院前围心搏骤停心肺复苏后自主循环恢复率15年变化趋势  

Trends in cardiac recovery rate after cardiopulmonary resuscitation from prehospital peri-cardial arrest within later fifteen years

作　　者：谷向民 刘庆阳 何忠杰 杨刚三[4] 王永刚 姚世斌 黄立锋 Gu Xiangmin;Liu Qingyang;He Zhongjie;Yang Gangsan;Wang Yonggang;Yao Shibin;Huang Lifeng(Immunization Program Division,Tianjin Binhai New Area Disease Prevention and Control Center,Tianjin 300458,China;Platinum Ten-Minute Studio of National Emergency Medicine Research Center,Beijing 100028,Chian;Department of critical medicine,The Fourth Medical Center of PLA General Hospital,Beijing 100048,China;Emergency Department,People’s Hospital of Xuecheng District,Zaozhuang 277000,China;Department of Traumatology,Hebei Hua Ao Hospital,Zhangjiakou 075031,China;Emergency department,Inner Mongolia Chifeng College Hospital,Chifeng 024000,China;Critical Care Medicine,Beijing Chaoyang Hospital,Capital Medical University,Beijing 100020,China)

机构地区：[1]天津市滨海新区疾病预防控制中心,天津300458 [2]国家应急医学研究中心白金十分钟工作室,北京100028 [3]中国人民解放军总医院第四医学中心重症医学科,北京100048 [4]枣庄市薛城区人民医院急诊科,山东枣庄277000 [5]河北华奥医院创伤中心,河北张家口075031 [6]内蒙古赤峰学院附属医院急诊科,内蒙古自治区赤峰024000 [7]北京首都医科大学附属朝阳医院重症医学科,100020

出　　处：《中华卫生应急电子杂志》2022年第2期95-101,共7页Chinese Journal of Hygiene Rescue(Electronic Edition)

基　　金：北京市卫计委北京市卫生与健康科技成果和适宜技术推广项目-"白金十分钟"急救理论及技术在社区的专业推广(TG-2017-04)。

摘　　要：目的系统评价院前心肺复苏患者自主循环恢复率15年的的变化趋势。方法检索数据库中国知网(1979年1月至2019年3月)、重庆维普数据库(1989年1月至2019年3月)、数据库万方(1990年1月至2019年3月)和Web of Science(1900年1月至2020年5月)相关文献,进行研究。收集汇总院前心搏骤停病患的相关临床资料,进行不同时间的心肺复苏数据分析。本研究由两名工作者独立的进行文献检索、筛选、收集资料,采用R软件的meta package进行分析(版本号3.61)。结果经纳入与排除的标准,共有文献资料共114篇,患者总计26334例,其中心搏恢复人数为2229例。异质性检验χ^(2)=5288.48,P<0.01,I=96.3%,存在高度异质性。如果数据存在高度的异质性,运用随机效应模型对数据进行分析。1.合并效应量为0.241[0.192;0.297],即研究期间,自主循环恢复率为24.1%;2.三个时间段2004至2008年、2009至2013年、2014至2018年自救循环恢复率分别为0.200[0.135;0.286]、0.230[0.147;0.342]、0.281[0.203;0.376],其自救循环恢复率有上升趋势,但三组之间没有统计学差异。结论1.对15年每隔5年时段的院前心肺复苏自救循环恢复率有逐段升高趋势的现象,但无统计学差异。2.心肺复苏在目击下就开始抢救,应在10 min之内,尽早尽快,越快越好。3.用时效规律引领今后的努力方向才是正确的:把急救技术储存在民间,并在公共场所装配AED设备,才能实现最大的抢救潜能。Objective To systematically evaluate the change trend of recovery of spontaneous circulation(ROSC)in patients with cardiopulmonary resuscitation(CPR).Methods The CNKI(1979-march 2019),Chongqing VIP(1989-2019 March),Wanfang database(1990-March 2019)and Web of Science(1900-May2020)were searched.The clinical data of patients with cardiac arrest before hospital,and analyze the cardiopulmonary resuscitation at different time were collected.Two researchers independently screened the literature and extracted the data.The meta package of R software was used for analysis(version No.3.61).Results 114 articles met the inclusion criteria,a total of 26334 patients,including 2229 cases of cardiac recovery.Heterogeneity test showedχ^(2)=5288.48 and I2=96.3%(P<0.01),suggesting high heterogeneity.Therefore,the random effect model was used for this analysis.The combined effect was 0.241[0.192;0.297];the ROSC in 2004-2008,2009-2013 and 2014-2018 was 0.200[0.135;0.286],0.230[0.147;0.342]and 0.281[0.203;0.376],respectively,and the success rate of ROSC had an upward trend,but there was no statistical difference among the three groups.Conclusion In recent 15 years,the ROSC of pre-hospital CPR has an increasing trend every five years,but there is no statistical difference.The CPR should start under the witness and it should be within 10 minutes oras soon as possible.It is correct to use the law of timeliness to guide the direction of efforts in the future.Only by storing the first-aid technology among the people and assembling AED equipment in public places can we realize the maximum rescue potential.

关 键 词：心脏骤停 心肺复苏 Meta分析 白金十分钟 

分 类 号：TP3[自动化与计算机技术—计算机科学与技术]