摘要
目的了解晕厥单元对提高疑似晕厥患者诊断效率和治疗预后的效果。方法回顾性分析2018年11月至2019年10月在新乡医学院附属南阳市第二人民医院就诊的235例疑似晕厥患者的临床资料,其中2018年11月至2019年4月(晕厥单元建设前)就诊者109例,2019年5—10月(晕厥单元建设后)就诊者128例。参考2018年欧洲心脏病学会晕厥诊断与管理指南和《晕厥诊断与治疗中国专家共识(2018)》,根据《中国晕厥中心建设专家建议》及结合本院的实际情况,进行晕厥单元建设。比较晕厥单元建设前、后患者的检查阳性率、治疗情况、治疗费用;就诊后1年门诊分别随访到67例和104例患者,比较门诊随访率、复发率、再住院率、就诊满意度、生存质量。结果晕厥单元建设后倾斜试验[61.90%(78/126)]、动态心电图监测[64.29%(81/126)]、运动试验[7.14%(9/126)]、有创电生理[40.48%(51/126)]、心脏影像学检查[9.52%(12/126)]、24 h血压监测[55.56%(70/126)]的阳性率,均明显高于晕厥单元建设前[44.95%(49/109),36.70%(40/109),5.50%(6/109),10.09%(11/109),2.75%(3/109),40.37%(44/109)],差异均有统计学意义(χ²=19.28、23.11、6.93、28.18、15.85、11.61,均P<0.01)。晕厥单元建设后患者病因诊断率为87.30%(110/126),明显高于晕厥单元建设前的77.06%(84/109),差异有统计学意义(χ²=21.70,均P<0.01);晕厥单元建设后患者从发病到心脏评估的时间[(3.68±1.93)h]、住院时间[(6.17±1.52)d]均明显短于晕厥单元建设前[(7.31±2.64)h,(10.83±2.09)d],住院率[3.17%(4/126)]、院内病死率[0.79%(1/126)]及治疗花费[(4.91±1.14)千元]均明显低于晕厥单元建设前[8.26%(9/109),2.75%(3/109),(7.05±2.53)千元],差异均有统计学意义(t=14.49,P<0.01;t=8.62,P=0.02;χ²=15.83,P<0.01;χ²=10.03,P<0.01;t=6.17,P=0.03)。晕厥单元建设后门诊随访率[82.54%(104/126)]、就诊满意度[91.35%(95/104)]明显高于晕厥单元建设前[61.47%(67/109),[64.18%(43/67)],复发�
Objective To evaluate the effectiveness of syncope unit in improving the diagnosis efficiency and treatment prognosis of patients with suspected syncope.Methods The standardized syncope unit was established in the Affiliated Nanyang Second General Hospital of Xinxiang Medical College in 2018.Patients with suspected syncope attending from November 2018 to April 2019(before the establishment of syncope unit)and from May to October 2019(after the establishment of syncope unit)were enrolled in the study.There were 109 cases attending before the establishment of syncope unit(control group)and 126 cases attending after establishment(syncope unit group).The positive rate of examination,the treatment and its cost before and after the establishment of syncope unit were compared.After one year,the follow-up rate,recurrence rate,rehospitalization rate,treatment satisfaction and quality of life of patients were documented and compared between two periods.Results The positive rates of tilt table test[61.90%),Holter monitoring[64.29%(81/126)],exercise stress test[7.14%(9/126)]invasive electrophysiology[40.48%(51/126)],cardiac imaging[9.52%(12/126)]and 24-h blood pressure monitoring[55.56%(70/126)]in syncope unit group were significantly higher than those in control group[44.95%(49/109),36.70%(40/109),5.50%(6/109),10.09%(11/109),2.75%(3/109)and 40.37%(44/109);χ²=19.28,23.11,6.93,28.18,15.85 and 11.61,respectively;all P<0.01].The diagnostic rate of etiology in syncope unit group was significantly higher than that in control group[87.30%(110/126)vs.77.06%(84/109),χ²=21.70,P<0.01].The time from onset to cardiac assessment and hospitalization time in syncope unit group were significantly shorter than those in control group[(3.68±1.93)h vs.(7.31±2.64)h;(6.17±1.52)d vs.(10.83±2.09)d].The hospitalization rate[3.17%(4/126)vs.8.26%(8/109)],hospital mortality[0.79%(1/126)vs.2.75%(3/109)]and treatment cost[(4.91±1.14)thousands Yuan vs.(7.05±2.53)thousands Yuan]in syncope unit group were significantly lower than those in control
作者
白雪蕾
王晓东
刘德蕊
景照地
樊延家
范梦丽
范鹏云
席自中
Bai Xuelei;Wang Xiaodong;Liu Derui;Jing Zhaodi;Fan Yanjia;Fan Mengli;Fan Pengyun;Xi Zizhong(Laboratory of Cardiac Physiology,the Affiliated Nanyang Second General Hospital,Xinxiang Medical College,Nanyang 473012,China;Department of Neurology,the Affiliated Nanyang Second General Hospital,Xinxiang Medical College,Nanyang 473012,China)
出处
《中华全科医师杂志》
2021年第6期662-667,共6页
Chinese Journal of General Practitioners
基金
河南省医学科技攻关计划(联合共建)项目(LHGJ20191464)
南阳市科技攻关计划(KJGG135)。
关键词
晕厥
疾病管理
诊断检查服务
预后
费用
医疗
Syncope
Disease management
Diagnostic services
Prognosis
Fees,medical
