儿童哮喘缓解期治疗依从性差的调查分析及对策

The investigation analysis and countermeasures of children asthma remission treatment adherence

目的通过分析儿童哮喘缓解期治疗依从性,探讨改善依从性差的对策,从而提高儿童哮喘的治愈水平。方法选择2006年12月～2009年12月期间因哮喘再次发作来院复诊的398例患儿,分析其哮喘规范化治疗依从性及糖皮质激素吸入治疗依从性,明确哮喘复发患儿治疗依从性差的主要原因。结果通过问卷调查发现,复诊患儿中共360例患儿哮喘规范化治疗依从性差,还发现糖皮质激素吸入依从性差患儿未按时来院随访,哮喘相关疾病知识欠缺是规范化治疗依从性差的主要原因。进一步分析糖皮质激素吸入治疗依从性差而复发哮喘的176例患儿,担心药物副作用而停药,没有掌握正确用法和用量认为哮喘痊愈而停药,患儿治疗不配合是导致糖皮质激素吸入治疗依从性差的主要因素。结论治疗依从性差是患儿复发哮喘的重要因素,针对患儿家长开展哮喘知识讲座,指导家长合理用药,定期来院随访是提高患儿哮喘治愈水平的重要手段。

Objective To improve curative rate of childhood asthma by strategy for making good compliance after an- alyzing the compliance of children being in the remission stage of asthma. Methods A total of 398 cases of childhood asthma happening and cured again in our hospital between Dec, 2006 and Dec, 2009 were analyzed, discussed the compliance of normative treatment and treatment with glucocorticoid, then found out the major cause influencing the compliance. Results Of the children suffering and cured again, we found out there were 360 cases having a bad compliance of normative treatment, and the major cause tbr that were not using glucocorticoid with the right way, not doing a good follow - up visit, lack of the knowledge of asthma. The major cause for 176 cases of bad compliance for treatment with glucocorticoid were worrying about side effect of the drug, way and amount of using drug were not mastered by parents, parents judging and stopping using the glucocorticoid, and children not cooperrating well. Conclusion Bad compliance for treatment is the major cause for childhood asthma happening again. Holding cathedra about childhood asthma for parents, guiding the right way of using drug, doing a regular follow - up visit are important for improving rate of childhood asthma.