Objective To explore the effect of a mobile-phone based two-way referral system on the timing of myocardial reperfusion and on a prognosis of patients with ST segment elevation myocardial infarction(STEMI). Methods Patients with STEMI were divided into an intervention group whose first admission clinics were equipped with a telemedicine system at the first medical contact(FMC) ,and a control group without a telemedicine system at FMC. The rate of heart failure and cardiac death during hospitalization ,every time point of transporting process ,the value of left ventricular ejection fractions(LVEF)measured at 24 h ,and length of hospital stay were collected and compared. Results In comparison of intervention versus control group ,the timing of myocardial reperfusion at every time point was shorter ( P ＜ 0.05 ) ,the value of LVEF within 24 h was significantly lower[(46.8 ± 3.9)%]vs[(50.3 ± 5.1)%](t＝ 2.32 ,P＜ 0.05) ,the cardiac mortality was lower(4% vs 7%) ,without statistical significance(χ2＝0.19 ,P＝0.66) ,and the length of hospital stay were lower[(6.35 ± 3.68)d]vs[(8.64 ± 5.19)d]without statistical significance (t＝ 2.75 ,P＝0.01). Conclusions A mobile-phone based telemedicine can significantly shorten the time delay of myocardial reperfusion in patients with STEMI ,improve heart function in acute stage ,and reduce the length of hospital stay.%目的 探讨移动远程医疗系统对急性ST段抬高型心肌梗死(STEMI)患者再灌注时间节点及临床预后的影响. 方法 依据STEMI患者首次医疗接触(FMC)时接诊单元是否配备移动远程医疗系统将患者分为试验组与对照组.观察两组患者转运过程中的各时间节点、在院期间心衰发生率和病死率、24 h左室射血分数(LEF)和总住院天数等. 结果 试验组各时间节点均短于对照组(P＜ 0.05) ;24 h LEF值对照组高于干预组(50.3 ± 5.1)% 和(46.8 ± 3.9)%(t＝2.32 ,P＜0.05) ,试验组心源性病死率低于对照组,但差异无统计学意义(4% 和7%,χ2＝ 0.19 , P＝0. 66) ;试验组总住院时间均低于对照组(6. 35 ± 3. 68 )d和(8. 64 ± 5. 19 )d ( t＝ 2. 75 ,P＝0.01) . 结论 移动远程医疗系统可缩短STEMI患者时间延迟、改善急性期心功能,降低患者病死率和住院天数.
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