摘要
目的评价使用机械心肺复苏对心脏骤停患者复苏结局的影响。方法系统检索中国知网、维普、万方、PUBMED、Web of Science等数据库中关于机械心肺复苏和徒手心肺复苏的相关文献,提取有效数据后用RevMan5.3软件进行Meta分析。结果共计纳入20项临床研究,包含29 727例患者,其中11 104例患者在复苏过程中使用了机械心肺复苏,18 623例患者在复苏过程中全程使用徒手心肺复苏。Meta分析结果显示,机械心肺复苏相对于徒手心肺复苏不能有效改善心脏骤停患者的自主循环恢复发生率(RR=1.10,95%CI:0.99~1.23,P<0.01)、入院存活率(RR=1.01,95%CI:0.95~1.08,P=0.67)、出院存活率(RR=1.00,95%CI:0.86~1.15,P=0.14)、神经功能预后(RR=0.81,95%CI:0.61~1.06,P=0.69)。结论机械心肺复苏对比徒手心肺复苏,并不能显著改善心脏骤停患者的预后。不推荐机械心肺复苏完全替代徒手胸外按压。
Objective To evaluate the effect of mechanical chest compression device in patients with cardiac arrest.Methods The relevant literatures about mechanical cardiopulmonary resuscitation and manual cardiopulmonary resuscitation were systematically searched from China Knowledge Network(CNKI),VIP,Wanfang,PubMed,Web of Science and other databases.The effective data were extracted and analyzed by RevMan5.3 software.Results A total of 20 clinical studies involving 29727 patients were included,of which 11104 patients received mechanical cardiopulmonary resuscitation and 18623 patients received traditional manual cardiopulmonary resuscitation.The results of meta-analysis showed that mechanical cardiopulmonary resuscitation could not effectively improve the restoration of spontaneous circulation(ROSC)rate,admission survival rate,discharge survival rate and neurological prognosis in patients with cardiac arrest compared with manual cardiopulmonary resuscitation.ROSC occurrence rate(RR=1.10,95%CI:0.99-1.23,P<0.01),admission survival rate(RR=1.01,95%CI:0.95-1.08,P=0.67),discharge survival rate(RR=1.OO,95%CI:0.86-1.15,P=0.14),and good neurological function rate(RR=0.81,95%CI:0.61-1.06,P=0.69)showed no significant differences between the mechanical cardiopulmonary resuscitation and manual cardiopulmonary resuscitation.Conclusions Mechanical chest compression device has no advantage compared with manual cardiopulmonary resuscitation.Mechanical cardiopulmonary resuscitation is not recommended to completely replace manual chest compression in cardiopulmonary resuscitation.
作者
龚青云
赵鹏程
王迪
秦正
李春雨
张成
娄爽
陈旭锋
张劲松
陈彦
Gong Qingyun;Zhao Pengcheng;Wang Di;Qin Zheng;Li Chunyu;Zhang Cheng;Lou Shuang;Chen Xufeng;Zhang Jingsong;Chen Yan(Emergency Medical Center,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China;Critical Medicine Department,Jiangsu Maternal and Child Health Hospital,Nanjing 210029,China;Science and Technology Department,Jiangsu Maternal and Child Health Hospital,Nanjing 210029,China;Outpatient Department,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China;Emergency Management Department,School of Health Policy&Management,Nanjing Medical University,Nanjing 211166,China;Research Institute of Health Jiangsu,Nanjing Medical University,Nanjing 211166,China)
出处
《中华急诊医学杂志》
CAS
CSCD
北大核心
2021年第3期342-350,共9页
Chinese Journal of Emergency Medicine
基金
江苏省医院协会医院管理创新研究课题(JSYGY-2-2019-150)
江苏省医学重点人才项目(ZDRCA2016016)
江苏省妇幼保健协会科研项目(FYX201915)。
关键词
心脏骤停
心肺复苏
机械心肺复苏
META分析
Cardiac arrest
Cardiopulmonary resuscitation
Mechanical chest compression device
Meta-analysis
