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目的探讨农村远程心电监测技术和服务模式的应用及临床意义。方法沂源县中医院在宽带网上申请设立IP心电远程会诊中心,中心下设终端分站,分站将所采集到的心电图信息通过宽带网传至中心,中心医生即刻作出诊断并回复。选择自2009年8月～2010年7月,我中心监测的异常心电图9353例为1组,心律失常3758例为Ⅱ组,异常ST-T改变3218例为Ⅲ组,急性心肌梗死65例为Ⅳ组。然后分组分别进行异常心电图四季监测人数、异常心电图每周周一至周日监测人数、心律失常四季监测人数、异常ST-T改变四季监测人数、心肌梗死四季监测人数的统计。结果共监测12导联同步24h动态心电图961例、常规心电图13630例,男9216例,女5375例,年龄1～92岁,共14591例,其中正常心电图5196例,异常心电图9395例,阳性率64.4%,心律失常3758例,阳性率25.7%,异常ST-T改变3218例,阳性率22%,心肌梗死65例,阳性率0.44%。结果表明,异常心电图和心脏事件易发时间为晨起、周一和冬季,心电远程监测心肌梗死的死亡率低于门诊监测。结论心电远程会诊的实施,从根本上解决了我县农村及社区卫生服务机构心电图设备差、心电学人才短缺、技术匮乏的状况。实现了心电图诊断标准规范化。有助于降低急性心肌梗死的死亡率。
Objective To explore the application and clinical significance of rural remote ECG monitoring technology and service mode. Methods Yiyuan County Hospital of Chinese medicine in the broadband network to apply for the establishment of IP tele-remote consultation center, the terminal set up under the terminal, sub-station will be collected by the ECG information to the center through the broadband network, the center doctor immediately make a diagnosis and reply. Choose from August 2009 ~ July 2010, our center abnormal ECG 9353 cases were 1 group, 3758 cases of arrhythmia Group Ⅱ, 3218 cases of abnormal ST-T changes in group Ⅲ, 65 cases of acute myocardial infarction Ⅳ group. Then the group were abnormal ECG four seasons monitoring the number of abnormal electrocardiogram weekly monday to Sunday monitoring the number of arrhythmia four seasons monitoring the number of abnormal ST-T changes in the four seasons monitoring the number of myocardial infarction monitoring statistics. Results A total of 961 cases of 12-lead electrocardiogram (ECG) were observed synchronously in 24 hours. There were 13630 routine electrocardiogram, 9216 males and 5375 females aged from 1 to 92 years with a total of 14 591 cases, including 5196 normal ECGs and 9395 abnormal electrocardiograms, with a positive rate of 64.4 %, Arrhythmia 3758 cases, the positive rate of 25.7%, 3218 cases of abnormal ST-T changes, the positive rate of 22%, 65 cases of myocardial infarction, the positive rate of 0.44%. The results showed that the abnormal electrocardiogram and cardiac events prone time for the morning, Monday and winter, the risk of myocardial infarction monitoring of ECG remote monitoring is lower than the clinic. Conclusions The implementation of remote consultation of ECG has fundamentally solved the situation of poor ECG equipment, shortage of electrocardiography talents and lack of technology in the rural community and community health service institutions in our county. To achieve the standardization of ECG diagnostic criteria. Helps reduce mortality from acute myocardial infarction.