延续性护理对儿童哮喘家庭管理效果的研究

梁娟 白博 胡雪慧 张美霞 汪萍

[摘要] 目的 研究延续护理对儿童哮喘家庭管理效果的影响。 方法 选择2016年5～12月空军军医大学西京医院儿科门诊就诊的中度持续性哮喘患儿60例，采用随机数字表法分为观察组和对照组，每组各30例。对照组患儿在院外接受一般常规护理干预措施，观察组患儿进行延续性健康教育的护理服务。干预6个月后，观察哮喘患儿呼吸峰流速占预计值百分比（PEF%）、第1秒用力呼气容积占预计值百分比（FEV1%）、儿童哮喘生命质量问卷评分（PAQLQ）、哮喘急性发作次数、再就诊次数、哮喘症状评分等指标的变化。 结果 护理干预6个月后，两组PEF%和FEV1%均较干预前显著增加，差异有统计学意义（P < 0.05）。观察组的PEF%和FEV1%、PAQLQ评分明显高于对照组，差异有统计学意义（P < 0.05）。观察组哮喘急性发作次数、再就诊次数、哮喘症状积分显著低于对照组，差异有统计学意义（P < 0.05）。 结论 延续性护理对儿童哮喘管理效果显著，可有效减少哮喘患儿急性发作频率，提高生命质量，值得临床推广应用。

[关键词] 延续性护理；哮喘；儿童；效果

[中图分类号] R725.6 [文献标识码] A [文章编号] 1673-7210（2018）10（b）-0141-04

[Abstract] Objective To study the effects of continuity care on the family management of asthma in children. Methods From May to December 2016， in Paediatrics Outpatient， Xijing Hospital， Air Force Medical University， 60 children with moderate persistent asthma were selected， they were divided into observation group and control group by random number table method， with 30 cases in each group. The control group was given general nursing interventions， the observation group was given continuing health education nursing services outside the hospital. Six months after the intervention， the changes of peak expiratory flow predicted values （PEF%）， forced expiratory volume in one second to forced vital capacity ratio （FEV1%）， pediatric asthma quality of life questionnaire （PAQLQ） score， the times of acute exacerbations of asthma and revisit and the scores of asthma symptom in asthmatic children were observed. Results Six months after the intervention， PEF% and FEV1% in two groups were significantly higher than those before the intervention， the differences were statistically significant （P < 0.05）. The PEF%， FEV1%， and PAQLQ scores in the observation group were significantly higher than the control group， the differences were statistically significant （P < 0.05）. The times of asthma attacks and revisits， asthma symptom scores in the observation group were significantly lower than the control group， the differences were statistically significant （P < 0.05）. Conclusion Continuity care has significant effect on children asthma management， it can effectively reduce the frequency of acute seizures and improve the quality of life in children with asthma， it is worthy of clinical application.

[Key words] Continuity care； Asthma； Children； Effect

支氣管哮喘是一种终身性慢性气道炎症性疾病，病情反复且发病率高，目前治疗哮喘的最重要的方法是长期规范化用药，但仅可降低复发概率[1-2]。诱发和加重哮喘的危险因素复杂多样且无法彻底消除，患儿家长缺乏哮喘相关知识，对疾病的重视度不够，对于激素治疗的副作用过分恐惧，依从性差等因素，常导致哮喘反复发作，严重影响患儿身心健康[3-5]。长期、持续、规范的护理管理可增强患儿和家长的家庭护理能力，减少发作次数，提高患儿生命质量，改善肺功能。传统的医疗治疗关系是从患者入院开始至出院结束，部分患者出院后便接受社区医疗服务甚至自己中止医疗，从而失去了医疗的连续性。……