关键词： 心脏猝死   心肺复苏术   技能培训   效果  

摘要： 目的通过对心脏猝死高危者家属进行心肺复苏知识与技能的培训,以探讨公众掌握心肺复苏知识与技能的重点和难点。方法应用方便取样方法,选取首都医科大学附属宣武医院、中国医学科学院阜外心血管病医院住院的心脏猝死(sudden cardiac death,SCD)高危人群的家属集中进行心肺复苏(cardiopulmonary resuscitation,CPR)培训。培训结束后对研究对象进行CPR知识和技能测试。结果培训后即刻对受训家属进行知识与技能的测试,98.4%的家属CPR知识测试通过,但是只有34.3%的家属技能测试合格,65.7%都需要多次反复指导才能做到技能达标。结论公众对CPR知识与技能的掌握程度不一致,CPR技能是公众CPR培训的重点与难点。

关键词： 心脏骤停   心肺复苏   成功率  

摘要： 目的：分析心脏骤停患者心肺复苏的成功率。方法对2007年6月～2011年4月我院急诊科抢救的60例心脏骤停患者的临床资料、抢救措施及复苏成功率进行回顾性分析。结果60例患者复苏成功率为18．3％，死亡率为72．7％。院内和院前发生呼吸心脏骤停的患者，复苏成功率分别为29％和7．1％，差异有统计学意义（P〈0．01）。复苏开始时间〈5min和〉15min的患者复苏戍功率分别为34．6％和5．9％，差异并亦有统计学意义伊〈0．05）。结论：心肺复苏成功率较低，尤其是院前发生呼吸心脏骤停的患者，应普及心肺复苏知识，缩短复苏开始时间，加强急救体系建设，以期提高复苏成功率。

关键词： 心脏停搏/治疗   心肺复苏术  

摘要： 目的探讨院内心脏骤停患者行连续胸外心脏按压心肺复苏能否提高复苏成功率。方法 67例院内发生心脏骤停的患者随机分为CCC-CPR组(即实验组n=35)和ICC-CPR组(即对照组n=32)。两组均按照2005国际心肺复苏指南要求进行抢救,实验组采用人工呼吸时不停止胸外心脏按压,做连续胸外心脏按压;对照组按照2:30的比率进行人工呼吸和心脏按压,每次做人工呼吸时,胸外心脏按压必须暂停,做间歇胸外心脏按压心肺复苏(ICC-CPR)。结果实验组自主循环恢复率明显高于对照组(85.5%vs 61.4%,P<0.05);24 h生存率实验组明显高于对照组(28.6%vs 15.6%,P<0.01)。结论 CCC-CPR可明显地提高院内心脏骤停患者自主循环恢复率和24 h生存率。

关键词： 心肺复苏   救治   护理  

摘要： 心脏骤停是指各种原因所致心脏射血功能突然终止,心肺复苏是抢救心脏骤停最基本、最重要的医疗技术和方法。近年来,心跳骤停复苏成功率明显提高,但复苏后仍需做大量细致的护理监测工作。现将护理体会报告如下。

关键词： Heart arrest   Cardiopulmonary resuscitation   Telephone instruction   Dispatcher   EMERGENCY CPR INSTRUCTION   BASIC LIFE-SUPPORT   VENTRICULAR-FIBRILLATION   UTSTEIN STYLE   TELEPHONE CPR   SURVIVAL   SWEDEN   COMPRESSION   GUIDELINES   EFFICACY  

摘要： Context: Early bystander cardiopulmonary resuscitation (CPR) provides an essential bridge to successful defibrillation from sudden cardiac arrest (SCA) and there is a need to increase the prevalence and quality of bystander CPR. Emergency medical dispatchers can give CPR instructions to a bystander calling for an ambulance enabling even an inexperienced bystander to start CPR. The impact of these instructions has not been evaluated. Objectives: To determine if, in adult and pediatric patients with out-of-hospital cardiac arrest, the provision of dispatch CPR instructions as opposed to no instructions improves outcome. Methods: Two independent reviewers used standardized forms and procedures to review papers published between January, 1985 and December, 2009. Findings were peer-reviewed by the International Liaison Committee on Resuscitation. Data synthesis: We identified 665 citations; five met the inclusion criteria. One retrospective cohort study reported improved survival with dispatch CPR instructions than without it. Three studies, two observational and one with retrospective controls showed trends toward increased survival after dispatcher-assisted CPR was implemented and one showed trend toward decreased survival. There were no randomised studies addressing the topic. No studies addressing dispatch CPR instructions in the pediatric population were found. Conclusion: There is limited evidence supporting the survival benefit of dispatch-assisted CPR instructions. All studies comparing survival outcomes when CPR is provided with or without the assistance of dispatch-assisted CPR instructions lack the statistical power to draw significant conclusions. Since it has been demonstrated that such instructions can improve bystander CPR rates, it is reasonable to recommend they should be provided to all callers reporting a victim in cardiac arrest. (C) 2011 Elsevier Ireland Ltd. All rights reserved.

关键词： 肾上腺素   血管加压素   胺碘酮   心肺复苏术  

摘要： 目的肾上腺素联合血管加压素、胺碘酮在心脏骤停患者心肺复苏术的临床疗效研究。方法选取2008年4月年2010年5月于我院施行心肺复苏术的心脏骤停患者68例,所有患者于心脏骤停7min内施行心肺复苏。男性39例,女性29例。年龄16～67岁,平均42.4±4.5岁。随机将2组患者平均分为2组,实验组和对照组,实验组患者施行心肺复苏同时给予肾上腺素、血管加压素及胺碘酮。对照组仅给予肾上腺素。观察2组患者自主循环恢复时间以及生存率。结果实验组患者自主循环恢复时间(8.4±2.3)min,对照组(14.5±3.8)min,差异有统计学意义,P<0.05.实验组患者1h存活率、24h存活率、出院存活率与对照组均有显著差异,优于对照组。结论血管加压素、胺碘酮能有效提高心肺复苏的成功率,与肾上腺素联用值得临床推广应用。

关键词： AHA Scientific Statements   resuscitation   HOSPITAL CARDIAC-ARREST   QUALITY-OF-LIFE   HIGH-DOSE EPINEPHRINE   IMPLANTABLE CARDIOVERTER-DEFIBRILLATOR   FUNCTIONAL NEUROLOGICAL RECOVERY   EMERGENCY CARDIOVASCULAR CARE   TISSUE-PLASMINOGEN-ACTIVATOR   BRAIN NATRIURETIC PEPTIDE   RANDOMIZED CLINICAL-TRIAL   ACUTE CEREBRAL INFARCTION  

摘要： Background and Purpose-The guidelines presented in this consensus statement are intended to serve researchers, clinicians, reviewers, and regulators in the selection of the most appropriate primary outcome for a clinical trial of cardiac arrest therapies. The American Heart Association guidelines for the treatment of cardiac arrest depend on high-quality clinical trials, which depend on the selection of a meaningful primary outcome. Because this selection process has been the subject of much controversy, a consensus conference was convened with national and international experts, the National Institutes of Health, and the US Food and Drug Administration. Methods-The Research Working Group of the American Heart Association Emergency Cardiovascular Care Committee nominated subject leaders, conference attendees, and writing group members on the basis of their expertise in clinical trials and a diverse perspective of cardiovascular and neurological outcomes (see the online-only Data Supplement). Approval was obtained from the Emergency Cardiovascular Care Committee and the American Heart Association Manuscript Oversight Committee. Preconference position papers were circulated for review; the conference was held; and postconference consensus documents were circulated for review and comments were invited from experts, conference attendees, and writing group members. Discussions focused on (1) when after cardiac arrest the measurement time point should occur; (2) what cardiovascular, neurological, and other physiology should be assessed; and (3) the costs associated with various end points. The final document underwent extensive revision and peer review by the Emergency Cardiovascular Care Committee, the American Heart Association Science Advisory and Coordinating Committee, and oversight committees. Results-There was consensus that no single primary outcome is appropriate for all studies of cardiac arrest. The best outcome measure is the pairing of a time point and physio

关键词： 心脏骤停   心肺复苏   肾脏损伤   血尿素氮   血肌酐  

摘要： 目的探讨心脏骤停心肺复苏成功患者肾脏损伤的发生情况。方法选择行心肺复苏成功的心脏骤停患者42例,根据心脏骤停时间分为两组,≤11分钟者为Ⅰ组(23例),>11分钟者为Ⅱ组(19例)。检测两组患者复苏后1天、2天、3天、7天时血尿素氮(BUN)、血肌酐(SCR)、尿红细胞(RBC)及尿蛋白(PRO)的变化水平,并选择健康体检者20例为对照。结果以对照组为基线,心肺复苏后1天时,Ⅰ组和Ⅱ组患者的血BUN、SCR及尿RBC计数、尿蛋白阳性率均开始升高,在复苏后2天时两组均达高峰,之后均逐渐下降,Ⅰ组在复苏后7天时各指标恢复至对照组基线水平,而Ⅱ组仍显著高于对照水平。组间比较,复苏后各时间点Ⅱ组的血BUN、SCR及尿RBC计数、尿蛋白阳性率均明显高于Ⅰ组。结论心肺复苏早期即存在肾功能改变,且多在1～3天内表现最为明显;心脏骤停时间越长,肾脏损伤越重,肾功能恢复越慢。

关键词： 复苏指南   急救知识   普通群众   技能健康教育  

摘要： 目的 通过采用美国心脏协会推荐的民众心肺复苏（Heart Saver）课程,对自愿参加培训的普通群众开展急救知识和技能培训,并对培训前后效果进行评价.方法 培训前进行问卷调查,随后使用＂挪威/Laerdal;Lae310045型＂复苏安妮全身训练模拟人进行培训,培训后再进行相同问题的问卷调查和实践考核并对收集的数据进行分析.结果 在〈2010美国心脏协会心肺复苏及心血管急救指南〉指导下,普通群众经培训后对心肺复苏知识和技能都能很好掌握,胸外按压效果最好,达到了98%,人工呼吸和急救技能掌握程度由培训前15%和20.8%,分别上升到49%和62%.结论 〈2010美国心脏协会心肺复苏及心血管急救指南〉对普通群众的培训更注重简单、有效、易于实施,能显著提高普通群众的基本急救技能.