智慧型紡織品應用於臨床早期胸痛患者之預後分析

Early Clinical Prognosis for High-risk Chest Pain Patients Using Smart Textiles

黃世鋒(Shih-Feng Huang)

指導教授 ： 李仁貴

國立臺北科技大學/電資學院/電腦與通訊研究所/碩士(2013年)

https://doi.org/10.6841/NTUT.2013.00309

摘要

心血管疾病占國人十大死因前三名已多年。根據統計，每日因胸悶、胸痛而前往醫院急診求診的病患占急診內科求診人數相當大的比例。心血管疾病屬於慢性疾病，醫師可能較難於病患求診時，當下根據其病徵進行診斷。為此，急診臨床需要一套「趨勢性的留院觀察分析」來協助醫生進行診斷。
急診遇到胸痛病人(統稱ACS, Acute Coronary Syndrome)的標準流程會先進行十二導程心電圖量測及相關抽血檢查。初步檢查無急性危險者則先留院觀察，並視情況給予壁掛式生理監視器監測。但醫護人員一天可能要面對上百位求診的病患，且醫院床位、醫療人力有限，如何能設計一套能給前來求診病患一個具有心率量測功能、活動方便、又能有效分配醫護人員工作效率的系統，便是我們當前首要目標。預後分析(prognosis)，在醫療上指的是根據一群大樣本數的線索，預測疾病的結果，樣本數愈大，預後分析便更加精準。
本研究以導電絲進行紡織品設計將電路與衣服結合，使用穿戴舒適的導電背心及胸帶，紀錄留院病人之連續性生理指標參數，透過無線傳輸記錄到醫師端電腦，可同時接收區域內多位病人之數據，於留院結束時總和醫院原有之各項指標與心跳變異率各項參數進行出院風險分數評斷，提供急診醫師一套針對胸痛病人更好的出院診斷，並以病患之三天內回診率及三十天內之回診率驗證本預後分析之準確性。

關鍵字

心跳變異率 ； 預後分析 ； 心臟衰竭 ； 穿戴式技術 ； 智慧紡織品

並列摘要

In modern society, cardiovascular diseases have been accounted for the top three leading causes of death for many years. According to statistics, patients suffered from chest pain and went to the hospital Emergency Department(ED) accounted for a large amounts of attendance in ED. Cardiovascular diseases are chronic diseases, physicians may be more difficult to do current diagnosis or seek for medical treatment based on their symptoms. Therefore, clinical need a "Trend analysis of stay in hospital for observation" to help doctors diagnose.
There are some standard operation procedures for ED to handle the chest pain patients: Measurement of ECG (Electrocardiography, ECG), body temperature, blood pressure, and exsanguinate tests. If there is no acute symptom of instant dangerous, doctors usually recommend patients staying in hospital for 4-6 hours observation.
However, medical staffs have to take care of big amounts of patients, so they need a heart rate measurement system with mobility and comfort that may ease their burden. Prognosis is a medical term for predicting the likely outcome of one's current standing. When applied to large statistical populations, prognostic estimates can be very accurate.
In this study, conductive yarn and comfortable chest strap have been sewn in the vest that we can easily record the continuous physiological parameters without movement restrictions. Additionally, the heart rate signal acquired from the vest is sent to a mobile phone, tablet or the physician terminal by wireless communication (Bluetooth and Wi-Fi), and saved for prognosis database. We proposed a discharging Risk Score for clinical discharging judgement using TIMI Risk Score.ER doctors can easily access observation parameters for specific patients to make a better decision in diagnosis for discharge. Three day recalling rate and thirty day recalling rate have been used to verify the accuracy of our prognosis.

並列關鍵字

Heart Rate Variability ； Prognosis ； Congestive Heart Failure ； Wearable ； Smart Textiles

參考文獻

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