臺灣博碩士論文加值系統

醫院e化的主要目的是創造一個無紙化、無片化的醫療文件管理環境。目前大部分醫院的12導程心電圖都是以紙張的方式做保存與管理，主要的原因是12導程心電圖儀的數位輸出，都需要購買相關廠商提供的軟硬體設備才能觀看與使用，造成e化過程中成本的大量付出，甚至在未來做醫療資訊交流時，各個醫療院所也都需要有相同的軟硬體設備才能做資料的交換與觀看，因此需要有一共通的標準來解決實際應用上的限制。西元2000年，DICOM 3.0制定了一維生物訊號的12導程心電圖診斷報告格式，而依DICOM標準發展出來的PACS系統是目前大部份醫院都擁有的，其功能針對影像做擷取、傳輸、儲存與管理，故希望藉此發展設計出e化的心電圖診斷報告，並且不受到各家廠牌機型的限制，讓資料交換無障礙。本研究主要目的是將醫療儀器所產生的SCP或XML心電圖檔轉換成DICOM心電圖導程檔，並整合至醫院PACS系統上，醫生可透過我們發展的DICOM-ECG瀏覽器觀看心電圖報告。本研究的主要流程是開發程式(1)將二進制的HP-SCP格式轉換成DICOM-ECG格式的程式、(2)將Philip-XML格式轉換成DICOM-ECG格式的程式、(3)與醫院PACS系統連結，發展DICOM-ECG檢查流程。藉由本系統的開發，讓醫院e化的過程更加完整，並且在做醫療資訊交換時，不會因為各家醫院不同廠牌的心電圖儀，而造成交換的困難。透過我們發展的SCP、XML解碼程式，可將原始12導程心電訊號萃取出來，未來在心電訊號特徵分析的應用上，有助於開發出適合國人心電特徵自動識別與自動診斷系統。

12-lead electrocardiograph (E.C.G.) is one of the most often used diagnostic tools in clinical cardiac medicine. However, the development of computerized E.C.G.. documentary system in e-hospitals is impeded by the encrypted and heterogeneous data format of E.C.G.. manufactures. The primary goal of this study is to develop a novel DICOM-based 12-lead computerized E.C.G.. documentary system. This system can allow clinicians to browse and interpret E.C.G.. reports by means of automatic conversion between SCP/XML and DICOM through PACS. As a first step, we developed an SCP-compatible/XML to DICOM-ECG converter to extract E.C.G.. interpreted messages and raw waveform E.C.G.. data. In addition, we also developed a practical computerized E.C.G. documentary system under PACS by the implantation of a DICOM-ECG converter gate server connected with the hospital information system, the DICOM-ECG data base server, and the DICOM-ECG viewer. At present time, an E.C.G. interpreter program is being developed to correct errors resulting from noise-interfered measurements. This newly developed computerized DICOM-based 12-lead E.C.G. documentary system has successfully assisted the development of e-hospitals in Taiwan and has been adopted by Taipei Veterans General Hospital and Cheng Hsin Medical Center in Taiwan.

中文摘要…………………………………………………………………1
英文摘要…………………………………………………………………3
致謝………………………………………………………………………5
目錄………………………………………………………………………6
圖目錄……………………………………………………………………8
表目錄……………………………………………………………………9
中英文對照……………………………………………………………10
第一章 緒論…………………………………………………………12
1. 1 研究動機…………………………………………………12
1. 2 研究內容…………………………………………………13
第二章 背景研究……………………………………………………14
2. 1 ECG…………………………………………………………14
2. 2 HL7/HIS及DICOM/PACS…………………………………15
2. 3 SCP-ECG/OpenECG…………………………………………17
2. 4 XML-ECG…………………………………………………19
2. 5 國內外電子式心電圖診斷報告相關研究………………20
第三章 研究方法……………………………………………………22
3. 1 SCP to DICOM Converter…………………………………22
3. 1. 1 探討標準的與HP的SCP共有與自定的section…24
3. 1. 2 HP的SCP解碼過程…………………………………29
3. 2 XML to DICOM Converter…………………………………34
3. 3 DICOM 格式設計…………………………………………35
3. 3. 1 DICOM檔案的寫入過程描述………………………37
3. 4 DICOM Viewer的程式設計………………………………40
3. 5 結合PACS系統……………………………………………41
第四章 結果與討論…………………………………………………42
4. 1 結果………………………………………………………42
4. 2 討論………………………………………………………45
參考文獻………………………………………………………………50
附錄A…………………………………………………………………52

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