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Randomized trial of physiotherapy and hypertonic saline techniques for sputum induction in asthmatic children and adolescents.

物理治疗和高渗盐水技术用于哮喘儿童和青少年痰液诱导的随机试验。

  • 影响因子:1.35
  • DOI:10.6061/clinics/2020/e1512
  • 作者列表:"Felicio-Júnior EL","Barnabé V","de Almeida FM","Avona MD","de Genaro IS","Kurdejak A","Eller MCN","Verganid KP","Rodrigues JC","Tibério IFLC","Martins MA","Saraiva-Romanholo BM
  • 发表时间:2020-01-24
Abstract

OBJECTIVES:This study aimed to analyze the efficiency of physiotherapy techniques in sputum induction and in the evaluation of pulmonary inflammation in asthmatic children and adolescents. Although hypertonic saline (HS) is widely used for sputum induction (SI), specific techniques and maneuvers of physiotherapy (P) may facilitate the collection of mucus in some asthmatic children and adolescents. METHODS:A randomized crossover study was performed in patients with well-controlled asthma, and 90 sputum samples were collected. Children and adolescents were assessed using spirometry and randomized at entry into one of three sputum induction techniques: (i) 3% hypertonic saline - HS technique; (ii) physiotherapy (oscillatory positive expiratory pressure, forced expiration, and acceleration of expiratory flow) - P technique; and (iii) hypertonic saline + physiotherapy - HSP technique. ClinicalTrials.gov: NCT03136042. RESULTS:The total cells (mL) and the percentage (%) of differential inflammatory cells were similar in all techniques. The sputum weight (g) in the HSP technique was significantly higher than that in the HS technique. In all techniques, the percentage of viable cells was >50%, and there was no difference between the HS and P techniques. Moreover, sputum induction did not cause any alterations in the pulmonary function of patients. CONCLUSION:The physiotherapy sputum collection technique was effective in obtaining viable cells from mucus samples and yielded the same amount of sputum as the gold standard technique (hypertonic saline). In addition, the physiotherapy maneuvers were both safe and useful for sputum induction in asthmatic children and adolescents with well-controlled asthma.

摘要

目的: 本研究旨在分析物理治疗技术在哮喘儿童和青少年痰液诱导和肺部炎症评估中的有效性。虽然高渗盐水 (HS) 广泛用于痰诱导 (SI),但物理治疗的特定技术和操作 (P) 可促进一些哮喘儿童和青少年的粘液收集。 方法: 在控制良好的哮喘患者中进行随机交叉研究,收集90份痰标本。使用肺活量测定法评估儿童和青少年,并在进入三种诱导痰技术中的一种时进行随机分组 :( i) 3% 高渗盐水-HS技术; (ii) 物理治疗 (振荡呼气正压、用力呼气和加速呼气流量)-P技术; 和 (iii)高渗盐水 + 理疗-HSP技术。ClinicalTrials.gov: nct03136042。 结果: 在所有技术中,总细胞 (mL) 和差异炎性细胞的百分比 (%) 相似。HSP技术的痰质量 (g) 显著高于HS技术。在所有技术中,活细胞的百分比> 50%,并且在HS和P技术之间没有差异。此外,痰诱导未引起患者肺功能的任何改变。 结论: 物理治疗痰液采集技术可有效地从粘液样本中获得活细胞,并获得与金标准技术 (高渗盐水) 相同的痰液量。此外,物理疗法对哮喘儿童和控制良好的哮喘青少年的痰液诱导既安全又有用。

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呼吸过敏性疾病方向

当空气中的花粉、细菌等过敏原通过呼吸作用进入到肺部,就容易引起鼻子、咽喉、气管等部位出现不适的症状,可能引发多种呼吸过敏性疾病的发作。其中主要包括外源性过敏性肺泡炎、变应性支气管肺曲霉菌病、哮喘及过敏性鼻炎。

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