新旧心肺复苏指南指导院外心源性猝死抢救效果的对比研究  

Intervention effects of old and new editions of cardiopulmonary resuscitation guideline on out-of-hospital sudden cardiac death

作　　者：郭翔云[1] 康国平[1] 李果[1] 吴龙飞[1] 

机构地区：[1]川北医学院附属巴中医院急诊科,四川巴中636000

出　　处：《中国循证心血管医学杂志》2013年第5期476-478,共3页Chinese Journal of Evidence-Based Cardiovascular Medicine

摘　　要：目的：比较2005年旧版心肺复苏（CPR）指南和2010年新版CPR指南指导下院外心源性猝死（SCA）的抢救效果。方法纳入2008年7月~2010年9月在旧版CRP指导下进行院外CRP抢救的SCA患者248例作为旧指南组，2011年1月~2013年3月在新版CRP指导下抢救的SCA患者282例作为新指南组，比较两组SCA患者经CPR抢救后的自主循环恢复率、1个月存活率以及1个月后无脑功能受损的存活率。结果与旧指南组比较，新指南组自主循环恢复率明显增加（12.77%vs.7.66%，P=0.045），其中SCA发作至接受CPR的时间≤10 min的患者中，新指南组自主循环恢复率明显高于旧指南组（36.23%vs.19.35%， P=0.032）；而超过10 min接受CPR的患者之间自主循环恢复率无差异（5.16%vs.3.76%，P=0.501）。新指南组1个月后存活率以及存活且无脑功能受损的患者比例均高于旧指南组，但差异均无统计学意义（P＞0.05）。结论新版CPR指南较旧版指南抢救SCA患者成功率更高，同时还可提高患者无脑功能受损的存活率。Objective To compare the rescue results of out-of-hospital （OOH） sudden cardiac death （SCD） guided by 2005 AHA CPR Guideline and 2010 AHA CPR Guideline. Methods The patients （n=248） with OOH CPR rescue guided by 2005 AHA CPR Guideline were chosen from July, 2008 to Sept. 2010 as 2005 group, and the patients （n=282） with OOH CPR rescue guided by 2010 AHA CPR Guideline were chosen from Jan. 2011 to Mar. 2013as 2010 group. The recovery rate of spontaneous circulation, one-month survival rate and survival rate without cerebral injury after one month were compared between two groups. Results Compared with 2005 group, the recovery rate of spontaneous circulation increased significantly in 2010 group （12.77% vs. 7.66%, P=0.045）. Among the patients accepted CPR within 10 minutes after SCD attack, the recovery rate of spontaneous circulation was significantly higher in 2010 group than that in 2005 group （36.23%vs. 19.35%, P=0.032）, while among those accepted CPR after 10 minutes, the recovery rate of spontaneous circulation had no difference between two groups （5.16%vs. 3.76%, P=0.501）. The proportion of one-month survival rate and survival rate without cerebral injury after one month were all higher in 2010 group than those in 2005 group but the difference was not statistically significant （P〉0.05）. Conclusion The success rate of rescuing SCD patients guided by 2010 AHA CPR Guideline is higher, and at the same time the survival rate of the patients without cerebral injury is improved.

关 键 词：心肺复苏 指南 心源性猝死 自主循环 

分 类 号：R541[医药卫生—心血管疾病]