# Analysis of Perioperative Nursing Intervention Effect of Cerebrovascular Intervention Patients Based on Intelligent Internet of Things

Authors: Jiayu Wen; Jing Liu; Wenping Xiong
Journal: BioMed Research International
 (2022)

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## Abstract

The postoperative results of cerebrovascular surgery patients have been successfully used in medical practice using the Internet. The results obtained through data analysis were used in the study. So far, 120 patients who underwent cerebrovascular surgery from February 2018 to December 2018 have been enrolled. The selected class was divided into two groups: 60 psychiatric patients, a control group and an observation group. The former is medical treatment and the latter is postoperative treatment.Results: The results showed that the blood pressure of control group was lower than that of control group, and the incidence of adverse events was lower than that of control group (P<0.05). Meanwhile, the average hospitalization rate of cerebrovascular disease patients in control group was lower than that in control group (P<0.05). Conclusion: For patients with cerebrovascular disease, postoperative nursing can reduce the incidence of postoperative complications, reduce the risk of surgery, and improve the effect of surgery. Acute ischemic stroke refers to a kind of clinical syndrome caused by abnormal blood supply in the brain, resulting in ischemia, hypoxic brain tissue necrosis, and focal or comprehensive neurological deficiency. Among them, progressive cerebral infarction accounted for about 20~35%, and most occurred in the early stage of the disease (48~72)h.


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## Body

## 1. Introduction

With the continuous progress of Internet of Things technology, people have also abandoned the concept of Internet of Things. Using sensing technology, a sensor as large as a mobile phone and as small as a pen is pasted on the patient, and the sensor terminal is embedded in the medical detection equipment. Doctors can check, diagnose, and treat patients anytime and anywhere through mobile phones or computers. However, there are still many problems to be solved when wireless to the field of medical monitoring to make it adapt to the development of medical information. For example, the interference of radio signals to medical equipment and patients implanted with cardiac pacemaker or cardiac defibrillator [1]; The node signal is difficult to penetrate the wall of the ward, and there are coverage blind spots, resulting in the loss of information; How to avoid frequent replacement of power supply batteries of portable nodes and reduce energy consumption more effectively; There are concerns about network security, which may reveal patient privacy and so on. Cerebrovascular disease is a major disease endangering human health, and its mortality rate is second only to malignant tumors (Figure 1). Cerebral vascular intervention is a method of percutaneous femoral artery puncture and digital subtraction whole cerebral angiography under systemic heparinization for vascular intervention [2]. However, during the treatment, patients have less knowledge about the disease and surgery, and are prone to anxiety, fear, and other emotions, and need to strengthen perioperative care.Figure 1
Perioperative nursing intervention.Fine care is able to reduce deep vein thrombosis in the lower limbs, and the mechanism may be associated with reducing inflammatory cells and reduced inflammatory cytokine expression. For percutaneous foraminal mirror treatment of cerebrovascular patients with lower limb deep vein thrombosis risk factors, give fine nursing measures help to improve perioperative hemodynamics, prevent related complications, improve postoperative patient quality of life, improve the patients and their families of satisfaction of perioperative treatment, nursing indicators, reduce pain index, improve the postoperative curative effect, and is beneficial to patients’ physical and mental health.But, there are still many diseases that affect and threaten human health, especially some sudden diseases. For example, cerebrovascular diseases are the main diseases threatening human health. According to relevant data, the mortality of cerebrovascular diseases is second only to malignant tumors, which also shows the harm degree of cerebrovascular diseases. Cerebrovascular intervention is a method of percutaneous femoral artery puncture and digital subtraction angiography with systemic heparin. It is also the most effective method for extracranial and extracranial arterial plaque and intracranial vascular stenosis. Of course, at present, there are many methods for the treatment of cerebrovascular diseases of different degrees, but such as the above-mentioned methods for the treatment of cerebrovascular diseases. In the process of treatment, patients have relatively little understanding of the disease and surgery. Therefore, it is easy to produce negative emotions such as anxiety and panic, which seriously affect the effect of treatment, so we must strengthen the nursing work in the enclosure period [3].


## 2. Literature Review

Bo et al. found that at present, the mechanism of contrast-induced nephropathy is not fully known in clinic. Most scholars believe that it is easy to cause renal function injury through the following mechanisms: (1) The balance between oxygen supply and oxygen demand of renal medulla is out of balance. Contrast medium is easy to lead to changes in renal medulla hemodynamics, vasodilation and increase of renal blood flow in patients early and short time, renal vasoconstriction and decrease of renal blood flow, destroy the balance of renal medulla, and cause obvious ischemic damage to renal medulla; (2) The glomerular membrane cells in the patient’s body were sensitive to contrast medium; (3) Contrast media can directly contract and straighten the blood vessels, resulting in the decrease of blood perfusion in the medulla of the kidney, especially in the outer medulla, and the ischemic state of the outer medulla of the kidney eventually leads to the occurrence of nephropathy. The nephrotoxic effect of contrast medium has also been confirmed [4]. Milis et al. believe that the renal ischemia after operation leads to the injury of renal tubular epithelial cells. In addition, the contrast agent can produce direct toxicity to renal tubular epithelial cells, resulting in the extracellular hypertonic environment and promoting the production of oxygen free radicals, thus causing oxidative stress and further inducing renal cell apoptosis [5]. Cao et al. believe that renal tubular obstruction or the formation of microemboli in renal vessels are closely related to the immune mechanism in some patients. Clinically, there is still a lack of ideal treatment for contrast-induced nephropathy. At present, hydration therapy has been widely recognized for the prevention of contrast-induced nephropathy [6]. Dai et al. found that although conventional methods can improve patients’ symptoms, reduce ball tube feedback, promote vasodilation in the kidney, reduce the concentration of contrast agent in the blood, reduce the toxicity to renal tubules, and reduce the occurrence of contrast agent nephropathy. Hydration therapy can effectively promote the expansion of blood vessels in the kidney. This method can effectively prevent the crystallization of contrast medium in renal tubules by increasing urine volume, so as to reduce the incidence of contrast medium nephropathy. During hydration therapy, patients should be actively encouraged to drink more water, correct subclinical dehydration, and reduce osmotic diuresis caused by contrast agents. However, during the treatment process, the patients did not achieve the expected goal of clinical treatment due to insufficient understanding and attention to contrast nephropathy [7]. Lyu et al. believe that refined nursing intervention is a new nursing model in recent years, and the nursing intervention model has more advantages than other nursing models. Fine nursing is based on medical science, based on the physiological, psychological and social needs of patients, and guided by humanistic care, from the admission of patients to the end of this treatment. Based on the idea of making each treatment, nursing and service and each link detailed, refined and practical, formulate and implement the corresponding nursing plan to improve its treatment effect, comfort and satisfaction with nursing work [8]. Zielonka et al. believe that nurses should make more reference to the individualized and refined nursing plan of patients’ disease types, nursing research results, patients’ surgical effect, and functional rehabilitation potential when formulating nursing intervention plan. Fine nursing intervention further embodies the concept of “patient-centered” [9]. They are also learning about various wireless diagnostics, including health care procedures during the provision of healthcare services in a joint venture with China Mobile Jiangsu, real-time cleaning of various types for adults on the Internet. Huang and Kieffer are developing a pulmonary function monitor for Internet of things medicine, which can timely find and give favorable guidance to severe patients with respiratory emergencies by monitoring the respiratory flow rate of patients in real time. In addition, brain disease, heart disease, and other monitoring equipment can also be incorporated into the Internet of things, so that more patients can monitor in real-time and find the symptoms of the disease as soon as possible [10]. According to Chen et al., it can be seen from the above that although the scientific Internet is considered as a solar energy industry, most domestic researches focus on theories, and few of them are really applied into practice. In the case of IoT drugs, many of the tasks are limited to pretests, or more studies and diagnostic tests of electronic medical records, with less need to monitor patients’ physical time. Our design uses the Internet of Things for healthcare to address this shortcoming [11].Cerebral Artery Stenosis (CAS) is the main cause of ischemic stroke, and Artery Stenting (Artery Stenting, AS)) is an effective treatment for CAS. Brest braking after AS is easy to lead to urinary retention, which can then cause increased blood pressure, becoming a risk factor for hyperperfusion syndrome, and preventive indwelling catheter will increase the risk of urinary tract infection. Therefore, it is necessary to promote independent urination, reduce the rate of indwelling catheterization, and stabilize postoperative blood pressure during the interventional perioperative period.In China, affected by the aging of the population, stroke has become the number one “killer” threatening the national life and health. At present, about 2.4 million people have new stroke, 1.1 million people die from stroke every year, and more than 11 million existing stroke patients. China is facing the biggest stroke challenge in the world. Among all stroke types, ischemic stroke accounts for about 69.6% ~81.9%, which is the main cause of disability in the population. It brings heavy care pressure and financial burden to families and society.


## 3. Intelligent Internet of Things Medical Health Monitoring System

### 3.1. System Principle

The standard diagnostic node is shown in Figure2. The nodes in the whole network are divided into three types: sensor nodes, routing nodes, and coordination nodes. There is a node administrator in the doctor’s office that is responsible for setting up the network, collecting the data sent through communication, and sending the data to the site for supervision and control through the serial port, which is convenient for doctors to inquire. Routing nodes are placed outside the church. After application and joining the network, it receives data from sensor nodes and wirelessly sends it to coordination nodes after simple operation. Each patient in the ward wears a sensor node that collects physiological information and sends it wirelessly to the routing node on a regular basis [12].Figure 2
Ward wireless network communication structure.Nodes are the basic functional units of wireless sensor networks. Due to different application fields and places, the design of nodes is also different. The hardware composition of coordinator node and routing node is basically the same, mainly including processing module and power module. The sensor node consists of sensor unit, signal processing module, communication module, and power module. The structure of the node is shown in Figure3. In addition, according to the specific application requirements, other functional units can be added, such as positioning system, mobile system, and power self-supply system [13].Figure 3
Structure diagram of wireless network nodes.The sensor node integrates various medical sensors and corresponding conditioning circuits. It is mainly responsible for collecting physiological parameters such as body temperature, heart rate, and ECG in real-time, and sending these information to the routing node or directly to the coordinator node in a wireless manner. In this process, we should pay attention to node coverage, routing in the transmission process, and so on. The coordinator node is responsible for aggregating the information sent by the routing node or sensor node. Send it to the monitoring center through RS3232 serial port. Doctors and nurses on duty can view the physiological parameters of patients at any time through the monitoring management center [14]. They cannot only find the possible emergencies of critical patients in time, but also provide the best suggestions and means of health treatment for ordinary patients. The overall structure of the medical monitoring system is shown in Figure 4.Figure 4
Structure diagram of medical monitoring system.To facilitate patient treatment, data from sensor nodes should be transmitted wirelessly to routing nodes and coordination nodes. At present, short wireless communication technology includes infrared technology, Bluetooth technology, RFID technology, ultrawideband technology, and so on. Through simple comparison and analysis of various wireless communication technologies, the system finally decided to use ZigBee technology more widely in many fields. ZigBee technology is an integrated short-range wireless communication system. Its standard PHY and MAC protocol is IEEE802.15.4. The network layer is developed by the ZigBee Technology Alliance. Users can create application layers based on their own application requirements. As a result, these tools can provide users with flexible and adaptive communication [15]. ZigBee can build up to 64,000 wireless data communications, building a wireless data communications network. They communicate in the form of self-organizing networks. At all network differences, each ZigBee network data transfer can recognize the connection, and the distance between each network node can be extended by a standard 74 m.


### 3.2. System Design Scheme

Patients with sensor nodes can move from one monitor to another. The ball starts receiving sensors that connect to a network that wirelessly sends physical data such as body temperature, pulse, and electrocardiogram to one direction of the church’s location chart. Routing nodes only establish trust and deliver it to partners. The node agent is placed in the service center and connected to a PC through a serial port. It is a high-performance medium-sized network device. It is responsible for setting up and starting the network, setting network parameters, recording received data, compressing it back, and sending important data from the port to the PC database. The physician is responsible for identifying the patient’s condition at any time by managing the consumer. In addition, patients leaving the parish church, after joining the network, will be able to send messages to parish doctors on sensor nodes they wear [16].Urinary nursing process design conforms to the clinical existing medical resources and the actual nursing work condition, nursing staff can be combined with their own professional skills, the use of conventional medical equipment, under the guidance of the process system coherent, standardized and efficiently to carry out the urination nursing work, help to improve the nursing work efficiency and service quality. In summary, blood pressure management is an important link in AS surgery in CAS patients, while urinary retention can increase blood pressure in patients and increase the variability of systolic blood pressure, which increases the difficulty of postoperative blood pressure management, which needs the high attention and care of clinical medical staff. It is necessary to take a series of preventive and treatment measures early to deal with postoperative urinary retention.


### 3.3. Hardware Design of Medical Monitoring System Based on Internet of Things

The application uses CC2430 chip, various medical sensors, and wireless communication technology to complete medical monitoring equipment, real-time monitoring of human data. It usually includes the electrical design of sensor nodes, routing nodes, and interconnections. Figure5 shows the hardware design of the medical diagram.Figure 5
The hardware design blocks the medical picture.All three nodes adopt CC2430 chip as the control core. The CC2430 integrates an 8051 controller and a 2.4 ghz RF transmitter, allowing for the creation, transmission, and storage of data through wireless systems, such as wireless data transfer. Sensor nodes are responsible for recording the patient’s physiological signals. It also includes various medical sensor interface circuits and other electrical equipment. Because the node administrator must send all received data to the computer, additional connections are required.(1)
System chip and minimum systemCC2430 chip adopts 0.18μm COMS standard, with current decreasing 27 with working. In receiving and transmitting modes, the current drop is less than 27 mA or 25 mA, respectively. It also features short sleep mode and switching to active mode, making it especially suitable for applications that require very long battery life [17].
(2)
Hardware design of coordinator nodeThe coordination node is responsible for creating and managing wireless sensor networks, sending network beacons, routing, receiving data from other nodes, processing data, sending data management, host communication, communication, and easily displaying information [18]. The routing node is responsible for collecting data on the sensor node and sending this information to the controller of the node. The hardware design is similar to the other devices, as shown in Figure 6. It is composed of CC2430 module, LCD display module, and keyboard module.
(3)
Hardware design of body temperature sensorFigure 6
Node structure of coordinator.Body temperature refers to the temperature inside the body and is an important index to understand the state of life. The level of body temperature is closely related to human health. Natural medicine has the view that maintaining an appropriate temperature is beneficial to health. Common temperature sensors include thermocouple temperature sensor, thermistor sensor, thermal resistance sensor, digital temperature sensor, semiconductor temperature sensor, and integrated temperature sensor. The measuring circuits and measuring ranges of various sensors are different. According to the temperature characteristics of human body, the temperature measurement range is between 25°C-45°C, and the temperature resolution is greater than 0.1°C. DS18B20 uses 12 bits to store the temperature value, the highest bit is the symbol bit, and the temperature storage format is shown in Figure7. The resolution adopted in this design is 0.0625°C, and the digital conversion resolution of temperature value can also be determined by setting the values of configuration registers R0 and R1, as shown in Table 1. Multiply the measured temperature value by 0.0625 to get the actual temperature [19].
(4)
Pulse measuring circuitFigure 7
DS18B20 temperature memory format.Table 1
Resolution setting table.
R1R0Resolution ratioMaximum temperature conversion time/ms009 sites92.650010 sites186.31111 sites365.001012Sites640.00First, infrared pulse measurement.According to Lambert Beer’s law, the absorbance of a substance at a certain wavelength is directly proportional to its concentration. When photons pass through the medium, the intensity attenuation caused by energy absorption can be described as(1)I=I0e−β×c×z.WhereI0 is the intensity of emitted light; I is the intensity of transmitted light; c is the density of the transmitted material; z is the optical path length; β is the extinction coefficient of a substance. For a substance, β is a constant.Using Taylor series expansion(2)ex=1+x+x22!+x33!+⋯⋯+xnn!.Whenx<<1.0, there can be
(3)ex=1+x.Becauseβ×c×z<<1, there is
(4)I=I01−β×c×z.The path of light changes with the filling of blood, the path of light is a function of timet. Under certain circumstances, both β and c are constants, and the formula can be simplified to
(5)I=I0zt.It is a single beam direct sampling photoelectric sensor. It has the characteristics of strong infrared light matching, high lens sensitivity, large collector current range, stable output signal, and so on. Its performance indicators are shown in Table2.Table 2
Technical indexes of ST1101 photoelectric sensor.
ProjectSymbolMinimumTypical caseMaximumUnitImportForward voltage dropVf—1.21.6VBack currentIR——10μAExportElectrode dark currentIceo——100nAAggregate bright currentIC0.6—40mASaturation voltageVCE——0.4VThe original signal collected by the infrared photoelectric sensor is connected to the next stage circuit through the coupling capacitor C28, which forms an RC high pass filter circuit with the input resistance R12. Due to the low frequency and small amplitude of pulse input signal, large capacitance should be selected, but when the coupling capacitance is too large [20], the circuit response becomes slow and the circuit delays. In order to avoid serious attenuation of input signal, the value of coupling capacitance shall not be less than 0.5 μF. Since the frequency of human pulse signal is very low (the normal pulse rate of adults is 60-100 times/min, 1-1.67 Hz), the bandpass filter with passband frequency of 0.5-10 Hz is designed. Finally, the coupling capacitance is determined to be 10 μF, and the calculation formula of cut-off frequency is
(6)f0=12πRC.TakeR12=36k,C28=10μF, and get f0=0.55Hz,. C31, and R14 constitute a low-pass filter, and its cut-off frequency f0=10.26Hz.(5)
ECG measuring circuitThe amplitude of human ECG signal is about 0-5 mV, and the main frequency range is 0.05 Hz-100 Hz. Since ECG signals are usually mixed with other electronic signals, and there is electromagnetic interference caused by 50 Hz energy frequency interference outside the human body, ECG noise and measurement after electrification is very difficult. Therefore, the key to ECG isolation is to eliminate interference and stabilize the base.There are many kinds of interference in measuring electrocardiogram; the most important is interference frequency (50 Hz). However, only changing the type of preamplifier is not enough to affect the interference; the right leg drive circuit must be used to eliminate the interference [21]. The alternating current of the electromagnetic field generates an induced voltage in the system. The method for calculating the interference voltage is
(7)Uinterference=Uspace×Z2Z1+Z2=Uspace1+Z1/Z2.WhereZ1 is the impedance between space and human body; Z2 is the impedance between human body and earth.The right leg drive circuit is a common mode voltage negative feedback circuit with the human body as the phase addition point, which is connected from R28 to the input pin of the negative feedback amplifier LM324. When the LM324 pin has no signal input, set the interference voltage of the space electric field on the human body asK. When the LM32413 pin has signal input, the system accesses negative feedback, and the interference voltage on the human body is K. N is the amplification factor of the inverting operational amplifier, and the output voltage is −nK1. When the LM324 pin has a signal input, there is (8)
(8)K+−nK1=K1.Arranged to(9)K1=K1+n.In the above formula,K is the interference without feedback (equivalent to the grounding of the right leg). It can be seen that the interference voltage generated by the space electric field on the human body has decreased by 1+n times, which effectively suppresses all kinds of interference [22].The maximum frequency of intentional electrical signal is about 100 Hz. In order to meet the sampling force of digital signal, that is(10)fs≥fMAXWherefs represents the sampling frequency of the system; fmax represents the frequency of the best component signal contained in the sampled signal.The sampling frequency of ADC shall be above 200 Hz. In order to filter out high-frequency signals, the design cut-off frequency is 100 Hz, and the low-pass filter is(11)As=AVF1+3−VF+sCR2.Where(12)Q=13−AVF.In order to prevent self-excited oscillation,AVF<3 is required, AVF=R34/R34=1 is taken, and the amplitude frequency response is the most flat when Q = 0.07. The time constant of low-frequency filter is huge, so the combination of large resistance and small capacitance should be adopted. Therefore, R32=R33=16KandC39=C40=0.1μF are selected, and its low-pass cut-off frequency is
(13)f−3dB=1/2πRC=99.52HZ.One of the biggest interferences in electronic application circuits is mains AC interference. The mains frequency used in China is 50 Hz. The signal interference generated at this frequency may drown the weak ECG signal. Therefore, a 50 Hz band stop filter needs to be designed to suppress it. Here, a dual-t active band stop filter is adopted, the center frequency of the notch circuit can be adjusted by a single potentiometer, and the notch attenuation intensity at the center frequency can be changed by adjusting the feedback voltage coefficient. The transfer function of dual-t active band stop filter is(14)As=s2−1/RC2s2+41−K/RC+1/R2C2=s2+ω2s2+ω0/Qs+ω2.Where(15)ω0=1RC,K=RbRa+Rb,Q=141+K.Adjusting the sliding rheostat can control the value ofK. When the value of K increases, Q will also increase. The closer K is to 1, the closer Q is to infinity, and the better the frequency selection characteristic of band stop filter circuit is. However, the Q value is too high and the filter performance is unstable. When the value of K is too large, too many signals will be lost near 50 Hz, resulting in waveform distortion. After repeated tests, the system selects Q=0.5, and other parameters are set as follows:
(16)C43=C44=0.068μF,R36=R37=47K.


## 3.1. System Principle

The standard diagnostic node is shown in Figure2. The nodes in the whole network are divided into three types: sensor nodes, routing nodes, and coordination nodes. There is a node administrator in the doctor’s office that is responsible for setting up the network, collecting the data sent through communication, and sending the data to the site for supervision and control through the serial port, which is convenient for doctors to inquire. Routing nodes are placed outside the church. After application and joining the network, it receives data from sensor nodes and wirelessly sends it to coordination nodes after simple operation. Each patient in the ward wears a sensor node that collects physiological information and sends it wirelessly to the routing node on a regular basis [12].Figure 2
Ward wireless network communication structure.Nodes are the basic functional units of wireless sensor networks. Due to different application fields and places, the design of nodes is also different. The hardware composition of coordinator node and routing node is basically the same, mainly including processing module and power module. The sensor node consists of sensor unit, signal processing module, communication module, and power module. The structure of the node is shown in Figure3. In addition, according to the specific application requirements, other functional units can be added, such as positioning system, mobile system, and power self-supply system [13].Figure 3
Structure diagram of wireless network nodes.The sensor node integrates various medical sensors and corresponding conditioning circuits. It is mainly responsible for collecting physiological parameters such as body temperature, heart rate, and ECG in real-time, and sending these information to the routing node or directly to the coordinator node in a wireless manner. In this process, we should pay attention to node coverage, routing in the transmission process, and so on. The coordinator node is responsible for aggregating the information sent by the routing node or sensor node. Send it to the monitoring center through RS3232 serial port. Doctors and nurses on duty can view the physiological parameters of patients at any time through the monitoring management center [14]. They cannot only find the possible emergencies of critical patients in time, but also provide the best suggestions and means of health treatment for ordinary patients. The overall structure of the medical monitoring system is shown in Figure 4.Figure 4
Structure diagram of medical monitoring system.To facilitate patient treatment, data from sensor nodes should be transmitted wirelessly to routing nodes and coordination nodes. At present, short wireless communication technology includes infrared technology, Bluetooth technology, RFID technology, ultrawideband technology, and so on. Through simple comparison and analysis of various wireless communication technologies, the system finally decided to use ZigBee technology more widely in many fields. ZigBee technology is an integrated short-range wireless communication system. Its standard PHY and MAC protocol is IEEE802.15.4. The network layer is developed by the ZigBee Technology Alliance. Users can create application layers based on their own application requirements. As a result, these tools can provide users with flexible and adaptive communication [15]. ZigBee can build up to 64,000 wireless data communications, building a wireless data communications network. They communicate in the form of self-organizing networks. At all network differences, each ZigBee network data transfer can recognize the connection, and the distance between each network node can be extended by a standard 74 m.


## 3.2. System Design Scheme

Patients with sensor nodes can move from one monitor to another. The ball starts receiving sensors that connect to a network that wirelessly sends physical data such as body temperature, pulse, and electrocardiogram to one direction of the church’s location chart. Routing nodes only establish trust and deliver it to partners. The node agent is placed in the service center and connected to a PC through a serial port. It is a high-performance medium-sized network device. It is responsible for setting up and starting the network, setting network parameters, recording received data, compressing it back, and sending important data from the port to the PC database. The physician is responsible for identifying the patient’s condition at any time by managing the consumer. In addition, patients leaving the parish church, after joining the network, will be able to send messages to parish doctors on sensor nodes they wear [16].Urinary nursing process design conforms to the clinical existing medical resources and the actual nursing work condition, nursing staff can be combined with their own professional skills, the use of conventional medical equipment, under the guidance of the process system coherent, standardized and efficiently to carry out the urination nursing work, help to improve the nursing work efficiency and service quality. In summary, blood pressure management is an important link in AS surgery in CAS patients, while urinary retention can increase blood pressure in patients and increase the variability of systolic blood pressure, which increases the difficulty of postoperative blood pressure management, which needs the high attention and care of clinical medical staff. It is necessary to take a series of preventive and treatment measures early to deal with postoperative urinary retention.


## 3.3. Hardware Design of Medical Monitoring System Based on Internet of Things

The application uses CC2430 chip, various medical sensors, and wireless communication technology to complete medical monitoring equipment, real-time monitoring of human data. It usually includes the electrical design of sensor nodes, routing nodes, and interconnections. Figure5 shows the hardware design of the medical diagram.Figure 5
The hardware design blocks the medical picture.All three nodes adopt CC2430 chip as the control core. The CC2430 integrates an 8051 controller and a 2.4 ghz RF transmitter, allowing for the creation, transmission, and storage of data through wireless systems, such as wireless data transfer. Sensor nodes are responsible for recording the patient’s physiological signals. It also includes various medical sensor interface circuits and other electrical equipment. Because the node administrator must send all received data to the computer, additional connections are required.(1)
System chip and minimum systemCC2430 chip adopts 0.18μm COMS standard, with current decreasing 27 with working. In receiving and transmitting modes, the current drop is less than 27 mA or 25 mA, respectively. It also features short sleep mode and switching to active mode, making it especially suitable for applications that require very long battery life [17].
(2)
Hardware design of coordinator nodeThe coordination node is responsible for creating and managing wireless sensor networks, sending network beacons, routing, receiving data from other nodes, processing data, sending data management, host communication, communication, and easily displaying information [18]. The routing node is responsible for collecting data on the sensor node and sending this information to the controller of the node. The hardware design is similar to the other devices, as shown in Figure 6. It is composed of CC2430 module, LCD display module, and keyboard module.
(3)
Hardware design of body temperature sensorFigure 6
Node structure of coordinator.Body temperature refers to the temperature inside the body and is an important index to understand the state of life. The level of body temperature is closely related to human health. Natural medicine has the view that maintaining an appropriate temperature is beneficial to health. Common temperature sensors include thermocouple temperature sensor, thermistor sensor, thermal resistance sensor, digital temperature sensor, semiconductor temperature sensor, and integrated temperature sensor. The measuring circuits and measuring ranges of various sensors are different. According to the temperature characteristics of human body, the temperature measurement range is between 25°C-45°C, and the temperature resolution is greater than 0.1°C. DS18B20 uses 12 bits to store the temperature value, the highest bit is the symbol bit, and the temperature storage format is shown in Figure7. The resolution adopted in this design is 0.0625°C, and the digital conversion resolution of temperature value can also be determined by setting the values of configuration registers R0 and R1, as shown in Table 1. Multiply the measured temperature value by 0.0625 to get the actual temperature [19].
(4)
Pulse measuring circuitFigure 7
DS18B20 temperature memory format.Table 1
Resolution setting table.
R1R0Resolution ratioMaximum temperature conversion time/ms009 sites92.650010 sites186.31111 sites365.001012Sites640.00First, infrared pulse measurement.According to Lambert Beer’s law, the absorbance of a substance at a certain wavelength is directly proportional to its concentration. When photons pass through the medium, the intensity attenuation caused by energy absorption can be described as(1)I=I0e−β×c×z.WhereI0 is the intensity of emitted light; I is the intensity of transmitted light; c is the density of the transmitted material; z is the optical path length; β is the extinction coefficient of a substance. For a substance, β is a constant.Using Taylor series expansion(2)ex=1+x+x22!+x33!+⋯⋯+xnn!.Whenx<<1.0, there can be
(3)ex=1+x.Becauseβ×c×z<<1, there is
(4)I=I01−β×c×z.The path of light changes with the filling of blood, the path of light is a function of timet. Under certain circumstances, both β and c are constants, and the formula can be simplified to
(5)I=I0zt.It is a single beam direct sampling photoelectric sensor. It has the characteristics of strong infrared light matching, high lens sensitivity, large collector current range, stable output signal, and so on. Its performance indicators are shown in Table2.Table 2
Technical indexes of ST1101 photoelectric sensor.
ProjectSymbolMinimumTypical caseMaximumUnitImportForward voltage dropVf—1.21.6VBack currentIR——10μAExportElectrode dark currentIceo——100nAAggregate bright currentIC0.6—40mASaturation voltageVCE——0.4VThe original signal collected by the infrared photoelectric sensor is connected to the next stage circuit through the coupling capacitor C28, which forms an RC high pass filter circuit with the input resistance R12. Due to the low frequency and small amplitude of pulse input signal, large capacitance should be selected, but when the coupling capacitance is too large [20], the circuit response becomes slow and the circuit delays. In order to avoid serious attenuation of input signal, the value of coupling capacitance shall not be less than 0.5 μF. Since the frequency of human pulse signal is very low (the normal pulse rate of adults is 60-100 times/min, 1-1.67 Hz), the bandpass filter with passband frequency of 0.5-10 Hz is designed. Finally, the coupling capacitance is determined to be 10 μF, and the calculation formula of cut-off frequency is
(6)f0=12πRC.TakeR12=36k,C28=10μF, and get f0=0.55Hz,. C31, and R14 constitute a low-pass filter, and its cut-off frequency f0=10.26Hz.(5)
ECG measuring circuitThe amplitude of human ECG signal is about 0-5 mV, and the main frequency range is 0.05 Hz-100 Hz. Since ECG signals are usually mixed with other electronic signals, and there is electromagnetic interference caused by 50 Hz energy frequency interference outside the human body, ECG noise and measurement after electrification is very difficult. Therefore, the key to ECG isolation is to eliminate interference and stabilize the base.There are many kinds of interference in measuring electrocardiogram; the most important is interference frequency (50 Hz). However, only changing the type of preamplifier is not enough to affect the interference; the right leg drive circuit must be used to eliminate the interference [21]. The alternating current of the electromagnetic field generates an induced voltage in the system. The method for calculating the interference voltage is
(7)Uinterference=Uspace×Z2Z1+Z2=Uspace1+Z1/Z2.WhereZ1 is the impedance between space and human body; Z2 is the impedance between human body and earth.The right leg drive circuit is a common mode voltage negative feedback circuit with the human body as the phase addition point, which is connected from R28 to the input pin of the negative feedback amplifier LM324. When the LM324 pin has no signal input, set the interference voltage of the space electric field on the human body asK. When the LM32413 pin has signal input, the system accesses negative feedback, and the interference voltage on the human body is K. N is the amplification factor of the inverting operational amplifier, and the output voltage is −nK1. When the LM324 pin has a signal input, there is (8)
(8)K+−nK1=K1.Arranged to(9)K1=K1+n.In the above formula,K is the interference without feedback (equivalent to the grounding of the right leg). It can be seen that the interference voltage generated by the space electric field on the human body has decreased by 1+n times, which effectively suppresses all kinds of interference [22].The maximum frequency of intentional electrical signal is about 100 Hz. In order to meet the sampling force of digital signal, that is(10)fs≥fMAXWherefs represents the sampling frequency of the system; fmax represents the frequency of the best component signal contained in the sampled signal.The sampling frequency of ADC shall be above 200 Hz. In order to filter out high-frequency signals, the design cut-off frequency is 100 Hz, and the low-pass filter is(11)As=AVF1+3−VF+sCR2.Where(12)Q=13−AVF.In order to prevent self-excited oscillation,AVF<3 is required, AVF=R34/R34=1 is taken, and the amplitude frequency response is the most flat when Q = 0.07. The time constant of low-frequency filter is huge, so the combination of large resistance and small capacitance should be adopted. Therefore, R32=R33=16KandC39=C40=0.1μF are selected, and its low-pass cut-off frequency is
(13)f−3dB=1/2πRC=99.52HZ.One of the biggest interferences in electronic application circuits is mains AC interference. The mains frequency used in China is 50 Hz. The signal interference generated at this frequency may drown the weak ECG signal. Therefore, a 50 Hz band stop filter needs to be designed to suppress it. Here, a dual-t active band stop filter is adopted, the center frequency of the notch circuit can be adjusted by a single potentiometer, and the notch attenuation intensity at the center frequency can be changed by adjusting the feedback voltage coefficient. The transfer function of dual-t active band stop filter is(14)As=s2−1/RC2s2+41−K/RC+1/R2C2=s2+ω2s2+ω0/Qs+ω2.Where(15)ω0=1RC,K=RbRa+Rb,Q=141+K.Adjusting the sliding rheostat can control the value ofK. When the value of K increases, Q will also increase. The closer K is to 1, the closer Q is to infinity, and the better the frequency selection characteristic of band stop filter circuit is. However, the Q value is too high and the filter performance is unstable. When the value of K is too large, too many signals will be lost near 50 Hz, resulting in waveform distortion. After repeated tests, the system selects Q=0.5, and other parameters are set as follows:
(16)C43=C44=0.068μF,R36=R37=47K.


## 4. Perioperative Nursing Intervention Effect of Patients with Cerebrovascular Intervention

### 4.1. Data and Methods

(1)
General information. A total of 120 stroke patients who underwent surgery in ward 1 of 3 hospitals of our hospital from February 2008 to December 2008 were divided into 2 groups, 60 cases in each group. There were 34 males and 26 females in the group, aged from 38 to 774 years, with an average age of (54.15±2.36). There are 25 deaf and 35 deaf. There were 33 men and 27 women in the quota group. In terms of age, the average age was 37-73, (54.18±2.34). There are 24 deaf and 36 deaf. For average data, there was no significant difference between the two groups (P>0.05)The nursing process can comprehensively cover the requirements or standards of perioperative urination care for CAS patients. The overall design of the process is coherent, and all links are close and reasonable. The process design takes the concept of “reducing the incidence of urinary retention and enhancing the stability of patients’ blood pressure”, which should effectively reflect the key points and particularity of the interventional treatment of perioperative urination care for such patients; the process emphasizes foresight and holistic care, the key steps should be clear and prominent, and the overall process needs a complete framework and hierarchy.(2)
Method. The control group carried out routine nursing in the operating room; that is, assisting the patients to make various preparations before operation, cooperating with the doctors during operation, returning the patients to the ward after operation, and doing a good job in the handover with the bed nurse [23]The observation group implemented perioperative nursing intervention measures. (1) The hospital performed routine skin preparation, catheterization, and other preparations in the preoperative hospital, introduced the operation process, estimated time, treatment purpose, and medical equipment to the patients, patiently answered the patients’ questions, and introduced the skills of urinating in bed. (2) In the intraoperative hospital, the nurses in the operating room will send the patients to the operating room, do a good job of body position nursing during the operation, and choose the body position that is comfortable and meets the operation requirements, so as to reduce the discomfort of the patients during the operation as much as possible. At the same time, during the operation [24], it is necessary to closely monitor and record the changes of blood pressure of patients. If it is beyond the normal range, it shall be reported to the surgeon in time. Communicate with patients more during the operation, so that patients can get peace of mind and sureness subconsciously, so as to alleviate their bad emotions. (3) The nurses in the operating room of the postoperative hospital personally sent the patients back to the ward and did a good job in the handover with the bed nurse. After the patient wakes up, give dietary guidance and puncture site care to the patient. At the same time, tell the patient not to worry too much and cooperate with treatment and nursing at ease.


### 4.2. Observation Indicators

Measurements: Systolic blood pressure was measured in two groups according to analysis. Dysuria, lumbar and back discomfort, formation of hematoma from punctures, and insomnia. The length of stay in both groups was calculated. The loan interest rate for both groups is set at 100 points. The higher the score, the better the elderly patients get.SPSS18.0 statistical software was used to generate data. Quantitative data were analyzed byT-test and quantitative data by Z-test. P<0.05 is significant.


### 4.3. Results

The blood pressure changes of the two groups were compared. The mean intraoperative systolic blood pressure increased from20.16±4.59mmHg in the control group and 25.58±4.54mmHg in the control group (T=6.503 and P=0.000).The incidence of postoperative problems in the control group was lower than that in the control group (P<0.05). As indicated in Figure 8.Figure 8
Comparison of incidence of postoperative related complications between the two groups (%).The mean postoperative hospital stay of the two groups was9.56±1.34d, lower than that of the control group (14.78±1.56d) (T=19.662, P=0.000). The average satisfaction of the elderly was 92.56±2.35, higher than 86.77±2.41 in the control group. T=13.324 and P=0.000.Hypertension, local hyperemia, local hematoma, dysuria, insomnia, and recurrence in control group were significantly higher than those in control group (P<0.05). As shown in Table 3.Table 3
Comparison of complications between the two groups (%).
GroupExample numberIntraoperative blood pressure was elevatedLocal congestionLocal hematomaDysuriaLose sleepWaist and back discomfortObservation group60332545Control group60111221X22.2512.1202.7533.1744.2316.315P0.0000.0000.0000.0000.0000.001Cerebrovascular intervention is a common treatment for cerebrovascular diseases in clinic. It has the advantages of less trauma and rapid postoperative recovery. However, most patients have insufficient cognition of intervention, which often produces psychological changes, affects the stability of intraoperative vital signs, and then affects the effect of operation [25]. This study compared the application effects of routine nursing and perioperative nursing intervention in the nursing of patients undergoing cerebrovascular intervention. The results showed that the advantages of perioperative nursing intervention were more prominent. Firstly, the increase of blood pressure during operation is smaller. Secondly, the probability of postoperative complications such as dysuria, low back discomfort, puncture site hematoma, and insomnia is smaller. Thirdly, the postoperative hospital stay was shorter. Finally, the overall satisfaction of patients with nursing work is higher, which fully reflects the clinical value and significance of perioperative nursing intervention. Perioperative nursing intervention is a more comprehensive nursing model in operating room nursing, which covers preoperative, intraoperative, and postoperative nursing intervention for patients in both psychological and physiological aspects. Through adequate preoperative preparation, patients can receive treatment in the best state. Through the psychological intervention and cooperation during the operation, the changes of vital signs of patients can be closely monitored, and positive psychological hints can be given to patients to ensure the smooth progress of the operation. Through the postoperative handover with the tube bed nurse and the health education to the patients, we can give more nursing support to the patients, so as to reduce the incidence of postoperative complications and be more conducive to postoperative rehabilitation. For example, in cerebrovascular patients, preoperative nursing care can reduce the incidence of perioperative and postoperative complications, leading to smoother operations, higher patient satisfaction, and shorter postoperative hospital stays are more common and should be used.


## 4.1. Data and Methods

(1)
General information. A total of 120 stroke patients who underwent surgery in ward 1 of 3 hospitals of our hospital from February 2008 to December 2008 were divided into 2 groups, 60 cases in each group. There were 34 males and 26 females in the group, aged from 38 to 774 years, with an average age of (54.15±2.36). There are 25 deaf and 35 deaf. There were 33 men and 27 women in the quota group. In terms of age, the average age was 37-73, (54.18±2.34). There are 24 deaf and 36 deaf. For average data, there was no significant difference between the two groups (P>0.05)The nursing process can comprehensively cover the requirements or standards of perioperative urination care for CAS patients. The overall design of the process is coherent, and all links are close and reasonable. The process design takes the concept of “reducing the incidence of urinary retention and enhancing the stability of patients’ blood pressure”, which should effectively reflect the key points and particularity of the interventional treatment of perioperative urination care for such patients; the process emphasizes foresight and holistic care, the key steps should be clear and prominent, and the overall process needs a complete framework and hierarchy.(2)
Method. The control group carried out routine nursing in the operating room; that is, assisting the patients to make various preparations before operation, cooperating with the doctors during operation, returning the patients to the ward after operation, and doing a good job in the handover with the bed nurse [23]The observation group implemented perioperative nursing intervention measures. (1) The hospital performed routine skin preparation, catheterization, and other preparations in the preoperative hospital, introduced the operation process, estimated time, treatment purpose, and medical equipment to the patients, patiently answered the patients’ questions, and introduced the skills of urinating in bed. (2) In the intraoperative hospital, the nurses in the operating room will send the patients to the operating room, do a good job of body position nursing during the operation, and choose the body position that is comfortable and meets the operation requirements, so as to reduce the discomfort of the patients during the operation as much as possible. At the same time, during the operation [24], it is necessary to closely monitor and record the changes of blood pressure of patients. If it is beyond the normal range, it shall be reported to the surgeon in time. Communicate with patients more during the operation, so that patients can get peace of mind and sureness subconsciously, so as to alleviate their bad emotions. (3) The nurses in the operating room of the postoperative hospital personally sent the patients back to the ward and did a good job in the handover with the bed nurse. After the patient wakes up, give dietary guidance and puncture site care to the patient. At the same time, tell the patient not to worry too much and cooperate with treatment and nursing at ease.


## 4.2. Observation Indicators

Measurements: Systolic blood pressure was measured in two groups according to analysis. Dysuria, lumbar and back discomfort, formation of hematoma from punctures, and insomnia. The length of stay in both groups was calculated. The loan interest rate for both groups is set at 100 points. The higher the score, the better the elderly patients get.SPSS18.0 statistical software was used to generate data. Quantitative data were analyzed byT-test and quantitative data by Z-test. P<0.05 is significant.


## 4.3. Results

The blood pressure changes of the two groups were compared. The mean intraoperative systolic blood pressure increased from20.16±4.59mmHg in the control group and 25.58±4.54mmHg in the control group (T=6.503 and P=0.000).The incidence of postoperative problems in the control group was lower than that in the control group (P<0.05). As indicated in Figure 8.Figure 8
Comparison of incidence of postoperative related complications between the two groups (%).The mean postoperative hospital stay of the two groups was9.56±1.34d, lower than that of the control group (14.78±1.56d) (T=19.662, P=0.000). The average satisfaction of the elderly was 92.56±2.35, higher than 86.77±2.41 in the control group. T=13.324 and P=0.000.Hypertension, local hyperemia, local hematoma, dysuria, insomnia, and recurrence in control group were significantly higher than those in control group (P<0.05). As shown in Table 3.Table 3
Comparison of complications between the two groups (%).
GroupExample numberIntraoperative blood pressure was elevatedLocal congestionLocal hematomaDysuriaLose sleepWaist and back discomfortObservation group60332545Control group60111221X22.2512.1202.7533.1744.2316.315P0.0000.0000.0000.0000.0000.001Cerebrovascular intervention is a common treatment for cerebrovascular diseases in clinic. It has the advantages of less trauma and rapid postoperative recovery. However, most patients have insufficient cognition of intervention, which often produces psychological changes, affects the stability of intraoperative vital signs, and then affects the effect of operation [25]. This study compared the application effects of routine nursing and perioperative nursing intervention in the nursing of patients undergoing cerebrovascular intervention. The results showed that the advantages of perioperative nursing intervention were more prominent. Firstly, the increase of blood pressure during operation is smaller. Secondly, the probability of postoperative complications such as dysuria, low back discomfort, puncture site hematoma, and insomnia is smaller. Thirdly, the postoperative hospital stay was shorter. Finally, the overall satisfaction of patients with nursing work is higher, which fully reflects the clinical value and significance of perioperative nursing intervention. Perioperative nursing intervention is a more comprehensive nursing model in operating room nursing, which covers preoperative, intraoperative, and postoperative nursing intervention for patients in both psychological and physiological aspects. Through adequate preoperative preparation, patients can receive treatment in the best state. Through the psychological intervention and cooperation during the operation, the changes of vital signs of patients can be closely monitored, and positive psychological hints can be given to patients to ensure the smooth progress of the operation. Through the postoperative handover with the tube bed nurse and the health education to the patients, we can give more nursing support to the patients, so as to reduce the incidence of postoperative complications and be more conducive to postoperative rehabilitation. For example, in cerebrovascular patients, preoperative nursing care can reduce the incidence of perioperative and postoperative complications, leading to smoother operations, higher patient satisfaction, and shorter postoperative hospital stays are more common and should be used.


## 5. Conclusion

With the success of new health technology and information technology in China, the new generation of information technology is represented by cloud computing, Internet of Things, and mobile Internet has become the norm. As an important guide to the development of the Internet of Things, the country is very important to the Internet. Therefore, intelligent Internet health management has become a hot topic in many universities and research organizations. Based on the current status of “Four Stages of Community Health Management”, this article will discuss the issues related to the development of family health management. This model recognizes the goal of holistic health management through simple, fast, and effective ways to monitor and manage health information on an ongoing basis.. “Internet of things technology” will create digital treatment and health management from the first stage of physical examination service to the last stage, full-time information, data full text, full information, health education and personal health services, and finally multi-level and multi-level health management. Also, many sites discuss health during the session. This model can provide some applications to improve smart health management in various Internet sites.Based on my time, energy, and ability, I have talked about many devices and understand the main technology of many network sensors, but I think there are many improvements and developments as my research deepened. More research needs to be done. With the development of sensors and Internet-of-medical devices, hospitals will know the exact diagnosis of patients who are healthy, sick, or unhealthy, reports for people, and reduce and monitor patient incidence and development. Develop knowledge about effective and cost-effective health care, disease prevention and control, public health, health assessment, and health management.



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*Source: 7800298-2022-09-24.xml*