Thumper心肺复苏仪在心脏骤停患者中应用效果的Meta分析

Application of Thumper cardiopulmonary resuscitation machine in patients with cardiac arrest:a Meta analysis

目的对比Thumper心肺复苏仪与人工徒手心肺复苏对心脏骤停患者的复苏成功率、存活率及骨折发生率的影响,系统评价Thumper心肺复苏仪的应用效果。方法将中英文检索词按照检索策略分别检索各数据库:中国知网(CNKI)、万方数据库、OVID、PubMed等关于Thumper心肺复苏仪与人工徒手心肺复苏对比的随机对照研究,通过RevMan5.3软件对Thumper心肺复苏仪与人工徒手心肺复苏抢救心脏骤停患者的复苏成功率、存活率以及骨折发生率进行Meta分析。研究结果的穂定性使用敏感性分析进行评价,发表偏倚使用漏斗图进行分析。结果共纳入25篇研究,包括3681例患者,其中Thumper心肺复苏仪组1810例患者,人工徒手心肺复苏组1870例患者。研究结果显示,Thumper心肺复苏仪组的复苏成功率显著高于人工徒手心肺复苏组[RR=1.56,95%CT 1.44~1.69,Z=11.14,P<0.00001];存活率明显高于人工徒手心肺复苏组[RR=2.41,95%CI 1.92~3.02,Z=7.58,P<0.00001];骨折发生率显著低于人工徒手心肺复苏组[RR=0.34,95%CI0.22~0.53,Z=4.83,P<0.00001]。漏斗图显示复苏成功率大体呈左右对称的倒漏斗分布,无显著发表偏倚;存活率、骨折发生率因纳入研究相对较少,无法具体评估漏斗图的对称性;总体考虑到本次研究纳入文献数量较少,因此并不能完全排除文献发表偏倚。结论根据本次Meta合并分析结果显示,针对心脏骤停患者采用Thumper心肺复苏仪可提高复苏成功率、存活率以及降低骨折发生率。在对心脏驟停患者实施抢救时,建议使用Thumper心肺复苏仪进行心肺复苏。

Objective To compare the effects of Thumper cardiopulmonary resuscitation and artificial cardiopulmonary resuscitation on resuscitation success rate,survival rate and fracture rate of patients with cardiac arrest,and to systematically evaluate the application effect of cardiopulmonary resuscitation instrument.Methods According to the search strategy,the Chinese and English key words were searched for RCT studies on Thumper cardiopulmonary resuscitation and artificial cardiopulmonary resuscitation from databases such as CNKI,Wanfang database,OVID and PubMed.The recovery success rate,survival rate and fracture rate of Thumper cardiopulmonary resuscitation and artificial cardiopulmonary resuscitation were analyzed by revman5.3 software.The stability of the results was evaluated by sensitivity analysis,and publication bias was analyzed by funnel plot.Results A total of 25 studies involving 3681 patients were included,including 1810 patients in the Thumper CPR group and 1870 patients in the artificial CPR group.The results showed that the resuscitation success rate of Thumper CPR group was significantly higher than that of artificial CPR Group[RR=1.56,95%CI1.44〜1.69,Z=11.14,P<0.00001];the sur-vival rate was significantly higher than that of artificial CPR Group[RR=2.41,95%CI1.92〜3.02,Z=7.58,P<0.00001];frac-ture rate was significantly lower than that of artificial CPR Group[RR=0.34,95%CI0.22〜0.53,Z=4.83,P<0.00001].Funnel plot showed that the resuscitation success rate was approximately symmetrical inverted funnel distribution,without significant publication bias;survival rate and fracture incidence rate were relatively few studies,so the symmetry of funnel diagram could not be specifically evaluated;considering the small number of studies included in this study,the publication bias could not be completely ruled out.Conclusion According to the results of this meta-analysis.Thumper cardiopulmonary resuscitation instrument can improve the success rate of resuscitation,survival rate and reduce the incidence of fracture in patients with cardiac arrest.It is suggested to use Thumper cardiopulmonary,resuscitation instrument for cardiopulmo-nary resuscitation in clinical rescue of patients with cardiac arrest.