基于“互联网+”的可穿戴式心电图应用分析  

The value of wearable electrocardiogram diagnostic platform based on "the Internet Plus"

作　　者：陈韬[1] 刘阁 韩宝石[1] 颜勇[1] 李丹丹[1] 汪晶晶[1] 郭军[1] 石亚君[1] 杨庭树[1] 陈韵岱[1] Chen Tao;Liu Ge;Han Baoshi(Department of Cardiology,Chinese PLA General Hospital,Beijing 100853,China)

机构地区：[1]解放军总医院第一医学中心心血管内科

出　　处：《中华保健医学杂志》2020年第1期16-18,共3页Chinese Journal of Health Care and Medicine

基　　金：国家重点研究计划(2018YFCZ001200);北京市科技新星项目(Z18100006218120);青年人才托举工程(17-JCJQ-QT-029)

摘　　要：目的探讨基于"互联网+"可穿戴式远程网络心电图诊断平台在院外场景的应用价值。方法选取2017年4月~2019年3月在院外采集并实时传输到解放军总医院心电图网络会诊中心的67 730例远程网络心电图。分析心电图的质量以及对心律失常与心肌缺血的诊断价值。结果无法正常判读心电图约794份(1.17%);检出标注为"危急"的心电图共311份(0.46%),标注为"急"的心电图共4 586份(6.77%)。发现心律失常25 797例(38.09%),其中恶性心律失常,如心室停搏> 2.5 s145例(0.21%)、三度房室传导阻滞14例(0.02%)、室性心动过速21例(0.03%)。共检出ST段改变患者7 991例(11.80%);确诊急性心肌缺血106例(0.16%);检出心肌梗死共86例(0.13%),其中陈旧性心梗53例(0.08%),急性ST段抬高型心肌梗死33例(0.05%)。33例急性心肌梗死患者中,30例被及时转诊行急诊PCI,转诊率达91%;三度房室传导阻滞、心室停搏患者均转诊至对应医院,转诊率100%;其中30例患者植入永久起搏器。结论远程网络可穿戴式心电图设备操作简便,适用于家庭及社区。心电图可诊断率高,出具报告时间短,危急患者可通过网络平台转诊,第一时间获得心电图诊断并得到及时救治。Objective To investigate the application value of wearable electrocardiogram(ECG)diagnostic platform based on "the Internet Plus" in out-patients.Methods A total of 67730 cases of remote network ECG were collected and transmitted to the ECG network consultation center of PLA general hospital in real time from April 2017 to March 2019.The quality of ECG and its diagnostic value for arrhythmia and ischemia were analyzed.Results 794 ECG(1.1%)could not be read properly because of the electromyography interference.A total of 311 cases(4‰)and 4586 cases(6.7%)were identified as "critical situation" and "emergency situation".There were 25707 arrhythmias(37.9%)ECGs,among which malignant arrhythmias,such as ventricular arrest( > 2.5 seconds)in 145 cases(0.21%),third-degree atrioventricular block in 14 cases(0.02%),and ventricular tachycardia in 21 cases(0.03%).A total of 7,991 patients(11.7%)with ST segment changes were detected.Acute ischemia was confirmed in 106 cases(0.15%),and 86 cases(0.13%)of myocardial infarction were detected,including 53 cases(0.08%)of old myocardial infarction and 33 cases(0.05%)of acute myocardial infarction(AMI).Among the 30 AMI patients,27 patients underwent emergency PCI,and the referral rate reached 90%.All patients with third-degree atrioventricular block and ventricular arrest were referred to the corresponding hospital and 30 patients had permanent pacemakers implanted.Conclusion The remote and wearable electrocardiogram is simple to operate and can be operated in the family and community.The diagnosis rate of the electrocardiogram is high and the reporting time is short.In addition,all critical patients can be referred to the network for diagnosis in the first time to avoid the disease exacerbation.

关 键 词：可穿戴式心电图 心律失常 心肌缺血 

分 类 号：R540.41[医药卫生—心血管疾病]