评价一种替代胸部物理疗法在呼吸道合胞病毒毛细支气管炎婴儿中的应用。

Evaluation of an alternative chest physiotherapy method in infants with respiratory syncytial virus bronchiolitis.

机构信息

Department of Pediatrics, Grand Hôpital de Charleroi, Montignies-sur-Sambre, Belgium.

出版信息

Respir Care. 2011 Jul;56(7):989-94. doi: 10.4187/respcare.00721. Epub 2011 Feb 22.

DOI:10.4187/respcare.00721

PMID:21352671

Abstract

BACKGROUND

We proposed a new chest physiotherapy (CPT) secretion clearance method to treat respiratory syncytial virus bronchiolitis in infants. Our new CPT method consists of 15 prolonged slow expirations, then 5 provoked cough maneuvers.

METHODS

We randomized 20 infants (mean age 4.2 months) into 2 groups: 8 patients received 27 sessions of nebulization of hypertonic saline; 12 patients received 31 sessions of nebulization of hypertonic saline followed by our new CPT method. We used the Wang clinical severity scoring system (which assesses wheezing, respiratory rate, retractions, and general condition) and measured S(pO(2)) and heart rate before each CPT session (T0), immediately after the 30-min session (T30), and 120 min after the session (T150).

RESULTS

Within the groups: in the first group, Wang score was significantly lower at T150 than at T0: 4.6 vs 5.0 (P = .008). In the new-method-CPT group, Wang score was significantly lower at T30 (3.6 vs 4.3, P = .001) and at T150 (3.7 vs 4.3, P = .002). Wheezing score was significantly lower at T150 than at T0 (1.1 vs 1.2, P = .02) in the first group, and in the new-method-CPT group at T30 than at T0 (0.8 vs 1.3, P = .001) and at T150 than at T0 (0.9 vs 1.3, P = .001). Between the groups: at T30 the improvement was significantly better in the new-method-CPT group for overall Wang score (P = .02), retractions (P = .05), respiratory rate (P = .001), and heart rate (P < .001). At T150 the Wang score was not significantly different between the groups. At T30 (versus T0) the difference in percent gain between the groups was significant for Wang score (P = .004), wheezing (P = .001), and heart rate (P = .02). Over 5-hospital days, the daily baseline (T0) Wang score decreased significantly in the new-method-CPT group (P = .002), whereas it did not in the first group. There were no adverse events. Average hospital stay was not significantly different between the groups.

CONCLUSIONS

Our new CPT method showed short-term benefits to some respiratory symptoms of bronchial obstruction in infants with acute respiratory syncytial virus bronchiolitis.

摘要

背景

我们提出了一种新的胸部物理治疗（CPT）排痰方法来治疗婴儿呼吸道合胞病毒细支气管炎。我们的新 CPT 方法包括 15 次延长缓慢呼气，然后是 5 次诱发咳嗽动作。

方法

我们将 20 名婴儿（平均年龄 4.2 个月）随机分为两组：8 名患者接受 27 次高渗盐水雾化；12 名患者接受 31 次高渗盐水雾化，然后采用我们的新 CPT 方法。我们使用 Wang 临床严重程度评分系统（评估喘鸣、呼吸频率、回缩和一般情况），并在每次 CPT 治疗前（T0）、30 分钟后（T30）和 120 分钟后（T150）测量 S(pO(2))和心率。

结果

在组内：在第一组中，T150 时 Wang 评分明显低于 T0：4.6 比 5.0（P =.008）。在新方法-CPT 组中，T30 时 Wang 评分明显降低（3.6 比 4.3，P =.001），T150 时也明显降低（3.7 比 4.3，P =.002）。T150 时第一组喘鸣评分明显低于 T0（1.1 比 1.2，P =.02），新方法-CPT 组 T30 时明显低于 T0（0.8 比 1.3，P =.001）和 T150 时明显低于 T0（0.9 比 1.3，P =.001）。组间：T30 时，新方法-CPT 组 Wang 评分整体改善（P =.02）、回缩（P =.05）、呼吸频率（P =.001）和心率（P <.001）明显优于对照组。T150 时两组间 Wang 评分无显著差异。T30（与 T0 相比）时，两组间 Wang 评分（P =.004）、喘鸣（P =.001）和心率（P =.02）的改善百分比差异有统计学意义。在 5 个住院日内，新方法-CPT 组的每日基线（T0）Wang 评分明显下降（P =.002），而第一组则没有。没有不良事件发生。两组的平均住院时间无显著差异。