摘要目的 探讨腹部提压心肺复苏(ALC-CPR)对于存在传统心肺复苏(CPR)禁忌证(如胸肋骨骨折、胸部外伤等)的心搏骤停(CA)患者的临床应用价值.方法 回顾性分析2015年6月至2016年12月在合肥市第二人民医院急诊科救治的CA患者临床资料,选择体重40~150 kg、CA 20 min内实施ALC-CPR的患者.记录患者复苏前及自主循环恢复(ROSC)30 min(复苏成功后)时的生命体征和血气分析指标.结果共纳入19例CA患者,均应用CPR-LW1000型ALC-CPR仪进行复苏,其中男性12例,女性7例;年龄43~87岁,平均(70.32±13.49)岁;心脏病因4例,非心脏病因15例.与复苏前比较,19例患者复苏成功后心率〔HR(次/min):115.05±21.70比0〕、平均动脉压〔MAP(mmHg,1 mmHg=0.133 kPa):66.05±11.69比0〕、脉搏血氧饱和度(SpO2:0.928±0.057比0.417±0.118)、pH值(7.05±0.23比6.80±0.28)、动脉血氧分压〔PaO2(mmHg):65.42±19.11比42.42±10.78〕、HCO3-(mmol/L:19.22±2.77比17.18±3.76)均明显改善(均P<0.05),动脉血二氧化碳分压(PaCO2)有所降低(mmHg:53.72±13.23比57.66±14.86,但P>0.05).结论 对于存在传统CPR禁忌证的CA患者,ALC-CPR有显著的临床应用价值.

abstractsObjective To investigate the clinical application of rhythmic abdominal lifting and compression cardiopulmonary resuscitation (ALC-CPR) in cardiac arrest (CA) patients with conventional cardiopulmonary resuscitation (CPR) contraindication (chest rib fracture, chest trauma, etc.).Methods The clinical data of patients with CA in emergency department of Hefei Second People's Hospital from June 2015 to December 2016 were analyzed retrospectively, and the patients with weights 40-150 kg and CA≤20 minutes, and resuscitated with ALC-CPR were selected. The vital signs and blood gas analysis indexes of patients before resuscitation and 30 minutes after return of spontaneous circulation (ROSC, after successful resuscitation) were recorded.Results A total of 19 patients with CA were treated with CPR-LW1000 type ALC-CPR apparatus for resuscitation, and with 12 males, 7 females; the age ranged from 43 to 87 years, and the average age was (70.32±13.49) years; there were 4 cases of heart disease, and 15 cases of non-heart disease. Compared with before resuscitation, the heart rate [HR (bpm): 115.05±21.70 vs. 0], mean arterial pressure [MAP (mmHg, 1 mmHg = 0.133 kPa): 66.05±11.69 vs. 0], pulse oxygen saturation (SpO2: 0.928±0.057 vs. 0.417±0.118), pH value (7.05±0.23 vs. 6.80±0.28), arterial oxygen partial pressure [PaO2 (mmHg): 65.42±19.11 vs. 42.42±10.78], HCO3- (mmol/L: 19.22±2.77 vs. 17.18±3.76) were significantly improved after successful resuscitation (allP < 0.05), and arterial blood carbon dioxide partial pressure (PaCO2) was decreased after successful resuscitation (mmHg: 53.72±13.23 vs. 57.66±14.86,P > 0.05).Conclusion Rhythmic ALC-CPR has obvious clinical value for CA patients with conventional CPR contraindication.