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新冠疫情期间远程医疗对遗传性出血性毛细血管扩张症患者的有益影响

Beneficial Effects of Remote Medical Care for Patients with Hereditary Hemorrhagic Telangiectasia during the COVID-19 Pandemic.

作者信息

Gaetani Eleonora, Agostini Fabiana, Di Martino Luigi, Occhipinti Denis, Passali Giulio Cesare, Santantonio Mariaconsiglia, Marano Giuseppe, Mazza Marianna, Pola Roberto

机构信息

Multidisciplinary Gemelli Group for HHT, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy.

Department of Translational Medicine and Surgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy.

出版信息

J Clin Med. 2021 May 25;10(11):2311. doi: 10.3390/jcm10112311.

Abstract

BACKGROUND

Hereditary hemorrhagic telangiectasia (HHT) needs high-quality care and multidisciplinary management. During the COVID-19 pandemic, most non-urgent clinical activities for HHT outpatients were suspended. We conducted an analytical observational cohort study to evaluate whether medical and psychological support, provided through remote consultation during the COVID-19 pandemic, could reduce the complications of HHT.

METHODS

A structured regimen of remote consultations, conducted by either video-calls, telephone calls, or e-mails, was provided by a multidisciplinary group of physicians to a set of patients of our HHT center. The outcomes considered were: number of emergency room visits/hospitalizations, need of blood transfusions, need of iron supplementation, worsening of epistaxis, and psychological status.

RESULTS

The study included 45 patients who received remote assistance for a total of eight months. During this period, 9 patients required emergency room visits, 6 needed blood transfusions, and 24 needed iron supplementation. This was not different from what was registered among the same 45 patients in the same period of the previous year. Remote care also resulted in better management of epistaxis and improved quality of life, with the mean epistaxis severity score and the Euro-Quality of Life-Visual Analogue Scale that were significantly better at the end than at the beginning of the study.

DISCUSSION

Remote medical care might be a valid support for HHT subjects during periods of suspended outpatient surveillance, like the COVID-19 pandemic.

摘要

背景

遗传性出血性毛细血管扩张症(HHT)需要高质量的护理和多学科管理。在新冠疫情期间,HHT门诊患者的大多数非紧急临床活动都暂停了。我们进行了一项分析性观察队列研究,以评估在新冠疫情期间通过远程会诊提供的医疗和心理支持是否可以减少HHT的并发症。

方法

由多学科医生团队通过视频通话、电话或电子邮件为我们HHT中心的一组患者提供结构化的远程会诊方案。所考虑的结果包括:急诊就诊/住院次数、输血需求、铁补充剂需求、鼻出血恶化情况以及心理状态。

结果

该研究纳入了45名共接受了八个月远程援助的患者。在此期间,9名患者需要急诊就诊,6名需要输血,24名需要补充铁剂。这与上一年同期这45名患者的记录情况并无差异。远程护理还使鼻出血得到了更好的管理,并改善了生活质量,研究结束时的鼻出血严重程度平均分和欧洲生活质量视觉模拟量表得分均显著优于研究开始时。

讨论

在门诊监测暂停期间,如新冠疫情期间,远程医疗护理可能是对HHT患者的一种有效支持。

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本文引用的文献

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Impact of COVID-19 pandemic on mental health: An international study.新冠疫情对心理健康的影响:一项国际研究。
PLoS One. 2020 Dec 31;15(12):e0244809. doi: 10.1371/journal.pone.0244809. eCollection 2020.
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Telemedicine in ophthalmology in view of the emerging COVID-19 outbreak.眼科的远程医疗在 COVID-19 疫情下的应用。
Graefes Arch Clin Exp Ophthalmol. 2020 Nov;258(11):2341-2352. doi: 10.1007/s00417-020-04879-2. Epub 2020 Aug 19.
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Psychological and social impact of COVID-19.COVID-19 的心理和社会影响。
Psychol Trauma. 2020 Jul;12(5):468-469. doi: 10.1037/tra0000656. Epub 2020 Jun 15.

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