中国医药指南
中國醫藥指南
중국의약지남
Guide of China Medicine
2015年
26期
22-23
,共2页
哮喘%社区卫生管理%儿童
哮喘%社區衛生管理%兒童
효천%사구위생관리%인동
Asthma%Community medical management%Children
目的:讨论社区卫生管理儿童哮喘的成效。方法依据《全球哮喘防治指南》的要求,对昆山地区发现的患哮喘儿童230例,建立和健全社区卫生医院管理儿童哮喘的方案,即建立患儿病案,通过专线、微信及网络等医患互动信息,对患儿与家长举办哮喘知识培训学校,督导规范用药,定期门诊随访。并对实施社区卫生管理前和管理1年后的哮喘患儿在规范用药,病情变化,抗生素等药物使用,家长认同等方面进行对比分析。结果管理1年后,用局部吸入糖皮质激素(75.8%)及口服白三烯受体拮抗剂-孟鲁司特(75.2%)与管理前使用(6.8%、6.5%)比较有显著增加(P<0.01)。哮喘年发作次数(0.8±0.3),抗生素及β2受体激动剂使用天数(3.9±1.8),最大呼气流量值提高50%的百分比(32.3±7.6)较管理前(4.8±2.6)、(17.4±5.9)、(70.3±10.8)比较,均有统计学意义(P均<0.01)。其管理后全身用激素(18.5%)与管理前(70.4%)比较明显减少(χ2=53.2,P<0.01);家长对治疗满意率为(97.2%)比管理前的(62.7%)明显提升(χ2=52.9,P<0.01)。有28例(12.2%)初始失诊,对其跟踪、教育,最后失诊为18例(7.8%)。结论把患哮喘儿童纳入社区卫生管理是防治儿童哮喘的有效模式。
目的:討論社區衛生管理兒童哮喘的成效。方法依據《全毬哮喘防治指南》的要求,對昆山地區髮現的患哮喘兒童230例,建立和健全社區衛生醫院管理兒童哮喘的方案,即建立患兒病案,通過專線、微信及網絡等醫患互動信息,對患兒與傢長舉辦哮喘知識培訓學校,督導規範用藥,定期門診隨訪。併對實施社區衛生管理前和管理1年後的哮喘患兒在規範用藥,病情變化,抗生素等藥物使用,傢長認同等方麵進行對比分析。結果管理1年後,用跼部吸入糖皮質激素(75.8%)及口服白三烯受體拮抗劑-孟魯司特(75.2%)與管理前使用(6.8%、6.5%)比較有顯著增加(P<0.01)。哮喘年髮作次數(0.8±0.3),抗生素及β2受體激動劑使用天數(3.9±1.8),最大呼氣流量值提高50%的百分比(32.3±7.6)較管理前(4.8±2.6)、(17.4±5.9)、(70.3±10.8)比較,均有統計學意義(P均<0.01)。其管理後全身用激素(18.5%)與管理前(70.4%)比較明顯減少(χ2=53.2,P<0.01);傢長對治療滿意率為(97.2%)比管理前的(62.7%)明顯提升(χ2=52.9,P<0.01)。有28例(12.2%)初始失診,對其跟蹤、教育,最後失診為18例(7.8%)。結論把患哮喘兒童納入社區衛生管理是防治兒童哮喘的有效模式。
목적:토론사구위생관리인동효천적성효。방법의거《전구효천방치지남》적요구,대곤산지구발현적환효천인동230례,건립화건전사구위생의원관리인동효천적방안,즉건립환인병안,통과전선、미신급망락등의환호동신식,대환인여가장거판효천지식배훈학교,독도규범용약,정기문진수방。병대실시사구위생관리전화관리1년후적효천환인재규범용약,병정변화,항생소등약물사용,가장인동등방면진행대비분석。결과관리1년후,용국부흡입당피질격소(75.8%)급구복백삼희수체길항제-맹로사특(75.2%)여관리전사용(6.8%、6.5%)비교유현저증가(P<0.01)。효천년발작차수(0.8±0.3),항생소급β2수체격동제사용천수(3.9±1.8),최대호기류량치제고50%적백분비(32.3±7.6)교관리전(4.8±2.6)、(17.4±5.9)、(70.3±10.8)비교,균유통계학의의(P균<0.01)。기관리후전신용격소(18.5%)여관리전(70.4%)비교명현감소(χ2=53.2,P<0.01);가장대치료만의솔위(97.2%)비관리전적(62.7%)명현제승(χ2=52.9,P<0.01)。유28례(12.2%)초시실진,대기근종、교육,최후실진위18례(7.8%)。결론파환효천인동납입사구위생관리시방치인동효천적유효모식。
Objective To discuss the efficacy of community medical management model of bronchial asthma in children.Method Through community medical center and clinic, 230 cases of children with asthma were enrolled from the kunshan area, aged 0 to 12 year, to build a community medical management model of asthma according to the Global Initiative for Asthma requirements combined with the actul situation of the community,both pediatics and patients with parents participated in case identification, file creation, and long-term standardized management, with repeated medical asthma education, the micro letter, the telephone call and interactive, network of asthma among pediatrics, children and parents, a pediatrics-patient relationship as established. The time of standardized medication, data of re-visiting to the hospital, frequency of asthma attacks, antibiotic and β2 receptor antagonist use, medical expenses, and the effective approve of parents etc. Before and after the implementation of community medical management model were analyzed and compared.Result After implementation of community medical management mod, use of inhaled corticosteroids (75.8%) and oral leukotriene receptor antagonist(75.2%) was significantly higher compared with central and before management level(6.8%, 6.5%),P<0.01. The time of attacks of asthma(0.8 ±0.3), the days of use with antibiotics and β2 receptor antagonist(3.9±1.8) significantly decreased. The approve of treating efficacy was higher. The use of systemic corticosteroids(18.5%), was significantly lower than before implementation(70.4%), χ2=53.2,P<0.01. In this study, 28 cases(12.2%) was dropout, by culling, micro letter and network supervision of lost cases, made some children return to management, eventually the dropout rate was 7.8%(18). Conclusion Enrolling children with bronchial asthma into community medical management model should make the children adhere to the management treatment regularly and a standardized management.