震荡呼气正压和主动循环呼吸技术治疗慢性气道疾病腺体高分泌的效果及患者偏好研究

A study of oscillating positive expiratory pressure and active cycle of breathing techniques on glandular hypersecretion in patients with chronic airway diseases

目的:比较震荡呼气正压(oscillating positive expiratory pressure,OPEP)和主动循环呼吸技术(active cycle of breathing techniques,ACBT)两种方法治疗慢性气道疾病腺体高分泌的效果及其安全性和患者偏好性。方法:于2021年11月—2022年2月对20例慢性气道疾病腺体高分泌的住院患者给予连续2天的随机交叉OPEP或ACBT排痰作业,比较患者两种方法所排的痰量及其特征、排痰作业期间的生命体征和患者掌握两种排痰方法所需要的培训时间。结果:两种方法所清除的痰液及其构成成分纯痰液和痰液水成分的容积及其重量、痰液性状、黏稠度和咳嗽难度均无显著性差异(P>0.05)。OPEP组和ACBT组在作业前、作业期间和作业后的呼吸困难分级指数(Borg评分)分别为(2.30±1.81)分、(3.43±1.94)分、(1.47±1.35)分和(2.08±1.87)分、(2.83±1.82)分、(1.43±1.43)分,均有显著性差异(OPEP组和ACBT组分别为:P=0.003和P=0.043);OPEP组和ACBT组作业前、作业期间和作业后的末梢血氧饱和度(SPO2)、心率和呼吸频率均无显著性差异(P均>0.05)。OPEP组和ACBT组的培训时间分别为(6.63±3.46)min和(10.17±3.04)min,有显著性差异(P=0.001)。20例患者对OPEP和ACBT偏好分别有13例和5例,两者均接受的有2例,有显著性差异(P=0.011)。结论:OPEP与ACBT对慢性呼吸系统疾病腺体高分泌的排痰效果和安全性相当,但OPEP易学易用,患者偏好度更高。

Objective:To compare the efficacy,safety and preference of oscillating positive expiratory pressure(OPEP)and active cycle of breathing techniques(ACBT)on glandular hypersecretion in patients with chronic airway diseases.Method:Twenty patients with chronic airway diseases and glandular hypersecretion were randomly assigned to two cross-over groups receiving OPEP or ACBT in two consecutive days during hospitalization.To compare the volume and characteristics of excreted sputum,the vital signs during therapy and the training time of mastering between two methods.Result:There was no statistical significance in the volume and weight of removed sputum and its constituent components(pure sputum and sputum water component),sputum properties,sputum stickiness and difficulty of cough between the two groups(P>0.05).In OPEP group and ACBT group,the Dyspnea grading index(Borg score)before,during and after therapy were(2.30±1.81)、(3.43±1.94)、(1.47±1.35)and(2.08±1.87)、(2.83±1.82)、(1.43±1.43),with statistically significant differences(P=0.003 in OPEP group and P=0.043 in ACBT group,respectively).There were no statistically significant differences in saturation of pulse oxygen(SPO2),heart rate and respiratory rate before,during and after therapy between two groups(P>0.05).The training time of OPEP group and ACBT group were(6.63±3.46)minutes and(10.17±3.04)minutes respectively,with statistically significant difference(P=0.001).In terms of preference,13 or 5 of the 20 patients preferred OPEP or ACBT respectively,and 2 patients preferred both,with statistically significant difference(P=0.011).Conclusion:OPEP and ACBT have similar expectoration effect and safety on chronic airway diseases with glandular hypersecretion.But OPEP is easy to train and use,and is favored by most patients.