| Objective To investigate the effects of the artificial sputum excretion method and the mechanical sputum excretion method in children with pertussis from 0?6 years old.The therapeutic effects of different treatment times were compared and the optimal duration of single treatment was determined.Methods In this study,181 children aged 0?6 years old with pertussis complicated with pneumonia who were hospitalized in the department of infectious diseases in a specialized infectious disease hospital in jinan city,shandong province from January to December 2019 were selected as the research objects,and the children were divided into 3 groups according to the admission order.Among them,62 children admitted from January to April 2019 were included in the group with the artificial sputum excretion method.The children admitted for treatment from may to August were included in group 1 with the mechanical sputum excretion method,with a total of 59 cases.The children admitted from September to December were included in group 2 with the mechanical sputum excretion method,a total of 60 cases.On the basis of standard treatment,children in the artificial sputum excretion group were given artificial backbeat sputum excretion for 20 minutes each time.Children in group 1 with the mechanical sputum excretion method were given mechanical assisted sputum excretion for 20 minutes each time.Children in group 2 with the mechanical sputum excretion method were given mechanical assisted sputum excretion for 10 minutes each time.Three groups of children with all intervention 7 days,observe and record the expectoration indicators(the amount of expectoration drainage,TcSO2,Lung auscultation,breathing rate,spasm,times of cough),inflammatory indicators(WBC,LYM,CRP and PCT),auxiliary indicators(temperature changes,children cooperation degree,imaging,hospitalization duration,hospitalization expenses,pneumonia curative effect).The daily sputum discharge,TcSO2,Lung auscultation,respiratory frequency,frequency of spasm,temperature change,and coordination degree of the children were measured and recorded during the intervention period.Changes of WBC,LYM,CRP,PCT and imaging after intervention were recorded.To evaluate the efficacy of pneumonia treatment at the end of intervention cycle and at the time of discharge;Record the length and cost of hospitalization.Statistical analysis was performed using SPSS26.0,including descriptive statistics,independent sample t test,one-way anova,chi-square test,and repetitive measure analysis of variance.Results1.Comparison of baseline data of children with pertussis complicated with pneumoniaThere were 181 children with pertussis complicated with pneumonia,with an average of(20.25±22.92)months.There were 88 male patients(48.6%),90.1%of the children were in the period of spasmodic cough.There were 62 patients in the group with the artificial sputum excretion method,59 patients in group 1 with the mechanical sputum excretion method and 60 patients in group 2 with the mechanical sputum excretion method,with an average age of(20.20±22.79)months,an average BMI of(21.80±2.32)kg/m2,an average birth weight of(3.24±0.30)kg.There were 25 male children(41.7%).The independent sample t test and chi-square test showed that there was no statistically significant difference(P>0.05)between the baseline socio-demographic information,disease information and observation indicators of the children in the group with the artificial sputum excretion method and group 1 with the mechanical sputum excretion method,group 1 and group 2 with the mechanical sputum excretion method,and the grouping was balanced.2.Comparison of the effects of the method of artificial sputum excretion and the method of mechanical sputum excretionAnalysis of variance of repeated measures showed that the differences of sputum discharge,TcSO2 change,lung auscultation rales,respiratory frequency,and number of spasm in the correlation indexes of sputum excretion in the group effect,the time effect,and the time × group interaction effect were statistically significant(P<0.05).In addition to breathing rate between groups effect(?2p=0.039)present the effect of small amount of levels,the rest of the the time × group interaction effect achieves the effect of medium to very large volume levels(?2p=0.059?0.970).Inflammatory indicators of the WBC count,CRP value,the improvement of the PCT values between the group effect,the time effect,and the time × group interaction effect were statistically significant(P<0.05),with the level of the medium to very large effect size(?2p=0.073?0.993);LYM count improvement effect statistically difference between groups(P=0.001,?2p=0.097),the time effect is statistically significant(P<0.001,?2p=0.916),but the time × group interaction effect were not statistical significance(P=0.728).Auxiliary indicators in the matching degree between the group effect,the time effect,the time × group interaction effect on the difference has statistical significance(P<0.05),and present level of medium effect size(?2p=0.113?0.210);In the time effect to the improvement of the temperature effect(P<0.001,?2p=0.466)and the time × group interaction effect were statistical significance(P=0.011,?2p=0.134),but the group effect was not statistical significance(P=0.055).Independent sample t test and chi-square test showed that in terms of hospitalization time,hospitalization cost and curative effect of 1 week,there were statistically significant differences between the artificial sputum excretion group and the mechanical sputum excretion group(P<0.05).In terms of imaging changes at 1 week and efficacy at discharge,the difference between the artificial sputum excretion method and group 1 with the mechanical sputum excretion method was not statistical significance(P>0.05).3.Comparison of the effects of the mechanical of sputum excretion in different durations.Repetitive measure analysis of variance showed that out sputum expectoration drainage relevant indicators and breathing rate between the group effect,the time effect,the time × group interaction effect were statistically significant(P<0.05),the effect of different levels(?3p=0.010?0.964);TcSO2 change,lung auscultation then sound,breathing rate,spasm,cough times in the time effect were statistically significant(P<0.001),and reach a very large effect level(?2p=0.892?0.978),but the group effect and the time × group interaction effect were not statistical significance(P>0.05).Inflammatory indicators of CRP value,the improvement of the PCT in the group effect,the time effect,the time × group interaction effect were statistical significance(P<0.05),the intervention effect of CRP value to achieve the effect of small amount level(?p=0.028),the intervention effect to medium effect of PCT levels(?2p=0.155);The time effect of the WBC count is improved(P<0.001,eta 2 P=0.944)and improve the time effect of LYM count(P<0.001,?2p=0.919)reached statistical significance,but the time × group interaction effect were not statistical significance(P>0.05).The time effect of auxiliary index of relevant cooperation degree(P=0.005,?2p=0.135)and the time effect of temperature to improve(P<0.001,?2p=0.600)reached statistical significance,but the group effect and the time × group interaction effect were not statistical significance(P>0.05).There was not statistically significant difference between group 1 and group 2 with the mechanical sputum excretion method on other indicators(P>0.05).Conclusion1.Both children with pertussis complicated with pneumonia of the method of artificial sputum excretion and the method of mechanical sputum excretion have certain therapeutic effect,but the mechanical sputum excretion method is superior to the artificial method in sputum expectoration,improving the inflammatory response,promoting the body temperature,and it can improve the treatment effect,shorten the length of hospital stay,reduce hospitalization expenses.2.Both mechanical sputum excretion method of single treatment for 10 minutes and 20 minutes in children with pertussis complicated with pneumonia have certain effect.The durations for 20 minutes is better than that for 10 minutes in the effect of sputum excretion and the improvement of inflammatory response.But the durations of mechanical sputum excretion method should be choosen depending on the infant's condition,receptivity,and human resources in clinical work. |
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