心肺复苏人工-机械转换过程中缩短按压暂停时间的研究

The study of reducing compression pause time during the artificial- mechanical conversion process in cardio-pulmonary resuscitation

目的观察持续质量改进在心肺复苏抢救人工-机械按压转换过程中减少按压暂停时间的作用。方法选择嘉兴市第一医院急诊科收治的院外心跳骤停患者（out-of-hospitalcardiacarrest，OHCA）30例，分为改进前组和改进后组，各15例。改进的内容包括人工-机械按压转换过程中医护人员的组织协调及角色分工等。通过录像调取的方法观察2组患者人工-机械按压转换过程中按压暂停的时间，以及自主循环恢复（returnofspontaneouscirculation，ROSC）4h生存率、出院生存率、30d神经系统良好比例等。结果2组患者在性别构成、年龄、发病至人院时间、送达医院方式、送达过程中是否心肺复苏、首次心电监护结果等方面均差异无统计学意义（P〉0．05）。改进后按压暂停的时间明显缩短（P〈0．05），但2组患者ROSC4h生存率、出院生存率、30d神经系统良好比例等的均差异无统计学意义（P〉0．05）。结论持续质量改进能减少心肺复苏抢救中人工-机械转换过程的按压暂停时间。

Objective To observe the effect of continuous quality improvement of A on the reduction of compression pause time during the artificial-mechanical conversion process in cardio-pulmonaFy resuscitation （CPR）. Method 30 cases with out-of-hospital cardiac arrest （OHCA） accepted in the Department of Emergency of our hospital from March, 2014 to February, 2015 were involved in this study, 15 cases for both before and after the improvement. Improved contents include the organization and coordination and role assignment of the medical staff during the artificial-mechanical conversion process. Videos were obtained to observe the compression pause time during the artificial-mechanical conversion process, and return of spontaneous circulation（ROSC） 4h survival rate, discharge survival rate, 30d fine nervous system rate and so on in 2 groups. Result The difference of gender composition, age, onset to admission time, methods to get to the hospital, whether there＇ s CPR on the way to hospital, result of first time electrophysiology monitoring in 2 groups had no statistical significance（P 〉0.05）. After the improvement, the compression pause time had been decreased significantly（22.3±5.4S VS 9.4± 1.8S, P 〈0.05）, but the comparison of ROSC 4h survival rate, discharge survival rate, 30d fine nervous system rate and so on in 2 groups had no statistical significanee（P 〉0.05）. Conclusion Continuous quality improvement can reduce the compression pause time during the artificial-mechanical conversion process in cardio-pulmonary resuscitation （CPR）.