不进行人工呼吸的心肺复苏同样有效 - 丁香园论坛-医学/药学/...【medical-news】

Studies: CPR Without Rescue Breathing OK
Bystanders Who Only Do Chest Compressions Save Nearly as Many, Researchers Find
By Kathleen Doheny
WebMD Health NewsReviewed by Elizabeth Klodas, MD, FACCJuly 28, 2010 -- Bystanders who perform CPR on patients with suspected heart attacks can safely skip the rescue breathing -- typically called mouth-to-mouth resuscitation -- and just perform the chest compressions, according to two new studies.
研究：不进行人工呼吸的心肺复苏同样有效
Kathleen Doheny的一项研究发现：只行胸外按压的心肺复苏术同样挽救了近3/4患者的性命（几乎和传统心肺复苏相同的人数？）。
此消息由医学博士Elizabeth Klodas先生，FACC（Fellow of the American College of Cardiology 美国心脏病学学会）成员，于2010年7月 28 在WebMD Health NewsReviewed中发表：根据两项新的研究，施救的路人对心脏骤停的患者行心肺复苏术时可以放心的地略过传统的口对口人工呼吸这一环节，仅行胸外按压术。

We feel comfortable saying chest compressions alone, when performed by a layperson, will provide at least the benefit that conventional CPR, with rescue breathing, will provide," researcher Thomas D. Rea, MD, medical director for King County, Wash., Medic One, tells WebMD.
研究员Thomas D Rea（医学博士，华盛顿州King County的医学主任，向WebMD提到：当我们提到外行人仅行胸外按压可以起到和传统的心肺复苏术一样的效果时真的挺欣慰的

The suggestion to skip the mouth-to-mouth part of CPR, he emphasizes, does not apply to emergency medical personnel, but only to laypeople who may be able to provide CPR after a suspected heart attack while waiting for professional medical help to arrive.
但是他强调，有关略过口对口人工呼吸的心肺复苏操作，并不适用于专业的急救医务人员，仅适用于那些外行人员对怀疑心脏病发作的患者急救直到专业的急救医务人员到来。

Rea's study, along with another head-to-head comparison of the two CPR approaches, is published in the New England Journal of Medicine.
Rea的这项研究和另外一项有关两种心肺复苏法的对照研究一起发表在新英格兰医学杂志。

We are trying urgently, desperately, to make CPR more accessible to bystanders," Rea says, noting that performing CPR soon after a heart attack can increase the likelihood of survival twofold. Hopefully, he says, the finding that the rescue breathing is not crucial will make the technique simpler and perhaps more palatable for people.
''我们试图让急救更快、更孤注一掷的进行，使心肺复苏术更容易有路人执行，“Rea指出，没有什么比心脏骤停后及时行心肺复苏更能提高患者的的生存率了。他说，我非常希望，人工呼吸并不是那么重要的这一发现可以使急救更加简单，更容易让人们接受


About CPR
CPR was first proposed about 50 years ago, when researchers suggested that external chest compression could provide blood circulation to the brain and heart after a heart attack. The mouth-to-mouth breathing was added later.
关于心肺复苏术
心肺复苏首次提出大约是在50年前，当时研究人员提到心脏病发作时胸外按可以促进心脑的血流循环。口对口人工呼吸是后来加上的。

But in recent studies, researchers have focused on whether both components are always crucial. In 2008, the American Heart Association issued an advisory for the public, advocating hands-only CPR for bystanders not trained in CPR with rescue breathing.
但在最近的研究中，研究人员都比较关注是否这两种操作都那么至关重要。 2008年，美国心脏协会向公众发出了倡导，倡导那些未行专业心肺复苏（包括人工呼吸操作的）的路人急救时只行胸外按压操作

CPR Techniques: The Studies
Rea's team evaluated 1,941 patients who had out-of-hospital heart attacks and were given CPR from bystanders being instructed by emergency dispatchers. Patients were randomly assigned to get either chest compression only or conventional CPR with rescue breathing.
心肺复苏技术：研究
Rea的研究小组评估了1941患者，这些院外心脏病发作的患者均被路人施予心肺复苏术，其中施救的路人的操作均受急救中心调度指挥。这些患者被随机的分为两组，一半被指定单行胸外按压另一半则行常规的心肺复苏术。

The researchers looked at the percent in each group that survived to hospital discharge.
研究人员观察了两组患者的存活至出院的人数的百分比。

"We found that survival in the chest compression alone group was 12.5% and survival in the conventional CPR group was 11%," Rea tells WebMD.
“我们发现，仅行胸外按压组的存活率为12.5％，行传统心肺复苏操作组存活率为11％，”Rea告诉WebMD。

Rea's study was supported in part by the Medic One Foundation and the Laerdal Foundation for Acute Medicine. In the second study, Swedish researchers evaluated 1,276 patients with suspected out-of-hospital heart attacks, assigning half to conventional CPR and half to compression-only.
Rea的研究受到了Medic One基金会和挪度基金会的支助。在另一项研究中，瑞典研究人员评估了1276例院外心脏病发作的患者，这些患者中的一半行传统的心肺复苏术，另一半仅行胸外按压术。

The rate of 30-day survival was similar in the groups -- 8.7% of those getting compression-only CPR and 7% of those getting conventional CPR. The Stockholm County Council, SOS Alarm, and the Swedish Heart-Lung Foundation supported the study.
两组患者30天存活率较相似， 仅行胸外按压组为 8.7%，传统心肺复苏组为7％。此项研究由斯德哥尔摩郡议会，SOS Alarm，和瑞典心肺基金会赞助。

CPR, With and Without Mouth-to-Mouth: Other Views
The two new studies are good news for bystanders, some of whom have been reluctant to do the rescue breathing part of CPR, says Myron L. Weisfeldt, MD, chairman of the department of medicine at Johns Hopkins University School of Medicine, Baltimore, who wrote an editorial to accompany the studies.
Some bystanders worry about the risk of disease transmission in mouth-to-mouth resuscitation, he tells WebMD, although the risk has been shown to be low.
心肺复苏术，需不需要人工呼吸：其他资讯
这两项新的研究对于一些勉强行人工呼吸的路人来说算是好消息，Myron L. Weisfeldt,（医学博士，巴尔的摩，约翰霍普金斯大学医学院系主任）说，并就相关研究此写了一篇社论。
他提到：虽然口对口人工呼吸传播疾病的风险已经被证明了极其低，但一些施救者还是相当担忧的


Based on the new studies, he says, "chest compression alone appears to be just as valuable as chest compression with rescue breathing." The new findings, he says, apply to adults with cardiac arrest.
根据新的研究，他说：“单纯胸外按压的急救和传统的心肺复苏的急救有同样的价值。”这些新的发现，适用于心脏骤停的成年人。

The chest compression component, he suspects, is also easier for most people to perform than the mouth-to-mouth.
与口对口人工呼吸的操作相比较，胸外按压的操作对大多数人来说更容易一些。

For the consumer, this is important [news]," says Sumeet Chugh, MD, associate director of the Cedars-Sinai Heart Institute, Cedars-Sinai Medical Center, Los Angeles. ''Enough data has accumulated to say that bystander CPR positively impacts survival," he tells WebMD. Now, the finding that chest compression alone seems adequate is even better news, he says.
对人们来说，这是很重要的消息，“ Cedars-Sinai洛杉矶心脏研究所、Cedars - Sinai医疗中心的副主任Sumeet Chugh,说。''已经有足够的数据表明，旁观者积极的行心肺复苏术会提高患者的生存率。现在，发现仅胸外按压的心肺复苏术就足够了，这甚至是更好的消息，他说。

"It is a little awkward to do rescue breathing on someone you don't know," he says.
对一个你不认识的人行人工呼吸是有些别扭和尴尬的，”他说。

But, he says, those who go to a CPR course should still expect to be taught the rescue breathing technique, he says, as it may be needed in other situations.
但是，他说，那些参加行心肺复苏训练的人总是期望被指导如何行人工呼吸，因为这种操作很可能在会在其他情况用到。