氣道清除治療知多少？

How Much do You Know About Airway Clearance Therapy?

正常氣道清除功能須包含通暢氣道、有功能的黏膜纖毛扶梯、充足水分及有效咳嗽。但當正常氣道清除功能受限時，則可能導致清除功能異常，使分泌物滯留，進而產生相關肺部合併症。氣道清除治療主要是幫助病人移動和清除滯留分泌物，進而改善氣體交換，促進肺泡擴張，減少呼吸功。氣道清除治療的技術主要是運用增加呼氣流量、振盪氣流和增加肺容量等方式。臨床常見技術有呼吸技術、呼氣氣道正壓、胸腔物理治療、咳嗽和相關排除技術、高頻振盪設備等等。現況除胸腔物理治療和呼氣氣道正壓系列較具強大背景方法外，當前技術已漸朝向對可攜式和排除分泌物設備的方向進行研發。然而一個成功氣道清除治療結果，需了解正常和異常生理學、清除裝置的工作原理，並嚴格應用實證方式小心選擇及評估病人，以及針對治療目標持續評估和追蹤。

Normal airway clearance must include patent airways, a functional mucociliary escalator, adequate hydration, and an effective cough. However, when the normal airway clearance function is impaired, the clearance function may be abnormal, resulting in the retention of secretions and related pulmonary complications. Airway clearance therapy is to help patients mobilize and remove retained secretions, thereby improving gas exchange, promoting alveolar expansion, and reducing work of breathing. Airway clearance therapy techniques are achieved by increasing expiratory flow, oscillating airflow, and increasing lung volume. Common clinical techniques include breathing techniques, positive expiratory pressure, chest physiotherapy, cough and related exclusion techniques, high-frequency oscillatory equipment, and so on. In addition to the more powerful background methods of thoracic physiotherapy and positive expiratory pressure series, the current technology has gradually developed towards portable and secretion removal equipment. A successful airway clearance treatment outcome requires an understanding of normal and abnormal physiology, how airway clearance devices work, careful patient selection and assessment using rigorous empirical methods, and ongoing assessment and tracking of treatment goals.