可穿戴远程医疗系统用户端的硬件研究
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摘要
随着我国人民生活水平的逐步提高和人口老龄化问题的日益严重,在人们对健康监护的需求与医护人员数量的不足、医疗费用居高不下之间形成了矛盾。远程医疗服务模式是缓解这一矛盾的有效途径,它使得以往单纯的医院为中心健康监护模式向医院、社区、家庭与个人相结合的模式转变。但在实际应用中,远程医疗仍然难以在社区或者家庭中普及,其核心问题集中在用户端部分的研究没有取得突破性进展,还存在某些需要克服的障碍。这些困难主要表现为测量时间不能长期连续、测量设备不够小巧方便、测量过程不太舒适轻松等。因此,设计一个合适的用户端对于远程医疗系统的发展具有重要意义。
心脏病作为一种常见多发慢性疾病,已成为人类健康的头号杀手,尤其对中老年患者的危害性极大。心电图作为心脏病诊断的重要依据,对它进行长期动态监测,对于心脏病的预防、早诊断、早治疗具有重要意义。
为此,本课题设计了一种基于穿戴式技术的心电远程监护系统用户端。整个用户端由一个前端模块和一个后端模块组成。前端模块穿戴在人体身上,它包含有一个心电采集模块、一个射频发射芯片及一个电源电路。心电采集模块完成从人体获取信号并进行放大、滤波及A/D转换处理;射频发射芯片用于完成心电数据从前端到后端的无线传输;而电源电路则为前端的各个器件供电。后端包含有一个射频接收芯片,用于接收前端的数据;一个由ARM和DSP组成的双核处理器,其中ARM作为主控制器,协调整个后端各个模块的工作,DSP作为从控制器,负责对来自前端心电数据进行数字滤波、压缩等处理以及心电图信号的初步诊断;一个GPRS模块,完成用户端数据到监护中心的数据远程传输以及接收中心的反馈信息(如诊断结果);同时,采用一块LCD触摸屏对DSP的初步诊断结果、病人基本信息以及中心的反馈信息进行智能化显示。
此外,为了保证数据在RF无线传输和GPRS远程传输过程中的安全性,在数据传输前,对它进行了128位的AES加密处理。
实验结果表明,用户端能够实现对人体非介人式、无创的心电诊断监测。同时,具备可移动操作、使用简便、长时间持续工作、智能显示诊断结果、异常生理状况警报、数据的安全传输等特点。有效改善了传统远程医疗系统用户端的不足。
The healthcare industry today suffered a set of significant challenges on several fronts accompanied by rapid economic development and increased life expectancy, viz., availability (or access), quality, and cost. Telemedicine maybe an effective method that can respond to these challenges successfully, its appearance makes the classical“hospital centred healthcare”shift towards“hospital/community/ home/ person centred healthcare”. However, telemedicine is not popularized in real life, for its client server is not well developed correspondingly and still has many problems not well settled, e.g. can not work continuously for a long time, monitor device is not light enough, the patient fells uncomfortable during measurement etc. So how to design a suitable client server is significant for telemedicine system.
Heart disease is a common, recurring, chronic disease, which has become the most prevalent diseases in endangering people's health, especially for older people. ECG is an important diagnostic tool for assessing heart function, and it is valuable to monitor it dynamically and perennially for heart disease prevention, early diagnosis and cure.
According to these, a design of the client server based on wearable technology for ECG telemonitor system is presented in this paper. The client server comprises of a front-end module and a back-end module. The front-end module is worn on patient’s body, and it includes a ECG acquisition module, a RF transmitting chip and a power circuit. The ECG acquisition circuit is used for ECG obtaining, amplifying, filtering and A/D converting; The RF transmitting chip is applied to implement ECG wireless transmission from the front-end module to the back-end module; The power circuit provides energy for all the components of the front-end module. The back-end module has a RF receiving chip for receiving the data from the front-end module, contains a dual processor combined by a ARM and a DSP chip, and the ARM chip is used as primary commanding unit for controlling the back-end, DSP chip is employed as a co-processor exclusively for processing the ECG data from the front-end, such as digital filtering, compressing .etc and automatic pre-diagnosis. The back-end module also includes a GPRS module for tele-transmitting the data of the client to the healthcare center and receiving the feedback from the healthcare center. Meanwhile, an LCD is installed to display DSP’s pre-diagnosis result, patients’information and healthcare center’s feedback.
Furthermore, the design fully considers the security of the data during its wireless transmission via RF and teletransmission via GPRS, an 128-bits AES encryption algorithm is applied before transmitting the data.
The test result shows that the design can successfully implement non-invasive monitoring and diagnosing patient’s ECG. And it also has the characters of mobility, easy-to-use, continuous monitoring, intelligent displaying diagnosis result, alarming abnormal physiological conditions, secure data transmission etc. That well improves the shortage of the traditional telemedicine system’s client server.
心脏病作为一种常见多发慢性疾病,已成为人类健康的头号杀手,尤其对中老年患者的危害性极大。心电图作为心脏病诊断的重要依据,对它进行长期动态监测,对于心脏病的预防、早诊断、早治疗具有重要意义。
为此,本课题设计了一种基于穿戴式技术的心电远程监护系统用户端。整个用户端由一个前端模块和一个后端模块组成。前端模块穿戴在人体身上,它包含有一个心电采集模块、一个射频发射芯片及一个电源电路。心电采集模块完成从人体获取信号并进行放大、滤波及A/D转换处理;射频发射芯片用于完成心电数据从前端到后端的无线传输;而电源电路则为前端的各个器件供电。后端包含有一个射频接收芯片,用于接收前端的数据;一个由ARM和DSP组成的双核处理器,其中ARM作为主控制器,协调整个后端各个模块的工作,DSP作为从控制器,负责对来自前端心电数据进行数字滤波、压缩等处理以及心电图信号的初步诊断;一个GPRS模块,完成用户端数据到监护中心的数据远程传输以及接收中心的反馈信息(如诊断结果);同时,采用一块LCD触摸屏对DSP的初步诊断结果、病人基本信息以及中心的反馈信息进行智能化显示。
此外,为了保证数据在RF无线传输和GPRS远程传输过程中的安全性,在数据传输前,对它进行了128位的AES加密处理。
实验结果表明,用户端能够实现对人体非介人式、无创的心电诊断监测。同时,具备可移动操作、使用简便、长时间持续工作、智能显示诊断结果、异常生理状况警报、数据的安全传输等特点。有效改善了传统远程医疗系统用户端的不足。
The healthcare industry today suffered a set of significant challenges on several fronts accompanied by rapid economic development and increased life expectancy, viz., availability (or access), quality, and cost. Telemedicine maybe an effective method that can respond to these challenges successfully, its appearance makes the classical“hospital centred healthcare”shift towards“hospital/community/ home/ person centred healthcare”. However, telemedicine is not popularized in real life, for its client server is not well developed correspondingly and still has many problems not well settled, e.g. can not work continuously for a long time, monitor device is not light enough, the patient fells uncomfortable during measurement etc. So how to design a suitable client server is significant for telemedicine system.
Heart disease is a common, recurring, chronic disease, which has become the most prevalent diseases in endangering people's health, especially for older people. ECG is an important diagnostic tool for assessing heart function, and it is valuable to monitor it dynamically and perennially for heart disease prevention, early diagnosis and cure.
According to these, a design of the client server based on wearable technology for ECG telemonitor system is presented in this paper. The client server comprises of a front-end module and a back-end module. The front-end module is worn on patient’s body, and it includes a ECG acquisition module, a RF transmitting chip and a power circuit. The ECG acquisition circuit is used for ECG obtaining, amplifying, filtering and A/D converting; The RF transmitting chip is applied to implement ECG wireless transmission from the front-end module to the back-end module; The power circuit provides energy for all the components of the front-end module. The back-end module has a RF receiving chip for receiving the data from the front-end module, contains a dual processor combined by a ARM and a DSP chip, and the ARM chip is used as primary commanding unit for controlling the back-end, DSP chip is employed as a co-processor exclusively for processing the ECG data from the front-end, such as digital filtering, compressing .etc and automatic pre-diagnosis. The back-end module also includes a GPRS module for tele-transmitting the data of the client to the healthcare center and receiving the feedback from the healthcare center. Meanwhile, an LCD is installed to display DSP’s pre-diagnosis result, patients’information and healthcare center’s feedback.
Furthermore, the design fully considers the security of the data during its wireless transmission via RF and teletransmission via GPRS, an 128-bits AES encryption algorithm is applied before transmitting the data.
The test result shows that the design can successfully implement non-invasive monitoring and diagnosing patient’s ECG. And it also has the characters of mobility, easy-to-use, continuous monitoring, intelligent displaying diagnosis result, alarming abnormal physiological conditions, secure data transmission etc. That well improves the shortage of the traditional telemedicine system’s client server.
引文
[1]中国居民营养与健康现状[M],卫生部、科技部、国家统计局,2004年10日12日.
[2]孟兆辉,白净等穿戴式技术在远程医疗领域的进展及应用[J].世界医疗器械,2006,12(1):49-51.
[3]滕晓非,张元亭.移动医疗:穿戴式医疗仪器的发展趋势[J].中国医疗器械杂志,2006,30(5):1-11.
[4]鲍淑娣,张元亭.远程医疗:穿戴式生物医疗仪器[J].中国医疗器械信息. 2001,10(5):1-4.
[5] A. Lymberis. Wearable Health Systems And Applications: The Contribution of Information & Communication Technologies[C].IEEE,2005:4199-4152.
[6]张政波,俞梦孙,张宏金.用可穿戴式技术设计单兵状态监视器[J].医疗卫生装备.第26卷第3期,2005:29-31.
[7] D. Marculescu etal.,”Electronic Textiles: A platform for pervasive Computing”[J], Proceedings of the IEEE,2003:1991-2016.
[8] L. Weber, D. Blanc, A. Dittmar .etc.“Telemonitoring of vital parameters with newly designed biomedical clothing VTAM”[J], Wearable e-Health Systems for Personalised Health Management, Studies in Health Technology and Informatics, No 108, IOS Press 2004, A. Lymberis and D. De Rossi (Eds.), pp 260-265.
[9] R. Paradiso, A. Gemignani, E.P Scilingo .etc. Knitted bioclothes for cardiopulmonary monitorining[C], in Proc. 25th Annual International Conference, IEEE-EMB, 2003(4):3720-3723.
[10] James Finneran, The Smart Tee Shirt[J]. Biomedical Enginering Seminar,2003:04-27.
[11] Sungmee Park, Sundaresan Jayaraman.Enhancing the quality of life through wearable technology[J]. IEEE, 2003, 22(3): 41-48.
[12] Carmen C.Y.Poon,Yee Man Wong, Yuan-Ting Zhang. M-Health: The Development of Cuff-less and Wearable Blood Pressure Meters for Use in Body Sensor Networks[J]. IEEE,2006.
[13]岳蜀华,王美涵,郭飞等.可穿戴式无线心电监测仪的研究现状[J].生物医学工程与临床.第10卷第4期,2006.7:262-266.
[14] K.Hung,B,L.Luk,W.H.Choy2B,TaiS.K.Tso.Multifunction Stethoscope for Telemedicine[J]. IEEE,2004: 87-89.
[15]张开滋,韩泽蓉,曲晓燕等.简明监测心电图图解[M].第1版.湖南:湖南科学技术出版社,2005:22-26.
[16]姚泰,乔健天等.生理学[M].第五版.北京:人民卫生出版社,2003.6:97—98.
[17]陈海颖.浅谈心电图检查在临床辅助诊断中的作用.黑龙江医学[J].2005,29(1):54.
[18]余学飞,陈光杰等.医学电子仪器原理与设计[M].第1版.广州:华南理工大学出版社,2007.7:82-83.
[19]童诗白,华成英.模拟电子技术基础[M].第3版.北京:高等教育出版社,2001:345-361.
[20]姜宗义,龚卫宁,储德宝.一种新型有源陷波器设计[J].中国生物医学工程学报,1997,16(4):323-326.
[21] Srdjan Krco,Vlado Delic.Personal wireless sensor network for mobile health care monitoring. Telecommunications in Modern Satellite, Cable and Broadcasting Service[C], 2003. TELSIKS 2003. 6th International Conference on, 2003(2): 471-474.
[22] Steve Warren,Luke Nagl,Ryan Schmitz .etc. A Distributed Infrastructure for Veterinary Telemedicine.Engineering in Medicine and Biology Society[C], 2003. Proceedings of the 25th Annual International Conference of the IEEE.2003(2): 1394-1397.
[23] K.Hung, B.L. Luk, W.H. Choy.Multifunction Stethoscope for Telemedicine.Medical Devices and Biosensors[C], 2004 2nd IEEE/EMBS International Summer School on, 2004: 87-89.
[24] DONG Jun,ZHU Hong-hai.Mobile ECG detector through GPRS/Internet Computer-Based Medical Systems[C], 2004. CBMS 2004. Proceedings. 17th IEEE Symposium on.2004 :485-489.
[25] K. Hung, Y.T. Zhang,B.Tai. Wearable Medical Devices for Tele-Home Healthcare Engineering in Medicine and Biology Society[C], 2006. EMBS '06. 28th Annual International Conference of the IEEE.2004(7): 5384– 5387.
[26] Dong Jun, Xu Miao1,Zhu Hong-hai .etc. Wearable ECG Recognition and Monitor. Engineering in Medicine and Biology Society[C], 2004. EMBC 2004. Conference Proceedings. 26th Annual International Conference of the IEEE.2004: 5384– 5387.
[27]罗祖秋,金纯,陈峰等.基于蓝牙和Zig Bee技术的可穿戴网络设计[J].电子技术应用.2006.3:29-31.
[28] Terry T. May. Medical information security:the evolving challenge[J].32nd Annual 1998 International Carnahan Conference on Security Technology.1998:85-92.
[29] Ricardo Isais, Khoi Nguyen, Gabriel Perez, Roberto Rubio, Homyoun Nazeran,“A Low-cost Microcontroller-based Wireless ECG-Blood Pressure Telemonitor for Home Care”[J]. IEEE, Engineering in Medicine and Biology Society, 2003,4(3): 3157– 3160.
[30] R. Fensli1, E. Gunnarson, O. Hejlesen,“A Wireless ECG System for Continuous Event Recording and Communication to a Clinical Alarm Station”[J]. IEEE,Engineering inMedicine and Biology Society, 2004,13(1): 2208– 2211.
[31] Rune Fensli, Einar Gunnarson, Torstein Gundersen,“A Wearable ECG-recording System for Continuous Arrhythmia Monitoring in a Wireless Tele-Home-Care Situation”[J]. IEEE,Symposium on Computer-Based Medical Systems,2005: 407– 412.
[32]徐立新,陈震,李庆亮.无线数传技术在远程心电监护系统中的应用[J].微计算机信息,2005,21(7):7-9.
[33]张舒,王卫东,李开元等.基于nRF系列射频芯片的三导联心电遥测系统[J].医疗卫生装备,2006,27(1):28-29.
[34]李罗,卢建刚.无线心电信号采集系统研究[J].计算机测量与控制,2006,14(12):1742-1744.
[35]谷大武,徐胜波.高级加密标准(AES)算法[M].第1版.北京.电子工业出版社.2003.3:65-72.
[36] Tariq Jamil.The Rijndael Algorithm[J]. Potentials, IEEE. 2004,23(2): 36-38.
[37]潘巨龙,黄宁,姚伏天等. ARM嵌入式Linux系统构建与应用[M].第1版.北京:北京航空航天大学出版社.2006.8:198-205.
[38]彭启琮,武乐琴,张舰等. TMS320VC55X系列DSP的CPU与外设[M].第1版.北京:清华大学出版社. 2005.12:1-13.
[39]王苗田等.嵌入式系统设计与实例开发——基于ARM微处理器与μC/OS-Ⅱ实时操作系统[M].第1版.北京:清华大学出版社.2002.9:1-16.
[40]魏永明,耿岳,钟书毅.LINUX设备驱动程序[M].第1版.北京:中国电力出版社. 2006.1:9-20.
[2]孟兆辉,白净等穿戴式技术在远程医疗领域的进展及应用[J].世界医疗器械,2006,12(1):49-51.
[3]滕晓非,张元亭.移动医疗:穿戴式医疗仪器的发展趋势[J].中国医疗器械杂志,2006,30(5):1-11.
[4]鲍淑娣,张元亭.远程医疗:穿戴式生物医疗仪器[J].中国医疗器械信息. 2001,10(5):1-4.
[5] A. Lymberis. Wearable Health Systems And Applications: The Contribution of Information & Communication Technologies[C].IEEE,2005:4199-4152.
[6]张政波,俞梦孙,张宏金.用可穿戴式技术设计单兵状态监视器[J].医疗卫生装备.第26卷第3期,2005:29-31.
[7] D. Marculescu etal.,”Electronic Textiles: A platform for pervasive Computing”[J], Proceedings of the IEEE,2003:1991-2016.
[8] L. Weber, D. Blanc, A. Dittmar .etc.“Telemonitoring of vital parameters with newly designed biomedical clothing VTAM”[J], Wearable e-Health Systems for Personalised Health Management, Studies in Health Technology and Informatics, No 108, IOS Press 2004, A. Lymberis and D. De Rossi (Eds.), pp 260-265.
[9] R. Paradiso, A. Gemignani, E.P Scilingo .etc. Knitted bioclothes for cardiopulmonary monitorining[C], in Proc. 25th Annual International Conference, IEEE-EMB, 2003(4):3720-3723.
[10] James Finneran, The Smart Tee Shirt[J]. Biomedical Enginering Seminar,2003:04-27.
[11] Sungmee Park, Sundaresan Jayaraman.Enhancing the quality of life through wearable technology[J]. IEEE, 2003, 22(3): 41-48.
[12] Carmen C.Y.Poon,Yee Man Wong, Yuan-Ting Zhang. M-Health: The Development of Cuff-less and Wearable Blood Pressure Meters for Use in Body Sensor Networks[J]. IEEE,2006.
[13]岳蜀华,王美涵,郭飞等.可穿戴式无线心电监测仪的研究现状[J].生物医学工程与临床.第10卷第4期,2006.7:262-266.
[14] K.Hung,B,L.Luk,W.H.Choy2B,TaiS.K.Tso.Multifunction Stethoscope for Telemedicine[J]. IEEE,2004: 87-89.
[15]张开滋,韩泽蓉,曲晓燕等.简明监测心电图图解[M].第1版.湖南:湖南科学技术出版社,2005:22-26.
[16]姚泰,乔健天等.生理学[M].第五版.北京:人民卫生出版社,2003.6:97—98.
[17]陈海颖.浅谈心电图检查在临床辅助诊断中的作用.黑龙江医学[J].2005,29(1):54.
[18]余学飞,陈光杰等.医学电子仪器原理与设计[M].第1版.广州:华南理工大学出版社,2007.7:82-83.
[19]童诗白,华成英.模拟电子技术基础[M].第3版.北京:高等教育出版社,2001:345-361.
[20]姜宗义,龚卫宁,储德宝.一种新型有源陷波器设计[J].中国生物医学工程学报,1997,16(4):323-326.
[21] Srdjan Krco,Vlado Delic.Personal wireless sensor network for mobile health care monitoring. Telecommunications in Modern Satellite, Cable and Broadcasting Service[C], 2003. TELSIKS 2003. 6th International Conference on, 2003(2): 471-474.
[22] Steve Warren,Luke Nagl,Ryan Schmitz .etc. A Distributed Infrastructure for Veterinary Telemedicine.Engineering in Medicine and Biology Society[C], 2003. Proceedings of the 25th Annual International Conference of the IEEE.2003(2): 1394-1397.
[23] K.Hung, B.L. Luk, W.H. Choy.Multifunction Stethoscope for Telemedicine.Medical Devices and Biosensors[C], 2004 2nd IEEE/EMBS International Summer School on, 2004: 87-89.
[24] DONG Jun,ZHU Hong-hai.Mobile ECG detector through GPRS/Internet Computer-Based Medical Systems[C], 2004. CBMS 2004. Proceedings. 17th IEEE Symposium on.2004 :485-489.
[25] K. Hung, Y.T. Zhang,B.Tai. Wearable Medical Devices for Tele-Home Healthcare Engineering in Medicine and Biology Society[C], 2006. EMBS '06. 28th Annual International Conference of the IEEE.2004(7): 5384– 5387.
[26] Dong Jun, Xu Miao1,Zhu Hong-hai .etc. Wearable ECG Recognition and Monitor. Engineering in Medicine and Biology Society[C], 2004. EMBC 2004. Conference Proceedings. 26th Annual International Conference of the IEEE.2004: 5384– 5387.
[27]罗祖秋,金纯,陈峰等.基于蓝牙和Zig Bee技术的可穿戴网络设计[J].电子技术应用.2006.3:29-31.
[28] Terry T. May. Medical information security:the evolving challenge[J].32nd Annual 1998 International Carnahan Conference on Security Technology.1998:85-92.
[29] Ricardo Isais, Khoi Nguyen, Gabriel Perez, Roberto Rubio, Homyoun Nazeran,“A Low-cost Microcontroller-based Wireless ECG-Blood Pressure Telemonitor for Home Care”[J]. IEEE, Engineering in Medicine and Biology Society, 2003,4(3): 3157– 3160.
[30] R. Fensli1, E. Gunnarson, O. Hejlesen,“A Wireless ECG System for Continuous Event Recording and Communication to a Clinical Alarm Station”[J]. IEEE,Engineering inMedicine and Biology Society, 2004,13(1): 2208– 2211.
[31] Rune Fensli, Einar Gunnarson, Torstein Gundersen,“A Wearable ECG-recording System for Continuous Arrhythmia Monitoring in a Wireless Tele-Home-Care Situation”[J]. IEEE,Symposium on Computer-Based Medical Systems,2005: 407– 412.
[32]徐立新,陈震,李庆亮.无线数传技术在远程心电监护系统中的应用[J].微计算机信息,2005,21(7):7-9.
[33]张舒,王卫东,李开元等.基于nRF系列射频芯片的三导联心电遥测系统[J].医疗卫生装备,2006,27(1):28-29.
[34]李罗,卢建刚.无线心电信号采集系统研究[J].计算机测量与控制,2006,14(12):1742-1744.
[35]谷大武,徐胜波.高级加密标准(AES)算法[M].第1版.北京.电子工业出版社.2003.3:65-72.
[36] Tariq Jamil.The Rijndael Algorithm[J]. Potentials, IEEE. 2004,23(2): 36-38.
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[38]彭启琮,武乐琴,张舰等. TMS320VC55X系列DSP的CPU与外设[M].第1版.北京:清华大学出版社. 2005.12:1-13.
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