咳嗽在清除气管支气管过多分泌物方面与胸部物理治疗同样有效吗？
Is cough as effective as chest physiotherapy in the removal of excessive tracheobronchial secretions?
作者信息
Bateman J R, Newman S P, Daunt K M, Sheahan N F, Pavia D, Clarke S W
出版信息
Thorax. 1981 Sep;36(9):683-7. doi: 10.1136/thx.36.9.683.
Abstract
The relative value of chest physiotherapy (including cough) and cough alone for the removal of excessive tracheobronchial secretions has been assessed in six patients with stable chronic obstructive lung disease. After labelling with inhaled radioactive tracer particles, clearance of secretions from selected central and peripheral lung regions was followed with a gamma camera linked to a computer. Cough alone and chest physiotherapy (including cough) were equally effective in the enhancement of central lung clearance. Physiotherapy but not cough along accelerated peripheral lung clearance (p less than 0.05). Sputum yield was greater during physiotherapy than during cough (p less than 0.05). These findings confirm the value of chest physiotherapy and high-light the limitation of cough in patients with excessive tracheobronchial secretion and impaired mucociliary clearance.
摘要
对6例稳定期慢性阻塞性肺疾病患者评估了胸部物理治疗（包括咳嗽）和单纯咳嗽在清除过多气管支气管分泌物方面的相对价值。在用吸入放射性示踪颗粒标记后，通过与计算机相连的γ相机跟踪选定的中央和外周肺区域分泌物的清除情况。单纯咳嗽和胸部物理治疗（包括咳嗽）在促进中央肺清除方面同样有效。物理治疗可加速外周肺清除，但咳嗽不能（p<0.05）。物理治疗期间的痰液生成量比咳嗽期间更多（p<0.05）。这些发现证实了胸部物理治疗的价值，并突出了咳嗽在气管支气管分泌物过多和黏液纤毛清除功能受损患者中的局限性。
相似文献
1
Is cough as effective as chest physiotherapy in the removal of excessive tracheobronchial secretions?咳嗽在清除气管支气管过多分泌物方面与胸部物理治疗同样有效吗？
Thorax. 1981 Sep;36(9):683-7. doi: 10.1136/thx.36.9.683.
2
Regional lung clearance of excessive bronchial secretions during chest physiotherapy in patients with stable chronic airways obstruction.稳定期慢性气道阻塞患者胸部物理治疗期间支气管分泌物过度的肺局部清除情况。
Lancet. 1979 Feb 10;1(8111):294-7. doi: 10.1016/s0140-6736(79)90705-0.
3
Chest physiotherapy: a review.胸部物理治疗：综述
Eur J Respir Dis. 1982 May;63(3):188-201.
4
Regional lung clearance during cough and forced expiration technique (FET): effects of flow and viscoelasticity.咳嗽和用力呼气技术（FET）期间的局部肺清除：流量和粘弹性的影响。
Thorax. 1994 Jun;49(6):557-61. doi: 10.1136/thx.49.6.557.
5
Mechanical vibration and conventional chest physiotherapy in outpatients with stable chronic obstructive lung disease.机械振动与传统胸部物理治疗用于稳定期慢性阻塞性肺疾病门诊患者
Chest. 1985 Apr;87(4):483-5. doi: 10.1378/chest.87.4.483.
6
Chest physiotherapy compared to no chest physiotherapy for cystic fibrosis.与不进行胸部物理治疗相比，囊性纤维化患者接受胸部物理治疗的情况。
Cochrane Database Syst Rev. 2013 Sep 4(9):CD001401. doi: 10.1002/14651858.CD001401.pub2.
7
Assessment of the forced expiration technique, postural drainage and directed coughing in chest physiotherapy.
Eur J Respir Dis. 1983 Jan;64(1):62-8.
8
[Physiotherapy in chronic obstructive pulmonary disease: oscillatory breathing with flutter VRP1].[慢性阻塞性肺疾病的物理治疗：使用弗洛特VRP1进行振荡呼吸]
Harefuah. 1996 Jul;131(1-2):14-7, 71.
9
Noninvasive clearance of airway secretions.气道分泌物的无创清除
Respir Care Clin N Am. 1996 Jun;2(2):323-45.
10
General review of tracheobronchial clearance.气管支气管清除的一般综述。
Eur J Respir Dis Suppl. 1987;153:123-9.
引用本文的文献
1
Addressing treatable traits in bronchiectasis through non-pharmacological therapies: a narrative review.通过非药物疗法解决支气管扩张症中可治疗的特征：一项叙述性综述
J Thorac Dis. 2025 Jun 30;17(6):4302-4322. doi: 10.21037/jtd-2024-2106. Epub 2025 Jun 18.
2
Modeling the effects of external oscillations on mucus clearance in obstructed airways.模拟外部振动对气道阻塞时黏液清除的影响。
Biomech Model Mechanobiol. 2024 Feb;23(1):335-348. doi: 10.1007/s10237-023-01778-3. Epub 2023 Oct 20.
3
Beneficial short-term effect of autogenic drainage on peripheral resistance in childhood cystic fibrosis disease.自主引流对儿童囊性纤维化疾病外周阻力的短期有益影响。
BMC Pulm Med. 2022 Jun 21;22(1):241. doi: 10.1186/s12890-022-02039-2.
4
Non-antimicrobial airway management of non-cystic fibrosis bronchiectasis.非囊性纤维化支气管扩张症的非抗菌气道管理
J Clin Tuberc Other Mycobact Dis. 2017 Dec 12;10:24-28. doi: 10.1016/j.jctube.2017.12.003. eCollection 2018 Jan.
5
Airway clearance techniques for bronchiectasis.支气管扩张症的气道廓清技术
Cochrane Database Syst Rev. 2015 Nov 23;2015(11):CD008351. doi: 10.1002/14651858.CD008351.pub3.
6
Airway clearance techniques for chronic obstructive pulmonary disease.慢性阻塞性肺疾病的气道廓清技术
Cochrane Database Syst Rev. 2012 Mar 14;2012(3):CD008328. doi: 10.1002/14651858.CD008328.pub2.
7
Investigation of the frequency and force of chest vibration performed by physiotherapists.对物理治疗师进行胸部振动的频率和力度的调查。
Physiother Can. 2008 Fall;60(4):341-8. doi: 10.3138/physio.60.4.341. Epub 2008 Nov 12.
8
Regional lung clearance during cough and forced expiration technique (FET): effects of flow and viscoelasticity.咳嗽和用力呼气技术（FET）期间的局部肺清除：流量和粘弹性的影响。
Thorax. 1994 Jun;49(6):557-61. doi: 10.1136/thx.49.6.557.
9
Cystic fibrosis.囊性纤维化
Lung. 1994;172(5):251-70. doi: 10.1007/BF00164308.
10
Impaired tracheobronchial clearance in patients with mild stable asthma.轻度稳定型哮喘患者的气管支气管清除功能受损。
Thorax. 1983 Jun;38(6):463-7. doi: 10.1136/thx.38.6.463.
本文引用的文献
1
Resistance to two-phase gas-liquid flow in airways.气道中对气液两相流的阻力。
J Appl Physiol. 1970 Oct;29(4):464-71. doi: 10.1152/jappl.1970.29.4.464.
2
Appraisal of postural drainage for chronic obstructive pulmonary disease.
Arch Phys Med Rehabil. 1971 Nov;52(11):528-30.
3
Evaluation of postural drainage by measurement of sputum volume and consistency.通过测量痰液量和黏稠度评估体位引流效果。
Am J Phys Med. 1971 Oct;50(5):215-9.
4
Chest physiotherapy: a physiological assessment during intermittent positive pressure ventilation in respiratory failure.
Can Anaesth Soc J. 1969 Nov;16(6):487-93. doi: 10.1007/BF03004542.
5
The role of two-phase flow in bronchial clearance.两相流在支气管清除中的作用。
Bull Physiopathol Respir (Nancy). 1973 Mar-Apr;9(2):359-76.
6
Patterns of distribution and clearance of aerosols in patients with bronchiectasis.支气管扩张症患者气溶胶的分布和清除模式。
Am Rev Respir Dis. 1972 Dec;106(6):857-66. doi: 10.1164/arrd.1972.106.6.857.
7
Conference on the scientific basis of respiratory therapy. Physical therapy--present state of the art.呼吸治疗科学基础会议。物理治疗——当前技术水平
Am Rev Respir Dis. 1974 Dec;110(6 Pt 2):132-6. doi: 10.1164/arrd.1974.110.6P2.132.
8
A preliminary study of the effect of guaiphenesin on mucociliary clearance from the human lung.愈创甘油醚对人肺黏液纤毛清除作用的初步研究。
Thorax. 1973 Nov;28(6):742-7. doi: 10.1136/thx.28.6.742.
9
Tracheal mucociliary transport in patients with cystic fibrosis and its stimulation by terbutaline.
Am Rev Respir Dis. 1975 Jun;111(6):733-8. doi: 10.1164/arrd.1975.111.6.733.
10
The effect of chest physiotherapy upon the FEV1 in chronic bronchitis.胸部物理治疗对慢性支气管炎患者第一秒用力呼气容积的影响。
Med J Aust. 1975 Jan 11;1(2):33-5. doi: 10.5694/j.1326-5377.1975.tb111210.x.
Zotero 插件