CN101517578A - 用于管理患者和伤口治疗疗法的历史的系统和方法 - Google Patents

用于管理患者和伤口治疗疗法的历史的系统和方法 Download PDF

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CN101517578A
CN101517578A CNA2007800338815A CN200780033881A CN101517578A CN 101517578 A CN101517578 A CN 101517578A CN A2007800338815 A CNA2007800338815 A CN A2007800338815A CN 200780033881 A CN200780033881 A CN 200780033881A CN 101517578 A CN101517578 A CN 101517578A
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克里斯多佛·布赖恩·洛克
马克·斯蒂芬·詹姆士·彼尔德
托马斯·保罗·罗洪
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Abstract

一种组织治疗系统，包括执行软件的处理单元、与处理单元通信的电子显示器和与处理单元通信的存储单元。软件可配置成使处理单元管理患者历史数据库、治疗历史数据库和图像历史数据库。处理单元可进一步配置成使临床医师能够访问和显示存储在这些数据库中的任何一个数据库中的信息。

Description

用于管理患者和伤口治疗疗法的历史的系统和方法
发明背景
1.发明领域
本发明的原理大体上涉及管理与患者和治疗历史相关的信息，且尤其是但不作为限制地涉及使临床医师能够使用组织治疗系统来将患者历史、治疗历史和伤口的照片存储在组织治疗系统上的系统和方法，以用于使用组织治疗系统来确定继续的组织治疗。
2.相关技术的描述
伤口治疗的领域在近年来进步了。伤口愈合治疗的进步之一是真空辅助的伤口愈合的发展。将减压或负压施加到伤口在临床上被示为提高了伤口或组织部位处的血液流动，增加了组织生长，减少了感染，并改进了愈合时间。照顾者和临床医师可使用这样的真空辅助的伤口愈合来治疗各种慢性和急性伤口类型，例如压疮、糖尿病伤口、腹部伤口、II度烧伤(partial-thickness burn)、外伤性伤口、皮瓣和移植物。
关于伤口和伤口愈合过程的背景
伤口通常被定义为皮肤中上皮完整性的破坏。然而这样的损伤可能非常深，包括真皮、皮下脂肪、筋膜、肌肉和甚至骨骼。适当的伤口愈合是导致组织修复的高度复杂、动态和协调的一系列步骤。急性伤口愈合是动态的过程，其涉及常驻和迁移的细胞群体在细胞外基质环境中以协调的方式作用来修复受伤组织。一些伤口不能以这种方式愈合(由于各种原因)，并可称为慢性伤口。
在组织损伤之后，伤口的协调愈合一般包括四个重叠的但定义明确的阶段：止血、炎症、增殖和重塑(remodeling)。止血涉及伤口反应和修复中的第一步骤，包括出血、凝固以及血小板和补体激活。炎症在第一天将要结束时达到高峰。细胞增殖出现在接下来的7-30天内，并包括面积测量可能最有益的时间段。在这个时期，出现纤维素增生、血管再生、再上皮化(re-epithelialization)和细胞外基质合成。伤口中最初的胶原质形成一般在大约7天后达到高峰。在最佳条件下，伤口再上皮化出现在大约48小时后，此时伤口可能被完全密封。愈合中的伤口可在3个星期时具有15％到20％的全抗张强度(full tensile strength)，且在4个月时具有60％的全强度。在第一个月之后，降解和重塑阶段开始，其中细胞结构和血管分布减少，而抗张强度增加。正常瘢痕的形成常常需要6到12个月。
相关领域中测量伤口愈合过程的成果
与提供有效的伤口治疗方案相当的是对伤口的尺寸及其愈合的速率进行测量的能力。一次疗程但确定伤口的愈合速率的通常有效的方式是追踪总的伤口尺寸随时间的变化。
临床医师历史地追踪伤口愈合的一种方法是拍摄伤口随时间的照片并将照片保存在患者的文件中，以便能够复查伤口随时间的变化的照片。临床医师还为患者建立治疗伤口的程序。如在本领域中所理解的，患者可在医疗机构中或作为门诊患者被治疗。不管是在医疗机构中还是在家里治疗患者，对临床医师来说共同的问题是治疗是否被正确地执行。在医疗机构中治疗患者的情况下，存在治疗设置不正确、在治疗期间断电、由于消毒盖布渗漏而导致真空压力减小、罐变满而中断真空治疗的可能性，或造成不能按临床医师所指定的提供组织治疗的任何数量的其它原因。在使用组织治疗系统在家治疗患者的情况下，存在与在医疗机构中的相同的问题，另外还有患者不能坚持不懈地遵循临床医师的治疗处方的可能性。例如，患者可能在太短或太长的时间段内进行治疗对话，略过治疗对话，或否则不遵循临床医师指定的伤口治疗疗法。
当没有正确地遵循组织治疗时，组织不能正确地愈合，且临床医师失去充分诊断和治疗伤口或其它组织部位的能力。因为伤口治疗可能在材料和专业护理时间上是昂贵的，所以治疗以患者正确地遵循治疗方案为基础。而且，伤口和伤口愈合过程的准确评测可能是基本的。
发明内容
为了使临床医师能够准确地管理和监控组织治疗，本发明的原理提供了一种组织治疗系统以利用数据库来储存患者历史和治疗历史，以便临床医师可证实患者遵循指定的治疗，并查看患者的组织对治疗的反应的历史信息。此外，组织治疗系统可访问包括被治疗的组织部位的图像和诸如组织面积的统计信息的数据库。临床医师可使用数据库中的信息来作出额外的治疗决定。
系统的一个实施方式包括组织治疗系统，该组织治疗系统包括执行软件的处理单元、与处理单元通信的电子显示器和与处理单元通信的存储单元。软件可配置成使处理单元管理患者历史数据库、治疗历史数据库和图像历史数据库。处理单元可进一步配置成使临床医师能够访问和显示存储在这些数据库中的任何一个数据库中的信息。
用于管理组织治疗信息的过程的一个实施方式可包括储存患者历史信息、储存治疗历史信息、储存患者的组织部位的图像历史信息，并访问患者、治疗和图像历史信息的至少一个记录，其中图像历史信息表示对组织部位的组织治疗的结果。可显示记录，以使临床医师能够根据提供给患者的历史治疗和对被治疗的组织部位的组织治疗的结果来作出组织治疗决定。
附图简述
图1是使用根据本发明的原理的组织治疗系统的示例性患者环境的图示；
图2是示例性主菜单图形用户界面的图示，以使临床医师能够控制图1的组织治疗系统；
图3是示例性设置图形用户界面的图示，以使临床医师能够建立用于治疗患者的组织部位的组织治疗；
图4是示例性连续压力图形用户界面的图示，以使临床医师能够选择将被连续地施加到患者的组织部位的压力；
图5是示例性间歇压力图形用户界面的图示，以使临床医师能够输入和选择将间歇的组织治疗应用到患者的伤口部位的工作和不工作时间(onand off time)；
图6是示例性选择伤口类型图形用户界面的图示，以选择被预先确定的由组织治疗系统治疗的多个伤口类型中的伤口类型；
图7是示例性强度图形用户界面的图示，以使临床医师能够选择对患者的组织部位应用组织治疗的强度；
图8是示例性确认图形用户界面的图示，以为患者的组织部位确认组织治疗；
图9是根据本发明的原理对患者的组织部位执行组织治疗的示例性组织治疗系统的方框图；
图10是用于根据本发明的原理执行功能的软件模块的方框图；
图11是示例性患者历史GUI的屏幕截图，其示出应用于患者的组织部位的组织治疗的患者历史；
图12是示例性组织历史GUI的屏幕截图，其示出应用于患者的组织部位的组织治疗的治疗历史；
图13是被治疗患者的组织部位的示例性图像历史GUI的屏幕截图；及
图14是用于储存和访问历史患者、治疗和组织部位图像信息的示例性过程的流程图，这些信息用于帮助临床医师确定组织治疗。
附图的详细描述
参考图1，示例性患者环境显示了具有组织部位104的患者102使用根据本发明的原理的组织治疗系统106。在一个实施方式中，组织治疗系统106可为真空辅助的治疗设备。可选地，组织治疗系统106可为通常用于在组织治疗的过程中帮助患者的任何系统。组织治疗系统106还可为任何计算系统，其配置成利用这里进一步描述的软件来帮助照顾者或临床医师监控组织部位104的愈合。
图像捕获设备108可用于将组织部位104的图像捕获在照片中。图像捕获设备108可为数码相机、移动电话、或配置成捕获数字或模拟格式的图像的任何其它电子设备。一般来说，为了加速对组织部位104的图像的捕获和加工，数码相机可配置成建立与组织治疗系统106的无线通信链接110。无线通信链接110可为802.11无线通信链接或WiFi通信链接。可利用任何其它无线通信链接协议。可选地或此外，可在组织治疗系统106和图像捕获设备108之间建立有线连接。图像捕获设备108还可利用可在电子设备之间传输的存储设备(未示出)。存储设备可包括闪存、记忆棒、迷你DVD或组织治疗系统106可兼容的任何其它存储设备。
如这里使用的，术语“组织部位”指位于任何组织上或内的伤口或缺陷，包括但不限于骨组织、脂肪组织、肌肉组织、神经组织、皮肤组织、血管组织、结缔组织、软骨、腱或韧带。术语“组织部位”可进一步指不一定受伤或有缺陷的任何组织的区域，而是被期望增加或促进额外组织的生长的区域。例如，减压组织治疗可用在某些组织区域中以培养可被获得并移植到另一组织位置的额外组织。
在这里使用术语“临床医师”，意指任何医学专业人员、用户、患者的家庭成员或与减压传送系统相互作用或通过界面连接的患者。
组织治疗系统106可配置成通过将减小的压力经由减压导管(未示出)施加到应用于被治疗的组织部位104的歧管(manifold)(未示出)来应用减压治疗。为了使临床医师正确地监控组织部位104愈合得多么好，图像捕获设备108可随时间捕获组织部位104的图像。图像可被传送到组织治疗系统106并显示在电子显示器112上。组织治疗系统106可配置成显示图形用户界面(GUI)114，并使组织部位104的图像显示在其上。组织治疗系统106可将每个图像储存在图像数据库中。
软按钮118a-118c或其它图形控制元件可布置在电子显示器112上，以使临床医师能够进入模式、编辑图像、或执行开发者可定义的且组织治疗系统106可执行的任何其它控制。例如，软按钮118a可使用户能够通过使用指示笔、计算机鼠标、手指、或在组织部位104的图像116的周界周围描绘或选择该周界上的点的任何其它方法来在组织部位104的图像116周围绘制迹线。响应于完成在组织部位104周围的迹线，通过按软按钮118a发起的功能可计算迹线内的面积。另一软按钮118b可使组织治疗系统106进入图像历史模式，由此组织部位的历史图像被显示且可由临床医师选择(见图13)。另一软按钮118c可使当前患者和当前组织部位的治疗历史被显示(见图12)。应理解，可在组织治疗系统106上设置使临床医师能够收集、处理、编辑、追踪、定义组织类型等的任何功能。
参考图2，示例性图形用户界面202可显示在组织治疗系统106的触摸屏112上，并使临床医师能够从用于控制组织治疗系统106的多个不同的选项中选择。一个控制选项可包括“设置”软按钮204，其使临床医师能够建立治疗设置。“设置向导”软按钮206可提供指示临床医师关于不同的设置选项和功能的信息。“密封检查”软按钮208可使临床医师能够在覆盖歧管的消毒盖布处定位密封渗漏，该歧管用于给组织部位提供减小的压力。“治疗历史”软按钮210可使临床医师能够显示治疗或疗法历史(图12)。“患者历史”软按钮212可使临床医师能够显示组织治疗系统106所记录的患者历史(图11)。“图像历史”软按钮214可使临床医师能够显示随时间拍摄的一个或多个组织部位的图像(图13)。应理解，根据本发明的原理，可利用帮助临床医师治疗组织部位的其它功能。
参考图3，设置GUI 300可响应于临床医师选择“设置”软按钮204(图2)而显示在组织治疗系统106的触摸屏112上。如所示，多个不同的软按钮可用于选择，以选择设定一个或多个组织治疗参数。可利用的选择包括(i)“压力”软按钮302，(ii)“强度”软按钮304，(iii)“连续”软按钮306，(iv)“间歇”软按钮308，以及(v)“持续时间”软按钮310。这些软按钮中的每个都可使单独的屏幕显示可用于选择的或设置为与选定功能相关的一个或多个参数。可选地，不是对每个功能都有单独的屏幕，每个功能的参数可在设置GUI 300上显示并由临床医师选择性地改变。应理解，几乎任何GUI元件或功能可用来使临床医师能够建立用于治疗患者的组织部位的治疗。
参考图4，可显示连续压力GUI 400，以使临床医师能够改变待施加到患者的组织部位的压力设置。文本显示框402可显示压力设置(例如125mmHg)，其可由临床医师按“+”软按钮404a或“-”软按钮404b而向上或向下改变。虽然被示为单一的，但是恒定压力、最大、最小和过渡压力设置可以可选地设置成使临床医师能够应用变化的减压治疗配置，而不是恒定的或间歇的减压治疗配置。
参考图5，可显示间歇压力GUI 500，以使临床医师能够设置被组织治疗系统106施加到患者的组织部位的间歇压力设置。间歇压力GUI 500可包括限定减小的压力施加到组织部位的时间的量(例如5分钟)的“工作时间”文本输入域502。“工作时间”文本输入域502可具有由临床医师选择“+”或“-”软按钮504而改变的值。“不工作时间”文本输入域506可限定在减小的压力的工作时间之间减小的压力不工作的时间的量。例如，不工作时间可设置为2分钟。软按钮508可用于增加或减少减小的压力的不工作时间。
参考图6，可显示选择伤口类型GUI 600，以使临床医师能够选择由组织治疗系统106治疗的伤口类型或组织类型。文本域602可用于显示可用于选择的不同的伤口类型。不同的伤口类型是预先确定的并具有用于治疗不同的伤口类型的特定的预先确定的参数。例如，慢性溃疡可以有与烧伤或撕脱伤口不同的治疗。软按钮604可允许临床医师显示并彻底搜索不同的预先确定的伤口类型。应理解，GUI 600是示例性的，并可根据本发明的原理利用其它界面例如具有滚动条的列表。
参考图7，可显示强度GUI 700，以使临床医师能够选择组织治疗的强度。在一个实施方式中，强度限定组织治疗系统106多么快得转换到减压设置。临床医师可分别通过选择软按钮702a、702b或702c之一来选择低、中或高强度。应理解，可选择可选的强度设置标记，包括1-10之间的数字、字母A-E或任何其它标记。
参考图8，可响应于被选择或设定的全部或一些设置来显示确认GUI800。如所示，伤口类型、压力、模式和强度由准备开始组织治疗的临床医师设置。响应于临床医师选择“OK”软按钮，组织治疗系统106将开始组织治疗。
参考图9，示例性组织治疗系统106可包括执行软件904的处理单元902。处理单元902可配置有相同或不同类型的一个或多个处理器。例如，处理单元902可包括一般处理单元和数字信号处理(DSP)单元，其配置成执行图像处理，以使临床医师能够编辑组织部位的图像、执行颜色调节、追踪、或根据本发明的原理的任何其它图形功能。
处理单元902可进一步与下列部件通信：(i)用于存储数据和软件代码的存储器906，(ii)用于无线地、通过导线或通过存储器输入设备(未示出)与诸如数码相机的其它设备和系统通信的输入/输出(I/O)单元908，(iii)可储存一个或多个数据储存库912a-912n(总称为912)的存储单元910，例如具有一个或多个文件的数据库，以及(iv)可以是或可以不是触敏的电子显示器112。软件904可配置成与每个其它设备(例如电子显示器112)通过界面连接以例如执行组织部位图像收集，并通过调节参考颜色标记物(reference color marker)的图像的颜色来调节组织部位的图像的颜色。
现在参考图10，可由处理单元902执行的软件904的软件模块1000(图9)可用于管理包括患者、治疗和图像的历史的数据库。所示软件模块1000是示例性的，并可包括提供相同或类似功能的额外的和/或其它的软件模块。
执行治疗模块1002是配置成使临床医师能够执行临床医师所建立的疗法的软件模块。例如，临床医师可建立参数来使用125mmHg的压力执行连续的减压治疗30分钟，且执行治疗模块1002将对患者的组织部位执行减压治疗疗法。
管理治疗历史数据库模块1004是配置成管理包括疗法或治疗历史的数据库的软件模块(见图12)。治疗历史可为一个或多个患者，并显示应用于患者的组织的减压治疗的历史。数据库可为任何类型的数据库，包括在本领域中所理解的关系、平面或其它结构。治疗历史数据库可为其它数据库的部分或与其它数据库有关，例如患者历史数据库。模块1004可配置成对临床医师和/或医生限制访问。
管理患者历史数据库模块1006是配置成管理包括患者的历史的数据库的软件模块。在一个实施方式中，模块1006可配置成对临床医师和/或医生限制访问。可选地，可使应用了减压治疗的患者能够观看他或她自己的治疗历史。
管理图像部位历史数据库模块1008是配置成管理随时间从患者的组织部位收集的组织部位图像的软件模块。使历史记录可用于组织治疗系统可使临床医师能够复查组织部位的历史、患者历史和治疗历史，并根据组织部位如何发展对组织部位执行的给定疗法来作出继续治疗的决定。
参考图11，组织治疗系统106被示为在电子显示器112上显示已对患者出现的事件的具有患者历史记录1102a-1102n(总称为1102)的患者历史GUI 1100。滚动条1104可设置成使临床医师能够在整个患者历史记录1102的列表中向上和向下滚动。可显示日期、时间和事件。然而，可提供其它信息来显示患者的事件的历史。数据库可储存多于一个的患者的记录，且每个患者的记录可由临床医师选择。临床医师可观看为患者输入到组织治疗系统中的每个事件。例如，事件可显示“125mmHg连续设置”，其表明临床医师在8/23/07在10:21:09时在记录1102m中设置125mmHg的连续压力。
参考图12，组织治疗系统106被示为在电子显示器112上显示已应用到患者的组织部位的事件的具有治疗历史记录1202a-1202n(总称为1202)的治疗历史GUI 1200。治疗历史记录1202显示每次对患者应用治疗时治疗的日期、开始时间、伤口类型、模式、压力、强度和持续时间。
参考图13，组织治疗系统106被示为显示被治疗的组织部位的具有图像历史记录1302a-1302n(总称为1302)的图像历史GUI 1300。图像历史记录1302可包括当每个图像被捕获或传送到组织治疗系统106时“缩略图(thumbnail)”的图像、日期和时间。临床医师可选择记录并将图像扩大到全尺寸，并可选地放大图像以看到组织的细节。如果临床医师将迹线、轮廓线、注释、面积、体积或其它信息应用于图像，则可将图像保持为原始图像，且可将信息保持为单独的或第二图像，该信息可被保存在数据库中。数据库可为关系数据库或任何其它类型的数据库，并与患者历史数据库和治疗历史数据库有关。
参考图14，提供了用于储存患者、组织治疗和组织部位图像信息的示例性过程1400。过程1400在步骤1402开始，其中可储存患者历史信息。在步骤1404，可储存治疗历史信息。在步骤1406，可储存组织部位图像信息。在步骤1408，可访问历史信息的至少一个记录。可显示记录以使临床医师能够根据提供给患者的历史治疗和对被治疗的组织部位的组织治疗的结果来作出组织治疗决定。
虽然根据前述实施方式描述了本发明的原理，该描述仅作为解释被提供，且不是被用来解释为本发明的限制。本领域技术人员应认识到，本发明的更改可适应特定的患者和伤口愈合环境。关于尺寸和甚至配置的这样的更改不一定偏离本发明的实质和范围，其中这样的更改仅仅符合伤口类型或被应用的治疗类型。

Claims (20)

1.一种组织治疗系统，其包括：
处理单元，其执行软件；
电子显示器，其与所述处理单元通信；以及
存储单元，其与所述处理单元通信，所述软件配置成使所述处理单元管理患者历史数据库、治疗历史数据库和图像历史数据库，所述处理单元配置成使临床医师能够访问和显示存储在上述数据库中的任何一个数据库中的信息。
2.如权利要求1所述的组织治疗系统，其进一步包括：
图像捕获设备，其配置成捕获组织部位的图像；以及
输入/输出单元，其与所述处理单元通信，并配置成接收由所述图像捕获设备捕获的组织部位的图像。
3.如权利要求1所述的组织治疗系统，其进一步包括：
触摸屏电子显示器，其与所述处理单元通信，且所述软件配置成使临床医师能够通过所述触摸屏电子显示器来访问患者历史、治疗历史和图像历史中的任何一个。
4.如权利要求1所述的组织治疗系统，其中所述患者历史数据库包括识别对患者执行组织治疗的日期、时间和事件的记录。
5.如权利要求1所述的组织治疗系统，其中所述治疗历史数据库包括识别治疗的日期、时间、模式、压力和持续时间的记录。
6.如权利要求1所述的组织治疗系统，其中所述图像历史数据库包括包含图像、日期和图像被捕获的时间的记录。
7.如权利要求6所述的组织治疗系统，其中所述处理单元进一步配置成显示组织部位随时间的缩略图图像，并使临床医师能够选择性地扩大图像。
8.如权利要求7所述的组织治疗系统，其中所述处理单元进一步配置成显示关于被扩大的图像的图形，以显示组织部位的轮廓。
9.如权利要求1所述的组织治疗系统，其中所述软件进一步配置成使临床医师能够输入组织治疗参数，并根据所述治疗参数使组织治疗被执行。
10.如权利要求9所述的组织治疗系统，其中所述软件进一步配置成使临床医师能够选择多个伤口类型之一作为组织治疗参数。
11.一种用于管理组织治疗信息的方法，其包括：
储存患者历史信息；
储存治疗历史信息；
储存患者的组织部位的图像历史信息，所述图像历史信息表示对所述组织部位的组织治疗的结果；以及
访问患者历史信息、治疗历史信息和图像历史信息的至少一个记录；以及
显示所述至少一个记录，以使临床医师能够根据提供给患者的历史治疗和对被治疗的所述组织部位的组织治疗的结果来作出组织治疗决定。
12.如权利要求11所述的方法，其进一步包括：
捕获组织部位的图像；以及
接收所述组织部位的被捕获的图像。
13.如权利要求11所述的方法，其进一步包括：
使临床医师能够通过触摸屏电子显示器来访问患者历史、治疗历史和图像历史中的任何一个。
14.如权利要求11所述的方法，其中储存患者历史的所述步骤包括储存识别对患者执行组织治疗的日期、时间和事件的记录。
15.如权利要求11所述的方法，其中储存治疗历史的所述步骤包括储存识别治疗的日期、时间、模式、压力和持续时间的记录。
16.如权利要求11所述的方法，其中储存图像历史的所述步骤包括储存包含图像、日期和图像被捕获的时间的记录。
17.如权利要求6所述的方法，其进一步包括：
显示组织部位随时间的缩略图图像；以及
使临床医师能够选择性地扩大图像。
18.如权利要求17所述的方法，其进一步包括显示关于被扩大的图像的图形，以显示所述组织部位的轮廓。
19.如权利要求11所述的方法，其进一步包括：
使临床医师能够输入组织治疗参数；以及
根据所述治疗参数执行组织治疗。
20.如权利要求19所述的方法，其进一步包括接收多个伤口类型之一的选择，作为组织治疗参数。
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