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高频胸壁振荡成功控制难治性哮喘。

High-frequency chest wall oscillation successful in controlling refractory asthma.

作者信息

Bose Sonali, Jun Jonathan, Diette Gregory B

机构信息

Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, MD 21205, USA.

出版信息

J Asthma. 2013 Mar;50(2):219-21. doi: 10.3109/02770903.2012.757773.

DOI:10.3109/02770903.2012.757773
PMID:23394251
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4888798/
Abstract

INTRODUCTION

High-frequency chest wall oscillation (HFCWO) has been traditionally implemented for airway secretion clearance in conditions such as cystic fibrosis (CF) and bronchiectasis. There have been few reports of its use in refractory asthma.

CASE REPORT

A 36-year-old, non-smoker male presented with a lifelong history of poorly controlled asthma. Despite multiple controller medications, he reported daily chest congestion, copious phlegm, and frequent exacerbations. Imaging, blood work, and bronchoscopy ruled out atypical infections, immunodeficiency, CF, and other chronic conditions. Pulmonary function tests supported a diagnosis of asthma.

RESULTS

We initiated HFCWO therapy twice daily in addition to standard inhaled pharmacological therapy. After 2 months, the patient noted resolution of respiratory symptoms as well as improvement in lung function. He remained symptom-free at his 2-year follow-up.

CONCLUSION

High-frequency chest oscillation may be useful in phenotypes of asthma characterized by prominent mucus hypersecretion.

摘要

引言

高频胸壁振荡(HFCWO)传统上用于囊性纤维化(CF)和支气管扩张等病症的气道分泌物清除。关于其在难治性哮喘中的应用报道很少。

病例报告

一名36岁、不吸烟男性,有哮喘控制不佳的终生病史。尽管使用了多种控制药物,但他仍报告每天胸部有闷堵感、大量痰液且频繁发作。影像学检查、血液检查和支气管镜检查排除了非典型感染、免疫缺陷、CF和其他慢性疾病。肺功能测试支持哮喘诊断。

结果

除标准吸入药物治疗外,我们开始每天两次进行HFCWO治疗。2个月后,患者指出呼吸道症状消失,肺功能改善。在2年随访中他一直无症状。

结论

高频胸壁振荡可能对以显著黏液分泌过多为特征的哮喘表型有用。

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本文引用的文献

1
High frequency chest wall oscillation for asthma and chronic obstructive pulmonary disease exacerbations: a randomized sham-controlled clinical trial.高频胸壁振荡治疗哮喘和慢性阻塞性肺疾病急性加重:一项随机假对照临床试验。
Respir Res. 2011 Sep 10;12(1):120. doi: 10.1186/1465-9921-12-120.
2
Airway mucus function and dysfunction.气道黏液的功能与功能障碍。
N Engl J Med. 2010 Dec 2;363(23):2233-47. doi: 10.1056/NEJMra0910061.
3
Phenotypic determinants of uncontrolled asthma.未控制哮喘的表型决定因素。
J Allergy Clin Immunol. 2009 Oct;124(4):681-7.e3. doi: 10.1016/j.jaci.2009.06.010. Epub 2009 Aug 8.
4
Remodeling in asthma.哮喘中的重塑
Proc Am Thorac Soc. 2009 May 1;6(3):301-5. doi: 10.1513/pats.200808-089RM.
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Manual therapy for asthma.哮喘的手法治疗
Cochrane Database Syst Rev. 2005 Apr 18(2):CD001002. doi: 10.1002/14651858.CD001002.pub2.
6
Pulmonary hyperinflation and respiratory distress following solvent aspiration in a patient with asthma: expectoration of bronchial casts and clinical improvement with high-frequency chest wall oscillation.哮喘患者吸入溶剂后出现肺过度充气和呼吸窘迫:咳出支气管铸型并通过高频胸壁振荡实现临床改善。
Respir Care. 2004 Nov;49(11):1335-8.
7
Clinical review: severe asthma.临床综述:重度哮喘
Crit Care. 2002 Feb;6(1):30-44. doi: 10.1186/cc1451. Epub 2001 Nov 22.
8
Effectiveness of a positive expiratory pressure device in conjunction with beta2-agonist nebulization therapy for bronchial asthma.一种呼气末正压装置联合β2受体激动剂雾化吸入疗法治疗支气管哮喘的疗效
J Microbiol Immunol Infect. 2001 Jun;34(2):92-6.
9
Effects of chest physical therapy on lung function in children recovering from acute severe asthma.胸部物理治疗对急性重症哮喘恢复期儿童肺功能的影响。
Pediatr Pulmonol. 1990;9(3):146-51. doi: 10.1002/ppul.1950090305.