远程医疗对房颤患者脑卒中干预作用的meta分析  

Role of Telemedicine for Intervention in Stroke:Systematic Review and Meta-analysis

作　　者：方聪聪[1] 孙璇[1] 张文君[1] FANG Congcong;SUN Xuan;ZHANG Wenjun(Renmin Hospital of Wuhan University,Wuhan 430060,Hubei,China)

机构地区：[1]武汉大学人民医院,湖北省武汉市430060

出　　处：《中国卫生信息管理杂志》2022年第3期356-364,共9页Chinese Journal of Health Informatics and Management

摘　　要：目的系统评价远程医疗在房颤患者脑卒中预防、抗凝管理方面的作用。方法在Embase、Pubmed、CochraneLibrary、CINAHL、万方、维普及中国知网数据库中进行文献追溯检索,收集2021年10月10日前发表的关于远程医疗在房颤患者脑卒中预防及抗凝治疗管理中作用的随机对照试验(RCT)。由2名研究者独立进行文献检索、筛选、质量评价,对提取资料采用RevMan5.4软件进行meta分析。结果共纳入13个RCT,共计16421例患者,其中干预组8601例,对照组7820例。meta分析结果显示:远程医疗在脑卒中预防[RR=-0.65,95%CI(0.57,0.74),P<0.001]、药物依从性[RR=1.21,95%CI(1.02,1.45),P=0.03]及INR达标率[RR=1.28,95%CI(1.19,1.39),P<0.001]比传统诊疗模式更具优势。结论与传统医疗相比,远程医疗在房颤患者脑卒中预防、抗凝指导方面更有优势,在房颤患者管理方面具有巨大的应用前景。Objective To systematically evaluate the effects of telemedicine on intervention in stroke and anticoagulant therapy among patients with atrial arrhythmia.Methods We searched Embase,Pubmed,Cochrane Library,CINAHL,VIP,CNKI and Wanfang Data database to collect randomized controlled trials(RCTs)related to the adoption of telemedicine interventions on stroke prevention and anticoagulant therapy for atrial arrhythmia from inception to October 2021.Meta-analysis was performed by two reviewers using RevMan 5.4 after literature screening,data extraction and quality evaluation.Results 13 RCTs were identified,with 16421 patients,including 8601 patients in the intervention group and 7820 patients in the control group.The meta-analysis found that there was a statistical difference in the intervention of stroke[RR=-0.65,95%CI(0.57,0.74),P<0.001],drug compliance[RR=1.21,95%CI(1.02,1.45),P=0.03]and standard-achieving rate of the international normalized ratio(INR)[RR=1.28,95%CI(1.19,1.39),P<0.001]between the intervention group and the control group.Conclusion The effects of telemedicine on the intervention in stroke and anticoagulant therapy in atrial arrhythmia are better than that of routine treatment,the results show that the telemedicine has a very good prospect for application in management of atrial arrhythmia.

关 键 词：房颤 远程医疗 脑卒中 抗凝 META分析 

分 类 号：R-058[医药卫生] R49