CCP与ICP院前急救模式对院外心搏骤停患者抢救及预后效果影响

Effect of pre-hospital first aid modes CCP and ICP on rescue and prognosis of patients with out-hospital cardiac arrest

目的:研究连续胸外按压(CCP)和间断胸外按压(ICP)院前急救模式对院外心搏骤停患者抢救及预后效果影响。方法:研究对象选取我院院前行心肺复苏(CPR)的心搏骤停患者128例,根据抢救方法不同将其分为CCP组和ICP组,每组各64例。CCP组患者院前接受CCP模式抢救,ICP组患者院前接受ICP模式抢救,比较两组患者的胸外按压分数、每分钟按压停顿次数、转移到医院人数、自主循环恢复(ROSC)人数、复苏成功率、出院存活人数以及远期预后质量。结果:ICP组患者的每分钟按压停顿次数明显低于CCP组(P<0.01),ICP组患者的转运到医院人数、住院人数、ROSC人数及复苏成功率均明显高于CCP组(P<0.05),ICP组患者的出院存活人数和1个月存活人数均明显高于CCP组(P<0.05)。结论:院外及时行CPR抢救对降低心搏骤停患者死亡率以及提高预后质量尤为重要,其中ICP抢救模式对患者院前抢救效果和远期预后均优于CCP模式,提示增加胸外按压频率并不能提高心搏骤停患者抢救质量。

Objective: To study the effect of continuous extrathoracic compression(CCP) and intermittent extrathoracic compression(ICP) on rescue and prognosis of patients with cardiac arrest outside hospital. Method: 128 patients with cardiac arrest undergoing cardiopulmonary resuscitation(CPR) were divided into CCP group and ICP group according to the different rescue methods. The extrathoracic compression scores, the times of pressing pauses per minute, the number of patients transferred to hospital and the number of patients with restoration of spontaneous circulation(ROSC), the success rate of resuscitation, the number of survivors from hospital and the quality of long-term prognosis were compared between the two groups. Result: The times of pressing pauses per minute in ICP group was significantly lower than that in CCP group(P<0.01). In ICP group, the number of patients transferred to hospital, the number of hospitalized patients, the number of patients with ROSC and the success rate of resuscitation were significantly higher than those in CCP group(P<0.05). The number of patients survival to discharge from hospital and one month later in ICP group were significantly higher than those in CCP group(P<0.05). Conclusion: Timely CPR rescue outside the hospital is particularly important to reduce the mortality of cardiac arrest and improve the prognosis. The pre-hospital rescue effect and long-term prognosis of the patients rescued by ICP model were better than those by CCP model, suggesting that increasing the frequency of extrathoracic compression could not improve the rescue quality of patients with cardiac arrest.