CAJ | 학술논문

目的：探讨心肺复苏机在心搏骤停患者院前急救中的应用效果，为心搏骤停院前急救提供依据。方法2011年1月至2013年5月海南省农垦三亚医院急诊科收治的院外心搏骤停患者93例，其中应用心肺呼吸机进行院前抢救的51例患者作为研究组，应用人工按压心肺复苏抢救的42例患者作为对照组。比较两组患者血氧饱和度、氧分压、二氧化碳分压和血压变化，观察两组患者心肺复苏时间、自主呼吸恢复时间和各项功能恢复情况。应用化学发光免疫分析法检测患者血清神经元特异性烯醇化酶（NSE）、N末端B型脑钠肽原（NT-proBNP）、肌钙蛋白 I（cTnI）和心型脂肪酸结合蛋白（H-FABP）水平。结果两组患者血氧饱和度、氧分压和二氧化碳分压比较，差异无统计学意义（P＞0．05）；研究组患者收缩压、舒张压显著高于对照组（P＜0．05）。研究组心肺复苏时间、自主呼吸恢复时间均显著低于对照组（P＜0．01）。两组术中心率、呼吸、血压和血氧饱和度比较，差异无统计学意义（P＞0．05）。研究组患者自主呼吸恢复、自主循环恢复、存活大于24 h和康复出院比例显著高于对照组（P＜0．05）。两组患者自主循环恢复即刻血清 NSE、NT-proBNP、cTnI、H-FABP比较，差异无统计学意义（P＞0．05）；自主循环恢复24 h后研究组 NSE、NT-proBNP、cTnI、H-FABP水平显著低于对照组（P＜0．01）。结论心肺复苏机应用于心搏骤停患者院前抢救可以有效缩短患者心肺复苏时间和自主循环恢复时间，降低患者心、脑、肺等重要脏器损伤，有效提高心肺复苏成功率。
목적：탐토심폐복소궤재심박취정환자원전급구중적응용효과，위심박취정원전급구제공의거。방법2011년1월지2013년5월해남성농은삼아의원급진과수치적원외심박취정환자93례，기중응용심폐호흡궤진행원전창구적51례환자작위연구조，응용인공안압심폐복소창구적42례환자작위대조조。비교량조환자혈양포화도、양분압、이양화탄분압화혈압변화，관찰량조환자심폐복소시간、자주호흡회복시간화각항공능회복정황。응용화학발광면역분석법검측환자혈청신경원특이성희순화매（NSE）、N말단B형뇌납태원（NT-proBNP）、기개단백 I（cTnI）화심형지방산결합단백（H-FABP）수평。결과량조환자혈양포화도、양분압화이양화탄분압비교，차이무통계학의의（P＞0．05）；연구조환자수축압、서장압현저고우대조조（P＜0．05）。연구조심폐복소시간、자주호흡회복시간균현저저우대조조（P＜0．01）。량조술중심솔、호흡、혈압화혈양포화도비교，차이무통계학의의（P＞0．05）。연구조환자자주호흡회복、자주순배회복、존활대우24 h화강복출원비례현저고우대조조（P＜0．05）。량조환자자주순배회복즉각혈청 NSE、NT-proBNP、cTnI、H-FABP비교，차이무통계학의의（P＞0．05）；자주순배회복24 h후연구조 NSE、NT-proBNP、cTnI、H-FABP수평현저저우대조조（P＜0．01）。결론심폐복소궤응용우심박취정환자원전창구가이유효축단환자심폐복소시간화자주순배회복시간，강저환자심、뇌、폐등중요장기손상，유효제고심폐복소성공솔。
Objective To investigate the applicative effect of cardiopulmonary resuscitation in pre-hospital care of emergency pa-tients with cardiac arrest and provide the basis for pre-hospital care of cardiac arrest.Methods Selected 93 cases of cardiac arrest in January 2011 to May 2013 occurred out of Hainan Province Nongken Sanya Hospital,including 51 cases of cardiopulmonary resusci-tation of pre hospital rescue as the study group,42 cases of the application of artificial compression cardiopulmonary resuscitation as control group.Compared blood oxygen saturation,oxygen and carbon dioxide partial pressure and blood pressure changes,CPR time,spontaneous breathing recovery time and the recovery of the function of two groups.Used chemiluminescence method to detect NSE,NT-proBNP,cTnI and H-FABP.Results The two groups of patients with blood oxygen saturation,oxygen and carbon diox-ide partial pressure showed no statistical difference(P>0.05);the DBP and SBP levels of the study group were significantly higher than the control group(P<0.05);the study group CPR time and spontaneous circulationtime were significantly higher than that in control group(P<0.05).Two groups of intraoperative heart rate,respiration,blood pressure and oxygen saturation had no signifi-cant difference(P>0.05).Study group of patients with spontaneous breathing recovery,the restoration of spontaneous circulation, survival is greater than 24 h and rehabilitation discharge rates were significantly higher than the control group(P<0.05).There was no significant difference in the serum levels of NSE,NT-proBNP,cTnI immediately,H-FABP recovery in spontaneous circula-tion(P>0.05);after 24 h,NSE,NT-proBNP,cTnI,H-FABP levels in study group were significantly lower than those in the control group(P<0.01).Conclusion The application of cardiopulmonary resuscitation in patients with cardiac arrest before salvage can ef-fectively shorten the recovery time of CPR patients and spontaneous circulation time,reduce the damage to heart,brain,lung and other organs,improve the success rate of cardiopulmonary resuscitation,worthy of clinical application.