%0杂志文章%@ 2291- 9694% I JMIR出版物%V 9%卡塔尔世界杯8强波胆分析 N 5% P e27175% T远程医疗用于肝移植后患者的随访管理:队列研究%A田敏，%A王敏，%A薛博，%A董赵，%A刘定辉，%A吴学敏，%A余荣谦，%A向梁，%A张俊熙，%A张晓刚，%A吕旭峰，%A Yi +西安交通大学第一附属医院肝胆外科，邮编:710061，西安雁塔西路277号，邮编:86 02985323900，luyi169@126.com %K肝移植%K最佳临床结果%K远程医疗%K远程医疗随访管理系统%K远程机器人%K快速恢复%K健康相关生活质量%K远程健康监测%K远程健康%K队列%K死亡率%K发病率%D 2021 %7 17.5.2021 %9原始论文%J JMIR Med Inform %G英文%X背景:进行肝移植的技术能力发展迅速;然而，可用肝脏的缺乏促使边缘供体移植的使用，包括循环性死亡、老年供体和肝脂肪变性后的供体移植，从而难以确定最佳的临床结果。目的:探讨远程医疗在肝移植术后随访管理中的应用效果。方法:为了确定远程医疗对肝移植术后随访的疗效，我们进行了一项临床观察队列研究，评估康复率、出院后30天内再入院率、死亡率和发病率。接受肝移植(公民死亡后器官捐赠的肝脏)的患者(n=110)被随机分配接受2周基于远程医疗的随访管理，除常规护理外，或仅接受常规护理随访。远程医疗组的患者免费使用机器人进行2周的随访。使用机器人，患者每天与移植专家互动约20分钟，专家评估呼吸频率、心电图、血压、氧饱和度和血糖水平;询问患者免疫抑制剂用药、饮食、睡眠、胃肠功能、运动、t管引流情况; and recommended rehabilitation exercises. Results: No differences were detected between patients in the telemedicine group (n=52) and those in the usual care group (n=50) regarding age (P=.17), the model for end-stage liver disease score (MELD, P=.14), operation time (P=.51), blood loss (P=.07), and transfusion volume (P=.13). The length and expenses of the initial hospitalization (P=.03 and P=.049) were lower in the telemedicine group than they were in the usual care follow-up group. The number of patients with MELD score ≥30 before liver transplantation was greater in the usual care follow-up group than that in the telemedicine group. Furthermore, the readmission rate within 30 days after discharge was markedly lower in the telemedicine group than in the usual care follow-up group (P=.02). The postoperative survival rates at 12 months in the telemedicine group and the usual care follow-up group were 94.2% and 90.0% (P=.65), respectively. Warning signs of complications were detected early and treated in time in the telemedicine group. Furthermore, no significant difference was detected in the long-term visit cumulative survival rate between the two groups (P=.50). Conclusions: Rapid recovery and markedly lower readmission rates within 30 days after discharge were evident for telemedicine follow-up management of patients post–liver transplantation, which might be due to high-efficiency in perioperative and follow-up management. Moreover, telemedicine follow-up management promotes the self-management and medication adherence, which improves patients’ health-related quality of life and facilitates achieving optimal clinical outcomes in post–liver transplantation. %M 33999008 %R 10.2196/27175 %U https://medinform.www.mybigtv.com/2021/5/e27175 %U https://doi.org/10.2196/27175 %U http://www.ncbi.nlm.nih.gov/pubmed/33999008