Caldwell G, Millar G, Quinn E, Vincent R, Chamberlain D A
Br Med J (Clin Res Ed). 1985 Sep 7;291(6496):627-30. doi: 10.1136/bmj.291.6496.627.
A prospective study was made of the value of the precordial thump and of cough version in life threatening ventricular arrhythmias. Of about 5000 medical and surgical patients, 68 were treated for persistent ventricular tachycardia and 248 for ventricular fibrillation, 86 of whom had presented outside hospital. Mechanical intervention was successful in 26 incidents occurring in 23 patients. Electrocardiographic records were obtained in 14 instances. Ventricular fibrillation was terminated by a thump in five patients and ventricular tachycardia by either a thump or a cough in a total of 17 patients. Four additional instances were recorded of successful recovery from asystolic or unspecified circulatory arrest after a precordial thump. Fifteen patients survived to be discharged from hospital. The potential benefit of the precordial thump and cough versions greatly outweighs their risks; hence these manoeuvres should probably be reintroduced into schedules for first aid resuscitation.
对胸前区捶击和咳嗽动作在危及生命的室性心律失常中的价值进行了一项前瞻性研究。在大约5000名内科和外科患者中，68例因持续性室性心动过速接受治疗，248例因心室颤动接受治疗，其中86例在医院外发病。机械干预在23例患者发生的26次事件中取得成功。在14例中获得了心电图记录。5例患者的心室颤动通过捶击终止，17例患者的室性心动过速通过捶击或咳嗽终止。另外记录到4例在胸前区捶击后从心搏停止或未明确的循环骤停中成功恢复的情况。15例患者存活并出院。胸前区捶击和咳嗽动作的潜在益处远大于其风险；因此，这些操作可能应重新纳入急救复苏流程。
