急诊科医护人员胸外按压疲劳影响因素与按压质量指标的相关性分析

Correlation analysis of fatigue influencing factors about chest compression and compression quality indexex of medical staffs in Emergency Department

目的探讨影响按压疲劳时间的相关因素，以及按压疲劳与胸外心脏按压质量指标之间的相关性。方法便利选取北京协和医院急诊科医护人员120名，按照（（2010美国心脏协会心肺复苏及心血管急救指南》（简称2010版新指南）对胸外心脏按压质量的要求，在复苏模拟人身上实施单人徒手胸外脏按压2min，电脑自动记录按压质量数据，包括按压频率、按压深度、胸壁回弹率等测试结果，并记录操作者自觉疲劳的时间。结果按压者自觉疲劳时间与操作者的性别、体质指数和按压姿势相关（r值分别为－0．233，0．232，0．400；P〈0．05）；男性自觉疲劳时间为（110．5±18．2）s，女性按压疲劳时间为（81．9±20．8）s，差异有统计学意义（P〈0．05）；低体质指数按压者较正常体质指数及超高体质指数者易产生疲劳，跪坐姿势按压疲劳时间长于站立姿势，按压疲劳时间与按压频率呈负相关，与按压深度呈正相关。结论为了延缓按压疲劳的产生，在胸外心脏按压过程中应尽量选用男性按压者，采用跪坐姿势，控制按压频率；女性和体质指数过低者应提早更换按压者，保证按压质量。

Objective To explore the influencing factors of compression fatigue time and the correlation between fatigue and the quality indexes of chest compression. Methods A convenience sample of 120 medical staff members in Emergency Department of PUMCH were selected and implement single hand chest compression 2 minutes according to the quality requirements of the AHA 2010 guidelines, and the computer automatically recorded the pressing quality data, including pressing frequency, pressing depth, chest wall recoil, and recording the operator fatigue time. Results The rescuer fatigue is associated with gender, body mass index and press posture （ r = - 0. 233, 0. 232, 0. 400 ;P 〈 0.05 ） ; fatigue time of the male was （ 110.5±18.2） s while the female was （81.9 ±20.8）s （P 〈0.05 ） ; low body mass index pressers as well as overweight tended to feel fatigue earlier than pressers with normal one. Fatigue time of kneeling posture pressing was longer than the standing posture; fatigue time was negatively associated with depressing frequency, and positive with the pressing depth. Conclusions In order to delay the compression fatigue in the chest compression process, the male and kneeling posture should be chosen with the control of pressing frequency; the female and underweight pressers should be early replaced to guarantee the pressing quality.