Telemedicine in Cardiovascular Disease

遠距醫療在心臟血管疾病的應用

蕭智忠(Chih-Chung Hsiao) ； 蔡瑞鵬(Jui-Peng, Tsai) ； 宋國慈(Kuo-Tzu Sung) ； 李秉穎(Ping-Ying Lee) ； 羅志賢(Chi-In Lo) ； 黃文弘(Wen-Hung Huang) ； 張雯姈(Wen-Lin Chang) ； 洪崇烈(Chung-Lieh Hung)

《內科學誌》 28卷3期 (2017/06) Pp. 133-139

https://doi.org/10.6314/JIMT.2017.28(3).03

摘要

Cardiovascular disease is a leading cause of death in the United States. Of all that, the coronary heart disease is the leading cause of deaths, followed by stroke, and high blood pressure. Heart failure is the common presentation of the cardiovascular disease and response for billions of medical cost. As the innovations of information technology and mobile wireless device, telemedicine has been utilized in various clinical disease to reduce medical cost and improve outcome, especially in cardiovascular disease. Physiologic parameters, such as blood pressure and sugar, heart rate, body weight, peripheral oxygen saturation, and electrocardiogram, are obtained at home and transmitted daily to care-providers. So that, early detection of the warning data before disease worsen, the physicians can adjust the medication and strategies. Several randomized trials and meta-analysis studies have demonstrated the clinical benefits of the telemedicine via invasive implanted device, either risk reduction of mortality or heart failure admission rate. However, there are still arguments and more studies are needed to identify the optimal care model in cardiovascular telemedicine.

關鍵字

Telemedicine ； Telemonitoring ； Remote monitoring

並列摘要

一直以來，心臟血管疾病在美國佔據死亡原因首位，其中冠狀動脈疾病包含心肌梗塞是最多數，其次是腦中風，緊接是高血壓性心臟病。然而，心臟衰竭在所有死亡人數中, 佔據超過三分之一的比例。大部分心臟血管疾病經常表現出心臟衰竭症狀，包括冠狀動脈疾病、心律不整、瓣膜性心臟病、心肌病變、及高血壓。這些病患經常因為心臟衰竭症狀而住院，每年花費大量醫療人力及資源。改善照顧品質，降低住院率及死亡率，進而減少醫療花費就成為一個重要的議題。隨著資訊科技及無線傳輸醫療儀器的廣泛應用，遠距醫療在眾多醫學次專科領域因應而起。尤其是在心臟血管疾病應用，包括急性心肌梗塞、腦中風、心律不整、心臟衰竭、高血壓及糖尿病。許多文獻已證實遠距醫療的好處，然而仍然有部分爭議需要更多大型臨床試驗數據來釐清疑惑及驗證效益。