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人們常在影視作品中見到這樣的場(chǎng)景：某人因心臟驟停而倒下，路人趕緊上前急救，有節(jié)律地按壓胸部并嘴對(duì)嘴人工呼吸。但英國權(quán)威醫(yī)學(xué)刊物《柳葉刀》15日刊登一份研究報(bào)告說，在這種情況下省去人工呼吸，集中精力按壓胸部往往更有效。

這份由奧地利和美國研究人員完成的報(bào)告說，他們綜合分析了1985年到2010年間關(guān)于心臟驟停急救的多項(xiàng)研究。這些研究中包含了大量心臟驟停急救的醫(yī)療記錄。分析結(jié)果顯示，與同時(shí)按壓胸部和人工呼吸相比，只按壓胸部的急救成功率要高出約20％。

研究人員說，這是因?yàn)樵谠S多心臟驟停案例中，上前急救的只是路人，他們往往沒有受過充分的訓(xùn)練，如果花時(shí)間在不得法的人工呼吸上，還不如一直進(jìn)行胸部按壓。這樣胸部按壓造成的血液流動(dòng)不會(huì)因?yàn)槿斯ず粑袛?，心臟復(fù)蘇效果會(huì)更好。（生物谷Bioon.com）

生物谷推薦英文摘要：

The Lancet doi:10.1016/S0140-6736(10)61454-7

Chest-compression-only versus standard cardiopulmonary resuscitation: a meta-analysis
Michael Hüpfl MD a, Harald F Selig MD a, Dr Peter Nagele MD a b

Background

In out-of-hospital cardiac arrest, dispatcher-assistedchest-compression-only bystander CPR might be superior to standardbystander CPR (chest compression plus rescue ventilation), but trialfindings have not shown significantly improved outcomes. We aimed toestablish the association of chest-compression-only CPR with survival inpatients with out-of-hospital cardiac arrest.

Methods

Medline and Embase were systematically reviewed for studies publishedbetween January, 1985, and August, 2010, in whichchest-compression-only bystander CPR was compared with standardbystander CPR for adult patients with out-of-hospital cardiac arrest. Inthe primary meta-analysis, we included trials in which patients wererandomly allocated to receive one of the two CPR techniques, accordingto dispatcher instructions; and in the secondary meta-analysis, weincluded observational cohort studies of chest-compression-only CPR. Allstudies had to supply survival data. The primary outcome was survivalto hospital discharge. A fixed-effects model was used for bothmeta-analyses because of an absence of heterogeneity among the studies(I2=0%).

Findings

In the primary meta-analysis, pooled data from three randomisedtrials showed that chest-compression-only CPR was associated withimproved chance of survival compared with standard CPR (14% [211/1500]vs 12% [178/1531]; risk ratio 1·22, 95% CI 1·01—1·46). The absoluteincrease in survival was 2·4% (95% CI 0·1—4·9), and the number needed totreat was 41 (95% CI 20—1250). In the secondary meta-analysis of sevenobservational cohort studies, no difference was recorded between the twoCPR techniques (8% [223/2731] vs 8% [863/11 152]; risk ratio 0·96, 95%CI 0·83—1·11).

Interpretation

For adults with out-of-hospital cardiac arrest, instructions tobystanders from emergency medical services dispatch should focus onchest-compression-only CPR.