数字化综合管理对射频消融术后心房颤动负荷及症状的影响  

Effect of digital integrated management on atrial fibrillation burden and symptoms after radiofrequency ablation

作　　者：汤志杰 杨刚[2] 孙国珍[1,2] 陈明龙[2] 游展鸿 王洁[2] 鲍志鹏 王琳[2] 王琴[2] TANG Zhijie;YANG Gang;SUN Guozhen;CHEN Minglong;YOU Zhanhong;WANG Jie;BAO Zhipeng;WANG Lin;WANG Qin(School of Nursing,Nanjing Medical University,Nanjing 211166,Jiangsu,China;Department of Cardiology,Jiangsu Province Hospital,Nanjing 210029,Jiangsu,China)

机构地区：[1]南京医科大学护理学院,江苏南京211166 [2]江苏省人民医院心血管内科,江苏南京210029

出　　处：《中国现代医生》2024年第7期38-41,共4页China Modern Doctor

基　　金：江苏省人民医院“临床能力提升工程”护理项目(JSPH-NC-2021-16)。

摘　　要：目的评估数字化管理对射频消融术后患者心房颤动(以下简称房颤)负荷、胃肠道症状和睡眠质量的影响。方法采用自身前后对照研究设计,选取2022年7月至11月于江苏省人民医院行房颤射频消融术的患者250例。纳入患者均接受数字化管理,应用48h单导联心电监护仪监测记录房颤负荷,采用胃肠道症状评定量表(gastrointestinal symptom rating scale,GSRS)评估胃肠道症状发生频率与严重程度,匹兹堡睡眠质量指数(Pittsburgh sleep quality index,PSQI)评估睡眠质量。结果250例房颤患者,男154例,女96例,平均年龄(60.23±11.69)岁,阵发性房颤171例,持续性房颤79例。干预1个月后失访21例,最终纳入229例患者进行自身前后对照分析。结果显示,干预1个月后,患者房颤负荷显著低于术后3d(P<0.05),未发生恶性心律失常;患者反酸、上腹部紧抽感、恶心呕吐、排气增多、稀便、排便紧迫感症状发生频率均显著下降,GSRS总分及腹痛、反流和腹泻评分均显著低于术后3d(P<0.05);PSQI评分显著低于术后3d(P<0.05)。结论数字化综合管理对降低房颤射频消融术后患者的房颤负荷、缓解整体胃肠道症状和睡眠障碍具有积极的促进作用。Objective To evaluate the effect of digital management on atrial fibrillation burden,gastrointestinal symptoms,and sleep quality after radiofrequency ablation.Methods A total of 250 patients who underwent radiofrequency ablation of atrial fibrillation in Jiangsu Province Hospital from July to November 2022 were enrolled in a self-controlled before and after study design.All the included patients were digitally managed,and the atrial fibrillation burden was monitored and recorded by 48h single-lead electrocardiogram monitor.Gastrointestinal symptom rating scale(GSRS)was used to evaluate the frequency and severity of gastrointestinal symptoms,and the Pittsburgh sleep quality index(PSQI)was used to assess sleep quality.Results There were 250 patients with atrial fibrillation,including 154 males and 96 females,with an average age of(60.23±11.69)years,171 patients with paroxysmal atrial fibrillation and 79 patients with persistent atrial fibrillation.After one month of intervention,21 patients were lost to follow-up,and 229 patients were finally included for their own before and after control analysis.The results showed that after one month of intervention,the atrial fibrillation burden was significantly lower than 3 days after operation(P<0.05),and no malignant arrhythmia occurred.The frequency of acid reflux,upper abdominal tightening,nausea and vomiting,increased exhaust,loose stools,and urgency of defecation were all significantly decreased.The total score of GSRS and abdominal pain,reflux and diarrhea scores were significantly lower than 3 days after operation(P<0.05).PSQI score was significantly lower than 3 days after operation(P<0.05).Conclusion Digital integrated management has a positive promoting effect on reducing the atrial fibrillation burden,alleviating the overall gastrointestinal symptoms and sleep disorders of patients after radiofrequency ablation.

关 键 词：心房颤动 数字医疗 房颤负荷 胃肠道症状 睡眠质量 

分 类 号：R541.75[医药卫生—心血管疾病]