Finer N N, Moriartey R R, Boyd J, Phillips H J, Stewart A R, Ulan O
J Pediatr. 1979 Jan;94(1):110-3. doi: 10.1016/s0022-3476(79)80371-6.
To determine the role of chest physiotherapy in the prevention of postextubation atelectasis in neonates intubated for greater than 24 hours, a retrospective survey compared the incidence of this complication in a newborn intensive care unit prior to and following the institution of a routine of chest physiotherapy. Eight of 23 infants extubated developed atelectasis in the "pre-physio" period, whereas only one collapse occurred in 20 infants treated with a routine of physiotherapy at extubation (P less than 0.025). Subsequently a prospective controlled trial compared the use of a routine of physiotherapy at extubation with no physiotherapy. Eight of 21 infants not receiving physiotherapy developed postextubation atelectasis and none of 21 infants receiving physiotherapy developed atelectasis (P less than 0.01). Seventy-six percent of the collapses involved the right upper lobe. A vigorous program of chest physiotherapy, including postural drainage emphasizing the positions of the right upper lobe and chest vibrations, will significantly reduce the incidence of postextubation atelectasis.
为确定胸部物理治疗在预防插管超过24小时的新生儿拔管后肺不张中的作用，一项回顾性调查比较了在新生儿重症监护病房实施胸部物理治疗常规前后该并发症的发生率。在“物理治疗前”阶段，23例拔管婴儿中有8例发生肺不张，而在拔管时接受物理治疗常规的20例婴儿中仅1例出现肺萎陷（P<0.025）。随后一项前瞻性对照试验比较了拔管时物理治疗常规与不进行物理治疗的情况。21例未接受物理治疗的婴儿中有8例发生拔管后肺不张，而21例接受物理治疗的婴儿中无一例发生肺不张（P<0.01）。76%的肺萎陷累及右上叶。积极的胸部物理治疗方案，包括强调右上叶位置的体位引流和胸部振动，将显著降低拔管后肺不张的发生率。
