不同气道廓清技术在迁延性细菌性支气管炎患儿呼吸道管理中的应用研究  

Application study of different airway clearance technique for airway management of children with protracted bacterial bronchitis

作　　者：魏红雨 刘玉琳[1] 杨帆[1] 王紫娟[1] 谢晓虹[1] 刘曦璇 WEI Hongyu;LIU Yulin;YANG Fan;WANG Zijuan;XIE Xiaohong;LIU Xixuan(Department of Respiratory,Children′s Hospital of Chongqing Medical University,Ministry of Education Key laboratory of Child Development and Disorder,China International Science and Technology Cooperation Base of Child Development and Critical Disorder,Chongqing Key Laboratory of Child Rare Diseases in Infection and Immunity,Chongqing,Sichuan 400042,China)

机构地区：[1]重庆医科大学附属儿童医院呼吸科,儿童发育疾病研究教育部重点实验室,国家儿童健康与疾病临床医学研究中心,儿童发育重大疾病国家国际科技合作基地,儿科学重庆市重点实验室,重庆400042

出　　处：《临床肺科杂志》2025年第2期163-169,共7页Journal of Clinical Pulmonary Medicine

基　　金：重庆市科卫联合技术创新与应用发展项目(No.2021MSXM340)。

摘　　要：目的比较主动循环呼吸技术(ACBT)与振荡呼气正压技术(OPEP)治疗迁延性细菌性支气管炎(PBB)患儿的效果。方法选取2022年7月~2023年12月于重庆市某三甲儿童医院呼吸科住院患儿随机分为OPEP组和ACBT组;两组患儿均给与抗感染、雾化吸入、支气管镜灌洗等常规治疗。在常规治疗的基础上,OPEP组使用OPEP装置辅助排痰,ACBT组使用ACBT进行干预;共干预2周。主要结局指标包括痰液性状、咳嗽难度、咳嗽症状积分;次要结局指标包括湿性咳嗽消失时间、生活质量、培训时长、安全性和不良反应。结果47例患儿完成了试验(OPEP组24例,ACBT组23例),一般资料比较具有可比性。干预后两组患儿痰液性状、咳痰难度、咳嗽症状积分时间效应具有统计学差异(P<0.05),咳痰难度组别效应具有统计学差异(P<0.05);干预后两组患儿生活质量得分高于干预前(P<0.05)。OPEP组的培训时长少于ACBT组,差异有统计学意义(P<0.05)。结论OPEP在清除气道分泌物和提高生活质量方面不劣于ACBT,且培训时间短,在降低患儿的咳痰难度方面优于ACBT,可优先选择OPEP作为PBB患儿气道廓清技术。Objective To compare the effectiveness of active cycle of breathing technique(ACBT)and oscillating positive expiratory pressure(OPEP)in treatment of children with protracted bacterial bronchitis(PBB).Methods Children hospitalized in the respiratory department of a tertiary children′s hospital in Chongqing from July 2022 to December 2023 were selected and randomly divided into the OPEP group and the ACBT group.Both groups of children received routine treatments such as anti-infection,nebulization inhalation,and bronchoscopy lavage.In addition to routine treatment,the OPEP group used OPEP devices to assist in sputum clearance,while the ACBT group received ACBT intervention.The intervention lasted for 2 weeks.The main outcome measures included sputum characteristics score,expectoration difficulty score,and daily cough scores.Secondary outcome measures included disappearance time of wet cough,quality of life,duration of training,safety,and adverse reactions.Results 47 pediatric patients completed the trial(24 in the OPEP group and 23 in the ACBT group),and their general data were comparable.The results of repeated measures ANOVA revealed statistically significant time effect on sputum characteristics score,expectoration difficulty score,and daily cough scores between the two groups post-intervention(P<0.05).Additionally,there was a statistically significant group effect on expectoration difficulty score(P<0.05).Furthermore,the quality of life scores for both groups were higher post-intervention compared to pre-intervention ( P <0.05). The duration of training for the OPEP group was significantly shorter than that of the ACBT group, with a statistically significant difference observed ( P <0.05). Conclusion OPEP is not inferior to ACBT in clearing airway secretions and improving quality of life, and it is superior to ACBT in reducing children′s expectoration difficulty score with shorter training time. OPEP may be preferred as an airway clearance technique for children with PBB.

关 键 词：迁延性细菌性支气管炎 气道廓清技术 主动循环呼吸技术 振荡呼气正压技术 儿童 

分 类 号：R725.6[医药卫生—儿科]