视频自学与课堂教学对公众心肺复苏技能获得与保持效果的荟萃分析

Effect of video-based self-instruction compared to traditional classroom instruction on the acquisition and retention of cardiopulmonary resuscitation skills for laypersons:a meta-analysis

目的评价视频自学（vsI）与传统课堂教学（TCI）对公众心肺复苏（CPR）技能获得与保持的效果。方法采用荟萃分析（meta分析）方法，计算机检索Cochrane图书馆、PubMed、EMBASE等数据库，收集公众CPR培训的随机对照试验，进行文献质量评价后，应用RevMan4．3软件进行敏感性和异质性分析，计算综合效应。结果共纳入10篇随机对照试验研究。据meta分析结果显示。VSI组与TCI组CPR技能合格率差异无统计学意义[OR=1．29，95％CI（0．44，3．75），P〉0．05]。敏感性分析显示，研究对象年龄≥40岁者，VSI组CPR技能合格率明显优于TCI组[OR=4．66，95％CI（1．12，19．32），P〈0．05]。培训结束后2—3个月，VSI组CPR技能保持率优于TCI组[OR=2．25，95％a（1．45，3．50），P〈0．05]；而培训结束后6—12个月，两组CPR技能保持率差异无统计学意义[OR=1．55，95％CI（0．75，3．21），P〉0．05]。结论VSI有利于年龄较大（≥40岁）者学习和掌握CPR技能；VSI比TCI更有利于公众短期CPR技能的保持。但对长期技能的保持效果并不能确定。建议进行多中心大样本随机对照试验研究，以进一步验证VSI对CPR技能的长期保持效果。

Objective To compare the effect of video-based self-instruction（VSI） versus traditional classroom instruction（TCI） on the acquisition and retention of cardiopulmonary resuscitation skills for laypersons. Methods The randomized,controlled clinical trials on CPR instruction for laypersons were collected in the databases such as Cochrane Library,PubMed,and EMBASE. After critical appraisal and analysis of sensitivity and heterogeneity for the involved studies,a meta analysis was conducted to estimate the cumulative effect by RevMan 4.3 software. Results Ten randomized controlled trial（RCT） were involved in the study. Meta analysis showed that there was no significant difference in CPR performance immediately after training by VSI or TCI （0R=1.29,95% confidence interval ranged from 0.44 to 3.75,PM）.05）. However,people 40 years old and over in VSI group showed better CPR performance than that of TCI group（OR=4.66,95% confidence interval ranged from 1.12 to 19.32, P〈0.05）. The CPR performance at 3 months after training in VSI group was significantly better than that of TCI group（OR= 2.25,95% confidence interval ranged from 1.45 to 3.50,P〈0.05）. While there was no significant difference in the CPR skills retention at 6 to 12 months after training between the two groups（OR=1.55,95% confidence interval ranged from 0.75 to 3.21,P〉0.05）. Conclusions Older adults 40 years old and over tend to have better skills acquisition of CPR with VSI than that with TCI. Compared to TCI,VSI is better for short-term but not for long-term retention on CPR skills. It is suggested to further conduct multi-center randomized controlled trials to confirm the effect of VSI on long-term retention of CPR skills