腹部提压装置在院前心肺复苏患者急救中的效果分析

Effect analysis of abdominal compression-decompression device in patients with cardiopulmonary resuscitation in pre-hospital first aid

目的探讨腹部提压心肺复苏(AACD-CPR)在院前呼吸、心搏骤停患者急救中的应用效果。方法选择甘肃省白银市中心医院2012年3月至2018年9月院前救治的45例存在胸外按压禁忌证的呼吸、心搏骤停患者,按随机数字表法分为两组,分别行AACD-CPR(腹部提压组,24例)和徒手腹部按压心肺复苏(CPR,徒手腹部按压组,21例)。观察两组抢救成功率,以及自主循环恢复(ROSC)患者CPR30min时的心率(HR)、脉搏血氧饱和度(SpO2)及血压的变化。结果腹部提压组24例患者中ROSC5例(占20.83%),徒手腹部按压组21例中ROSC2例(占9.52%),腹部提压组复苏成功率明显高于徒手腹部按压组(P<0.05)。腹部提压组ROSC患者CPR30min时HR明显低于徒手腹部按压组(次/min:139.45±5.08比147.62±5.24,P<0.05),SpO2和血压均明显高于徒手腹部按压组,差异均有统计学意义〔SpO2:0.92±0.03比0.85±0.03,收缩压(SBP,mmHg,1mmHg=0.133kPa):118.23±3.26比98.51±3.10,舒张压(DBP,mmHg):60.10±2.50比56.36±2.45,均P<0.05〕。结论AACD-CPR的救治效果明显优于徒手腹部按压CPR法,对于抢救呼吸、心搏骤停且存在胸部按压禁忌的患者具有较高的应用价值。

Objective To investigate the effect of active abdominal compression-decompression cardiopulmonary resuscitation (AACD-CPR) in patients with pre-hospital respiratory and cardiac arrest. Methods Forty-five patients with respiratory and cardiac arrest, and with contraindication of chest compression admitted to Baiyin Central Hospital of Gansu Province from March 2012 to September 2018 were enrolled, and they were divided into two groups according to random number table. AACD-CPR (abdominal compression-decompression group, n = 24) and cardiopulmonary resuscitation (CPR) with unarmed abdominal compression (unarmed abdominal pressure group, n = 21) were performed respectively. The success rate of rescue was observed in the two groups, and the changes in heart rate (HR), pulse oxygen saturation (SpO2) and blood pressure 30 minutes after CPR in patients with restoration of spontaneous circulation (ROSC) were observed. Results Among the 24 patients in the abdominal compression-decompression group, 5 patients (20.83%) had ROSC, and 2 patients (9.52%) had ROSC in 21 patients of the unarmed abdominal pressure group. The success rate of resuscitation in the abdominal compression-decompression group was significantly higher than that in the unarmed abdominal pressure group (P < 0.05). HR of ROSC patients at 30 minutes of CPR in abdominal compression-decompression group was significantly lower than that in unarmed abdominal compression group (bpm: 139.45±5.08 vs. 147.62±5.24, P < 0.05), and SpO2 and blood pressure were significantly higher than those in unarmed abdominal compression group with significant differences [SpO2: 0.92±0.03 vs. 0.85±0.03, systolic blood pressure (SBP, mmHg, 1 mmHg = 0.133 kPa): 118.23±3.26 vs. 98.51±3.10, diastolic blood pressure (DBP, mmHg): 60.10±2.50 vs. 56.36±2.45, all P < 0.05]. Conclusion The effect of AACD-CPR was superior to that of unarmed abdominal pressure CPR, which had higher application value to rescue patients with respiratory and cardiac arrest with chest pressure contraindication.