东莞地区儿童哮喘社区干预模式的建立与效果评价  

Establishment and effect evaluation of childhood asthma community intervention model in Dongguan area

作　　者：范雪金[1] 彭琪[1] 陆小梅[1] 赖茂 陈秀英[1] 黎四平[1] 李文瑞[1] 马可泽[1] 何晓光[1] 程庆秋 刘绍基[1] 

机构地区：[1]东莞市儿科研究所广东医学院附属石龙博爱医院,523325

出　　处：《中国小儿急救医学》2014年第3期134-136,139,共4页Chinese Pediatric Emergency Medicine

基　　金：广东省卫生厅医学科研基金项目（A2012803）

摘　　要：目的建立一套适合东莞地区的儿童哮喘社区干预模式以提高哮喘患儿及家长的认知水平和防治能力，降低社区儿童的哮喘发病率。方法通过建立社区居民动态档案，经调查访问收集68例支气管哮喘患儿，对患儿及父母实施系统化的社区干预，包括建立个人健康档案，监督患儿合理规范用药，建立哮喘患儿日常记录卡，成立社区哮喘防治小组进行健康教育等，定期随访并对干预效果进行评估。结果经过为期一年系统化的社区干预，患儿家长对哮喘知识的认知水平显著提高，规范化治疗率由68．2％升高至86．3％，人均年平均急诊次数由（3．2±0．4）次降至（1．5±0．2）次，人均年平均发病次数由（4．5±0．8）次降至（2．0±0．4）次，人均年住院天数由（8．0±2．8）d降至（5．0±1．6）d，人均住院花费由（2698±20．2）元降至（1554±30．9）元，干预前后，各项指标差异均有统计学意义（P〈0．05）。结论对哮喘儿童实施社区干预，进行长期的监测、管理和教育工作可有效地控制病情急性发作，提高诊治效率，缓解病情，降低就医成本。Objective To establish a set of childhood asthma community intervention model suitable for Dongguan area which can improve the cognitive level and prevention ability of the children and their par- ents, reduce the incidence rate of childhood asthma in community. Methods Through the establishment of community residents dynamic files ,68 cases of bronchial asthma children were collected in our study. System- atic community intervention were implemented into the children and their parents, including the establishment of personal health records, supervising children with asthma reasonable and standardized medication, establis- hing asthmatic children daily record card, establishing community asthma control panel to give health educa- tion, regular follow-up and evaluating effect of intervention. Results After one-year systematic community intervention, the cognitive level to asthma knowledge of parents had been significantly improved, the standard- ized treatment rate reached to 86.3% from 68.2%, annual average times of emergency treatment per capita reduced to 1.5 _＋ 0. 2 from 3.2 -2_ 0. 4, annual average incidence per capita reduced to 2. 0 _＋ 0. 4 from 4. 5 _＋ 0. 8, annual average hospital stays per capita reduced to （ 5.0 _＋ 1.6 ） days from （ 8.0 _＋ 2.8 ） days, and the average hospitalization expenses reduced to （ 1 554 _＋ 30. 9 ） yuan from （ 2 698 e 20. 2） yuan. There were sig- nificant differences of all these indexes between before and after community intervention （ P 〈 0. 05 ）. Conclusion The implementation of community intervention on children with asthma and long-term monitoring, manage- ment and education can effectively control the disease of acute attack, which also can improve the treatment efficiency, alleviate the condition and reduce the medical cost.

关 键 词：社区干预 哮喘 儿童 

分 类 号：R725.6[医药卫生—儿科]