儿童皮下注射行特异性免疫治疗脱落原因分析

Loss of Causes of Specific Immunotherapy by Subcutaneous Injection in Children

目的:探讨儿童皮下注射行特异性免疫治疗的脱落原因,进一步规范皮下注射行特异性免疫治疗的流程管理。方法:收集2006年12月至2018年3月我院特异性免疫治疗中心诊断为支气管哮喘、变应性鼻炎患儿的临床资料,对未完成特异性免疫治疗的患儿进行回顾性调查分析。结果:共917例患儿接受特异性免疫治疗,82例发生治疗脱落,其中男53例,女29例,年龄5.00~20.60(8.44±2.83)岁。82例患儿中诊断为支气管哮喘12例,变应性鼻炎17例,支气管哮喘合并变应性鼻炎41例,支气管哮喘合并变应性鼻炎及变应性皮炎10例,支气管哮喘合并变应性鼻炎及其他过敏性疾病2例。脱落患儿现居住地主要集中于城镇,家长学历主要为本科及以上。主要脱落原因为家长认为治疗效果好提前结束治疗、认为疗效不佳或无效放弃治疗、路途远交通不便、转诊至外院继续治疗。结论:儿童皮下注射行特异性免疫治疗的脱落主要与疗效、家长对特异性免疫治疗认识不足有关,治疗过程中医护人员应通过宣教提高家长对疾病和治疗的认知,建立严格的特异性免疫治疗信息平台管理、监督和随访,以提高特异性免疫治疗的依从性。

Objective: To probe into the loss of causes of specific immunotherapy by subcutaneous injection in children, so as to standardize the procedure management of specific immunotherapy by subcutaneous injection. Methods: Clinical data of children diagnosed with bronchial asthma and allergic rhinitis in the specific immunotherapy center of our hospital from Dec. 2006 to Mar. 2018 were collected, and children who did not complete the specific immunotherapy were retrospectively analyzed. Results: A total of 917 children received specific immunotherapy, and 82 cases developed treatment loss, including 53 males and 29 females, aged from 5.00 to 20.60(8.44±2.83) years. Among the 82 children, 12 were diagnosed with bronchial asthma, 17 with allergic rhinitis, 41 with bronchial asthma complicated with allergic rhinitis, 10 with bronchial asthma complicated with allergic rhinitis and allergic dermatitis, and 2 with bronchial asthma complicated with allergic rhinitis and other allergic diseases. The current residence of the children developed treatment loss was mainly concentrated in towns and cities, and the parents’ education level was mainly bachelor’s degree or above. The main causes for treatment loss were respectively early end of treatment due to good efficacy by the patients, withdrawal of treatment due to poor efficacy by the patients, long distances and inconvenient transportation, and referral to outside hospitals for further treatment. Conclusion: The loss of specific immunotherapy by subcutaneous injection in children is mainly related to the efficacy and insufficient awareness of specific immunotherapy. Medical staff should improve parents’ awareness of the disease and treatment through education during treatment, and establish the strict information platform for management, supervision and follow-up of specific immunotherapy in order to improve the compliance with specific immunotherapy.