CAJ | 학술논문

目的：探讨一医三护协作模式与心肺复苏专用车在临床心肺复苏中的应用。方法将81例心跳呼吸骤停患者分为对照组（41例）和观察组（40例）。观察组采用一医三护协作模式与心肺复苏专用车进行心肺复苏，对照组采用一医二护协作模式与传统急救车。比较两组患者入科时APACHEⅡ评分和原发病因、心肺复苏开始和完成时间、完成气管插管和心脏电除颤时间、复苏成功率、24 h存活率、14 d存活率、复苏成功后pH值、氧分压（ PaO2）、二氧化碳分压（ PaCO2）、血乳酸（ Lac）等指标，同时比较分析实施救治的医务人员对两种抢救方案的满意度。结果两组患者在入科时APACHEⅡ评分及病因无明显差异（ P＞0.05）。观察组心肺复苏开始和完成时间、完成气管插管和心脏电除颤时间均少于对照组（P＜0.01），复苏成功率及14 d存活率高于对照组（P＜0.05，P＜0.01），复苏成功后观察组患者动脉血pH值和PaO2高于对照组（P＜0.01），但PaCO2和Lac水平则低于对照组（P＜0.01）。医务人员对观察组抢救方案满意度高于对照组（P＜0.05）。结论一医三护与心肺复苏专用车的协助复苏方案较传统复苏模式可缩短抢救措施的实施时间，提高复苏成功率及存活率，改善复苏后患者的酸碱失衡及氧合，更易为医护人员所接纳及实施，适合在临床推广。
목적：탐토일의삼호협작모식여심폐복소전용차재림상심폐복소중적응용。방법장81례심도호흡취정환자분위대조조（41례）화관찰조（40례）。관찰조채용일의삼호협작모식여심폐복소전용차진행심폐복소，대조조채용일의이호협작모식여전통급구차。비교량조환자입과시APACHEⅡ평분화원발병인、심폐복소개시화완성시간、완성기관삽관화심장전제전시간、복소성공솔、24 h존활솔、14 d존활솔、복소성공후pH치、양분압（ PaO2）、이양화탄분압（ PaCO2）、혈유산（ Lac）등지표，동시비교분석실시구치적의무인원대량충창구방안적만의도。결과량조환자재입과시APACHEⅡ평분급병인무명현차이（ P＞0.05）。관찰조심폐복소개시화완성시간、완성기관삽관화심장전제전시간균소우대조조（P＜0.01），복소성공솔급14 d존활솔고우대조조（P＜0.05，P＜0.01），복소성공후관찰조환자동맥혈pH치화PaO2고우대조조（P＜0.01），단PaCO2화Lac수평칙저우대조조（P＜0.01）。의무인원대관찰조창구방안만의도고우대조조（P＜0.05）。결론일의삼호여심폐복소전용차적협조복소방안교전통복소모식가축단창구조시적실시시간，제고복소성공솔급존활솔，개선복소후환자적산감실형급양합，경역위의호인원소접납급실시，괄합재림상추엄。
Objective To discuss the clinical application of new cooperative mode of 3 nurses and 1 doctor with integrated vehicle in CPR .Methods A total of 81 cases of patients with cardiopulmonary arrest were included and ran-domly divided into control group ( n=41 ) and treatment group ( n=40 ); in which cooperative mode of 2 nurses and 1 doctor with conventional emergency vehicle and mode of 3 nurses and 1 doctor with advanced integrated vehicle were used , respectively.The APACHE Ⅱscores, primary diseases, CPR duration, endotracheal intubation time , electrical defibril-lation time, resuscitation success rate, survival rates at 24 h and on 14 d, pH value, and PaO2, PO2 and Lac after CPR were compared;and the satisfaction degree from medical staff were also investigated .Results At admission , there was no significant difference in the APACHE Ⅱ score or primary disease between the two groups (P>0.05).After CPR, the CPR duration, endotracheal intubation time and electrical defibrillation time were significantly shorter in treatment group than those in control group (P<0.01), with significantly higher resuscitation success rate (P<0.05), survival rate on 14 d (P<0.01);Significant higher artery pH value (P<0.01) and PaO2(P<0.01), and lower PaCO2(P<0.05) and Lac level (P<0.05) were also observed in treatment group .Meanwhile, the satisfaction degree from medical staff was al-so significantly higher in treatment group (P<0.05).Conclusion Compared with conventional mode and vehicle , the new cooperative mode of 3 nurses and 1 doctor with advanced integrated vehicle can reduce the rescue time , improve the acid-base imbalance and oxygenation , increase resuscitation success rate and survival rate in CPR patients , with more feasible application .