136例社区哮喘儿童系统管理体会

The Experience of Systematic Management of 136 Community Children with Asthma

目的:探讨全球哮喘防治创议(GINA)系统管理社区哮喘患儿的效果。方法:对136例哮喘患儿(管理组)社区系统管理前后结果及对照组患儿的结果进行比较。结果:在系统管理前后,管理组对哮喘问卷知识的认识差异有统计学意义(P<0.01);管理组吸药技术正确率由指导1次的11.03%,上升至74.26%(指导3次)、94.12%(指导4次);在系统管理6、12个月后,两组PEF>80%的比率比较差异有统计学意义(P<0.01);两组哮喘发作次数、急诊次数和住院次数比较差异均有统计学意义(P<0.05)。结论:有效的哮喘防治知识学习班是教育患者的必要形式,正确使用吸药装置是保障疗效的重要环节,用峰流速仪监测PEF是评估和监测严重程度的最佳形式,采用社区与家庭相结合的社区系统管理是长期控制儿童哮喘行之有效的方式。

Objective：To discuss the effect of systematic management of community asthma children with GINA. Method：The results of 136 children with asthma before and after community systematic management and the result with that of the children in control group were compared. Result：Before and after the systematic management,the difference of the understanding of the asthma questionnaire knowledge in the managed group was statistically significant（P〈0.01）. The inhalation method correct rate had been increased from 11.03%（1 times’guidance）to 74.26%（3 times’guidance）,94.12%（4 times’ guidance）in the managed group. After systematic management for 6 and 12 months,the rate of PEF〉80%of the two groups was compared,the difference was statistically significant（P〈0.01）. The asthmatic attack time,emergency time and time in hospital in the two groups were compared,the differences were statistically significant（P〈0.05）. Conclusion：Effective asthma prevention knowledge class is the essential form of teaching patients. Correct use of absorbing device is the important part of guaranteeing the effect. Monitoring the PEF with peak flow meter is the best form of evaluating and monitoring the severity. It is an effective method to control the asthma of children in long term with the community systematic management combining community and family.