Johnson D H, Robart P
Pulmonary and Critical Care Unit, Massachusetts General Hospital, Boston, MA 02114, USA.
Respir Care. 2000 Oct;45(10):1182-7.
Assess the role of evaluation, instruction, and use of spacers by patients using metered dose inhalers (MDIs) in the home.
Patients (age 64 +/- 15 y [mean +/- standard deviation]) receiving home visits by respiratory care practitioners for oxygen therapy had their inhaler technique checked.
A detailed acceptable/unacceptable check-off list was used with 172 patients to evaluate inhaler technique. Patients with poor technique were given instruction and their technique was reassessed. A subgroup of 43 patients was reevaluated on up to 3 visits.
Only 18% of patients using MDIs without spacers were rated acceptable with the detailed check list. Instruction improved inhaler technique, but few patients with initially poor technique without spacers developed fully acceptable technique. Improvements made immediately following instruction were lost when patients were reevaluated months later. Few patients received spacers after they were recommended. Technique was markedly better with spacers. Most patients (76%) had initially proper technique with spacers, and most who had poor technique could learn and retain proper technique.
Improper inhaler technique without spacers is very common among patients evaluated at home, and the majority of patients were unable to learn and retain proper technique. Most patients would benefit from using spacers with their inhalers. = 33 for first and second. = 26 for third. FRC = functional residual capacity. RV = residual volume. TLC = total lung capacity.¿., Fig. 3¿/PICK;0404f3;;;page;;;;yes;1¿ ¿/GRAPH;rk1000404003;comptd;;center;stack¿ ¿/CAPT;;;center;stack;2112n¿
评估在家中使用定量吸入器（MDIs）的患者对吸入器的评估、指导及储雾罐使用情况的作用。
接受呼吸治疗师家访以进行氧疗的患者（年龄64±15岁[均值±标准差]）接受了吸入器技术检查。
对172名患者使用一份详细的可接受/不可接受检查表来评估吸入器技术。技术不佳的患者接受指导并重新评估其技术。43名患者的亚组接受了多达3次的重新评估。
在使用不带储雾罐的MDIs的患者中，只有18%在详细检查表中被评为可接受。指导改善了吸入器技术，但最初技术不佳且未使用储雾罐的患者中很少有人能形成完全可接受的技术。指导后立即出现的改善在数月后患者重新评估时消失。推荐使用储雾罐后，很少有患者使用。使用储雾罐时技术明显更好。大多数患者（76%）最初使用储雾罐时技术正确，大多数技术不佳的患者能够学习并保持正确技术。
在家中接受评估的患者中，不使用储雾罐的吸入器技术不当非常普遍，大多数患者无法学习并保持正确技术。大多数患者使用带储雾罐的吸入器会受益。= 第一次和第二次为33。= 第三次为26。FRC = 功能残气量。RV = 残气量。TLC = 肺总量。¿., 图3¿/PICK;0404f3;;;页面;;;;是;1¿ ¿/图形;rk1000404003;comptd;;居中;堆叠¿ ¿/标题;;;居中;堆叠;2112n¿
