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[住院婴儿的胸部物理治疗与细支气管炎。双盲临床试验]

[Chest physiotherapy and bronchiolitis in the hospitalised infant. Double-blind clinical trial].

作者信息

Sánchez Bayle M, Martín Martín R, Cano Fernández J, Martínez Sánchez G, Gómez Martín J, Yep Chullen G, García García M C

机构信息

Servicio de Pediatría, Hospital Infantil del Niño Jesús, Madrid, España.

出版信息

An Pediatr (Barc). 2012 Jul;77(1):5-11. doi: 10.1016/j.anpedi.2011.11.026. Epub 2012 Jan 26.

Abstract

OBJECTIVE

[corrected] To study the utility of chest physiotherapy by increased exhalation technique with assisted cough in the acute bronchiolite of the hospitalized new-born babys.

PATIENTS AND METHODS

Double-blind clinical trial accomplished on 236 patients of age lower than 7 months and hospitalizad with diagnosis of acute bronchiolitis, first episode, in a pediatric department in Madrid.The patients were randomized in two groups: those who have received maneuvers of chest physiotherapy and those who have received maneuvers placebo. Only physiotherapist were aware of the allocation group of the infants. The days of hospitalization and the hours of oxygentherapy were used like result measurement.

RESULTS

From the totality of the studied children 57,6% received maneuvers of chest physiotherapy and 42,4% remaining received maneuvers placebo. In the group that received chest physiotherapy the average stay in the hospital was 4,56 days (95% confidence interval [CI] 4,36-6,06) and the average time of oxygentherapy was 49,98 (95% CI 43,64-67,13) hours opposite to 4,54 days (95%CI 3,81-5,73) and 53,53 hours (95% CI 48,03-81,40) respectively in the group that did not receive chest physiotherapy. In the patients with analytical print for VRS and that received chest physiotherapy less hours of oxygen therapy were needed 48,80 hours (95% CI 42,94-55,29) opposite to 56,68 hours (95% CI 55,46-65,52) respectively, being the only one turned out as per statistics significantly (P=.042).

CONCLUSIONS

Results show that chest physiotherapy has not been effective in reducing hospital stay or length of oxygentherapy in patients with acute bronchiolitis, but in the positive study of children with respiratory syncytial virus in nasopharyngeal aspirate showed a reduced need hours of oxygen. hours (P=.042).

摘要

目的

研究在住院新生儿急性细支气管炎中采用增加呼气技术辅助咳嗽进行胸部物理治疗的效用。

患者与方法

在马德里一家儿科病房对236名年龄小于7个月、诊断为首次发作的急性细支气管炎的住院患者进行双盲临床试验。患者被随机分为两组:接受胸部物理治疗操作的患者和接受安慰剂操作的患者。只有物理治疗师知晓婴儿的分组情况。将住院天数和氧疗小时数用作结果测量指标。

结果

在所有研究儿童中,57.6%接受了胸部物理治疗操作,其余42.4%接受了安慰剂操作。接受胸部物理治疗的组平均住院时间为4.56天(95%置信区间[CI]4.36 - 6.06),平均氧疗时间为49.98小时(95%CI 43.64 - 67.13);而未接受胸部物理治疗的组分别为4.54天(95%CI 3.81 - 5.73)和53.53小时(95%CI 48.03 - 81.40)。在进行呼吸道合胞病毒分析检测呈阳性且接受胸部物理治疗的患者中,所需氧疗小时数为48.80小时(95%CI 42.94 - 55.29),而未接受胸部物理治疗的患者为56.68小时(95%CI 55.46 - 65.52),这是唯一经统计学检验有显著差异的结果(P = 0.042)。

结论

结果表明,胸部物理治疗在缩短急性细支气管炎患者的住院时间或氧疗时长方面并无效果,但在对鼻咽抽吸物中呼吸道合胞病毒呈阳性的儿童进行的阳性研究中显示,所需氧疗小时数有所减少(P = 0.042)。

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