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妊娠期哮喘知识、护理及转归:QAKCOP研究

2018/04/09

   摘要
   哮喘是影响妊娠的最常见的慢性病。优化孕期哮喘管理对母亲和婴儿的健康都是至关重要的。这项研究的主要目标是评估患者对哮喘的认识,哮喘护理水平,以及富裕国家在孕产妇和胎儿保健的巨大改善基础上哮喘孕产妇及胎儿的转规。第二个目标是确定影响哮喘控制的障碍。这是一项面对面前瞻性横断面调查,研究对象为医生诊断为哮喘的80名孕妇。约56%的患者报告说,他们在怀孕期间哮喘控制恶化,其中52.3%在第三孕期感觉恶化。大约65%的患者在怀孕期间哮喘没有控制,64.4%的患者吸入技术是不正确的。只有38%的患者知道控制和缓解哮喘药物之间的差异,12.7%的患者接受了书面哮喘行动计划,17%在过去的5年里有肺功能检查,有3.8%在家使用峰流速仪检测。30%的哮喘患者缺乏正确的哮喘药物知识,19%的患者担心吸入糖皮质激素的副作用。没有财务原因被报告。妊娠总数、对哮喘药物的不良感知、分娩期间哮喘恶化和哮喘控制不佳之间有显著的相关性。先兆子痫和先天畸形的发病率高于全国报告的一般人群。孕产妇保健和社会经济状况的巨大改善似乎并没有成为全球公认的孕期哮喘护理的障碍。重要战略需要被采取。
 
                         (中日友好医院呼吸与危重症一部 李红雯 摘译 林江涛审校)
(Chron Respir Dis. 2018 Jan 1:1479972318767719. doi: 10.1177/1479972318767719. [Epub ahead of print])
 



Asthma knowledge, care, and outcome during pregnancy: The QAKCOP study.
 
Ibrahim WH, Rasul F, Ahmad M.
 
Abstract
Asthma is the most common chronic medical condition affecting pregnancy. Optimizing asthma management in pregnancy is paramount for the well-being of both the mother and the baby. The primary objectives of this study were to assess patient's knowledge about asthma, the level of asthma care, and fetal and maternal outcomes among pregnant asthmatic women in this wealthy country with tremendous improvement in maternal and fetal health care. The secondary objective was to identify barriers to asthma control. This was a cross-sectional, face-to-face, prospective study of 80 pregnant women with physician-diagnosed asthma. About 56% of patients reported worsening of their asthma control during pregnancy, of which 52.3% felt this worsening in the third trimester. About 65% of patients had uncontrolled asthma during their pregnancy, and inhaler technique was incorrect in 64.4%. Only 38% of patients knew the difference between controller and reliever asthma medications, 12.7% of patients had received written asthma action plan, 17% had a spirometry done in the previous 5 years, and 3.8% had peak expiratory flow meter at home. The main reasons for uncontrolled asthma were lack of knowledge about right asthma medications in 30% and fear of side effects of inhaled corticosteroids in 19% of patients. No financial reason was reported. Significant associations between total number of pregnancies, poor perception of asthma medications, asthma exacerbation during delivery and poor asthma control were observed. Preeclampsia and congenital anomalies occurred at higher rates than previously reported among general population in this country. The tremendous improvements in maternal health care and socioeconomic status do not seem to be a barrier to the globally recognized poor asthma care in pregnancy. Important strategies are much needed.


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