远程医疗指导脑梗死患者二级预防的效果及依从性研究
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摘要
目的探讨远程医疗指导脑梗死患者二级预防的效果及依从性。方法回顾性选取2016年8月至2018年8月中山大学附属第三医院粤东医院神经内科收治的脑梗死患者200例,将入组患者按二级预防方式分为两组:一组为微信平台远程指导组(n=100),另一组为传统方式随诊指导组(n=100),统计分析两组患者出院后3个月、6个月、12个月、2年的复发情况,以及NIHSS评分、改良Rankin评分、FMA评分、Barthel指数、依从性。结果微信平台远程指导组患者出院后3个月、6个月、12个月、2年的复发率为0、0、3. 0%(3/100)、6. 0%(6/100),均显著低于传统方式随诊指导组10. 0%(10/100)、13. 0%(13/100)、20. 0%(20/100)、26. 0%(26/100)(P <0. 05);微信平台远程指导组患者NIHSS评分、改良Rankin评分明显低于传统方式随诊指导组(P <0. 05),FMA评分、Barthel指数明显高于传统方式随诊指导组(P <0. 05),依从性[97. 0%(97/100)]显著高于传统方式随诊指导组[70. 0%(70/100)](P <0. 05)。结论远程医疗指导能够有效提升脑梗死患者二级预防的效果及依从性。
Objective To study the effect and compliance of two level prevention of cerebral infarction patients guided by telemedicine.Methods 200 cases of patients with cerebral infarction from August 2016 to August 2018 were retrospectly selected. These patients were divided into two groups according to the secondary prevention mode. One group was the Wechat platform remote guidance group( n = 100),the other group was the traditional follow-up guidance group( n = 100). The recurrence rates 3 months,6 months,12 months and 2 years after discharge,NIHSS scores,modified Rankin scores,FMA scores,Barthel indexes and compliances of the two groups were statistically analyzed. Results The recurrence rates 3,6,12 months and 2 years after discharge of the Wechat platform remote guidance group was 0,0,3. 0%( 3/100) and 6. 0%( 6/100) were significantly lower than the traditional follow-up guidance group 10. 0%( 10/100),13. 0%( 13/100),20. 0%( 20/100) and26. 0%( 26/100)( P < 0. 05). The NIHSS score and improved Rankin score of the Weixin platform remote guidance group were significantly lower than those of the traditional follow-up guidance group( P < 0. 05),while the FMA score and Barthel index of the Weixin platform remote guidance group were significantly higher than those of the traditional follow-up guidance group( P < 0. 05). The compliance 97. 0%( 97/100)was significantly lower than the traditional follow-up guidance group 70. 0%( 70/100)( P < 0. 05). Conclusion Telemedicine guidance can effectively enhance the effect and compliance of grade two prevention of patients with cerebral infarction.
Objective To study the effect and compliance of two level prevention of cerebral infarction patients guided by telemedicine.Methods 200 cases of patients with cerebral infarction from August 2016 to August 2018 were retrospectly selected. These patients were divided into two groups according to the secondary prevention mode. One group was the Wechat platform remote guidance group( n = 100),the other group was the traditional follow-up guidance group( n = 100). The recurrence rates 3 months,6 months,12 months and 2 years after discharge,NIHSS scores,modified Rankin scores,FMA scores,Barthel indexes and compliances of the two groups were statistically analyzed. Results The recurrence rates 3,6,12 months and 2 years after discharge of the Wechat platform remote guidance group was 0,0,3. 0%( 3/100) and 6. 0%( 6/100) were significantly lower than the traditional follow-up guidance group 10. 0%( 10/100),13. 0%( 13/100),20. 0%( 20/100) and26. 0%( 26/100)( P < 0. 05). The NIHSS score and improved Rankin score of the Weixin platform remote guidance group were significantly lower than those of the traditional follow-up guidance group( P < 0. 05),while the FMA score and Barthel index of the Weixin platform remote guidance group were significantly higher than those of the traditional follow-up guidance group( P < 0. 05). The compliance 97. 0%( 97/100)was significantly lower than the traditional follow-up guidance group 70. 0%( 70/100)( P < 0. 05). Conclusion Telemedicine guidance can effectively enhance the effect and compliance of grade two prevention of patients with cerebral infarction.
引文
[1]李迥,吴莉青,孟令海,等.远程家庭康复指导结合中药贯冬饮治疗43例恢复期脑梗死的疗效观察[J].重庆医学,2012,41(13):1321-1322.
[2]李迥,吴莉青,尚淑玲,等.远程家庭康复指导与脑梗死患者康复效果[J].中国康复医学杂志,2012,27(6):572-573.
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[4]李迥,吴莉青,尚淑玲,等.远程家庭康复指导对脑梗死患者日常生活活动能力和运动功能的影响[J].中国康复理论与实践,2011,17(9):887-888.
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[6]徐如祥.移动CT数字化成像与移动医疗在神经外科的应用[J/CD].中华神经创伤外科电子杂志,2017,3(5):257-259.
[7]黄立宏,冯小芳,黄流清,等.脑梗死二级预防中他汀类药物的应用情况及中断他汀类药物治疗对预后和复发的影响[J].中国老年学杂志,2017,37(3):631-633.
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[9]程越朋,孙书军,杨光,等.影响急性脑梗死患者二级预防用药依从性的调查研究[J].卒中与神经疾病,2017,24(1):30-33.
[10]唐学梅,李剑,杨重胜,等.实施远程卒中对偏远地区急性缺血性卒中患者静脉溶栓的使用和短期临床转归的影响[J].国际脑血管病杂志,2018,26(5):346-352.
[11]毛妮,张蕾,郭洪伟,等.脑梗死患者抗血小板药物二级预防后脑梗死复发类型及其危险因素研究[J].中国医药导刊,2017,19(1):51-52.
[12]袁丽,栾志红.调查脑梗死二级预防患者的服药信念并探究其影响因素[J].当代护士(下旬刊),2018,25(6):32-35.
[13]史朗峰,赵倩华,张苗怡,等.房颤合并脑梗死患者二级预防抗凝率的初步调查及影响因素分析[J].中国临床神经科学,2018,26(4):412-417.
[14]李欣,刘兰星,刘意琼,等.阿司匹林用于脑梗死二级预防中发生抵抗的原因分析及氯吡格雷干预效果研究[J].脑与神经疾病杂志,2017,25(8):490-493.
[15]苏达京,邓品瑞,秦文军,等.阿司匹林在不同年龄段脑梗死患者中二级预防的研究[J].内科急危重症杂志,2017,23(1):29-31.
[2]李迥,吴莉青,尚淑玲,等.远程家庭康复指导与脑梗死患者康复效果[J].中国康复医学杂志,2012,27(6):572-573.
[3]李迥,尚淑玲,孟令海,等.远程家庭康复指导对脑梗死恢复期患者日常生活活动能力的影响[J].中国全科医学,2011,14(23):2604-2605.
[4]李迥,吴莉青,尚淑玲,等.远程家庭康复指导对脑梗死患者日常生活活动能力和运动功能的影响[J].中国康复理论与实践,2011,17(9):887-888.
[5]李迥,尚淑玲,孟令海,等.远程家庭康复指导对脑梗死偏瘫恢复期患者运动功能的影响[J].中国康复,2011,26(5):358-359.
[6]徐如祥.移动CT数字化成像与移动医疗在神经外科的应用[J/CD].中华神经创伤外科电子杂志,2017,3(5):257-259.
[7]黄立宏,冯小芳,黄流清,等.脑梗死二级预防中他汀类药物的应用情况及中断他汀类药物治疗对预后和复发的影响[J].中国老年学杂志,2017,37(3):631-633.
[8]邵元.阿托伐他汀与瑞舒伐他汀在脑梗死患者二级预防中应用效果的对比研究[J].实用心脑肺血管病杂志,2017,25(4):73-76.
[9]程越朋,孙书军,杨光,等.影响急性脑梗死患者二级预防用药依从性的调查研究[J].卒中与神经疾病,2017,24(1):30-33.
[10]唐学梅,李剑,杨重胜,等.实施远程卒中对偏远地区急性缺血性卒中患者静脉溶栓的使用和短期临床转归的影响[J].国际脑血管病杂志,2018,26(5):346-352.
[11]毛妮,张蕾,郭洪伟,等.脑梗死患者抗血小板药物二级预防后脑梗死复发类型及其危险因素研究[J].中国医药导刊,2017,19(1):51-52.
[12]袁丽,栾志红.调查脑梗死二级预防患者的服药信念并探究其影响因素[J].当代护士(下旬刊),2018,25(6):32-35.
[13]史朗峰,赵倩华,张苗怡,等.房颤合并脑梗死患者二级预防抗凝率的初步调查及影响因素分析[J].中国临床神经科学,2018,26(4):412-417.
[14]李欣,刘兰星,刘意琼,等.阿司匹林用于脑梗死二级预防中发生抵抗的原因分析及氯吡格雷干预效果研究[J].脑与神经疾病杂志,2017,25(8):490-493.
[15]苏达京,邓品瑞,秦文军,等.阿司匹林在不同年龄段脑梗死患者中二级预防的研究[J].内科急危重症杂志,2017,23(1):29-31.