阅读说明：本技术 一种昏迷患者的预后评估方法和评估系统 (Prognosis evaluation method and evaluation system for coma patient ) 是由 肖华 于 2019-10-21 设计创作，主要内容包括：本发明公开了一种昏迷患者的预后评估方法和评估系统,评估方法包括患者的生命体征检查和记录、CSI值与GCS评分的数据记录和利用记录的大数据开发出评估软件系统进行患者的预后评估,评估系统包括患者CSI值和GCS评分项目输入模块、数据处理模块、数据输出模块,所述患者CSI值和GCS评分项目输入模块、数据处理模块和数据输出模块之间通信连通。本发明的昏迷患者的预后评估方法和评估系统可以对昏迷患者的预后进行评估和判断,了解患者苏醒的可能性和恢复程度,帮助判断治疗效果和治疗方法是否合适,防止过度医疗。(The invention discloses a prognosis evaluation method and an evaluation system for a coma patient, wherein the evaluation method comprises vital sign examination and recording of the patient, data recording of a CSI value and a GCS score, and development of an evaluation software system by utilizing recorded big data to carry out prognosis evaluation on the patient, the evaluation system comprises a patient CSI value and GCS score item input module, a data processing module and a data output module, and the patient CSI value and GCS score item input module, the data processing module and the data output module are communicated. The prognosis evaluation method and the evaluation system for the coma patient can evaluate and judge the prognosis of the coma patient, know the possibility and recovery degree of patient awakening, help judge whether the treatment effect and the treatment method are proper or not and prevent over-treatment.)

1. A method for the prognostic assessment of a coma patient, comprising the steps of:

(1) determining an evaluation object, wherein the included evaluation object needs to simultaneously meet the following four criteria:

(a) a GCS score of less than 8 points at the time of admission or at the time of admission to the patient over 6 hours;

(b) calling eyes of the user to be uncovered;

(c) failure to answer questions correctly;

(d) movement following advice cannot be followed;

(2) filling a coma patient prognosis statistics questionnaire for each evaluation subject, wherein the questionnaire comprises etiology, age and vital signs of the patient at the time of admission;

(3) the brain damage degree of the evaluation object is checked, and the checking result is recorded in a coma patient prognosis statistics questionnaire;

(4) the brain function state detection is carried out on the evaluation object by using a brain state monitor in the treatment process of the evaluation object, and CSI values of the evaluation object in different treatment periods after admission are respectively recorded;

(5) observing and recording the change condition of the consciousness development of the evaluated object, wherein the observation contents comprise: carrying out a motion reaction, a language reaction and an eye opening reaction, carrying out GCS scoring on the evaluation object and recording a scoring result;

(6) respectively inputting the CSI values and the GCS scores of the plurality of evaluation objects into data analysis software for data analysis to obtain a data corresponding relation between the CSI values and the GCS scores;

(7) setting an awakening grade or awakening possibility percentage relationship, and establishing a corresponding relationship between a CSI value and a GCS score and the awakening grade or the awakening possibility percentage;

(8) establishing the corresponding relation between the CSI value and the GCS score in the step (7) and the awakening level or the awakening possibility percentage into coma patient awakening assessment software, wherein the coma patient awakening assessment software comprises a patient CSI value and GCS score input module, a data processing module for the CSI value and the GCS score and the awakening level or the awakening possibility percentage, and a data output module for the awakening level or the awakening possibility percentage;

(9) and (4) estimating the awakening possibility of the brain coma patient by using the coma patient awakening estimation software in the step (8), inputting the CSI value and the GCS scoring item of the brain coma patient through the CSI value and GCS scoring input module, and automatically outputting the awakening grade or the awakening possibility percentage of the patient by the data output module.

2. The method of claim 1, further comprising recording changes in the brain electrical activity of the subject.

3. The method for the prognostic evaluation of a coma patient according to claim 1, wherein, in the case of detecting the brain function state of the subject to be evaluated using the brain state monitor, the CSI values of the subject to be evaluated are recorded 2 to 3 times within 1 hour, and then the average of the 2 to 3 recordings is taken as the CSI value recorded on the same day.

4. The method for the prognostic evaluation of a coma patient according to claim 3, wherein, in the detection of the brain function state of the evaluation subject using the brain state monitor, the CSI values of the evaluation subject are recorded on the 3 rd, 7 th and 14 th days of admission of the evaluation subject, respectively.

5. The method for the prognostic evaluation of a coma patient according to claim 1, wherein the observation of the time point of evaluating the change in consciousness development of the subject in the step (5) includes the following points: a. when the total GCS score of the patient is more than or equal to 9 points, the eye-opening movement score is more than or equal to 3, and the patient can close eyes or answer questions correctly or exercise limbs in compliance; b. when the patient dies; c. the observation time is more than or equal to 3 months.

6. An assessment system applied to the coma patient prognosis assessment method according to any one of claims 1 to 5, characterized by comprising a patient CSI value and GCS score item input module, a CSI value and GCS score and wake-up level or wake-up likelihood percentage data processing module, a wake-up level or wake-up likelihood percentage data output module, wherein the patient CSI value and GCS score item input module, the CSI value and GCS score and wake-up level or wake-up likelihood percentage data processing module, the wake-up level or wake-up likelihood percentage data output module are in communication with each other, the patient CSI value and GCS score item are input through the CSI value and GCS score item input module, the input patient CSI value and GCS score item are data-processed through the CSI value and GCS score and wake-up level or wake-up likelihood percentage data processing module, and then the data processing result is displayed through a data output module of the awakening grade or the awakening possibility percentage.

7. The system of claim 6, wherein the data output module for the wake-up level or the percentage of likelihood of wake-up comprises a display device for displaying the data processing result.

8. The evaluation system of claim 6, wherein the GCS scoring items include motor responses, language responses, and eye-open responses.

Technical Field

The invention relates to a prognosis evaluation method and an evaluation system for a coma patient.

Background

Coma patients due to various reasons are many at present, some can get better or recover gradually after treatment, and some can evolve into plants and even die finally. At present, a few studies about disturbance of consciousness and coma exist at home and abroad, but the study focuses on the treatment of coma patients, and the prognosis evaluation of the coma patients is rare. The research in the aspect is mostly single-factor research, lacks multi-factor comprehensive research, and is not seen in the large database establishment and intelligent evaluation system research for the prognosis evaluation of coma patients. Therefore, the study results are not practical because of large variation. For the family members of the unconscious patients, the family members need to know how much the patients are expected to be cured or how much the patients can be recovered, and doctors and hospitals can judge whether the treatment effect and the treatment method are suitable or not by judging and evaluating the possibility of patient recovery and the recovery degree. The prevention of over-medical treatment, the liberation of the family thought of the patient and the reduction of the social burden are significant.

Disclosure of Invention

The invention mainly solves the technical problem of providing a prognosis evaluation method for a coma patient, and the prognosis of the coma patient can be evaluated and judged by the evaluation method, so that the possibility and the recovery degree of the patient for waking up can be known, the judgment on whether the treatment effect and the treatment method are proper or not can be helped, and the over-treatment can be prevented.

In order to solve the technical problems, the invention adopts a technical scheme that: provided is a method for prognosis evaluation of a coma patient, comprising the steps of:

(1) determining an evaluation object, wherein the included evaluation object needs to simultaneously meet the following four criteria:

(a) a GCS score of less than 8 points at the time of admission or at the time of admission to the patient over 6 hours;

(b) calling eyes of the user to be uncovered;

(c) failure to answer questions correctly;

(d) movement following advice cannot be followed;

(2) filling a coma patient prognosis statistics questionnaire for each evaluation subject, wherein the questionnaire comprises etiology, age and vital signs of the patient at the time of admission;

(3) the brain damage degree of the evaluation object is checked, and the checking result is recorded in a coma patient prognosis statistics questionnaire;

(4) the brain function state detection is carried out on the evaluation object by using a brain state monitor in the treatment process of the evaluation object, and CSI values of the evaluation object in different treatment periods after admission are respectively recorded;

(5) observing and recording the change condition of the consciousness development of the evaluated object, wherein the observation contents comprise: carrying out a motion reaction, a language reaction and an eye opening reaction, carrying out GCS scoring on the evaluation object and recording a scoring result;

(6) respectively inputting the CSI values and the GCS scores of the plurality of evaluation objects into data analysis software for data analysis to obtain a data corresponding relation between the CSI values and the GCS scores;

(7) setting an awakening grade or awakening possibility percentage relationship, and establishing a corresponding relationship between a CSI value and a GCS score and the awakening grade or the awakening possibility percentage;

(8) establishing the corresponding relation between the CSI value and the GCS score in the step (7) and the awakening level or the awakening possibility percentage into coma patient awakening assessment software, wherein the coma patient awakening assessment software comprises a patient CSI value and GCS score input module, a data processing module for the CSI value and the GCS score and the awakening level or the awakening possibility percentage, and a data output module for the awakening level or the awakening possibility percentage;

(9) and (4) estimating the awakening possibility of the brain coma patient by using the coma patient awakening estimation software in the step (8), inputting the CSI value and the GCS scoring item of the brain coma patient through the CSI value and GCS scoring input module, and automatically outputting the awakening grade or the awakening possibility percentage of the patient by the data output module.

Preferably, the method further comprises recording the brain electrical changes of the evaluation object.

Preferably, when the brain function state of the evaluation object is detected by using the brain state monitor, the CSI value of the evaluation object is recorded 2 to 3 times within 1 hour, and then the average value of the 2 to 3 times is taken as the CSI value recorded on the same day.

Preferably, when the brain function state of the evaluation subject is detected by using the brain state monitor, the CSI values of the evaluation subject are recorded on the 3 rd day, the 7 th day, and the 14 th day of admission of the evaluation subject, respectively.

Preferably, the time point of ending the observation of the change in consciousness development of the evaluation subject in step (5) includes the following points: a. when the total GCS score of the patient is more than or equal to 9 points, the eye-opening movement score is more than or equal to 3, and the patient can close eyes or answer questions correctly or exercise limbs in compliance; b. when the patient dies; c. the observation time is more than or equal to 3 months.

The invention also provides an evaluation system applied to the coma patient prognosis evaluation method, which comprises a patient CSI value and GCS scoring item input module, a CSI value and GCS score and awakening level or percent awakening possibility data processing module, an awakening level or percent awakening possibility data output module, wherein the patient CSI value and GCS scoring item input module, the CSI value and GCS score and awakening level or percent awakening possibility data processing module and the awakening level or percent awakening possibility data output module are in data communication, the CSI value and GCS scoring item of the patient are input through the CSI value and GCS scoring item input module, the input CSI value and GCS scoring item of the patient are subjected to data processing through the CSI value and GCS score and awakening level or percent awakening possibility data processing module, and then the data processing result is displayed through a data output module of the awakening grade or the awakening possibility percentage.

Preferably, the data output module for the wake-up level or the percentage of wake-up possibility includes a display device for displaying the data processing result.

Preferably, the GCS scoring items include motor responses, language responses, and eye-open responses.

The invention has the beneficial effects that: the prognosis evaluation method and the evaluation system for the coma patient can evaluate and judge the prognosis of the coma patient, know the possibility and recovery degree of patient awakening, help judge whether the treatment effect and the treatment method are appropriate, prevent over-treatment, and are beneficial to relieving the family thought burden of the patient and relieving the social burden.

Drawings

In order to more clearly illustrate the technical solutions in the embodiments of the present invention, the drawings needed to be used in the description of the embodiments are briefly introduced below, it is obvious that the drawings in the following description are only some embodiments of the present invention, and other drawings can be obtained by those skilled in the art without inventive efforts, wherein:

FIG. 1 is a schematic block diagram of an assessment system of the present invention for use in a method of prognostic assessment of a comatose patient.

Detailed Description

The technical solutions in the embodiments of the present invention will be clearly and completely described below, and it is obvious that the described embodiments are only a part of the embodiments of the present invention, and not all embodiments. All other embodiments, which can be derived by a person skilled in the art from the embodiments given herein without making any creative effort, shall fall within the protection scope of the present invention.

The embodiment of the invention comprises the following steps:

the method for the prognosis evaluation of a coma patient of the present invention comprises the steps of:

(1) determining an evaluation object, wherein the included evaluation object needs to simultaneously meet the following four criteria:

(a) the GCS score at the time of admission or at the time of admission of the patient is less than 8 points over 6 hours, the evaluation of the GCS score, i.e. the glasgow coma index, among which there are three aspects of eye-opening response, language response and limb movement;

(b) calling eyes of the user to be uncovered;

(c) failure to answer questions correctly;

(d) movement following advice cannot be followed;

patients who meet the four conditions are coma patients;

(2) filling a coma patient prognosis statistics questionnaire for each evaluation subject, wherein the questionnaire comprises etiology, age and vital signs of the patient at the time of admission;

(3) the brain injury degree of an evaluation object is checked, the check result is recorded in a prognosis statistical questionnaire of a coma patient, generally, the brain CT check of the evaluation object, namely a patient, is carried out by CT equipment, or the brain injury condition of the patient is examined by nuclear magnetic resonance MRI and transcranial Doppler, and whether the patient has cerebral hemorrhage or not, and the position and the amount of the hemorrhage are checked and recorded;

(4) the brain function state detection is carried out on the evaluation object by using a brain state monitor in the treatment process of the evaluation object, and CSI values, namely brain state indexes, of the evaluation object in different treatment periods after admission are respectively recorded;

(5) observing and recording the change condition of the consciousness development of the evaluated object, wherein the observation contents comprise: carrying out a motion reaction, a language reaction and an eye opening reaction, carrying out GCS scoring on the evaluation object and recording a scoring result;

(6) respectively inputting the CSI values and the GCS scores of the plurality of evaluation objects into data analysis software for data analysis to obtain a data corresponding relation between the CSI values and the GCS scores;

(7) setting an awakening grade or awakening possibility percentage relationship, and establishing a corresponding relationship between a CSI value and a GCS score and the awakening grade or the awakening possibility percentage;

(8) establishing the corresponding relation between the CSI value and the GCS score in the step (7) and the awakening level or the awakening possibility percentage into unconscious patient awakening assessment software, wherein the unconscious patient awakening assessment software comprises a patient vital sign and CSI value and GCS score input module, a data processing module for the vital sign and CSI value and the GCS score and the awakening level or the awakening possibility percentage, and a data output module for the awakening level or the awakening possibility percentage;

(9) and (3) estimating the awakening possibility of the brain unconscious patient by utilizing the awakening estimation software of the unconscious patient in the step (8), inputting the vital signs, the examination result of the brain damage degree, the CSI value and the GCS scoring item of the brain unconscious patient through a CSI value and GCS scoring input module, processing the input data through a data processing module of the CSI value, the GCS scoring and the awakening level or the percentage of the awakening possibility, and automatically outputting the awakening level or the percentage of the awakening possibility of the patient through a data output module according to the corresponding relation between the vital signs, the examination result of the brain damage degree, the CSI value and the GCS scoring and the awakening level or the percentage of the awakening possibility of the patient, so that the awakening estimation result of the unconscious patient can be. The coma patient awakening assessment software can rapidly assess the awakening condition of the coma patient, so that the coma patient and family members can know the coma degree, whether the coma patient is possible to awaken and the awakening recovery degree as soon as possible, and a doctor can know whether the treatment effect and the treatment method are appropriate or not, thereby preventing over-medical treatment, and being beneficial to relieving the thought burden of the family members of the patient and relieving the social burden.

Preferably, the method further comprises recording the brain electrical changes of the evaluation object. The electroencephalogram of the patient is checked and recorded, the electroencephalogram physiology of the patient is known and compared with the head image of the patient, and finally the electroencephalogram physiology of the patient is compared with the awakening condition of the patient, so that the corresponding relation between the electroencephalogram physiology change of the patient and the CT check result and the awakening condition of the patient can be obtained.

Preferably, when the brain function state of the evaluation object is detected by using the brain state monitor, the CSI value of the evaluation object is recorded 2 to 3 times within 1 hour, and then the average value of the 2 to 3 times is taken as the CSI value recorded on the same day. The CSI value obtained in this way is true and objective.

Preferably, when the brain function state of the evaluation target is detected by using the brain state monitor, the CSI values of the evaluation target are recorded at the time of admission, on the 3 rd day, on the 7 th day, and on the 14 th day of admission, respectively, of the evaluation target. Recording the CSI value of the evaluation object at different admission times can realize the change trend of the CSI value of the patient and the relation with the final awakening condition.

Preferably, the time point of ending the observation of the change in consciousness development of the evaluation subject in step (5) includes the following points: a. when the total GCS score of the patient is more than or equal to 9 points, the eye-opening movement score is more than or equal to 3, and the patient can close eyes or answer questions correctly or exercise limbs in compliance; b. when the patient dies; c. the observation time is more than or equal to 3 months. When the above three cases of going occur, observation and study of the change in consciousness development of the evaluation subject were stopped. When the patient has a GCS score of 9 or more, an open eye movement score of 3 or more, and can follow the eyes closed or answer questions correctly or follow the movement limbs, the patient is stated to be awake. No observation studies were necessary when the patient died. When the observation time is more than or equal to 3 months, the observation time is enough, and the observation research is not needed to be continued.

Through observation and study of 119 patients, 69 patients were awake at the end of the observation and study, accounting for 57.98%, and were classified as awake; 32 patients still coma, accounting for 26.89%, and classified as coma group; in 18 cases, the patients died, accounting for 15.13%, and were classified as dead group. Through observation and study of the 119 patients at admission time, 3 days, 7 days and 14 days of admission, the CSI value data statistics of the 119 patients at the 4 time points are shown in the following table one:

table one, CSI value data statistics for 119 patients at 4 different time points:

group of	Number of examples	CSI value at admission	CSI value on day 3 of admission	CSI value at 7 days of admission	CSI value at day 14 of admission
						Sobering group	69	68.38±12.18	80.42±7.34	86.58±8.01	90.19±7.06
Coma group	32	47.41±17.40	62.50±9.02	70.56±8.20	72.75±7.54
						Death group	18	23.72±22.98	20.56±21.99	13.61±21.09	20.56±21.99

Through data statistical analysis, the CSI value of the patient and the GCS score are in a positive correlation relationship, the higher the CSI value is, the better the patient is in the awakening condition, the higher the GCS score of the patient is, and the higher the possibility that the patient is awakened is.

In addition, through research and record of more than six hundred patients, the coma patient awakening assessment software is developed by cooperating with an artificial intelligence big data department of the eye center of the university of Zhongshan. The coma patient awakening assessment software is applied to assess the prognosis of the coma patient, and the accuracy of the assessment method in clinical application reaches about 92%.

The coma patient prognosis statistics questionnaire used in the present invention is as follows:

study form filler: study time: numbering:

the invention also provides an evaluation system applied to the prognosis evaluation method of the coma patient, as shown in fig. 1, comprising a patient vital sign, a CSI value and a GCS scoring item input module; a data processing module for vital signs, CSI values and GCS scores and wake-up levels or wake-up likelihood percentages; the data processing module is used for processing the input CSI value and the input GCS scoring item of the patient and displaying the data processing result through the data output module of the wake-up grade or the wake-up possibility percentage.

Preferably, the data output module for the wake-up level or the percentage of wake-up possibility includes a display device, such as a mobile phone, a display, etc., for displaying the data processing result.

Preferably, the GCS scoring items include motor responses, language responses, and eye-open responses. Different motor responses, language responses and eye-opening responses of the patients correspond to different GCS scoring results.

Through the collection and the filling of the whole data, the information of the patient is input into the evaluation system, the system automatically obtains the awakening probability and the awakening time of the unconscious patient, the awakening probability is high, the survival quality is good, the treatment is actively carried out, the awakening rate is too low, and the recommended family members with high mortality rate give up.

The coma patient prognosis evaluation system evaluates the performance of vital signs (body temperature, pulse, respiration, blood pressure, CT, electroencephalogram and the like) of a patient, and the condition of the vital signs, the CSI value and the GCS score of the patient are in positive correlation with the probability of awakening and the prognosis. Higher score indicates lower degree of sack damage, and good prognosis, otherwise poor prognosis. The state of the illness can be fully grasped through the result obtained by evaluation, and the adjustment of the treatment scheme of the patient by medical staff is facilitated.

The above description is only an embodiment of the present invention, and not intended to limit the scope of the present invention, and all modifications of equivalent structures and equivalent processes, which are made by the present specification, or directly or indirectly applied to other related technical fields, are included in the scope of the present invention.