家庭口服皮质类固醇预防急诊就诊和住院：是否遵循了美国指南？
2010/12/31
摘要
背景：在家庭哮喘恶化治疗中，自1991年以来，NIH/NHLBI指南就推荐采用口服皮质类固醇（OCS）进行治疗。作为书面行动计划的常规组成部分，家庭OCS治疗与急诊（ED）就诊和住院次数下降及死亡率下降相关。
方法：通过PubMed, EMBASE和SCOPUS数据库，查询1991年至2009年的英语相关文献，对研究哮喘恶化后家庭治疗中对国家指南依从性的文献进行评价。
结果：我们的结果显示，某些研究揭示，一小部分(<3-26%)患者在急诊就诊前，在家采用OCS来治疗哮喘恶化。其他研究显示，书面行动计划的使用率极低，这表明在哮喘恶化的家庭治疗中，缺少OCS治疗。
结论：尽管证据显示，国家和国际指南推荐的在家OCS治疗有助于降低急诊就诊次数和住院次数，但在家采用OCS治疗哮喘恶化的接受程度仍然较低。有必要采取措施，确保家庭使用OCS，使其作为书面行动计划的一部分，以预防哮喘恶化导致的急诊就诊和住院。
（苏楠 审校）
J Asthma. 2010 Dec;47(10):1123-1127. Epub 2010 Nov 1.
Preventing Emergency Department Visits and Hospitalizations for Asthma by Use of Oral Corticosteroids at Home: Are We Adhering to National Guidelines?
Self TH, Chrisman CR, Jacobs AR, Vo NH, Winton JC.
University of Tennessee Health Science Center and Methodist University Hospital, Memphis, TN, USA.
Abstract
Background: Oral corticosteroids (OCS) in the home management of asthma exacerbations have been recommended in the NIH/NHLBI guidelines since 1991. As a routine component of written action plans, OCS treatment at home is associated with reduced emergency department (ED) visits and hospitalizations as well as decreased mortality.
Methods: A literature search of English language journals from 1991 to 2009 was performed using several databases, including PubMed, EMBASE, and SCOPUS. We assessed studies that evaluated adherence to national guidelines for home management of asthma exacerbations.
Results: Our review of the literature found that several studies reveal that a small percentage (<3-26%) of patients are receiving OCS at home to manage asthma exacerbations prior to an ED visit. Additional studies were found showing very low use of written action plans, strongly suggesting lack of OCS for home management of asthma exacerbations.
Conclusions: Despite evidence of reduced ED visits and hospitalizations and the recommendations of national and international guidelines, the home use of OCS in managing asthma exacerbations remains unacceptably low. New strategies are needed to ensure home use of OCS as part of written action plans to prevent ED visits and hospitalizations for asthma exacerbations.
J Asthma. 2010 Dec;47(10):1123-1127. Epub 2010 Nov 1.
背景：在家庭哮喘恶化治疗中，自1991年以来，NIH/NHLBI指南就推荐采用口服皮质类固醇（OCS）进行治疗。作为书面行动计划的常规组成部分，家庭OCS治疗与急诊（ED）就诊和住院次数下降及死亡率下降相关。
方法：通过PubMed, EMBASE和SCOPUS数据库，查询1991年至2009年的英语相关文献，对研究哮喘恶化后家庭治疗中对国家指南依从性的文献进行评价。
结果：我们的结果显示，某些研究揭示，一小部分(<3-26%)患者在急诊就诊前，在家采用OCS来治疗哮喘恶化。其他研究显示，书面行动计划的使用率极低，这表明在哮喘恶化的家庭治疗中，缺少OCS治疗。
结论：尽管证据显示，国家和国际指南推荐的在家OCS治疗有助于降低急诊就诊次数和住院次数，但在家采用OCS治疗哮喘恶化的接受程度仍然较低。有必要采取措施，确保家庭使用OCS，使其作为书面行动计划的一部分，以预防哮喘恶化导致的急诊就诊和住院。
（苏楠 审校）
J Asthma. 2010 Dec;47(10):1123-1127. Epub 2010 Nov 1.
Preventing Emergency Department Visits and Hospitalizations for Asthma by Use of Oral Corticosteroids at Home: Are We Adhering to National Guidelines?
Self TH, Chrisman CR, Jacobs AR, Vo NH, Winton JC.
University of Tennessee Health Science Center and Methodist University Hospital, Memphis, TN, USA.
Abstract
Background: Oral corticosteroids (OCS) in the home management of asthma exacerbations have been recommended in the NIH/NHLBI guidelines since 1991. As a routine component of written action plans, OCS treatment at home is associated with reduced emergency department (ED) visits and hospitalizations as well as decreased mortality.
Methods: A literature search of English language journals from 1991 to 2009 was performed using several databases, including PubMed, EMBASE, and SCOPUS. We assessed studies that evaluated adherence to national guidelines for home management of asthma exacerbations.
Results: Our review of the literature found that several studies reveal that a small percentage (<3-26%) of patients are receiving OCS at home to manage asthma exacerbations prior to an ED visit. Additional studies were found showing very low use of written action plans, strongly suggesting lack of OCS for home management of asthma exacerbations.
Conclusions: Despite evidence of reduced ED visits and hospitalizations and the recommendations of national and international guidelines, the home use of OCS in managing asthma exacerbations remains unacceptably low. New strategies are needed to ensure home use of OCS as part of written action plans to prevent ED visits and hospitalizations for asthma exacerbations.
J Asthma. 2010 Dec;47(10):1123-1127. Epub 2010 Nov 1.
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无泵体外人工肺辅助技术在治疗严重、难治性哮喘持续状态中的作用
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鼻内给予皮质类固醇对伴有轻度哮喘的过敏性鼻炎患者哮喘控制和生活质量的影响
