心脏远程监护系统自动预警功能的临床应用评价
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摘要
目的探讨心脏远程监护系统(CRMS)自动预警功能的临床应用效果。方法选取2016年8月～2018年8月江西省人民医院收治的2000例心律失常患者作为研究对象,均佩带心脏远程监护仪iHolter,应用CM1、CM5双通道记录,采用自动报警、无声模式,按照医嘱实时监控24 h。佩戴iHolter之前均行常规作12导联心电图检测,患者摘除iHolter后,均将预警器进行USB监测数据回放,出具诊断报告。根据监测存储数据研究分析应该预警次数和实际发生的预警次数,并比较CRMS与常规12导联心电图的心律失常阳性诊断率。结果 CRMS实际发生预警的有效率为94.76%(2260/2385),与应预警的93.43%(2091/2238)比较,差异无统计学意义(P>0.05)。2000例心率失常患者采用CRMS检测的阳性率为69.05%(1381/2000),显著高于常规12导联心电图检测的33.75%(675/2000),差异有统计学意义(P<0.05)。在不同类型的心率失常患者中,CRMS诊断心率失常的阳性率均也显著高于常规12导联心电图,差异有统计学意义(P<0.05)。结论 CRMS自动预警功能在疾病诊断、预防等方面具有较高的临床应用价值。
Objective To explore the clinical application effect of automatic warning function in the cardiac remote monitoring system(CRMS). Methods A total of 2000 patients with arrhythmia who were hospitalized in Jiangxi Provincial People′s Hospital from August 2016 to August 2018 were included in this study. All the patients wore the iHolter,and were monitored 24 hours in real time following the doctors′ advice. During the performance, CM1 and CM5 dual channels were used to record the data and automatic alarm, silent mode were performed. Before wearing the iHolter, all patients were examined by conventional 12 leads electrocardiogram. After removing the iHolter, the monitoring data were played back and the diagnostic report was issued. According to the monitoring and storage data, the number of hypothesis warnings and actual warnings was analyzed. The positive rate of arrhythmia between CRMS and conventional12 leads electrocardiogram was compared. Results The effective rate of actual warning in CRMS was 94.76%(2260/2385), which was not statistically significantly different from 93.43%(2091/2238) of hypothesis warning in CRMS(P>0.05). The positive rate of CRMS in 2000 patients with arrhythmia was 69.05%(1381/2000), which was significantly higher than that of conventional 12 leads electrocardiogram accounting for 33.75%(675/2000), and the difference was statistically significant(P<0.05). Among the different types of arrhythmia patients, the positive rate in CRMS diagnosis of arrhythmia was also significantly higher than that in the conventional 12 leads electrocardiogram, and the difference was statistically significant(P<0.05). Conclusion The automatic warning function of CRMS is of a high value in disease diagnosis and prevention.
Objective To explore the clinical application effect of automatic warning function in the cardiac remote monitoring system(CRMS). Methods A total of 2000 patients with arrhythmia who were hospitalized in Jiangxi Provincial People′s Hospital from August 2016 to August 2018 were included in this study. All the patients wore the iHolter,and were monitored 24 hours in real time following the doctors′ advice. During the performance, CM1 and CM5 dual channels were used to record the data and automatic alarm, silent mode were performed. Before wearing the iHolter, all patients were examined by conventional 12 leads electrocardiogram. After removing the iHolter, the monitoring data were played back and the diagnostic report was issued. According to the monitoring and storage data, the number of hypothesis warnings and actual warnings was analyzed. The positive rate of arrhythmia between CRMS and conventional12 leads electrocardiogram was compared. Results The effective rate of actual warning in CRMS was 94.76%(2260/2385), which was not statistically significantly different from 93.43%(2091/2238) of hypothesis warning in CRMS(P>0.05). The positive rate of CRMS in 2000 patients with arrhythmia was 69.05%(1381/2000), which was significantly higher than that of conventional 12 leads electrocardiogram accounting for 33.75%(675/2000), and the difference was statistically significant(P<0.05). Among the different types of arrhythmia patients, the positive rate in CRMS diagnosis of arrhythmia was also significantly higher than that in the conventional 12 leads electrocardiogram, and the difference was statistically significant(P<0.05). Conclusion The automatic warning function of CRMS is of a high value in disease diagnosis and prevention.
引文
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[14]姬金虎,夏文文,张陶,等.互联网+穿戴式心电监护设备的研发[J].中国数字医学,2017,12(2):78-79,95.
[15]殷欣,聂文博,从悦,等.远程护理在“互联网+”时代居家养老中的应用进展[J].中华现代护理杂志,2017,23(6):873-877.
[2]陈守强,郝鑫,高海青,等.心脏远程监护系统的临床应用及评价[J].中华全科医学,2011,9(2):185-186.
[3]彭南昕,陈庆伟,柯大智,等.老年冠心病心脏康复的风险评估与干预策略[J].中华老年病研究电子杂志,2018,5(3):13-18.
[4]贾海忠,和星亮,蒙蒙.冠心病的预警信号与预防[J].中老年保健,2016,275(9):12-14.
[5]潘荣全,张焕基,林茴,等.心脏远程实时监护系统临床应用效果分析[J].心血管康复医学杂志,2017,26(6):656-660.
[6]钟宁,陆军,廉启国,等.远程心电图诊断系统的社区应用及评价[J].中国全科医学,2011,14(19):2145-2146,2149.
[7]吴清,蒙海秀,余芝娟.阵发性房颤诊断治疗中应用十二导联常规心电图的价值[J].中外医学研究,2017,15(3):55-57.
[8]郑光卓.常规12导联心电图与24 h动态心电图诊断起搏器植入患者心律失常检出率的对比观察[J].临床和实验医学杂志,2016,15(9):905-907.
[9]马慧琴.12导联动态心电图诊断冠心病心律失常的价值分析[J].内科,2017,12(3):395-396,422.
[10]高硕.常规心电图与动态心电图在冠心病心律失常诊断中的应用比较[J].中西医结合心血管病电子杂志,2018,6(27):39-42.
[11]朱丹琼.动态心电图与常规心电图诊断冠心病的对比[J].中国继续医学教育,2018,10(25):101-102.
[12]王磊.低功耗便携式心电仪设计与研制[D].哈尔滨:哈尔滨工程大学,2007.
[13]杨宁,任付先,司定然,等.心脏远程监护系统对心律失常的诊断价值和临床意义[J].中国现代医生,2015,53(15):93-95,98.
[14]姬金虎,夏文文,张陶,等.互联网+穿戴式心电监护设备的研发[J].中国数字医学,2017,12(2):78-79,95.
[15]殷欣,聂文博,从悦,等.远程护理在“互联网+”时代居家养老中的应用进展[J].中华现代护理杂志,2017,23(6):873-877.