吸入性气雾剂不同宣教途径在慢性阻塞性肺疾病患者管理中的应用

Roles of different teaching ways of inhalable aerosols application in the management of chronic obstructive pulmonary disease patients

目的分析吸入性气雾剂不同宣教途径在慢性阻塞性肺疾病(COPD)患者管理中的应用可行性及效果。方法前瞻性选取2022年1月至2023年1月期间入住首都医科大学附属北京友谊医院呼吸内科的120例COPD患者作为研究对象,按照随机数字表法将其分为床旁宣教组、宣传册宣教组和联合宣教组,每组各40例。床旁宣教组采用床旁宣教,宣传册宣教组采用宣传册宣教,联合宣教组联合组采用床旁宣教联合宣传册宣教,各组均连续宣教3 d。6个月后,对3组患者进行随访并复查肺功能,统计3组患者气雾剂吸入装置正确使用、宣教掌握情况和宣教内容掌握的达标率,并统计肺功能改善率。结果联合宣教组的气雾剂吸入正确率为97.50%,显著高于床旁宣教组(75.00%)和宣传册宣教组(62.50%),差异均有统计学意义(P<0.05)。联合宣教组的屏气时间恰当、吸气速度恰当、漱口、口咽部无不适的患者比率分别为95.00%、90.00%、90.00%、85.00%,均高于床旁宣教组(70.00%、80.00%、75.00%、72.50%)和宣传册宣教组(75.00%、55.00%、62.50%、65.00%),差异均有统计学意义(P<0.05)。床旁宣教组与联合宣教组达标率分别为85.00%、92.50%,均显著高于宣传册宣教组(62.50%),差异均有统计学意义(P<0.05)。联合宣教组的1 s用力呼气量(FEV1)改善率为(5.74±1.70)%,显著高于床旁宣教组[(4.15±1.40)%]和宣传册宣教组[(2.75±0.90)%],差异均有统计学意义(P<0.05)。结论采用多种途径相结合的方式对COPD患者使用吸入性气雾剂装置进行宣教,不仅可提高COPD患者气雾剂吸入的正确率,同时也可改善患者肺功能水平,为达到COPD患者的治疗目标提供保障,有临床推广实践的价值。

Objective To analyze the feasibility and effectiveness of different teaching pathways of inhalation aerosols in the management of patients with chronic obstructive pulmonary disease(COPD).Methods A total of 120 COPD patients admitted to the Department of Respiratory,Beijing Friendship Hospital,Capital Medical University between January 2022 and January 2023 were prospectively selected as the study subjects.They were divided into bedside education group,brochure education group,and joint education group using a random number table method,with 40 patients in each group.The bedside education group adopts bedside education,while the brochure education group adopts brochure education,joint education group used a bedside education joint brochure all group were give continusous education for 3 days.Six months later,the patients in the three groups were followed up and reviewed the pulmonary function,the correct use of aerosol inhalation devices,the mastery of education,and the compliance rate of education content among three groups were analyzed,and the rate of pulmonary function improvement was counted.Results The correct inhalation rate of aerosols in the joint education group was 97.50%,which was significantly higher than that in the bedside education group(75.00%)and the brochure education group(62.50%),and the differences were statistically significant(P<0.05).The proportions of patients with appropriate breath holding time,appropriate inhalation speed,mouthwash,and no discomfort in the oropharynx in the joint education group were 95.00%,90.00%,90.00%,and 85.00%,respectively,which were higher than those in the bedside education group(70.00%,80.00%,75.00%,72.50%)and the brochure education group(75.00%,55.00%,62.50%,and 65.00%),and the differences were statistically significant(P<0.05).The compliance rates of the bedside education group and the joint education group were 85.00%and 92.50%,respectively,which were significantly higher than those of the brochure education group(62.50%),and the differences were statistically significant(P<0.05).The improvement rate of forced expiratory volume in 1 second(FEV1)in the joint education group was(5.74±1.70)%,which was significantly higher than that in the bedside education group[(4.15±1.40)%]and the brochure group[(2.75±0.90)%],and the differences were statistically significant(P<0.05).Conclusion Adopting a combination of multiple approaches to educate COPD patients on the use of inhaled aerosol devices can not only improve the accuracy of aerosol inhalation in COPD patients,but also improve their lung function levels,providing guarantees for achieving the treatment goals of COPD patients,and has clinical promotion and practical value.