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溺水相关院外心脏骤停患者流行病学及临床特点 被引量:5

Analysis of epidemiology characteristics and clinical features in drowning related out-of-hospital cardiac arrests patients
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摘要 目的探讨溺水引起院外心脏骤停(OHCA)流行病学及临床特征。方法以北美复苏终点联盟于2011至2015年期间纳入所有溺水引起OHCA患者为研究对象,分析其流行病学特征及临床特点。结果本研究纳入溺水OHCA患者共54例,其中男性43例(79.6%),女性11例(20.4%),年龄中位数(IQR)30.0(8.5~51.5)岁。幸存者与死亡组相比,旁观者目击比例(57.1%vs.17.0%),心脏停搏的比例(42.9%vs.78.7%),心肺复苏(CPR)持续的时间(10.5 min vs.22.8 min),低温治疗比例(28.6%vs.2.1%)差异有统计学意义(P<0.05)。所有溺水引起OHCA中,仅7例(13.0%)出院,其中2名成人(28.6%)和5名儿童(71.4%);发生在住宅区概率会更大(71.4%),急救医疗服务(EMS)反应时间为3.7 min;其中4例(57.1%)具有旁观者目击,4例(57.1%)院前恢复自主心律,3例(42.9%)具有旁观者CPR,CPR平均持续时间为11.9 min,2例(28.6%)进行了高级气道处理。结论溺水引起OHCA存活率与其他OHCA相当,儿童的存活率可能相对较高;预防工作和增加旁观者目击可能会改善溺水患者的生存。 Objectives There are few studies on drowning-related out-of-hospital cardiac arrest (OHCA). This study aimed to investigate the epidemiology and clinical features of drowning related out-of-hospital cardiac arrests. Methods In this study, all drowning related OHCA patients enrolled in the Resuscitation Outcomes Consortium (for the period) between 2011 and 2015 were selected as study subjects and their epidemiological characteristics and clinical features were analyzed. Results This study included 54 drowning-related OHCA patients. Of these patients, 43 (79.6%) were male, 11 (20.4%) were female, median age (IQR) was 30.0 (8.5~51.5) years old. The comparison of survivor group versus death group showed that witnessed by bystander (57.1% vs. 17.0% ) , cardiac arrest (42.9% vs. 78.7% ) , duration of cardio- pulmonary resuscitation (CPR) ( 10.5 rain vs. 22.8 min ) , therapeutic hypothermia ( 28.6% vs. 2.1% ) were all significantly different (P〈0.05). Of all the OHCA patients caused by drowning, only 7 (13.0%) survived to hospital discharg-2 adults (28.6%) and 5 children (71.4%) ; drowning related OHCA happened in uptown had higher chance to survive to hospital discharge ( 71.4% ) ; the response time of emergency medical services ( EMS ) was 3.7 min ; 4 witnessed by bystander (57.1%) , 4 recovered autonomous cardiac rhythm prior to hospital admission (57.1%), 3 was under CPR treatment with bystander (42.9%) , the average duration of CPR was 11.9 min, 2 was treated with advanced airway management. Conclusions Rate of survival of drowning related OHCA was nearly equal to other OHCA. Children were more likely to survive ; prevention and increased witness by bystander might improve the survial rate of drowning person.
作者 姚顺 黄振华 古钎林 韦秋霞 陈伟栋 詹红 熊艳 杨震 YAO Shun1, HUANG Zhen-hua2, GU Qian-lin2, WEI Qiu-xia2, CHEN Wei-dong2, ZHAN Hong2, XIONG Yan2, YANG Zhen1,3(1. Department of Cardiology, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong 510080; 2. Department of Emergency, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou , Guangdong 510080; 3. Key Laboratory on Assisted Circulation, Ministry of Health, Guangzhou, Guangdong 510080, China)
出处 《热带医学杂志》 CAS 2018年第3期275-278,284,共5页 Journal of Tropical Medicine
基金 国家自然科学基金(81670220 31270992 30800215) 广东省自然科学基金(2014A030313086) 广东省科技计划项目(2015A020212013 2013B021800275) 广州市科技计划珠江新星项目(2013J2200019) 中山大学青年教师培育项目(17ykzd18 13ykpy24)
关键词 溺水 院外心脏骤停 初始心律 旁观者目击 Drowning Out-of-hospital cardiac arrest Initial rhythm Witness by bystander
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