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Objective·To explore the effect of continuous nursing based on EMS[environment management(E),medicine direction(M)and self monitoring(S)]management mode on the preschool children with asthmatic diseases.Methods·A total of 67 children aged 0 to 6 years with asthmatic diseases admitted to the Department of Respiratory Medicine,Shanghai Children's Hospital,Shanghai Jiao Tong University School of Medicine from December 2019 to November 2020 were selected and divided into observation group(33 cases)and control group(34 cases)according to the random number table method,with 3 cases lost,and finally 32 cases in each group.The observation group received continuous nursing care based on EMS management mode,while the control group received routine care and discharge follow-up through the telephone.The children in the two groups were followed up at 1,3,and 6 months after discharge to evaluate the results of Test for Respiratory and Asthma Control in Kids(TRACK)and wheezing recurrence;Medication Adherence Report Scale for Asthma(MARS-A)and Nursing Job Satisfaction Questionnaire were used to evaluate medication adherence and nursing job satisfaction 6 months after discharge.Results·There was no significant difference in demographic characteristics and clinical baseline characteristics between the two groups.Repeated measures analysis of variance showed that effects of time,groups and the interaction of groups×time on the total score of TRACK were statistically significant.The total scores of TRACK in the observation group were significantly higher than those in the control group at 1,3,and 6 months after discharge(P=0.000).The total scores of TRACK in the two groups gradually increased with time(P=0.000).The recurrence rates of wheezing in the observation group were 25.0%,18.7%,and 9.4%at 1,3,and 6 months after discharge,which were significantly lower than those in the control group(50.0%,43.7%,and 31.3%,respectively,P<0.05).Generalized estimating equation analysis showed that there was a statistically significant difference between the two groups(P=0.013),and the intervention effect of the observation group was better than that of the control group(OR=0.292).The MARS-A score of the observation group was 4.519±0.395 at 6 months after discharge,which was significantly higher than that of the control group(3.994±0.739,P=0.001).The nursing job satisfaction of the observation group was significantly higher than that of the control group(P=0.000).There was a moderate positive correlation between the MARS-A score and the nursing job satisfaction(r=0.389,P=0.001).Conclusion·Continuous nursing based on EMS management mode can significantly improve the medication compliance and wheezing control level of the preschool children with asthmatic diseases,significantly reduce the recurrence rate of wheezing,and improve the nursing satisfaction.
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OBJECTIVE One of the aims of this study is to know the morbidity of LPR in children with chronic cough. And also to explore the relationship among the morbidity of LPR,the pH value in the laryngopharynx, the frequency of ref lux events,the duration of ref lux with age, sex, position, allergy and so on. METHODS A retrospective analysis was conducted on 185 children with pH monitoring in Shanghai Children's Hospital from February 1, 2015 to August 31, 2018. The pH monitoring was taken in those patients for the reasons of chronic cough, and can't be remitted by regular treatment. The sex, diagnosis, allergy and the results of 24h pH monitoring were recorded. RESULTS A total of 185 cases were reviewed. 60％(111/185) were boys and 40％(74/185) were girls. LPR was present in 36.8％ of all the children(68/185). Compared with older patients, children younger than 12m had significant higher morbidity of LPR. Higher morbidity of LPR was also found in patients with food allergy. CONCLUSION LPR has high morbidity in children. In our study, 36.8％ of the chronic cough children combined with LPR. Children younger than 12m had higher morbidity of LPR. There may be a correlation between LPR and food allergy in children.
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Objective To explore the clinical characteristics of bronchial foreign bodies in children. Method The clinical data of 147 children with exogenous bronchial foreign body admitted between 2014 and 2016 were retrospectively analyzed, and the applications of rigid bronchoscopy and flexible bronchoscopy for foreign body extraction were compared. Results All 147 cases were diagnosed with bronchial foreign bodies by chest CT, chest X-ray or respiratory endoscopy. In these cases (104 boys and 43 girls) , 87.8％ of whom were aged 1-3 years, the most common types of bronchial foreign body were nuts. The common complications were bronchial mucosal granulation tissue hyperplasia (88 cases, 59.86％) , pneumonia (56 cases, 38.1％) , atelectasis (15 cases, 10.2％) , respiratory failure (14 cases, 9.52％) and bronchiectasis (4 cases, 2.72％) respectively. The foreign bodies were removed by soft bronchoscopy in 106 cases which were successfully removed at one time in 100 cases. Respiratory endoscopy was undergone in 141 cases to remove foreign bodies, and flexible bronchoscope was applied in 106 (72.11％) cases and foreign bodies were successfully removed in first attempt in 100 cases (94.34％) . Rigid bronchoscope was used in 35 cases (23.81％) and foreign bodies were successfully removed in first attempt in 28 cases (80.0％) . Conclusion The majority of children with bronchial foreign body are male. Both flexible and rigid bronchoscopes can remove exogenous foreign bodies in the lower respiratory tract.
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Objective To explore the requirement of on-site first-aid knowledge of sever hand in workers,and evaluate the corresponding training effect.Methods Through the questionnaire survey in 120 workers,making the sever hand on-site first-aid knowledge courseware,during the one-year training,we sent two teachers to give lectures,provided tools for workers to practice every week.At the end of training,we examined workers through the written and practical examination and made the statistical analysis.Results 97.5％ workers presented training needs,54.2％ workers had mastered sever hand onsite first-aid knowledge compared with that before training.Conclusions Workers have higher rates of accidents,however,there is lack of knowledge of first aid in general,and they have training requirement.We take the form of participative training and give the workers both theoretical and technique training,and this can effectively improve the awareness rate of on-site sever hand first-aid knowledge and technique.