人性化护理在小儿支气管哮喘临床护理中的应用

目的 探讨人性化护理在小儿支气管哮喘临床护理中的应用.方法 选自2013年1月～2014年1月我院收治的小儿支气管哮喘患儿180例,将其随机分成两组,每组90例患儿,分别命名为研究组和对照组,对照组患儿给予基础护理,对研究组患儿在基础护理的同时,给予患儿人性化护理,对比两组患儿的临床护理效果.结果 研究组患儿住院时间短于对照组患儿,研究组患儿家长对护理工作的满意率高于对照组.且研究组患儿风险事件发生率及护理纠纷发生率低于对照组患儿.结论 人性化护理在小儿支气管哮喘临床护理中应用效果显著,该种护理方法值得在临床上推广.     

儿童情绪与哮喘病情的关系及对IL-8的影响

支气管哮喘是儿童期较常见的一种变态反应性疾病 ,我国小儿哮喘的患病率为 0 .5 %～ 2 % ,个别地区高达 5 %。儿童哮喘的诱发因素除过敏、感染等之外 ,有相当部分与社会心理因素有关。对不易控制的哮喘发作者 ,情绪或行为的紊乱本身与疾病病情关系甚为密切。本研究采用《儿童状态 -特质焦虑问卷》(ＳＴＡ ＩＣ)和《儿童抑郁障碍自评量表》(ＳＤＤＳＣ)对 4 0例轻、中度哮喘患儿的情绪状态进行评定 ,同时采用有效的非创伤性方法检测了其中 33例患儿痰液白细胞介素 - 8(ＩＬ - 8)水平 ,观察不同严重度哮喘患儿的情绪状态及其与痰中ＩＬ - 8水…     

外周血淋巴细胞β受体变化与哮喘遗传的相关研究

本文采用放射配基受体结合分析方法,对支气管哮喘急性发作期患儿及其父亲外用血淋巴细胞肾上腺素能β受体（简称β-AR）及血浆cAMP水平进行观察。结果显示哮喘发作期患儿外周血淋巴细胞β-AR为4148．3±372．5site/cellcAMP为17．0±1．5pm／ml,患儿父亲β-AR为2176±678．2site／call,cAMP为14．4±2．0PM／ml,．患儿母亲β-AR为1721．1±96．3site／site,cAMP为13．3±1．4pm／ml,哮喘息性发作期患儿及其父母的外周血淋巴细胞β-AR密度均明显升高P＜0．01,表明哮喘患儿及其父母的β-AR功能低下或受到阻滞。而且患儿与其父母亲之间存在一定的遗传倾向。父母亲β-AR功能低下,其小儿可能易患支气管哮喘,小儿气道上的β-AR由于遗传因素影响而处于反应低下,可能是小儿支气管哮喘高发的基础。     

哮喘患者的情绪障碍调查

支气管哮喘 (简称哮喘 )是临床上一组常见疾病 ,早在二十世纪二十年代就把哮喘作为心身疾病进行研究。心身医学的研究认为不仅生化因素在哮喘的发病中起到重要作用 ,包括情绪因素在内的心理社会因素在疾病的发生、发展及预后中也起到一定作用。情绪变化可诱发或加重哮喘。哮喘患者情绪障碍的发生率较高 ,以焦虑和抑郁多见。本研究旨在调查哮喘患者的焦虑、抑郁等情绪障碍的发病情况 ,并对有关因素进行分析 ,以期为该疾病的全面认识和治疗提供资料。1　研究对象与方法1.1　对象1998年 2月至 1999年 12月本院门诊及住院的哮喘患者 10 0例。诊…     

健康宣教指导在小儿支气管哮喘遵医行为中的应用效果分析

目的分析健康宣教指导在小儿支气管哮喘遵医行为中的应用效果。方法选择2017年6月至2019年6月本院收治的124例支气管哮喘患儿作为研究对象,按照是否进行健康宣教指导分为研究组(n=63)和对照组(n=61)。对照组患儿采用普通健康宣教,研究组患儿在此基础上增加健康宣教指导。记录所有研究对象临床资料及随访情况,测量患儿随访前与随访1年后用力肺活量(FVC)、第一秒用力呼气量(FEV_1)及第一秒用力呼气量/用力肺活量(FEV_1/FVC),比较两组患儿随访1年后遵医行为情况及随访1年内复诊率、再次住院率、急性发作次数。结果研究组患儿随访1年后FVC、FEV1、FEV1/FVC水平均显著高于对照组(P0.05);研究组患儿掌握疾病相关知识、正确合理用药、指导患儿合理饮食及家居、参加户外及体育活动及正确处理急性期发作人数显著多于对照组(P0.05);研究组患儿随访1年内复诊率、再次住院率显著低于对照组,1年内急性发作次数明显少于对照组(P0.05)。结论健康宣教指导可提高支气管哮喘患儿遵医行为,改善其肺功能,对降低支气管哮喘复发率、延长发作间隔时间有积极意义,值得临床推广。     

循证护理干预在小儿支气管哮喘治疗中的应用价值分析

目的探讨循证护理干预在小儿支气管哮喘治疗中的应用价值。方法选取2018年1月～2018年7月本院收治的80例支气管哮喘患儿作为研究对象,随机将对象平均分为对照组与观察组,每组各40例。对照组予常规护理干预,观察组予循证护理干预,3个月后观察两种护理干预对支气管哮喘患儿预后的影响。结果观察组患儿在雾化吸入掌握情况、症状缓解情况、相关知识掌握情况均较对照组明显提高,观察组患儿平均住院时间较对照组明显缩短,差异具有统计学意义(χ~2分别为7.565,10.912,7.813,9.402,P均0.05)。结论与常规护理干预比较,循证护理干预更能改善支气管哮喘患儿的临床症状,增进患儿及家属对疾病的认知,缩短患儿住院时间,值得临床推广。     

氨茶碱联合盐酸氨溴索治疗小儿支气管哮喘的临床探析

目的探析小儿支气管哮喘应用氨茶碱与盐酸氨溴索联合治疗的临床效果。方法选取2013年3月~2014年3月我院收治的支气管哮喘患儿85例,分为两组。对照组应用氨茶碱、糖皮质激素、抗感染与营养支持治疗,观察者同时应用盐酸氨溴索治疗,对比两组治疗效果。结果观察组总有效率(94.65%)与对照组(84.61%)相比明显较高,咳嗽、喘息、呼吸困难、肺部啰音消失时间短于对照组,两组治疗效果差异显著,有统计学意义(P<0.05)。结论小儿支气管哮喘应用氨茶碱与盐酸氨溴索治疗能够有效改善患儿症状体征,促进患儿及早康复,值得临床广泛应用。     

儿童支气管哮喘变应原分析

对 4 6例儿童支气管哮喘进行了血清特异性IgE水平的检测 ,以发现引起哮喘的体外致病因素。 2 0 0 1年 1月～2 0 0 3年 1月南京中医药大学第二附属医院哮喘专科门诊儿童支气管哮喘患者共4 6例 ,男 2 5例 ,女 2 1例 ,年龄 2～ 14岁 ,其中 2～ 4岁 10例 ,5～ 8岁 19例 ,9～ 14岁 17例。病史 2个月～ 10年。依据《全国小儿呼吸道疾病学术会议》提出的标准诊断为支气管哮喘。检测于症状缓解期进行。用激素或抗组胺药物治疗者停药 1周以上。空腹静脉采血 3～ 5ml,离心分离血清 30℃保存待检。根据病史及临床情况选择南京地区常见的过敏原作为检测…     

硫酸镁联合孟鲁司特钠治疗对小儿支气管哮喘肺功能及免疫功能的影响分析

目的分析硫酸镁联合孟鲁司特钠治疗对小儿支气管哮喘肺功能及免疫功能的影响。方法回顾性分析2018年2月至2019年10月本院收治的89例支气管哮喘患儿临床资料,按照治疗方法的差异分为联合组(n=43)和对照组(n=46)。对照组在常规药物治疗基础上加用硫酸镁治疗,联合组则采用硫酸镁联合孟鲁司特钠片治疗。比较两组患者治疗前后肺功能、免疫功能、临床疗效及不良反应发生情况。结果联合组临床总有效率为95.35%,显著高于对照组的78.26%(P0.05);联合组治疗后FVC、FEV_1、FEV1/FVC水平均显著高于对照组(P0.05);治疗后两组患者免疫功能各指标均有所升高,且联合组IgM、IgG、IgA、CD_(4+)、CD_(4+)/CD_(8+)均显著高于对照组(P0.05);两组患者不良反应发生率比较,差异无统计学意义(P0.05)。结论硫酸镁联合孟鲁司特钠治疗小儿支气管哮喘效果显著,可明显改善患儿肺功能并调节其免疫功能,安全性高,值得临床推广。     

普米克令舒与万托林联合雾化吸入治疗小儿支气管哮喘效果评价分析

目的：探究普米克令舒与万托林联合雾化治疗小儿支气管哮喘的临床疗效。方法挑选2012年1月~2013年3月入院的患有支气管哮喘的患儿164例,按照随机分组的原则分为研究组和对照组两组,各82例,研究组采用普米克令舒联合万托林雾化疗法,对照组则只使用普米克令舒雾化治疗,比较两组的疗效情况及副作用产生情况。结果研究组总有效率97.56%明显高于对照组的82.92%,研究组产生副作用率13.41%明显比对照组的24.39%低,结果具有统计学意义(<0.5)。结论在治疗小儿支气管哮喘时运用普米克令舒联合万托林雾化疗法,改善临床症状等方面疗效优势更明显,且对患儿的身体产生不良反应的较少,提倡在儿科的临床治疗过程中广泛运用。     

社会技能训练为主的综合心理治疗疗效观察——附12例注意缺陷多动障碍儿童疗效报告

目的 :探讨以社会技能训练为主的综合心理治疗对注意缺陷多动障碍儿童的疗效 ,并探索社会技能训练的方法。方法 :以社会技能训练为主的综合心理治疗对 12例注意缺陷多动障碍儿童进行为期 8周的治疗 ,用Rutter儿童行为问卷 ,Conners儿童行为问卷 ,Achenbach儿童行为量表进行疗效评价。结果 :治疗后 ,Rutter儿童行为问卷总分较治疗前显著下降 (t =5 487,P <0 0 0 1) ;Conners儿童行为问卷结果显示 ,总分 (t =3 3 75 ) ,行为因子分 (t =2 493 )、学习 (t =2 5 45 )、多动 (t =3 117)、多动指数 (t =2 43 2 )较治疗前显著下降 (p <0 0 5～ 0 0 1) ;Achenbach儿童行为量表显示部分患儿部分因子分下降。结论 :本研究所使用的社会技能训练方法切实可行 ,社会技能训练为主的综合心理治疗对降低注意缺陷多动障碍儿童的行为问题有效。     

首发支气管哮喘患者心理健康状况及生存质量分析

目的调查首次发病支气管哮喘患者的心理健康状况,并分析心理学因素对患者生活质量的影响。方法采用抑郁自评量表、焦虑自评量表、多伦多述情障碍评定量表、社会支持评定量表、特质应对方式问卷、世界卫生组织生存质量测定量表简表调查112例首次发病支气管哮喘患者及110例正常对照者的心理健康状况。结果①首发支气管哮喘患者SAS评分显著高于对照组（t=4．89,P〈0．01）,SDS评分也显著高于对照组（t=3．69,P〈0．01）;②首发支气管哮喘患者较对照组客观支持少（t=2．05,P〈0．05）,对社会支持的利用较差（t=5．69,P〈0．01）;③首发支气管哮喘患者更多采用消极的应对方式（t=2．17,P〈0．05）;④患者较对照组存在述情困难,表现为难以描述自己的情感（t=6．35,P〈0．01）;⑤患者生活质量差于对照组,主要体现在生理领域（t=2．00,P〈0．05）;⑥相关分析结果表明,患者的生活质量受焦虑、抑郁情绪、述情困难、应对方式、较少的社会支持以及对支持的利用不足等多方面影响（P〈0．05或〈0．01）。结论首发支气管哮喘患者存在较多心理问题,影响患者的生活质量。心理健康状况差是支气管哮喘发病的危险因素。     

社会技能训练对儿童行为问题的干预研究

目的:建立社会技能训练的方法,并探讨社会技能训练对儿童行为问题的干预效果.方法:应用社会技能训练对30例儿童行为问题患儿进行为期8周的干预,采用Rutter儿童行为问卷,Conners儿童行为问卷,Achenbach儿童行为量表进行干预前后评价,并进行临床疗效评定.结果:干预后,Rutter儿童行为问卷总分、A分和N分均较治疗前显著下降(P<0.001,P<0.05,P<0.01),临床评定总有效率达76.67%;Conners儿童行为问卷总分及因子分行为、学习、多动、多动指数较治疗前显著下降(P<0.05～0.01),总有效率63.33%;Achenbach儿童行为量表显示因子分违纪显著下降(P<0.05),总有效率60%.结论:社会技能训练的方法切实可行,并对儿童行为问题的改善有效.     

Neonatal ultrasound results following very preterm birth predict adolescent behavioral and cognitive outcome

This study investigated the association between different neonatal ultrasonographic classifications and adolescent cognitive, educational, and behavioral outcomes following very preterm birth. Participants included a group of 120 adolescents who were born very preterm (<33 weeks of gestation), subdivided into three groups according to their neonatal cerebral ultrasound (US) classifications: (a) normal (N = 69), (b) periventricular hemorrhage (PVH, N = 37), and (c) PVH with ventricular dilatation (PVH + DIL, N = 14), and 50 controls. The cognitive functions assessed were full-scale IQ, phonological and semantic verbal fluency, and visual-motor integration. Educational outcomes included reading and spelling; behavioral outcomes were assessed with the Rutter Parents' Scale and the Premorbid Adjustment Scale (PAS). Adolescent outcome scores were compared among the four groups. A main effect for group was observed for full-scale IQ, Rutter Parents' Scale total scores, and PAS total scores, after controlling for gestational age, socioeconomic status and gender, with the PVH + DIL group showing the most impaired scores compared to the other groups. The current results demonstrate that routine neonatal ultrasound classifications are associated with later cognitive and behavioral outcome. Neonatal ultrasounds could aid in the identification of subgroups of children who are at increased risk of neurodevelopmental problems. These at risk subgroups could then be referred to appropriate early intervention services.     

血清IL-33、IFN-γ与IgE在支气管哮喘患者中的表达及临床意义

目的观察血清白细胞介素-33(IL-33)、干扰素-γ(IFN-γ)及IgE在支气管哮喘患者中的表达及意义。方法选取94例急性发作期支气管哮喘患者,同时选取同期60例健康体检的人群为对照组,采用酶联免疫法测定血清中IgE、IL-33及IFN-γ水平。比较两组IgE、IL-33和IFN-γ的水平。分析IL-33、IFN-γ和IgE的相关性。结果支气管哮喘患者外周血中IFN-γ水平低于正常人群(t=4.533,P<0.001);IL-33、IgE水平高于正常人群(t=5.831、66.129,P<0.001,<0.001),差异有统计学意义。IgE水平与IL-33水平呈正相关(r=0.667,P=0.032),IFN-γ与IgE、IL-33呈负相关(r=-0.714,P=0.024;r=-0.623,P=0.038)。结论血IgE、IL-33和IFN-γ水平的变化在支气管哮喘患者发病过程中起到一定的作用。     

血清骨膜蛋白和脂联素联检诊断儿童支气管哮喘价值研究

目的 探讨支气管哮喘患儿血清骨膜蛋白及脂联素（ADP）水平检测对诊断支气管哮喘的临床价值。方法 选取选取2017年1月~12月在常州儿童医院儿科就诊的40例支气管哮喘患儿（哮喘组）和40名同期健康儿童体检者（对照组）作为研究对象,ELISA法检测哮喘组急性发作期和缓解期及对照组的血清Periostin、ADP及IgE水平;采用ROC曲线评价Periostin及ADP对支气管哮喘病情评估效能预测。结果 哮喘组患儿发作期及缓解期血清Periostin和血清ADP水平均高于对照组（P＜0.05）且发作期高于缓解期（P＜0.05）;采用血清Periostin和ADP水平诊断支气管哮喘,其诊断灵敏度分别为85.02%和80.48%,特异度为92.51%和81.98%,当血清Periostin和血清ADP分别在147.52 μg/L和20.31 mg/L时,其Youden 值最大,分别为0.7752和0.7504,其AUC分别为0.8262和0.7823,两者联检可将灵敏度和特异性分别提高到87.03%和95.52%。支气管哮喘急性发作期和缓解期血清Periostin与IgE的相关系数分别为0.9916和0.9358,而急性发作期和缓解期血清ADP与IgE的相关系数分别为0.4767和0.2344。结论　动态监测支气管哮喘患儿血清中Periostin及ADP水平有助于判断支气管哮喘病情转归效果;二者联检可作为排查儿童支气管哮喘的指标,血清Periostin可作为诊断支气管哮喘良好血清学指标。     

Bronchial hyperresponsiveness in children with atopic rhinitis: a 7-year follow-up

BACKGROUND: A high prevalence of bronchial hyperresponsiveness (BHR) was found in atopic subjects with rhinitis. Those subjects may be at higher risk for developing bronchial asthma. We evaluated, in a 7-year follow-up, BHR and atopy in a homogeneous population of nonasthmatic children with allergic rhinitis (AR), and their role in asthma development. METHODS: Twenty-eight children (6-15 years) with AR were studied. At enrollment (T(0)), skin tests, total serum IgE assay, peak expiratory flow (PEF) monitoring and methacholine (Mch) bronchial challenge were performed. BHR was computed as the Mch dose causing a 20% forced expiratory volume (FEV)(1) fall (PD(20)FEV(1)) and as dose-response slope (D(RS)). Subjects were reassessed after 7 years (T(1)) using the same criteria. RESULTS: At T(0), 13 children (46%), showing a PD(20)FEV(1) <1526 microg of Mch, had BHR (Mch+), although PEF variability (PEFv) was within normal limits. None of the children with negative methacholine test developed bronchial asthma after 7 years. Of the 13 Mch+, only two reported asthma symptoms after 7 years. No significant change was seen in the other parameters of atopy considered. CONCLUSION: Children with allergic rhinitis present a high prevalence of BHR. Nevertheless, their PEFv is normal and the rate of asthma development low.     

焦虑性障碍儿童行为问题与自我意识研究

目的:探讨焦虑性障碍儿童的行为问题与自我意识特点。方法:对湖南中小学生心理健康状况流行病学调查中的全部研究对象进行DSM-IV临床诊断,最后选出单纯儿童焦虑性障碍组(n1=110人)、正常对照组(n2=113人),入组儿童由父母填写Achenbach儿童行为量表(CBCL),其本人(三年级及其以上学生)填写儿童自我意识量表(CSCS)。结果:①焦虑障碍组的行为问题总分高于对照组,除性问题外其余各因子得分焦虑障碍组均高于对照组(P<0.05);社会能力各因子分及总分均低于对照组(P<0.05)。②Piers-Harris儿童自我意识量表各分量表得分及总分焦虑障碍组均低于对照组(P<0.05)。结论:焦虑障碍儿童与正常儿童相比较其行为问题比较多,自我评价低。     

Exhaled nitric oxide of childhood asthma]

Chronic airway inflammation is a central feature of pathology of bronchial asthma. In order to evaluate inflammatory status in asthma, examinations such as bronchoscope or induced sputum test can be done. Because of difficulty of those examinations we need non-invasive and simple measures for childhood asthma. Here we investigated eNO in childhood asthma. Twenty-six of atopic asthma, 13 non-asthmatic atopic children and 12 normal children were enrolled in this study. eNO was measured by chemiluminescence analyzer. eNO was significantly collerated with % FEV 1.0 and blood eosinophil counts (R = -0.494, R = 0.416, respectively). Geometrical mean of eNO in normal, non-asthmatic atopic, asthma without inhaled corticosteroid (ICS) and asthma with ICS was 16.3, 23.7, 71.6, 43.6 ppb, respectively. eNO was significantly higher in asthma than in normals. eNO in patients without ICS were significantly higher than in non-asthmatic atopic. We concluded that eNO might be useful marker for evaluation of airway inflammation in asthmatic children.     

Screening for childhood asthma using an exercise test.

BACKGROUND. Screening for asthma in children in the community could have advantages at a time when prevalence rates of the condition and associated hospital admission rates are rising. AIM. The aim of this study was to assess the usefulness of a standard exercise test as a marker of asthma or potential asthma in children, and to examine the relationship between asthma and other respiratory tract illnesses. METHOD. In 1985 a cross-sectional research study was undertaken in 10 primary schools in West Glamorgan; the children were followed up over six years until 1991. The exercise test involved measuring peak expiratory flow rate before and after the children ran as fast as they could for six minutes. A control group of children with a negative exercise test result were compared with those not known to have asthma who had a positive result (fall in peak expiratory flow rate of 15% or greater), using clinical data. Similar clinical comparisons were undertaken between the children known to have asthma and a control group. RESULTS. Of 864 children not known to have asthma, 60 had a positive exercise result. Of 92 children known to have asthma, 33 had a positive test result and seven were unable to finish the test because of bronchospasm, a sensitivity of 43% and a specificity of 93%. Follow up of 55 of the 60 children not known to have asthma but who had an abnormal response to the test showed that 32 had developed clinically recognizable asthma six years later. There was a significantly higher prevalence of atopic and respiratory illnesses (otitis media, hay fever and eczema) in the group of children with bronchial hyperreactivity demonstrated on exercise than in those without bronchial hyperreactivity. CONCLUSION. This research shows that bronchial hyperreactivity demonstrated by an exercise test can be a marker for childhood asthma. The study has also identified other respiratory tract illnesses which appear to belong to the same spectrum as asthma.