Practice of standardized management of allergic rhinitis immunotherapy clinics for pediatric patients

doi:10.3761/j.issn.0254-1769.2020.01.016

Abstract

Abstract:

Objective To implement standardized management of allergic rhinitis immunotherapy clinics for pediatric patients and explore its effects. Methods 101 pediatric patients with allergic rhinitis immunotherapy were selected in a tertiary hospital from January 2017 to January 2018 by convenience sampling. Integrated management team was established;new communication methods between patients and medical staff were established through newly developed specific immunotherapy APP platform;continuing nursing for patients was performed by a series of standardized management. Effects on symptom control,quality of life and level of family management were analyzed Results The VAS score of nasal congestion in pediatric patients decreased from（8.23±1.15） to（4.07±2.35）;the nasal resistance TR decreased from（0.27±0.14）Pa/（cm ³·s） to （0.15±0.08）Pa/（cm ³·s）;the total quality of life was reduced from（92.67±5.17） to （66.54±4.86）;the total score of family management scale was increased from（151.20±5.75） to （189.05±5.97） after one-year standardized management. The differences were statistically significant（P<0.05）. Conclusion The standardized management of allergic rhinitis immunotherapyclinic for pediatric patients can effectively improve the compliance of pediatric patients and parents,improve the control level of rhinitis,reduce family pressure and improve family function and quality of life.

Key words: Rhinitis, Allergic, Perennial, Outpatient Medical Service, Benchmarking, Health Services Administration, APP Platform, Pediatric Nursing

摘要：

目的开展儿童变应性鼻炎免疫治疗门诊医护一体规范化管理并探讨其效果。方法采用方便抽样法,选取2017年1月—2018年1月在某三级甲等医院鼻炎专科门诊接受皮下免疫治疗的101例患儿作为研究对象,成立免疫治疗门诊规范化管理团队,运用新开发的特异性免疫治疗APP平台,建立护患互动交流新模式,通过一系列规范管理对患儿实施延续性护理。分析该管理模式对患儿鼻炎症状的控制、生活质量、家庭管理水平的影响。结果规范化管理1年后,患儿的鼻塞视觉模拟量表评分由（8.23±1.15）分降至（4.07±2.35）分;鼻阻力值由（0.27±0.14） Pa/（cm ³·s）降至（0.15±0.08） Pa/（cm ³·s）;生存质量总分由（92.67±5.17）分降至（66.54±4.86）分;家庭管理量表总分由（151.20±5.75）分提升至（189.05±5.97）分,差异具有统计学意义（P<0.05）。结论儿童变应性鼻炎门诊规范化管理能有效提高患儿及家长的依从性、提高患儿鼻炎控制水平、降低家庭压力、提高家庭功能、改善其生活质量。

关键词: 鼻炎, 变应性, 常年性, 门诊医疗, 规范, 卫生服务管理, APP平台, 儿科护理学

YAN Haiou, YANG Mei, JIANG Qin. Practice of standardized management of allergic rhinitis immunotherapy clinics for pediatric patients[J]. Chinese Journal of Nursing, 2020, 55(1): 96-101.

严海鸥, 杨梅, 姜琴. 儿童变应性鼻炎免疫治疗门诊规范化管理的实践[J]. 中华护理杂志, 2020, 55(1): 96-101.

Figures/Tables 2

References 20

[1]	Kim JL, Brisman J, Aberg MA , et al. Trends in the prevalence of asthma,rhinitis,and eczema in 15 year old adolescents over an 8 year period[J]. Respir Med, 2014,108(5):701-708.
[2]	李科琼 . 过敏性鼻炎儿童生存质量调查及黄芪甲苷对过敏性鼻炎作用机制初探[D]. 重庆:重庆医科大学, 2016.
[3]	中华医学会中华耳鼻咽喉头颈外科杂志编辑委员会. 变应性鼻炎的诊治原则和推荐方案[Z]. 兰州, 2004: 37-39.
[4]	王成硕, 王向东, 张伟 . 变应性鼻炎屋尘螨变应原皮下免疫治疗的远期疗效研究[J]. 中华耳鼻咽喉头颈外科杂志, 2012,47(10):804-808.
[5]	Hellings PW, Pugin B, Mariën G , et al. Stepwise approach towards adoption of allergen immunotherapy for allergic rhinitis and asthma patients indaily practice in Belgium[J]. Clin Transl Allergy, 2019,9:1.
[6]	王晓龙, 汪茵, 胡林涛 . 尘螨过敏原皮下免疫治疗脱失情况及原因分析[J]. 护理学报, 2016,23(14):35-37.
[7]	林静, 许渝 . 儿童皮下特异性免疫治疗终止的原因分析与护理[J]. 中华护理杂志, 2014,49(2):230-232.
[8]	中华耳鼻咽喉头颈外科杂志编辑委员会鼻科组, 中华医学会耳鼻咽喉头颈外科学分会鼻科学组. 变应性鼻炎诊断和治疗指南(2015)[J]. 中华耳鼻咽喉头颈外科杂志, 2016,51(1):6-24.
[9]	赵延明, 张媛, 张罗 . 慢性鼻窦炎患者和医生症状视觉模拟量表评分的差异性研究[J]. 临床耳鼻咽喉头颈外科杂志, 2015,29(23):2030-2034.
[10]	王学艳, 任华丽, 石海云 , 等. 变应性鼻炎症状评分及视觉模拟量表适用性比较[J]. 中国耳鼻咽喉头颈外科, 2012, 19(11), 11:609-611.
[11]	陈曦, 陈东兰, 孙建军 . 成年人鼻声反射与鼻阻力测量的正常参数[J]. 临床耳鼻咽喉头颈外科杂志, 2011,25(14):630-632,635.
[12]	Clement PA . Committee report on standardization of rhinomanometry[J]. Rhinology, 1984,22(3):151-155.
[13]	Vogt K, Bachmann-Harildstad G, Lintermann A , et al. The new agreement ofthe international RIGA consensus conference on nasal airway function tests[J]. Rhinology, 2018,56(2):133-143.
[14]	Juniper EF, Guyatt GH . Development and testing of a new measure of health status for clinical trials in rhinoconjunctivitis[J]. Clin Exp Allergy, 1991,21(1):77-83.
[15]	张莹 . 慢性病患儿家庭管理方式及家庭干预效果研究[D]. 北京:北京协和医科大学, 2009.
[16]	Lima-Rodríguez JS, Lima-Serrano M, Domínguez-Sánchez I . Psy-chometric properties of an instrument to measure family disease management[J]. Int J Clin Health Psychol, 2015,15(3):253-264.
[17]	蒋玉梅, 贺杨宇, 赵宇 , 等. 变应性鼻炎患儿持续院外免疫治疗不依从原因分析及对策[J]. 护理学报, 2013,20(24):66-67.
[18]	张芬, 殷勇, 沈南平 , 等. 儿童哮喘门诊规范化管理的实践[J]. 中华护理杂志, 2018,53(11):1347-1352.
[19]	王英杰, 李杨 . 以家庭为中心的教育干预对活动性癫痫患儿服药依从性及健康状况的影响[J]. 中华护理杂志, 2015,50(10):1157-1162.
[20]	刘花艳, 谷利凤, 朱丽辉等. 癫痫患儿家庭管理干预的效果研究[J]. 中华护理杂志, 2017,52(10):1157-1162.