摘要
目的以Calenderview日历访视系统为基础,建立中重度外周动脉疾病(PAD)患者腔内治疗后步行锻炼的信息化随访系统,了解其效果。方法设计3个月的步行锻炼方案,并在患者出院前教会患者完成1、2次步行锻炼,记录患者6 min步行试验情况;在Calenderview内建立步行锻炼随访模块,根据随访需求设置相应功能配合便携式手环,将中重度PAD患者纳入随访系统,做到对患者步行锻炼的远程提醒和监督;利用系统推送PAD疾病患者专用的行走受损问卷,了解患者的行走情况;在完成3个月干预后及在6个月随访时由系统推送随访信息完成现场踝肱指数(ABI)、血流通畅率和6 min步行试验的检测后,分析及统计以上数据,了解该系统作为随访手段在患者步行锻炼干预和随访中的应用情况。结果2017年12月至2019年6月共纳入研究对象42例,步行锻炼干预期3个月内的系统使用率为100%;6个月的系统使用率为95.1%;行走受损问卷在干预前、干预3个月时和6个月随访时均由信息化管理平台收集完成,平台利用率100%。现场随访情况:干预期3个月后42例患者中仅1例患者血流存在问题,结束随访,再次手术干预,其余经彩色多普勒超声诊断血流均通畅、患者6 min步行距离(t=8.36,P<0.01)和行走受损问卷得分(t=6.99,P<0.01)均显著优于干预前,差异有统计学意义;6个月随访时,41例患者中33例患者经彩色多普勒超声诊断血流通畅,另8例患者需再次手术干预结束随访、患者6 min步行距离(t=6.99,P<0.01)和行走受损问卷得分(t=5.39,P<0.01)均显著优于干预前,差异有统计学意义;干预3个月和6个月随访时相比,两者血流通畅率差异无统计学意义(χ~2=4.46,P=0.11)、6 min步行试验距离差异无统计学意义(t=1.30,P=1.21),而行走受损问卷得分3个月优于6个月时随访结果,差异有统计学意义(t=3.94,P=0.00)。结论步行锻炼有益于患者的3个月和6个月的血流通畅率
Objective Based on calender visiting system(Calenderview)to establish an informationbased follow-up system for guiding walking exercise in patients with moderate and severe peripheral artery disease(PAD)after receiving endovascular therapy so as to monitor the effect of walking exercise.Methods A 3-month walking exercise program was designed.The patients were asked to complete 1-2 times of designed walking exercise before discharge.The 6-minute walking experiment was recorded.The follow-up module of walking exercise was established in Calenderview,and according to the follow-up requirements the corresponding functions were set up.The portable bracelets were provided to integrate patients with moderate-severe PAD into the follow-up system,so as to realize remote reminder and supervision on patients’walking exercise.A walking impaired questionnaire for patients with PAD disease was pushed by the system to understand their walking conditions.After completing the 3-month intervention,the on-site tests of ankle-brachial index(ABI),blood flow patency rate and 6-minute walking experiment were accomplished at the 6-month follow-up by onsite follow-up information pushed by the system.The above data were statistically analyzed so as to clarify the application value of this system,as a follow-up method,in the patient’s walking exercise intervention and follow-up.Results From December 2017 to June 2019,a total of 42 subjects were enrolled in this study.The utilization rate of this system within 3 months period of walking exercise intervention was 100%,and the utilization rate of 6-month follow-up was 95.1%.The walking impairment questionnaires were collected by the system before intervention,3 months after intervention and the 6-month follow-up,and the platform utilization rate was 100%.On-site follow-up showed that only one patient in 42 patients had blood flow problem after 3-month intervention.After the follow-up ended,the color Doppler ultrasound revealed that the blood flow was unobstructed in rest of the patients.T
作者
张婷
张岚
叶猛
唐伟
ZHANG Ting;ZHANG Lan;YE Meng;TANG Wei(Department of Vascular Surgery,Affiliated Renji Hospital,Medical College of Shanghai Jiao Tong University,Shanghai 200127,China)
出处
《介入放射学杂志》
CSCD
北大核心
2020年第11期1154-1158,共5页
Journal of Interventional Radiology
基金
上海交通大学医学院护理科研基金(jyh1717)。
关键词
监督指导下的步行锻炼
步行锻炼
下肢动脉疾病
下肢动脉硬化闭塞
随访
walking exercise under supervision
walking exercise
arterial disease of lower extremity
arteriosclerosis obliterans of lower extremity
follow up
