以短訊息為基礎的可移動心電監測系統

Abstract

根據2008年台灣行政院公佈的十大死因中，惡性腫瘤(28.9%)和心血管疾病(9.3%)分別排名第二和第三。這些心血管疾病的患者在有緊急情況發生時，如果能給予適當的治療和照護，其實可以減低其喪失性命的可能。因此，這些心血管疾病的患者不論他們在那裡都需要隨時監看他們的健康狀況，如此才能在問題發生時給予最適當的治療。在本篇論文中，提出一套以短訊息為基礎的可移動心電監測系統。該系統包含兩個主要部分: 一套可移動個人監測裝置，其中包括心電訊號擷取模組和心電訊號監測手機，和一個健康看護伺服器。這套系統可以在全球移動通訊系統網路底下使用。當心電訊號監測手機偵測到異常的心律時，該手機不僅會發出一個警示音，而且會將異常的心律資料和患者的全球定位系統位置透過簡訊息傳送到健康看護伺服器上，如此緊急救護人員就可以即時知道患者的位置和生理狀態，以提供緊急照護和醫療。在日常生活的資料上傳中，心電訊號監測手機可以儲存每分鐘內的心律變化資料，並且每兩個小時利用短訊息將心律變化歷史資料上傳到健康看護伺服器中。如此可以讓醫生依據心律的歷史資料去追蹤患者的狀況。在長期監測模式下，患者的心電訊號和經緯度位置可以儲存到手機的記憶卡或者內建的記憶體中。在健康看護伺服器上，夾帶著心電訊號和全球定位系統位置的短訊息，醫生可以透過全球移動通訊系統數據機或手機接收及讀取。在論文的最後，測試及分析了使用不同的電信業者和基地台的時間，以及R波演算法的驗證。測試的結果顯示出本系統確實可以提供一套遠端照護機制。

According to the report of Department of Health, Executive Yuan, Taiwan in 2008, in the ten leading causes of death in Taiwan, Malignant neoplasm (28.9%) and heart disease (9.3 %) ranked second and third respectively. Some of theses lives can often be saved if prompt emergency care and cardiac surgery are provided within golden hour. Thus, patients with a risk of sudden heart failure need to monitor their cardiac health frequently whether they are indoors or outdoors, so that emergency treatment can be given if problems arise. In this study, a short message service (SMS) -based mobile electrocardiogram (ECG) monitoring system was proposed. The proposed system includes two major components: a personal mobility monitoring device, which contains an ECG acquisition module and an ECG monitoring mobile phone, and a health care server. The personal monitoring device and health care server can be located anywhere in the globe if they are under the coverage of Global System for Mobile Communications (GSM) cellular network. When the abnormal variation of heart rate (HR) was detected, not only the ECG monitoring program in the mobile phone would play an alert sound, but also the abnormal ECG data with global positioning system (GPS) information would be combined into the alert message and be transmitted via SMS of GSM network to health care server. Then the rescue team can know the patient location and physical status and to provide healthcare and treatment on time. In daily upload, the monitor program can store the HR every minute, and then send to health care server every two hour. It makes physician to trace the patient status according to history of heart rate. In long-term store-and-forward mode, raw ECG data with location information could also be stored into extended secure digital (SD) memory plugged in mobile phone or the built-in memory of mobile phone. In the health care server, SMS which contains ECG raw data with location of latitude and longitude could be extracted and received by a GSM modem or commercial mobile phone which could be read by physicians. Finally, analysis of message transmission performance using different telecoms and different base stations, and reliability of R peak detection algorithm were performed. The experimental results showed that our proposed system architecture can indeed provide better tele- and mobile healthcare services in practice.