阅读说明：本技术 一种aki分层预警、临床病情监测管理方法及系统 (AKI layered early warning and clinical disease monitoring management method and system ) 是由 潘玲 于 2021-07-28 设计创作，主要内容包括：本发明公开了一种AKI分层预警、临床病情监测管理方法及系统,包括：步骤一、AKI分层预警；步骤二、确诊AKI患者的临床病情监测及院内外一体化管理。本发明与现有技术相比的优点在于：1)对AKI早诊早治,及时专科干预；2)对AKI进行分层预警,更有针对性对病因及高危因素制定个体化精准诊疗措施；3)通过院内外一体化管理,掌握患者病情变化及药物治疗效果,对患者跟踪随访管理,确保有效的治疗,准确评估预后情况。(The invention discloses an AKI layered early warning and clinical disease monitoring management method and a system, comprising the following steps: step one, AKI layered early warning; and step two, the clinical condition monitoring and the hospital internal and external integrated management of confirmed AKI patients. Compared with the prior art, the invention has the advantages that: 1) early diagnosis and early treatment of AKI, and timely special intervention; 2) performing layered early warning on AKI, and making individual accurate diagnosis and treatment measures aiming at the etiology and high-risk factors; 3) through the integrated management inside and outside the hospital, the state of illness change and the drug treatment effect of the patient are mastered, the follow-up visit management is carried out on the patient, the effective treatment is ensured, and the prognosis condition is accurately evaluated.)

1. An AKI layered early warning and clinical disease monitoring management method and system are characterized by comprising the following steps:

step one, AKI hierarchical early warning, the function is realized through an AKI hierarchical early warning module based on a system architecture, the AKI hierarchical early warning module comprises an AKI screening standard module and an AKI module, the AKI screening standard module is based on a Lis or His system in a hospital, 3 conforming standards are formulated according to an Scr or urine volume standard, patient information conforming to the standards enters a screening AKI patient module through a channel erected in the system, the function comprises frame-bouncing early warning and automatic display of the patient information on an early warning platform, and the patient in the stage of CKD5 is removed and then is subjected to consultation by a specialist in nephrology department and then is layered on the system; the AKI module carries out AKI layered early warning according to renal functions, imaging and drug keywords, and after the system displays reminding, special physicians in nephrology carry out AKI confirmation diagnosis, wherein the AKI module comprises a pre-renal AKI module, a post-renal AKI module and a renal AKI module;

step two, the clinical disease monitoring and the hospital internal and external integrated management of the confirmed AKI patient, according to the information of the confirmed AKI patient in the step one, after obtaining informed consent, the information is imported into the constructed on-line clinical disease hospital internal and external integrated nephropathy management system through a registration number of a His system, the patient is followed up for 3 months, and a doctor in the hospital makes a disease evaluation, complication monitoring and diagnosis and treatment scheme; the hospital continues to carry out follow-up management on patients, monitor the renal function recovery condition, adjust the treatment scheme according to the disease condition, carry out on-line health promotion and education, control the risk factors, prevent recurrence aggravation and improve the prognosis.

2. The AKI hierarchical early warning and clinical condition monitoring management method and system according to claim 1, wherein: the conformity standard formulated by the AKI screening standard module is respectively as follows: 1) the increase of Scr is more than or equal to 0.9mg/dl (26.5 mu mol/L) within 48 hours;

2) confirm or speculate that Scr increased 50% over basal within 7 days;

3) the urine volume is less than 0.5ml/(kg.h) and is continuously more than or equal to 6 h.

3. The AKI hierarchical early warning and clinical condition monitoring management method and system according to claim 1, wherein: the standard of the prerenal AKI module is Bun/Scr: 15: 1;

the key word of the imaging examination of the post-renal AKI module on the display layer indicates that the key word is hydronephrosis or ureteral dilatation;

the renal AKI module includes a pharmaceutical unit and a non-pharmaceutical functional unit.

4. The AKI hierarchical early warning and clinical condition monitoring management method and system according to claim 3, wherein: keywords on the presentation layer of the drug-containing unit of the renal AKI module suggest "vancomycin", "cisplatin", "amphotericin", "contrast agent";

the keywords of the non-drug functional units of the renal AKI module on the display layer indicate that the rhabdomyolysis, the crush syndrome and the poisoning exist.

Technical Field

The invention relates to a medical system, in particular to an AKI layered early warning and clinical disease monitoring management method and system.

Background

Acute kidney injury is a group of clinical syndromes, referring to sudden (within 1-7 d) and sustained (>24h) sudden decline in renal function, defined as an increase of at least 0.5mg/dl 1 in serum creatinine (SCr), manifested by azotemia, aqueous electrolyte and acid-base balance and systemic symptoms throughout the body, which may be accompanied by oliguria (<400ml/24h or 17ml/h) or anuria (<100ml/24 h).

Disclosure of Invention

The invention aims to solve the technical problem that an AKI early warning and detection management system is lacked at present and does not meet the current clinical requirements.

In order to solve the technical problems, the technical scheme provided by the invention is as follows: an AKI layered early warning and clinical disease monitoring management method and a system thereof comprise the following steps:

step one, AKI layering early warning, namely realizing functions through an AKI layering early warning module based on a system architecture, wherein the AKI layering early warning module comprises an AKI screening standard module and an AKI module, the AKI screening standard module is based on a Lis or His system in a hospital, 3 conforming standards are formulated according to an Scr or urine volume standard, patient information conforming to the standards enters a screening AKI patient module through a channel erected in the system, the functions comprise frame popping early warning and automatic display of the patient information on an early warning platform, and layering is performed on the system after patients in CKD5 stage are removed and consultation is performed by a specialist in nephrology department; the AKI module carries out AKI layering early warning according to renal functions, imaging and drug keywords, and after the system displays reminding, special physicians in nephrology carry out AKI confirmation diagnosis, wherein the AKI comprises a pre-renal AKI module, a post-renal AKI module and a renal AKI module;

step two, the clinical disease monitoring and the hospital internal and external integrated management of the confirmed AKI patient, according to the information of the confirmed AKI patient in the step one, after obtaining informed consent, the information is imported into the constructed on-line clinical disease hospital internal and external integrated nephropathy management system through a registration number of a His system, the patient is followed up for 3 months, and a doctor in the hospital makes a disease evaluation, complication monitoring and diagnosis and treatment scheme; the hospital continues to carry out follow-up management on patients, monitor the renal function recovery condition, adjust the treatment scheme according to the disease condition, carry out on-line health promotion and education, control the risk factors, prevent recurrence aggravation and improve the prognosis.

Compared with the prior art, the invention has the advantages that: 1) early diagnosis and early treatment of AKI, and timely special intervention; 2) performing layered early warning on AKI, and making individual accurate diagnosis and treatment measures aiming at the etiology and high-risk factors; 3) through the integrated management inside and outside the hospital, the state of illness change and the drug treatment effect of the patient are mastered, the follow-up visit management is carried out on the patient, the effective treatment is ensured, and the prognosis condition is accurately evaluated.

As an improvement, the compliance standards established by the AKI screening standard module are respectively: 1) the increase of Scr is more than or equal to 0.9mg/dl (26.5 mu mol/L) within 48 hours;

2) confirm or speculate that Scr increased 50% over basal within 7 days;

3) the urine volume is less than 0.5ml/(kg.h) and is continuously more than or equal to 6 h.

For improvement, the prerenal AKI module standard is Bun/Scr: 15: 1;

the key word of the imaging examination of the post-renal AKI module on the display layer indicates that the key word is 'hydronephrosis' or 'ureter expansion';

the renal AKI module includes a pharmaceutical unit and a non-pharmaceutical functional unit.

As an improvement, keywords on the presentation layer for the drug-containing unit of the renal AKI module suggest "vancomycin", "cisplatin", "amphotericin", "contrast agent";

keywords of the non-drug functional units of the renal AKI module on the display layer indicate that the rhabdomyolysis, the crush syndrome and the poisoning exist.

Drawings

Fig. 1 is a schematic view of the workflow of a method and a system for AKI hierarchical early warning and clinical condition monitoring management.

Detailed Description

The present invention will be described in further detail with reference to the accompanying drawings.

In specific implementation, the invention provides an AKI layered early warning and clinical disease monitoring management method and a system, comprising the following steps:

step one, AKI hierarchical early warning, the function is realized through an AKI hierarchical early warning module based on a system architecture, the AKI hierarchical early warning module comprises an AKI screening standard module and an AKI module, the AKI screening standard module is based on a Lis or His system in a hospital, 3 conforming standards are formulated according to an Scr or urine volume standard, patient information conforming to the standards enters a screening AKI patient module through a channel erected in the system, the function comprises frame-bouncing early warning and automatic display of the patient information on an early warning platform, and the patient in the stage of CKD5 is removed and then is subjected to consultation by a specialist in nephrology department and then is layered on the system; the AKI module carries out AKI layered early warning according to renal functions, imaging and drug keywords, and after the system displays reminding, special physicians in nephrology carry out AKI confirmation diagnosis, wherein the AKI module comprises a pre-renal AKI module, a post-renal AKI module and a renal AKI module;

step two, the clinical disease monitoring and the hospital internal and external integrated management of the confirmed AKI patient, according to the information of the confirmed AKI patient in the step one, after obtaining informed consent, the information is imported into the constructed on-line clinical disease hospital internal and external integrated nephropathy management system through a registration number of a His system, the patient is followed up for 3 months, and a doctor in the hospital makes a disease evaluation, complication monitoring and diagnosis and treatment scheme; the hospital continues to carry out follow-up management on patients, monitor the renal function recovery condition, adjust the treatment scheme according to the disease condition, carry out on-line health promotion and education, control the risk factors, prevent recurrence aggravation and improve the prognosis.

The conformity standard formulated by the AKI screening standard module is respectively as follows: 1) the increase of Scr is more than or equal to 0.9mg/dl (26.5 mu mol/L) within 48 hours;

2) confirm or speculate that Scr increased 50% over basal within 7 days;

3) the urine volume is less than 0.5ml/(kg.h) and is continuously more than or equal to 6 h.

The standard of the prerenal AKI module is Bun/Scr: 15: 1;

the key word of the imaging examination of the post-renal AKI module on the display layer indicates that the key word is hydronephrosis or ureteral dilatation;

the renal AKI module includes a pharmaceutical unit and a non-pharmaceutical functional unit.

Keywords on the presentation layer of the drug-containing unit of the renal AKI module suggest "vancomycin", "cisplatin", "amphotericin", "contrast agent";

the keywords of the non-drug functional units of the renal AKI module on the display layer indicate that the rhabdomyolysis, the crush syndrome and the poisoning exist.

The working principle of the invention is as follows: the technical scheme of the invention comprises the following two contents:

1. AKI layered early warning

(1) AKI screening criteria

Based on Lis or His system in hospital, screening AKI patients according to Scr or urine volume standard of KDIGO guide in 2012 and meeting 3 standards, performing frame-flipping early warning or automatically displaying patient information on an early warning platform, removing the patients in CKD5 stage, and then performing consultation by special nephrology physicians for layering.

(2) AKI layered early warning

AKI layering early warning is carried out according to renal function, imaging and medicine keywords, and after reminding is displayed by a system, AKI confirmation diagnosis is carried out by a specialist in nephrology department, wherein the AKI layering early warning comprises the following steps: 1) prerenal (Bun/Scr: 15: 1) (ii) a 2) Postrenal sex: the keywords of the imaging examination prompt the 'hydronephrosis' or the 'ureter dilation'; 3) renal: the medicine property: vancomycin, cisplatin, amphotericin, contrast agents; ② non-drug property: rhabdomyolysis, crush syndrome, poisoning.

2. Clinical disease monitoring and hospital internal and external integrated management of confirmed AKI patient

After informed consent is obtained by confirmed AKI patients, introducing the confirmed AKI patients into a constructed on-line clinical disease hospital internal and external integrated nephropathy management system through a His system registration number, and performing disease evaluation, complication monitoring and diagnosis and treatment scheme formulation by doctors in the hospital after the patients visit for 3 months; the hospital continues to carry out follow-up management on patients, monitor the renal function recovery condition, adjust the treatment scheme according to the disease condition, carry out on-line health promotion and education, control the risk factors, prevent recurrence aggravation and improve the prognosis.

Furthermore, the terms "first", "second" and "first" are used for descriptive purposes only and are not to be construed as indicating or implying relative importance or implicitly indicating the number of technical features indicated. Thus, a feature defined as "first" or "second" may explicitly or implicitly include one or more of that feature, and in the description of the invention, "plurality" means two or more unless explicitly specifically defined otherwise.

In the present invention, unless otherwise specifically stated or limited, the terms "mounted," "connected," "fixed," and the like are to be construed broadly and may, for example, be fixedly connected, detachably connected, or integrally connected; can be mechanically or electrically connected; they may be connected directly or indirectly through intervening media, or they may be interconnected between two elements. The specific meanings of the above terms in the present invention can be understood by those skilled in the art according to specific situations.

In the present invention, unless otherwise expressly stated or limited, "above" or "below" a first feature means that the first and second features are in direct contact, or that the first and second features are not in direct contact but are in contact with each other via another feature therebetween. Also, the first feature being "on," "above" and "over" the second feature includes the first feature being directly on and obliquely above the second feature, or merely indicating that the first feature is at a higher level than the second feature. A first feature being "under," "below," and "beneath" a second feature includes the first feature being directly above and obliquely above the second feature, or simply meaning that the first feature is at a lesser level than the second feature.

In the description herein, reference to the terms "one embodiment," "some embodiments," "an example," "a specific example," or "some examples" or the like means that a particular feature, structure, material, or characteristic described in connection with the embodiment or example is included in at least one embodiment or example of the invention. In this specification, the schematic representations of the terms used above do not necessarily refer to the same embodiment or example. Furthermore, the particular features, structures, materials, or characteristics described may be combined in any suitable manner in any one or more embodiments or examples.

Although embodiments of the present invention have been shown and described above, it is understood that the above embodiments are exemplary and should not be construed as limiting the present invention, and that variations, modifications, substitutions and alterations can be made in the above embodiments by those of ordinary skill in the art without departing from the principle and spirit of the present invention.