2G／3G远程医疗移动通讯系统在院外危重患者急救信息传输中的效果评价

Effect assessment of 2G/3G remote mobile communication system in transfer for critical patients

目的评估2G／3G远程医疗移动通讯系统在院外传输危重患者急救信息的可行性和安全性。方法常规救护车上安装2G／3G移动通讯传输系统，入选2014年4月-2015年1月经过上海嘉定区医疗急救中心院外急救与转运需要预报的年龄≥18岁的患者。医生在现场或急救车上采集患者的年龄、性别、院外诊断、P、R、SPO2、NIBP、12-ECG、血糖、GCS、TI等急救信息可传输到医院信息终端，医院急诊室医护人员则记录数据的传输结果。结果（①共传输了3362例患者信息，年龄、性别与院外诊断基础数据由2G网络和卫生专网传输，成功率为83．04％～97．04％。②现场用智能除颤监护仪采集患者临床数据分别为P3 324例、R3 330例、SpO2 2668例、NIPB systolic 2862例、12-ECG2256例。采集的临床数据由3G和卫生专网传输，成功率为67．99％-74．34％。③现场检测血糖644例、GCS评分841例、TI评分447例，对其中的危重指标通过电话，对讲机做院外预报，预报成功率为95．35％～96．88％。④2G／3G传输失败的主要原因为网络故障，另外，现场采集数据困难、仪器故障、路由器电量不足、人员操作不熟练也是传输失败的原因。结论远程医疗移动通讯系统传输院外危重患者的急救信息是可行的，安全的。但是网络通讯技术有待升级改造，系统的人机结合有待磨合。

Objective To assess the feasibility and reliability of ambulance-based mobile communication telemedicine system in transferring critical patients. Methods The retrospective assessment was performed on the cases of which the patients were transferred by Jiading District Emergency Medical Center between April 2014 and January 2015. The patients＇ clinical data was transmitted to each hospital＇ s emergency department prior to the arrival. Meanwhile, the corresponding staff in the hospital were taking the data and creating the patient＇ s medical record. Results ① In the total of 3,362 cases, the successful rate of data transmission via 2G and Unified Health Network was 83.04%-97.04%. ② The successful rate of the clinical data obtained on site with intelligent defibrillation monitor via 3G and Unified Health Network was 67.99%-74.34%.③The success rates for pre-hospital notification via phone and intercom were 95.35%-96.88%. ④ Failures for transmission of patients＇ clinical data were mainly caused by network technical problems, malfunction of the devices, power shortage, as well as unskillful EMS personnel. Conclusion Transmission of critical patients＇ clinical date with mobile communication telemedicine system is considered being feasible and reliable. Yet, an advanced network communication technology is expected.