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囊性纤维化患者的临床和微生物学监测:通过远程医疗进行三年随访的实证研究

Clinical and microbiological monitoring of Cystic Fibrosis patients, three years of follow-up via Tele-Medicine: an empirical research.

作者信息

De Biase R V, Cristiani L, Paglia C, Alghisi F, Giordani B, Lucidi V, Bella S

机构信息

Cystic Fibrosis Center, Children's Hospital and Research Institute Bambino Gesù, Rome.

Department of Pediatrics, Sapienza University of Rome.

出版信息

Clin Ter. 2020 Sep-Oct;171(5):e381-e384. doi: 10.7417/CT.2020.2244.

Abstract

OBJECTIVES

Evaluation of the effectiveness of home care through a telemonitoring system in reducing the incidence of new colonization by Pseudomonas Aeruginosa in a population of patients with Cystic Fibrosis (CF) followed by the CF clinic of the Bambino Gesù Hospital in Rome over a period of 36 months.

MATERIALS AND METHODS

Two groups of patients were recruited, homogeneous for age, sex, BMI, FEV1, prevalence of CF-related Diabetes and CF-related Hepatopathy, access to new therapies with modulators: a) an IN group (N = 44 ) followed through a home telemonitoring system, b) an OUT control group (N = 110) followed according to the standards of care. The following parameters were detected for all patients: pulmonary colonization of the lungs, number and type of hospital admissions, respiratory function, BMI.

RESULT

The OUT group had a statistically significant increase in the prevalence of Pseudomonas Aeruginosa infections during the observation period. Furthermore, a significant decrease in lung function assessed through FEV1 was also observed in the OUT group.

CONCLUSION

Adolescent and adult patients belonging to the CF center who are not followed through the dedicated home telemonitoring service show, in the three-year period 2017-19, an increase in Pseudomonas Aeruginosa infections and a greater decrease in respiratory function. The use of telemedicine in CF is therefore an effective system not only in monitoring the disease but also as a treatment strategy, in the context of an evolving multidisciplinary model. As advantages, telemedicine can reduce the number of Pseudomonas Aeruginosa lung infections and the greater stability of respiratory function over time.

摘要

目的

评估通过远程监测系统进行家庭护理在降低罗马巴贝里尼儿童医院囊性纤维化(CF)门诊随访的CF患者群体中铜绿假单胞菌新定植发生率方面的有效性,为期36个月。

材料与方法

招募两组患者,在年龄、性别、体重指数(BMI)、第1秒用力呼气容积(FEV1)、CF相关糖尿病和CF相关肝病患病率、使用调节剂新疗法方面具有同质性:a)干预组(N = 44)通过家庭远程监测系统进行随访,b)对照组(N = 110)按照护理标准进行随访。对所有患者检测以下参数:肺部定植情况、住院次数和类型、呼吸功能、BMI。

结果

在观察期内,对照组铜绿假单胞菌感染患病率有统计学意义的增加。此外,对照组通过FEV1评估的肺功能也有显著下降。

结论

在2017 - 19年的三年期间,未通过专门的家庭远程监测服务进行随访的CF中心青少年和成年患者,铜绿假单胞菌感染增加,呼吸功能下降幅度更大。因此,在不断发展的多学科模式背景下,CF中使用远程医疗不仅是监测疾病的有效系统,也是一种治疗策略。远程医疗的优势在于可以减少铜绿假单胞菌肺部感染的数量,并随着时间推移使呼吸功能更稳定。

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