CN-122005966-A - Pancreatic fistula early warning type abdominal cavity drainage device and nursing method

CN122005966ACN 122005966 ACN122005966 ACN 122005966ACN-122005966-A

Abstract

The invention provides an early warning type pancreatic fistula abdominal cavity drainage device and a nursing method, wherein the device comprises a drainage main body, a monitoring unit, a data processing unit and an early warning unit, wherein the drainage main body is connected between an in-vivo drainage tube and an in-vitro collection bag; the care method comprises preoperative evaluation, device deployment, real-time monitoring and hierarchical intervention. The invention solves the problem of early warning hysteresis of pancreatic fistula, reduces nursing subjectivity, reduces artificial judgment errors, improves nursing efficiency and improves patient prognosis.

Inventors

XU JING
HUANG LEI
MA ZHILONG
CHEN HAIDI

Assignees

复旦大学附属肿瘤医院

Dates

Publication Date: 20260512
Application Date: 20260227

Claims (7)

1. The utility model provides a pancreas fistula early warning formula peritoneal drainage device, its characterized in that, including drainage main part, monitoring unit, data processing unit and early warning unit, the drainage main part is connected between internal drainage tube and external collection bag, and the monitoring unit is disposed in the drainage passageway of drainage main part, and the monitoring unit includes flow sensor, amylase sensing chip and colour identification sensor, and data processing unit calculates risk level and warning through early warning unit based on pancreas fistula risk classification early warning algorithm after receiving monitoring unit data.
2. The pancreatic fistula early-warning type abdominal drainage device of claim 1, further comprising a communication unit, wherein the data processing unit is connected with the medical care end APP through the communication unit and pushes early-warning information synchronously.
3. The pancreatic fistula early warning abdominal drainage device of claim 1, wherein the pancreatic fistula risk classification early warning algorithm comprises: S1, carrying out data normalization and index generation, namely carrying out normalization treatment on each monitoring index and converting the monitoring index into a risk index between 0 and 1; S2, dynamic weight distribution and comprehensive risk score calculation; And S3, judging the risk level and triggering early warning.
4. The pancreatic fistula early warning type peritoneal drainage device of claim 3, wherein step S1 comprises: a. Normalizing the amylase concentration index: -setting the patient post-operative day 1 laboratory measured basal amylase value as a_base (U/L); -setting the real-time monitoring value as a_real (U/L); -calculating the relative rate of change Δa= (a_real-a_base)/a_base; The amylase index i_a is determined by the following piecewise function: -if a_real <200, i_a=0; -if 200 +.a_real < 500, i_a=0.3+0.4× (Δa/Δa_threshold 1), where Δa_threshold1 is a medium risk threshold rate of change preset according to the type of procedure; -if a_real is ∈500, i_a=0.7+0.3×min (1, Δa/Δa_threshold 2), Δa_threshold2 is a high-risk threshold rate of change, and the maximum value is 1; b. Normalizing the flow index: -setting a normal alert flow preset according to the type of surgery and the body surface area of the patient as F alert; -setting the real-time monitoring flow to f_real (ml/h); -the flow index i_f is calculated as follows: if F _ real < F _ alert, i_f=0; -if f_alert is less than or equal to f_real < 150, i_f=0.5× (f_real-f_alert)/(150-f_alert); -if f_real is ∈150, i_f=0.5+0.5×min (1, (f_real-150)/100), maximum 1; c. normalizing the color index: after the sensor obtains the numerical value, the numerical value is matched with a preset color feature library, and the numerical value is divided into four types, namely clear/light yellow (C1), dark yellow/brown yellow (C2), bloody (C3) and cloudiness/purulent (C4), wherein the color index I_C is directly assigned, i_C1=0, i_C2=0.2, i_C3=0.8 and i_C4=1.0.
5. The pancreatic fistula early warning type peritoneal drainage device of claim 4, wherein step S2 comprises: Basic weight, namely setting a postoperative time factor T (in days) according to different postoperative stages and different early warning importance of various indexes; Early post-operation (t≤3 days) flow and colour changes are more sensitive, weight distribution w_a=0.3, w_f=0.5, w_c=0.2; Mid-postoperative (3 days < T≤7 days) amylase levels as main indicator, weight distribution w_A=0.6, w_F=0.3, w_C=0.1; Late postoperative (T >7 days) recovery period, concern about abnormal rebound, weight assignment in mid-term or clinically adjusted; -comprehensive risk score (R) calculation: R=w_a×i a+w_f x I F + W C x I C, R ranges from 0 to 1.
6. The pancreatic fistula early warning type peritoneal drainage device of claim 5, wherein step S3 comprises: Low risk (green indication) 0 < R < 0.3, maintaining the normal monitoring frequency, only the local display screen; the medium risk (yellow indication) is that R is more than or equal to 0.3 and less than or equal to 0.6, the local audible and visual alarm is triggered, the display screen highlights abnormal indexes, the system automatically pushes early warning information to the responsible mobile terminal through Bluetooth, and the reinforced monitoring is prompted; High-risk (red indication) that R is more than or equal to 0.6, triggering local high-intensity audible and visual alarm, and simultaneously pushing information to a central monitoring screen of a nurse station and a doctor terminal on duty to prompt the need of emergency treatment.
7. A nursing method, characterized in that the nursing method is realized based on the pancreatic fistula early-warning type abdominal drainage device as set forth in any one of claims 1 to 6, and comprises the following steps: S1, preoperative evaluation, namely collecting the age of a patient, the operation mode and the preoperative serum amylase level, and inputting a system as a basis of an early warning algorithm; step S2, arranging a drainage device within 24 hours after operation, debugging a monitoring unit and setting a personalized early warning threshold; Step S3, real-time monitoring, wherein the system automatically collects data once every 15 minutes, and the microprocessor calculates the risk level through an algorithm; step S4, performing grading intervention, namely recording data every 4 hours, performing routine nursing, wherein the step S4 is low in risk, the step S ② is high in risk, namely starting reinforced monitoring, immediately sending drainage liquid to adjust the liquid supplementing amount, and the step S64 is high in risk, namely triggering emergency alarm, informing a doctor, preparing emergency examination, and performing pancreatic fistula targeted nursing; And S5, dynamically adjusting, namely updating the early warning threshold value every 24 hours according to the recovery condition of the patient until the tube is drawn.

Description

Pancreatic fistula early warning type abdominal cavity drainage device and nursing method Technical Field The invention belongs to the technical field of pancreatic tumor nursing, and particularly relates to a pancreatic fistula early-warning type abdominal cavity drainage device and a nursing method. Background Pancreatic fistula has a incidence rate of up to 10-20% after pancreatic tumor operation, is one of the most serious complications after operation, and is easy to cause abdominal infection, bleeding and even death if the pancreatic fistula is not found in early stage. The existing clinical nursing relies on manual timing observation of the quantity, color and property of drainage liquid, and the amylase concentration of the drainage liquid is detected in a laboratory, so that the problems of 'monitoring lag, large error and incapability of real-time early warning' exist, and the optimal treatment opportunity is often missed after obvious symptoms appear. The prior art has the defects that the ① traditional drainage device only has a drainage function and does not have a real-time monitoring module, the ② part of intelligent drainage device only can monitor flow and cannot detect key biochemical indexes (such as amylase) of drainage liquid, ③ lacks a complete closed loop of monitoring data, risk assessment and nursing intervention, and a monitoring result cannot directly guide nursing operation. Disclosure of Invention Accordingly, the present invention is directed to an early warning type abdominal drainage device for pancreatic fistula and a nursing method thereof, so as to solve the defects in the prior art. In order to achieve the above purpose, the invention is realized by the following technical scheme: In one aspect, an early-warning type pancreatic fistula abdominal drainage device is provided, wherein, including drainage main part, monitoring unit, data processing unit and early warning unit, the drainage main part is connected between internal drainage tube and external collection bag, and in the drainage passageway of drainage main part was joined in marriage to the monitoring unit, the monitoring unit includes flow sensor, amylase sensing chip and colour identification sensor, and data processing unit calculates risk level and warning through early warning unit based on pancreatic fistula risk classification early warning algorithm after receiving monitoring unit data. Further, pancreas fistula early warning formula peritoneal drainage device still includes communication unit, and data processing unit passes through communication unit and connects medical end APP, synchronous push early warning information. Further, the pancreatic fistula risk classification early warning algorithm in the pancreatic fistula early warning type abdominal cavity drainage device comprises the following steps: S1, carrying out data normalization and index generation, namely carrying out normalization treatment on each monitoring index and converting the monitoring index into a risk index between 0 and 1; S2, dynamic weight distribution and comprehensive risk score calculation; And S3, judging the risk level and triggering early warning. Further, the step S1 in the pancreatic fistula early-warning type abdominal cavity drainage device includes: a. Normalizing the amylase concentration index: -setting the patient post-operative day 1 laboratory measured basal amylase value as a_base (U/L); -setting the real-time monitoring value as a_real (U/L); -calculating the relative rate of change Δa= (a_real-a_base)/a_base; The amylase index i_a is determined by the following piecewise function: -if a_real <200, i_a=0; -if 200 +.a_real <500, i_a=0.3+0.4× (Δa/Δa_threshold 1), where Δa_threshold1 is a medium risk threshold rate of change preset according to the type of procedure; -if a_real is ∈500, i_a=0.7+0.3×min (1, Δa/Δa_threshold 2), Δa_threshold2 is a high-risk threshold rate of change, and the maximum value is 1; b. Normalizing the flow index: -setting a normal alert flow preset according to the type of surgery and the body surface area of the patient as F alert; -setting the real-time monitoring flow to f_real (ml/h); -the flow index i_f is calculated as follows: If F _ real < F _ alert, i_f=0; -if f_alert is less than or equal to f_real <150, i_f=0.5× (f_real-f_alert)/(150-f_alert); -if f_real is ∈150, i_f=0.5+0.5×min (1, (f_real-150)/100), maximum 1; c. normalizing the color index: after the sensor obtains the numerical value, the numerical value is matched with a preset color feature library, and the numerical value is divided into four types, namely clear/light yellow (C1), dark yellow/brown yellow (C2), bloody (C3) and cloudiness/purulent (C4), wherein the color index I_C is directly assigned, i_C1=0, i_C2=0.2, i_C3=0.8 and i_C4=1.0. Further, step S2 in the pancreatic fistula early-warning type abdominal cavity drainage device includes: Basic weight, namely setting a postoperative time factor T (in days) accordi