家长对哮喘儿童喘鸣监测的临床意义

Clinical Significance of Monitoring Childhood Bronchial Wheezing by Their Parents

目的教会患儿家长用双耳听诊哮喘儿童的胸部以判断患儿喘鸣是否存在及严重程度。方法教会52位哮喘儿童的家长用双耳听诊,然后与医生听诊结果比较。教会5岁以上儿童家长使用峰流速仪,测呼气峰流速率(PE-FR)。结果医生在312次听诊中,有喘鸣63.6%,家长用耳听诊有喘鸣54.8%。在医生易听到喘鸣中,家长听到94.4%,平均PEFR为(52.0±2.5)%;在医生较难听到喘鸣中,家长听到70.4%,平均PEFR(71±2)%;当未听到喘鸣时,平均PEFR(92.0±1.8)%。三者相互比较,P<0.01。结论教会家长用耳判断患儿喘鸣的存在及严重程度有助于家长决定是否需要就诊。

Objective To teach parents how to auscultate chest with hinaural stethcoscope and estimate bronchial wheezing existing or not and the serious level. Methods The Parents of 52 children were taught how to auscultate chest with binaural stethoscope, and the auscultatory results were compared with the results of doctors. The parents of children greater than or equal to five year-old were taught how to use pneumotachograph of peak expiratory flow and exam peak expiratory flow rate （PEFR）. Results There is 63.6% The bronchial wheezing heard in 312 auscultations by doctor,while 54.8% by parents. Bronchial wheezing easily to be heard by doctor can be heard by parents about 94.4 %, the mean PEFR was （ 52.0 ± 2.5） %. The bronchial wheezing diffieuh to be heard by doctor can be heard by parents about 70.4%, the mean PEFR was （71 ± 2） %. When bronchial wheezing can not be heard, the mean PEFR was （72.0 ±1.8） %. There were significant difference among the three conditions （P〈0. 001）. Conclusions To teach parents how to auscultate chest with binaural stethoscope and estimate bronchial wheezing existing or not and the serious level is helpful for parents to decide whether or not to see a doctor.