Clinical analysis of high-frequency chest wall oscillation expectoration and traditional airway clearance in the treatment of severe pneumonia

doi:10.3877/cma.j.issn.1674-6902.2025.05.025

Abstract

Abstract:

Objective

To analyze the clinical efficacy of high-frequency chest wall oscillation expectoration (HFCWOE) versus traditional airway clearance techniques (TACT) in the treatment of severe pneumonia.

Methods

A retrospective analysis was conducted on 71 elderly patients with severe pneumonia, divided into control group 39 cases and observation group 32 cases according to the distinct treatment methods they received. Control group received fiberoptic bronchoscopic alveolar lavage combined with TACT. Observation group received fiberoptic bronchoscopic alveolar lavage combined with HFCWO. Clinical efficacy, symptom relief time, lung function, blood gas parameters, inflammatory mediator levels, and immune function were compared between the two groups.

Results

After treatment, The total response rate of observation group was 87.50%, peak expiratory flow (PEF) (2.93±0.38)L/s, forced vital capacity (FVC) (2.61±0.33)L, forced expiratory volume in 1 second (FEV₁) (2.28±0.26)L, partial pressure of O₂ (PaO₂) (83.27±7.24)mmHg, PaO₂/fraction of inspiration O₂ (FiO₂) (341.86±37.54)mmHg, CD3⁺ T cell (CD3⁺ ) (62.53±11.28) % and natural killer cell (NK) (15.76±3.51)% were higher than those in control group 66.67%, (2.74±0.29)L/s, (2.42±0.28)L, (2.13±0.17)L, (78.92±6.86)mmHg, (320.63±42.79)mmHg, (55.78±10.36)%, (13.92±2.98)% (P<0.05). The disappearance time of lung wet rale (5.30±1.16)d, sputum relief time (4.89±1.07)d in observation group were shorter than those in control group (5.96±1.28)d, (5.46±1.19) d (P<0.05). partial pressure of CO₂(PaCO₂) (41.63±5.19) mmHg, neutrophil elastas (NE) (10.34±2.36)ng/L, soluble form of triggering receptors expressed on myeloid cell-1 (sTREM-1) (24.31±3.27)ng/L, interleukin-10(IL-10) (19.54±3.22)ng/L, CD8⁺ T cell (CD8⁺ ) (24.63±3.58)% in observation group were lower than those in control group (44.52±4.71) mmHg, (11.94±2.75)ng/L, (26.82±4.19) ng/L, (21.73±4.16)ng/L, (27.09±4.45) % (P<0.05).

Conclusions

HFCWOE has good clinical effect on patients with severe pneumonia. Compared with the use of TACT, it can shorten the time of relieving clinical symptoms, improve lung function and immune function of patients, regulate blood gas level of patients, and reduce inflammatory response.

Key words: Severe pneumonia, High-frequency chest wall oscillation, Traditional airway clearance techniques, Lung function

Hong Liu, Guorong Li, Xiangzhe Zhan, Haiyan Gao, Hongqian Liu, Yonghui Zhao. Clinical analysis of high-frequency chest wall oscillation expectoration and traditional airway clearance in the treatment of severe pneumonia[J]. Chinese Journal of Lung Diseases(Electronic Edition), 2025, 18(05): 802-806.

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References 27

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分　组	例数	PaO₂(mmHg)		PaCO₂(mmHg)		PaO₂/FiO₂(mmHg)
分　组	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
观察组	32	59.21±5.36	83.27±7.24^a	65.27±4.49	41.63±5.19^a	179.51±34.37	341.86±37.54^a
对照组	39	58.63±4.74	78.92±6.86^a	64.33±4.18	44.52±4.71^a	174.86±31.42	320.63±42.79^a
t值		0.484	2.593	0.912	2.457	0.595	2.197
P值		0.630	0.012	0.365	0.017	0.554	0.031

分　组	例数	PaO₂(mmHg)		PaCO₂(mmHg)		PaO₂/FiO₂(mmHg)
分　组	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
观察组	32	59.21±5.36	83.27±7.24^a	65.27±4.49	41.63±5.19^a	179.51±34.37	341.86±37.54^a
对照组	39	58.63±4.74	78.92±6.86^a	64.33±4.18	44.52±4.71^a	174.86±31.42	320.63±42.79^a
t值		0.484	2.593	0.912	2.457	0.595	2.197
P值		0.630	0.012	0.365	0.017	0.554	0.031

分　组	例数	PEF(L/s)		FVC(L)		FEV₁(L)
分　组	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
观察组	32	1.81±0.24	2.93±0.38^a	1.89±0.31	2.61±0.33^a	1.24±0.25	2.28±0.26^a
对照组	39	1.86±0.27	2.74±0.29^a	1.84±0.26	2.42±0.28^a	1.29±0.21	2.13±0.17^a
t值		0.816	2.389	0.739	2.625	0.916	2.923
P值		0.417	0.020	0.462	0.011	0.363	0.005

分　组	例数	PEF(L/s)		FVC(L)		FEV₁(L)
分　组	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
观察组	32	1.81±0.24	2.93±0.38^a	1.89±0.31	2.61±0.33^a	1.24±0.25	2.28±0.26^a
对照组	39	1.86±0.27	2.74±0.29^a	1.84±0.26	2.42±0.28^a	1.29±0.21	2.13±0.17^a
t值		0.816	2.389	0.739	2.625	0.916	2.923
P值		0.417	0.020	0.462	0.011	0.363	0.005

分　组	例数	NE(ng/L)		sTREM-1(ng/L)		IL-10(ng/L)
分　组	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
观察组	32	14.83±2.74	10.34±2.36^a	47.38±8.10	24.31±3.27^a	51.36±6.11	19.54±3.22^a
对照组	39	14.76±2.88	11.94±2.75^a	46.22±8.74	26.82±4.19^a	51.89±6.47	21.73±4.16^a
t值		0.104	2.598	0.798	2.766	0.352	2.438
P值		0.917	0.011	0.428	0.007	0.726	0.017

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