Sun Jiali, Chen Jinglong, Wang Libo, Lu Aizhen
Departments of Pneumonology, Children's Hospital of Fudan University, Shanghai, China.
Transl Pediatr. 2021 Feb;10(2):315-322. doi: 10.21037/tp-20-237.
It is well documented that vibration techniques and positive expiratory pressure (PEP) can improve airway clearance, however, few clinical trials have studied the efficacy of vibrating PEP therapy on refractory () pneumonia (RMPP) in children. This study aimed to explore using vibrating PEP therapy in children with RMPP.
Sixty participants in the remission stage of RMPP were recruited into this randomized study and divided into two groups. The Acapella group (n=30) used the Acapella Choice twice daily for 2 months to clear their airways. The control group (n=30) used traditional chest percussion or postural drainage to mediate sputum expectoration. The groups administered their respective treatments at home and were followed up weekly. Participants kept a record of their treatment and condition in a daily log. The primary outcome of this study was the resolution of chest images, and the secondary outcome was the sputum period.
There was no significant difference in sex or age distribution between the two groups. There were no significant differences at baseline between the groups in the location of their lesions (P=0.11). After 2 months of treatment, there was a better resolution of chest images in the Acapella group (P=0.00) compared with the control group. Additionally, the mean sputum period was significantly shorter for the Acapella group than for the control group (Acapella: 7.97±1.54 days; control: 11.90±1.64 days; P=0.00).
Vibrating PEP therapy is an effective therapy for children with RMPP, both in airway clearance and the resolution of lung abnormalities.
有充分的文献记载，振动技术和呼气末正压（PEP）可改善气道清除功能，然而，很少有临床试验研究振动PEP疗法对儿童难治性支原体肺炎（RMPP）的疗效。本研究旨在探讨振动PEP疗法在RMPP患儿中的应用。
60例处于RMPP缓解期的参与者被纳入这项随机研究，并分为两组。Acapella组（n = 30）每天使用两次Acapella Choice，持续2个月以清理气道。对照组（n = 30）采用传统的胸部叩击或体位引流来促进痰液咳出。两组在家中进行各自的治疗，并每周进行随访。参与者在每日日志中记录他们的治疗情况和病情。本研究的主要结局是胸部影像的改善，次要结局是排痰期。
两组之间的性别或年龄分布无显著差异。两组在病变部位的基线情况无显著差异（P = 0.11）。治疗2个月后，与对照组相比，Acapella组的胸部影像改善情况更好（P = 0.00）。此外，Acapella组的平均排痰期明显短于对照组（Acapella组：7.97±1.54天；对照组：11.90±1.64天；P = 0.00）。
振动PEP疗法对RMPP患儿是一种有效的治疗方法，在气道清除和肺部异常的改善方面均有效果。
