早產兒的慢性肺疾病：呼吸評估與物理治療介入

Chronic Lung Disease in Premature Infants: Respiratory Assessment and Physical Therapy Intervention

陳佩珊(Pei-Shan Chen) ； 吳晏慈(Yen-Tzu Wu) ； 王儷穎(Li-Ying Wang) ； 鄭素芳(Suh-Fang Jeng)

《物理治療》 28卷5期 (2003/10) Pp. 258-268

摘要

慢性肺疾病乃早產兒常見的併發症，長期追蹤研究顯示罹患慢性肺疾病的早產兒，日後容易出現呼吸、生長與神經系統方面的問題，因此早期的呼吸系統與功能的評估及介入是臨床工作人員需重視的問題。本篇文章即在回顧早產兒慢性肺疾病的相關文獻，介紹慢性肺疾病的定義、病程、預後、呼吸系統與功能的評估以及物理治療介入。呼吸系統與功能的評估包括理學檢查、肺功能評估以及慢性肺疾病嚴重程度臨床評估。慢性肺疾病的物理治療介入則應用小兒胸腔物理治療技術，包括神經生理性呼吸誘發術、肺部清潔技術以及呼吸運動。由於胸腔物理治療應用於新生兒及早產兒的研究很少，目前僅限於肺部清潔技術，未來需進行相關的研究以幫助訂定安全的適用時間及標準化的治療流程。至於神經生理性呼吸誘發術及呼吸運動則無相關之研究，亟需日後實驗以支持其治療效果。

關鍵字

慢性肺疾病 ； 早產 ； 呼吸功能評估 ； 胸腔物理治療

並列摘要

Chronic lung disease (CLD) is a common neonatal complication in premature infants. Longitudinal follow-up studies of premature infants with CLD showed that CLD has adverse impacts on their subsequent pulmonary function, growth and neurodevelopment. Medical professionals working on these infants need to be equipped with the knowledge of early respiratory assessment and intervention. This article is aimed at reviewing the literature of CLD that has focused on the definition, pathology, respiratory assessments and physical therapy interventions. Respiratory assessments include physical examination, pulmonary function assessments and clinical scoring systems for assessing severity of CLD. Physical therapy interventions mainly incorporate chest physical therapy (CPT) that consists of neurophysiological facilitation of respiration, bronchial hygience and breathing exercise. Previous studies that examined the effects of CPT on premature infants have primarily focused on bronchial hygiene. Future study needs to establish safe, appropriate time and standardized procedure of CPT. More studies are also needed to examine the therapeutic effects of neurophysiological facilitation and breathing exercise on these children.

並列關鍵字

Chronic lung disease ； Prematurity ； Pulmonary function assessment ； Chest physical therapy