摘要
目的分析院外心肺复苏成功患者存活出院的院外影响因素，为提高院外心肺复苏生存出院率提供依据。方法对272例院外心肺复苏（CPR）成功并送院患者进行完整的1个月的院内追踪和院外随访随访，对影响生存出院的相关参数进行统计分析。SAS8．1统计学软件。结果①272例病例进入研究队列，出院34死亡238生存出院率为12．5％；②logistic单因素回归发现，生存出院与年龄~〈60y、无脉室速／室颤、循环系统疾病、症状反应时间≤5min、心肺复苏时间≤10min、球囊面罩通气、肾上腺素使用剂量≤3mg显著相关；经Logistic多因素回归分析发现，无脉室速／室颤、心肺复苏时间≤10min、未插管、肾上腺素使用剂量≤3mg与生存出院独立相关生存出院组的年龄、症状反应时间、CPR时间和肾上腺素使用剂量上均显著低于死亡组（均P〈0．001）；③生存出院组与死亡组的院外心跳骤停（OHCA）的心电图、系统病因构成比差异有统计学意义（P〈0．001），生存出院组和死亡组在性别、急救反应时间、除颤次数和复苏后心电图方面差异无统计学意义（P〉0．05）；④多因素分析发现，无脉室速／室颤（On=11．59；95％CI：3．61．37．23；P〈0．001），心肺复苏时间≤10min（OR=3．95；95％CI：1．15-13．56；P=-0．029），球囊面罩通气（OR=6．51；95％CI：2．01～21．05；P=0．002），肾上腺素使用剂量43mg（OR=5．05；95％CI：1．55-16．49；P=0．007）与生存出院独立相关。结论无脉室速／室颤及心肺复苏成功患者中用时短的患者可能具有更高的生存率；球囊通气而非气管插管以及适量使用肾上腺素可能有利于提高院外心肺复苏成功患者的生存出院。
Objective To investigate the related factors of survival to discharge among patients undergoing successful pre-hospital cardiopulmonary resusciation （CPR） . Methods The clinical data of 272 patients with out-of-hospital cardioc arrest （OHCA） who underwent successful prehospital CPR were analyzed. In one month of sudessful CPR follow-up was conducted to the last admitting hospitals or the patients＇ families to know their outcomes. Univariate and multi-variate logistic regression analyses were used to investigate the related factors. Rusults 34 of the 272 patients （12.5%） survived and were discharged. The age and dosage of adrenaline were significantly lower, and the the symptom response time and the in pre-hospital CPR time were significantly shorter in the survival to discharge group than in the death group （all P 〈 0.001）. Univariate logistic regression analysis showed significant correlation of sirvival to discharge with s ventricular tachycardia （pVT）/ventricular fibrillation, （VF）, circulatory system diseases, symptom response time≤5 min, pre-hospital CPR time≤10 min, and dose of adrenaline≤3 mg （all P〈0.005 or P〈0.01）. Logistic multivariate regression analysis showed significant independent correlation of survival to discharge with pVT/ VF, circulatory system diseases, no endotracheal intubation, CPR time≤ 10 min, and dose of adrenalin≤3 mg （all P〈 0.005 or P〈0.01）.②The age and dosage of adrenaline were significantly lower, and the the symptom response time and the in pre-hospital CPR time were significantlyshorter in the survival to discharge group than in the death group （all P〈0.001）. Conclusion pVT/VF, shorter pre-hospital CPR time, balloon mask ventilation, and appropriate adrenaline dosage are beneficial to survival to discharge for patients undergoing successful CPR.
出处
《中国急救复苏与灾害医学杂志》
2016年第10期971-974,共4页
China Journal of Emergency Resuscitation and Disaster Medicine
关键词
心肺复苏
心脏骤停
院外急救
Cardiopulmonary resusciation （CPR）
Cardioc arrest
Pre-hospital care
