分析呼气末二氧化碳分压对心脏骤停患者接受腹部提压心肺复苏术复苏效果的评估价值。

选择2014年9月至2016年10月收治的92例CA患者为研究对象，所有患者均行经口气管插管，远端连接红外线CO₂探测仪，监测腹部提压CPR复苏前、中、后的心率、平均动脉压(MAP)、血气分析[动脉血氧分压(PaO₂)、动脉血二氧化碳分压(PaCO₂)]及动态监测复苏过程中不同时刻的呼气末二氧化碳分压(P_ETCO₂)变化值；记录开始实施CPR至自主循环恢复(ROSC)时间，根据复苏结局分为成功组和失败组，成功组记录30 min、60 min的生存患者例数并计算复苏成功率，最后回顾分析影响心肺复苏成功率的因素。

复苏结局成功组和失败组患者开始时P_ETCO₂值约为9～10 mmHg，两组比较差异无统计学意义(P>0.05)。成功组在CPR过程中P_ETCO₂值逐渐上升，失败组则在2～5 min内稍升高，之后逐渐下降。复苏过程中P_ETCO₂平均值≥20 mmHg者复苏成功，而相反者复苏失败，两组比较差异有统计学意义(P<0.05)。复苏过程中血气分析结果与开始复苏前的血气结果比较差异有统计学意义(P<0.05)，ROSC 20 min与腹提中比较MAP、PaO₂、PaCO₂差异有统计学意义(P<0.05)。成功组30 min及60 min的自主循环恢复率为17.4%(16/92)。创伤性疾病与脑源性疾病引起的心脏骤停与心肺复苏成功与否关系密切(P<0.05)。经腹部提压CPR成功复苏CA患者37(40.22%)例，且成功复苏患者的ROSC时间为(10.20±3.52)min，较失败患者[(23.70±5.20)min]明显缩短，差异有统计学意义(t＝-13.796，P<0.05)。

P_ETCO₂值变化可以作为临床评价和预测腹部提压CPR成功率的指标。腹部提压CPR对于创伤性疾病与脑源性疾病引起的CA的复苏成功率较低。ROSC时间越短，ROSC率越高。

To analyze the clinical value of the end tidal carbon dioxide partial pressure (P_ETCO₂ ) in evaluating the efficacy of abdominal lifting and compression CPR in patients with cardiac arrest.

Ninety-two patients with cardiac arrest were selected from September 2014 to October 2016. All patients underwent oral endotracheal intubation whose distal end of trachea cannula were connected to a CO₂ infrared detector monitoring the heart rate (HR), mean arterial pressure (MAP), blood gas analysis of arterial oxygen partial pressure (PaO₂) and arterial partial pressure of carbon dioxide (PaCO₂) before, during and after abdominal lifting and compression CPR. P_ETCO₂ of CPR was also monitored at different time points dynamically. Meanwhile, the time from the beginning of CPR to the restoration of spontaneous circulation (ROSC) was recorded. All patients were divided into success group and failure group according to the ultimate outcome of CPR, the number of patients with 30-min and 60-min survival was recorded and the recovery success rate calculated in the success group. Finally, the factors affecting the success rate of abdominal lifting and compression CPR were retrospectively analyzed.

At the beginning of CPR, the P_ETCO₂ value in both groups was about 9-10 mmHg, with insignificant difference between the two groups (P>0.05). The P_ETCO₂ value in success group was rising gradually during the abdominal lifting and compression CPR process, and increased slightly at 2-5 min but then gradually decreased in the failure group. The average value of P_ETCO₂ was larger than 20 mmHg in the success group but was lower than 20 mmHg in the failure group, with significant difference between two groups (P<0.05). There was significant difference in the results of blood gas analysis between CPR process and beginning of CPR (P< 0.05). The difference of MAP, PaO₂ and PaCO₂ 20 minutes after ROSC was statistically significant compared with abdominal lifting and compression CPR process (P< 0.05). The recovery success rate of 30 min and 60 min after ROSC was both 17.4% (16/92) in the success group. The Cardiac arrest caused by traumatic disease and cerebral diseases was closely related to the cardiopulmonary resuscitation success or not (P<0.05). The successful resuscitation via abdominal lifting and compression CPR in CA patients was 37 cases (40.22%). The time for successful recovery of patients with ROSC was (10.20±3.52)min, shorter than [(23.70±5.20)min] in failure group, with statistically significant difference between two group (t=-13.796, P< 0.05).

The variation of P_ETCO₂ value can be used as a clinical index to evaluate and forecast the success rate of abdominal lifting and compression CPR. Cardiopulmonary resuscitation success rate is low for abdominal lifting and compression CPR in traumatic or cerebral-induced CA patients. The ROSC time is negatively correlated with the ROSC rate.