昆明地区中重度慢性阻塞性肺疾病患者缓解期控制现状调查

目的调查昆明地区中重度慢性阻塞性肺疾病患者缓解期控制的现状.方法分别从患者和医生的角度,通过问卷的方式,从戒烟、肺功能检查、吸氧、吸入糖皮质激素、支气管扩张剂、吸入装置的使用、康复锻炼、随访情况以及开展的健康教育等方面调查缓解期的控制情况.结果 （1）患者的调查显示：33.8%的患者表示需要长期氧疗,34.78%平时坚持吸入气雾剂,41.54%的患者能够正确使用不同吸入装置,有24.15%对呼吸康复治疗方法略有了解,只有4.83%患者定期到门诊复查肺功能,没有患者在缓解期曾到过医院行氧饱和度监测,28.02%COPD患者认为参加COPD防治知识讲座很有必要.（2）医生的调查显示：45.2%医生建议患者定期复查肺功能（χ2=24.723,P〈0.01）,介绍患者行肺康复治疗的医生50.7%（χ2=17.656,P〈0.01）,调查患者能否坚持长期氧疗的医生为63%（χ2=8.96,P〈0.05）,建议长期吸入激素治疗的医生为49.3%（χ2=12.68,P〈0.01）,建议长期吸入支气管扩张剂的医生为48.6%（χ2=15.51,P〈0.01）,认为吸入长效支气管扩张剂为52.1%（χ2=14.11,P〈0.01）,省市级医生明显高于县级.而对固定开展健康教育、定期随访、正确使用吸入装置率及氧饱和度的监测的调查三级医院之间差异无统计学意义.结论昆明地区慢性阻塞性肺疾病缓解期的管理存在严重不足,应该提高缓解期管理的意识.

Current Situation of Management for Moderate and Severe Chronic Obstructive Pulmonary Disease in Remission Stage in Kunming

Objective To investigate the current situation of management for moderate and severe chronic obstructive pulmonary disease in remission stage in Kunming.Methods From the perspective of patients and doctors,we investigated the current situation of management for COPD in remission stage through the questionnaire including smoking cessation,pulmonary function tests,oxygen,inhaled corticosteroids,bronchodilators,inhalation device used,rehabilitation exercises,as well as follow-up health education.Results（1）The survey of patients：33.8% of patients required long-term oxygen therapy.34.78% usually insisted on inhaling aerosol.41.54% of patients rightly used different inhalation devices.24.15% of patients knew a little about the respiratory rehabilitation treatment.Only 4.83% of patients rechecked the lung function regularly in clinic,and no patients in remission stage had visited the hospital to monitor the oxygen saturation.Only 28.02% of patients thought it was necessary to participate in lectures on prevention of COPD.（2）The survey of doctors：45.2% of doctors recommended periodic review of lung function in patients（χ2=24.723,P0.01）.50.7% of doctors introduced pulmonary rehabilitation to patients（χ2=17.656,P0.01）.63% doctors took the investigation on patients＇ adherence to long-term oxygen therapy（χ2=8.96,P0.05）.49.3% of doctors recommended long-term inhaling steroid therapy to patients（χ2=12.68,P0.01）.48.6% of doctors recommended long-term inhaling bronchodilator to patients（χ2=15.51,P0.01）.52.1% of doctors recommended inhaling long-acting bronchodilator（χ2=14.11,P0.01）.which were significantly higher for provincial and municipal doctors than county doctors.The regular health education,regular follow-up,right use of the inhalation device rate and oxygen saturation monitoring surveys had no statistical differences between hospitals.Conclusion There is a serious shortage in management for chronic obstructive pulmonary disease in remission in Kunming,the management awareness should be improved.