新冠疫情期间，先天性心脏病患儿术前通过微信使用远程医疗：回顾性分析。
Telemedicine usage via WeChat for children with congenital heart disease preoperatively during COVID-19 pandemic: a retrospective analysis.
机构信息
Department of Cardiac Surgery, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, No.18 of Danshan Road Fuzhou, Fujian 350001, China.
Fujian Key Laboratory of Women and Children's Critical Diseases Research, Fujian Maternity and Child Health Hospital, No.18 of Danshan Road Fuzhou, Fujian 350001, China.
出版信息
Int J Qual Health Care. 2021 Apr 22;33(2). doi: 10.1093/intqhc/mzab066.
OBJECTIVE
During the COVID-19 pandemic, parents of infants having medical problem face challenges of insufficient medical resources at home. The purpose of this study was to investigate the effect of WeChat-based telehealth services on the preoperative follow-up of infants with congenital heart disease (CHD) during the COVID-19 pandemic.
METHODS
This study retrospectively analyzed the medical records of 190 infants with CHD who underwent remote follow-up via WeChat from December 2019 to May 2020 in Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University. In addition, the psychological benefits of WeChat on the parents of these infants were analyzed.
RESULTS
In total, 190 infants were involved in this study, including 72 cases of ventricular septal defects, 42 cases of patent ductus arteriosus, 55 cases of atrial septal defects, 3 cases of tetralogy of Fallot, 2 cases of endocardial cushion defects, 12 cases of pulmonary stenosis, 2 cases of total anomalous pulmonary venous connection and 2 cases of aortic arch constriction. During the follow-up period, 48 infants who received surgical indications were hospitalized in time for surgical treatment. It was recommended that 10 infants with respiratory tract infections be treated in local hospitals through the WeChat platform. We provided feeding guidance to 28 infants with dysplasia through the WeChat platform. The psychological evaluation results of parents showed that the median score and range of Self-Rating Depression Scale scores were 42 and 32-58, respectively. Nine parents (4.7%) were clinically depressed, while the majority had mild depression. The median score and range of Self-Rating Anxiety Scale scores were 44 and 31-59, respectively. Twenty parents (10.5%) had clinical anxiety, while the rest had mild anxiety.
CONCLUSION
During the COVID-19 pandemic, follow-up management and health services for infants with CHD prior to surgery through the WeChat platform were useful in identifying the state of an infant's condition as well as in identifying and relieving care pressure, anxiety and depression in the parents.
目的
在 COVID-19 大流行期间，有医疗问题的婴儿的父母面临家庭医疗资源不足的挑战。本研究旨在探讨基于微信的远程医疗服务对 COVID-19 大流行期间先天性心脏病（CHD）婴儿术前随访的影响。
方法
本研究回顾性分析了 2019 年 12 月至 2020 年 5 月期间，福建医科大学附属福建妇幼保健院通过微信进行远程随访的 190 例 CHD 婴儿的病历。此外，还分析了微信对这些婴儿父母的心理益处。
结果
本研究共纳入 190 例婴儿，其中室间隔缺损 72 例，动脉导管未闭 42 例，房间隔缺损 55 例，法洛四联症 3 例，心内膜垫缺损 2 例，肺动脉瓣狭窄 12 例，完全性肺静脉异位连接 2 例，主动脉弓缩窄 2 例。随访期间，48 例有手术指征的婴儿及时住院接受手术治疗。建议通过微信平台在当地医院治疗 10 例呼吸道感染婴儿。通过微信平台为 28 例发育不良婴儿提供喂养指导。家长的心理评估结果显示，抑郁自评量表评分中位数和范围分别为 42 和 32-58，9 位家长（4.7%）存在临床抑郁，多数为轻度抑郁。焦虑自评量表评分中位数和范围分别为 44 和 31-59，20 位家长（10.5%）存在临床焦虑，其余为轻度焦虑。
结论
在 COVID-19 大流行期间，通过微信平台对 CHD 婴儿进行手术前的随访管理和健康服务，有助于识别婴儿的病情状态，以及识别和缓解父母的护理压力、焦虑和抑郁。
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