规范化管理教育对哮喘患儿肺功能的影响

The effects of standardized management and education on pulmonary function in children with asthma

目的探讨规范化管理教育对哮喘患儿肺功能的影响。方法在儿科哮喘门诊就诊或住院的哮喘患儿110例,随机分为管理组和非管理组各55例。对管理组患儿家长和学龄患儿进行哮喘及其药物基本知识教育,根据病情吸入不同剂量的布地奈德或丙酸倍氯米松(必可酮),定期随诊,适时升级或降级治疗;对照组仅进行发作期治疗。观察1年,对两组治疗前后临床疗效及肺功能进行比较。结果1年后管理组总有效率高于对照组(P<0.05);管理组患儿各项肺功能指标升高,与对照组比较差异有显著性(P<0.05),对照组观察前后各项指标比较差异无显著性(P均<0.05);管理组患儿1年内哮喘发作次数及治疗费用较观察前明显减少(P<0.05),对照组观察前后两项指标比较差异无显著性(P均>0.05)。结论对哮喘患儿进行规范化管理教育后患儿临床症状得到控制,肺功能显著改善,值得推广应用。

Objective To explore the effects of standardized management and education on pulmonary function in children with asthma. Methods One hundred and ten children with asthma including inpatient and outpatient department were included. They were divided into management and non-management groups randomly with 55 cases in each group. The detailed files of every case had been built up by specialists when the patients were first seen by the doctors. In the management group, the patients and their parents were taught with the knowledge about asthma and the medicine as well as how to inhale the Becotide or Pulmicore in different dosage according to the severity of the diseases. And they were followed-up regularly and adopt upgrade or downgrade the treatment timely based on the program of the Global Initiative for Asthma （GINA）. In non-management group, the patients went to hospital only＇when they had the episodes. The differences in clinical outcome and pulmonary function between these two groups were monitored after 1 year. Results The efficacy of the treatment was significantly higher in the management group （P〈0.05） . FEV1, anticipate PEF, Vso and V2s rose and the differences were statistically significant before and after 1 year. And these figures raised obviously in comparison with the non-management group with no significant differences in later group. Conclusions With standardized management and education adopted, the patient＇s conditions have been significantly improved, such as the clinical manifestations could be easily controlled, with the pulmonary function improved, the frequency of episodes and hospitalization reduced, and the medical expenditure decreased. The methods have practical value and worthy of recommendation.