孙红儿 马素敏 李倩晓

[摘要] 目的 探討美国心脏协会（American Heart Association，AHA）基础生命支持（Basic Life Support，BLS）培训对低年资护士胸外按压效果的研究。 方法 对2014年3月～2016年3月新入职的低年资护士，按随机数字表法分为观察组和对照组，观察组采用AHA模式进行BLS培训，而对照组采用传统的模式进行培训，观察组和对照组同时在1年内完成BLS培训。1年后由护理部统一对低年资护士进行胸外按压考核，对两组护士的按压频率、深度和回弹情况进行评估。 结果 两组5个循环的按压频率逐渐降低，两组频率比较差异无统计学意义（P>0.05）;观察组有效按压比例高于对照组（71.71% vs 60.56%，P<0.05）。两组的按压深度逐渐降低，第5个循环的深度差异有统计学意义（P<0.05）;观察组的有效按压深度比例高于对照组（73.14% vs 64.23%，P<0.05）。两组的CPR按压回弹率比较观察组大于对照组，差异具有统计学意义（P<0.05），观察组总体回弹比例高于对照组（95.8% vs 86.5%，P<0.05）。 结论 AHA-BLS培训能更有效提高低年资护士胸外按压的质量，提高院内心肺复苏的水平。

[关键词] 美国心脏协会; 生命支持课程; 低年资护士;胸外按压

[中图分类号] R473 [文献标识码] B [文章编号] 1673-9701（2018）09-0162-03

Study on the effect of external chest compression by junior nurses after the training of basic life support courses of the American Heart Association

SUN Honger MA Sumin LI Qianxiao

1.Yinzhou District Second Hospital， Ningbo 315100， China; 2.Department of Cardiology， Hangzhou Red Cross Hospital， Hangzhou 310003， China

[Abstract] Objective To investigate the effect of external chest compression by junior nurses after the training of basic life support（BLS） of the American Heart Association（AHA）. Methods From March 2014 to March 2016， the newly recruited junior nurses were divided into observation group and control group according to the random number table. The observation group was given AHA model for BLS training， and the control group was given traditional model for training. The observation group and the control group completed BLS training within one year at the same time. One year later， the junior nurses were assessed on the external chest compression by the Department of Nursing. The frequency of compression， depth and resilience of the two groups of nurses were evaluated. Results The compression frequency of 5 cycles was gradually decreased in both groups， with no statistically significant difference between the two groups（P>0.05）; the effective compression ratio in the observation group was higher than that in the control group（71.71% vs 60.56%， P<0.05）. The depth of compression in the two groups was gradually decreased， and the difference of the depth of the 5th cycle was statistically significant（P<0.05）; the ratio of effective compression depth in the observation group was higher than that in the control group（73.14% vs 64.23%， P<0.05）. The CPR compression resilience rate in the observation group was higher than that in the control group， and the differences were statistically significant（P<0.05）. The overall rate of resilience in the observation group was higher than that in the control group（95.8% vs 86.5%， P<0.05）. Conclusion AHA-BLS training can effectively improve the quality of external chest compression by junior nurses and improve the level of hospital CPR.

[Key words] American Heart Association（AHA）; Life support course; Junior nurses; External chest compression

呼吸心跳骤停是威胁生命的首要急症，在医院抢救过程中，既需得到有效的基础生命支持（Basic Life Support，BLS），也需得到高级心血管生命支持（Advanced Cardiac Life Support，ACLS）[1，2]。而这一切都要从有效和高质量的心肺复苏术（cardiopulmonary resuscitation，CPR）开始，早期有效的CPR直接影响到患者的预后[1，3]。在院内心搏骤停（cardiac arrest，CA）的抢救中，护士常是第一目击者和施救者，因此熟练并标准地掌握CPR并尽早实施胸外按压，是提高院内CA抢救成功率的关键[4-6]。但由于低年资护士刚进入临床工作，对急救知识和技能的掌握较为局限，在遇到突发事件时胸外按压不标准，会降低复苏的成功率[7]。我院于2016年3月开展2010版AHA的培训，发现AHA培训较传统培训更能提高低年资护士的CPR质量，提高CA的抢救成功率，现将结果报道如下。

1 对象与方法

1.1 研究对象

将2014年3月～2016 年3月新入职的146名低年资护理人员纳为研究对象，按随机数字表法分为观察组和对照组，每组各73例。观……