高流量鼻管治療在支氣管擴張症之有效應用

The Effectiveness of High Flow Nasal Therapy in Bronchiectasis

蘇千玲(Chien-Ling Su) ； 陳慧秦(Hui-Chin Chen) ； 杜美蓮(Mei-LienTu)

《長庚科技學刊》 37期 (2022/12) Pp. 1-8

https://doi.org/10.6192/CGUST.202212_(37).1

摘要

支氣管擴張症是以支氣管壁破壞和氣道擴張為特徵，且是持續進行性的疾病，屬於長期慢性肺部疾病。因反覆感染，導致痰液分泌增加，影響支氣管纖毛活動度下降，加重發炎反應，進而刺激支氣管壁持續擴張，因此粘液分泌過多及過度積聚堵塞，形成部分或完全氣道阻塞是支氣管擴張的特徵。高流量鼻管治療是透過鼻管，傳送加熱加濕的空氣或氧氣到達末端支氣管。臨床上已用於成人和嬰幼兒，對於慢性肺阻塞、急性呼吸衰竭、心臟疾病等都有很好的實證應用。肺阻塞和支氣管擴張症是胸腔科，痰液較多的慢性疾病，高流量鼻管系統對於肺阻塞應用已有較多探討，因此本篇文獻回顧探討，濕度對於呼吸道痰液清除影響和高流量鼻管應用，對於支氣管擴張症治療之效益。

關鍵字

高流量鼻管 ； 支氣管擴張症 ； 呼吸道痰液清除

並列摘要

Bronchiectasis is a persistently progressive disease characterized by destruction of the bronchial walls and dilation of the airways, which is a kind of long-term chronic lung disease. The bronchial walls became dilated because of repeated infection contributing to increased bronchial secretion, destruction of bronchial ciliary activity, and aggravation inflammatory process. Therefore, excessive mucus secretion and accumulation, resulting in partial or complete airway obstruction are the features of bronchiectasis. High-flow nasal cannula therapy, is delivered through heated and humidified air or oxygen. It has been clinically used in adults and infants, and has good empirical applications for chronic pulmonary obstruction, acute respiratory failure, and heart disease. Pulmonary obstruction and bronchiectasis are chronic diseases with a large amount of sputum inside dilated bronchial trees. The application of high-flow nasal cannula systems for pulmonary obstruction has been widely discussed. Therefore, this article reviews the effect of humidification on bronchial secretion clearance, and the therapeutic benefit management for bronchiectasis.

並列關鍵字

high-flow nasal cannula ； bronchiectasis ； bronchial secretion clearance

參考文獻

Andrews, J., Sathe, N. A., Krishnaswami, S.,& McPheeters, M, L. (2013). Nonpharmacologic airway clearance techniques in hospitalized patients: a systematic review. Respiratory Care,58(12), 2160-2186.

Belli, S., Prince, I., Savio, G., Paracchini, E.,Cattaneo, D., Bianchi, M., Masocco, F., Bellanti,M. T., & Balbi, B. (2021). Airway Clearance Techniques: The Right Choice for the Right Patient. Frontiers in Medicine (Lausanne).,8,544826. doi: 10.3389/ fmed.2021.544826

Brennan, M., McDonnell, M. J.,Duignan,N.,Gargoum, F., & Rutherford, R. M. (2022).The use of cough peak flow in the assessment of respiratory function in clinical practice-A narrative literature review. Respiratory Medicine, 193 , 106740. doi: 10.1016/j.rmed.2022.106740. Epub 2022 Jan 15

Chatwin, M., Toussaint, M., Gonçalves, M. R.,Sheers, N., Mellies, U., Gonzales-Bermejo, J.,Sancho, J., Fauroux, B., Andersen, T., Hov,B.,Nygren-Bonnier, M., Lacombe, M., Pernet, K.,Kampelmacher, M., Devaux, C., Kinnett, K.,Sheehan, D., Rao, F., Villanova, M., Berlowitz,D., & Morrow, B. M. (2018). Airway clearance techniques in neuromuscular disorders: a state of the art review. Respiratory Medicine, 136 ,98-110.

Fahy, J. V., & Dickey, B. F. (2010). Airway mucus function and dysfunction. New England Journal of Medicine, 363 (23), 2233-2247.