两种胸外按压模式对院外心脏骤停患者按压质量效果分析

Comparison of the effects of unarmed and mechanical external chest compression in out-of-hospital cardiac arrest patients

目的分析徒手和器械两种胸外按压模式对院外心脏骤停患者按压质量的效果。方法选取北京急救中心71例心跳骤停患者，随机分成人工胸外按压组（医护双人交替）和器械胸外按压组（LUCAS2），分别在每5个心肺复苏周期后记录呼气末二氧化碳分压（PETCO2）的测量值，监测胸外按压的效果。结果徒手按压在第2个循环周期后质量下降，第5~6个循环周期后达不到标准，而器械按压始终保持高质量的按压。对自主循环恢复（ROSC）的效果分析其恢复率，可除颤心律组：徒手胸外按压组81．25％，器械胸外按压组40％。不可除颤心律及不利于徒手按压组：徒手胸外按压组4．5％，器械胸外按压组4．35％。结论对可除颤心律心脏骤停患者徒手按压优于器械按压，对于不利于徒手按压：如救护人员不足、疲劳、移动状态下及不可除颤心律心脏骤停患者，器械按压有其明显优势。

Objective To compare the effects of unarmed and mechanical external chest compressions in out-of-hospital patients with cardiac arrest. Methods A total of 71 patients with cardiac arrest in Beijing Emergency Center were enrolled into the current study. They were randomly divided into two groups： an unarmed external chest compression group （two medical staff working alternatively） and a mechanical external chest compression group （using LUCAS2）. The value of the partial pressure of end-tidal carbon dioxide （PETCO2） was measured after each of five eardiopulmonary resuscitation （CPR） cycles, in order to monitor the effect of external chest compressions. Results The effect of unarmed compression declined after the second cycle, which then failed to achieve the standard after 5~6 cycles. In contrast, mechanical compression reached high standard throughout. Based on the effect of restoration of spontaneous circulation （ROSC）, the recovery rate was analyzed. The defibrillation rhythm group produced a recovery rate of 81.25% through unarmed external chest compression and 40% through mechanical compression. For patients with non-defibrillation rhythm and unable to undergo manual compression, they had a recovery rate of 4.5% through unarmed external chest compression and 4.35% through mechanical compression. Conclusion Unarmed external chest compression is suitable for cardiac arrest patients with defibrillation rhythm. Mechanical compression has advantages in treatment of patients in case of lack of medical staff, fatigue, movement and those without defibrillation rhythm.