护理干预对哮喘患儿定量气雾剂吸入的依从性及对血IgE的影响

Effect of compliance by means of metered dose inhaler and the change of serum immunoglobulin E by nursing intervention in children with asthma

目的探讨护理干预对哮喘患儿使用定量气雾剂(MDI)治疗依从性及治疗前后血清学IgE水平的影响。方法 260例哮喘患儿,随机分为两组,ICS组135例,采取专项护理措施,对照组125例,采用常规的用药指导方法,评价护理干预的依从性及检测治疗前及治疗后3个月血清IgE水平。结果 ICS组依从性较对照组好(P<0.01)。对照组及ICS组治疗3个月较治疗前IgE水平均下降(P<0.05)。ICS组治疗后3个月IgE水平较对照组明显降低(P<0.05)。结论积极的护理干预,能提高哮喘患儿使用MDI的依从性,提高疗效。ICS糖皮质激素可使哮喘儿童血清IgE水平降低。

Objective To investigate the effect of compliance by means of metered dose inhaler and the change of serum immunoglobulin E by nursing intervention in children with asthma. Methods From Dec 2007 to Mar 2009, two hundred and sixty asthmatic children in our hospital were randomly divided into the inhaled corticosteroids （ICS） treated group （n = 135） and control group （n = 125 ）. Within the ICS group, special nursing intervention was implied in the children, while conventional medical guideline was mainly used in control group. During the treatment, the patients of the control and the ICS groups were followed up for 3 months to compare the compliance and the total IgE levels before and after treatment. Results The compliance of ICS（82.9% ） was much better than that of control group（54. 4% ） （χ^2 =24. 858 ,P 〈0.01 ）. Before and after 3 months treatment, the serum total IgE of control group were （360. 43 ± 35.58 ） ng/L and （ 391.27 ± 37.48 ） ng/L （P〈0.05） respectively. As to the ICS group before and after 3 months treatment, the serum total IgE were （560.43±43.58 ） ng/L and （430.43 ±25.53 ） ng/L （ P 〈 0. 05 ） respectively. After the treatment of three months, the serum total IgE of ICS group was significantly decreased than that of control group. Conclusion Positive nursing intervention can enhance the compliance and efficiency of asthmatic children. Inhaled corticosteroids can decrease the serum total IgE in children with asthma.