杜志伟,王路,陈艳,等.振动正压通气联合高频胸壁震荡对支原体肺炎患儿肺功能的影响[J].中华物理医学与康复杂志,2026,48(3):249-253
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| 振动正压通气联合高频胸壁震荡对支原体肺炎患儿肺功能的影响 |
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| DOI：10.3760/cma.j.cn421666-20231211-00987 |
| 中文关键词: 振动正压通气治疗 高频胸壁震荡 支原体肺炎 肺功能 |
| 英文关键词: Oscillating positive expiratory pressure therapy High-frequency chest wall concussions Mycoplasma pneumonia Lung function |
| 基金项目:国家重点研发计划项目（2020YFC2005700）；广州市卫生健康科技项目（20231A010049） |
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| 中文摘要: |
| 目的 观察振动正压通气（OPEP）联合高频胸壁震荡对支原体肺炎患儿肺功能的影响，并探讨其作用机制。方法 募集支原体肺炎患儿 90 例，采用随机数字表法将其分为对照组、震荡组、联合组，每组患儿 30 例。3 组患儿均接受常规治疗，包括药物治疗（如退热、止咳、抗感染、雾化、吸氧等）和常规康复治疗，震荡组在常规治疗的基础上增加高频胸壁震荡治疗，联合组则增加 OPEP 联合高频胸壁震荡进行治疗。震荡组和联合组的治疗每日 2 次，连续治疗 7d。记录 3 组患儿咳嗽消失时间、肺部啰音消失时间、住院时间以及排痰量，并于治疗前和治疗 7d 后（治疗后）对患儿进行肺功能评估，主要参数包括用力肺活量（FVC）、第一秒用力呼气容积占正常预计值百分比（FEV1% pred）和呼气峰流速（PEF），同时检测并比较 3 组患儿血清炎症因子中血清降钙素原（PCT）和血清超敏 C 反应蛋白（hs-CRP）的水平。结果 联合组患儿咳嗽消失时间 [(6.70±1.80) d]、肺部啰音消失时间 [(4.47±1.20) d]、住院时间 [(6.47±1.68) d] 以及入院后第 1~3 天和入院后第 4~6 天的排痰总量均显著优于震荡组和对照组（P<0.05）。治疗后，3 组患儿的 FVC、FEV1% pred、PEF、hs-CRP、PCT 较组内治疗前均显著改善（P<0.05），且联合组治疗后的 FVC、FEV1% pred、PEF、hs-CRP、PCT 均显著优于对照组和震荡组治疗后，组间差异均有统计学意义（P<0.05）。结论 OPEP 联合高频胸壁震荡可更有效地降低支原体肺炎患儿的炎症反应，促进其肺功能康复，提升疗效。 |
| 英文摘要: |
| Objective To quantify any effect of combining oscillating positive expiratory pressure (OPEP) with high-frequency chest wall oscillations to improve the pulmonary functioning of children with mycoplasmal pneumonia, and to explore its mechanism. Methods Ninety children with mycoplasmal pneumonia were divided at random into a control group, an oscillation group and a combined therapy group, each of 30. In addition to conventional treatment including antipyretic, antitussive and anti-infection medication, nebulization and oxygen inhalation and routine nursing care, the oscillation group was additionally given high-frequency chest wall oscillation therapy, while the combined therapy group received OPEP combined with high-frequency chest wall oscillation, twice a day for 7 consecutive days. Cough resolution times, pulmonary rale disappearance, hospital stays and sputum output were recorded. Each child's pulmonary functioning was assessed before and after the treatment. Forced expiratory volume in one second as a percentage of the normal predicted value (FEV1%pred), forced vital capacity (FVC), and peak expiratory flow (PEF) were the principal output variables. Serum levels of the inflammatory factors high-sensitivity C-reactive protein (hs-CRP) and procalcitonin (PCT) were detected and compared among the three groups. Results The average cough resolution time [(6.70±1.80)d], pulmonary rale disappearance time [(4.47±1.20)d], hospital stay [(6.47±1.68)d], and the total sputum output during days 1-3 and days 4-6 after admission in the combined therapy group were significantly superior to the other two groups' averages. FVC, FEV1%pred, PEF, hs-CRP and PCT had improved significantly in all three groups compared with before the treatment, with the combined group's averages significantly better than those of the other two groups. Conclusions Oscillatory positive expiratory pressure combined with high-frequency chest wall oscillation can more effectively alleviate inflammation and promote the recovery of pulmonary function in children with mycoplasmal pneumonia. |
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