Hofmeyr J L, Webber B A, Hodson M E
Thorax. 1986 Dec;41(12):951-4. doi: 10.1136/thx.41.12.951.
It has been suggested that positive expiratory pressure may assist the clearance of bronchial secretions in the treatment of cystic fibrosis. It has been compared with currently used postural drainage techniques. Three treatment regimens were compared in 18 patients with cystic fibrosis. Treatment A consisted of breathing exercises emphasising inspiration, interspersed with the forced expiration technique in gravity assisted positions; treatment B comprised breathing exercises with positive expiratory pressure alternating with the forced expiration technique in the same gravity assisted positions; and treatment C comprised breathing exercises with positive expiratory pressure and the forced expiration technique in the sitting position. During treatment A a significantly greater quantity of sputum was produced than during treatments B and C (p less than 0.025 and p less than 0.001 respectively). Treatment B produced more sputum than treatment C (p less than 0.005). There were no significant differences in arterial oxygen saturation, FEV1 or forced vital capacity. Most adolescent and adult patients are able to carry out their treatment independently using gravity assisted positions, breathing exercises emphasising inspiration, and the forced expiration technique. Sputum clearance was less effective when positive expiratory pressure was included in the treatment regimen.
有人提出，呼气末正压可能有助于在囊性纤维化的治疗中清除支气管分泌物。它已与目前使用的体位引流技术进行了比较。在18例囊性纤维化患者中比较了三种治疗方案。治疗A包括强调吸气的呼吸练习，在重力辅助体位中穿插强制呼气技术；治疗B包括在相同重力辅助体位中进行呼气末正压呼吸练习与强制呼气技术交替；治疗C包括在坐位进行呼气末正压呼吸练习和强制呼气技术。在治疗A期间产生的痰液量明显多于治疗B和C期间（分别为p<0.025和p<0.001）。治疗B产生的痰液比治疗C多（p<0.005）。动脉血氧饱和度、第一秒用力呼气量（FEV1）或用力肺活量无显著差异。大多数青少年和成年患者能够使用重力辅助体位、强调吸气的呼吸练习和强制呼气技术独立进行治疗。当治疗方案中包括呼气末正压时，痰液清除效果较差。
