| Objective: To investigate the application of REM in the diagnosis and treatment of cardiovascular diseases in remote areas,and to evaluate the accuracy,practicability,and accessibility of the technique.Methods:The REM network system was established in Zhangjiajie area,including one central station and eight base stations for health service at township levels.Four hundred patients who had been examined for REM at outpatient clinics of Zhangjiajie REM network system from January 2016 to December 2018 were drawn by grouped random sampling according to the inclusion criteria.Among them,200 patients at the central station were used as the control group,and the other 200 patients at township base stations(25 at each base station)were used as the experimental group.Statistical analysis was performed on various dimensions,such as detection rate of abnormal electrocardiogram,medical travel distance,waiting time for medical treatment,medical expenses,and medical service satisfaction.Results:1.400 cases,including 200 cases in the central station group as the control group,87 cases of males and 113 cases of females,with an average age of 59.20±12.93;Among them,48 patients were from the communities of the central station near,and 152 patients were from other township.There were 25 cases of each base station and 200 cases of each base station in other township health service base stations as the experimental group,81 cases of males and 119 cases of females,with an average age of 59.25±13.97;All 200 patients are from the base station corresponding jurisdiction.There was no significant difference in gender or age between the two groups(P>0.05).2.Among the 400 patients examined for REM,a total of 271(67.75%)were detected with abnormal ECG,including 38 cases(6.94%)of sinus arrhythmia,166(28.81%)of atrial arrhythmia,170(29.51%)of ventricular arrhythmia,43(7.46%)of heart conduction block,30(5.2%)of atrioventricular junction arrhythmia,and 127(22.04%)of ST-T change.3.Partial abnormal ECG recorded by REM detection.4.The detection rate of abnormal ECG at base stations was 67.5%(135/200),including 22 cases of sinus arrhythmia,79 of atrial arrhythmia,80 of ventricular arrhythmia,25 of heart conduction block,14 of atrioventricular junction arrhythmia,and 59 of ST-T change.The detection rate of abnormal ECG at central station was 68%(136/200),including 18 cases of sinus arrhythmia,87 of atrial arrhythmia,90 of ventricular arrhythmia,18 of heart conduction block,16 of atrioventricular junction arrhythmia,and 68 of ST-T change.There was no significant difference in the detection rate of ECG abnormalities between the two groups(P>0.05).5.By the 400 patients,remote real-time alert was performed 58 times,and ECG information was sent 92 times due to discomfort.In addition,eight patients had electrode pads falling off,and they were immediately notified and guided to properly install the electrode pads back.As a result,the integrity and diagnosis of the patients’ ECG information were not affected.6.The medical expenses in the base station group was significantly lower than those in the central station group,and the difference was statistically significant(P<0.05).Both medical travel distance and waiting time for treatment in the central station group were significantly greater than those in the base station group,and the difference was statistically significant(P<0.05).7.There was no significant difference in the medical service satisfaction between the two groups(P>0.05).Conclusion:1.REM could provide convenient and accurate ECG monitoring services for patients with CVD in remote areas,which would beconducive to the diagnosis and treatment of CVD.2.The establishment of REM network system in remote areas gave CVD patients access to high-quality medical resources in tertiary hospitals nearby and enabled them to save waiting time and financial costs for treatment. |
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