心肺复苏机在心搏骤停患者院前急救中的应用效果

Applicative effect of cardiopulmonary resuscitation in pre-hospital care of emergency patients with cardiac arrest

目的探讨心肺复苏机在心搏骤停患者院前急救中的应用效果,为心搏骤停院前急救提供依据。方法 2011年1月至2013年5月海南省农垦三亚医院急诊科收治的院外心搏骤停患者93例,其中应用心肺呼吸机进行院前抢救的51例患者作为研究组,应用人工按压心肺复苏抢救的42例患者作为对照组。比较两组患者血氧饱和度、氧分压、二氧化碳分压和血压变化,观察两组患者心肺复苏时间、自主呼吸恢复时间和各项功能恢复情况。应用化学发光免疫分析法检测患者血清神经元特异性烯醇化酶(NSE)、N末端B型脑钠肽原(NT-proBNP)、肌钙蛋白I(cTnI)和心型脂肪酸结合蛋白(H-FABP)水平。结果两组患者血氧饱和度、氧分压和二氧化碳分压比较,差异无统计学意义(P>0.05);研究组患者收缩压、舒张压显著高于对照组(P<0.05)。研究组心肺复苏时间、自主呼吸恢复时间均显著低于对照组(P<0.01)。两组术中心率、呼吸、血压和血氧饱和度比较,差异无统计学意义(P>0.05)。研究组患者自主呼吸恢复、自主循环恢复、存活大于24h和康复出院比例显著高于对照组(P<0.05)。两组患者自主循环恢复即刻血清NSE、NT-proBNP、cTnI、H-FABP比较,差异无统计学意义(P>0.05);自主循环恢复24h后研究组NSE、NT-proBNP、cTnI、H-FABP水平显著低于对照组(P<0.01)。结论心肺复苏机应用于心搏骤停患者院前抢救可以有效缩短患者心肺复苏时间和自主循环恢复时间,降低患者心、脑、肺等重要脏器损伤,有效提高心肺复苏成功率。

Objective To investigate the applicative effect of cardiopulmonary resuscitation in pre-hospital care of emergency pa-tients with cardiac arrest and provide the basis for pre-hospital care of cardiac arrest.Methods Selected 93 cases of cardiac arrest in January 2011 to May 2013 occurred out of Hainan Province Nongken Sanya Hospital,including 51 cases of cardiopulmonary resusci-tation of pre hospital rescue as the study group,42 cases of the application of artificial compression cardiopulmonary resuscitation as control group.Compared blood oxygen saturation,oxygen and carbon dioxide partial pressure and blood pressure changes,CPR time,spontaneous breathing recovery time and the recovery of the function of two groups.Used chemiluminescence method to detect NSE,NT-proBNP,cTnI and H-FABP.Results The two groups of patients with blood oxygen saturation,oxygen and carbon diox-ide partial pressure showed no statistical difference（P〉0.05）;the DBP and SBP levels of the study group were significantly higher than the control group（P〈0.05）;the study group CPR time and spontaneous circulationtime were significantly higher than that in control group（P〈0.05）.Two groups of intraoperative heart rate,respiration,blood pressure and oxygen saturation had no signifi-cant difference（P〉0.05）.Study group of patients with spontaneous breathing recovery,the restoration of spontaneous circulation, survival is greater than 24 h and rehabilitation discharge rates were significantly higher than the control group（P〈0.05）.There was no significant difference in the serum levels of NSE,NT-proBNP,cTnI immediately,H-FABP recovery in spontaneous circula-tion（P〉0.05）;after 24 h,NSE,NT-proBNP,cTnI,H-FABP levels in study group were significantly lower than those in the control group（P〈0.01）.Conclusion The application of cardiopulmonary resuscitation in patients with cardiac arrest before salvage can ef-fectively shorten the recovery time of CPR patients and spontaneous circulation time,reduce the damage to heart,brain,lung and other organs,improve the success rate of cardiopulmonary resuscitation,worthy of clinical application.