安置永久心脏起搏器患者常规随访与创新随访效果比较

Comparative Study of the Effects between Innovative and Conventional Approach of Follow-up after Permanent Pacemaker Implantation

目的比较安置永久起搏器患者常规随访与创新随访两种随访模式的随访效果。方法对2012年1月-2013年6月收治的400例住院安置永久心脏起搏器患者,术后随机分为对照组200例和研究组200例,两组在年龄、性别、心功能、高血压、患者所选用的起搏器型号、起搏电极以及电极放置的部位等均无统计学意义。对照组使用常规的随访模式,研究组使用创新的随访模式,即常规随访+电话/短信/传真/电子邮件/伤口视频/微信群/家庭随访,专人负责,提供24 h随访服务。观察比较两组患者术后对随访的满意度、患者术后健康状况、患者术后并发症的发生率、再入院率以及患者术后门诊随访次数等情况,对创新的随访模式的效果进行评价。结果研究组患者术后对随访的满意度高于对照组(P<0.05)。研究组患者术后健康状况各项评价指标得分均高于对照组,差别具有统计学意义(P<0.05)。与对照组相比,患者术后并发症的发生率及术后门诊随访平均次数均显著减少,差别均具有统计学意义(P<0.05)。结论创新随访模式的效果优于常规随访模式的随访效果,可将创新随访模式应用于临床。

Objective To explore the effi cacy of an innovative approach of follow-up in patients implanted with permanent pacemaker（DDD）. Methods A total of 400 patients who underwent permanent pacemaker（DDD） implantation between June 2011 and June 2013 were included in the present study. Patients were randomly assigned to the innovative and conventional follow-up groups in a 1︰1 manner（200 patients in each group）. The baseline characteristics were well balanced with no statistically signifi cant differences in the mean age, proportion of male sex, prevalence of hypertension, position of the electrode or the device used between the two groups. At the end of the follow-up, patient outcomes were compared between the two groups. Results The outcomes of patients were better in the innovative follow-up group, with higher degree of satisfaction, better state of health, lower incidence of complications, and less frequent readmission and follow-up visits（all P 〈0.05）. Conclusion The innovative approach of follow-up considerably improves patient outcomes, and can be useful in future clinical practice.