目的:本研究的目的是比较胸部物理治疗(CPT)和高频胸壁振荡(HFCWO)对肺移植受者肺功能的影响。
背景:肺移植后常规使用胸部理疗和HFCWO以减轻呼吸困难,增加呼气流量,并提高分泌物清除率。
方法:在两组实验中,具有重复措施的交叉设计,45例肺移植受者(27例,双侧18岁;64%男性;平均年龄,57年)被随机分配在上午10:00和下午2:00接受CPT,然后在术后第3天在下午6:00和下午10:00接受HFCWO(n=22),反之亦然(n=23)。呼吸困难(修正的Borg评分),在治疗前和治疗后测量Spo2/FiO2和峰值呼气流量(PEF)。数据分析采用卡方检验,t测试,和线性混合效应模型。
结果:在接受HFCWO和CPT的患者中,呼吸困难或PEF的治疗效果无统计学意义。然而,对SpO2/FiO2比值有显著的治疗效果(p<0.0001)。
结论:初步结果表明,肺移植后HFWCO可改善肺功能(通过SpO2/FiO2测量)。尽管呼吸困难和PEF在治疗类型之间没有显着差异,HFCWO可能是一种有效的,CPT的可行替代方案。
OBJECTIVE: The aim of this study is to compare the effects of chest physiotherapy (CPT) and high-frequency chest wall oscillation (HFCWO) on lung function in lung transplant recipients.
BACKGROUND: Chest physiotherapy and HFCWO are routinely used after lung transplant to attenuate dyspnea, increase expiratory flow, and improve secretion clearance.
METHODS: In a two-group experimental, crossover design with repeated-measures, 45 lung transplant recipients (27 single, 18 bilateral; 64% male; mean age, 57 years) were randomized to receive CPT at 10:00 AM and 2:00 PM followed by HFCWO at 6:00 PM and 10:00 PM (n=22) or vice versa (n=23) on postoperative day 3. Dyspnea (modified Borg score), Spo2/FiO2, and peak expiratory flow (PEF) were measured pre-treatment and post-treatment. Data were analyzed using chi-square tests, t tests, and linear mixed effects models.
RESULTS: There was no statistically significant treatment effect for dyspnea or PEF in patients who received HFCWO versus CPT. However, there was a significant treatment effect on the Spo2/FiO2 ratio (p<0.0001).
CONCLUSIONS: Preliminary results suggest that lung function (measured by Spo2/FiO2) improves with HFWCO after lung transplantation. Although dyspnea and PEF did not differ significantly between treatment types, HFCWO may be an effective, feasible alternative to CPT.