血压、心电远程监测医疗平台在松江区心血管疾病管理及分级诊疗中的应用研究

Application of blood pressure and electrocardiogram remote monitoring platform in cardiovascular disease management and hierarchic diagnosis and treatment in Songjiang District

目的探讨血压、心电远程监测医疗平台在松江区心血管疾病管理及分级诊疗中的临床应用价值。方法选取2016年1月至2017年8月松江区中心医院、部分社区卫生服务中心及卫生室接受治疗的380例心血管疾病患者,按照数字表法随机分为观察组和对照组,每组190名,全部患者均签署知情同意书。观察组给予血压、心电实时远程监控,对照组给予常规心电图及血压测量。比较2组患者急性心肌梗死(acute myocardial infarction,AMI)、高血压急症、恶性心律失常的检出率,1年后统计2组患者的致残率、死亡率及患者的满意度。结果观察组AMI、高血压急症及恶性心率失常的检出率分别为88.6%、86.7%及86.7%,对照组检出率分别为77.8%、74.0%和65.5%,观察组显著高于对照组,差异均有统计学意义(P<0.05);观察组患者死亡率和致残率较对照组显著减少,观察组患者满意度显著高于对照组,差异均具有统计学意义(均P<0.05或P<0.01)。结论血压、心电实时远程监控医疗平台可显著提高患者AMI、高血压急症及恶性心律失常的检出率,降低患者死亡率及致残率,值得有条件的医院应用推广。

Objective To explore the clinical value of blood pressure（ BP） and electrocardiogram（ ECG） remote monitoring platform in the cardiovascular disease management and hierarchic treatment in Songjiang district. Methods Three hundred and eighty cardiovascular disease patients who received treatment in community health centers and clinics affiliated to the Central Hospital of Songjiang District from January 2016 to August 2017 were recruited for the study,and were randomly divided into the observation group and the control group,each consisting of 190 patients. The observation group received real-time remote monitoring of BP and ECG,while the control group just received routine ECG and BP measurement. Detection rates of acute myocardial infarction（ AMI）,emergency hypertension and severe arrhythmia were compared between the 2 groups. Rates of disability,mortality and patient satisfaction of the 2 groups were evaluated and analyzed one year later. Results The detection rates of AMI,emergency hypertension and severe arrhythmia in the observation group were 88. 6%,86. 7% and 86. 7%,respectively,while those of the control group were 77. 8%,74. 0% and 65. 5% respectively,indicating that the observation group was obviously superior to the control group,with statistical significance（ P〈 0. 05）. The rates of mortality and disability of the observation group were significantly lower than those of the control group（ P〈 0. 05）. The rate of satisfaction for the observation group was also significantly higher than that for the control group,and statistical significance could be noted when comparisons were made between them（ P〈 0. 05）. Conclusion BP and ECG remote monitoring platform could significantly increase the detection rates of AMI,emergency hypertension and severe arrhythmia,and at the same time decrease the rates of mortality and disability. For this reason,it was worth further clinical promotion in those hospitals with required medical conditions.