先进急诊医学

基于海姆立克急救原理的气道异物梗阻自救装置构型设计与压力控制策略研究进展

张 鑫

宁夏医科大学检验学院

宋 林锴

宁夏医科大学第一临床医学院

任 宜佳

宁夏医科大学第二临床医学院

叶 佳昊

宁夏医科大学第一临床医学院

李 金哲

宁夏医科大学口腔医学院

DOI: https://doi.org/10.59429/xjjz.v8i3.15587

Keywords: 气道异物梗阻；海姆立克急救法；腹部冲击；自救装置

---

Abstract

气道异物梗阻起病突然，严重时可在短时间内引起窒息、缺氧性脑损伤甚至死亡。腹部冲击能够通过升高腹 腔和胸腔压力形成瞬时呼气气流，是清醒成人严重气道异物梗阻的重要急救方法。但传统腹部冲击通常依赖他人实 施，独处患者自行握拳或借助椅背自救时，容易受到施力位置、方向、强度及身体状态影响。机械自救装置可将人 工腹部冲击转化为可重复的机械脉冲，但其临床价值取决于定位固定、执行机构、接触结构、压力控制和安全终止 等环节。本文综述气道异物梗阻的急救现状、腹部冲击的作用机制、自救装置研究进展及主要构型，分析力、位移 和脉冲节律的控制方法，并结合自适应腹压脉冲装置讨论其应用场景、效果评价和证据局限，为相关设备的设计与 临床前验证提供参考。

---

References

[1] ZHENG P, ZHANG N, CHEN Z, et al. Global, regional, and national assessment of foreign body aspiration (1990–2021): novel insights into incidence, mortality, and disability-adjusted life years[J]. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, 2025, 33(1): 40. DOI:10.1186/s13049-025-01352-z.

[2] IGARASHI Y, NORII T, KIM S H, et al. Airway obstruction time and outcomes in patients with foreign body airway obstruction: multicenter observational choking investigation[J]. Acute Medicine & Surgery, 2022, 9(1): e741. DOI: 10.1002/ams2.741.

[3] KLEINMAN M E, BUICK J E, HUBER N, et al. Part 7: Adult basic life support: 2025 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care[J]. Circulation, 2025, 152(16 Suppl 2): S448-S478. DOI: 10.1161/CIR.0000000000001369.

[4] JOYNER B L Jr, DEWAN M, BAVARE A, et al. Part 6: Pediatric basic life support: 2025 American Heart Association and American Academy of Pediatrics Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care[J]. Circulation, 2025, 152(16 Suppl 2): S424-S447. DOI: 10.1161/CIR.0000000000001370.

[5] PAVITT M J, SWANTON L L, HIND M, et al. Choking on a foreign body: a physiological study of the effectiveness of abdominal thrust manoeuvres to increase thoracic pressure[J]. Thorax, 2017, 72(6): 576-578. DOI: 10.1136/thoraxjnl-2016-209540.

[6] COUPER K, ABU HASSAN A, OHRI V, et al. Removal of foreign body airway obstruction: a systematic review of interventions[J]. Resuscitation, 2020, 156: 174-181. DOI: 10.1016/j.resuscitation.2020.09.007.

[7] DAY R L, CRELIN E S, DUBOIS A B. Choking: the Heimlich abdominal thrust vs back blows: an approach to measurement of inertial and aerodynamic forces[J]. Pediatrics, 1982, 70(1): 113-119. DOI: 10.1542/peds.70.1.113.

[8] LEE S L, KIM S S, SHEKHERDIMIAN S, et al. Complications as a result of the Heimlich maneuver[J]. The Journal of Trauma: Injury, Infection, and Critical Care, 2009, 66(3): E34-E35. DOI: 10.1097/01.ta.0000219291.27245.90.

[9] PATTERSON E, TANG H T, JI C, et al. The efficacy and usability of suction-based airway clearance devices for foreign body airway obstruction: a manikin randomised crossover trial[J]. Resuscitation Plus, 2021, 5: 100067. DOI: 10.1016/j.resplu.2020.100067.

[10] DUNNE C L, OSMAN S, VIGUERS K, et al. Phase One of a Global Evaluation of Suction-Based Airway Clearance Devices in Foreign Body Airway Obstructions: a retrospective descriptive analysis[J]. International Journal of Environmental Research and Public Health, 2022, 19(7): 3846. DOI: 10.3390/ ijerph19073846.

[11] RAMASWAMY A, DONE A, SOLIS R, et al. The efficacy of two commercially available devices for airway foreign body relief: a cadaver study[J]. Laryngoscope Investigative Otolaryngology, 2023, 8(3): 708-711. DOI: 10.1002/ lio2.1057.

[12] SANUKI T, SUGIOKA S, SON H, et al. Comparison of two methods for abdominal thrust: a manikin study[J]. Resuscitation, 2009, 80(4): 499-500. DOI: 10.1016/ j.resuscitation.2008.12.011.

[13] CARDALDA-SERANTES B, CARBALLO-FAZANES A, RODRÍGUEZ-RUIZ E, et al. Would anti-choking devices be correctly and quickly managed by health science students? A manikin crossover trial[J]. BMC Medical Education, 2023, 23(1): 365. DOI: 10.1186/s12909-023- 04345-7.

[14] SUGA R, IGARASHI Y, KITANO S, et al. Effectiveness of the abdominal thrust maneuver for airway obstruction removal: analysis of data from the National Emergency Medical Services Information System[J]. Journal of Nippon Medical School, 2024, 91(3): 270-276. DOI: 10.1272/ jnms.JNMS.2024_91-305.