〔Abstract〕 Objective To investigate the effect of external diaphragm pacing combined with postural change on pulmonary infection in bedridden stroke patients with tracheotomy. Methods From June 2018 to June 2020, sixty cases of stroke patients with tracheotomy and pulmonary infection in the Second People's Hospital of Shenzhen were randomly divided into observation group and control group, thirty cases in each group. Both groups were given conventional treatment, and the observation group was given two additional treatments on the basis of conventional treatment: (1) external diaphragm pacing. (2) body position change. After 3 weeks of treatment, the following indexes were compared between the two groups: (1)the changes of the total amount of sputum in the fi rst, second and third day, average daily sputum output in the fi rst and second week after treatment in each group. (2) the differences in the time it takes for body temperature to return to normal between two groups. (3) the difference in the days of antibiotic use in the two groups. (4) the differences of diaphragm displacement before and after treatment in each group. Results (1) Compared with before treatment, there was no signifi cant change in the total amount of sputum on the fi rst, second and third day after treatment in the two groups (P > 0.05). In the observation group, the average daily sputum excretion decreased in the fi rst week and the second week (P < 0.05). In the control group, there was no signifi cant change in the average daily sputum output in the fi rst week (P > 0.05), but decreased in the second week (P < 0.05). (2) Compared with the control group, the time for body temperature toreturn to normal and the days of antibiotic use in the observation group were signifi cantly shorter, and the difference was statistically signifi cant (P < 0.01). (3) After treatment, the activity of diaphragm in the observation group was signifi cantly increased (P < 0.01), but the change of activity of diaphragm in the control group was not statistically signifi cant (P > 0.05). Conclusion External diaphragm pacing combined with position change therapy can improve diaphragmatic activity, reduce sputum volume, shorten the fever time of patients with pulmonary infection, promote the recovery of pulmonary infection, and reduce the use of antibiotics in bedridden patients with stroke after tracheotomy.