支气管哮喘患者糖皮质激素吸入技术的评价

A study of evaluating inhalation technique for glucocorticoids in patients with asthma

目的描述门诊成人支气管哮喘患者使用吸入性糖皮质激素的吸入技术现状,并分析其影响因素。方法采用横断面调查性研究,便利抽样方法,调查北京市某三级医院呼吸科门诊就诊且符合纳入和排除标准的196例哮喘患者。采用一般资料问卷测评患者的一般资料和疾病资料;让患者采用相应的吸入装置模型演示吸入方法,根据吸入技术的6个步骤评价患者的吸入技术。用二元logistic回归分析吸入技术的影响因素。结果 196例患者中,吸入方法不完全正确者为81例(41.3%),其中屏气错误者为44例(54.3%)、漱口错误者为41例(50.6%)、吸药错误者为40例(49.4%)、呼气错误者为30例(37.0%)。二元logistic回归分析结果显示性别[OR=2.481,95%CI(1.311,4.703),P<0.001]和是否定期门诊复诊[OR=2.114,95%CI(1.112,4.007),P=0.020]对吸入技术的影响有显著性差异。结论门诊成人支气管哮喘患者的吸入技术有待提高,性别和是否定期门诊复诊影响患者的吸入技术。

Objective To describe the status of inhalation technique for inhaled corticosteroids in adult outpatients with asthma and to analyze influencing factors. Methods A cross-sectional study was conducted to recruit 196 outpatients with asthma using convenient sampling method in one tertiary hospital in Beijing, General information questionnaire was used to collect data and patient＇s inhalation technique was also evaluated. Binary logistic regression analysis was used to explore influencing factors. Results Among 196 patients,inappropriate use of asthma inhaler devices was observed in 81 （41.3%） cases,including holding breath for 5-10s after removal of the inhaler （54.3%）, gargling with water （50.6%）, inhalation errors （49.4%） and exhalation errors （ 37.0% ）. Binary logistic regression analysis showed gender[OR=2.481,95%Cl（1.311,4.703）,P〈0.001] and regular outpatient return visit[OR= 2.114,95%CI （1.112,4.007）,P=0.020] were influencing factors of inhalation technique. Conclusion The status of inhalation technique in adult outpatients with asthma is suboptimal. Gender and regular outpatient return visit are predictors of correct inhalation technique.