CAJ | 학술논문

目的探讨改良出院后家庭管理模式对降低支气管肺发育不良(BPD)患儿出院后病死率及再住院率的价值.方法选取2006年1月至2013年12月在中山大学附属中山医院新生儿监护室住院的BPD患儿为研究对象,其中2010年1月至2013年12月应用改良出院后家庭管理模式31例BPD患儿为试验组,2006年1月至2009年12月应用传统出院后家庭管理模式27例BPD患儿为对照组.应用x2检验比较2组出院后3个月内病死率和再住院率;应用t检验比较2组在校正胎龄40周及校正年龄3月龄时肺功能情况.结果试验组出院后3个月内的病死率[3.22％(1/31例)]明显低于对照组[22.22％(6/27例)],差异有统计学意义(x2 =4.907,P＜0.05).试验组再住院率[25.80％(8/31例)]明显低于对照组[77.78％(21/27例)],差异有统计学意义(x2=15.591,P ＜0.05).校正年龄3月龄时试验组(存活30例)呼吸频率低于对照组(存活21例),2组比较差异有统计学意义(t=9.225,P＜0.05),试验组达峰时间、达峰容积、25％潮气量时呼气流速、50％潮气量时呼气流速和75％潮气量时呼气流速均高于对照组,2组比较差异均有统计学意义(t=3.992、3.301、4.645、3.152、2.916,P均＜0.05),校正年龄3月龄时试验组BPD患儿的肺功能明显优于对照组.结论改良出院后家庭管理模式有利于降低BPD患儿出院后3个月内的病死率和再住院率,有利于肺功能的改善.
목적 탐토개량출원후가정관리모식대강저지기관폐발육불량(BPD)환인출원후병사솔급재주원솔적개치.방법 선취2006년1월지2013년12월재중산대학부속중산의원신생인감호실주원적BPD환인위연구대상,기중2010년1월지2013년12월응용개량출원후가정관리모식31례BPD환인위시험조,2006년1월지2009년12월응용전통출원후가정관리모식27례BPD환인위대조조.응용x2검험비교2조출원후3개월내병사솔화재주원솔;응용t검험비교2조재교정태령40주급교정년령3월령시폐공능정황.결과 시험조출원후3개월내적병사솔[3.22％(1/31례)]명현저우대조조[22.22％(6/27례)],차이유통계학의의(x2 =4.907,P＜0.05).시험조재주원솔[25.80％(8/31례)]명현저우대조조[77.78％(21/27례)],차이유통계학의의(x2=15.591,P ＜0.05).교정년령3월령시시험조(존활30례)호흡빈솔저우대조조(존활21례),2조비교차이유통계학의의(t=9.225,P＜0.05),시험조체봉시간、체봉용적、25％조기량시호기류속、50％조기량시호기류속화75％조기량시호기류속균고우대조조,2조비교차이균유통계학의의(t=3.992、3.301、4.645、3.152、2.916,P균＜0.05),교정년령3월령시시험조BPD환인적폐공능명현우우대조조.결론 개량출원후가정관리모식유리우강저BPD환인출원후3개월내적병사솔화재주원솔,유리우폐공능적개선.
Objective To explore the value of improved family management model to reduce the occurrence of death and rehospitalization rate of children with bronchopulmonary dysplasia (BPD) after discharge.Methods The children with BPD who were admitted in Neonatal Intensive Care Unit of Zhongshan Hospital Affiliated to Sun Yat-Sen University from January 2006 to December 2013 were enrolled.Thirty-one cases with BPD used with improved family management mode after discharge from January 2010 to December 2013 were as experimental group.Twenty-seven cases with BPD used with traditional family management mode after discharge from January 2006 to December 2009 were as control group.The occurrence of death and rehospitalization were observed because of apnea,choking,respiratory failure,pneumonia and asthma within 3 months after discharge and compared the difference between two groups with chi-square test.The lung functions of all cases were checked in 40 week of the corrected gestational age and 3 month of the corrected age and compare the difference between the experimental group and control group with t test.Results The occurrence of death in the experimental group was 3.22％ (1/31 cases),and that of the control group was 22.22％ (6/27 cases),there was significantly statistical difference in the occurrence of death between two groups (x2 =4.907,P ＜0.05).The occurrence of rehospitalization in the experimental group was 25.80％ (8/31 cases),and that of the control group was 77.78％ (21/27 eases),there was significantly statistical difference in the occurrence of rehospitalization because of apnea,choking,respiratory failure,pneumonia and asthma between two groups (x2 =15.591,P ＜ 0.05).The difference of the lung functions between two groups in 40 week of the corrected gestational age was not statistically significant.The respiratory rate in the experimental group (30 survivors) were lower than those in the control group (21 survivors) in 3 month of the corrected gestational age (t =9.225,P ＜ 0.05),and time to peak tidal expiratory flow,volume to peak tidal expiratory flow,25 ％ tidal expiratory flow,50％ tidal expiratory flow,75 ％ tidal expiratory flow levels in the experimental group were higher than those in the control group in 3 month of the corrected gestational age,the difference of lung functions between 2 groups were statistically significant (t =3.992,3.301,4.645,3.152,2.916,all P ＜ 0.05),the lung functions in experimental group were significantly better than that in control group in 3 month of the corrected age.Conclusions The improved family management mode can reduce the occurrence of death and rehospitalization for the children with BPD after discharge and is conducive to the improvenent of pulmonary function.