习服训练对初进高原驻训医护人员心肺复苏操作质量影响的研究

Effect of Plateau Acclimatization Training on the Quality of Cardiopulmonary Resuscitation Performed by Medical Staff Who Are New to High Altitude

目的分析高原习服训练对初进高原驻训的医护人员心肺复苏操作质量的影响。方法采取目的抽样法,选取2020年9~12月从平原地区某部队医院赴高原执行卫勤训练任务的医护人员79名作为研究对象。医护人员分别在初进高原后的第2天和经过4周的高原习服训练后,完成1次心肺复苏操作;使用平板电脑记录高原习服训练前后每名医护人员心肺复苏操作的各指标变化,在操作完成后5 min内,使用军队疲劳程度判定量表对其疲劳状态进行评分。结果医护人员在高原习服训练后,实施心肺复苏操作的平均时间明显缩短,心肺复苏操作总体得分、按压频率、按压深度合格率、潮气量合格率明显提高(P<0.05);初进高原后和高原习服训练后,医护人员胸外心脏按压的深度均随操作时间增加呈下降趋势,其中初进高原后的胸外心脏按压深度下降更明显,从第3轮开始,高原习服训练后的医护人员胸外心脏按压深度明显高于初进高原后的医护人员(P<0.05);高原习服训练后,医护人员疲劳程度判定量表的总分及4个项目得分均低于初进高原后(P<0.05)。结论在高原环境下,医护人员心肺复苏操作质量下降,主要表现在胸外心脏按压的频率、深度及潮气量等方面。医护人员完成心肺复苏操作的疲劳感较强,这可能是影响心肺复苏操作质量的重要原因之一。通过科学化、规范化的高原习服训练,可提升医护人员体能储备,改善缺氧、疲劳状态,进而提升医护人员心肺复苏操作质量。

Objective To analyze the effect of plateau acclimatization training on the quality of cardiopulmonary resuscitation(CPR)performed by medical staff who are new to high altitude.Methods From September to December 2020,a total of 79 medical staff from a military hospital in plain area who went to plateau for medical service training were selected as the subjects by objective sampling method.They performed CPR on the second day after entering the plateau and again after four weeks of plateau acclimatization training.The changes of various indexes of CPR operation of each medical staff before and after plateau acclimatization training were recorded by a tablet.The fatigue status of the medical staff was evaluated by the Military Fatigue Scale within 5 minutes after the completion of CPR.Results In terms of operation time and quality of CPR,after plateau acclimatization training,the average time of CPR operation was significantly shortened,the qualified rate of chest compression frequency,chest compression depth and tidal volume were significantly improved,and the total score of CPR operation was significantly improved(P<0.05).In terms of CPR compression depth,it decreased with the extension of operation time,whether in the first CPR operation after entering the plateau or in the first CPR operation after taking plateau acclimatization training,and it decreased more obviously in the former operation.However,the medical staff scored significantly higher in the depth of chest compression from the third round of CPR operation after plateau acclimatization training than they did in their first CPR operation after entering the plateau(P<0.05).In terms of fatigue state after CPR,the medical staff scored lower in the total score and the scores of four sub-items of the fatigue scale after plateau acclimatization training than they did when they were new to the plateau(P<0.05).Conclusion The operation quality of CPR by medical staff who are new to high altitude is reduced,mainly in frequency of chest compression,depth of chest compression,and tidal volume.Medical staff at high altitude have a strong sense of fatigue when performing CPR,which may be one of the important reasons affecting the quality of CPR operation.Scientific and standardized plateau acclimatization training can enhance the physical reserve of medical staff,improve their state of hypoxia and fatigue,and then better the quality of CPR operation.