心搏骤停中心建设标准及临床效果的文献分析

Construction standards and clinical outcomes of cardiac arrest center:a literature review

目的 检索国内外数据库中有关心搏骤停中心的研究,明确建设该中心所需具备的条件,并汇总分析其临床效果,为国内开展相关实践提供参考和借鉴。方法 检索Pubmed、Embase、Web of science、Sciencedirect、中国生物医学文献数据库、中国知网、万方数据库和维普数据库,检索时限为2005年1月—2022年7月。2名研究者根据纳入排除标准独立筛选文献并提取信息,之后对其进行分析。结果 共纳入45篇文献,心搏骤停中心的建设条件包括医疗护理技术、人员培训、组织管理等方面,出现频次最高的3项为心导管介入能力、目标体温管理能力及多学科合作团队;多项观察性研究表明建设CAC有利于提高OHCA患者生存率并改善预后,但证据等级总体较低,需进一步实践研究。结论 国内外的研究水平存在较大差异,国内研究者应积极开展相关临床实践,探讨适合我国国情的心搏骤停中心认证标准,逐步建立起针对OHCA患者的区域化救治体系,以期不断提高该类患者生存率。

Objective To search the relevant research of cardiac arrest center(CAC),define the necessary conditions for the construction of such centers,and summarize their clinical effects to provide a guidance for domestic practice.Methods Pubmed,Embase,Web of science,Sciencedirect,SINOMED,CNKI,Wanfang and VIP Database from January 2005 to July 2022 were comprehensively searched.Two researchers independently screened the literature according to the inclusion and exclusion criteria and extracted the key information.The included studies were summarized and analyzed.Results A total of 45 articles were included.Conditions for the construction of CAC include medical technology,personnel training,organization and management,etc.The three conditions with the highest frequency were cardiac catheterization,target temperature management,and multidisciplinary team.A number of observational studies showed that the construction of CAC is beneficial for improving survival rate and prognosis,but the level of evidence remains generally low and requires further practice and research.Conclusion The level of research regarding CAC is quite different at home and abroad.Domestic researchers should actively carry out relevant clinical practices,explore the certification standards of CAC which suit the actual status in China,steadily establish a regional treatment system for OHCA patients,and continuously improve the survival rate of such patients.