规范化培训对奥运医疗志愿者心肺复苏质量的作用

The role of standard CPR training in olympic medical volunteers

目的通过与同期三级医院急诊医务人员复苏操作质量对照，评价反复规范化急救技能训练对北京地区奥运志愿者心肺复苏操作质量的作用。方法随机检测北京某奥运场馆连续参加规范化心肺复苏技术培训6个月44名医疗志愿者（规范化培训组）的心肺复苏操作质量，并与同期北京市三级医院急诊科近1年内未参加规范化心肺复苏培训72名医务人员（对照组）的复苏操作质量进行对照。应用QCPR3535除颤监护仪（飞利浦公司提供）检测，指标为单人模拟心肺复苏操作规范程度，包括按压幅度、按压频率、按压问释放压力及操作时间，结果记录入表格中，并计算出每分钟实际按压次数。结果进行x2检验与t检验。对心肺复苏操作影响因素（性别、年龄、按压位置、按压手法、按压姿势及是否反复培训）进行等级划分赋予参数，进行Logistic回归分析。结果奥运志愿者完成心肺复苏技术操作质量明显优于对照组，总合格率分别为86．4％和31．9％，志愿者按压幅度、按压频率、按压问释放压力合格率高于对照组（88．6％，93．2％，95．5％VS．40．3％，43．0％，86．1％，P〈0．01）；整个操作时间差异无统计学意义[（118．4±18．5）SVS．（116．0±5．4）S，P〉0．05]；单组通气时间明显短于对照组[（6．38±1．3）vs.（7．57±1．6），P〈0．01]；每分钟实际按压次数差异无统计学意义[（77．2±3．5）VS．（77．8±12．2），P〉0．05）]；按压／通气时间比分别为（2．6：1VS．2．1：1）。Logistic回归分析结果显示心肺复苏操作质量与按压手法、按压姿势及反复规范化培训明显相关，分别为[OR13．12，95％CI（2．35～73．2）；OR30．89，95％CI（3．62～263．5）；OR4．07，95％CI（1．16～14．2）]。结论经反复规范培训的奥运志愿者心肺复苏操作质量明显优于未经培训的医护人员，规范化培训有助于提高CPR操作质量。

Objective To evaluate the role of standard CPR training in Beijing Olympics medical volunteers by compared with the no-training medical personnel. Method Performance qualities of CPR was evaluated in the 44 medical volunteers, who worked in a Beijing Olympic Venue. They received the training on standard CPR for 6 monthes, and served as training group. The performance of another 72 emergency medical workers from first-class hospitals without the training on stand CPR within 1 year （control group） was compared with training group. Phillips QCPR3535 monitor was used to measure the compression frequency, depth and chest re-expand between the compression and the operation time via the sternal chest compression pad fitted with an accelerometer. Personal practical results of 5 circles of CPR operation were recorded in a table and the numbers of practical compression in one minute were counted. Data were analyzed with chi-quare test and t -test. The parameters of the influence factor （gender, age, hand placement, hand skill, compression posture and standard training） were brought into logistic regression analysis. Results Compared with the control group, the qualification rate of general CPR performance in the training group was much higher（ 86.4 % vs. 31.9 % ）, and the compression qualification rates of the chest compression rate, depth and chest re-expand between the compression were higher（88.6 %, 93.2 %, 95.5 % vs. 40.3%, 43.0%, 86.1%, P 〈 0.01 ）, the duration of ventilation in each operation seoion was shorter [ （6.38 ± 1.3） vs. （7.57 ± 1.6）, P 〈 0.01 ], but the total performance durations were not significant different （ 118.4 ± 18.5） s vs. （ 116.0 ± 5.4） s, P 〉 0.05 ], pratical compression number in one minute was not different [（77.2± 3.5） vs. （77.8± 12.2）, P 〉 0.05）] ,the ratios of the duration of compression to that of ventilation was higher（2.6：1 vs. 2.1：1 ）. Logistic analysis showed that hand skill, compression posture and standard CPR trainings were high correlated with the CPR performance qualifies（ P 〈 0.05）. Conclusions The performance quality of training group is much higher than that of control group. The standard and continuous CPR training is ef- fective in improving the quality of CPR operation.