不同CPR在严重胸部外伤致呼吸、心搏骤停患者救治中的应用价值分析  

Application value of different CPR methods in treatment of respiratory and cardiac arrest caused by severe chest trauma

作　　者：雍辉 严专 刘海浪 蒋超 陈雨[1] YONG Hui;YAN Zhuan;LIU Hailang;JIANG Chao;CHEN Yu(Department of Cardiology,Huai'an First People's Hospital,Huai'an 223001,China)

机构地区：[1]淮安市第一人民医院心血管内科,江苏淮安223001 [2]淮安市第一人民医院急诊科,江苏淮安223001 [3]淮安市第一人民医院肿瘤内科,江苏淮安223001

出　　处：《中国急救复苏与灾害医学杂志》2020年第7期772-774,787,共4页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：江苏省科技项目(编号:BK20160231)。

摘　　要：目的探讨腹部提压心肺复苏(cardiopulmonary resusctaion,CPR)与徒手腹部按压CPR治疗严重胸部外伤致呼吸心搏骤停患者的效果。方法选取2017年1月-2019年8月在淮安市第一人民医院治疗的严重胸部外伤致呼吸心跳骤停患者111例,根据采用CPR方法分为观察组(n=60)和对照组(n=51),其中观察组给予腹部提压CPR,对照组给予徒手腹部按压CPR,观察两组CPR成功率,检测CPR前后动脉血氧分压(partial rterial ox-ygen pressure,PaO2)、动脉血二氧化碳分压(partial arterial carbon dioxide pressure,PaCO2)、心率及平均动脉压(mean arterial presure,MAP)。结果观察组和对照组CPR成功率分别为20.00%和19.61%,差异比较无统计学意义(P>0.05);观察组CPR后30min时PaO2,为(73.03±8.11)mmHg,明显高于对照组(P<0.05),而PaCO2,为(41.02+6.55)mmHg,明显低于对照组(P<0.05);观察组CPR后30 min时心率和MAP分别为(110.48±9.28)次/min和(68.82±8.82)mmHg,明显高于对照组(P<0.05)。结论相比较徒手腹部按压CPR,在严重胸部外伤致呼吸心搏骤停患者救治中,腹部提压CPR有助于稳定患者生命体征,但CPR成功率无明显差异。Objective To compare the effects of abdominal pressure lifting cardiopulmonary resuscitation(CPR)and bare hand abdominal pressure CPR in the treatment of traumatic cardiopulmonary arrest(TCPA)caused by severe chest injury.Methods 111 patients with respiratory and cardiac arrest caused by severe chest trauma were randomly divided into 2 groups:observation group(n=60)undergoing treatment with abdominal CPR compression-decompression instrument for 30 min and control group(n=51)given bare hand abdominal compression CPR for 30 min.Before and 30 min after CPR,heat rate(HR),mean arterial pressure(MAP),pH value,partial arterial oxygen pressure(PaO2),and partial arterial cearbon dioxide pressure(PaCO2)were measured,and the success rate was observed 30 min after the treat ment.Results The success rate of the observation group was 20.00%,not significantly different from that of the control group(19.61%,P>0.05).The PaO2 level 30 min after CPR the observation group al was(73.03±8.11)mmHg.significanly higher than that of the control group[(62.39±9.921)mmHg,P<0.05]The PaCO2 level 30 min after CPR of the observation group was(41.02+6.55)mmHg,significantly lower than that of the control group(53.30±7.20)mmHg,P<0.05.The HR and MAP 30 min after CPR of the observation group were(110.48±9.28)times/min and(68.82±8.82)mmHg respectively,both significantly higher than those of the control group[(91.39±8.28)times/min and(59.95±9.03)mmHg respectively,both P<0.05].Conclusion Compared with bare hand abdominal compression CPR,the abdominal pressure lifting CPR is more conducive to stabilize the vital signs of patients,but there is no significant difference in the success rate between these 2 CPR methods.

关 键 词：腹部提压心肺复苏 徒手腹部按压心肺复苏 胸部外伤 呼吸心搏骤停 临床效果 

分 类 号：R459.7[医药卫生—急诊医学]