上海交通大学学报(医学版) ›› 2022, Vol. 42 ›› Issue (3): 275-281.doi: 10.3969/j.issn.1674-8115.2022.03.003

• 心脑血管慢病协防共管专题 • 上一篇    下一篇

基于“互联网+”的可穿戴式心电设备在冠心病患者PCI术后慢病管理中的应用效果评价

梁存禹1(), 赵倩1, 宋宁1, 门莉1, 陈清杰1, 楚俊昆1, 卜军2, 李晓梅1, 杨毅宁1,3()   

  1. 1.新疆医科大学第一附属医院心脏中心,乌鲁木齐 830054
    2.上海交通大学医学院附属仁济医院心内科,上海 200127
    3.新疆维吾尔自治区人民医院心内科,乌鲁木齐 830001
  • 收稿日期:2022-02-10 出版日期:2022-03-28 发布日期:2022-05-09
  • 通讯作者: 杨毅宁 E-mail:597974547@qq.com;yangyn5126@163.com
  • 作者简介:梁存禹(1991—),男,硕士生;电子信箱:597974547@qq.com
  • 基金资助:
    国家重点研发计划(2018YFC1312804);新疆维吾尔自治区重点研发计划(2020B03002)

Evaluation of the management effect of "Internet+"-based wearable ECG devices in coronary heart disease patients undergoing PCI

Cunyu LIANG1(), Qian ZHAO1, Ning SONG1, Li MEN1, Qingjie CHEN1, Junkun CHU1, Jun PU2, Xiaomei LI1, Yining YANG1,3()   

  1. 1.Heart Centre, the First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, China
    2.Department of Cardiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
    3.Department of Cardiology, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830001, China
  • Received:2022-02-10 Online:2022-03-28 Published:2022-05-09
  • Contact: Yining YANG E-mail:597974547@qq.com;yangyn5126@163.com
  • Supported by:
    National Key R&D Program of China(2018YFC1312804);Key R&D Program of Xinjiang Uygur Autonomous Region(2020B03002)

摘要:

目的·探讨基于“互联网+”的可穿戴式心电设备在冠心病患者经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)后慢病管理中的应用效果。方法·将2021年4—9月在新疆医科大学第一附属医院心脏中心住院并接受PCI治疗的冠心病患者随机分为对照组和干预组,每组60例。对照组采用出院前健康宣教、常规随访的管理模式;干预组在此基础上应用可远程穿戴的心电设备在日常和运动时进行心电监测,并采用社交媒体平台管理、宣教的“互联网+”慢病管理模式。观察2组患者干预后静息心率(resting heart rate,RHR)及其达标率、冠心病知识评价调查表(Perceived Knowledge Scale for Coronary Heart Diseases,PKS-CHD)评分和冠心病自我管理行为量表(Coronary Artery Disease Self-Management Scale,CSMS)评分的变化,以及心电图中心律失常、ST段改变检出率。结果·干预前,2组患者的RHR、PKS-CHD评分比较,差异均无统计学意义。干预后,2组患者的RHR达标率、RHR、PKS-CHD总分及5个维度(危险因素、诱发因素、临床表现、药物知识及二级预防)得分、CSMS总分及5个维度(不良嗜好管理、一般生活管理、症状管理、疾病知识管理、依从性管理)得分比较,差异均有统计学意义(均P<0.05)。干预组心电图心律失常检出率(44.8%)、ST段改变检出率(22.4%)均高于对照组(分别为26.8%和8.9%),差异均有统计学意义(均P<0.05)。结论·基于“互联网+”的可穿戴式心电设备应用于冠心病PCI术后慢病管理,可以降低患者RHR并提高其达标率,可改善患者冠心病自我管理行为和知识水平,提高心律失常和ST段改变的检出率。

关键词: 互联网+, 可穿戴心电设备, 慢病管理, 冠心病

Abstract:

Objective·To explore the application effect of the wearable electrocardiogram (ECG) device based on “Internet+” on chronic disease management of patients with coronary heart disease (CHD) after percutaneous coronary intervention (PCI).

Methods·Patients with CHD hospitalized in the Heart Center of the First Affiliated Hospital of Xinjiang Medical University from April 2021 to September 2021 and treated with PCI were randomly divided into control group and intervention group, with 60 cases in each group. All patients in the control group were treated with the management mode of health education and routine follow-up before discharge, while those in the intervention group were treated with additional ECG monitoring daily and during exercise by using the remotely wearable ECG device in the “Internet+” chronic disease management mode managed and promoted on social media platform. The changes of the resting heart rate (RHR) and its compliance rate, the scores of Perceived Knowledge Scale for CHD (PKS-CHD) and the scores of Coronary Artery Disease Self-Management Scale (CSMS) in the two groups after intervention as well as the detection rates of arrhythmia and ST segment changes in electrocardiogram were observed.

Results·Before intervention, there was no significant difference in RHR and PKS-CHD scores between the two groups. After intervention, there were significant differences in RHR compliance rate, RHR, the total score of PKS-CHD, the scores of five dimensions (risk factors, inducing factors, clinical manifestations, drug knowledge and secondary prevention) of PKS-CHD, the total score of CSMS and the scores of five dimensions (bad habits management, general life management, symptom management, disease knowledge management, and compliance management) of CSMS between the two groups (all P<0.05). The detection rate of arrhythmia (44.8%) and ST segment changes (22.4%) in the intervention group were higher than those in the control group (26.8% and 8.9%, respectively), and the differences were statistically significant (both P<0.05).

Conclusion·The application of the wearable ECG device based on “Internet+” in chronic disease management of CHD patients after PCI can improve the compliance rate by decreasing RHR, the self-management behavior and knowledge level, as well as the detection rate of arrhythmia and ST segment changes.

Key words: Internet+, wearable electrocardiogram device, chronic disease management, coronary heart disease (CHD)

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