Kang S W, Bach J R
Department of Physical Medicine and Rehabilitation, University of Medicine and Dentistry of New Jersey-The New Jersey Medical School, Newark, NJ, USA.
Chest. 2000 Jul;118(1):61-5. doi: 10.1378/chest.118.1.61.
To investigate the effect of deep lung insufflations on maximum insufflation capacities (MICs) and peak cough flows (PCFs) for patients with neuromuscular disease.
Forty-three patients with neuromuscular disease were trained in stacking delivered volumes of air to deep lung insufflation and were prescribed a program of air stacking once their vital capacities (VCs) were noted to be < 2,000 mL. VC, MIC, and unassisted and assisted PCF were monitored. The initial data were compared with the highest MICs subsequently achieved. For those patients whose MICs only decreased, we compared the initial data with the most recent data.
The MICs increased from (mean +/- SD) 1,402 +/- 530 mL to 1,711 +/- 599 mL (p < 0.001) for 30 patients and only decreased for 13 patients. Patients for whom the MICs increased also had a significant increase in assisted PCF from 3.7 +/- 1.4 to 4.3 +/- 1.6 L/s (p < 0.05) despite having somewhat decreasing VCs and unassisted PCFs.
With training, the capacity to stack air to deep insufflations can improve despite progressive neuromuscular disease. This can result in increased cough effectiveness.
探讨深肺吹气对神经肌肉疾病患者最大吹气容量（MICs）和咳嗽峰值流速（PCFs）的影响。
对43例神经肌肉疾病患者进行将呼出气体量叠加至深肺吹气的训练，一旦其肺活量（VCs）被记录为<2000 mL，即给他们制定一个气体叠加方案。监测VC、MIC以及自主和辅助PCF。将初始数据与随后达到的最高MICs进行比较。对于那些MICs仅下降的患者，我们将初始数据与最新数据进行比较。
30例患者的MICs从（均值±标准差）1402±530 mL增加至1711±599 mL（p<0.001），仅有13例患者下降。MICs增加的患者，尽管VCs和自主PCF有所下降，但其辅助PCF也从3.7±1.4显著增加至4.3±1.6 L/s（p<0.05）。
通过训练，尽管存在进行性神经肌肉疾病，将气体叠加至深吹气的能力仍可得到改善。这可导致咳嗽有效性增加。
