腹膜炎篩檢方法應用於腹膜透析居家照護系統

A Peritonitis Screening Method for Peritoneal Dialysis Patients Using Portable Homecare System

盧彥丞(Lu, Yen Chen)

指導教授 ： 馬席彬

國立清華大學/電機資訊學院/電機工程學系/碩士(2016年)

摘要

在台灣腎臟病是一個常見且嚴重的疾病，針對腎臟病的處理，腹膜透析是一個僅次於血液透析的洗腎方式，這個方法比起血液透析可以更節省醫療成本，但是很容易發生感染產生腹膜炎，因此我們設計了一套腹膜透析的居家照護系統去監督病患的透析液情形並且記錄下來提供醫生做參考
不同於傳統的利用生化分析的結果去做預測需要耗費較多的時間，我們的系統主要是利用色度和濁度去篩檢病患做完腹膜透析之後的透析液來判斷是否有腹膜炎的現象發生，我們的方法可以有效的省去生化篩檢的時間。在資料的蒐集上面，我們會先把透析液倒入我們特製的容器中，利用手機照相功能還有我們自製的手機程式去獲得透析液的色度，再利用一個LED的發射器發射光源到透析液內部藉由測量光線的衰減來判斷透析液的混濁程度。
在篩檢的流程上面，我們用了一個簡單的三步驟去執行，第一步是用高斯混和模型(Gaussian Mixture Model)去檢測該透析液顏色是否異常，第二步是針對我們目前所蒐集到的實驗資料做假設檢定(Hypothesis Testing)的一個透光度和發炎與否的標準來判斷是否有發炎的情形，針對在模糊地區的資料，我們會再根據同一個人過去的測量結果利用指數移動平均法(Exponential Moving Average)做一個趨勢分析判斷他的透析液情形是正在好轉或是惡化。
總共我們蒐集到的75筆資料裡面，根據這些資料下去做篩檢可以得到94.5%的準確率，總而言之，我們的這套系統的篩檢方法不但承襲了原先可以快速篩檢的優勢在準確率上更有顯著的提升。

關鍵字

腹膜炎 ； 腹膜透析 ； 腎臟病 ； 居家照護 ； 腹膜炎篩檢

並列摘要

In Taiwan, kidney disease is an usual disease and common issue. Peritoneal dialysis (PD) is common way to treat kidney disease patient. We have develop a portable homecare system to supervise the patients' dialysate condition and record for the doctors to diagnosis. However, our expectation on this system is to help the users can grasp their health condition immediately, and give them a suggestion about visiting the doctors or not. Therefore, my research focused on the develop of the algorithm which can preliminary screen out the inflammation samples and normal samples for doctors and users to refer.
Different from the traditional biomedical testing, our system use colorimetric information and absorbance to screen out the peritonitis from patients with PD treatment. To collect the colorimetric of the PD effluent, we should pour the PD effluent into the transparent container, then take a picture for the color checker and the container with effluent. To get the absorbance of the PD effluent, we use arduino micro controller to drive the light emitter to incident the light pass through the PD effluent and calculate the light intensity to get the absorbance of the PD effluent. After these steps, the data will be sent to the cloud data base and we can analysis the patients' condition with our screening method base on the data we collected.

In our screening method, we establish a three steps flow for the screening. First, using gaussian mixture model (GMM) cluster the samples of PD effluent into undetectable and detectable two groups. This step we take the colorimetric information from the dialysate for the features. Thus, the undetectable samples will be exclude. and the detectable samples will be sent to the next screening stage. Second, according to the hypothesis test, we calculate a standard threshold according to the turbidity data collected by National Taiwan University Hospital (NTUH) and we. Operating with this standard, according to the the region where the samples are distributed to, once their region are located on the fuzzy region, then the third step will be operated to solve it. In the last stage, we use the exponential moving average (EMA) to calculate the same users' historical data and compare with it to see whether the newest sample getting better or not. In brief, these three stages screening can give a simple and fast determination after the users finish the whole screening.
So far, we have 75 samples, based on this database, this algorithm can reach 94.5\% accuracy. In summary we design an screening algorithm on our homecare system, and it not only improve the accuracy from the original system but also adopts the characteristic of the fast screening and easy to operate. We believe this system can bring the users a better life.

並列關鍵字

Peritonitis ； Peritoneal Dialysis ； End-stage kidney disease ； Homecare system ； Peritonitis screening

參考文獻

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