摘要
目的分析小儿院外呼吸或心跳停止(或呼吸、心跳停止)的病因、临床特征及影响心肺复苏预后的相关因素,为提高儿科急诊心肺复苏成功率及改善预后寻找可行方法。方法对急诊创伤中心(EDTC)2001年3月至2007年3月急诊心肺复苏(CPR)患儿的临床资料、心肺复苏原因及预后进行总结分析。结果共有199例患儿在EDTC进行CPR。就诊时呼吸停止84例(42.21%),出院时存活54例(64.29%);心跳停止115例(57.79%),急诊CPR后恢复自主循环(ROSC)38例(33.04%),出院时存活9例(7.83%);呼吸停止与心跳停止者病死率比较差异有统计学意义(χ2=71.52,P=0.000)。呼吸停止或心跳停止时157例(78.89%)有现场目击者,其中137例目击者为家长(87.26%),42例(21.11%)无目击者;有目击者予院前CPR20例(12.74%);有目击者与无目击者最终病死率比较差异无统计学意义(χ2=0.09,P=0.45)。意外伤害性疾病(58例,29.15%)是导致小儿急诊CPR的首要原因,其次为先天性心脏病(49例,24.62%)和严重感染性疾病(32例,16.08%)。院前救护车转运52例(26.13%)。结论小儿院外呼吸或心跳停止者病死率高,尤其是院外心跳停止者;意外伤害是儿童期急诊CPR的最常见原因,家长是儿童呼吸或心跳停止最常见的目击者;要提高儿科急诊CPR成功率,需要加强监护人对儿童的监护意识,预防意外伤害的发生;同时需要对监护人普及儿科急救的基本知识,提高他们第一时间救护患儿的能力,从而改善院外呼吸或心跳停止患儿的预后。
Objectives To analyze the etiology and characteristics of children with out-of-hospital respiratory arrest or cardiac arrest （or cardiopulmonary arrest）, discuss factors impacting the outcome of patients with cardiopulmonary resuscitation （CPR）. To explore the feasible methods and policies that may improve the prognosis and survival rate of pediatric CPR patients. Methods Records of the patients who accepted CPR in our emergency department trauma center （EDTC） between March 2001 and March 2007 were reviewed, including clinical features of the patients, etiology of CPR and their outcomes. Results One hundred and ninety-nine （199） patients were accepted CPR in our EDTC.＇Eighty four cases （42.21%） were respiratory arrest patients at arriving EDTC, 54 were alive at discharge （survival rate 64.29%）; 115 cases （57.79%） were cardiac arrest patients, and 38 cases （33.04%） had return of spontaneous circulation （ROSC） after resuscitation efforts at EDTC, 9 were alive at discharge （survival rate 7.83%） ; there were significant differences in mortality between respiratory arrest patients and cardiac arrest patients, with X^2 = 71.52, P = 0.000. 157 out of 199 cases （78.89%） were witnessed when respiratory arrest or cardiac arrest happened, 137 cases （87.26%） scenario witnessed were parents, 15 cases （9.55%） were ambulance staff or doctors, and 5 cases （3.19%） were policemen, passengers or neighbors; however, 42 out of 199 cases （21.11%） were no witnesses. Only 20 patients （12.74%） received pre-hospital CPR by witnesses; there were no significant differences in mortality between＇ the cases with witnesses and without witnesses （X^2 = 0.09, P = 0.45）. Accidental injury diseases （58 cases, 29.15%） were the main cause of the children with CPR in EDTC, others were congenital heart diseases （49 cases, 24.62% ） and severe infectious diseases （32 cases, 16.08% ）. Conclusions The mortality is high in children with out-of-hospital respiratory arrest or
出处
《临床儿科杂志》
CAS
CSCD
北大核心
2007年第11期890-893,共4页
Journal of Clinical Pediatrics
关键词
心肺复苏
儿科急诊室
预后
cardiopulmonary resuscitation
pediatric emergency department
prognosis
