CAJ | 학술논문

目的：分析心脏永久性起搏器植入患者门诊随访依从性的现状、影响因素及探讨提高随访依从性的方法。方法：回顾性分析2006-01至2013-01在我院住院植入心脏永久性起搏器的患者817例，对术后1年内的门诊随访情况进行依从性评判，并分析其影响因素。实际随访790例（96.70%），1年内未进行门诊随访者入电话随访组（n=350例），至少进行过1次门诊随访者入门诊随访组（n=440例）。结果：研究对象中，失访26例，失访率3.18%；非起搏器相关死亡1例，实际随访790例，实际随访率96.7%，其中门诊随访者440例（55.70％），电话随访者350例（44.30％）。两组在文化程度、医疗费用、居住地、对心律失常的了解、固定陪护人员方面的差异有统计学意义（P<0.05）。高中以上文化程度、医疗费用可报销、本地居住、对心律失常知识了解、有固定陪护人员的患者门诊随访率高。1年内总体并发症发生率1.8%，均未造成严重后果。随访时进行优化参数设置者占59.5%。结论：心脏永久性起搏器植入患者门诊随访率较低。影响因素较多，包括文化程度、医保制度、居住地、对心律失常的认知程度、有无陪护人员。
목적：분석심장영구성기박기식입환자문진수방의종성적현상、영향인소급탐토제고수방의종성적방법。방법：회고성분석2006-01지2013-01재아원주원식입심장영구성기박기적환자817례，대술후1년내적문진수방정황진행의종성평판，병분석기영향인소。실제수방790례（96.70%），1년내미진행문진수방자입전화수방조（n=350례），지소진행과1차문진수방자입문진수방조（n=440례）。결과：연구대상중，실방26례，실방솔3.18%；비기박기상관사망1례，실제수방790례，실제수방솔96.7%，기중문진수방자440례（55.70％），전화수방자350례（44.30％）。량조재문화정도、의료비용、거주지、대심률실상적료해、고정배호인원방면적차이유통계학의의（P<0.05）。고중이상문화정도、의료비용가보소、본지거주、대심률실상지식료해、유고정배호인원적환자문진수방솔고。1년내총체병발증발생솔1.8%，균미조성엄중후과。수방시진행우화삼수설치자점59.5%。결론：심장영구성기박기식입환자문진수방솔교저。영향인소교다，포괄문화정도、의보제도、거주지、대심률실상적인지정도、유무배호인원。
Objective: To analyze the current condition and inlfuencing factors for clinical compliance in patients with permanent pacemaker implantation and to improve the follow-up condition in relevant patients. Methods: A total of 817 patients with permanent pacemaker implantation in our hospital from 2006-01 to 2013-01 were retrospectively studied. The clinical compliance condition and inlfuencing factors were accessed for 1 year period. Results: There were 26/817 (3.18%) patients lost contact and 1 patient died. A total of 790 (96.7%) patients finished the followed-up study by 2 groups: Clinical visit group,n=440 (55.70%) and Telephone visit group,n=350 (44.30%). The education level, medical cost, residency, comprehension of arrhythmia and accompany personnel were different between 2 groups,P<0.05. The patients were with high school education or above, reimbursed medical cost, local residency, comprehension of arrhythmia and accompany personnel had the higher clinical visit rate. The overall 1 year occurrence rate of complication was 1.8% without severe event. There were 59.5% of patients optimized the pacemaker parameters during clinical visit. Conclusion: The patients with permanent pacemaker implantation had the lower rate of clinical follow-up visit which should be improved in several issues.