胸外按压反馈技术提高急诊科医生胸外按压质量的效果评价  

The cardiopulmonary resuscitation feedback system can improve the quality of chest compression provided by emergency physicians

作　　者：马林浩[1] 管军[1] 陈坤[1] 瞿金龙[1] 林兆奋[1] 

机构地区：[1]上海长征医院急救科ICU,上海200003

出　　处：《中国急救医学》2016年第5期411-414,共4页Chinese Journal of Critical Care Medicine

摘　　要：目的探讨胸外按压实时反馈技术能否改善急诊科医生胸外按压质量指标及这种改善对按压者生理反应的影响。方法随机抽取18名急诊科青年医师作为受试者，先在心肺复苏（CPR）模拟人上进行无反馈提示的常规胸外按压，充分休息后，进行反馈提示下的胸外按压。胸外按压实时反馈通过美国Zoll公司的AEDPLUS除颤仪实现。语音提示按压深度是否达标及按压频率是否达到至少1000rJmin。观察记录所有受试者在按压前后血压（BP）、心率（HR）和经皮血氧饱和度（SpO2）。结果实施常规胸外按压时，受试者的胸外按压频率明显比反馈按压时偏快[（138±13）min vs．（106±6）min，P〈0．001]。而反馈按压时的平均按压深度比常规按压时显著增加[（5．8±0．9）cmvs．（4．6±1．1）cm，P=0.004]。反馈按压的综合指南达标率更是远高于常规按压（59．7％vs．0．1％，P=0．012）。两种按压方式所导致受试者的BP、HR和SpO2变化差异均无统计学意义（P〉0．05）。结论急诊科医生的CPR质量需要进一步提高，而复苏质量实时反馈技术能有效地改善CPR按压质量，并且这种改善不以增加体能消耗为代价。Objective To assess the effect of a feedback device on the emergency physician＇ s quality of chest compression （CC） and their physiology response. Methods This is a prospective randomized crossover study of emergency physicians at a university-affiliated hospital. Eighteen participants performed CC on a mannequin. Firstly, they performed 2 minutes CC without feedback. After 15 seconds interval for pulse and ECG checking, they finished another 2 minutes CC. After at least 40 minutes rest, they repeated g minutes CC with feedback. Feedback during CPR was with the assistance of AED Plus （M-series, Zoll Medical, Chelmsford, MA, USA）. The auditory prompted ＂Push Harder＂ if the measured compression depth （CD） was less than 5 cm or ＂Good Compression＂ if the measured compression depth was more than 5 cm. It also has a built-in metronome set to beep at 100 bpm so as to lead the compression rate （CR） at least 100 bpm. Based on the newest consensus statement from the American Heart Association, CR less than 100 bpm was recognized as compression too slow, while 100-120 bpm was good and more than 120 bpm was too fast; CD less than 5 cm was recognized as too shallow, while more than 5 cm as good. CR, CD, and the participants＇ heart rate, blood pressure and oxygen saturation before and after CC were all documented. Results Mean CR was significant higher （138±13 vs. 106±6, P〈0.001） and mean CD was significant lower [（4.6±1.1）cm vs. （5.8±0.9） cm,P = 0.004）] when the participants do CC without feedback. The excellent percentage was significant higher when participants finished CC with feedback （59.7% vs. 0.1% ,P = 0.012）. There was no statistical difference in the participants＇ heart rate, blood pressure and oxygen saturation with or without feedback devices. Conclusion The quality of cardiopulmonary resuscitation among emergency physicians needs to be improved. The quality of chest compression during cardiopulmonary resuscitation can be improved through the help of feedback de

关 键 词：心肺复苏(CPR) 反馈装置 胸外按压 心脏骤停 实时反馈 

分 类 号：R605.974[医药卫生—急诊医学]