经皮氧饱和度监测在院外心脏骤停患者心肺脑复苏中的应用

摘要

目的探讨经皮氧饱和度（SpO2）监测在院外心脏骤停患者心肺脑复苏中的意义。方法394例院外心脏骤停患者分成两组，监测组221例患者入院后立即进行心肺脑复苏，同时予以SpO2监测并观察波形为指导持续胸外按压；未监测组173例患者入院后立即进行心肺脑复苏，但未予以SpO2监测；两组比较心、脑肺复苏成功率及心跳骤停持续时间、自主心跳恢复时间和脑缺血缺氧时间。结果监测组心肺复苏成功117例（52.94％）与未监测组心肺复苏成功72例（41.62％）比较，差异有统计学意义（χ2=4.98，P＜0.05），监测组脑复苏成功14例（6.33％）与未监测组脑复苏成功6例（3.47％）比较，差异无统计学意义（χ2=1.66，P＞0.05）。监测组的心跳骤停持续时间（43.93±23.33） min短于未监测组（52.92±26.28）min，自主心跳恢复时间（22.13±18.72） min亦短于未监测组（29.09±21.40）min，差异均有统计学意义（t分别=2.45、2.35，P均＜0.05）；而两组脑缺血缺氧时间比较，差异无统计学意义（t=1.16，P＞0.05）。结论在经皮SpO2监测指导下进行胸外按压有助于提高胸外按压的有效性，从而提高心肺复苏的成功率。%Objective To explore the significance of SpO2 monitoring in cardio-pulmonary-cerebral resuscitation of patients with out-of-hospital cardiac arrest. Methods A total of 394 patients with out-of-hospital cardiac arrest were randomly assigned into two groups, 221 cases as the monitoring group who received continuous chest compression with SpO2 monitoring by both figure and shape as a guide and 173 cases as the non-monitoring group who received cardio-pulmonary-cerebral resuscitation. The success rate of cardio-pulmonary-cerebral resuscitation, cardiac arrest duration, spontaneous cardiac recovery time, cerebral ischemia and hypoxia time of two groups were compared. Results The success rate of cardio-pulmonary resuscitation of monitoring group(52.94%) was significantly higher than that of the non-monitoring group (41.62%)(χ2=4.98,P<0.05). The success rate of cerebral resuscitation survival between the two groups had no significant difference(χ2=1.66,P>0.05).The cardiac arrest duration of the monitoring group was(43.93±23.33)minutes while the non-monitoring group was (52.92±26.28)minutes, the spontaneous cardiac recovery time of the monitoring group was (22.13± 18.72) minutes while the non-monitoring group was(29.09±21.40)minutes, the differences between them were statistically significant (t=2.45,2.35,P<0.05). There was no significant difference in cerebral ischemia and hypoxia time between two groups (t=1.16,P>0.05). Conclusions SpO2 monitoring is helpful to improve the efficacy of chest compression, so as to improve the success rate of cardiopulmonary resuscitation.