儿童哮喘阶梯式治疗及管理和系统教育的临床研究

目的探讨儿童哮喘阶梯式治疗及管理与哮喘知识系统教育的临床意义。方法将196例哮喘患儿随机分为观察组和对照组各98例,两组患儿均建立病历档案。观察组采用阶梯式方案治疗,在管理上不论哮喘有无发作,每2~4周随访1次,及时评价病情变化和治疗效果,调整用药剂量和纠正错误的吸入方法,同时对患儿及家长进行哮喘基本知识、自我病情判断及治疗方面知识的系统教育。对照组无治疗方案,仅进行发作期治疗;治疗1年后随访1次,中间未进行定期随访,未进行哮喘知识的系统教育。结果两组疗效间差异有显著性意义(P<0·001),患儿哮喘发作次数、急诊次数、住院次数、缺课天数和呼气峰流速(PEF)值均与对照组间差异有显著性意义(P<0·001)。结论儿童哮喘采用阶梯式治疗,进行管理和哮喘知识的系统教育,是落实防治哮喘措施、提高防治水平的重要环节。对于长期有效地控制患儿病情,提高患儿的肺功能和生活质量,减轻家庭和社会的经济负担具有重要意义。

A Clinical Study of Gradient Treatment-Management and Educational Programs for Asthmatic Children

Objective To explore the clinical significance of gradient treatment-management and education for asthmatic children.Methods Totally 196 cases with asthma were randomly divided as observation group(98 cases) and control group(98 cases),the medical records of the patients in two groups were set up.Patients in the observation group were intervened by the following measurements:receiving the gradient treatment,learning the knowledge of asthma and self-judgment and asthma treatment,how to use metered-dose inhaler(MDI),followed-up from once every 2 weeks to 1 month,adjusting the dosage of remedy according to the change of conditions.The patients in control group only received routine treatment on stage of attack,and one time follow-up after a year treatment.Results The clinical control rate,evident efficiency rate and total efficiency rate in observation group were higher than those in control group(P<0.001),and the frequencies of acute attack,emergency department visiting,hospital admission and the days of off-school were all less than those in control group(P<0.001).The PEF value in observation group was significantly higher than that in control group(P<0.001).Conclusion Application of the gradient treatment-management and systematic education could improve pulmonary function and quality of life for asthmatic children,and spare the medical expenditure.