基于Utstein模式下徒手CPR与萨勃心肺复苏器CPR在急诊科应用效果的比较  

Comparative study for effects of bare-handed CPR with Thumper cardiopulmonary resuscitator CPR in emergency department based on ＂the Utstein style＆quot;

作　　者：张重阳[1] 王耀辉[1] 刘洪伟[1] 郝艾香 徐俊祥 孟庆义[3] Zhang Chongyang Wang Yaohui Liu Hongwei Hao Aixiang Xun Junxiang Meng Qingyi(Department of Emergency, the First Hospital of Qinhuangdao, Qinhuangdao 066000, Hebei, Chin the Health Emergency Dispatch Center of Qinhuangdao City, Qinhuangdao 066000, Hebei, Chin Department of Emergeney, PLA General Hospital, Beijing 100853, China)

机构地区：[1]秦皇岛市第一医院急诊科,河北秦皇岛066000 [2]秦皇岛市卫生应急调度中心,河北秦皇岛066000 [3]解放军总医院急诊科,北京100853

出　　处：《中华危重病急救医学》2017年第10期937-939,共3页Chinese Critical Care Medicine

基　　金：河北省秦皇岛市科学技术研究与发展计划项目（201502A160）

摘　　要：目的 基于心肺复苏（CPR）Utstein模式客观、规范比较在急诊抢救过程中徒手CPR与萨勃心肺复苏器CPR的复苏效果.方法 从Utstein模式注册登记表中选择2015年1月至2017年1月在河北省秦皇岛市第一医院急诊抢救室进行CPR的成人患者.将其中使用萨勃心肺复苏器进行CPR的70例患者纳入萨勃CPR组,进行人工徒手标准CPR的80例患者纳入徒手CPR组.收集患者自主循环恢复（ROSC）和自主呼吸恢复情况,以及复苏5、15 min的血气分析指标〔动脉血氧分压（PaO2）、动脉血二氧化碳分压（PaCO2）、动脉血氧饱和度（SaO2）、血乳酸〕.结果 两组患者性别、年龄、心搏骤停（CA）原因差异均无统计学意义.与徒手CPR组比较,萨勃CPR组ROSC率显著升高〔68.57％（48/70）比51.25％（41/80）,χ2=4.642,P=0.031〕,而自主呼吸恢复率差异无统计学意义〔48.57％（34/70）比47.50％（38/80）,χ2=0.017,P=0.896〕.两组患者复苏5 min时血气分析指标差异均无统计学意义;但复苏15 min时,萨勃CPR组PaO2和SaO2明显高于徒手CPR组〔PaO2（mmHg,1 mmHg=0.133 kPa）：88.13±5.06比84.26±5.53,SaO2：0.828±0.068比0.766±0.061,均P〈0.05〕,PaCO2、血乳酸明显低于徒手PCR组〔PaCO2（mmHg）：34.04±4.62比40.43±5.29,血乳酸（mmol/L）：6.90±2.07比8.50±2.12,均P〈0.05〕.结论 在急诊抢救过程中,采用萨勃心肺复苏器进行CPR较徒手CPR具有更高的复苏成功率,较长时间复苏时更有利于节省人力,使患者获得更好的代谢效果,值得临床推广与应用.Objective To objectively and standardly compare the bare-handed CPR and Thumper cardiopulmonary resuscitation CPR recovery effect based on cardiopulmonary resuscitation （CPR） Utstein model.Methods A retrospective study was conducted. CPR adult patients admitted to the Emergency Room of First Hospital of Qinhuangdao in Hebei Province from January 2015 to January 2017 were enrolled. Seventy patients who underwent CPR using the Thumper cardiopulmonary resuscitator were included in the Thumper CPR group; 80 patients who underwent manual hand-held CPR were included in the bare-handed CPR group. Return of spontaneous circulation （ROSC） and return of spontaneous breathing, and blood gas analysis indexes of recovery for 5 minutes and 15 minutes [arterial oxygen partial pressure （PaO2）, arterial blood carbon dioxide partial pressure （PaCO2）, arterial blood oxygen saturation （SaO2）, blood lactic acid （Lac）] were collected.Results There was no significant difference in gender, age and cardiac arrest （CA） causes between the two groups. Compared with the bare-handed CPR group, the ROSC rate in the Thumper CPR group was significantly increased [68.57% （48/70） vs. 51.25% （41/80）,χ2 = 4.642,P = 0.031], but there was no significant difference in return of spontaneous breathing rate [48.57% （34/70） vs. 47.50% （38/80）,χ2 = 0.017,P = 0.896]. There was no significant difference in blood gas index between the two groups after 5 minutes of recovery. The PaO2 and SaO2 in the Thumper CPR group were significantly higher than those in the bare-handed CPR group [PaO2 （mmHg, 1 mmHg = 0.133 kPa）： 88.13±5.06 vs. 84.26±5.53, SaO2： 0.828±0.068 vs. 0.766±0.031, bothP 〈 0.05）, PaCO2 and Lac were significantly lower than those in the bare-handed CPR group [PaCO2 （mmHg）：34.04±4.62 vs. 40.43±5.29, Lac （mmol/L）： 6.90±2.07 vs. 8.50±2.12, bothP 〈 0.05].Conclusions In the process of emergency rescue, Thumper cardiopulmonary resuscitator is more successful than bare-handed CPR

关 键 词：UTSTEIN模式 心肺复苏 心肺复苏器 效果 

分 类 号：R459.7[医药卫生—急诊医学]