呼吸機整合管理系統之建購

臨床資訊系統即時訊息的取得，為攸關病人生命維持的重要因子，其可讓醫護人員獲得即時訊息並處置來強化病人之生命延續及治療；在加護病房環境中，因呼吸系統疾病而引起敗血性休克而導致死亡，其最常見的原因是呼吸衰竭，而25％至50％病人發展為成人性呼吸窘迫症候群(ARDS)，其中的80％至90％病人死亡。另國內老化人口增加，長期慢性疾病病患問題日趨嚴重，尤其長期依賴呼吸器之病患數量日益增加，更需集中加強照護。因此病人呼吸參數資料的即時獲得與否，將攸關醫師及照護人員能否做出即時之判斷，並從事立即的處置，將會對緊急病患的救治有極大的幫助。基於上述理由，呼吸參數資訊的整合對於醫療人員在做出醫療處置及照護時是十分重要的，但在專業醫護人員的不足現在，如果有一套良好的呼吸器管理整合系統，讓醫師及照護人員做出即時之判斷，並從事立即的處置，將會對緊急病患的救治有極大的幫助。本論文建構了一套使用於呼吸機之整合管理系統，其包含病患基本資料介面(Patient Information)、呼吸機控制參數設定介面(Control settings)、呼吸機警告參數設定介面(Alarm settings)、病患端呼吸監視參數介面(Monitored Parameters)、警告訊息界面(Alarm messages)、呼吸波形介面(Wave Form)與查詢介面(Query)；且其呼吸參數資料將依IEEE P1073.1.1.1之標準來儲存至資料庫，以利未來醫療資訊標準之整合與傳輸。

關鍵字

臨床資訊系統；呼吸機； IEEE 1073

並列摘要

Acquiring the clinical information in real-time from a bedside monitoring system is a very important factor to both the patient and healthcare professionals. The clinical data can be used by professional personnel such as respiratory therapist or a physician to improve the treatment and save patient’s life. In the environment of intensive care unit, patients with severe disorder of the respiratory system may become breathing exhaustion and induce septicemia shock that results in death. 25% to 50% patients develop to ARDS, and among these patients 80% to 90% died. Furthermore, because of the problem of aging population in Taiwan, the number of the patients who need chronic healthcare increases a lot recently in our society. Especially, the patients who require long-term healthcare using ventilator need to be taken care intensively. Therefore, acquiring the patients’ respiratory parameters at the immediate moment will have great value to the respiratory therapists and clinical doctors since they can make more accurate decisions for different situations. It is valuable for a patient in emergent conditions. As the reasons described above, the integration of a management system for respiratory parameter is very important for professional medical care personnel to provide suitable treatments to patients. In the present the situation of shortage of professional personnel and doctors, a good ventilator information management system can let the doctors and professionals make good instant decisions and help the emergent patients. In this thesis, we created a set of integrated management system used on ventilator, including Patient’s Information, Control Settings, Alarm Settings, Monitored Parameters, Alarm messages, Waveform displaying, and Commanding query. The data of respiratory parameters was stored to a database, which conformed to the IEEE P1073.1.1.1 international standard. This system can be applied on different ventilators and improve the integration and transmission of medical information in the future.

並列關鍵字

Clinical information System ； Ventilator ； IEEE1073

參考文獻

中文文獻白中和譯，《RS232C介面技術應用》，台北：全華科技圖書，民84. 12。紀崑山，《重症照護暨呼吸治療辭彙》，台北：文錚，民87.8。徐家杰、張魁恆譯，《呼吸系統疾病護理》，台北：五南，民90.8。楊瓊珠，《呼吸護理學-生理與技術》，台北：藝軒圖書，民73. 5。謝勝治，《圖控式程式語言Lab VIEW(修訂版)》，台北：全華科技圖書，民88.7。謝勝治，《圖控式程式語言Lab VIEW(含自動量測暨資料擷取)》，台北：全華科技圖書，民90.6。英文文獻 Barton DM, Burns SM, Fahey SA, A microcomputer application for managing information used when weaning patients from mechanical ventilation. Computer nurse 1992;10(2)65-71 Dick, R.S., Steen, E.B., Detmer, D.E, The Computer-based Patient Record: An Essential Technology for Health Care, Revised edition, Institute Of Medicine, 1997 Friesdorf W, Gross-Alltag F, Konicgezky S, Schwilk B, Fattroch A, Fett P. Lessons learned while building an integrated ICU workstation. Journal of clinical monitor computer 1994;11(2)89-97 Peter Michels, Dipl. Ing, Dietrich Gravenstein, Dwayne R. Westenskow. An integrated graphic data display improves detection and identification of critical events during anesthesia. Yearbook of medical informatics 1999; 415-25 電子資料中央健保局資訊網, Available at http://www.nhi.gov.tw, Accessed Jan 1, 2003 婦科加護病房的照顧, Available at http://med.mc.ntu.edu.tw/~obsgyn/cd/Gyn/Gyn_017.html, Accessed Jan 1, 2003 CPRI(Computer-based Patient Record Institute) Work Group on CPR Description (1995), Description of the Computer-based Patient Record(CPR) and Computer-based Patient Record System, Available at , Accessed Dec 1, 2002. DICOM，Available at http://medical.nema.org, Accessed Dec 1, 2002. HL7, Available at http://www.hl7.org, Accessed Dec 1, 2002. IEEE 1073, Available at , Accessed Sep 1, 2002.

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