Guimarães Fernando S, Moço Vanessa J R, Menezes Sara L S, Dias Cristina M, Salles Raquel E B, Lopes Agnaldo J
Serviço de Pneumologia, Hospital Universitário Pedro Ernesto, Universidade Estadual do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
Rev Bras Fisioter. 2012 Apr;16(2):108-13. Epub 2012 Apr 10.
Although respiratory physical therapy is considered fundamental in the treatment of hypersecretive patients, there is little evidence of its physiological and therapeutic effects in bronchiectasis patients.
To evaluate the acute physiological effects of ELTGOL and Flutter VRP1® in dynamic and static lung volumes in patients with bronchiectasis and, secondarily, to study the effect of these techniques in sputum elimination.
Patients with clinical and radiological diagnosis of bronchiectasis were included. Patients underwent three interventions in a randomized order and with a one-week washout interval between them. Before all interventions patients inhaled two puffs of 100 mcg of salbutamol. There was a cough period of five minutes before and after the control protocol and the interventions (ELTGOL and Flutter VRP1®). After each cough series patients underwent assessments of dynamic and static lung volumes by spirometry and plethysmography. The expectorated secretions were collected during the interventions and during the second cough series, and quantified by its dry weight.
We studied 10 patients, two males and eight females (mean age: 55.9±18.1 years). After using Flutter VRP1®and ELTGOL there was a significant decrease in residual volume (RV), functional residual capacity (FRC) and total lung capacity (TLC) (p<0.05). There was a higher sputum production during ELTGOL compared with Control and Flutter VRP1® (p<0.05).
The ELTGOL and Flutter VRP1® techniques acutely reduced lung hyperinflation, but only the ELTGOL increased the removal of pulmonary secretions from patients with bronchiectasis.
尽管呼吸物理治疗被认为是治疗分泌物过多患者的基础,但几乎没有证据表明其对支气管扩张症患者的生理和治疗效果。
评估在支气管扩张症患者中,呼气末正压发生器(ELTGOL)和弗洛特VRP1®对动态和静态肺容量的急性生理影响,其次,研究这些技术在痰液清除方面的效果。
纳入临床和影像学诊断为支气管扩张症的患者。患者按随机顺序接受三种干预,每次干预之间间隔一周的洗脱期。在所有干预前,患者吸入两喷100微克的沙丁胺醇。在对照方案和干预措施(ELTGOL和弗洛特VRP1®)前后有五分钟的咳嗽期。每次咳嗽系列后,通过肺活量测定和体积描记法对患者的动态和静态肺容量进行评估。在干预期间和第二次咳嗽系列期间收集咳出的分泌物,并通过其干重进行定量。
我们研究了10名患者,2名男性和8名女性(平均年龄:55.9±18.1岁)。使用弗洛特VRP1®和ELTGOL后,残气量(RV)、功能残气量(FRC)和肺总量(TLC)显著降低(p<0.05)。与对照组和弗洛特VRP1®相比,ELTGOL期间的痰液产生量更高(p<0.05)。
ELTGOL和弗洛特VRP1®技术可急性减轻肺过度充气,但只有ELTGOL增加了支气管扩张症患者肺部分泌物的清除。