【正文】 或其它） 基本單元或醫(yī)生單元（它也可是手提式電腦或其它，一般都位于中心醫(yī)院里 面 圖一描述了系統(tǒng)的總體體系機構，系統(tǒng)的每個不同的應用即遠程醫(yī)療單元位于病人所在處，而基本單元（或是叫醫(yī)生單元）即接收和監(jiān)測病人 的生理信號及肖像處。 在系統(tǒng)技術實現(xiàn)以前，上述遠程醫(yī)療系統(tǒng)應用的總設想應根據(jù)目前的發(fā)展趨勢和需求而制定，只有這樣，在設計和發(fā)展過程中，才能把諸多因素都考慮進去，所以才能在任何環(huán)境和情形下達到最大的適用性和可用性。 b)另一個位于醫(yī)生所在地，叫做基本單元。通過這些具體實踐，我們已經(jīng)定相了解了實現(xiàn)遠程醫(yī)療裝置的需要，這將進一步促進我們形成一個靈活的體系結構，可用于需要信息傳輸?shù)木o急病例或者是監(jiān)測病例。 所收集的病人生理信號（然后傳送到基本單元）主要有： ? 心電圖，由病人所用的監(jiān)視器決定 ? 心跳率 ? 無入侵血壓 ? 入侵血壓 ? 體溫 ? 肺活量 所使用的計算機由遠程應用的類型決定（遠程醫(yī)療單元所發(fā)揮的作用），如表一所示， a)要求系統(tǒng)自動化，形狀小的，一臺像東芝， 100ct 的筆記本電腦即可，較輕便的機器裝置如圖 3 所示。遠程醫(yī)療單元用戶要做的僅僅是把生理信號檢測器連接到病人，然后打開計算機。另外，基本單元的計算機還負責顯示遠程醫(yī)療單元的輸入信號。 機械專業(yè)中英文文獻翻譯 第 5 頁 共 19 頁 通過基本單元，用戶可以完全控制遠程醫(yī)療端。該單元可完全控制遠程醫(yī)療部分。采用什么 方法取決于所傳輸?shù)男碾妶D的波形通道和無線通路的數(shù)據(jù)傳輸率。最新監(jiān)測數(shù)據(jù)是以 1 次 /s 進行刷新，所以傳輸少量數(shù)據(jù)大約可以達到 200bits/s,系統(tǒng)使用的所有監(jiān)測器可以提供收集到的信號的數(shù)字輸出量。使用不同種類的衛(wèi)星系統(tǒng)會增加儀器的價錢和用戶的開銷。傳輸生理信號有兩種方法實時傳輸，連續(xù)地將信號從客戶端傳輸?shù)郊曳掌?；儲存和轉發(fā)傳輸，信號提前獲得并儲存在客戶端，然后作為文件傳輸給服務器。 數(shù)據(jù)傳輸使用的是 TCP/IP網(wǎng)絡協(xié)議，網(wǎng)絡傳輸數(shù)據(jù)使用 TCP/IP協(xié)議簡單且容易 ，又具有高帶寬、低誤碼率。 考慮到數(shù)據(jù)傳輸?shù)纳鲜鰞煞N情況，尤其是那種低帶寬、高差錯率的網(wǎng)絡（像 GSM移動網(wǎng)絡和衛(wèi)星連接）。數(shù)據(jù)包的大小依次有 字節(jié)。 結論 我們已經(jīng)開發(fā)了適于遠程醫(yī)療應用的醫(yī)療產(chǎn)品，該裝置使用 GSM 移動電話連接，衛(wèi)星連接或 POTS 連接，允許收集和傳輸生理信號、病人的肖像，具有雙向視頻功能。據(jù)現(xiàn)在的發(fā)展情形可以看出系統(tǒng)很有前景，所以為滿足 未來需求，激勵著我們不斷發(fā)展和提高該系統(tǒng)。s office or hospital. The system allows the transmission of vital biosignals (3–12 lead ECG, SPO2, NIBP, IBP, Temp) and still images of the patient. The transmission is performed through GSM mobile telemunication work, through satellite links (where GSM is not available) or through Plain Old Telephony Systems (POTS) where available. Using this device a specialist doctor can telematically move to the patient39。s third highest death rate due to car crashes, show that 77,4 % of the 2500 fatal injuries in accidents were injured far away from any petent healthcare institution, thus resulting in long response times. In addition, the same studies reported that 66% of deceased people passed away during the first 24 hours. The reduction of all those high death rates is definitely achievable through strategies and measures, which improve access to care, administration of prehospital care and patient monitoring care telemetry is another case of handling emergency situations. The main point is to monitor continuously intensive care units39。s unit (which can be portable or not portable depending on the case and usually located at a Central Hospital). Figure 1 describes the overall system architecture. In each different application the Telemedicine unit is located at the patient39。 forward) needs, ECG leads required (3 or 12 leads), etc. These last are examined in more detail in the next paragraph, where the overall technical description of the system is provided. System design and technical implementation As mentioned above, the system consists of two separate modules (Figure 1): a) the unit located at the patient39。s unit is responsible for receiving and displaying ining data. The information flow (using a layered description) between the two sites can be seen in Figure 2. a) Telemedicine Unit The Telemedicine unit mainly consists of four modules, the biosignal acquisition module, which is responsible for biosignals acquisition, a digital camera responsible for image capturing, a processing unit, which is basically a Personal Computer, and a munication module (GSM, Satellite or POTS modem). The biosignal acquisition module was designed to operate with some of the most mon portable biosignal monitors used in emergency cases or in Intensive care Units such as a) CRITIKON DINAMAP PLUS Monitor Model 8700/9700 family of monitors, b) PROTOCOLWelch Allyn Propaq 1xx Vital Signs Monitor, c) PROTOCOLWelch Allyn Propaq Encore 2xx Vital Signs Monitor. The biosignals collected by the patient (and then transmitted to the Base Unit) are: ? ECG up to 12 lead, depending on the monitor used in each case. ? Oxygen Saturation (SpO2). ? Heart Rate (HR). ? NonInvasive Blood Pressure (NIBP). ? Invasive blood Pressure (IP). ? Temperature (Temp) ? Respiration (Resp) 機械專業(yè)中英文文獻翻譯 13 The PC used depends on the type of the Telemedicine application (role of the Telemedicine unit). As shown in Table 1: a) in cases where the autonomy and small size of the system are important (mainly in ambulances), a sub notebook like Toshiba libretto 100 ct portable PC is used, a picture of a portable device is shown in Figure 3 b) in cases where we need some autonomy but size is not considered an important element a Typical Pentium portable PC is used。s user can monitor biosignals or still images ing from the Telemedicine unit, thus keeping a continuous online munication with the patient site. This unit has the full control of the Telemedicine session. The doctor (user) can send all possible mands concerning both still image transmission and biosignals transmission. Figure 6 presents a typical biosignalreceiving window (continuous operation). 機械專業(yè)中英文文獻翻譯 15 c) Technical Constraints – Feasibility Biosignals transmission 機械專業(yè)中英文文獻翻譯 16 Along with biosignals, information concerning the monitor, such as the alarms or the monitor status, is transmitted from the Telemedicine unit to the base unit. The ECG waveform and SpO2 or Co2 Waveform (where available) is the continuous signals transmitted, trends are transmitted for the rest of data. ECG data are sampled at a rate of 200 samples/sec by 10 bits/sample or 12 bits/sample, for all monitors used, thus resulting in a generation of 2020 bits/sec and 2400 bits/sec for one ECG channel. SpO2 and Co2 waveforms are sampled at a rate of 100 samples/sec by 10 bit/sample。 allows transmission of data up to 9600 bps (when operating on the normal mode) and is able to reach up to 43200 bps when using the HSDC (High Speed Circuit Switched Data). The satellite links transmission rate depends on the equipment and the satellite system used in each case。 buffers from 71 up to 479 bytes were select