CCP与ICP用于成人心搏骤停患者院前急救对生存预后的影响对比

Comparison of the effects of CCP and ICP on prognosis of patients with adult cardiac arrest in pre-hospital first aid

目的:对比连续胸外按压(CCP)与间断胸外按压(ICP)在成人心搏骤停患者院前急救中的应用效果及对患者生存预后的影响。方法:选取124例行院前急救心肺复苏(CPR)的心搏骤停患者作为研究对象,根据院前急救胸外按压方式的不同分为两组:连续组(58例)实施CCP,间断组(66例)实施ICP。对两组患者的院前急救情况、临床资料等进行回顾性对照分析。结果:连续组的初期ROSC率、初期复苏成功率均显著高于间断组(P<0.05)。连续组与间断组的CPR持续时间、CPR启动时间、气管插管时间比较,均差异无统计学意义(P>0.05);连续组的ROSC平均时间显著短于间断组(P<0.05)。连续组的24 h存活率、出院存活率、出院后1个月存活率、出院后6个月存活率均显著高于间断组(P<0.05)。多因素分析显示CPR启动时间、ROSC时间、胸外心脏按压方式均是心搏骤停患者生存预后的影响因素(P<0.05)。结论:在心搏骤停患者的院前急救中,实施CCP进行CPR的效果优于ICP,其能有效提高CPR成功率,心搏骤停到CPR实施时间间隔、CPR到ROSC时间间隔、胸外按压方式是心搏骤停患者生存预后的主要影响因素。

Objective:To compare the effects of continuous chest compression(CCP)and intermittent extrathoracic compression(ICP)on pre-hospital first aid in patients with adult cardiac arrest and the impacts on survival prognosis.Method:One hundred and twenty-four patients with cardiac arrest(CA)who underwent pre-hospital emergency cardiopulmonary resuscitation(CPR)were enrolled in the study.They were divided into two groups according to the pre-hospital first-aid chest compressions:continuous group(58 cases)with CCP,discontinuous group(66 cases)with ICP.A retrospective comparative analysis of the pre-hospital emergency conditions and clinical data of the two groups of patients was performed.Result:The initial ROSC rate and initial recovery success rate of the continuous group were significantly higher than those of the discontinuous group(P<0.05).There were no significant differences in CPR duration,CPR initiation time and tracheal intubation time between the continuous group and the discontinuous group(P>0.05).The average time of ROSC in the continuous group was significantly shorter than that in the discontinuous group(P<0.05).The 24 h survival rate,discharge survival rate,1-month survival rate after discharge,and 6-month survival rate after discharge were significantly higher in the continuous group than those in the discontinuous group(P<0.05).Multivariate analysis showed that CPR initiation time,ROSC time,and the way of chest external compression were the influencing factors of survival prognosis in patients with cardiac arrest(P<0.05).Conclusion:In the pre-hospital first aid of patients with cardiac arrest,the effect of CCP for cardiopulmonary resuscitation is better than that of ICP.CCP can effectively improve the CPR success rate.Cardiac arrest to CPR implementation interval,CPR to ROSC interval,the way of chest compression are the main influencing factors of survival prognosis in patients with cardiac arrest.