远程心电诊断系统在心电图危急值管理中的应用价值

The clinical application value of remote electrocardiographic diagnosis system in the management of critical electrocardiograms

目的探讨远程心电诊断系统在心电图危急值管理中的临床应用价值。方法搜集2017年1月—2019年2月经淮滨县人民医院远程心电系统进行心电图诊断的6300例心血管疾病患者资料,进行回顾性研究。统计描述心电图危急值的检出情况、分类、治疗及转归,危急值参考《心电图危急值2017中国专家共识》。结果6300例远程心电图中,检出心电图危急值78例,包括急性心肌梗死23例、急性心肌缺血18例、室性心动过速15例(含心室率>180次/min的心动过速12例)、多源性RonT型室性期前收缩5例、频发性室性期前收缩并Q-T间期延长2例、预激综合征伴快速心室率心房颤动2例、二度Ⅱ型及以上的房室传导阻滞6例、心室率<40次/min的心动过缓4例、心室停搏>2 s 3例。结论借助远程心电诊断系统进行心电图检查和诊断,能够及时发现心电图危急值,对心血管病的及时诊断和治疗有重要意义。

Objective To explore the clinical application value of the remote electrocardiographic diagnosis system in the management of critical electrocardiograms.Methods Data of 6300 patients with cardiovascular disease who underwent electrocardiographic diagnosis through the remote electrocardiographic system of Huai Bin County People's Hospital from January 2017 to February 2019 were collected for a retrospective study.The detection,classification,treatment and outcomes of critical electrocardiogram value were statistically described,referring to the'2017 Chinese Expert Consensus on Critical Electrocardiographic Value'.Results Among the 6300 remote electrocardiograms,78 critical electrocardiogram values were detected,including 23 cases of acute myocardial infarction,18 cases of acute myocardial ischemia,15 cases of ventricular tachycardia(including 12 cases of tachycardia with a ventricular rate>180 beats/min),5 cases of polymorphic R-on-T ventricular premature contractions,2 cases of frequent ventricular premature contractions with prolonged Q-T intervals,2 cases of pre-excitation syndrome with rapid ventricular rate atrial fibrillation,6 cases of second-degree type II and higher-degree atrioventricular block,4 cases of bradycardia with a ventricular rate<40 beats/min,and 3 cases of ventricular arrest>2 s.Conclusion The use of remote electrocardiographic diagnosis for electrocardiogram examination and diagnosis can promptly identify critical electrocardiogram values,which is of great significance for the timely diagnosis and treatment of cardiovascular diseases.