually increase the nutrient solution concentration, maintain the nutrient solution temperature between 38℃ and 40℃, and routine observation prompts. Under the restricted maintenance suggestion, it generates suggestions to maintain the current feeding rate, maintain the current nutrient solution concentration, continue to control the nutrient solution temperature, and strengthen the observation of the dominant abnormal indicators. Under the reduced intervention suggestion, it generates suggestions to reduce the feeding rate and / or reduce the nutrient solution concentration, and at the same time generates suggestions to verify the nutrient solution temperature and nursing intervention prompts related to the dominant abnormal indicators. Under the pause / recovery suggestion, it generates suggestions to pause the infusion, risk observation prompts during the pause, suggestions to restart at a low rate and low concentration after the recovery conditions are met, and prompts to continue reassessment after recovery. The above suggestion content is not used as a treatment action directly executed by the system, but is used as feeding control suggestion content for nursing staff or feeding management equipment to review and call.

[0025] The output unit combines the feeding speed adjustment suggestions, nutrient solution concentration adjustment suggestions, nutrient solution temperature control suggestions, and nursing intervention prompts generated by the suggestion content generation unit into a feeding control suggestion corresponding to the current assessment cycle, and outputs it to the display interface, nursing record interface, or feeding management terminal. During output, each feeding control suggestion is associated with and saved with the current assessment cycle number, current feeding status, nutritional tolerance score, dominant abnormal indicators, and current tolerance change trend, allowing subsequent assessment cycles to call upon the suggestions from the previous assessment cycle for comparison. If the suggestion content includes a pause / recovery suggestion, the output unit simultaneously marks the recovery conditions. The recovery conditions are that the nutritional tolerance score in the subsequent assessment cycle is in the range of 7 to 12 points or 0 to 6 points, and the current tolerance change trend is an improving trend or a stable trend. This marking is used to determine whether to output a low-speed, low-concentration restart suggestion when switching suggestions in the future.

[0026] The subsequent status acquisition unit operates after new quantitative results are generated in subsequent assessment cycles. It first acquires the nutritional tolerance score, dominant abnormal indicators, and current tolerance change trend for the subsequent assessment cycle, and determines the current feeding status for the subsequent assessment cycle according to the same rules as the status determination module. Specifically, the subsequent status acquisition unit first determines the tolerance level based on the score range of the nutritional tolerance score for the subsequent assessment cycle, and then determines the incremental maintenance status, restricted maintenance status, reduced intervention status, or pause recovery status by combining the dominant abnormal indicators and current tolerance change trend for the subsequent assessment cycle. After the determination is completed, the subsequent status acquisition unit reads the current feeding status and feeding control recommendations recorded in the previous assessment cycle, so that the subsequent recommendation switching unit and recommendation maintenance unit can process the status changes based on the adjacent two assessment cycles. The suggestion switching unit compares the current feeding status of the subsequent assessment cycle with the current feeding status of the previous assessment cycle. When the two are inconsistent, the suggestion switching unit outputs a feeding regulation suggestion that is consistent with the current feeding status of the subsequent assessment cycle. Switching suggestions include specific types such as switching from incremental maintenance to restricted maintenance, from restricted maintenance to reduced intervention, from reduced intervention to restricted maintenance, and from pause / recovery to low-rate, low-concentration restart. For example, if the previous assessment cycle was a restricted maintenance state, and the subsequent assessment cycle is determined to be a reduced intervention state due to an increased nutritional tolerance score and a worsening trend in current tolerance, the suggestion switching unit outputs a change from a restricted maintenance suggestion to a reduced intervention suggestion. If the previous assessment cycle was a pause / recovery state, and the nutritional tolerance score in the subsequent assessment cycle drops to the 7-12 range with an improving trend in current tolerance, the output changes from a pause / recovery suggestion to a low-rate, low-concentration restart suggestion.

[0027] The maintenance unit is recommended to handle situations where the current feeding status remains unchanged. When the current feeding status in a subsequent assessment period is consistent with that in the previous assessment period, and the dominant abnormal indicators remain unchanged and the current tolerance trend is stable, the maintenance unit outputs a maintenance recommendation for the feeding control recommendations of the previous assessment period. This maintenance recommendation indicates that the recommendation type and main recommendations of the previous assessment period will continue to be used, and the new nutritional tolerance score, dominant abnormal indicators, and current tolerance trend of this period will be added to the recommendation record. If the current feeding status is consistent but the dominant abnormal indicators change, or the current tolerance trend changes from a stable trend to a worsening trend or an improving trend, the maintenance unit will not directly output a maintenance recommendation. Instead, the recommendation type determination unit will regenerate a feeding control recommendation that matches the status and abnormality source of the subsequent assessment period to avoid the recommendation content becoming outdated.

[0028] The first priority recommendation unit is used to adjust the focus of recommendations when the dominant abnormal indicator directly indicates a feeding safety risk. When the dominant abnormal indicator is vomiting / reflux or residual gastric volume, and the current tolerance trend is worsening, the first priority recommendation unit will prioritize feeding rate adjustment recommendations. These recommendations may include reducing the current feeding rate, pausing the incremental feeding rate, increasing the focus of reassessment, or suggesting a low-rate restart in the pause / resumption recommendation. This priority recommendation does not replace the current feeding status assessment, but rather adjusts the display order and focus of recommendations within the incremental maintenance recommendation, restricted maintenance recommendation, reduced intervention recommendation, or pause / resumption recommendation, so that risks related to gastric retention and reflux are highlighted first.

[0029] The second priority suggestion unit is used to handle situations where the frequency of diarrhea is the dominant abnormal indicator and the current tolerance trend is worsening. In this case, the system prioritizes the output of nutrient solution concentration adjustment suggestions and nutrient solution temperature control suggestions. Nutrient solution concentration adjustment suggestions may include pausing the concentration increase, reducing the nutrient solution concentration by one level, or maintaining a low concentration for observation. Nutrient solution temperature control suggestions include prompting that the nutrient solution temperature be controlled within the range of 38°C to 40°C, and prioritizing temperature correction before continuing the infusion process if the temperature deviates from this range. Through this processing, the focus of suggestions when the frequency of diarrhea worsens is no longer solely on reducing the feeding rate, but rather prioritizes the generation of suggestions around concentration load and temperature stimulation. The third priority suggestion unit is used to output nursing intervention prompts when the dominant abnormal indicator is the degree of abdominal distension or abdominal signs. The third priority suggestion unit first reads the score range of the nutritional tolerance score, the current tolerance change trend, and the current feeding status, and then determines the combination of nursing intervention prompts and suggestion types. When the nutritional tolerance score is in the range of 0 to 6 and the current tolerance change trend is an improving or stable trend, the incremental maintenance suggestion adds prompts to re-examine abdominal signs and observe changes in abdominal distension. When the nutritional tolerance score is in the range of 7 to 12 and the current feeding status is a restricted maintenance status, the restricted maintenance suggestion adds prompts to adjust body position, strengthen abdominal observation, abdominal massage, or abdominal heat application. When the nutritional tolerance score is in the range of 13 to 18 and the current tolerance change trend is a worsening trend, the reduction intervention suggestion adds prompts to cooperate with gastrointestinal decompression, observe gas and defecation, and re-examine bowel sounds. When the nutritional tolerance score is in the range of 19 or above or the abdominal signs are significantly worsening, the pause and recovery suggestion adds prompts to observe risks and re-evaluate during the pause period. The nursing intervention prompts output by the third priority suggestion unit, together with the suggestions for adjusting feeding speed, adjusting nutrient solution concentration, and controlling nutrient solution temperature, constitute the final feeding control suggestions.

[0030] Through the above implementation process, it is suggested that the output module convert the current feeding status output by the status determination module into structured, recordable, and switchable feeding regulation suggestions, and use the dominant abnormal indicators to adjust the priority of the suggestion content. This avoids the system directly implementing clinical intervention actions and provides continuous and clear suggestions for the enteral nutrition management of the assessed individuals. In practical application: if the nutritional tolerance score for the current assessment period is 15 points, the dominant abnormal indicator is gastric residual volume, and the current tolerance change trend is a deterioration trend, the status determination module outputs a reduction intervention status. Then, the suggestion type determination unit outputs a reduction intervention suggestion, the first priority suggestion unit places the feeding rate adjustment suggestion in the priority output position, and the suggestion content generation unit generates suggestions to reduce the feeding rate, maintain the nutrient solution temperature, and strengthen the reassessment of gastric residual volume. If the nutritional tolerance score drops to 10 points in the next assessment period and the current feeding status changes to a restricted maintenance status, the suggestion switching unit switches the output from a reduction intervention suggestion to a restricted maintenance suggestion, so that the suggestion content is updated synchronously with the continuous assessment results.

[0031] The periodic recording module is used to solidify the nutritional tolerance score, dominant abnormal indicators, current tolerance trend, current feeding status, and feeding control recommendations generated within each assessment period into a traceable periodic record. This record serves as the preliminary basis for the trend analysis module and the recommendation output module in subsequent assessment periods. This module does not recalculate the five indicator scores or reassess the current feeding status; instead, it is responsible for saving, retrieving, and transmitting the previous results according to a unified field, ensuring continuity between adjacent assessment periods. This implementation process includes: After completing the recommendation output for the current assessment cycle, the cycle recording module reads the nutritional tolerance score and dominant abnormality index output by the quantitative scoring module, the current tolerance change trend output by the trend analysis module, the current feeding status output by the status determination module, and the feeding regulation recommendations output by the recommendation output module. Subsequently, the cycle recording module writes the above information into the current cycle record. The current cycle record includes at least the assessment cycle number, assessment end time, nutritional tolerance score, dominant abnormality index, current tolerance change trend, current feeding status, and feeding regulation recommendations. The assessment cycle number is generated by the data acquisition module when dividing the current assessment cycle; the assessment end time is the current assessment point in time; the nutritional tolerance score represents the overall tolerance level within the current assessment cycle; the dominant abnormality index represents the main source of abnormality within the current assessment cycle; the current tolerance change trend represents the direction of change relative to the adjacent preceding assessment cycle; the current feeding status represents the determination result of the status determination module; and the feeding regulation recommendations represent the recommendations output by the recommendation output module. During writing, the cycle recording module binds all fields within the same assessment cycle to the same assessment cycle number to avoid mixing scores, trends, or recommendations from different assessment cycles in subsequent calls.

[0032] In subsequent evaluation cycles, the cycle recording module retrieves the previous cycle record based on the subsequent evaluation cycle number or evaluation end time. The previous cycle record refers to a cycle record that is chronologically preceding and adjacent to the subsequent evaluation cycle. The cycle recording module retrieves the nutritional tolerance score from the previous cycle record and passes it to the trend analysis module. The trend analysis module calculates the difference between the newly generated nutritional tolerance score in the subsequent evaluation cycle and the nutritional tolerance score in the previous cycle record to determine the current tolerance change trend corresponding to the subsequent evaluation cycle. The cycle recording module also retrieves the current feeding status and feeding regulation suggestions from the previous cycle record and passes them to the suggestion output module. The suggestion output module compares the current feeding status, reassessed in the subsequent evaluation cycle, with the current feeding status in the previous cycle record. If they are consistent and the dominant abnormal indicators have not changed, and the current tolerance change trend is stable, a maintenance suggestion for feeding regulation is generated. If they are inconsistent, a switching suggestion for feeding regulation consistent with the current feeding status in the subsequent evaluation cycle is generated.

[0033] To ensure that periodic records can be accurately accessed by subsequent modules, the periodic record module can set a record status field when writing the current periodic record. The record status field includes "Pending Completion" and "Completed." If any of the following fields are missing from the current periodic record: nutritional tolerance score, dominant abnormal indicators, current tolerance trend, current feeding status, or feeding regulation recommendations, the record status field is marked as "Pending Completion," and this periodic record will not be used as a previous period record in subsequent difference calculations and recommendation switching. Once all the above fields have been written, the record status field is marked as "Completed," and this periodic record is then allowed to be accessed by the trend analysis module and the recommendation output module. In practice, if only five indicators are collected for an assessment period but feeding regulation recommendations have not yet been generated, the periodic record module first saves the collection and scoring results and marks the record status as "Pending Completion." After the recommendation output module generates feeding regulation recommendations, the record status is updated to "Completed." This method avoids incomplete records being included in subsequent period comparisons, which could lead to inaccurate current tolerance trends or recommendation switching results.

[0034] Through the above implementation process, the cycle recording module integrates the scoring results, anomaly sources, trend results, status determination results, and suggestion output results of each assessment cycle into a single traceable record. This allows the trend analysis module to reliably obtain the nutritional tolerance score of the previous cycle, and the suggestion output module to reliably obtain the current feeding status and feeding regulation suggestions of the previous cycle, thereby ensuring a closed loop between continuous assessment, status determination, and suggestion maintenance or switching. In practical application: if the nutritional tolerance score in the first assessment cycle record is 15 points, the current feeding status is a reduction intervention status, and the feeding regulation suggestion is a reduction intervention suggestion, after the next assessment cycle generates a new nutritional tolerance score of 10 points, the cycle recording module calls the 15 points from the previous cycle for the trend analysis module to calculate the score difference, and calls the reduction intervention status and reduction intervention suggestions from the previous cycle for the suggestion output module to compare; if the next assessment cycle is determined to be a restriction maintenance status, the suggestion output module generates a switching suggestion from a reduction intervention suggestion to a restriction maintenance suggestion, which is then written into a new cycle record by the cycle recording module.

[0035] Working principle: The system first determines the assessment frequency based on the postoperative time stage of the subject and divides the current assessment cycle according to this frequency. Then, within the current assessment cycle, it acquires data on gastric residual volume, degree of abdominal distension, frequency of diarrhea, vomiting and regurgitation, and abdominal signs, assigns scores to each of the five data points, sums them to obtain a nutritional tolerance score, and identifies the most significant source of abnormality, i.e., the dominant abnormality indicator. Next, the system compares the nutritional tolerance score of the current assessment cycle with that of the previous assessment cycle to determine whether the current tolerance trend is improving, stabilizing, or worsening. Finally, the system combines the nutritional tolerance score, the dominant abnormality indicator, and the current tolerance trend to determine the current feeding status and outputs suggestions for adjusting feeding rate, adjusting nutrient solution concentration, controlling nutrient solution temperature, and providing nursing intervention prompts. Subsequent assessment cycles recall the records of the previous cycle to determine whether to maintain or switch the suggestions, thus forming a continuously updated closed loop of feeding regulation suggestions. For example, if the person being evaluated is receiving enteral nutrition support 12 hours post-surgery, the system classifies this as the initial feeding period and forms the current assessment cycle every 4 hours. At the end of a cycle, the system reads the gastric residual volume, degree of abdominal distension, frequency of diarrhea, vomiting and regurgitation, and abdominal signs. If the calculated nutritional tolerance score is 15 points, and the dominant abnormal indicator is the gastric residual volume, and the nutritional tolerance score has increased compared to the previous cycle, then the tolerance trend is judged to be deteriorating, and the current feeding status is further determined to be a reduction intervention status. At this time, the system outputs reduction intervention suggestions prioritizing feeding rate adjustment, such as suggesting to reduce the feeding rate, maintain an appropriate nutrient solution temperature, and strengthen the reassessment of gastric residual volume. If the nutritional tolerance score drops to 10 points in the next cycle, the current feeding status changes to a restricted maintenance status, and the system outputs a prompt to switch from reduction intervention suggestions to restricted maintenance suggestions, so that the feeding control suggestions are continuously adjusted according to the changes in tolerance.

[0036] The above description is merely a preferred embodiment of the present invention and is not intended to limit the present invention. Any modifications, equivalent substitutions, improvements, etc., made within the spirit and principles of the present invention should be included within the protection scope of the present invention.

Claims

1. A system for quantitative assessment and feeding regulation recommendations of postoperative enteral nutrition tolerance in general surgery, characterized in that, include: The data acquisition module acquires the tolerance assessment data of the subject within the current assessment cycle, determines the assessment frequency based on the different time stages of the subject after surgery, and divides the current assessment cycle according to the determined assessment frequency. The tolerance assessment data includes gastric residual volume, degree of abdominal distension, frequency of diarrhea, vomiting and reflux, and abdominal signs. The quantitative scoring module assigns scores based on gastric residual volume, degree of abdominal distension, frequency of diarrhea, vomiting and reflux, and abdominal signs to obtain the nutritional tolerance score for the current assessment period. The dominant abnormal indicators for the current assessment period are determined based on the scores of each indicator. The trend analysis module continuously acquires the nutritional tolerance score and dominant abnormal indicators for each assessment period, forming a scoring sequence arranged in chronological order. Based on the changes in nutritional tolerance score between the current assessment period and the adjacent previous assessment period in the scoring sequence, the current tolerance change trend is determined. The status determination module determines the current feeding status as incremental maintenance, restricted maintenance, reduced intervention, or pause recovery based on the nutritional tolerance score, dominant abnormal indicators, and tolerance change trend of the current assessment period. The output module suggests feeding control recommendations based on the current feeding status. These recommendations include suggestions for adjusting feeding speed, adjusting nutrient solution concentration, controlling nutrient solution temperature, and providing nursing intervention prompts. In subsequent evaluation cycles, the module also provides maintenance or switching recommendations for the feeding control recommendations based on the updated nutritional tolerance score, dominant abnormal indicators, and tolerance change trends.

2. The system according to claim 1, characterized in that, The data acquisition module includes: The phase division unit obtains the postoperative duration corresponding to the current assessment time of the subject and divides the subject into the initial feeding period of 6-24 hours after surgery, the feeding incremental period of 24-72 hours after surgery, or the stable feeding period after 72 hours after surgery based on the postoperative duration. The frequency determination unit determines the assessment frequency as follows: once every 4 hours when the subject is in the initial feeding period, once every 6 hours when the subject is in the feeding increment period, and once every 12 hours when the subject is in the stable feeding period. The cycle is divided into units, with the current assessment time as the end point. The current assessment cycle is formed by backtracking according to the determined assessment frequency. The gastric residual volume, degree of abdominal distension, number of diarrhea, vomiting and reflux, and abdominal signs in the current assessment cycle are marked as tolerance assessment data of the same current assessment cycle.

3. The system according to claim 1, characterized in that, The quantitative scoring module includes: The single-item scoring unit reads the gastric residual volume, degree of abdominal distension, frequency of diarrhea, vomiting and reflux, and abdominal signs within the current assessment period, and assigns scores according to the four-level grading standard corresponding to each indicator. The four-level scores for each indicator are 0, 2, 4, and 6 points, respectively. The summation scoring unit sums the scores for gastric residual volume, abdominal distension, frequency of diarrhea, vomiting and regurgitation, and abdominal signs to obtain the nutritional tolerance score for the current assessment period.

4. The system according to claim 3, characterized in that, The quantitative scoring module also includes: The scoring comparison unit obtains the scores for gastric residual volume, abdominal distension, frequency of diarrhea, vomiting and regurgitation, and abdominal signs within the current assessment period, and compares the scores for gastric residual volume, abdominal distension, frequency of diarrhea, vomiting and regurgitation, and abdominal signs. The dominant abnormal indicator determination unit identifies the indicator with the highest score as the dominant abnormal indicator for the current assessment period. When two or more indicators have the same score, the dominant abnormal indicator for the current assessment period is determined in the following priority order: vomiting and regurgitation, gastric residual volume, abdominal signs, frequency of diarrhea, and degree of abdominal distension.

5. The system according to claim 1, characterized in that, The trend analysis module includes: The sequence forming unit acquires the nutritional tolerance score and dominant abnormal indicators for the current assessment period, and arranges them in chronological order with the nutritional tolerance scores and dominant abnormal indicators for the previous assessment period to form a scoring sequence. The difference calculation unit extracts the nutritional tolerance score of the current assessment period and the nutritional tolerance score of the adjacent previous assessment period in the scoring sequence, and calculates the difference between the two scores. The trend determination unit determines the current tolerance change trend as an improving trend when the score difference is less than zero, as a stable trend when the score difference is equal to zero, and as a deteriorating trend when the score difference is greater than zero.

6. The system according to claim 1, characterized in that, The status determination module includes: The tolerance level determination unit obtains the nutritional tolerance score, dominant abnormal indicators, and current tolerance change trend for the current assessment period. When the nutritional tolerance score is in the range of 0-6, it is determined as the first tolerance level; when the nutritional tolerance score is in the range of 7-12, it is determined as the second tolerance level; when the nutritional tolerance score is in the range of 13-18, it is determined as the third tolerance level; and when the nutritional tolerance score is 19 or above, it is determined as the fourth tolerance level. The feeding status assessment unit determines the current feeding status as follows: when the nutritional tolerance score is 0-6 and the current tolerance trend is improving or stable, the current feeding status is classified as increasing maintenance; when the nutritional tolerance score is 0-6 and the current tolerance trend is worsening, the current feeding status is classified as restrictive maintenance; when the nutritional tolerance score is 7-12 and the current tolerance trend is improving, the current feeding status is classified as increasing maintenance; when the nutritional tolerance score is 7-12 and the current tolerance trend is stable, the current feeding status is classified as restrictive maintenance; when the nutritional tolerance score is 7-12 and... When the previous tolerance trend is deteriorating, the current feeding status is determined to be a reduced feeding intervention status; when the nutritional tolerance score is 13-18 and the current tolerance trend is improving, the current feeding status is determined to be a restricted maintenance status; when the nutritional tolerance score is 13-18 and the current tolerance trend is stable or deteriorating, the current feeding status is determined to be a reduced feeding intervention status; when the nutritional tolerance score is 19 or above, the current feeding status is determined to be a paused recovery status; when the dominant abnormal indicator is vomiting and regurgitation and the current tolerance trend is deteriorating, the current feeding status is determined to be a paused recovery status.

7. The system according to claim 1, characterized in that, The suggestion output module includes: The suggestion type determination unit outputs an incremental maintenance suggestion when the current feeding state is an incremental maintenance state, a restricted maintenance suggestion when the current feeding state is a restricted maintenance state, a reduced intervention suggestion when the current feeding state is a reduced intervention state, and a pause recovery suggestion when the current feeding state is a pause recovery state. The suggestion content generation unit generates suggestions for adjusting feeding rate, adjusting nutrient solution concentration, controlling nutrient solution temperature, and nursing intervention prompts based on incremental maintenance suggestions, restricted maintenance suggestions, reduced intervention suggestions, or pause and recovery suggestions. The output unit suggests that suggestions for adjusting feeding rate, adjusting nutrient solution concentration, controlling nutrient solution temperature, and nursing intervention prompts be output as feeding control suggestions for the current assessment period.

8. The system according to claim 7, characterized in that, The suggestion output module also includes: The subsequent status acquisition unit acquires the nutritional tolerance score, dominant abnormal indicators, and current tolerance change trend for the subsequent assessment period, and determines the current feeding status for the subsequent assessment period based on the nutritional tolerance score, dominant abnormal indicators, and current tolerance change trend for the subsequent assessment period. The unit suggests switching to a feeding regulation suggestion that is consistent with the current feeding status of the subsequent evaluation cycle when the current feeding status of the subsequent evaluation cycle is inconsistent with the current feeding status of the previous evaluation cycle. The maintenance unit recommends maintaining the feeding control recommendations from the previous assessment period if the current feeding status in the subsequent assessment period is consistent with the current feeding status in the previous assessment period, the dominant abnormal indicators have not changed, and the current tolerance trend is stable.

9. The system according to claim 7, characterized in that, The suggestion output module also includes: The first priority recommendation unit prioritizes feeding rate adjustment recommendations when the dominant abnormal indicator is vomiting and regurgitation or gastric residual volume, and the current tolerance trend is deteriorating. The second priority recommendation unit prioritizes the output of recommendations on adjusting nutrient solution concentration and controlling nutrient solution temperature when the dominant abnormal indicator is the number of diarrhea episodes and the current tolerance trend is deteriorating. The third priority suggestion unit prioritizes nursing intervention prompts when the dominant abnormal indicator is the degree of abdominal distension or abdominal signs. It also outputs corresponding feeding control suggestions based on the nutritional tolerance score range, the current tolerance trend, and the current feeding status.

10. The system according to claim 1, characterized in that, It also includes a periodic recording module: Write the nutritional tolerance score, dominant abnormal indicators, current tolerance trend, current feeding status, and feeding control recommendations for the current assessment period into the current period record. In subsequent evaluation cycles, the records from the previous cycle are retrieved, and the nutritional tolerance data from the previous cycle are used in the trend analysis module to determine the current tolerance change trend. The current feeding status and feeding regulation suggestions from the previous cycle are used in the suggestion output module to generate maintenance or switching suggestions for feeding regulation.

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