一种基于云平台的远程监护系统构建及临床应用  

Construction of a cloud-based remote monitoring system and its clinical application

作　　者：钱雪华 徐红蕾[2] 王晓蓉[2] 夏梦轩 周青[3] 吴辉[4] QIAN Xuehua;XU Honglei;WANG Xiaorong;XIA Mengxuan;ZHOU Qing;WU Hui(Department of Information,the First Affiliated Hospital of Wenzhou Medical University,Wenzhou 325015,China;Department of Intensive Care Medicine,the First Affiliated Hospital of Wenzhou Medical University,Wenzhou 325015,China;Medical Record Room,the First Affiliated Hospital of Wenzhou Medical University,Wenzhou 325015,China;Department of Anesthesiology,the First Affiliated Hospital of Wenzhou Medical University,Wenzhou 325015,China)

机构地区：[1]温州医科大学附属第一医院信息处 [2]温州医科大学附属第一医院重症医学科,浙江温州325015 [3]温州医科大学附属第一医院病案室,浙江温州325015 [4]温州医科大学附属第一医院麻醉科,浙江温州325015

出　　处：《温州医科大学学报》2024年第10期833-838,共6页Journal of Wenzhou Medical University

基　　金：温州市基础性科研项目(2022Y1084);温州市科技局社会发展(医疗卫生)科技项目(ZY2021028)。

摘　　要：目的:构建一种基于云平台研发的适用于重症和麻醉监护等多应用场景的远程监护系统,可实现在任一监护单元内同时定向监护邻近多个监护单元患者状况。方法:借助现代音视频传输技术和数字处理技术,结合息化手段,针对应用场景的特殊性及其要求研制了远程监护系统。回顾性分析2020年至2023年在温州医科大学附属第一医院重症监护病房患者随机选002、013、040、044、045床位号住院的648例患者临床资料,其中男437例,女211例。2020年的患者相关数据作为非远程监护的对照组,2021年至2023年的患者相关数据按年份分为应用远程监护系统的3个观察组。统计患者3种导管相关性感染指标,收集整理护理记录中生命体征数据的计划时间和实际采集时间,机器实时监测的响应速度。用R(4.2.1版本)工具进行数据分析。结果:相较于对照组,2021年、2022年和2023年的呼吸机相关性肺炎发生率、血管内导管相关感染率显著下降(P<0.001),导尿管相关感染率差异无统计学意义。护理记录采集数据的及时性显著提高(P<0.001)。系统关键接口的平均响应时间快,在0.2 s以内。结论:基于云平台的远程监护系统运行可靠,有效地节约了医疗资源,提高了医疗效率,并降低了医疗成本,为进一步推广应用提供依据。Objective:To build a remote monitoring system based on cloud platform development that is suitable for multiple application scenarios such as intensive care and anesthesia monitoring,and can simultaneously monitor the conditions of multiple patients in adjacent units within any monitoring unit.Methods:With the aid of modern audio-video transmission technology and digital processing technology,combined with information technology,a remote monitoring system has been developed targeting the uniqueness and requirements of various application scenarios.A retrospective analysis was conducted on the clinical data of 648 patients randomly selected from bed numbers 002,013,040,044 and 045 in the intensive care unit of the First Affiliated Hospital of Wenzhou Medical University from 2020 to 2023,including 437 males and 211 females.The patient data from 2020 were used as the control group without remote monitoring,while the patient data from 2021 to 2023 were divided by year into three observation groups of the remote monitoring system.Statistics were collected on three sorts of catheter-associated infection indicators among patients,including the planned and actual collection times of vital sign data in nursing records,and the response speed of real-time machine monitoring.Data analysis was performed using the R(version 4.2.1)tool.Results:Analysis of the three sorts of catheter-related infection indicators showed that compared with the control group,there was a statistically significant difference(P<0.001)between the three groups of ventilators and intravascular catheters.The infection rate significantly decreased in 2021,2022,and 2023.The timeliness of data collection in nursing records improved significantly,with statistical difference(P<0.001).The average response time of the key interface of the system was as fast as within 0.2 seconds.Conclusion:The remote monitoring system based on the cloud platform runs well,effectively saves medical resources,improves medical efficiency and reduces medical costs,thus providing evi

关 键 词：云平台 远程监护系统 导管相关性感染 实时监测 

分 类 号：R47[医药卫生—护理学] TP311.5[医药卫生—临床医学]