胸部物理治疗新进展

Advancement in chest physiotherapy

胸部物理治疗主要是在改善痰液引流和预防痰液潴留两方面发挥作用,传统方法包括体位引流、胸部叩拍以及呼吸锻炼等,近年来在此基础上又创造了多种新技术（如气道内拍击、机械吸呼治疗等）。这些新技术着重于松动痰液和促进有效咳嗽两方面,国外学者就这些技术应用于不同的病种作了多项研究,到目前为止各种方法的疗效仍存在一定的争议,已有一些证据支持这些新技术至少与传统的方法是同样有效的,在减轻体力强度及避免传统方法因人而异的缺点方面具有一定优势,随着应用逐渐广泛,这些新技术的疗效将会得到更为清晰的认识与评价。

Chest physiotherapy has been designed to remove secretions, as well as prevent sputum accumulation. Traditionally, chest physiotherapy involved postural drainage, percussion and vibration, combined with cough training. Over the years, several new techniques such as flutter, mechanical insufflation- exsufflation （MIE） have been introduced to augment or substitute the traditional approaches. These newer techniques are efficient for helping mobilize mucus and increase the effectiveness of cough, which have been studied in different kinds of diseases with impaired airway clearance. There is some evidence that the new forms of airway clearance are at least as effective as conventional chest physiotherapy, with advantages of relieving the workload and reducing operator dependence. However, the evidence in support of these techniques is still variable.