我院慢性阻塞性肺疾病患者氧气驱动雾化吸入调查及药学监护

Study on the Application of Oxygen-driven Aerosol Inhalation in Chronic Obstructive Pulmonary Disease Patients and Pharmaceutical Care in Our Hospital

目的：为规范慢性阻塞性肺疾病患者氧气驱动雾化吸入提供参考,并探讨药学监护要点。方法：调查我院呼吸内科慢性阻塞性肺疾病患者使用氧气驱动雾化吸入的基本情况、操作细节及舒适度,并对数据进行统计和分析。结果：共调查101例患者,其中接受药师教育34例（A组）,接受护师教育35例（B组）,自行用药32例（C组）。A、B、C组Sp O2分别为（96.07±0.93）%、（95.54±0.97）%、（94.92±0.97）%,提示经药师教育的患者Sp O2较其他两组患者显著改善（P〈0.05）。经药师或护师教育的患者在吸气时紧闭口唇、吸气时按住出气口操作及全身感觉上优于患者自行用药;经药师教育的患者在吸气后屏气3~5 s、呼气时移开喷气口、呼气时缓慢呼气及用药后漱口的操作上,优于经护师教育或自行用药患者,且比护师教育更少出现呼吸困难的现象。结论：大部分经药学教育的患者能较好地掌握雾化吸入操作细节,呼吸道症状明显改善,舒适度更佳,药师的药学监护可以成为慢性阻塞性肺疾病患者综合治疗的一个重要措施。

OBJECTIVE： To provide reference for standardizing the application of oxygen-driven aerosol inhalation in chronic obstructive pulmonary disease （COPD） patients and investigate the points of pharmaceutical care. METHODS： The application of oxygen-driven aerosol inhalation in COPD patients in respiratory department of our hospital was investigated in respects of basic sit- uation, operation details and degree of comfort. The data were analyzed statistically. RESULTS： Among 101 enrolled patients, 34 cases accepted pharmacist education （group A） ; 35 cases were educated by nurses （group B） ; 32 patients used aerosol inhalation by themselves （group C）. The SpO2 of 3 groups were （96.07 ± 0.93）%, （95.54 ± 0.97）% and （94.92 ± 0.97）%, respectively. The patients who were educated by pharmacists achieved significant improvement in SpO2, compared with other two groups （P〈0.05）. The operation in closing lips, holding the air outlet when inhaling and general feeling of the patients who were educated by pharma- cists or nurses were better than those of patients who operated by themselves. The patients who accepted pharmacist education were better than the patients who were educated by nurses or used themselves in the operation of holding breath for 3-5 s after inhaling, removing the nozzles when exhaling, exhaling slowly and rinsing the mouth after treatment, and had less difficulty in breathing than that educated by nurses. CONCLUSIONS ： The majority of patients can master the operation details of aerosol inhalation after pharmacist education, and have improved respiratory disorder and feel more comfortable. The pharmaceutical care is crucial for the treatment of COPD patients.