心脏永久性起搏器植入患者门诊随访依从性分析

The Follow-up Study for Clinical Compliance in Patients With Permanent Pacemaker Implantation

目的:分析心脏永久性起搏器植入患者门诊随访依从性的现状、影响因素及探讨提高随访依从性的方法。方法:回顾性分析2006-01至2013-01在我院住院植入心脏永久性起搏器的患者817例,对术后1年内的门诊随访情况进行依从性评判,并分析其影响因素。实际随访790例(96.70%),1年内未进行门诊随访者入电话随访组(n=350例),至少进行过1次门诊随访者入门诊随访组(n=440例)。结果:研究对象中,失访26例,失访率3.18%;非起搏器相关死亡1例,实际随访790例,实际随访率96.7%,其中门诊随访者440例(55.70%),电话随访者350例(44.30%)。两组在文化程度、医疗费用、居住地、对心律失常的了解、固定陪护人员方面的差异有统计学意义(P<0.05)。高中以上文化程度、医疗费用可报销、本地居住、对心律失常知识了解、有固定陪护人员的患者门诊随访率高。1年内总体并发症发生率1.8%,均未造成严重后果。随访时进行优化参数设置者占59.5%。结论:心脏永久性起搏器植入患者门诊随访率较低。影响因素较多,包括文化程度、医保制度、居住地、对心律失常的认知程度、有无陪护人员。

Objective： To analyze the current condition and inlfuencing factors for clinical compliance in patients with permanent pacemaker implantation and to improve the follow-up condition in relevant patients. Methods： A total of 817 patients with permanent pacemaker implantation in our hospital from 2006-01 to 2013-01 were retrospectively studied. The clinical compliance condition and inlfuencing factors were accessed for 1 year period. Results： There were 26/817 （3.18%） patients lost contact and 1 patient died. A total of 790 （96.7%） patients finished the followed-up study by 2 groups： Clinical visit group,n=440 （55.70%） and Telephone visit group,n=350 （44.30%）. The education level, medical cost, residency, comprehension of arrhythmia and accompany personnel were different between 2 groups,P〈0.05. The patients were with high school education or above, reimbursed medical cost, local residency, comprehension of arrhythmia and accompany personnel had the higher clinical visit rate. The overall 1 year occurrence rate of complication was 1.8% without severe event. There were 59.5% of patients optimized the pacemaker parameters during clinical visit. Conclusion： The patients with permanent pacemaker implantation had the lower rate of clinical follow-up visit which should be improved in several issues.