CN110021427A - A method of for carrying out automatic screening and diagnosis and treatment to patients with heart failure - Google Patents
A method of for carrying out automatic screening and diagnosis and treatment to patients with heart failure Download PDFInfo
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- CN110021427A CN110021427A CN201910252979.4A CN201910252979A CN110021427A CN 110021427 A CN110021427 A CN 110021427A CN 201910252979 A CN201910252979 A CN 201910252979A CN 110021427 A CN110021427 A CN 110021427A
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- heart failure
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Classifications
-
- G—PHYSICS
- G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
- G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
- G16H50/00—ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics
- G16H50/20—ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics for computer-aided diagnosis, e.g. based on medical expert systems
-
- G—PHYSICS
- G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
- G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
- G16H50/00—ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics
- G16H50/70—ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics for mining of medical data, e.g. analysing previous cases of other patients
Landscapes
- Engineering & Computer Science (AREA)
- Health & Medical Sciences (AREA)
- Medical Informatics (AREA)
- Public Health (AREA)
- Data Mining & Analysis (AREA)
- Biomedical Technology (AREA)
- Databases & Information Systems (AREA)
- Pathology (AREA)
- Epidemiology (AREA)
- General Health & Medical Sciences (AREA)
- Primary Health Care (AREA)
- Investigating Or Analysing Biological Materials (AREA)
Abstract
The present invention relates to a kind of method for carrying out automatic screening and diagnosis and treatment to patients with heart failure, be related to medical information system field itself the following steps are included: S1, being acquired to the data source of hospital internal；S2, screening patients with heart failure is carried out by the data of acquisition；S3, the patients with heart failure data filtered out are managed collectively；S4, diagnosis and treatment suggestion is provided to patients with heart failure.Patient can be acquired in the information of hospital, and judge automatically whether it is patients with heart failure, while provide medical advice for its people, the time of doctor and patient are greatly saved during this.
Description
Technical field
The present invention relates to medical information system field, more particularly, to one kind for patients with heart failure carry out automatic screening and
The method of diagnosis and treatment.
Background technique
Heart failure (heart failure) abbreviation heart failure, refers to the contractile function and (or) diastolic function due to heart
Obstacle occurs, heart cannot be sufficiently discharged in venous return, lead to venous system sludging, arterial system hemoperfusion
Deficiency shows as pulmonary venous pleonaemia, vena cave extravasated blood so as to cause cardiac cycle obstacle syndrome in such obstacle disease cluster.The heart
Force failure is not an independent disease, but the terminal stage of heart disease development.Wherein most of heart failure
All it is to be started with left heart failure, that is, first appears as pulmonary circulatory stasis.
Heart failure inducement has very much, including infection, severe arrhythmia, cardiac load increasing, drug effect, improper work
Dynamic and mood, other diseases etc..
When hospital is detected, the project for needing to detect has electrocardiogram, x-ray detection, echocardiogram, arterial blood for heart failure
Gas analysis, laboratory testing, heart failure marker, myocardial necrosis marker etc., inspection item is more.
In the prior art, after patient's inspection finishes, doctor is needed to carry out studying it to the inspection data of each patient
After determine whether it is patients with heart failure, then providing diagnostic recommendations for its people's concrete condition, this process can waste disease
The plenty of time of people and doctor.A kind of method for carrying out automatic screening and diagnosis and treatment to patients with heart failure is now provided.
Summary of the invention
The object of the present invention is to provide a kind of methods for carrying out automatic screening and diagnosis and treatment to patients with heart failure, can be to trouble
Person is acquired in the information of hospital, and judges automatically whether it is patients with heart failure, while providing medical advice for its people,
The time of doctor and patient are greatly saved during this.
Foregoing invention purpose (or goal of the invention one) of the invention has the technical scheme that
A method of for carrying out automatic screening and diagnosis and treatment to patients with heart failure, comprising the following steps:
S1, the data source of hospital internal is acquired；
S2, screening patients with heart failure is carried out by the data of acquisition；
S3, the patients with heart failure data filtered out are managed collectively；
S4, diagnosis and treatment suggestion is provided to patients with heart failure.
The data of patient in hospital can be acquired by using above-mentioned technical proposal by using this method, and
Can Automatic sieve select patients with heart failure, give patients with heart failure certain diagnosis and treatment suggestion, and the process, patient checks after terminating,
It has skipped doctor and has checked the process for checking data, thus, the consultation time of patient has been saved to a certain extent, meanwhile, also subtract
The light workload of doctor.
The present invention is further arranged to: in step s 2, acquire information in match regular expression "/heart failure | heart failure
| heart failure | cardiac insufficiency | heart failure | expansion { 0,1 } cardiomyopathy | ischemic { 0,1 } cardiomyopathy/" information trouble
Person is patients with heart failure.
The present invention is further arranged to: in step s 2, in acquisition information including the trouble that NYHA classification is 3 to 4 grades of information
Person is patients with heart failure.
The present invention is further arranged to: in step s 2, being classified in acquisition information comprising Killip is 2/3/4 grade of information
Patient be acute heart failure patient.
By using above-mentioned technical proposal, the data of patient can be screened, doctor is replaced by the screening process
Artificial screening can be realized by the methods of programming and make screening by oneself, save the plenty of time of patient and doctor.
The present invention is further arranged to: in step s 2, after patients with heart failure is filtered out, to patients with heart failure further progress
Classification.
The present invention is further arranged to: in step s 2, in patients with heart failure information, being believed in kit for diagnosing heart failure comprising " urgency " word
The patient of breath is acute heart failure patient.
The present invention is further arranged to: in step s 2, in patients with heart failure information, it is anxious that Killip classification, which is 2/3/4,
Property patients with heart failure.
The present invention is further arranged to: in step s 2, in patients with heart failure information, acquisition information includes " cardiogenic to stop
Gram " patient of information is acute heart failure patient.
The present invention is further arranged to: in step s 2, in patients with heart failure information, showing in doctor's advice/inspection there is ultrasound
Information diagnosis aroused in interest is to use echocardiogram.
The present invention is further arranged to: in step s 2, in patients with heart failure information, " LVEF is less than for display in information
40% " patient is diagnosed as ejection fraction reduction property heart failure number of cases.
The present invention is further arranged to: in step s 2, in patients with heart failure information, " LVEF is 40% for display in information
Patient to 49% " is diagnosed as the heart failure number of cases that ejection fraction is in intermediate range.
The present invention is further arranged to: in step s 2, in patients with heart failure information, in information display " LVEF be greater than etc.
In 50% " patient, it is diagnosed as ejection fraction retention heart failure number of cases.
The present invention is further arranged to: in step s 2, in patients with heart failure information, with regular expression/brain nature peptide
N-terminal precursor protein | Type B rush urine ([receive | sodium]) excretion peptide | Type B ([receive | sodium]) (acid | urine) peptide | BNP | brain (urine)? it ([receives
| sodium]) peptide | benefit ([receive | sodium]) peptide precursor | Type B benefit ([receive | sodium]) peptide/i or regular expression/brain nature peptide N-terminal precursor egg
It is white | Type B rush urine ([receive | sodium]) excretion peptide | B type ([receive | sodium]) (acid | urine) peptide | BNP | brain (urine)? ([receive | sodium]) peptide |
Benefit ([receive | sodium]) peptide precursor | Type B benefit ([receive | sodium]) peptide | the patient that Applications of Cardiac Markers/i matches is diagnosed as using BNP.
The present invention is further arranged to: in step s 2, drug chemistry name is shown in patients with heart failure information, in information
With regular expression "/Sha Kuba is bent | promise it is glad it is appropriate/" patient that matches is diagnosed as using ARNI class drug.
The present invention is further arranged to: in step s 2, in the doctor's advice information of patients with heart failure, using drug chemistry name with
Regular expression "/Captopril | Acertil | Lotensin | Puli/" when matching, it is diagnosed as before leaving hospital using ACEI.
The present invention is further arranged to: in step s 2, in the doctor's advice information of patients with heart failure, using drug chemistry name with
Regular expression "/An Bowei | An Bonuo | Bei Bote | Valsartan | multiple Valsartan | Cozaar | proud smooth | Micardis | Hyzaar | it must Lip river
This | Sha Tan/" match, and when not including " Sha Kuba bent ", be diagnosed as before leaving hospital using ARB.
The present invention is further arranged to: in step s 2, in the doctor's advice information of patients with heart failure, using drug chemistry name with
Regular expression "/metoprolol | bisoprolol | Carvedilol | Betaloc | Kang Xin | network moral | Nebivolol | atenolol |
Labetalol | Arottnolol/" when matching, it is diagnosed as before leaving hospital using beta-blockers.
The present invention is further arranged to: in step s 2, in the doctor's advice information of patients with heart failure, using drug chemistry name with
Regular expression "/frusemide | Katlex | bumetanide | Torasemide | pool is logical | Hydrochioro | indapamide | amiloride |
Dyrenium | furosemide | Su Maika | furosemide | metolazone | ethacrynic acid/" when matching, it has been diagnosed as edematous patient's loop benefit
Urinate agent number.
The present invention is further arranged to: in step s 2, in step s 2, in the doctor's advice information of patients with heart failure, being used
Drug chemistry name and regular expression "/spirolactone | spiral shell lactones | eplerenone | antisterone/" when matching, it is diagnosed as leaving hospital
When use aldosterone receptor antagonist.
The present invention is further arranged to: in step s 2, in the doctor's advice information of patients with heart failure, using drug chemistry name with
Regular expression "/neodicoumarin | warfarin | dabigatran | razaxaban | Eliquis | safe Bi Quan | visit it is auspicious it is appropriate/" when matching
And the patients with heart failure for being diagnosed as atrial fibrillation uses anticoagulant therapy.
The present invention is further arranged to: in step s 2, in the doctor's advice information of patients with heart failure, " atrium is shown in information
Trembling "/" atrial fibrillation "/' atrial fibrillation " and the patients with heart failure for being diagnosed as atrial fibrillation use anticoagulant therapy.
It by using above-mentioned technical proposal, can be screened with the data further progress of patients with heart failure, and be diagnosed as inhomogeneity
The patients with heart failure of type realized by the methods of programming and makes screening by oneself instead of the link that doctor manually makes a definite diagnosis, saved patient with
The plenty of time of doctor.
The present invention is further arranged to: show in step s 4, in information BNP/NT-pro-BNP result continuously increase or
Weight continuously increases, and the diagnosis and treatment suggestion provided is a, diuretics dosage, and b goes to a doctor in time, c, continues to monitor weight, BNP, kidney function
Energy, electrolyte.
The present invention is further arranged to: it is continuous twice for showing that BNP/NT-pro-BNP result continuously increases in information
BNP/NT-pro-BNP is as a result, more previous increase more than 30%.
The present invention is further arranged to: display body reconnection is continuous in information increases as continuous weight twice as a result, more previous
It increases more than 1kg.
The present invention is further arranged to: showing that heart failure new-onset atrial fibrillation patient or heart failure merge room in step s 4, in information
Quiver patient, and CHA2DS2-VASc scoring is more than or equal to 2 points, and diagnosis and treatment suggestion is a, adds after comprehensive assessment bleeding risk and use anticoagulation
Object, b, Holter check c, thyroid function, d, electrolyte inspection, e, atrial fibrillation comprehensive assessment.
The present invention is further arranged to: showing any time < 3.5mmol/ of nearly 5 serum potassiums in step s 4, in information
L, diagnosis and treatment suggestion are monitoring blood potassium and give benefit potassium drug.
The present invention is further arranged to: in step s 4, potential renal insufficiency patient is shown in information, is estimated glomerular filtration
Less than 30, diagnosis and treatment suggestion is a, monitors renal function rate (eGFR), and whether b, assessment medication meet renal function requirement；The drug being related to
Have: ACEI/ARB, statin, anticoagulation.
The present invention is further arranged to: show in step s 4, in information be not used ACEI/ARB and SBP be greater than 00 and
EGFR is greater than 30, if diagnosis and treatment suggestion is to add to use ACEI/ARB in time without taboo.
The present invention is further arranged to: show in step s 4, in information used ACEI/ARB and SBP be greater than 120 or
DBP is greater than 70, and diagnosis and treatment suggestion is according to clinical setting by ACEI/ARB dosage.
The present invention is further arranged to: show in step s 4, in information patient be HfrEF, NYHA be II or III level,
It is avoided to ACEI/ARB well-tolerated, and without ARNI；Diagnosis and treatment suggestion is to deactivate ACEI/ARB according to clinical setting, and be changed to
ARNI。
The present invention is further arranged to: showing beta-blocker is not used in patient and SBP is greater than etc. in step s 4, in information
In 100 and pulse/heart rate be more than or equal to 70, diagnosis and treatment suggestion be such as without taboo in time add use beta-blocker.
The present invention is further arranged to: showing patient has used beta-blocker and SBP is greater than etc. in step s 4, in information
In 100 and pulse/heart rate be more than or equal to 70, diagnosis and treatment suggestion is according to clinical setting by beta-blocker dosage.
The present invention is further arranged to: show in step s 4, in information patient be LVEF be less than etc. have 35%, NYHA
It is greater than 30, blood potassium < 5mmol/L for II-IV grades, eGFR or the past has myocardial infarction and LVEF is less than or equal to 40%, diagnosis and treatment is built
View is a, is added according to clinical setting and use aldosterone receptor antagonist；B, blood potassium is monitored closely；C, renal function is monitored closely.
The present invention is further arranged to: showing SBP < 110 in step s 4, in information and pulse/heart rate >=70 and sinus property
The rhythm of the heart, diagnosis and treatment suggestion are to be added to use Ivabradine according to clinical setting.
The present invention is further arranged to: show in step s 4, in information merge coronary heart disease and without Parkinson and eGFR it is big
In being equal to 30, diagnosis and treatment suggestion is to be added to use Trimetazidine according to clinical setting.
The present invention is further arranged to: show in step s 4, in information NYHA be II-III grade, and LVEF less than etc.
It is greater than 40 days in 35%, and after heart infarction, and expected existence is greater than 1 year, diagnosis and treatment suggestion is that ICD implantation is considered according to clinical setting.
The present invention is further arranged to: showing that NYHA is II-IV grades in step s 4, in information, and LVEF is less than or equal to
35%, and normal sinus rhythm and QRS wave are both greater than equal to 150ms or to merge LBBB, diagnosis and treatment suggestion is according to clinical setting
Consider implantation CRT/CRT-D.
By using above-mentioned technical proposal, the above diagnosis and treatment suggestion is after checking data by screening hospital, to be suffered from according to heart failure
The different situations of person can give different diagnosis and treatment suggestions automatically, thus, facilitate patient that can determine the medical of oneself faster
Direction, and this process has saved the time of doctor also without the participation of doctor to a certain extent.
In conclusion the invention has the following advantages:
1, by using this method, the data of patient in hospital can be acquired, and can Automatic sieve select heart failure
Patient gives patients with heart failure certain diagnosis and treatment suggestion, and the process, and patient checks after terminating, and has skipped doctor and has checked inspection
The process of data, thus, the consultation time of patient has been saved to a certain extent, meanwhile, also mitigate the workload of doctor.
2, the data of patient can be screened, doctor's artificial screening is replaced by the screening process, has saved patient
With the plenty of time of doctor.
3, the above diagnosis and treatment suggestion is after checking data by screening hospital, to can oneself according to the different situations of patients with heart failure
It is dynamic to give different diagnosis and treatment suggestions, thus, facilitate patient that can determine medical direction self faster, and this process does not have equally
There is the participation of doctor, has saved the time of doctor to a certain extent.
Specific embodiment
A kind of method for carrying out automatic screening and diagnosis and treatment to patients with heart failure disclosed by the invention, comprising the following steps:
S1, the data source of hospital internal is acquired；
S2, screening patients with heart failure is carried out by the data of acquisition；
S3, the patients with heart failure data filtered out are managed collectively；
S4, diagnosis and treatment suggestion is provided to patients with heart failure.
In step sl, concentrated collection is carried out to the data of hospital internal, the information of acquisition can be on case of hospital
Diagnostic message, discharge record, doctor's advice record, inspection record etc., in this step, adopt the diagnostic message of patient in hospital
Collection.
In step s 2, screening patients with heart failure is carried out by the data of acquisition, the information of screening is extracted.In the step
Patients with heart failure is screened in rapid, judgment criteria is as follows:
1, acquire information in match regular expression "/heart failure | heart failure | heart failure | cardiac insufficiency | heart function
Can failure | expansion { 0,1 } cardiomyopathy | ischemic { 0,1 } cardiomyopathy/" patient of information is patients with heart failure.
2, in the homepage discharge diagnosis of case of hospital, NYHA classification is that 3 to 4 grades of patient is patients with heart failure；Wherein,
NYHA is the classification of heart failure.
3, in the homepage discharge diagnosis of case of hospital, Killip classification is that 2/3/4 grade of patient is acute heart failure patient；
Killip classification is the clinical scale for the heart failure caused by AMI (acute myocardial infarction).
Whether by the above rule, tentatively make a definite diagnosis to patient is patients with heart failure, can be with by using this method
The data of patient in hospital are acquired, and can Automatic sieve select patients with heart failure, avoid doctor's artificial screening, thus,
The plenty of time of doctor and patient are saved.
After filtering out patients with heart failure, it is divided into carrying out postsearch screening to patients with heart failure according to the different situations of patient
Different types of patients with heart failure, thus, facilitate the later period to give different types of diagnosis and treatment suggestion to different types of patients with heart failure.Its
In, postsearch screening rule is as follows:
1, in patients with heart failure information, the patient in kit for diagnosing heart failure comprising " urgency " word information is acute heart failure patient.
2, in patients with heart failure information, it is acute heart failure patient that Killip classification, which is 2/3/4,.
3, in patients with heart failure information, acquisition information includes that the patient of " cardiogenic shock " information is acute heart failure patient.
4, in patients with heart failure information, showing has the information diagnosis of ultrasonic cardiography in doctor's advice/inspection be using ultrasonic cardiography
Figure.
5, show that the patient of " LVEF is less than 40% " is diagnosed as ejection fraction reduction property in patients with heart failure information, in information
Heart failure number of cases.
6, show that the patient of " LVEF is 40% to 49% " is diagnosed as at ejection fraction in patients with heart failure information, in information
In the heart failure number of cases of intermediate range.
7, in patients with heart failure information, the patient of display " LVEF is more than or equal to 50% ", is diagnosed as ejection fraction in information
Retention heart failure number of cases.
8, in patients with heart failure information, with regular expression/brain nature peptide N-terminal precursor protein | Type B rush urine ([receive | sodium])
Excretion peptide | Type B ([receive | sodium]) (acid | urine) peptide | BNP | brain (urine)? ([receive | sodium]) peptide | benefit ([receive | sodium]) peptide precursor | B
Type benefit ([receive | sodium]) peptide/i or regular expression/brain nature peptide N-terminal precursor protein | Type B promotees urine ([receive | sodium]) excretion contracting ammonia
Acid | Type B ([receive | sodium]) (acid | urine) peptide | BNP | brain (urine)? ([receive | sodium]) peptide | benefit ([receive | sodium]) peptide precursor | Type B benefit ([receive |
Sodium]) peptide | the patient that Applications of Cardiac Markers/i matches is diagnosed as using BNP.
9, shown in patients with heart failure information, in information drug chemistry name and regular expression "/Sha Kuba is bent | Nuo Xin
Appropriate/" patient that matches is diagnosed as using ARNI class drug.
10, in the doctor's advice information of patients with heart failure, using drug chemistry name and regular expression "/Captopril | Acertil |
Lotensin | Puli/" when matching, it is diagnosed as before leaving hospital using ACEI.
11, in the doctor's advice information of patients with heart failure, using drug chemistry name and regular expression "/An Bowei | An Bonuo |
Times Bo Te | Valsartan | multiple Valsartan | Cozaar | proud smooth | Micardis | Hyzaar | must Loews | Sha Tan/" match, and do not include
When " Sha Kuba is bent ", it is diagnosed as before leaving hospital using ARB.
12, in the doctor's advice information of patients with heart failure, using drug chemistry name and regular expression "/metoprolol | peso Lip river
You | Carvedilol | Betaloc | Kang Xin | network moral | Nebivolol | atenolol | labetalol | Arottnolol/" match
When, it is diagnosed as before leaving hospital using beta-blockers.
13, in the doctor's advice information of patients with heart failure, using drug chemistry name and regular expression "/frusemide | Katlex |
Bumetanide | Torasemide | pool is logical | Hydrochioro | indapamide | amiloride | dyrenium | furosemide | Su Maika | furan thiophene
Rice | metolazone | ethacrynic acid/" when matching, it has been diagnosed as edematous patient's loop diuretic number.
14, in the doctor's advice information of patients with heart failure, using drug chemistry name and regular expression "/spirolactone | spiral shell lactones |
Eplerenone | antisterone/" when matching, it is diagnosed as using aldosterone receptor antagonist when discharge.
15, in the doctor's advice information of patients with heart failure, using drug chemistry name and regular expression "/neodicoumarin | warfarin |
Dabigatran | razaxaban | Eliquis | safe Bi Quan | visit it is auspicious it is appropriate/" when matching and be diagnosed as the patients with heart failure of atrial fibrillation
Use anticoagulant therapy.
16, in the doctor's advice information of patients with heart failure, in information show " auricular fibrillation "/" atrial fibrillation "/' atrial fibrillation " and examine
Break to there is the patients with heart failure of atrial fibrillation to use anticoagulant therapy.
According to the above rule, it can classify to patients with heart failure further progress, the later period is facilitated to suffer from different types of heart failure
Person gives different diagnosis and treatment suggestions.
S3, the patients with heart failure data filtered out are uniformly managed；
It is provided in diagnosis and treatment suggestion in step S4, to patients with heart failure, to each patients with heart failure, according to different treatment feelings
Condition gives different treatment recommendations, at the same time, according to different treatment conditioies, while providing specific diagnosis and treatment and suggesting,
Suggestion content can be provided, specific as follows:
(1) BNP/NT-pro-BNP result continuously increases or weight continuously increases, and the diagnosis and treatment suggestion provided is a, diuretics
Dosage, b go to a doctor in time, c, continue to monitor weight, BNP, renal function, electrolyte.
NT-pro-BNP indicates brain natriuretic peptide before N-terminal, is the relatively reliable index of a diagnosis heart failure, if clinical consider heart failure,
Because NT-proBNT detection can quick obtaining inspection result and result reliability, first inspection project that must be done, and NT-
ProBNT elevated-levels and heart failure severity are positively correlated, and NT-proBNT negative patient can exclude heart failure possibility.
Wherein, BNP/NT-pro-BNP result increases standard continuously as continuous BNP/NT-pro-BNP twice as a result,
More previous raising is more than 30%.The suggestion content that the conditional plan provides is that BNP is continuously increased.
Weight continuously increases as continuous weight twice as a result, more previous raising is more than 1kg.What the conditional plan provided mentions
Show that content is that weight continuously increases.
(2) heart failure new-onset atrial fibrillation patient or heart failure merge patients with atrial fibrillation, and CHA2DS2-VASc scoring is more than or equal to 2 points.
The suggestion content that the conditional plan provides is that atrial fibrillation stroke is high-risk, and diagnosis and treatment suggestion is a, after comprehensive assessment bleeding risk
Add and use anticoagulant, b, Holter check c, thyroid function, d, electrolyte inspection, e, atrial fibrillation comprehensive assessment.
(3) nearly 5 serum potassiums are any secondary less than 3.5mmol/L.
The suggestion content that the conditional plan provides is once to have hypopotassaemia, and diagnosis and treatment suggestion is monitoring blood potassium and gives benefit potassium medicine
Object.
(4) potential renal insufficiency patient estimates glomerular filtration rate (eGFR) less than 30.
The suggestion content that the conditional plan provides is renal insufficiency.Diagnosis and treatment suggestion is a, monitors renal function, and b, assessment are used
Whether medicine meets renal function requirement；The drug being related to has: ACEI/ARB, statin, anticoagulation.
(5) ACEI/ARB is not used and SBP is greater than 00 and eGFR and is greater than 30.
The suggestion content that the conditional plan provides be patient's heart failure, consider whether need to or use ACEI instead, diagnosis and treatment suggestion is
If in time plus using ACEI/ARB without taboo.
(6) it has used ACEI/ARB and SBP is greater than 120 or DBP and is greater than 70.
The suggestion content that the conditional plan provides is that patients' blood is higher, and ACEI/ARB considers dosage, and diagnosis and treatment suggestion is root
According to clinical setting by ACEI/ARB dosage.
(7) if patient is HfrEF, NYHA is II or III level, is avoided to ACEI/ARB well-tolerated, and without ARNI.
The suggestion content that the conditional plan provides is it is contemplated that using ARNI, and diagnosis and treatment suggestion is to be deactivated according to clinical setting
ACEI/ARB, and it is changed to ARNI.
(8) beta-blocker is not used in patient and SBP is more than or equal to 100 and pulse/heart rate is more than or equal to 70.
The suggestion content that the conditional plan provides is patient's heart failure, considers whether that, using beta-blocker, diagnosis and treatment suggestion is such as nothing
Taboo adds in time uses beta-blocker.
(9) patient has used beta-blocker and SBP is more than or equal to 100 and pulse/heart rate is more than or equal to 70.
The suggestion content that the conditional plan provides is that pulse/heart rate is fast, according to beta-blocker considers that dosage, diagnosis and treatment are suggested
Clinical setting is by beta-blocker dosage.
(10) patient is that LVEF is less than etc. that have 35%, NYHA be II-IV grade, eGFR is greater than 30, blood potassium < 5mmol/L or both
Toward thering is myocardial infarction and LVEF to be less than or equal to 40%.
The suggestion content that the conditional plan provides is that need to consider using aldosterone receptor antagonist, and diagnosis and treatment suggestion is a, basis
Clinical setting, which adds, uses aldosterone receptor antagonist；B, blood potassium is monitored closely；C, renal function is monitored closely.
(11) SBP<110 and pulse/heart rate>=70 and sinus rhythm.
The suggestion content that the conditional plan provides is that pulse/heart rate is fast, considers plus use Ivabradine, and diagnosis and treatment suggestion is root
According to clinical setting plus use Ivabradine.
(12) merge coronary heart disease and without Parkinson and eGFR is more than or equal to 30.
The suggestion content that the conditional plan provides is that heart failure merges coronary heart disease, considers to apply Trimetazidine, diagnosis and treatment suggestion is
According to clinical setting plus use Trimetazidine.
(13) NYHA is II-III grades, and LVEF is less than or equal to 35%, and is greater than 40 days after heart infarction, and expected existence is greater than
1 year.
The suggestion content that the conditional plan provides is that heart failure merges heart infarction, considers implantation ICD, and diagnosis and treatment suggestion is according to clinic
Situation considers ICD implantation.
(14) NYHA is II-IV grades, and LVEF is less than or equal to 35%, and normal sinus rhythm and QRS wave are both greater than equal to
150ms is merging LBBB,
The suggestion content that the conditional plan provides is that heart failure merges wide QRS complex, considers implantation CRT/CRT-D, diagnosis and treatment suggestion
To consider implantation CRT/CRT-D according to clinical setting.
Wherein, to patients with heart failure provide diagnosis and treatment suggest in, can just by using be printed as paper document, prestige, QQ,
The modes such as pop-up are read for patients with heart failure.
By using this method, the data of patient in hospital can be acquired, and can Automatic sieve select heart failure trouble
Person gives patients with heart failure certain diagnosis and treatment suggestion, and the process, and patient checks after terminating, and has skipped doctor and has checked inspection number
According to process, the data of patient are screened automatically, after screening terminates, by screening hospital check data after, according to
The different situations of patients with heart failure can give different diagnosis and treatment suggestions automatically, thus, facilitate patient that can determine oneself faster
Medical direction, and this process has saved the time of doctor also without the participation of doctor to a certain extent.
The embodiment of present embodiment is presently preferred embodiments of the present invention, not limits protection of the invention according to this
Range, therefore: the equivalence changes that all structures under this invention, shape, principle are done, should all be covered by protection scope of the present invention it
It is interior.
Claims (36)
1. it is a kind of for patients with heart failure carry out automatic screening and diagnosis and treatment method, it is characterised in that: it is characterized by comprising with
Lower step:
S1, the data source of hospital internal is acquired；
S2, screening patients with heart failure is carried out by the data of acquisition；
S3, the patients with heart failure data filtered out are managed collectively；
S4, diagnosis and treatment suggestion is provided to patients with heart failure.
2. the method according to claim 1 for carrying out automatic screening and diagnosis and treatment to patients with heart failure, it is characterised in that:
In step S2, acquire information in match regular expression "/heart failure | heart failure | heart failure | cardiac insufficiency | heart function
Failure | expansion { 0,1 } cardiomyopathy | ischemic { 0,1 } cardiomyopathy/" information patient be patients with heart failure.
3. the method according to claim 1 for carrying out automatic screening and diagnosis and treatment to patients with heart failure, it is characterised in that:
In step S2, acquire information in comprising NYHA classification be 3 to 4 grades of information patient be patients with heart failure.
4. the method according to claim 1 for carrying out automatic screening and diagnosis and treatment to patients with heart failure, it is characterised in that:
In step S2, acquire information in comprising Killip classification be 2/3/4 grade of information patient be patients with heart failure.
5. special according to the described in any item methods for carrying out automatic screening and diagnosis and treatment to patients with heart failure of claim 2-4
Sign is: in step s 2, after patients with heart failure is filtered out, to patients with heart failure secondary classification.
6. the method according to claim 5 for carrying out automatic screening and diagnosis and treatment to patients with heart failure, it is characterised in that:
In step S2, in patients with heart failure information, the patient in kit for diagnosing heart failure comprising " urgency " word information is acute heart failure patient.
7. the method according to claim 5 for carrying out automatic screening and diagnosis and treatment to patients with heart failure, it is characterised in that:
In step S2, in patients with heart failure information, it is acute heart failure patient that Killip classification, which is 2/3/4,.
8. the method according to claim 5 for carrying out automatic screening and diagnosis and treatment to patients with heart failure, it is characterised in that:
In step S2, in patients with heart failure information, acquisition information includes that the patient of " cardiogenic shock " information is acute heart failure patient.
9. the method according to claim 5 for carrying out automatic screening and diagnosis and treatment to patients with heart failure, it is characterised in that:
In step S2, in patients with heart failure information, showing in doctor's advice/inspection has the patient of the information of ultrasonic cardiography to be diagnosed as using ultrasound
Cardiogram.
10. the method according to claim 5 for carrying out automatic screening and diagnosis and treatment to patients with heart failure, it is characterised in that:
In step s 2, show that the patient of " LVEF is less than 40% " is diagnosed as ejection fraction reduction in patients with heart failure information, in information
Property heart failure number of cases.
11. the method according to claim 5 for carrying out automatic screening and diagnosis and treatment to patients with heart failure, it is characterised in that:
In step s 2, show that the patient of " LVEF is 40% to 49% " is diagnosed as ejection fraction in patients with heart failure information, in information
Heart failure number of cases in intermediate range.
12. the method according to claim 5 for carrying out automatic screening and diagnosis and treatment to patients with heart failure, it is characterised in that:
In step s 2, in patients with heart failure information, the patient of display " LVEF is more than or equal to 50% ", is diagnosed as ejection fraction in information
Retention heart failure number of cases.
13. the method according to claim 5 for carrying out automatic screening and diagnosis and treatment to patients with heart failure, it is characterised in that:
In step s 2, in patients with heart failure information, with regular expression "/brain nature peptide N-terminal precursor protein | Type B promote urine ([receive |
Sodium]) excretion peptide | Type B ([receive | sodium]) (acid | urine) peptide | BNP | brain (urine)? ([receive | sodium]) peptide | benefit ([receive | sodium]) peptide precursor
| Type B benefit ([receive | sodium]) peptide/i " or regular expression "/brain nature peptide N-terminal precursor protein | Type B promotees urine ([receive | sodium]) excretion
Peptide | Type B ([receive | sodium]) (acid | urine) peptide | BNP | brain (urine)? ([receive | sodium]) peptide | benefit ([receive | sodium]) peptide precursor | Type B benefit
([receive | sodium]) peptide | the patient that Applications of Cardiac Markers/i " matches is diagnosed as using BNP.
14. the method according to claim 5 for carrying out automatic screening and diagnosis and treatment to patients with heart failure, it is characterised in that:
In step s 2, shown in patients with heart failure information, in information drug chemistry name and regular expression "/Sha Kuba is bent | Nuo Xin
Appropriate/" patient that matches is diagnosed as using ARNI class drug.
15. the method according to claim 5 for carrying out automatic screening and diagnosis and treatment to patients with heart failure, it is characterised in that:
In step s 2, in the doctor's advice information of patients with heart failure, using drug chemistry name and regular expression "/Captopril | Acertil |
Lotensin | Puli/" when matching, it is diagnosed as before leaving hospital using ACEI.
16. the method according to claim 5 for carrying out automatic screening and diagnosis and treatment to patients with heart failure, it is characterised in that:
In step s 2, in the doctor's advice information of patients with heart failure, using drug chemistry name and regular expression "/An Bowei | An Bonuo |
Times Bo Te | Valsartan | multiple Valsartan | Cozaar | proud smooth | Micardis | Hyzaar | must Loews | Sha Tan/" match, and do not include
When " Sha Kuba is bent ", it is diagnosed as before leaving hospital using ARB.
17. the method according to claim 5 for carrying out automatic screening and diagnosis and treatment to patients with heart failure, it is characterised in that:
In step s 2, in the doctor's advice information of patients with heart failure, using drug chemistry name and regular expression "/metoprolol | peso Lip river
You | Carvedilol | Betaloc | Kang Xin | network moral | Nebivolol | atenolol | labetalol | Arottnolol/" when matching,
It is diagnosed as before leaving hospital using beta-blockers.
18. the method according to claim 5 for carrying out automatic screening and diagnosis and treatment to patients with heart failure, it is characterised in that:
In step s 2, in the doctor's advice information of patients with heart failure, using drug chemistry name and regular expression "/frusemide | Katlex |
Bumetanide | Torasemide | pool is logical | Hydrochioro | indapamide | amiloride | dyrenium | furosemide | Su Maika | furosemide
| metolazone | ethacrynic acid/" when matching, it has been diagnosed as edematous patient's loop diuretic number.
19. the method according to claim 5 for carrying out automatic screening and diagnosis and treatment to patients with heart failure, it is characterised in that:
In step s 2, in step s 2, in the doctor's advice information of patients with heart failure, using drug chemistry name and regular expression " in/spiral shell
Ester | spiral shell lactones | eplerenone | antisterone/" when matching, it is diagnosed as using aldosterone receptor antagonist when discharge.
20. the method according to claim 5 for carrying out automatic screening and diagnosis and treatment to patients with heart failure, it is characterised in that:
In step s 2, in the doctor's advice information of patients with heart failure, using drug chemistry name and regular expression "/neodicoumarin | warfarin |
Dabigatran | razaxaban | Eliquis | safe Bi Quan | visit it is auspicious it is appropriate/" when matching and be diagnosed as the patients with heart failure of atrial fibrillation
Use anticoagulant therapy.
21. the method according to claim 5 for carrying out automatic screening and diagnosis and treatment to patients with heart failure, it is characterised in that:
In step s 2, in the doctor's advice information of patients with heart failure, in information show " auricular fibrillation "/" atrial fibrillation "/' atrial fibrillation " and examine
Break to there is the patients with heart failure of atrial fibrillation to use anticoagulant therapy.
22. according to the described in any item methods for carrying out automatic screening and diagnosis and treatment to patients with heart failure of claim 6-21,
It is characterized in that: showing that BNP/NT-pro-BNP result continuously increases as continuous BNP/NT- twice in step s 4, in information
Pro-BNP is as a result, more previous raising is more than 30%, and the diagnosis and treatment suggestion that provides is a, diuretics dosage, and b goes to a doctor in time, c, after
Continuous monitoring weight, BNP, renal function, electrolyte.
23. according to the described in any item methods for carrying out automatic screening and diagnosis and treatment to patients with heart failure of claim 6-21,
Be characterized in that: display body reconnection is continuous in step s 4, in information increases as continuous weight twice as a result, more previous raising is more than
1kg, the diagnosis and treatment suggestion provided are a, diuretics dosage, and b goes to a doctor in time, c, continue to monitor weight, BNP, renal function, electrolyte.
24. according to the described in any item methods for carrying out automatic screening and diagnosis and treatment to patients with heart failure of claim 6-21,
It is characterized in that: showing that heart failure new-onset atrial fibrillation patient or heart failure merge patients with atrial fibrillation, CHA2DS2-VASc in step s 4, in information
Scoring is more than or equal to 2 points, and diagnosis and treatment suggestion is a, adds after comprehensive assessment bleeding risk and use anticoagulant, and b, Holter check c, first shape
Gland function, d, electrolyte inspection, e, atrial fibrillation comprehensive assessment.
25. according to the described in any item methods for carrying out automatic screening and diagnosis and treatment to patients with heart failure of claim 6-21,
It is characterized in that: showing any secondary < 3.5mmol/L of nearly 5 serum potassiums in step s 4, in information, diagnosis and treatment suggestion is monitoring blood
Potassium simultaneously gives benefit potassium drug.
26. according to the described in any item methods for carrying out automatic screening and diagnosis and treatment to patients with heart failure of claim 6-21,
It is characterized in that: in step s 4, potential renal insufficiency patient is shown in information, estimate that glomerular filtration rate (eGFR) less than 30, is examined
It treats and suggests being a, monitors renal function, whether b, assessment medication meet renal function requirement；The drug being related to has: ACEI/ARB, statin,
Anticoagulation.
27. according to the described in any item methods for carrying out automatic screening and diagnosis and treatment to patients with heart failure of claim 6-21,
It is characterized in that: showing unused ACEI/ARB in step s 4, in information and SBP is greater than 100 and eGFR and is greater than 30, diagnosis and treatment suggestion
If using ACEI/ARB to add in time without taboo.
28. according to the described in any item methods for carrying out automatic screening and diagnosis and treatment to patients with heart failure of claim 6-21,
It is characterized in that: showing the patient for having used ACEI or ARB in step s 4, in information, and SBP is greater than 120 or DBP and is greater than 70,
Diagnosis and treatment suggestion is according to clinical setting by ACEI/ARB dosage.
29. according to the described in any item methods for carrying out automatic screening and diagnosis and treatment to patients with heart failure of claim 6-21,
It being characterized in that: showing that patient is HfrEF in step s 4, in information, NYHA is II or III level, to ACEI/ARB well-tolerated,
And it is avoided without ARNI；Diagnosis and treatment suggestion is to deactivate ACEI/ARB according to clinical setting, and be changed to ARNI.
30. according to the described in any item methods for carrying out automatic screening and diagnosis and treatment to patients with heart failure of claim 6-21,
It is characterized in that: showing that beta-blocker is not used in patient and SBP is more than or equal to 100 and pulse/heart rate is big in step s 4, in information
In being equal to 70, diagnosis and treatment suggestion is such as to add to use beta-blocker in time without taboo.
31. according to the described in any item methods for carrying out automatic screening and diagnosis and treatment to patients with heart failure of claim 6-21,
It is characterized in that: showing that patient has used beta-blocker and SBP is more than or equal to 100 and pulse/heart rate is big in step s 4, in information
In being equal to 70, diagnosis and treatment suggestion is according to clinical setting by beta-blocker dosage.
32. according to the described in any item methods for carrying out automatic screening and diagnosis and treatment to patients with heart failure of claim 6-21,
It is characterized in that: showing that patient is that LVEF is less than etc. and to have that 35%, NYHA is II-IV grades, eGFR is greater than in step s 4, in information
30, there are myocardial infarction in blood potassium < 5mmol/L or the past and LVEF is less than or equal to 40%, and diagnosis and treatment suggestion is a, is added according to clinical setting
Use aldosterone receptor antagonist；B, blood potassium is monitored closely；C, renal function is monitored closely.
33. according to the described in any item methods for carrying out automatic screening and diagnosis and treatment to patients with heart failure of claim 6-21,
It is characterized in that: showing SBP < 110 in step s 4, in information and pulse/heart rate >=70 and sinus rhythm, diagnosis and treatment suggestion are root
According to clinical setting plus use Ivabradine.
34. according to the described in any item methods for carrying out automatic screening and diagnosis and treatment to patients with heart failure of claim 6-21,
It is characterized in that: showing merge coronary heart disease and without Parkinson and eGFR is more than or equal to 30 in step s 4, in information, diagnosis and treatment suggestion is
According to clinical setting plus use Trimetazidine.
35. according to the described in any item methods for carrying out automatic screening and diagnosis and treatment to patients with heart failure of claim 6-21,
It is characterized in that: showing that NYHA is II-III grades in step s 4, in information, and LVEF is less than or equal to 35%, and is greater than after heart infarction
40 days, and expected existence is greater than 1 year, diagnosis and treatment suggestion is that ICD implantation is considered according to clinical setting.
36. according to the described in any item methods for carrying out automatic screening and diagnosis and treatment to patients with heart failure of claim 6-21,
It is characterized in that: showing that NYHA is II-IV grades in step s 4, in information, and LVEF is less than or equal to 35%, and normal sinus rhythm
Both greater than it is equal to 150ms with QRS wave or to merge LBBB, diagnosis and treatment suggestion is to consider implantation CRT/CRT-D according to clinical setting.
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