心肺复苏主动强化策略对院前救治措施的影响分析

Impact of the active reinforcement strategy for cardiopulmonary resuscitation on prehospital treatment measures

目的 建立心肺复苏主动强化策略,评估该策略效果。方法 将院前急救团队分成传统心肺复苏(cardiopulmonary resuscitation,CPR)组与CPR主动强化组,利用视频和小程序记录急救过程。2021年6月-2021年12月,收集到传统CPR组49个病例与CPR主动强化组51个病例,统计抢救时间、按压时间、除颤时间、机械按压设备安装时间、首次肾上腺素使用时间以及气管插管时间等指标,比较两组的差异。结果 CPR主动强化组的前10 min胸外按压比例[69.67(61.75,75.33)%]和高级气道建立比例(84.3%)高于传统CPR组[46.0(31.5,53.5)%和61.2%],差异有统计学意义(均P <0.05)。两组在机械按压使用率、肾上腺素使用率、复苏机械安装用时、救治开始至复苏机械安装完成用时、救治开始至首次肾上腺素使用时间、救治开始至高级气道建立完成用时等方面差异均无统计学意义(均P> 0.05)。在心肺复苏结局方面,传统CPR组和CPR主动强化组院前自主循环恢复率分别为38.8%(19/49)和35.3%(18/51),差异无统计学意义(P> 0.05)。结论 实施CPR主动强化策略能明显提高院前心搏骤停患者的前10 min胸外按压比例,视频回顾与急救措施登记分析能有效提高心肺复苏的质量,值得进一步推广。

Objective To establish an active reinforcement strategy for cardiopulmonary resuscitation(CPR)and evaluate its effect.Methods The pre-hospital emergency teams were divided into the conventional CPR group and the CPR active reinforcement group,and the rescue process was recorded by video and mini-program.From June 2021 to December 2021,the data of 49 cases in the conventional CPR group and 51 cases in the CPR active reinforcement group were collected,and indicators such as rescue time,compression time,defibrillation time,mechanical compression device installation time,first adrenaline use time,and tracheal intubation time were calculated and compared between the two groups.Results The chest compression fraction[69.67(61.75,75.33)%]and advanced airway establishment rate(84.3%)in the first 10 minutes in the CPR active reinforcement group were higher than those in the conventional CPR group[46.0(31.5,53.5)%and 61.2%],and the difference was statistically significant(P<0.05).There was no statistically significant difference between the cases in two groups in terms of mechanical compression use rate,adrenaline use rate,rescue mechanical installation time,time from rescue start to rescue mechanical installation completion,time from rescue start to first adrenaline use,time from rescue start to advanced airway establishment completion,etc.(P>0.05).In terms of CPR outcome,the pre-hospital return of spontaneous circulation(ROSC)rates in the conventional CPR group and the CPR active reinforcement group were 38.8%(19/49)and 35.3%(18/51),respectively,and the difference was not statistically significant(P>0.05).Conclusions The implementation of the CPR active reinforcement strategy can significantly improve the chest compression fraction of pre-hospital cardiac arrest patients in the first 10 minutes,and the video review and rescue measures registration analysis can effectively improve the quality of CPR,which is worth further promotion.