目的 通过检索国内外成人俯卧位心肺复苏(PP-CRP)相关文献，分析内容、总结证据，为临床医护人员提供参考。方法 系统检索中国知网、中国生物医学文献服务系统(SinoMed)、万方数据、维普数据库、美国国立医学图书馆PubMed数据库、荷兰医学文摘Embase数据库、护理和辅助医学文献累积索引(CINAHL)、Cochran图书馆数据库、科学网(Web of Science)、Scopus文献数据库等中英文数据库，检索时限为建库至2024年6月15日。提取PP-CPR相关随机对照试验(RCT)、非RCT(前瞻性或回顾性)、队列研究和病例报告的内容，并进行系统分析，采用范围综述的方法对检索结果进行规范化报告。结果 通过检索数据库获得文献523篇，追索其参考文献及灰色文献获得14篇，共入选537篇文献。经过2名研究者严格筛查，最终共纳入26篇文献，3篇为非随机对照试验(RCT)，23篇为病例报告，涉及12个国家，中文3篇、英文19篇、法文2篇、德文1篇、韩文1篇。纳入的3篇非RCT研究表明，与标准心肺复苏(CPR)相比，PP-CPR能产生更高的血压，提供良好的呼吸和循环支持。纳入的23篇病例报告中共涉及25例成人患者，其中17例报道了复苏总时间，有13例PP-CPR时间≤5 min，且均恢复了自主循环，说明PP-CPR技术具有一定的有效性;在最终结局方面，4例(16。0％)患者死亡，21例(84。0％)存活，说明PP-CPR技术可以为俯卧位心搏骤停患者提供及时的血液循环，改善临床结局;而在报道了复苏后并发症的11例患者中，短期结局均未出现神经功能损伤等并发症，说明PP-CPR技术具有一定的安全性。结论 PP-CPR可以为无法迅速仰卧的心搏骤停患者提供及时的血液循环，为除颤和进一步救治赢得"黄金时间";医护人员在临床实践中需评估急救环境、施救人员数量和患者具体病情，尽快实施急救，减少俯卧位心搏骤停患者重要器官无血流时间，改善临床预后。
Prone position-cardiopulmonary resuscitation in adults:a scoping review
Objective To comprehensively search the relevant literature on prone position-cardiopulmonary resuscitation (PP-CPR) in adults at home and abroad,analyze the content,summarize the evidence,and provide reference for clinical health care professionals. Methods Systematic search of CNKI,China Biomedical Literature Service System (SinoMed),Wanfang Data,VIP database,PubMed,Embase,Cumulative Index to Nursing and Allied Health Literature (CINAHL),Cochran Library,Web of Science,Scopus literature database and other Chinese and English databases was conducted. The search period was from inception to June 15 in 2024. The contents of PP-CPR from randomized controlled trial (RCT),non-RCT (prospective or retrospective),cohort studies and case reports were extracted and systematically analyzed. The search results were standardized by the method of scoping review. Results A total of 523 articles were obtained through preliminary search,and 14 references and gray literature were retrieved,totaling 537 articles. After strict screening by two researchers,a total of 26 literatures were included,3 were non-RCT and 23 were case reports,involving 12 countries,including 3 in Chinese,19 in English,2 in French,1 in German,and 1 in Korean. Three non-RCT demonstrated that compared with standard cardiopulmonary resuscitation (CPR),PP-CPR could produce higher pressure,and provide good respiratory and circulatory support. A total of 25 adult patients were included in the 23 case reports,of which 17 reported total recovery time and 13 reported PP-CPR time ≤ 5 minutes,all of which recovered spontaneous circulation,indicating the effectiveness of PP-CPR technology. In terms of final outcome,4 patients (16.0％) died and 21 patients (84.0％) survived,indicating that PP-CPR technology could provide timely blood circulation and improve clinical outcomes for prone cardiac arrest patients. Among the 11 patients who reported complications after resuscitation,no neurological damage was found in the short-term outcomes,indicating that PP-CPR technology had a certain level of safety. Conclusions PP-CPR can provide timely blood circulation for patients with cardiac arrest who are unable to lie supine quickly,and win "golden time" for defibrillation and further treatment. In clinical practice,medical staff need to evaluate the emergency environment,the number of rescuers and the specific condition of the patient,and implement first aid as soon as possible,so as to reduce the time of no blood flow in the vital organs of patients with cardiac arrest in prone position,and improve the clinical prognosis.
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