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目的探讨移动医疗模式在学龄前哮喘患儿的随访管理中的作用。方法选择2015年9月-2016年2月符合哮喘诊断标准的学龄前患儿200例为研究对象,随机分为智能管理组和对照组,每组100例。智能管理组采用移动医疗模式,通过移动电话智能管理软件记录,软件每周根据评分系统统计并发送哮喘评估报告和建议,指导患儿调整治疗方案每周发送哮喘相关知识、评估报告和建议,指导患儿调整治疗方案;对照组采用哮喘日记管理模式,使用哮喘日记记录,每周由患儿家长根据学龄前儿童哮喘症状控制水平调整治疗方案。观察患儿日常哮喘症状(包括睡眠情况、咳嗽严重程度、夜间是否因哮喘憋醒、哮喘是否引起呼吸困难和影响日常活动),药物的使用情况,是否需要使用咳嗽应急缓解药,记录晨间第1秒用力呼气容积(FEV1)、第1秒用力呼气容积占预计值的百分比(FEV1%pred)和呼气高峰流量(PEFR),记录哮喘发作与就医情况,进行SF-12生活质量(QoL)生理评分(PCS)和心理评分(MCS),随访患儿家长综合满意度。结果入组6个月后,智能管理组患儿FEV1、FEV1%pred和PEFR均明显优于对照组,且明显优于入组前(P<0.05);智能管理组SF-12生活质量生理评分和综合满意度明显高于对照组,且SF-12生活质量PCS和MCS均明显高于入组前(P<0.05);观察6个月期间,智能管理组患儿哮喘急性发作次数和急诊就医次数明显低于对照组(P<0.05)。结论移动医疗模式应用到学龄前哮喘患儿随访管理,有利于哮喘控制,改善哮喘患儿的呼吸,减少哮喘急性发作,提高生活质量,且患儿及家长满意度高。
Objective To explore the role of mobile medical model in follow-up management of children with preschool asthma. Methods A total of 200 preschoolers who met the diagnostic criteria of asthma from September 2015 to February 2016 were selected as study subjects and randomly divided into two groups: control group (n = 100) and control group (n = 100). The intelligent management group adopts the mobile medical model and records the information through the intelligent management software of the mobile phone. The software collects and sends asthma assessment reports and suggestions on a weekly basis according to the scoring system, and instructs the children to adjust the treatment program to send weekly asthma knowledge, assessment reports and suggestions and guidance The treatment regimen was adjusted in children. In the control group, the asthma diary management mode was used. Asthma diary records were used to adjust the treatment regimen weekly according to the level of asthma control in preschool children. Observe the daily asthma symptoms in children (including sleep condition, severity of cough, whether asthma is aroused at night, whether asthma causes dyspnea and affect daily activities), the use of drugs, the need to use cough emergency relief drugs, (FEV1), FEV1% pred, and peak expiratory flow (PEFR) of 1 second were recorded. The asthma attacks and medical conditions were recorded, and the quality of life of SF-12 QoL) Physiological Score (PCS) and Psychological Score (MCS). The parents’ comprehensive satisfaction was followed up. Results Six months after enrollment, the FEV1, FEV1% pred and PEFR scores in the intelligent management group were significantly better than those in the control group (P <0.05), and the scores of SF-12 quality of life in the intelligent management group And overall satisfaction were significantly higher than the control group, and the quality of life PCS and MCS SF-12 were significantly higher than before (P <0.05); observed 6 months, intelligent management of children with acute asthma attack and emergency medical treatment The number of times was significantly lower than that of the control group (P <0.05). Conclusion The application of mobile medical model to follow-up management of preschool-aged asthmatic children is beneficial to asthma control, improvement of respiration in asthmatic children, reduction of acute asthma attacks, improvement of quality of life, and high satisfaction of children and parents.