Hemodialysis Room, Wenling Traditional Chinese Medicine Hospital, Wenling 317500, Zhejiang, China.
Hemodialysis Room, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai 317000, Zhejiang, China.
J Healthc Eng. 2021 Dec 16;2021:3413692. doi: 10.1155/2021/3413692. eCollection 2021.
In order to investigate the impact of holistic care on line coagulation and safety in hemodialysis and to address limitations of the conventional ultrasound flow vector imaging (VFM) technique, which requires proprietary software to acquire raw Doppler and scatter tracking data, a combined deep-learning-enabled holistic care approach to line coagulation in hemodialysis is proposed. First, velocity along the direction of the sound beam, which is provided by the color Doppler echocardiogram, is obtained as the radial velocity component using a velocity scale. Moreover, the left ventricular wall contour is automatically identified using a U-Net network and the left ventricular wall velocity is calculated as the boundary condition of continuity equation by a retrained PWC-Net model. Likewise, the velocity component of each blood mass in the vertical direction of the sound beam is obtained by solving the continuity equation (i.e. tangential velocity component). Finally, the velocity vector map of cardiac flow field was synthesized and visualized in the flow diagram. For this purpose, sixty patients admitted to receive hemodialysis from February 2019 to June 2020 were randomly divided into two groups of 30 patients where the control group implemented conventional care and the study group implemented all-round care on the basis of conventional care. The nursing effects of both groups were compared. Incidence of pipeline coagulation and complications in the study group were lower than those in the control group and the difference was statistically significant ( < 0.05). The nursing detail score, nursing attitude score, nursing professionalism score, and total satisfaction score in the study group were higher than those in the control group and the difference was statistically significant ( < 0.05). Applying all-round nursing in hemodialysis can effectively reduce the incidence of line coagulation complications and improve the safety of hemodialysis, as well as improve patients' satisfaction with nursing care.
为了研究整体护理对血液透析中管路凝血及安全性的影响，并解决传统超声血流向量成像（VFM）技术的局限性，该技术需要专用软件来获取原始多普勒和散射跟踪数据，我们提出了一种结合深度学习的整体护理方法来进行血液透析中的管路凝血研究。首先，利用彩色多普勒超声心动图提供的声束方向上的速度作为径向速度分量，通过速度标度获得。此外，使用 U-Net 网络自动识别左心室壁轮廓，并使用重新训练的 PWC-Net 模型将左心室壁速度作为连续性方程的边界条件进行计算。同样，通过求解连续性方程（即切向速度分量）获得声束垂直方向上每个血质量的速度分量。最后，在流程图中综合和可视化心脏流场的速度矢量图。为此，将 2019 年 2 月至 2020 年 6 月收治的 60 例接受血液透析的患者随机分为两组，每组 30 例，对照组实施常规护理，研究组在常规护理基础上实施全面护理。比较两组的护理效果。研究组的管道凝血发生率和并发症发生率低于对照组，差异有统计学意义（ < 0.05）。研究组的护理细节评分、护理态度评分、护理专业评分和总满意度评分均高于对照组，差异有统计学意义（ < 0.05）。在血液透析中应用全面护理可以有效降低管路凝血并发症的发生率，提高血液透析的安全性，同时提高患者对护理的满意度。
