Selçuk ACAR, Gülru POLAT, Melih BÜYÜKŞİRİN, Sabri KALENCİ, Serpil Karadağ POLAT, Gültekin TİBET, Özer GÜNDÜZ

KRONİK OBSTRÜKTİF AKCİĞER HASTALIĞINDA AKUT ATAK DÖNEMİNDE MEDİKAL TEDAVİ İLE BİRLİKTE SOLUNUM FİZYOTERAPİSİNİN ETKİNLİĞİ

KOAH'lı olgularda medikal tedaviye ilaveten uygulanan destek tedavilerinden en önemlisi solunum fizyoterapisidir. Bu çalışmanın amacı, orta-ağır şiddette hava yolu obstrüksiyonu olan olgularda medikal tedaviye ilave edilen solunum fizyoterapisinin solunum fonksiyon testleri ve arteryel kan gazı değerleri üzerine etkisini araştırmaktır. Eylül 2001-Ekim 2002 tarihleri arasında kliniğimizde akut atak nedeniyle yatarak tedavi gören, orta-ağır şiddette hava yolu obstrüksiyonu gösteren 90 olgu çalışmaya alındı. Kontrol grubuna (45 olgu) 14 gün sadece medikal tedavi, çalışma grubuna (45 olgu) medikal tedaviye ilaveten solunum fizyoterapisi uygulandı. ‚alışma ve kontrol grubundaki olgular arasında yaş, cinsiyet, sigara içimi öyküsü, KOAH öyküsü, başlangıç fonksiyonel ve arteryel kan gazı değerleri, aldıklar ı tedavi süresi yönünden fark yoktu. ‚alışma ve kontrol grubunda 1. ve 14. günlerde elde edilen fonksiyonel ve arteryel kan gazı değişimleri karşılaştırıldığında FEF25-75(lt,%) ve PEF (lt,%) değerlerinde çalışma grubu lehine anlamlı fark izlendi (P

Anahtar Kelimeler:

KOAH, akut atak, fizyoterapi

THE EFFECT OF RESPIRATORY PHYSIOTHERAPY TOGETHER WITH MEDICAL TREATMENT IN ACUTE ATTACK OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE

In chronic obstructive pulmonary disease(COPD), one of the most important treatments which supports medical treatment is respiratory physiotherapy. The aim of this study is to investigate the effect of respiratory physiotherapy on respiratory function tests and arterial blood gases of cases with moderate or severe obstructive airway disease. Ninety cases with moderate or severe obstructive airway disease who were hospitilised because of acute attack between september 2001-october 2002 involved in this study. Control group consisted of 45 cases who were given only medical treatment for 14 days. Study group also consisted of 45 cases who were given medical treatment together with respiratory physiotherapy. There was no statistical difference between case and control group for age, sex, smoking history, COPD history, functional and arterial blood gas parameters at the begining of the treatment and duration of treatment. When functional and arterial blood gas parameters which were taken 1st and 14th days of the treatment compared for the case and the control group, there was statistical difference for FEF25- 75(lt,%) and PEF(lt,%) in favor of study group (p

Keywords:

COPD, acute attack, physiotherapy,

PDF

___

1. Pauwels RA, Buis t AS, Calverley PM, et al. The GOLD Scientific Commitee: global strategy for the diagnosis, management and prevention of Chronic Obstructive Pulmonary Disease: NHBI / WHO GOLD Workshop summary. Am J Respir Crit Care 2001; 163: 1256-76.
2. Süerdem M. KOAH’ta akut atak tedavisi. Kronik Obstrüktik Akci¤er Hastal›¤›. Umut S, Erdinç E. (Yard eds). Toraks Kitaplar›, ‹stanbul, 2000: 188-197.
3. Saifakas NM, Vermeire P, Pride NB, et al. Optimal assessment and management of chronic obstructive pulmonary disease(COPD). Eur Respir J 1995; 8: 1398-420.
4. Ries AL. Pulmonary rehabilitation. Joint ACCP/ AACVPR evidence-based guidelines. Chest 1997; 112: 1363-96.
5. Niederman MS, Clemente PH, Fein AM, et al. Benefits of a multidisciplinary pulmonary rehabilitation program. Chest 1991; 99: 798-804.
6. Gürses N. KOAH’da rehabilitasyon. Kronik Obstrüktik Akci¤er Hastal›¤›. Umut S, Erdinç E. (Yard eds). Toraks Kitaplar›, ‹stanbul, 2000: 213-224.
7. Barr RN. Pulmonary rehabilitation. In: Hillegass EA, Sadowsky HS (eds). Essentials of cardiopulmonary physical therapy. Philedelphia: WB Saunders Company, 1994: 677-702.
8. American Thoracic Society. Pulmonary Rehabilitation 1999. American Journal of Respiratory and Critical Care Medicine 1999; 159: 1666-82.
9. BTS Statement. Pulmonary rehabilitation. Thorax 2001; 56: 827-34.
10. Cochane GM, Webber BA. Effect of sputum on pulmonary function. British Medical Journal 1977; 2: 1181-3.
11. May BD, Munt PW. Physiologic effect of chest percussion and postural drainage in patients with stable Chronic Bronchitis. Chest 1979; 75 (1): 14.
12. Woolf CR, Suero JT. Alterations in lung mechanics and gas exchange following training in Chronic Obstructive Lung Disease. Chest 1969; 55: 37.
13. Herola M, Ginslason T. Chest Physiotherapy , Evaluation by transcutaneous blood gas monitoring. Chest 1988; 93 (4): 800-2.
14. Feldman J, Traver GA. Maximal expiratory flows after postural drainage. American Review of respiratory Disease 1979; 119: 239-45.