摘要
目的:探讨集束化电话指导心肺复苏术(TCPR)在院外心脏性猝死(SCD)患者中的应用价值,并对该技术在我国推广的可行性进行浅析。方法:回顾性分析2011年1月1日至2014年12月31日在美国亚利桑那州经院前紧急医疗(EMS)救治的SCD成年患者的资料,分为两组:未得到旁观者心肺复苏术组(无CPR组)和接受集束化TCPR组(TCPR组),比较两组间的生存率和神经功能预后,分析集束化TCPR的应用价值。结果:本研究共纳入4391例患者,其中1760例符合纳入标准(平均年龄63岁,男性占1152例),其中无CPR组758例、TCPR组1002例。整体生存率为10.40%,神经功能预后良好率为7.56%。参照无CPR组,Logistic回归分析显示:TCPR组出院时的生存率分别是无CPR组的1.64倍(95%可信区间:1.16,2.30);出院时,神经功能预后良好率分别是无CPR组1.56倍(95%可信区间:1.06,2.31)。结论:集束化TCPR可改善院外SCD患者的生存率和神经功能预后,具有一定的应用价值,可尝试在我国进行推广。
Objective： To investigate the Bundled Telephone Cardio-pulmonary Resuscitation （TCPR） in out-of- hospital sudden cardiac arrest （SCD） patients and analyze its potential implementation methods in China. Methods： This study was conducted from January 1st 2011 to December 31st 2014.Out-of-hospital SCD patients who were rescued via Emergency Medical System （EMS） were classified into two groups： No CPR group （without bystander CPR before EMS arrival） and TCPR group （dispatcher-initiated CPR before EMS arrival）. The survival and neurological outcome be- tween these two groups were compared, further to analyze the implementation of bundled TCPR. Results ： 4391 patients were enrolled while 1760 patients met the including criteria （mean age 63 yrs, 1152 males）. They were classified into No CPR group （758 patients） and TCPR group （ 1002 patients）. The total survival rate was 10.40% and the rate of favorable neurological outcome was 7.56%. Using no CPR as the reference group, the multivariate adjusted odds ratio for sur- vival at hospital discharge was 1.64 （95% CI, 1.16, 2.30） for TCPR. The multivariate adjusted odds ratio of favorable neurological outcome at discharge was 1.56 （95% CI, 1.06, 2.31） for TCPR. Conclusion： The bundled TCPR can im- prove the survival rate and favorable neurological outcome in out-of-hospital SCD patients. And its successful experiences could be implemented in China.
出处
《岭南急诊医学杂志》
2018年第1期24-27,36,共5页
Lingnan Journal of Emergency Medicine
基金
国家自然科学基金青年科学基金项目(81703303)
广东省佛山市科技局医学类科技攻关项目(2015AB00355
2016AB003623
2017AB002631)
广东省佛山市科技创新平台项目(2015AG10001
2017AG100061和2017AG100082)
上海市浦江人才计划(17PJC070)
广东省佛山市重点专科培育项目(Fspy2-2015004)
广东省佛山市十三五重点专科建设项目(FSGSPZD135025和FSZDZK135016)
关键词
心肺复苏术
集束化电话指导心肺复苏术
心脏性猝死
生存率
预后
cardio-pulmonary resuscitation
bundled telephone cardio-pulmonary resuscitation
sudden cardiac ar- rest
survival rate
outcome
