经手机微信行心电远程会诊的应用

The application valuel of remote ECG monitoring by mobile phone wechat in countryside

目的探讨建立农村手机微信心电远程会诊的应用价值。方法沂源县中医院医师在手机上申请设立IP心电远程会诊中心(微信群主)一处,中心下设终端分站群(网点),分站群将所采集到的心电图信息经手机拍照后,通过手机微信传至中心,中心医生即刻作出诊断并回复。结果自2016年1月至12月共收集微信诊断静态常规心电图1035例,男612例,女423例,年龄12~94岁,其中正常心电图323例,异常心电图712例,阳性率68.8%,心律失常357例,阳性率34.5%,异常ST-T改变410例,阳性率39.6%,心肌梗死9例,阳性率0.86%。由群点转入我院治疗的病人76例,抢救群点急危重症病人47例,医院专家通过手机微信对农村卫生室首诊的复杂病症患者给予了91人次的远程指导性治疗方案的提供,结果表明,全县63个农村站群点实现了心电图诊断标准化,实现了远程会诊、分级医疗和双向转诊的医疗服务。急性心肌梗死患者因即可获知病情并及时救治,死亡率降低。结论农村手机微信心电远程监测会诊的建立,实现了以基层医疗卫生服务手机微信为基础的医疗服务体系的公共卫生服务功能,建立了信息互通、农村卫生室首诊、分级医疗的服务体系。实现了在手机微信上快速、及时、准确的心电图诊断报告发送。缩短了急性心肌梗死的救治时间,降低了急性心肌梗死的死亡率。

Objective To investegatet the application valuel of Remote ECG Monitoring by mobile phone wechat in Countryside.Methods Doctor in Yiyuan traditional Chinese Medical Hospital applied a Remote ECG consultation center in mobile phone wechat.It has many terminal substations,which photograph ECG informations and pass them to it through mobile phone wechat.Doctors diagnosed and responddthese informationsimmediately.Results We monitored 1035 steady ECG from January 2016 to December 2016,age from 12 to 94 years old.323 cases of normal ECG.712 cases of unnormal ECG,whose positive rate is 68.8%.357 cases of arrhythmia,whose positive rate is34.5%.410 cases of Abnormal ST-T changes,whose positive rate is 39.6%.9 cases of myocardial infarction,whose positive rate is 0.86%.We treated 76 cases of patients who were transferred from terminal substation.We rescued about 47 critically ill patients who were transferred from terminal substation.Experts given more than 91 remote guiding-treatment by mobile phone wechat in Countryside and the patients had complex disorders.More than 63 countryside substations achieved the standardized diagnostic of ECG,the remote consultation,medical grade and two-way referral medical services.The mortality rate of AMI patients was low whose Course was shorter and given timely treatment.Conclusions The established of Remote ECG Monitoring by mobile phone wechat in Countryside,achieve the public health services which was based on the grassroots health service network.It established a health care system which had information exchange、rural first diagnosis and classification medical.It achieved the speedy,timely and exactly of ECG diagnosis.It shorted the treatment duration of AMI.It reducee the mortality rate of AMI.