远程常规心电图危急值临床应用及质控分析

赵桂华; 王云朋; 王晓娜; 王焕霞; 张娜; 王亚青; 陈琼

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远程常规心电图危急值临床应用及质控分析

临床研究 | 更新时间：2025-10-15

- 远程常规心电图危急值临床应用及质控分析
- Clinical application and quality control analysis of critical value of remote routine electrocardiogram consultation
- 临床心电学杂志 2022年第3期页码：181-185
- 作者机构：
  
  河南省人民医院
- 作者简介：
- 基金信息：
- DOI：
  中图分类号： R540.41
- 纸质出版：2022
- 稿件说明：
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赵桂华, 王云朋, 王晓娜, 等. 远程常规心电图危急值临床应用及质控分析[J]. 临床心电学杂志, 2022,(3):181-185.

Zhao guihua, Wang yunpeng, Wang xiaona, et al. Clinical application and quality control analysis of critical value of remote routine electrocardiogram consultation[J]. 2022, (3): 181-185.
赵桂华, 王云朋, 王晓娜, 等. 远程常规心电图危急值临床应用及质控分析[J]. 临床心电学杂志, 2022,(3):181-185. DOI：

Zhao guihua, Wang yunpeng, Wang xiaona, et al. Clinical application and quality control analysis of critical value of remote routine electrocardiogram consultation[J]. 2022, (3): 181-185. DOI：

摘要

目的分析远程常规心电图会诊危急值临床应用及心电图采集情况，以进一步更好服务于基层医院及患者。方法回顾性分析河南省人民医院自2019年5月1日至2021年4月30日通过云心电网络远程会诊的心电图共51282份，通过对近两年心电图会诊量、会诊心电图危急值种类、会诊心电图采集不合格情况进行对比分析，观察远程心电图会诊危急值临床应用及进一步规范心电图采集。结果 2019年5月1日至2020年4月30日（第1年）通过云心电网络远程会诊30012份心电图。2020年5月1日之2021年4月30日（第2年）共会诊心电图21270份。第1年会诊病例中共有危急值病例597例，占比全年会诊量1.99%。第2年会诊病例中共有危急值病例1687例，占比全年会诊量7.93%，第1年、第2年心电图会诊危急值占比差异具有统计学意义（p<0.05）。第1年及第2年危急值分布均以“疑似急性心肌梗死”占比最高。选取10小类数量相对较多危急值心电图进行分析，可见第2年心电图会诊过程中疑似心肌梗死、疑似急性心肌缺血、心室扑动、心室颤动、室性心动过速等发生率较第1年高，差异具有统计学意义（p<0.05）。第1年会诊病例共有1730例心电图采集不合格，占比全年会诊量5.76%。第2年会诊病例中共有1065例心电图采集不合格，占比全年会诊量5.01%，第1年、第2年心电图会诊心电图不合格率差异具有统计学意义（p<0.05）。具体情况为第2年导联反接、干扰大、基线漂移、导联未连接或脱落发生率较第1年低，伪差及设备故障发生率较第1年高，差异具有统计学意义（p<0.05）。结论远程常规心电图会诊危急值设置可以使基层医院及时发现患者危重状态，使危重症患者更快得到救治，利于患者后期诊治。同时对于心电图采集，我们应该进一步严格控制采集质量，以期更好为基层患者服务。

Abstract

Objective To analyze the clinical application and electrocardiogram（ECG） collection of critical values in remote routine electrocardiogram consultation

so as to better serve basic hospitals and patients. Methods From May 1

2019 to April 30

2021

a total of 51

282 ECG remotely consulted by ECG cloud network in Henan Provincial People’s Hospital were retrospectively analyzed. ECG consultation volume

types of critical ECG values and unqualified ECG collection in the two years were compared and analyzed. To observe the clinical application of critical value of remote ECG consultation and further standardize the next ECG collection. Results From May 1

2019to April 30

2020（The first year）

30012 ECG were remotely consulted through ECG cloud network. From May 1

2020 to April 30

2021（year 2）

a total of 21270 ECG were consulted. In the first year

597 cases of critical value were consulted

accounting for 1.99% of the annual consultation volume. In the second year of consultation

there were1687 cases with critical value

accounting for 7.93% of the annual consultation volume. The difference of critical value in ECG consultation in the first year and the second year was statistically significant（p<0.05）. In the distribution of critical value in the first year and the second year

"suspected acute myocardial infarction" accounted for the highest proportion. The ECG of 10 small categories with a relatively large number of critical values was selected for analysis. It was found that the incidence of suspected myocardial infarction

suspected acute myocardial ischemia

ventricular flutter

ventricular fibrillation and ventricular tachycardia during ECG consultation in the second year was higher than that in the first year

and the difference was statistically significant（p<0.05）. In the first year of consultation

1730cases of ECG collection were unqualified

accounting for 5.76% of the annual consultation. In the second years’ consultation cases there were a total of 1065 cases of ECG acquisition is unqualified

accounting for 5.01% than the annual amount of consultation

the first year and the second years’ electrocardiogram consultation

ECG fraction defective differences were statistically significant（p<0.05）. In the second years

the lead reverse connection

large interference

baseline drift

lead not connected or the loss rate was lower than the first year. The incidence of false error and equipment failure was higher than that in the first year

and the difference was statistically significant（p<0.05）.Conclusions Setting the critical value of remote routine ECG consultation can make the basic hospital find the critical state of patients in time

make the critical patients get treatment faster

and facilitate the later diagnosis and treatment of patients. At the same time

we should further strictly control the quality of ECG collection in order to better serve patients at the grass-roots level.

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