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目的：探讨120电话指导现场第一目击者心肺复苏对院前急救心肺复苏成功率及患者预后的影响。方法随机选取2014年1月至2014年12月140例经120呼救的呼吸心跳骤停患者，按第一目击者是否接受电话指导将患者分为观察组（第一目击者接受电话指导，例=85）和对照组（第一目击者不接受电话指导，例=55）。统计分析两组临床资料、复苏成功率、患者预后情况及自主循环恢复时间、血压恢复时间和自主呼吸恢复时间。结果两组性别、年龄、病因等临床资料比较差异均无统计学意义（P>0.05）。观察组复苏成功率为30.59%，高于对照组的18.18%，差异有统计学意义（P<0.05）。与对照组比较，观察组预后良好的患者比例升高，死亡率和重残率则均下降，差异有统计学意义（P<0.05）。观察组存活患者自主循环恢复时间、血压恢复时间和自主呼吸恢复时间分别为（35.54±3.78）min、（13.38±2.55）min和（47.15±4.68）min，均短于对照组的（48.78±4.26）min、（25.59±3.49）min和（63.58±5.79）min，差异有统计学意义（P0.05). Success rate of recovery of observation group was 30.59%, which was higher than 18.18%of the control group with a statistical significant (P<0.05). Comparing with the control group, a greater positive prognosis and a lower mortality and residual ratio were found with a statistical difference (P <0.05). Survival spontaneous circulation recovery time, blood pressure recovery time and spontaneous breathing recovery time of the observation group was 35.54±3.78 minutes, 13.38±2.55 minutes and 47.15 ± 4.68 minutes respectively, which were shorter than the 48.78 ± 4.26 minutes, 25.59 ± 3.49 minutes, and 63.58 ± 5.79 minutes of the control group with a significant difference (P<0.05). Conclusion An on-site first witness’CPR performance guided by medical personnel through 120 phone line phone is considered being effective in increasing the success rate of cardiopulmonary resuscitation, improving the prognosis, and shortening spontaneous circulation recovery time, blood pressure recovery time, as well as spontaneous breathing recovery time.