远程实时心电监测在社区医联体中的应用价值

发布时间：2018-03-24 21:29

本文选题：远程心电监测　切入点：心律失常　出处：《实用心电学杂志》2017年01期

【摘要】：目的探讨远程实时心电监测在社区医联体中的应用价值。方法选取2015年5月25日至2016年6月22日在暨南大学附属第一医院医联体下行远程实时心电监测的患者共2 858例,统计各类心律失常的检出率、恶性心律失常的预警率、不良事件的发生率、符合心脏电生理手术指征的检出率、不同年龄段及时间段心律失常的检出情况。结果入选患者中共发现窦性心动过缓88例,房性心动过速1 050例,房性早搏2 014例,心房扑动28例,心房颤动195例,室性心动过速131例,室性早搏1 530例,预激综合征7例,左束支阻滞25例,右束支阻滞120例,交界性心律46例,窦性停搏7例。在恶性心律失常预警方面,室速出现1 980例次(69.28%),长RR间期(RR间期2 s)1 258例次(44.02%),Ron T 304例次(10.64%),ST段抬高1 133例次(39.64%),ST段压低1 141例次(39.92%),疑似心肌梗死32例次(1.12%)。不良事件的发生情况如下:伪差出现9例(0.31%),导联脱落43例(1.50%)。在符合心脏电生理手术指征的检出方面,符合射频消融术指征者41例(1.43%),其中频发室性早搏27例、心房颤动10例、预激综合征4例;符合心脏起搏器植入术指征者16例(0.56%)。60岁以上患者的室速、窦性停搏等心律失常及疑似心肌梗死的发生率明显升高,符合起搏器植入术的患者人数随年龄增大直线上升,且不同年龄组间比较差异有统计学意义(P=0.022)。结论远程实时心电监测中心律失常的检出率较高,可作为心血管疾病筛查和诊断的重要方法在社区医疗中进行推广应用。
[Abstract]:Objective to explore the application value of remote real-time ECG monitoring in community medical association. Methods from May 25, 2015 to June 22, 2016, a total of 2858 patients with remote real-time ECG monitoring were selected from the first affiliated Hospital of Jinan University. The detection rate of various arrhythmias, the warning rate of malignant arrhythmias, the incidence of adverse events, the detection rate of cardiac electrophysiologic indications, Results 88 cases of sinus bradycardia, 1 050 cases of atrial tachycardia, 2 014 cases of atrial premature beats, 28 cases of atrial flutter and 195 cases of atrial fibrillation were found. There were 131 cases of ventricular tachycardia, 1 530 cases of ventricular premature beat, 7 cases of preexcitation syndrome, 25 cases of left bundle branch block, 120 cases of right bundle branch block, 46 cases of borderline arrhythmia and 7 cases of sinus arrest. Ventricular tachycardia occurred in 1 980 cases (69.28), long RR interval (2 s-1 / 2 258), Ron T 304 (n = 1 133) and St segment elevation (39.64) in 1 133 cases (n = 1 141), suspected myocardial infarction in 32 cases (n = 1.12). The incidence of adverse events was as follows:. The lead was dropped in 43 cases, and it was 1.50. In the detection of cardiac electrophysiological surgical indications, 41 cases were in accordance with the indication of radiofrequency ablation, including 27 cases of frequent ventricular premature beats, 10 cases of atrial fibrillation, 4 cases of preexcitation syndrome, 16 cases of ventricular tachycardia of patients over the age of 0.56 years. The incidence of arrhythmias such as sinus arrest and suspected myocardial infarction increased significantly, and the number of patients with pacemaker implantation increased linearly with age. Conclusion the detection rate of arrhythmia in remote real-time ECG monitoring is high, which can be used as an important method for screening and diagnosis of cardiovascular diseases in community medicine.
【作者单位】：暨南大学附属第一医院心血管内科;
【基金】：国家自然科学基金资助项目(81673635)
【分类号】：R540.41

【相似文献】