CN119564425B

CN119564425B - Control system and method for turning over of intensive care bed based on pulmonary electrical impedance imaging

Info

Publication number: CN119564425B
Application number: CN202411856115.0A
Authority: CN
Inventors: 田柏剑; 田雨恒
Original assignee: Chengdu Jiangxue Medical Devices Co ltd
Current assignee: Chengdu Jiangxue Medical Devices Co ltd
Priority date: 2024-12-17
Filing date: 2024-12-17
Publication date: 2025-09-05
Anticipated expiration: 2044-12-17
Also published as: CN119564425A

Abstract

The application belongs to the technical field of medical equipment, and particularly relates to a control system and a control method for guiding a patient to turn over based on lung electrical impedance imaging, which comprise EIT equipment, an EIT information acquisition unit, an automatic turning over parameter determination unit, a control unit and a patient monitoring bed, wherein the EIT information acquisition unit acquires lung ventilation or perfusion state data provided by the EIT equipment in real time, the automatic turning over parameter determination unit compares the data with a preset threshold range, if the data is in the threshold range, the system keeps original turning over parameters, if the data exceeds the threshold range, the system adjusts the turning over parameters to achieve a positive treatment effect, and the control unit instructs the patient monitoring bed to perform corresponding body position change operation according to the adjusted turning over parameters.

Description

Control system and method for guiding patient bed to turn over based on pulmonary impedance imaging

Technical Field

The application belongs to the technical field of medical appliances, and particularly relates to a control system and a control method for guiding a patient bed to turn over based on pulmonary impedance imaging.

Background

The lung electrical impedance imager (lung EIT) is the only device capable of realizing the bedside real-time dynamic monitoring of the lung ventilation and lung perfusion of a patient at present, and is used for realizing the bedside dynamic monitoring by placing electrodes on the chest surface of a human body and injecting weak safe current, measuring the change of the surface voltage of the body, and displaying the lung ventilation distribution and blood flow perfusion state of the patient in real time and dynamically through a corresponding imaging algorithm. The electrical impedance imaging technology has been proposed for three or forty years, and through technical iteration for many years, the clinical application of the pulmonary electrical impedance imager (EIT) reaches the maturity stage, so that the invention has a realizable foundation.

Turning over can improve the pulmonary ventilation status of patients with respiratory disorders, especially for gravity dependent diseases such as Acute Respiratory Distress Syndrome (ARDS), altering the pulmonary gravity distribution can be beneficial, for example:

ARDS patient, in the horizontal state, patient's lung receives the influence of pathological changes such as phlegm accumulation, pressure, the dorsal part of left and right lungs, can appear the alveolar collapse area, and this part collapse area alveolus has lost the function of qi and blood exchange, make patient in low ventilation and low state of filling, patient's dyspnea, if the alveolar that collapses is enough, patient's very easily dies suddenly because of respiratory failure, when patient turns over on the right, left chest risen, left lung is used for the space of blood oxygen gas exchange to increase, and then the ventilation ability is increased, patient's left lung respiratory state is changing forward, when patient turns over from the right side and returns to the horizontal position, left lung collapsed alveolus has obtained partial double-tension, left lung ventilation ability is increased, patient's respiratory state is changed forward, patient's pulmonary alveolus that has been collapsed has obtained double-tension, ventilation ability is increased when patient turns over from left side to horizontal position, patient's right lung respiratory state has been used for blood oxygen gas exchange to have been obtained double-tension, patient's positive ventilation ability has been changed.

Therefore, how to combine the pulmonary impedance imager to adjust the posture state of the patient and further change the gravity distribution of the lung, so that the positive change of the breathing state of the patient is a technical problem to be solved.

Disclosure of Invention

The invention provides a control system and a method for guiding a patient to turn over based on pulmonary impedance imaging, which aim to adjust the posture state of a patient by combining data of a pulmonary impedance imaging instrument so as to change the gravity distribution of the lung and ensure that the breathing state of the patient is positively changed.

The control system for guiding the patient to turn over based on the pulmonary impedance imaging comprises EIT equipment, an EIT information acquisition unit, an automatic turn-over parameter determination unit, a control unit and a patient care bed;

the EIT information acquisition unit is used for acquiring information related to the pulmonary ventilation state in EIT equipment;

The automatic turning-over parameter determining unit compares the information related to the lung ventilation or perfusion state with a threshold range, and if the information is in the threshold range, the automatic turning-over parameter is kept, and if the information is not in the preset threshold range, the automatic turning-over parameter is changed with the aim of forward treatment;

the control unit controls the monitoring sickbed to execute the automatic turning-over parameters based on the determined automatic turning-over parameters.

The invention provides a control system for guiding a patient to turn over based on lung electrical impedance imaging, which comprises EIT equipment, an EIT information acquisition unit, an automatic turning over parameter determination unit, a control unit and a patient bed, wherein the EIT information acquisition unit acquires lung ventilation or perfusion state data provided by the EIT equipment in real time, then the automatic turning over parameter determination unit compares the data with a preset threshold range, if the data is in the threshold range, the system keeps original turning over parameters, if the data exceeds the threshold range, the system adjusts the turning over parameters to achieve a positive treatment effect, namely, the lung ventilation or perfusion state is improved, the control unit instructs the patient bed to perform corresponding body position change operation according to the adjusted turning over parameters, in this way, the system can dynamically adjust the body position of a patient, optimize lung ventilation or perfusion and further improve the respiratory condition of the patient, so that the patient can turn over more accurately and effectively based on a dynamic adjustment method of the EIT data, and the patient bed is beneficial to improving the treatment effect of the patient.

Preferably, the information related to the pulmonary ventilation state in the EIT equipment comprises one or a combination of the information related to the pulmonary ventilation or perfusion state provided by a front view of the EIT equipment, the information related to the pulmonary ventilation or perfusion state provided by a delta EELI diagram of the EIT equipment, the information related to the pulmonary ventilation or perfusion state in a trend chart provided by the EIT equipment, the information related to the pulmonary ventilation or perfusion state in an analysis view provided by the EIT equipment, and the information related to the pulmonary ventilation or perfusion state provided by an LHM view provided by the EIT equipment.

Preferably, the EIT information acquisition unit adopts a mode of integrating the artificial vision information acquisition or the machine vision information acquisition or the cable connection information acquisition or the monitoring disease bed and the EIT into a whole to realize information acquisition.

Preferably, the automatic turning parameters comprise a back lifting angle, a leg lifting angle, a bed left side turning angle, a bed right side turning angle, a bed front tilting angle, a bed rear tilting angle and an automatic turning cycle time, wherein the automatic turning cycle time comprises a bed horizontal time, a bed left side turning time, a bed right side turning time, a bed front tilting time and a bed rear tilting time.

Preferably, the automatic turning device further comprises a man-machine interaction interface, wherein the man-machine interaction interface is used for inputting the automatic turning parameters.

The control method for guiding the patient bed to turn over based on the lung electrical impedance imaging is realized based on the control system for guiding the patient bed to turn over based on the lung electrical impedance imaging, and comprises the following steps:

step 1, acquiring information related to the ventilation or perfusion state of the lung in EIT equipment based on an EIT information acquisition unit;

step 2, an automatic turn-over parameter determining unit selects lung ventilation or perfusion state related information of any one time node as a reference parameter based on the acquired information related to the lung ventilation or perfusion state;

step 3, setting turning-over parameters with the aim of maximizing the forward change of the patient based on the reference parameters by the automatic turning-over parameter determining unit;

step 4, transmitting the set automatic turning-over parameters to a control unit;

Step 5, controlling the monitoring sickbed to execute the automatic turning-over parameters based on the control unit;

step 6, controlling the monitoring sickbed to execute circulation by a control unit based on the automatic turning-over circulation time set in the automatic turning-over parameters, and detecting the change of information related to the pulmonary ventilation state in EIT equipment in the automatic turning-over circulation;

and 7, if the change of the lung ventilation or perfusion state related information is within the threshold range, the automatic turning-over parameter is not changed, and if the change of the lung ventilation or perfusion state related information is not within the threshold range, the automatic turning-over parameter is changed for the purpose of forward treatment, wherein the purpose of forward treatment is to change the automatic turning-over parameter to indicate the automatic turning-over parameter to be changed for the purpose of improving the lung ventilation or perfusion state.

Preferably, the EIT information acquisition unit in the step 1 acquires information related to the ventilation or perfusion state of the lung in the EIT equipment in a manual mode;

when information related to pulmonary ventilation or perfusion status in the EIT apparatus is acquired manually:

in the step 2, the lung ventilation or perfusion state related information of any time node is selected manually to serve as a reference parameter;

In the step 3, setting automatic turning parameters for the purpose of maximizing forward change of a patient through a human-computer interaction interface according to medical experience;

Step 6, acquiring the change of the information related to the ventilation or perfusion state of the lung in the EIT equipment in the automatic circulation process based on a manual mode;

In the step 7, whether the change is within a threshold value is judged by combining knowledge in the medical field based on a manual mode.

Preferably, the EIT information acquisition unit in the step 1 is realized in an automatic acquisition mode, and the automatic acquisition is realized in a mode of integrating machine vision information acquisition or cable connection information acquisition or monitoring patient bed and EIT into a whole;

When the automatic acquisition is adopted to acquire information related to the ventilation or perfusion state of the lung in EIT equipment:

in the step 2, the lung ventilation or perfusion state related information based on any preset time node is used as a reference parameter;

In the step 3, all automatic turning parameters of the ventilation or perfusion state of the lung are changed through traversing forward, and the automatic turning parameter with the maximum forward change is used as the set automatic turning parameter;

in the step 6, the change of the information related to the pulmonary ventilation or perfusion state in the EIT equipment in the automatic circulation process is acquired in an automatic acquisition mode;

And in the step 7, whether the change of the lung ventilation or perfusion state related information is in the threshold range is judged based on the preset threshold range.

Preferably, the threshold range is as follows:

;

Wherein: Pulmonary ventilation status related information indicating the i-th time; Representing a reference parameter; indicating allowable deviation when When the value is 1, the data is normal, and the automatic turning-over parameter is not required to be changed; when (when)When the value is 0, the data is abnormal, and the automatic turning-over parameter needs to be changed.

The beneficial effects of the invention include:

Drawings

In order to more clearly illustrate the technical solutions of the embodiments of the present application, the drawings that are needed in the embodiments or the description of the prior art will be briefly described below, it being obvious that the drawings in the following description are only some embodiments of the present application, and that other drawings may be obtained according to these drawings without inventive effort for a person skilled in the art.

Fig. 1 is a schematic diagram of a system architecture according to an embodiment of the present invention.

Fig. 2 is a front view of EIT apparatus provided in an embodiment of the present invention.

Fig. 3 is a delta EELI interface of EIT apparatus provided in an embodiment of the present invention.

Fig. 4 is a trend chart interface of EIT equipment provided in an embodiment of the present invention.

Fig. 5 is an analysis view interface of EIT apparatus provided in an embodiment of the present invention.

Fig. 6 is a LHM view cross section of EIT apparatus provided in an embodiment of the present invention.

Fig. 7 is a schematic diagram of an operation interface according to an embodiment of the present invention.

Detailed Description

In order to make the technical problems, technical schemes and beneficial effects to be solved more clear, the application is further described in detail below with reference to the accompanying drawings and embodiments. It should be understood that the specific embodiments described herein are for purposes of illustration only and are not intended to limit the scope of the application.

Referring to fig. 1, a preferred embodiment of the present invention will be further described;

example 1

The EIT information acquisition unit is used for acquiring information related to the ventilation or perfusion state of the lung in EIT equipment;

The automatic turning-over parameter determining unit compares the information related to the pulmonary ventilation or perfusion state with a threshold range, and if the information is in the threshold range, the automatic turning-over parameter is kept, and if the information is not in the preset threshold range, the automatic turning-over parameter is changed with the aim of forward treatment;

As one possible implementation manner of the embodiment, the information related to the pulmonary ventilation or perfusion state in the EIT apparatus includes one or a combination of the information related to the pulmonary ventilation or perfusion state provided by the front view of the EIT apparatus, the information related to the pulmonary ventilation or perfusion state provided by the delta EELI diagram of the EIT apparatus, the information related to the pulmonary ventilation or perfusion state in the trend diagram provided by the EIT apparatus, the information related to the pulmonary ventilation or perfusion state in the analysis view provided by the EIT apparatus, and the information related to the pulmonary ventilation or perfusion state provided by the LHM view provided by the EIT apparatus;

It should be noted that, with the development of EIT technology, new EIT views provide ventilation and perfusion status information of the patient's lungs, which is also within the technical coverage scope of the present invention.

The front view of the EIT equipment provides view interfaces such as real-time lung ventilation, perfusion dynamics, state, curve, moisture frequency, ventilation center and the like, and the lung ventilation state can be known based on the information of any interface diagram;

The delta EELI diagram of the EIT equipment provides an impedance change from the beginning of inspiration to the beginning of the next breath in a breathing cycle, namely an impedance change value from one end-expiration to the next end-expiration, and reflects the change of the residual air quantity in the lung at the end-expiration in a period of time;

The trend graph provided by the EIT equipment provides a result of qualitatively and quantitatively reflecting lung ventilation or lung perfusion change at any two time points in a monitoring area, and the distribution and change of the lung in a period of time of lung ventilation and perfusion are observed;

The analysis view provided by the EIT equipment is a respirator PEEP titration view, and the LHM view provided by the EIT equipment is provided with MI-low frequency high frequency matching index, DI-low frequency deletion index, SI-high frequency deletion index, GI-integral non-uniformity index and the like.

The view information of the five EIT devices is five different view interfaces provided aiming at different clinical application emphasis, but for guiding the automatic turning parameter setting of the monitored sickbed, the essential basis of the automatic turning parameter determination is to compare the difference between the reference state provided by the EIT and the selected change of the existing state, namely the difference value, and the turning parameter for forward treatment of the current patient is selected according to the change condition of the difference value and provided for the control unit.

It is pointed out here that the positive treatment referred to in the present invention does not refer to positive and negative values, but positive and negative values are present in the values described in the images, curves, values for different diseases or patients, where positive and negative values may be positive treatment, i.e. positive improvement, for patients, for example, positive increase in pulmonary ventilation for ARDS patients, positive improvement, but excessive pulmonary ventilation, in turn, would cause lung injury, which negative increase in pulmonary ventilation would be positive for this treatment phase, and for example, for a certain specific parameter, positive improvement of the patient is only provided if the progress in one direction, e.g. ventilation center CoV, only its data is positive increase, indicating that ventilation from ventral to dorsal is more uniform, only positive increase, positive improvement of the patient is only provided, so that the positive treatment referred to in the present invention does not refer to positive and negative values, but means a treatment which is beneficial for the current state of the patient.

As a possible implementation manner of this embodiment, the EIT information collection unit adopts a manner of integrating the manual visual information collection or the machine visual information collection or the cable connection information collection or the patient bed and the EIT into a whole to realize information collection.

For the description of the four acquisition modes, the optimal mode is to acquire by adopting a manual mode or a machine vision mode at present, because the EIT equipment at present has no external port, if the EIT equipment needs to be communicated with the EIT equipment, only the port of the EIT equipment can be added for data acquisition, the EIT equipment needs to be improved by manufacturers, the EIT equipment cannot be timely applied to clinic, the manufacturing cost is increased, the cost increased by adopting an integrated mode is higher, the cost is lowest by adopting the manual or machine vision mode and the EIT equipment is easy to realize, the numerical value in a screen is read by adopting the machine vision mode and is a conventional technical means, therefore, the invention is not repeated, only one camera needs to be installed, the camera faces the screen of the EIT equipment, and how to set the algorithm to read the numerical value is a conventional technical means in the field, so that the invention is not repeated.

As one possible implementation manner of the embodiment, the automatic turning-over parameters comprise a back lifting angle, a leg lifting angle, a bed left side turning angle, a bed right side turning angle, a bed front tilting angle, a bed rear tilting angle and an automatic turning-over cycle time, wherein the automatic turning-over cycle time comprises a bed horizontal time, a bed left side turning time, a bed right side turning time, a bed front tilting time and a bed rear tilting time.

As a possible implementation manner of this embodiment, the apparatus further includes a man-machine interaction interface, where the man-machine interaction interface is used to input the automatic turning-over parameter.

The control system for guiding the patient bed to turn over based on the lung electrical impedance imaging comprises EIT equipment, an EIT information acquisition unit, an automatic turning over parameter determination unit, a control unit and a patient bed, wherein the EIT information acquisition unit acquires lung ventilation state data provided by the EIT equipment in real time, then the automatic turning over parameter determination unit compares the data with a preset threshold range, if the data is in the threshold range, the system keeps the original turning over parameters, if the data exceeds the threshold range, the system adjusts the turning over parameters to achieve a positive treatment effect, namely the lung ventilation state is improved, the control unit instructs the patient bed to perform corresponding body position change operation according to the adjusted turning over parameters, in this way, the system can dynamically adjust the body position of a patient, optimize lung ventilation and further improve the respiratory condition of the patient, so the patient bed can be turned over more accurately and effectively based on a dynamic adjustment method of the EIT data, and the patient treatment effect and comfort level of the patient are improved.

Example 2

In this embodiment, the main view information of the EIT apparatus is taken as the main view information, and the detailed description is made in this embodiment by means of manual observation and adjustment;

The front view information of the EIT equipment comprises a ventilation and perfusion impedance dynamic diagram, a ventilation and perfusion impedance state diagram, a ventilation and perfusion impedance reference diagram, a global lung ventilation impedance curve, a global lung perfusion impedance curve, a state curve of the ventilation impedance curve in each quadrant, a percentage of ventilation and perfusion impedance in each quadrant, a moisture frequency, a ventilation center, a reference point and the like;

The lung ventilation (LPB), perfusion (HPB) impedance dynamic map is a lung ventilation, lung perfusion real-time image reflecting the condition of the patient's breathing swing during the breathing cycle;

The pulmonary ventilation (LPB) impedance state diagram is a lung ventilation state diagram of a patient for one respiratory cycle. A pulmonary perfusion (HPB) impedance state diagram is a state diagram of pulmonary blood flow perfusion impedance values averaged over 5 seconds;

The global lung ventilation impedance curve and the global lung perfusion impedance curve are graphs of the impedance changes of the lung ventilation and the lung perfusion in the monitoring time;

The local lung ventilation impedance curve is a curve graph of the lung ventilation impedance change in the monitoring time in the local area of the lung, namely in the 1 st to 4 th quadrant areas, wherein the 1 st to 4 th quadrant areas can be divided horizontally from the abdomen side to the back side and can be divided into upper, lower, left and right quarters as shown in the figure;

Local lung ventilation and lung perfusion percentage are values of percentage of the respective areas in the local area of the lung, namely in the 1 st to 4 th quadrant areas;

The ventilation center reflects the uniformity of lung ventilation in the ventral-dorsal direction, and the greater the ratio, the more ventilation is at the dorsal part of the lung;

The tidal frequency is the breathing frequency;

the cut point frequency is the number of frames of video displayed per minute for a picture.

step 1, acquiring information of a front view in EIT equipment based on an EIT information acquisition unit, wherein referring to fig. 2, the ventilation percentage of a2 nd quadrant of the front view is taken as a monitoring reference;

Step 2, taking the ventilation rate of the second quadrant of 12% as a reference parameter, wherein the patient is in a lying state at the moment, and the angle parameter of the monitoring sickbed is in an initial state, namely, turning over the patient left and right for 0 degree, lifting the patient back for 0 degree, lifting the patient legs for 0 degree, and tilting the patient back and forth for 0 degree;

Step 3, because the 2 nd quadrant reflects the deficiency of ventilation on the abdomen side of the left lung, according to the theory of turning over and changing respiratory disorder of a patient, the patient should be turned over on the right side, medical staff adjusts the monitoring sickbed to select the dominant right side turning over angle parameter, if the patient is adjusted to be turned over on the right side by 25 degrees, the patient is lifted by 30 degrees, the ventilation ratio of the 2 nd quadrant is lifted to 20% when the patient is lifted by 15 degrees, and then the ventilation ratio is changed to be lower than 20%, which means that the maximum value of positive change of the respiration of the patient is 20% after the turning over parameter of the patient is changed, according to the illness state requirement of the patient, at this time, the automatic turning over dominant parameter of S2 can be set to be 25 degrees of turning over on the right side, 30 degrees of lifting back, 15 degrees of lifting leg, the automatic turning over cycle time is that the patient is lying down for 10 minutes, 30 minutes of turning over to the lying down state, and 0 degree of turning over on the left side;

step 4, turning right for 25 degrees, lifting back for 30 degrees, lifting legs for 15 degrees, and automatically turning over for 10 minutes, turning right for 30 minutes, returning to the prone state for 10 minutes, and inputting a man-machine conversation page of a monitoring sickbed by 0 degree of turning left;

step 6, controlling the monitoring sickbed to execute circulation through a control unit based on the automatic turning-over circulation time set in the automatic turning-over parameters, and manually observing the change of the ventilation duty ratio of the 2 nd quadrant of the EIT main view in the automatic turning-over circulation;

And 7, if the change of the lung ventilation state related information is not in the threshold range, judging whether the change is in the threshold or not by combining knowledge in the medical field based on a manual mode, and changing the automatic turning-over parameter with the aim of forward treatment, wherein the forward treatment aims at changing the automatic turning-over parameter to express the automatic turning-over parameter to improve the lung ventilation state.

Example 3

The embodiment is also described in detail with main view information of EIT equipment as a main part;

the method comprises the steps of 1, acquiring information related to the pulmonary ventilation state in EIT equipment based on an EIT information acquisition unit, wherein the EIT information acquisition unit is realized in an automatic acquisition mode, and the automatic acquisition is realized in a mode of integrating machine vision information acquisition or cable connection information acquisition or monitoring patient bed and EIT;

By automatically acquiring EIT main view information, taking the ventilation percentage of the second quadrant of the main view as a monitoring reference;

and 2, taking the ventilation rate of 12% in the 2 nd quadrant as a reference parameter. At the moment, in the horizontal state of the patient, the angle parameter of the patient monitoring sickbed is an initial state, namely, the patient turns on one's side to the right and turns on one's side by 0 degree, backs up by 0 degree, legs up by 0 degree and tilts back and forth by 0 degree;

Step 3, because the 2 nd quadrant reflects the deficiency of ventilation on the abdomen side of the left lung, according to the theory of changing respiratory disorder of a patient by turning over, the patient should turn over on the right, medical staff adjusts the monitoring sickbed to select the dominant right-turn angle parameter, namely, supposing that a doctor adjusts the angle of the monitoring sickbed to 25 degrees on the right, lifts 30 degrees on the back, and when the leg lifts 15 degrees, the ventilation ratio of the 2 nd quadrant rises to 20%, and then changes the parameters, the ventilation ratio is lower than 20%, which indicates that the above-mentioned turning over angle parameter is optimal, at the moment, the automatic turning over dominant parameter of S2 can be set to 25 degrees on the right, 30 degrees on the back, 15 degrees on the leg, the automatic turning over cycle time is that the patient is lying for 10 minutes, 30 minutes on the right, returns to the lying state for 10 minutes, and turns over on the left for 0 degree;

The description of the cyclic automatic turning is that in the turning of ARDS patients, two modes are adopted, namely, the prone position turning of the patient facing downwards and the supine position turning of the patient facing upwards are adopted, when the alveolar collapse ventilation of the 3 rd quadrant and the 4 th quadrant of the patient is insufficient, the prone position turning of the patient under deep sedation is adopted, namely, the patient is in the prone position with the head facing downwards, the back facing upwards for 8-12 hours or longer per day, the mechanical ventilation of a breathing machine is seriously required, in the embodiment, the patient shown in the figure 2 is a respiratory disorder of the 2 nd quadrant and is a respiratory disorder of the abdomen side of the lung, so that the patient is selected to face upwards and is in the state of not being sedated, the cyclic automatic turning cycle time setting is suitable for the prone position turning and the supine position turning, and the lifting angles of the back and the legs of the patient are all 0 DEG when the prone position turning is adopted, and the lifting angles of the back and the legs of the patient can be set;

Step 6, controlling the monitoring sickbed to execute circulation by a control unit based on the automatic turning-over circulation time set in the automatic turning-over parameters, and automatically collecting ventilation duty ratio change of the 2 nd quadrant of the EIT main view in the automatic turning-over circulation;

Step 7, if the change of the lung ventilation state related information is within the threshold range, the automatic turning-over parameter is not changed, and if the change of the lung ventilation state related information is not within the threshold range, the automatic turning-over parameter is changed with the aim of forward treatment;

The threshold range is as follows:

;

Wherein: Pulmonary ventilation status related information indicating the i-th time; Representing a reference parameter; indicating allowable deviation when When the value is 1, the data is normal, and the automatic turning-over parameter is not required to be changed; when (when)When the value is 0, the data is abnormal, and the automatic turning-over parameter needs to be changed;

If it is The value of (2) is 20,If 1, ifThe ventilation ratio is lower than the lowest value of the threshold range, and the right side turning-over parameter of the patient bed is required to be increased. If the built-in side turning angle of the monitoring sickbed is 2 degrees per step, the monitoring sickbed automatically adjusts the turning parameters to be 27 degrees for right turning, 30 degrees for back lifting and 15 degrees for leg lifting, and the automatic turning cycle time is that the patient is prone for 10 minutes, the patient is turned right for 30 minutes, the patient returns to the prone state for 10 minutes, and the patient is turned left for 0 degree.

If it isThe ventilation ratio is higher than 20% than the preset value, and the monitoring sickbed needs to reduce the right side turning-over parameters. Assuming that the built-in side turning angle of the monitoring sickbed is 2 degrees per step, the monitoring sickbed automatically adjusts the turning parameters to be 23 degrees in a right turning mode, 30 degrees in a back lifting mode and 15 degrees in a leg lifting mode, and the automatic turning cycle time is that the patient lies on the back for 10 minutes, the patient turns on the right for 30 minutes, returns to the lying state for 10 minutes and turns on the left for 0 degree.

Based on the above, it is known that when automatically adjusting the rollover angle, the rollover angle is set based on forward rotation at the time of presetting, and how to set the rollover rule is set based on common knowledge in the medical field, so that the description thereof, such as the above, is omitted in the present inventionIn this case, how to preset the turnover rule so that when the change of the lung ventilation status related information is detected not to be within the threshold range, making a corresponding turnover adjustment is a conventional technical means in the art, so that a detailed description is omitted in the present invention.

The automatic alarm is also included in the embodiment, when the ventilation ratio of the 2 nd quadrant is detected to be changed to be lower than 12% in the circulation process, the automatic turn-over is indicated to be in progress towards the direction which is unfavorable for changing the respiratory disorder of the patient, and the medical staff is required to be provided for processing, so that the medical staff is reminded through the automatic alarm, wherein the automatic alarm adopts an audible and visual alarm mode, only the audible and visual alarm module is required to be electrically connected with the control unit, and the information is acquired when the ventilation ratio is lower than 12% through the control unit, and the audible and visual alarm module is controlled to work.

Example 4

The embodiment guides the monitoring sickbed to turn over automatically based on the delta EELI chart interface information of the EIT, and the embodiment is the same as the flow of the embodiment 2 and the embodiment 3, and the difference is only that the acquired data and the compared data are different, namely the set threshold value corresponds to the acquired data;

The delta EELI plot of EIT provides the change in impedance from the beginning of inspiration to the beginning of the next inspiration, i.e., the change in electrical impedance from one end-expiration to the next end-expiration, over a period of time, reflecting the change in residual air in the lungs at the end-expiration. This change is the end-tidal lung impedance at point C in FIG. 3 minus the end-tidal lung impedance at point Ref;

Different from the main view reflecting a plurality of EIT information of a patient, the Delta EELI diagram reflects the state of end breathing, and in clinical application, only the difference value between the point C and the point Ref is needed to be compared, the operation steps in the clinical application are the same as those in the embodiment 1 and are not repeated;

It should be noted that this difference, if positive, increases, EELI shows a lake blue color, if negative, EELI shows an orange color, decreases, and that it is not absolutely good or bad, e.g., in a patient with COPD with slow lung obstruction, it is desirable that his hyperventilation be reduced, so that a negative value is good at this time. However, positive values are good for patients with intrapulmonary collapse, reflecting an increased ventilation, and point C is selected based on clinical decisions, e.g., treatment time is around 11, and point C is selected at 11.

Therefore, on the basis of the above description, the application of the data of embodiment 4 to the process flow of embodiment 2 or embodiment 3 belongs to a conventional technical means in the art, so that the repeated description of this embodiment is omitted.

Example 5

The flow of the embodiment 5 is the same as that of the embodiment 2 and the embodiment 3, and the difference is that the collected data and the compared data are different, namely, the set threshold value corresponds to the collected data;

The trend graph of EIT provides a result of qualitatively and quantitatively reflecting lung ventilation or lung perfusion change at any two time points in a monitored area, the distribution and change of lung ventilation and perfusion in a period of time are observed, and the distribution and change of lung ventilation and perfusion reflecting the respiratory cycle is different from EELI graph reflecting the positive end pressure of breath, in clinical application, only the difference value between the C point and the Ref point is needed to be compared, the difference value is relatively single, and the operation steps in clinical application are the same as those in the embodiment 1and are not repeated.

Referring to fig. 4, the trend view has three sets of views, the first ventilation and perfusion difference change plot. That is, the LPB change C vs Ref is an image obtained by subtracting the LPB value at Ref from the LPB value at C, and the ventilation conditions in the 1, 2, 3, and 4 regions are all orange, and in a reduced state, only small blue small blocks appear in the middle of the 1, 2 regions, and the ventilation conditions in this region are positively increased. The following change in HPB, C vs Ref, is also the subtraction of the HPB value at Ref point from the HPB value at C point, reflecting that the perfusion status showed a weak orange patch in region 1, with no change in other regions, indicating that blood perfusion was reduced in region 1, with no change in other regions. The middle is the LPB and HPB plot at Ref, the right is at C, and the time interval scale between two points is 10 minutes.

The trend view is that the reference point is selected to correspond to the comparison breath, unlike EELI which reflects positive end-tidal pressure, which reflects the condition of the whole respiratory cycle, as shown in fig. 4, the ventilation condition of the region 2 and 4 of the point C is worse, and the ventilation condition of the region 2 and 4 of the LPB of the reference point Ref is better. In fig. 4, there are 2 trend curves, the upper blue is pulmonary ventilation, the reference point Ref is seen to be downward from point C, the ventilation condition at the point Ref is reflected to be better than that at point C, the lower red is pulmonary perfusion and blood flow, the pulmonary arterial hypertension is reflected, and the blood perfusion between the two points can be compared, and Ref is also more abundant than that at point C. The two curves also monitor the air flow ratio, i.e. the V/Q value, since the tidal volume V of the lung ventilation and the blood flow Q of the lung perfusion are both proportional to the L (PB) and H (PB) resistances of EIT, L/h=v/Q K, where K is validated based on clinical data.

Therefore, on the basis of the above description, the application of the data of embodiment 5 to the process flow of embodiment 2 or embodiment 3 belongs to a conventional technical means in the art, so that the repeated description of this embodiment is omitted.

Example 6

The process of this embodiment 6 is the same as that of embodiments 2 and 3, except that the collected data and the compared data are different, i.e. the set threshold value corresponds to the collected data;

referring to fig. 5, an analysis view of EIT provides a PEEP titration view of a ventilator, which is a view plate for assisting in adjusting the ventilator to select an optimal PEEP value for titration, and in a combined application scene of the ventilator and the monitoring sickbed turning, the view interface can be used for automatically turning the EIT-guided monitoring sickbed.

In clinical application, the differences of PEEP points are compared, and the operation steps are the same as those of example 2 or example 3, and the description will not be repeated.

Example 7

The procedure of this embodiment 7 is the same as that of embodiments 2 and 3, except that the collected data and the compared data are different, i.e. the set threshold value corresponds to the collected data;

referring to fig. 6, the LHM view of eit provides a view of the distribution of individual dedicated index changes, including indices such as MI-low frequency high frequency matching index, DI-low frequency deficiency index, SI-high frequency deficiency index, L-pulmonary ventilation, H-pulmonary perfusion, L/H-air flow ratio, GI-global non-uniformity index, coV-ventilation center, etc.

In clinical applications, the change of each index was compared, and the procedure was the same as in example 2 or example 3, and the description was not repeated.

As an implementation manner of any one of the foregoing embodiments, the monitoring hospital bed of the present application is a monitoring hospital bed of a medical instruments limited company in chengzhu, and the monitoring hospital bed is provided with an operation interface, and the monitoring hospital bed can realize automatic control of the hospital bed based on the automatic turning parameters of the present application, where the operation interface is shown in fig. 7, and fig. 7 is a control panel thereof, that is, the operation interface of the present application, through which corresponding automatic turning parameters can be entered, and then through which a control unit controls the corresponding driving device to drive the hospital bed to turn correspondingly, and because the hospital bed is in the prior art, no corresponding description is made in the present application.

In any of the above embodiments, the EIT view is a view of EIT products of medical image limited company of beijing, and if other EIT product view interfaces of different companies or different types are adopted, the EIT monitoring method is the same, which is not in conflict with the present invention.

The foregoing description of the preferred embodiments of the application is not intended to be limiting, but rather is intended to cover all modifications, equivalents, and alternatives falling within the spirit and principles of the application.

Claims

1. A control system for bed turning guided by electrical pulmonary impedance imaging, comprising an EIT device, an EIT information acquisition unit, an automatic turning parameter determination unit, a control unit, and a bed;

The EIT information acquisition unit is used to acquire information related to lung ventilation or perfusion status in the EIT device;

The automatic turning parameter determination unit compares the information related to the pulmonary ventilation or perfusion state with a threshold range, and if the information is within the threshold range, maintains the original automatic turning parameter; if the information is not within the preset threshold range, changes the automatic turning parameter for the purpose of positive therapy; the changing the automatic turning parameter for the purpose of positive therapy means changing the automatic turning parameter for the purpose of improving the pulmonary ventilation or perfusion state;

The automatic turning parameters include: back lifting angle, leg lifting angle, left side turning angle of the bed, right side turning angle of the bed, front tilt angle of the bed, rear tilt angle of the bed, and automatic turning cycle time; the automatic turning cycle time includes: bed flat time, bed left side turning time, bed right side turning time, bed front tilt time, and bed rear tilt time;

The control unit controls the intensive care bed to execute the automatic turning parameter based on the determined automatic turning parameter.

2. The control system for bed turning based on pulmonary electrical impedance imaging guidance according to claim 1, wherein the information related to pulmonary ventilation or perfusion status in the EIT device comprises one or a combination of: information related to pulmonary ventilation or perfusion status provided by a main view of the EIT device, information related to pulmonary ventilation or perfusion status provided by a ΔEELI graph of the EIT device, information related to pulmonary ventilation or perfusion status in a trend graph provided by the EIT device, information related to pulmonary ventilation or perfusion status in an analysis view provided by the EIT device, and information related to pulmonary ventilation or perfusion status provided by a LHM view provided by the EIT device;

The △EELI graph provides the impedance change from the start of inspiration to the start of the next breath in a respiratory cycle, that is, the change in electrical impedance from the end of one exhalation to the end of the next, reflecting the change in the residual air volume in the lungs at the end of exhalation over a period of time.

The LHM view provides a distribution view of the changes in various dedicated indices, including: MI--low-frequency high-frequency matching index, DI--low-frequency loss index, SI--high-frequency loss index, L--lung ventilation, H--lung perfusion, L/H--air-to-blood ratio, GI--global heterogeneity index, and CoV--ventilation center.

3. The control system for turning over a monitored bed based on electrical pulmonary impedance imaging according to claim 1 is characterized in that the EIT information acquisition unit acquires information by artificial vision information acquisition, machine vision information acquisition, cable connection information acquisition, or by integrating the monitored bed with the EIT.

4. The control system for turning over a monitored bed based on electrical pulmonary impedance imaging guidance according to claim 1, further comprising a human-computer interaction interface for inputting the automatic turning parameters.

5. A control method for turning over a patient bed guided by electrical pulmonary impedance imaging, characterized in that it is implemented based on the control system for turning over a patient bed guided by electrical pulmonary impedance imaging according to any one of claims 1 to 4, and comprises the following steps:

Step 1: Acquire information related to lung ventilation or perfusion status from the EIT device based on the EIT information acquisition unit;

Step 2: The automatic turning parameter determination unit selects information related to the pulmonary ventilation or perfusion state at any time point as a reference parameter based on the acquired information related to the pulmonary ventilation or perfusion state;

Step 3: The automatic turning parameter determination unit sets the turning parameters based on the reference parameters in order to maximize the positive change of the patient;

Step 4: Transmit the set automatic turning parameters to the control unit;

Step 5: Controlling the intensive care bed to execute the automatic turning parameters based on the control unit;

Step 6: controlling the intensive care bed to execute a cycle based on the automatic turning cycle time set in the automatic turning parameter through the control unit, and detecting changes in information related to the lung ventilation status in the EIT device during the automatic turning cycle;

Step 7: If the change in information related to the pulmonary ventilation or perfusion status is within the threshold range, the automatic turning parameters are not changed; if the change in information related to the pulmonary ventilation or perfusion status is not within the threshold range, the automatic turning parameters are changed for the purpose of positive therapy; the changing of the automatic turning parameters for the purpose of positive therapy means changing the automatic turning parameters for the purpose of improving the pulmonary ventilation or perfusion status.

6. The control method for bed turning under electrical pulmonary impedance imaging guidance according to claim 5, wherein the EIT information acquisition unit in step 1 manually acquires information related to pulmonary ventilation or perfusion status from the EIT device;

When manually acquiring information related to lung ventilation or perfusion status from the EIT device:

In step 2, information related to the lung ventilation or perfusion state at any time point is manually selected as a reference parameter;

In step 3, the automatic turning parameters are set through the human-computer interaction interface based on medical experience to maximize the positive change of the patient;

In step 6, changes in information related to lung ventilation or perfusion status in the EIT device during the automatic cycle are obtained manually;

In step 7, it is determined whether the change is within the threshold based on manual methods combined with medical knowledge.

7. The control method for turning over a monitored bed under electrical pulmonary impedance imaging guidance according to claim 5, wherein the EIT information acquisition unit in step 1 is implemented by automatic acquisition, wherein the automatic acquisition is implemented by machine vision information acquisition, cable connection information acquisition, or by integrating the monitored bed with the EIT;

When automatically acquiring information related to lung ventilation or perfusion status from an EIT device:

In step 2, information related to the lung ventilation or perfusion state at any preset time point is used as a reference parameter;

In step 3, all automatic turning parameters that positively change the pulmonary ventilation or perfusion state are traversed, and the automatic turning parameter with the largest positive change is used as the set automatic turning parameter;

In step 6, changes in information related to lung ventilation or perfusion status in the EIT device during the automatic cycle are obtained by automatic acquisition;

In step 7, it is determined whether the change in the information related to the lung ventilation state is within the threshold range based on the preset threshold range.

8. The control method for bed turning under pulmonary electrical impedance imaging guidance according to claim 7, wherein the threshold range is as follows:

;

Where: Represents information related to the lung ventilation status at the i-th moment; Indicates reference parameters; Indicates the permissible deviation; when When it is 1, it means the data is normal and there is no need to change the automatic turning parameters; when When it is 0, it means the data is abnormal and the automatic turning parameters need to be changed.