摘要
目的 探讨机械按压和徒手按压在心肺复苏过程中效果的优劣.方法 采用前瞻性、随机对照的研究方法.共收集符合纳入标准的需进行心肺复苏患者95例,按照按压方式,分为机械按压组(n=48),徒手按压组(n=47),收集两组的人口学特征、临床过程、复苏开始后5、15、30 min和结束复苏时的动脉、静脉血气分析,主要分析pH值、氧分压、细胞外碱剩余、实际碳酸氢根、乳酸、钙离子和中心静脉氧饱和度等指标.资料整理和统计分析使用Microsoft Excel、SAS 9.4等分析软件处理,计数资料使用频数和百分数表示,组间比较使用x2检验.计量资料使用均数±标准差(x±s)表示,组间比较使用单因素方差分析.多元分析使用Logistic回归.结果 机械按压组和徒手按压组患者在年龄、病因等分布上差异无统计学意义(均P＞0.05);机械按压组和徒手按压组复苏时间分别为(22±14) min、(27±19) min,复苏成功率分别为81％、54％,住院时间分别为(37±16)d、(41 ±20)d,两组比较差异有统计学意义(均P＜0.05);转归方面,机械按压组和徒手按压组分别痊愈17例、10例,存活21例、9例、死亡10例、28例,两组比较差异有统计学意义(均P ＜0.05);机械按压组和徒手按压组肌钙蛋白Ⅰ分别为(4.1±2.0)ng/ml、(5.6±1.9) ng/ml,肌酸激酶同功酶MB分别为(31 ±15) U/L、(43 ±22) U/L,两组比较差异有统计学意义(均P＜0.05);徒手按压组在电除颤能量及除颤次数等指标明显高于机械按压组(均P ＜0.05);多元Logistic回归分析显示,按压开始第5分钟的中心静脉氧饱和度(x2=65.0538,P ＜0.0001)、结束按压时的动脉血pH值(x2 =21.5779,P＜0.0001),以及5％碳酸氢钠用量与复苏存活预后明显相关,机械按压组优于徒手按压组(x2=3.1421,P=0.0463).其他指标(氧分压、细胞外碱剩余、实际碳酸氢根、乳酸、钙离子)对两组病例预后影响方面差异无统计学意义(P＞0.05).结论 机械按压效
Objective To analyze the effect of mechanical press and manual press in cardiopulmonary resuscitation.Methods A prospective randomized controlled study was performed.A total of 95 cases who needed cardiopulmonary resuscitation were collected,according to the inclusion criteria,which including mechanical compression group (n =48),and the manual compression group (n =47).Demographic,clinical course of two groups were collected.Arterial and venous blood gas analysis in the recovery after the start of 5 minutes,15 minutes,30 minutes,the end of recovery were also collected and the pH value,partial pressure of oxygen,extracellular base remaining,actual bicarbonate,lactic acid,calcium and central venous oxygen saturation (ScvO2) and other data were mainly analyzed.All data collation and statistical analysis were used Microsoft excel,SAS 9.4.The enumeration data were expressed by the frequency and percentage,and chi square test was used.The measurement data were expressed by mean and standard deviation,and t test was used.Multiple Logistic regression analysis was performed to analysis of the effect of various factors.Results There were no statistically differences in age and pathogenic factors between the mechanical compression group and manual compression group (P ＞ 0.05).The press time,success rate of resuscitation and hospitalization days were respectively (22 ±14) minutes,81％,(37 ± 16) days in the mechanical compression group and (27 ± 19) minutes,54％,(41 ±20) days in the manual compression group,with no statistically significant differences (all P ＞ 0.05).Mechanical compression group and manual compression group were cured in 17 cases,10 cases,survived in 21 cases,9 cases,deaded in 10 cases,28 cases,with statistically significant differences between 2 groups (P ＜0.05).The troponin Ⅰ and creatine kinase MB were respectively (4.1 ± 2.0) ng/ml,(31 ± 15) U/L in the manual compression group and (5.6 ± 1.9) ng/ml,(43 ± 22) U/L in the mechanical compression group,with statistically significant differenc
出处
《国际外科学杂志》
2017年第10期668-672,共5页
International Journal of Surgery
关键词
心肺复苏术
预后
自动心肺复苏机
机械按压
徒手按压
心脏骤停
Cardiopulmonary resuscitation
Prognosis
Automatic cardiopulmonary resuscitation machine
Mechanical compression
Manual compression
Cardiac arrest
