Xue Sujing, Lin Kewu, Lin Ledan, Zhou Huijie, Dong Lishuang, Chen Huafen, Zhang Tengfei
Department of Pediatric Internal Medicine, Wenzhou People's Hospital, Wenzhou Maternal and Child Health Care Hospital, Wenzhou, Zhejiang, China.
Department of Nursing, Wenzhou People's Hospital, Wenzhou Maternal and Child Health Care Hospital, Wenzhou, Zhejiang, China.
Front Pediatr. 2025 Jun 26;13:1539218. doi: 10.3389/fped.2025.1539218. eCollection 2025.
Sputum retention in pediatric pneumonia hinders recovery. This study evaluated the therapeutic benefits of incorporating mechanical vibration-assisted sputum clearance (MVSC) as an adjunct to standard pharmacological treatment and developed a nomogram to optimize treatment parameters.
In this randomized controlled trial, 160 children with pneumonia were randomly assigned (1:1) to a control group receiving pharmacological treatment or a treatment group receiving additional mechanical vibration therapy. The proportion of patients showing clinical improvement (defined as "markedly improved" or "improved") was assessed, along with symptom resolution times, lung function, blood gas parameters, and inflammatory markers, which were measured at baseline and treatment completion. LASSO regression identified predictors of clinical improvement.
A significantly greater proportion of patients exhibited clinical improvement in the treatment group (93.75%) compared to the control group (75%, < 0.05). The treatment group also showed significantly shorter times for symptom resolution (pulmonary rales, fever, and cough) and hospital stay ( < 0.05). Improvements in lung function (FEV1, FEV1/FVC), blood gas parameters (PaO₂, PaCO₂, pH), and greater reductions in inflammatory markers (CRP, PCT), were observed in the treatment group ( < 0.05). A nomogram was developed using age, chest circumference, moist rales, disease severity, vibration frequency, and pressure to determine optimal mechanical vibration settings for individualized treatment. The nomogram showed high predictive accuracy (AUC = 0.943) in estimating clinical improvement, aiding in the optimization of MVSC in pediatric pneumonia.
MVSC enhances the treatment of pediatric pneumonia, with the nomogram optimizing the parameters of the sputum clearance device.
小儿肺炎中的痰液潴留会阻碍康复。本研究评估了将机械振动辅助排痰（MVSC）作为标准药物治疗辅助手段的治疗效果，并制定了列线图以优化治疗参数。
在这项随机对照试验中，160名肺炎患儿被随机（1:1）分配至接受药物治疗的对照组或接受额外机械振动治疗的治疗组。评估显示临床改善（定义为“显著改善”或“改善”）的患者比例，以及在基线和治疗结束时测量的症状缓解时间、肺功能、血气参数和炎症标志物。LASSO回归确定了临床改善的预测因素。
与对照组（75%）相比，治疗组中表现出临床改善的患者比例显著更高（93.75%，P<0.05）。治疗组的症状缓解时间（肺部啰音、发热和咳嗽）和住院时间也显著更短（P<0.05）。治疗组的肺功能（FEV1、FEV1/FVC）、血气参数（PaO₂、PaCO₂、pH）有所改善，炎症标志物（CRP、PCT）的降低幅度更大（P<0.05）。利用年龄、胸围、湿啰音、疾病严重程度、振动频率和压力制定了列线图，以确定个体化治疗的最佳机械振动设置。该列线图在估计临床改善方面显示出较高的预测准确性（AUC = 0.943），有助于优化小儿肺炎的MVSC治疗。
MVSC可增强小儿肺炎的治疗效果，列线图可优化排痰设备的参数。
