Abstract: Objective　To explore the application effect of multi-frequency vibration sputum elimination machine for expectoration in children with severe pneumonia. Methods　A retrospective study method was used to study 50 children with severe pneumonia who were admitted to Children's Hospital Affiliated to Zhengzhou University from January to December 2021. The observation group had 14 males and 11 females, with an age of (5.23±1.01) years old; the control group had 13 males and 12 females, with an age of (5.26±1.04) years old. The control group was treated with artificial back knocking to expel sputum, and the observation group was treated with multi-frequency vibration sputum elimination machine to expel sputum. The treatment effect, respiratory function, serum inflammatory factors levels, and improvements of symptoms and signs were compared between the two groups. Independent sample t test was used for the measurement data, and χ² test or Fisher's exact probability method was used for the count data. Results　The total effective rate of the observation group was 100.00% (25/25), which was higher than 76.00% (19/25) of the control group, with a statistically significant difference (P=0.022). After treatment, the arterial partial pressure of carbon dioxide (PaCO₂) [(36.96±2.41) mmHg (1 mmHg=0.133 kPa)] and work of breathing (WOB) [(0.67±0.07) J/L] in the observation group were lower than those in the control group, and the arterial partial pressure of oxygen (PaO₂) [(95.41±5.73) mmHg], oxygen saturation (SaO₂) [(95.19±4.94)%], dynamic compliance (Cydn) [(38.49±3.52) mL /cmH₂O (1 cmH₂O=0.098 kPa)], and oxygenation index (PaO₂/FiO₂) [(384.49±50.65)] were higher than those in the control group, with statistically significant differences (all P<0.05). After treatment, the serum C-reactive protein (CRP) [(13.85±2.51) ng/L], white blood cell count (WBC) [(6.95±1.10) ×10⁹/L], interleukin-6 (IL-6) [(6.09±1.06) μg/ml], and procalcitonin (PCT) [(1.32±0.45) μg/L] in the observation group were lower than those in the control group, with statistically significant differences (all P<0.05). The cough relief time [(6.23±1.15) d], fever resolution time [(2.78±0.36) d], lung rales disappearance time [(6.04±1.09) d], and hospital stay [(12.37±3.26) d] in the observation group were shorter than those in the control group, with statistically significant differences (all P<0.05). Conclusion　The multi-frequency vibration sputum elimination machine to expel sputum can improve the respiratory function in children with severe pneumonia, reduce the inflammatory reaction, improve the clinical efficacy, and promote their rehabilitation.

Key words: Bronchoscopic alveolar lavage, Severe pneumonia, Multi-frequency vibration sputum elimination machine, Respiratory function, Inflammatory cytokines

摘要： 目的　探讨多频振动排痰机排痰在重症肺炎患儿中的应用效果。方法　采用回顾性研究方法对郑州大学附属儿童医院2021年1月至12月收治的50例重症肺炎患儿进行研究，观察组男14例，女11例，年龄（5.23±1.01）岁；对照组男13例，女12例，年龄（5.26±1.04）岁。对照组采取人工叩背排痰，观察组采用多频振动排痰机排痰。比较两组治疗效果、呼吸功能、血清炎症因子水平和症状及体征改善情况。计量资料用独立样本t检验，计数资料用χ²检验或Fisher确切概率法。结果　观察组治疗总有效率为100.00%（25/25），高于对照组的76.00%（19/25），差异有统计学意义（P=0.022）。观察组治疗后动脉二氧化碳分压（PaCO₂）［（36.96±2.41）mmHg（1 mmHg=0.133 kPa）］、呼吸做功量（WOB）［（0.67±0.07）J/L］低于对照组，动脉血氧分压（PaO₂）［（95.41±5.73）mmHg］、血氧饱和度（SaO₂）［（95.19±4.94）%］、动态顺应性（Cydn）［（38.49±3.52）ml/cmH₂O（1 cmH₂O=0.098 kPa）］、氧合指数（PaO₂/FiO₂）［（384.49±50.65）］高于对照组，差异均有统计学意义（均P<0.05）；观察组治疗后血清C反应蛋白（CRP）［（13.85±2.51）ng/L］、白细胞计数（WBC）［（6.95±1.10）×10⁹/L］、白细胞介素-6（IL-6）［（6.09±1.06）μg/ml］和降钙素原（PCT）［（1.32±0.45）μg/L］均低于对照组，差异均有统计学意义（均P<0.05）。观察组咳嗽缓解时间［（6.23±1.15）d］、发热消退时间［（2.78±0.36）d］、肺啰音消失时间［（6.04±1.09）d］和住院时间［（12.37±3.26）d］均短于对照组，差异均有统计学意义（均P<0.05）。结论　多频振动排痰机排痰能够改善重症肺炎患儿呼吸功能，减轻炎性反应，提高临床疗效，从而促进患儿康复。

关键词: 纤维支气管镜肺泡灌洗术, 重症肺炎, 多频振动排痰机, 呼吸功能, 炎性因子