溺水儿童非传统顺序心肺复苏成功的原因探讨

目的　探讨溺水儿童院前非传统顺序心肺复苏 (CPR)的可行性。方法　 4 3例因溺水而心搏骤停即行院前CPR的患儿 ,CPR顺序按ABC (开放气道人工呼吸胸外按压 )和CAB (胸外按压开放气道人工呼吸 )分为传统顺序组 (2 1例 )和非传统顺序组 (2 2例 ) ,分析比较两组复苏效果。结果　两组基本情况及初步复苏成功率、复苏无效率、神经系统病残率无明显差异 ,入院初HR、RR、MBP和血气分析基本相似 ;非传统顺序组复苏成功存活及入院初PaCO2 均明显高于传统顺序组 (P <0 0 0 1) ,复苏成功未存活明显少于传统顺序组 (P <0 0 5 )。结论　限于条件 ,儿童溺水院前急救CPR初期 ,先行胸外按压、开放气道 ,人工通气相对延后 ,其方法简单有效 ,值得探索。

The reason of successful cardiopulmonary resuscitation with unconventional sequence in drowning children

Objective To explore the reason of successful cardiopulmonary resuscitation (CPR) with unconventional sequence in drowning children. Methods According to the CPR sequence of ABC(airway-breathing-circulation) and CAB (circulation-airway-breathing) before admission, 43 drowning children with cardiac arrest were classified to conventional group (21/43) and unconventional group (22/43). The artificial breathing of unconventional group is partial ventilation by compressing chest only.CPR effect of the two groups were compared. Results There were no difference in the two groups between basic data and initial successful resuscitation rate, inefficacy rate, leave over nerve system damage rate. Their HR, RR, MBP and blood gas analysis were also the same at admission. Unconventional group was obviously higher than conventional group in successful resuscitation and surviving,and in PaCO 2 at admission (P<0.001);but was obviously lower in successful resuscitation and death(P<0.05).Conclusion Compressing chest and opening airway first,postponing artificial respiration comparatively may be a simple and advisable measure before admission for drowning children.