Pedersen S, Frost L, Arnfred T
Allergy. 1986 Feb;41(2):118-24. doi: 10.1111/j.1398-9995.1986.tb00287.x.
256 asthmatic children receiving regular inhalation therapy demonstrated how they used their inhalers. Pulmonary function measurements (PFM) were made before and after the demonstrations, and errors in technique were recorded. 242 children had reversible airway obstruction on the day of study. In only 109 (45%) did the inhalation result in an increase in FEV1 greater than or equal to 15% (efficient technique). An efficient inhalation technique was found in 46% of children who demonstrated a pressurized aerosol, 59% who demonstrated a tube spacer aerosol and 46% who demonstrated a rotahaler, and the frequency of efficient technique varied from 17% to 84% between six different groups of instructors. 87% of children controlled and 25% not controlled with PFM at the time of prescription had an efficient technique. Children under 6 years had a more inefficient and a more faulty technique than older children, but otherwise age did not influence the result. Neither was time since instruction of any importance for efficiency or number of errors. The errors recorded that seem to influence efficiency most were: coordination problems, rapid inspirations, ceasing to inspire when the aerosol was fired, and inhalation through the nose. The results emphasize the paramount importance of clear instructions and control of inhalation technique at the time the treatment is prescribed.
256名接受常规吸入治疗的哮喘儿童演示了他们如何使用吸入器。在演示前后进行了肺功能测量（PFM），并记录了技术错误。242名儿童在研究当天存在可逆性气道阻塞。只有109名（45%）儿童的吸入操作使第一秒用力呼气容积（FEV1）增加大于或等于15%（有效技术）。在演示使用压力定量气雾剂的儿童中，46%采用了有效吸入技术；演示使用储雾罐气雾剂的儿童中，59%采用了有效技术；演示使用旋转式吸入器的儿童中，46%采用了有效技术。在六组不同的指导人员中，有效技术的频率从17%到84%不等。在处方时肺功能测量显示得到控制的儿童中有87%采用了有效技术，未得到控制的儿童中有25%采用了有效技术。6岁以下儿童的技术效率较低且错误较多，但除此之外年龄并未影响结果。自接受指导后的时间对效率或错误数量也没有任何影响。记录显示，最影响效率的错误是：协调问题、吸气过快、气雾剂喷出时停止吸气以及经鼻吸气。结果强调了在开出处方时明确指导和控制吸入技术的至关重要性。
