支气管哮喘合并鼻窦炎患者鼻窦术前哮喘管理方式探索

Exploration of preoperative asthma management in patients with asthma and sinusitis

目的探索峰流速仪联合微信APP进行支气管哮喘(简称哮喘)患者远程慢病管理方式。方法选取2020年2月至2021年2月拟行鼻部手术的哮喘合并鼻窦炎患者为研究对象,按照随机数字表法分为研究组(46例)和对照组(47例);研究组应用峰流速监测及微信APP进行慢病管理;对照组门诊就诊时仅进行常规哮喘宣教及用药指导。收集并分析两组患者术前临床资料、哮喘控制评分(ACT)、急性发作频率、实验室检查、呼出气一氧化氮检测(FeNO)、肺功能及围术期不良事件发生率。结果研究组术前1年急性发作、急诊就诊及住院诊治次数均明显低于对照组,且用药规范性及依从性优于对照组患者,差异有统计学意义(P<0.05)。研究组肺功能、ACT评分显著高于对照组,而FeNO值低于对照组;围术期哮喘急性发作、延期手术、暂停手术的发生率明显低于对照组,差异均有统计学意义(P值均<0.05)。与入组前对比,研究组患者入组后肺功能、FeNO值及ACT评分均显著改善,日峰流速变异率明显降低,用药依从性及规范性明显改善,差异均具有统计学意义。结论利用微信联合呼气峰流速仪对哮喘伴鼻窦炎患者进行管理,可以提高哮喘患者依从性及控制率,便于鼻窦疾病手术的实施。

Objective To explore the usefulness of peak flow meter combined with WeChat APP for chronic disease management of asthma patients.Methods We selected asthma patients with sinusitis for nasal surgery from February 2020 to February 2021 as the research objects,and they were randomly divided into a study group and a control group.The research group used peak flow monitoring and WeChat APP for chronic disease management;and the control group only received routine asthma education and medication guidance during outpatient clinic visits.We collect and compare the preoperative clinical data,asthma control score(ACT),acute attack frequency,laboratory tests,exhaled nitric oxide detection(FeNO)and lung function of the two groups of patients,and compare the incidence of perioperative adverse events.Results The preoperative results showed that the number of acute attacks,emergency visits and hospitalizations in the study group in the previous year were significantly lower than those in the control group,and the medication standardization and compliance were better than those in the control group.The lung function and ACT score of the study group were significantly higher than those of the control group,while the FeNO value was lower than that of the control group.In the study group,the incidence of acute asthma attack,delayed surgery,and suspension of surgery during the perioperative period was significantly lower than that of the control group,and the differences were statistically significant.Compared with before enrollment,the lung function,FeNO value and ACT score of the study group were significantly improved after enrollment,the daily peak flow rate variation rate was significantly reduced,medication compliance and standardization were significantly improved,and the differences were statistically significant.Conclusions The use of WeChat combined with a respiratory peak flow meter can improve the compliance and control rate of asthma and sinusitis patients,and facilitate the implementation of sinus surgery.