摘要目的 了解中小学生进行胸外按压培训的适宜年龄.方法 2017年3月至2018年1月采用分层随机抽样的方法从余姚市城区的中、小学校各选取2所学校,采用抽签法选取其中小学三～六年级和初一、二年级各1个班的437名9～15岁的学生为培训对象,其中9、10、11、12、13、14和15岁者分别为61、62、66、64、63、63和58名,由余姚市人民医院急诊科医生参照美国2015版心肺复苏指南进行胸外按压培训,学习30 min理论课程后在模拟人上进行6 min练习,之后对每位学生进行考核,记录胸外按压的深度、频率、位置及滞留等质量情况.结果 9～15岁学生身高分别为(135.2±5.2)、(140.7±6.2)、(146.1±10.0)、(153.6±12.5)、(159.0±12.7)、(163.2±11.3)和(165.7±9.3)cm,体重分别为(33.5±3.1)、(34.0±3.7)、(39.2±9.4)、(44.7±9.4)、(44.7±9.4)、(51.1±9.9)和(52.4±8.8)kg;进行胸外按压的平均深度分别为3.8、4.1、4.6、5.1、5.2、5.6和5.6 cm,准确率分别为24.6％(14/61)、25.8％(16/62)、50.2％(33/66)、70.5％(45/64)、79.4％(50/63)、88.9％(56/63)和91.4％(53/58);与9～11岁者相比,12～15岁者胸外按压的平均深度明显增加、准确率显著提高,差异均有统计学意义(t值为-11.370～-3.095,x2值为5.586～65.671,均P＜0.05).所有学生进行胸外按压的频率平均为110～ 116次/min、准确率86.4％～ 95.2％,按压位置的准确率为90.9％～ 96.8％,差异均无统计学意义.各组学生进行胸外按压的滞留率分别为81.3％(122/150)、67.3％(101/150)、64.7％(94/150)、48.0％(72/150)、48.7％(73/150)、33.3％(50/150)和27.3％(41/150);与9～11岁者相比,12～ 15岁者胸外按压的平均滞留率明显下降,差异均有统计学意义(x2值为5.927～119.920,均P＜0.05).相关性分析显示,按压深度、滞留率与学生年龄、体重、身高、BMI等指标呈显著相关(按压深度r值分别为0.96、0.89、0.91、0.86,滞留率r值分别为-0.99、-0.90、-0.93、-0.86,均P＜0.01).结论 年龄≥12岁学生有能力进行有效的胸外按压,是接受胸外按压培训的适宜年龄.

abstractsObjective To investigate the appropriate age of primary and secondary school students for cardiopulmonary resuscitation (CPR) training.Methods A total of 437 students aged 9-15 years at 3 to 6 grade in the primary schools or 1 to 2 grade in the secondary schools were selected from 2 Yuyao primary and secondary schools by stratified random sampling between March 2017 and January 2018.The numbers of students with the age of 9,10,11,12,13,14 and 15 y were 61,62,66,64,63,63 and 58,respectively.All students received chest compression training provided by Yuyao emergency department People's Hospital according to the 2015 Cardiopulmonary Resuscitation Guidelines.The training included 30 min theoretic teaching and 6 min practice in the simulator.The quality of chest compression performed by students was assessed;the depth,rate,position and retention of chest compression were recorded.Results The mean depth of chest compression in the students aged 9-15 years was 3.8,4.1,4.6,5.1,5.2,5.6 and 5.6 cm,respectively;the accuracy rate was 24.6％(14/61),25.8％ (16/62),50.2％ (33/66),70.5％ (45/64),79.4％(50/63),88.9％(56/63) and 91.4(53/58),respectively.Compared with the students aged 9-11 years,the mean depth of chest compression was significantly increased and accuracy rate was significantly improved in the students aged 12-15 years (Compared with 9-y students,t=-8.936,-9.502,-10.640 and-11.370;x2=35.019,47.599,63.013 and 65.671;compared with 10-y students,t=-6.927,-8.179,-10.70 and-11.047;x2=24.977,35.967,50.916 and 52.727;compared with 1 1-y students,t=-3.095,-4.177,-6.785 and-6.995;x2=5.586,12.114,22.786 and 24.870;all P＜0.05).The mean rate of chest compression was 110-116/min and its accuracy rate was 86.4％-95.2％;the accuracy rate of chest compression position was 90.9％-96.8％ in all students,there were no significant differences among the 7 groups.The mean retention rate of chest compression in the 7 groups was 81.3％(122/150),67.3％(101/150),64.7％ (94/150),48.0％(72/150),48.7％(73/150),33.3％(50/150) and 27.3％(41/150),respectively.Compared with the students aged 9-11 years,the mean retention rate of chest compression was significantly decreased in the students aged 12-15 years (compared with the 9-y students,x2=36.472,35.179,70.64 and 119.92;compared with 10-y students,x2=11.483,10.728,34.682 and 72.150;compared with 11-y students,x2=6.528,5.927,25.855 and 59.11;all P＜0.05).Correlation analysis showed that the depth (r=0.96,0.89,0.91 and 0.86;P＜0.01) and retention rate (r=-0.99,-0.90,-0.93 and-0.86;all P＜0.01) of chest compression were significantly associated with the age,body weight,height and body mass index of students.Conclusion The students with an age of 12 years or more are able to effectively perform chest compression;thus,12 years and above might be the appropriate age for CPR training.