药师联合门诊对儿童急性鼻窦炎循证干预的成效分析

Effect analysis of evidence-based intervention in children with acute rhinosinusitis in joint outpatient department

目的:探索联合门诊基于循证的综合干预对儿童急性鼻窦炎的治疗成效。方法:选取2020年1月至2021年12月于武警江西总队医院就诊的160例急性鼻窦炎患儿,按随机数字法分为干预组和对照组,干预组严格按照循证医学原则,在对症支持,抗菌药物使用指征、品种、剂量、疗程,家庭护理等方面进行综合治疗和用药教育,对照组进行常规治疗。对比治疗前后的视觉模拟量表(visual analogue scale,VAS)评分及生活质量评分,随访3个月鼻内镜检查客观量化评分及1年内再发急性鼻窦炎次数。结果:治疗1周后,干预组流涕、张口呼吸、打鼾、经济压力与精神负担评分优于对照组(P<0.05);治疗1个月后,干预组鼻塞、咳嗽、鼻痒、口臭、休息睡眠、学习、日常生活、情绪心态评分优于对照组(P<0.05)。干预组治疗后3个月鼻内镜评分呈现持续改善(P<0.01),治疗成本效果比明显优于对照组(P<0.01),1年内再发急性鼻窦炎次数显著少于对照组(P<0.05)。结论:联合门诊的循证干预,能够明显提升儿童急性鼻窦炎的治疗效果,降低治疗费用及再发风险。

OBJECTIVE To explore the efficacy of evidence-based intervention in the treatment of children acute rhinosinusitis in joint outpatient department.METHODS 160 children were selected with acute rhinosinusitis from January 2020 to December 2021,and were randomly divided into intervention group and control group.The intervention group received comprehensive treatment and medication education in symptomatic support,indication,variety,dosage and course of use of antibacterial drugs and family nursing which strictly followed the principle of evidence-based medicine.The control group received routine treatment.The visual analog scale(VAS)scores and quality of life scores were compared between the two groups before and after treatment,the scores of nasal endoscopy were followed up for three months and the frequency of recurrent were followed up within one year.RESULTS After one week of treatment,the scores of snot,mouth opening breathing,snoring,the economic pressure and treatment burden in the intervention group were better than those in the control group(P<0.05).After one month of treatment,the scores of nasal congestion,cough,nasal itching,halitosis,rest and sleep,study,daily life,mood and mentality in the intervention group were better than those in the control group(P<0.05).Nasal endoscopy scores in the intervention group showed continuous improvement in three months after treatment(P<0.01),the cost-effectiveness ratio in the intervention group were better than the control group(P<0.01),and the recurrence frequency were significantly less than those in the control groupwithin one year(P<0.05).CONCLUSION Through the evidence-based intervention of the joint outpatient,the treatment effect of children's acute rhinosinusitis can be significantly improved,the treatment cost and the risk of recurrence can be decreased.