自动心肺复苏机的加入在院外急救中的应用效果评价  

The application effect of automatic cardiopulmonary resuscitation machine in pre-hospital first aid

作　　者：章楠 邵俊 何利琴 朱娴 王芳 蔡春凤[1] ZHANG Nan;CAI Chunfeng;SHAO Jun;ZHU Xian;WANG Fang(College of Nursing,Wuhan University,Wuhan Hubei 430000,China)

机构地区：[1]武汉大学护理学院,湖北武汉430000 [2]宜兴市急救中心,江苏宜兴214200 [3]宜兴市中医医院,江苏宜兴214200

出　　处：《中国急救复苏与灾害医学杂志》2023年第9期1159-1162,1175,共5页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：2021年宜兴市科技创新专项资金“陶都之光”科技攻关计划(社会发展类)(编号:2021SF12)。

摘　　要：目的比较人工按压联合机械按压和单纯人工按压对院外心脏骤停患者(OHCA)在院外急救中的复苏效果,评价自动心肺复苏机的加入在院外急救中的临床应用价值。方法本研究为病例对照研究,研究对象为宜兴市急救中心于2020年1月—2022年1月现场救治的OHCA患者,根据不同的按压方式分为人工联合机械按压组和单纯人工按压组。人工联合机械为研究组,单纯人工按压组为对照组。比较两组间院外心肺复苏(CPR)持续时间,院外自主循环(ROSC)恢复率,4 h生存率,24 h生存率及72 h生存率。结果共有163例院外心脏骤停患者符合入组标准,其中研究组85例(24/85),对照组78例(14/78)。研究组院外自主循环恢复率、4 h生存率、24 h生存率明显高于对照组(31.76%vs.17.95%,25.88%vs.12.82%,15.30%vs.5.13%)(P<0.05),但两组间的心肺复苏持续时间及72 h生存率[44(35,50)vs.44(37,50),5.88%vs.2.56%]差异无统计学意义(P>0.05)。结论相对于单纯人工胸外按压,人工联合机械按压保证了按压的质量,也提高了OHCA患者的院外ROSC率和短期生存率,自动心肺复苏机的加入在院外急救机构中值得推广。Objective To compare the resuscitation effect of manual compression combined with mechanical compression and manual compression on patients with out-of-hospital cardiac arrest(OHCA)in pre-hospital first aid,and to evaluate the effect of automatic cardiopulmonary resuscitation machine in pre-hospital first aid.Methods A total of 163 OHCA patients who were treated on-site in the Yixing Emergency Center from January 2020 to January 2022 was studied.There were two groups according to compression methods.One group as study group(85 cases)was manual combined with mechanical compression;and another group as control(78 cases)was manual compression.The duration of prehospital cardiopulmonary resuscitation(CPR),prehospital recovery of spontaneous circulation(ROSC),4 hours;24 hours and 72 hours survival rate were compared between the two groups.Results The ROSC rate,4 hours survival rate,and 24 hours survival rate of the study group were significantly higher than those of the control group(31.76%vs.17.95%,25.88%vs.12.82%,15.30%vs.5.13%respectively)(P<0.05).There was no significant difference in the duration of cardiopulmonary resuscitation and the 72 hour survival rate[44(35,50)vs.44(37,50),5.88%vs.2.56%respectively](P>0.05).Conclusion Manual combined with mechanical compression can ensure the quality of compression in OHCA patients,and also improve the pre-hospital ROSC rate and short-term survival rate.

关 键 词：院外心搏骤停 机械胸外按压 徒手心肺复苏 心肺复苏机 自主循环恢复 生存率 

分 类 号：R459.7[医药卫生—急诊医学]