肺部疾病患者空气压缩雾化吸入疗法局部发生不良反应的原因及对策研究

Local adverse effect of compressed-air aerosol inhalation for patients with pulmonary diseases and countermeasures

目的 了解肺部疾病患者空气压缩雾化吸入治疗局部发生不良反应的原因,并提出应对策略.方法 采用便利取样方法,选取天津市某三级甲等医院呼吸内科接受雾化吸入治疗的呼吸系统疾病患者150例.采用横断面问卷调查法,调查患者的一般资料、雾化知识掌握情况、雾化治疗期间患者主观感受到的不良反应及应对策略.结果 150例患者中,127例患者临床症状得以改善,总有效率为84.67%.其中有136例出现局部不良反应,占90.67%,主要表现为口鼻嗓干、口苦、咽部不适和咳嗽等,有4例出现声音嘶哑感,仅有1例因为严重上呼吸道干燥感,且长期得不到缓解而中断雾化治疗.不同性别、文化程度、月收入、雾化时间以及雾化知识掌握程度等患者局部不良反应发生率比较,差异有统计学意义（P〈0.05）.不同年龄和雾化药物患者局部不良反应发生率比较,差异无统计学意义（P〉0.05）.结论 导致雾化吸入治疗局部不良反应发生的原因主要是患者对雾化知识了解少以及缺乏专业性技术指导,护理人员应主动向患者提供雾化相关的技术指导,减少局部不良反应发生,提高患者的治疗依从性.

ObjectiveTo explore the reasons of local adverse effect of compressed-air aerosol inhalation for patients with pulmonary diseases,and to put forward corresponding countermeasures.Methods By convenience sampling,150 patients with respiratory diseases,treated by aerosol inhalation in Department of Respiratory Medicine in a Level Ⅲ-Class A hospital in Tianjin,were selected,and were surveyed by a cross sectional questionnaire about their general data,knowledge of aerosol inhalation,the adverse effect the patients percepted during aerosol inhalation and their countermeasures.Results Within the 150 patients,clinical symptoms of 127 had been improved,with a total effective rate of 84.67%. Local adverse effect happened to 136 patients,accounting for 90.67%,including dryness in mouth,nose or throat,bitter taste,pharyngeal discomfort, cough,etc. Hoarseness happened to four patients. Only one patient discontinued the aerosol inhalation because of long lasting serious dryness in the upper respiratory tract. Comparison of incidence rate of local adverse effect in patients′ gender,educational background,monthly income,time of aerosol inhalation and mastery of relevant knowledge showed statistical significance （P〈0.05）. Comparison of incidence rate of local adverse effect in patients′ age,drugs of aerosol inhalation showed no statistical significance （P〉0.05）.Conclusions Main reasons leading to local adverse effect during aerosol inhalation are the patients′ lack of relevant knowledge and professional guidance. So during aerosol inhalation,nursing staff should take the initiative to guide the patients technologically, so that incidence rate of local adverse effect can be lowered,and patients′ treatment compliance improved.