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題 名 | 哮喘或慢性阻塞性肺疾之門診患者不正確使用霧氣治療之評估=Evaluation of Misuse of Aerosol Therapy by Patients with Asthma or COPD in Outpatient Settings |
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作 者 | 李珮菁; 賴瑞生; 盧朝勇; | 書刊名 | 胸腔醫學 |
卷 期 | 15:4 2000.12[民89.12] |
頁 次 | 頁189-194 |
分類號 | 415.428 |
關鍵詞 | 霧氣治療; 定量噴霧吸入器; 乾粉式吸入器; Aerosol therapy; Metered-dose inhaler; Dry-powder inhaler; |
語 文 | 中文(Chinese) |
中文摘要 | 霧氣治療對喘患者是相當經濟、方便且有效的治療。治療效果的好壞取決於吸入器的設計和人為操作的正確性。常用之吸入器有兩種:1)定量噴霧吸入器(metered-dose inhaler,MDI);與2)乾粉式吸入器(dry-power inhaler,DPI)。有研究報告指出患者常有明顯誤用吸入器的情形。本研究之目的是在評估患有哮喘或慢性阻塞性肺疾之門診患者對於定量噴霧吸人器與乾粉式吸入器是否能正確的操作。 研究對象為南部某醫學中心胸腔科門診患有哮喘或慢性阻塞性肺疾之患者75人。實施方法為觀察與記錄患者對於定量噴霧吸入器與乾粉式吸入器(包括準納乾粉定量吸器,Accuhaler及易吸乾粉定量吸入器,Easyhaler)的各個操作步驟,能否正確達成,而予以評分。並依據作評比將受測者區分為良、普與不好之等級,來比較不同吸入器的差異。 結果顯示有相當高比率的患者(定量噴霧吸入器76%,乾粉式吸入器58%)未能良好的操作各種吸入器。常見之共同錯誤步驟是在吸藥前未能將氣儘量吐出以及藥後未能閉氣;操作定量噴霧吸入器另外之缺點在於未能達到手啟動-吸氣協調;而乾粉式吸入器則是未能快速的深吸氣。統計上,患者能良好操作乾粉式吸入器(Accuhaler)的比率比其使用定量噴霧吸入器有顯著的增加(48%vs24%, p=0.002);反之,在操作不好的患者中,其使用定量噴霧吸入器的比率比使用乾粉式吸入器(Accuhaler)者亦有顯著的增加(17%vs7%, P=0.044)。 要正確使用吸入器需仰賴於正確的衛教示範與個人的反覆練習。研究顯示氣喘患者對於吸入器的操作確有加強的必要。面對推陳出新的吸器,醫護人員當把握各進修機會充實霧氣治療的技能,才能提供患者正確的衛教,而獲得最有效的治療。 |
英文摘要 | Aerosol therapy is an economic, convenient and effective treatment for patients with dyspnea. The efficiency of the aerosol therapy depends on the design of the inhalers and correct performance of the patients. The major inhaler devices include 1) metered-dose inhaler (MDI), and 2) dry-power inhaler (DPI). Many studies have demonstrated the m issue of aerosol therapy by the patients. The aim of present investigation was to evaluate the knowledge and skill of the patients with dyspnea in the proper use of aerosol therapy. Seventy-five patients of asthma or COPD in the chest medicine clinic of a medical center in Southern Taiwan were included. They were assessed as to their proficiency in the use of MDI(including lpradol and Atrovent) or DPI(including Accuhaler and Easyhaler). We recorded correct steps of each inhaler achieved by the patients and divided the patients into three groups: good, fair and poor, according of the achievement. Statistical analysis was carried out to evaluated the difference between inhaler. The study confirms that a large percentage of patients used MDI(76%) or DPI(58%) incorrectly. The most common problems were a) failing to keep breath-holding after inspiration, and b) failing to exhale out before drug inhalation. The other major problem in MDI was discordance between actuating and breathing; however, the problem in DPI was failing to breathe-in forcefully and deeply. Statistically, the incidence of good score in the performance of DPI (Accuhaler) was much higher than that in the MDI performance (48% vs 24%, p=0.002). Similarly, significant difference was also demonstrated between MDI and DPI(Accuhaler) performance in the groups of poor score.(MDI 17% vs DPI 17%, p=0.044) Both correct demonstration and repeated practice are necessary to achieve proper performance of the inhalers. The physicians and nurses should try hard to learn each kind of new inhaler devices before the can demonstrate correctly to the patients. |
本系統中英文摘要資訊取自各篇刊載內容。