摘要
目的调查儿科急诊室内小儿心搏呼吸骤伊隋况，分析影响心肺复苏效果的因素，并对复苏效果做初步评估。方法采用标准的院内Utstein格式（the in-hospital Utstein style）前瞻陛收集数据，填写调查表，内容包括：心搏呼吸骤停的原因、影响心肺复苏效果的因素及复苏效果。用自主循环恢复（return of spontaneous circulation，ROSC）评估初步复苏效果。结果2008年7月113至2010年2月28日，北京儿童医院急诊室全部就诊患者（29d至18岁）182 380例，心搏呼吸骤停237例（0.13％）。实施心肺复苏169例，其中ROSC88例（52．1％）。性别和年龄对ROSC的影响差异无统计学意义。原发病和初始节律对ROSC的影响有显著性意义。有无院前转运的ROSC分别为64．1％和44．8％；CPR时间≤10min、10-30min及〉30min的ROSC分别为67．5％、61．4％和30．5％，差异均具有统计学意义。多元逐步Logistic回归分析显示，初始节律和CPR持续时间对ROSC有明显影响。结论急诊室内小儿心肺复苏的ROSC为52．1％。初始节律和CPR持续时间对ROSC有明显影响。
Objective To investigate the incidence, etiology and risk factors of cardiorespiratory arrest （CRA） in pediatric emergency room and preliminarily evaluate the efficacy of cardiopulmonary resuscitation （CPR）. Methods The unified, standard in-hospital Utstein style was used for data collection with filling answers in the questionnaire. The survey items included the causes of cardiorespiratory arrest and the factors influencing the efficacy of CPR. The restoration of spontaneous circulation （ROSC） was used to evaluate short-term efficacy of CPR. Results Totally 182 380 patients aged from 28 days to 18 years were admitted to emergency room of Beijing Children＇ s Hospital between July 1, 2008 and February 28, 2010. Of them, 237 patients （0. 13% ） were subjected to cardiorespiratory arrest, of which 169 patients received CPR and 88 patients （52. 1% ） got sustained ROSC. Neither sex nor age distribution affected ROSC. The primary cause of CRA and kind of initial abnormal rhythm of heartbeat leading to CRA were associated with the rate of ROSC. The rates of ROSC occurred in patients with or without pre-hospital transport were 64. 1% and 44. 8%, respectively. The rate of ROSC was closely related to time consumed for getting ROSC by CPR, and as CPR durations were ≤10 min, 10 to 30 min, and 〉 30 rain, the rates of ROSC were 67. 5%, 61.4% and 30. 5 % , respectively. Multiple stepwise logistic regression analysis showed that kind of initial abnormal rhythm and CPR duration were associated with the rate of ROSC. Conclusions The incidence of CRA in emergency was 0. 13% , and the rate of ROSC after CPR was 52. 1%. The kind of initial abnormal rhythm of heartbeat and CPR duration were independent factors associated with the rate of ROSC.
出处
《中华急诊医学杂志》
CAS
CSCD
北大核心
2012年第11期1237-1241,共5页
Chinese Journal of Emergency Medicine
基金
首都医学发展科研基金（2007-3031）
关键词
院内Utstein模式
心搏呼吸骤停
心肺复苏
儿童
In-hospital Utstein style
Cardiorespiratory arrest
Cardiopulmonary resuscitation
Pediatric
