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| 5G远程机器人超声检查在网络远程会诊及边牧区义诊中的应用探索(附新疆克州地区356例总结) |
| 张其杰,阿衣努尔.买买提力,米力努尔.艾尼瓦尔,胡轩楠,巧丽潘.玉奴,古丽努尔.阿不力米提,伍利,陈萱,叶新华,杨杰,宋宁宏 |
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| (南京医科大学第一附属医院泌尿外科;新疆克州人民医院超声诊断科;新疆克州人民医院模式交互型互联网医院;深圳华大基因科技有限公司;新疆克州人民医院科研教学部转化医学中心;深圳华大智造云影医疗科技有限公司;南京医科大学第一附属医院超声诊断科) |
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| 摘要: |
| 目的:探讨在新疆克州地区网络远程会诊及边牧区义诊中开展5G远程机器人超声检查的应用流程及模式创新，并总结了已有356例应用体会。方法:回顾性分析2020-6至2022-4新疆克州人民医院依托本院模式交互型互联网医院开展的356例5G远程超声检查案例与156例同时期本院门诊床旁超声检查案例，对检查项目、信号传输参数、医患双方应用体验以及诊断效能等指标进行统计。结果:356例检查中，江苏南京至新疆克州超远程网络会诊114例，克州区域内远程网络会诊185例，克州区域内远程义诊57例，与156例床旁超声在检查项目组成上无显著差异。与南京至克州超远程会诊和远程义诊相比，克州区域内远程会诊的信号传输的带宽更高（p<0.001），延迟更短（p<0.001），丢包率更低（p<0.001）。医生对南京至克州超远程超声和远程义诊的操作满意度（p<0.05）、图像满意度（p<0.05）和交流满意度（p<0.05）均低于传统床旁超声，而克州区域内远程超声与床旁超声无明显差异（p>0.05）。患者对南京至克州超远程会诊的接受度与传统床旁超声无显著差异（p>0.05）。相较于传统超声，患者在远程机器人超声检查中更为紧张（p<0.05），但后者在探头压迫舒适度（p<0.05）和隐私保护满意度（p<0.001）上更为占优。南京至克州超远程会诊的疾病检出率和诊断效能与传统超声相比无显著差异。结论:已初步成功建立5G远程机器人超声检查的临床应用体系，虽目前仍有通讯技术和临床应用上的不足，但有利于促进我国东部沿海发达地区优质医疗资源向祖国边疆地区有效下沉，是响应国家卫健委医疗体制改革的一次可贵实践与模式创新。 |
| 关键词: 优质医疗资源下沉 5G远程通讯 机器人超声 网络远程会诊 边牧区义诊 |
| DOI： |
| 投稿时间：2022-06-09修订日期：2022-07-26 |
| 基金项目:国家自然科学基金(82071638) |
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| Application and exploration of 5G remote robotic ultrasound examination in network remote consultation and free consultation in border and pastoral areas (with a summary of 356 cases in Kezhou, Xinjiang) |
| Qijie Zhang,Ayinuer Maimaitili,Milinuer Ainiwaer,Xuannan Hu,Qiaolipan Yunusi,Gulinuer Abulimiti,Li Wu,Xuan Chen,Xinhua Ye,Jie Yang,Ninghong Song |
| (Department of Urology,The First Affiliated Hospital of Nanjing Medical University,Nanjing,China) |
| Abstract: |
| Objective: To discuss the application process and model innovation of 5G remote robotic ultrasound examination in network remote consultation and free consultation in border and pastoral areas in Kezhou, Xinjiang, and summarize the application experience of 356 cases. Methods: A total of 356 cases of 5G remote ultrasound examination carried out in our model interactive internet hospital and 156 cases of outpatient bedside ultrasound examination in our hospital from June 2020 to April 2022 were retrospectively analyzed. Statistics on examination items, signal transmission parameters, application experiences of both doctors and patients, and diagnostic efficiency were conducted. Results: Among 356 cases, there were 114 cases of ultra-remote network consultation from Nanjing, Jiangsu to Kezhou, Xinjiang, 185 cases of remote network consultation in the Kezhou area, and 57 cases of remote free consultation in the Kezhou area. No significant difference in the composition of examination items was observed in comparison with 156 cases of bedside ultrasound. Compared with ultra-remote consultation from Nanjing to Kezhou and remote free consultation, higher signal transmission bandwidth (<0.001), shorter delay (<0.001), and lower packet loss rate (<0.001) were noticed in remote consultation in Kezhou area. For doctors, the operation satisfaction (P<0.05), image satisfaction (P<0.05), and communication satisfaction (P<0.05) of ultra-remote ultrasound from Nanjing to Kezhou and remote free consultation were significantly lower than those of traditional bedside ultrasound, while no obvious difference existed between remote ultrasound in Kezhou area and bedside ultrasound (P>0.05). For patients, there was no significant difference in acceptance between ultra-remote consultation from Nanjing to Kezhou and traditional bedside ultrasound (P>0.05). Compared with traditional ultrasound, patients were more nervous during remote robotic ultrasound examination (P<0.05), but the latter had more advantages in probe compression comfort (P<0.05) and privacy protection satisfaction (P<0.001). No significant difference on disease detection rate and diagnostic efficiency was observed between ultra-remote consultation from Nanjing to Kezhou and traditional ultrasound. Conclusions: The clinical application system of 5G remote robotic ultrasound examination has been preliminarily established. Although there are still shortcomings in communication technology and clinical application, it is conducive to promoting the effective sinking of high-quality medical resources from developed areas in the eastern coastal areas to the border areas of the motherland, which is a valuable practice and model innovation in medical system reform of the National Health Commission. |
| Key words: sinking of high-quality medical resources 5G remote communication robotic ultrasound network remote consultation free consultation in border and pastoral areas |
