下肢弯曲按压心肺复苏与标准心肺复苏的比较：一项前瞻性多中心试验
[Comparison of cardiopulmonary resuscitation by bending and pressing the lower extremities with standard cardiopulmonary resuscitation: a prospective multicenter trial].
作者信息
Li Xiang, Liu Jianjun, Tian Rui, Tang Jianguo, Wang Ruilan, Wang Liuyun, Zhou Tonghao, Huang Hui
机构信息
Department of Intensive Care Unit, Lu'an Civily Hospital, Lu'an 237002, Anhui, China (Li X, Zhou TH, Huang H); Trauma, Emergency and Intensive Care Medical Center, the 5th People's Hospital of Shanghai, Fudan University, Shanghai 200240, China (Liu JJ, Tang JG); Department of Emergency and Intensive Care Unit, the First People's Hospital of Shanghai, Shanghai Jiaotong University, Shanghai 200080, China (Tian R, Wang RL); Department of Emergency, Shanghai Hudong Hospital, Shanghai 200129, China (Wang LY). Corresponding author: Li Xiang, Email:
出版信息
Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2018 Apr;30(4):360-364. doi: 10.3760/cma.j.issn.2095-4352.2018.04.015.
OBJECTIVE
To compare the effects of cardiopulmonary resuscitation by bending and pressing the lower extremities (BPLE-CPR) with standard cardiopulmonary resuscitation (S-CPR).
METHODS
A multicenter prospective nonrandomized controlled study was performed. Patients with cardiac arrest (CA) treated in the emergency departments and intensive care units (ICU) of seven hospitals in Eastern China from January 2013 to February 2017 were enrolled. BPLE-CPR or S-CPR was used for resuscitation according to the patient's condition. Data registration was completed in Utstein style. The primary outcome was recovery of spontaneous circulation (ROSC) rate, and the secondary outcome included survival rate at discharge, the resuscitation time of ROSE patients, blood pressures during resuscitation, the survival rates within 24 hours and beyond 24 hours, and the cerebral performance categories (CPC) of discharged patients.
RESULTS
A total of 279 patients completed data registration, including 142 in the BPLE-CPR group and 137 in the S-CPR group. ROSC rate, survival rates over 24 hours and at discharge in BPLE-CPR group were significantly higher than those in S-CPR group [ROSC rate: 63.4% (90/142) vs. 29.2% (40/137), survival rate over 24 hours: 56.7% (51/90) vs. 45.0% (18/40), survival rate at discharge: 43.0% (61/142) vs. 20.4% (28/137), all P < 0.01]. The CPR duration of ROSC patients in BPLE-CPR group was significantly shorter than that in S-CPR group [minute: 10 (5, 15) vs. 20 (11, 30), P < 0.01], while systolic blood pressure during CPR was significantly higher than that in S-CPR group [mmHg (1 mmHg = 0.133 kPa): 92.0 (80.0, 110.0) vs. 73.5 (65.5, 80.0), P < 0.01]. In survival discharged patients, the proportion of CPC 1 patients in BPLE-CPR group was significantly higher than that in S-CPR group [24.6% (15/61) vs. 10.7% (3/28), P < 0.01].
CONCLUSIONS
BPLE-CPR is superior to S-CPR in terms of ROSC rate and discharge survival rate. In addition, the BPLE-CPR procedure is simple and easy to expand in public.
CLINICAL TEST REGISTRATION
Chinese Clinical Trial Registry, ChiCTR-TRC-13003150.
目的
比较下肢屈伸按压式心肺复苏（BPLE-CPR）与标准心肺复苏（S-CPR）的效果。
方法
进行一项多中心前瞻性非随机对照研究。纳入2013年1月至2017年2月在中国东部七家医院急诊科和重症监护病房（ICU）接受治疗的心脏骤停（CA）患者。根据患者病情采用BPLE-CPR或S-CPR进行复苏。数据按照Utstein格式进行记录。主要结局指标为自主循环恢复（ROSC）率，次要结局指标包括出院生存率、ROSC患者的复苏时间、复苏期间的血压、24小时内及24小时后的生存率以及出院患者的脑功能分类（CPC）。
结果
共279例患者完成数据记录，其中BPLE-CPR组142例，S-CPR组137例。BPLE-CPR组的ROSC率、24小时以上及出院时的生存率显著高于S-CPR组[ROSC率：63.4%（90/142）对29.2%（40/137），24小时以上生存率：56.7%（51/90）对45.0%（18/40），出院生存率：43.0%（61/142）对20.4%（28/137），均P<0.01]。BPLE-CPR组ROSC患者的心肺复苏持续时间显著短于S-CPR组[分钟：10（5，15）对20（11，30），P<0.01]，而心肺复苏期间的收缩压显著高于S-CPR组[mmHg（1mmHg = 0.133kPa）：92.0（80.0，110.0）对73.5（65.5，80.0），P<0.01]。在存活出院患者中，BPLE-CPR组CPC 1级患者的比例显著高于S-CPR组[24.6%（15/61）对10.7%（3/28），P<0.01]。
结论
BPLE-CPR在ROSC率和出院生存率方面优于S-CPR。此外，BPLE-CPR操作简单，易于在公众中推广。
临床试验注册
中国临床试验注册中心，ChiCTR-TRC-13003150。
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