Valenza-Demet G, Valenza M C, Cabrera-Martos I, Torres-Sánchez I, Revelles-Moyano F
Physiotherapy Department, Faculty of Health Sciences, University of Granada, Spain.
Physiotherapy Department, Faculty of Health Sciences, University of Granada, Spain
Clin Rehabil. 2014 Nov;28(11):1087-95. doi: 10.1177/0269215514530579. Epub 2014 Apr 14.
To investigate the effects of a physiotherapy protocol on patients with pleural effusion.
Randomized controlled trial.
University hospital.
A total of 104 consecutive inpatients with a medical diagnosis of pleural effusion.
Patients were randomly allocated to a control group receiving standard treatment (medical treatment and drainage) or an intervention group treated with physiotherapy added to standard treatment. The physiotherapy programme included deep breathing exercises, mobilizations and incentive spirometry.
Spirometric predicted values and chest radiographs were measured before treatment and at discharge and the length of hospital stay was recorded. Assessors were blinded to the intervention.
A comparative analysis showed a significant improvement of spirometric parameters in the intervention group; pre-to-post hospitalization predicted values showed significant changes in vital capacity (73.1 ± 12.6% to 72.13 ± 13.7 %, P<0.001 ), forced expiratory volume in first second (72.13 ± 13.7% to 78.98 ± 16.9%, P<0.001) and forced expiratory flow at 25-75 % (64.8 ± 35.1% to 76.78 ± 35.3%, P=0.198) compared to the control group that showed no significant changes across treatment. The radiographic findings showed better scores on the affected side of the thorax at discharge in the physiotherapy group. Length of hospital stay was also significantly (P=0.014) shorter in the intervention group (26.7 ± 8.8 days) compared to the control group (38.6 ± 10.7 days).
A physiotherapy programme added to standard treatment improves the spirometric parameters and the radiological findings and reduces the hospital stay in patients with a pleural effusion.
探讨物理治疗方案对胸腔积液患者的影响。
随机对照试验。
大学医院。
共有104例连续住院的经医学诊断为胸腔积液的患者。
患者被随机分配至接受标准治疗（药物治疗和引流）的对照组或在标准治疗基础上加用物理治疗的干预组。物理治疗方案包括深呼吸练习、活动和激励肺活量测定。
在治疗前和出院时测量肺活量预测值和胸部X光片，并记录住院时间。评估者对干预措施不知情。
对比分析显示，干预组的肺活量测定参数有显著改善；与对照组相比，住院前后预测值显示肺活量（从73.1±12.6%至72.13±13.7%，P<0.001）、第1秒用力呼气量（从72.13±13.7%至78.98±16.9%，P<0.001）和25%-75%用力呼气流量（从64.8±35.1%至76.78±35.3%，P=0.198）有显著变化，而对照组在整个治疗过程中无显著变化。影像学检查结果显示，物理治疗组出院时患侧胸部评分更高。干预组的住院时间（26.7±8.8天）也显著短于对照组（38.6±10.7天，P=0.014）。
在标准治疗基础上加用物理治疗方案可改善肺活量测定参数和影像学检查结果，并缩短胸腔积液患者的住院时间。
