五位一体管理模式对学龄期哮喘患儿疾病防控的影响  

Influence of five-in-one management mode on disease prevention and control of school children with asthma

作　　者：路玲[1] 林荣军[1] 管仁政[1] 刘玉娟 王修岩 Lu Ling;Lin Rongjun;Guan Renzheng;Liu Yujuan;Wang Xiuyan(Department of Comprehensive Pediatrics,Affiliated Hospital of Qingdao University,Qingdao 266000,China;Department of Nutrition,Qingdao Women and Children′s Hospital,Qingdao 266000,China;Department of Track and Field,Qingdao Sports School,Qingdao 266000,China)

机构地区：[1]青岛大学附属医院综合儿科,266000 [2]青岛市妇女儿童医院营养科,266000 [3]青岛市体育运动学校田径系,266000

出　　处：《中华儿科杂志》2019年第11期870-875,共6页Chinese Journal of Pediatrics

摘　　要：目的探讨五位一体管理模式(哮喘规范化治疗、哮喘日记、最大呼气流速(PEF)监测、合理膳食、体育运动)对学龄期哮喘患儿疾病防控的影响。方法采用随机对照研究,选取2018年4月至10月在青岛大学附属医院综合儿科就诊的临床缓解期哮喘患儿70例。抽签法随机分为研究组和对照组,每组35例。研究组有5例失访,实际入组30例。对照组有6例失访,实际入组29例。对照组患儿接受常规用药并定期门诊复诊,研究组患儿接受五位一体的哮喘管理模式。分别于首次就诊时、随访3个月及6个月时进行哮喘控制测试评分、用药依从性指数评分,检测肺功能指标[第1秒用力呼气容积(FEV1)、PEF],记录随访6个月期间哮喘急性发作急诊就诊次数,并进行家长满意度调查,体重、身高及生化指标检测。哮喘患儿肺功能指标、哮喘控制评分以及超重患儿体质指数比较采用t检验,用药依从性比较采用χ2检验,哮喘急性发作急诊就诊次数、家长满意度比较采用秩和检验。结果纳入的哮喘患儿实际共59例,研究组30例,年龄(8.1±1.5)岁;对照组29例,年龄(9.2±1.1)岁。随访3个月研究组患儿FEV1、PEF、哮喘控制评分分别为(86.3±1.5)%、(83.3±2.4)%、(24.7±2.6)分,对照组分别为(84.4±2.5)%、(82.2±1.9)%、(21.1±1.3)分,研究组高于对照组(t=3.62、1.97、6.64,P均<0.05)。随访6个月研究组患儿FEV1、PEF、哮喘控制评分分别为(88.4±2.3)%、(85.4±2.2)%、(26.8±1.8)分,对照组分别为(85.5±1.9)%、(83.2±1.7)%、(22.5±1.4)分,研究组均明显高于对照组(t=5.34、4.24、10.41,P均<0.05)。随访6个月期间,研究组与对照组患儿哮喘急性发作急诊就诊次数分别为0.42(0.36,0.59)次、0.92(0.72,1.27)次,研究组明显低于对照组(Z=3.21,P<0.05)。随访3个月研究组与对照组患儿用药依从性好的比例分别为67%(20/30)、62%(18/29),依从性差的比例分别为27%(8/30)、34%(10/29),不依从的比例�Objective To investigate the influence of five-in-one management mode(standardized asthma treatment,asthma diary,peak expiratory flow(PEF)monitoring,reasonable diet and physical exercise)on disease prevention and control of school children with asthma.Methods From April to October 2018,70 children with asthma in clinical remission were selected from Affiliated Hospital of Qingdao University using randomized controlled study design.These children were randomly divided into study group and control group,with 35 cases in each group.In the study group,5 cases were lost to follow-up,and 30 cases were actually enrolled.In the control group,6 cases were lost to follow-up,and 29 cases were actually enrolled.Children in the control group received routine medication and regular outpatient consultation,and children in the study group received the five-in-one asthma management model.In the first time of seeing a doctor,after 3 months and 6 months of follow-up,asthma control test score,medication compliance index score and lung function index(forced expiratory volume in 1 second(FEV1)),PEF were evaluated respectively.Parental satisfaction,asthma acute episodes,weight,height and biochemical index were recorded during the 6 months of follow-up.Pulmonary function index,asthma control score and body mass index of overweight children with asthma were compared with t-test,medication compliance was compared with chi-square test,and the rank sum test was used for the comparison of the number of emergency visits of asthma attacks and parents′satisfaction.Results A total of 59 children with asthma were included,among them 30 were in the study group(8.1±1.5)years old and 29 in the control group(9.2±1.1)years old.After 3 months of follow-up,FEV1,PEF,asthma control score in the study group were(86.3±1.5)%,(83.3±2.4)%,(24.7±2.6)points respectively;and in the control group,FEV1,PEF,asthma control score were(84.4±2.5)%,(82.2±1.9)%,(21.1±1.3)points respectively.The indicators in the study group were higher than those in the control

关 键 词：哮喘 儿童 疾病管理 

分 类 号：R47[医药卫生—护理学]