Orlik T
Zaklad Usprawniania Leczniczego, Instytut Matki i Dziecka, Kasprzaka 17a, 01-211, Warszawa, Poland.
Med Wieku Rozwoj. 2000 Jul-Sep;4(3):233-46.
In Poland the standard treatment of pulmonary manifestation of cystic fibrosis consists of physiotherapy techniques of postural drainage with clapping. However many studies demonstrated that various alternative airway clearance techniques performed in Europe the last few years have been more effective than postural drainage. The aim of the study was a comparative analysis of the efficiency of selected chest physiotherapy methods used in the treatment of children with cystic fibrosis. We studied 21 patients, aged 5-18 (x 10.57), who were hospitalised in the Paediatric Clinic of National Research Institute of Mother and Child in Warsaw, Poland. We compared five chest physiotherapy techniques: 1 - postural drainage with clapping, 2 - postural drainage with clapping and vibration, 3 - active cycle of breathing technique, 4 - Flutter(R), 5 - Flutter(R) with relaxation. Every investigated drainage method was tested by each patient according to a determined procedure. The following indices were measured: weight of coughed up sputum, oxygen saturation (SaO2) before, during and after drainage, peak expiratory flaw (PEF) before and after drainage. The biggest quantity of sputum determined by its coughed up weight was with active cycle of breathing technique (x 2.126 g). In comparison, in patients using postural drainage with clapping and clapping with vibration average sputum expectoration was 0.895 and 1.012 g. Flutter device is recommended for individual usage. Our findings demonstrate that the Flutter with relaxation effectively facilitates removal of mucus from airways (Flutter - x 1.48 g, Flutter with relaxation - x 2.012 g). We observed PEF decrease (p > 0.05) during postural drainage with clapping and vibration. There were no significant differences in SaO2 between the values before and after drainage in every investigated technique.
在波兰，囊性纤维化肺部表现的标准治疗包括采用拍打法进行体位引流的物理治疗技术。然而，许多研究表明，过去几年在欧洲实施的各种替代性气道清理技术比体位引流更有效。本研究的目的是对用于治疗囊性纤维化儿童的选定胸部物理治疗方法的效果进行比较分析。我们研究了21名年龄在5至18岁（平均10.57岁）的患者，他们在波兰华沙国家母婴研究所儿科诊所住院。我们比较了五种胸部物理治疗技术：1 - 拍打法体位引流，2 - 拍打法及振动法体位引流，3 - 主动呼吸循环技术，4 - 福罗（Flutter）装置，5 - 福罗装置结合放松法。每位患者按照既定程序对每种研究的引流方法进行测试。测量了以下指标：咳出痰液的重量、引流前、引流期间和引流后的血氧饱和度（SaO2）、引流前后的呼气峰值流速（PEF）。通过咳出痰液重量确定的痰液量最大的是主动呼吸循环技术（平均2.126克）。相比之下，采用拍打法体位引流和拍打法及振动法体位引流的患者平均咳痰量分别为0.895克和1.012克。建议福罗装置单独使用。我们的研究结果表明，福罗装置结合放松法能有效促进气道黏液的清除（福罗装置 - 平均1.48克，福罗装置结合放松法 - 平均2.012克）。我们观察到在拍打法及振动法体位引流期间PEF下降（p>0.05）。在每种研究技术中，引流前后的SaO2值之间没有显著差异。
