危重患者抢救决策的影响因素及其合理性分析被引量：5

Influencing factors and rationality analysis of rescue decision in critical patients

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摘要目的探讨临床工作中性别、年龄及基础疾病对危重患者是否进行抢救决策的影响并对其合理性进行分析.方法选取2015年5月至2017年7月就诊于解放军总医院急诊科,进行基础疾病治疗过程中出现心跳停止的危重患者.按照患者是否进行抢救分为抢救组及放弃抢救组,其中抢救组按照抢救是否成功进一步分为抢救成功组及抢救失败组,分别对放弃抢救组与抢救组、抢救成功组及抢救失败组患者的性别、年龄、基础疾病的数量及具体疾病种类进行统计分析.结果抢救组及放弃抢救组患者平均年龄分别为(56.98±18.04)岁及(69.12 ±17.23)岁,差异有统计学意义(P<0.05);抢救成功组及抢救失败组患者平均年龄分别为(64.33±17.95)岁及(58.41±18.13)岁,差异无统计学意义(P>0.05).203例(64.24%)男性患者接受抢救,99例(48.53%)女性患者接受抢救,差异有统计学意义(P<0.05);13.00%男性患者抢救成功,12.38%女性患者抢救成功,差异无统计学意义(P>0.05).抢救组患者中男性明显多于女性,抢救成功组及抢救失败组在性别上差异无统计学意义.抢救组及放弃抢救组患者的基础疾病种类分别为(2.12±1.56)种及(2.53±1.66)种,差异有统计学意义(P<0.05);抢救成功组及抢救失败组患者基础疾病种类分别为(2.42±1.74)种及(2.07±1.52)种,差异无统计学意义(P>0.05).创伤及心血管系统急症患者接受抢救的比例在抢救组中明显高于放弃抢救组的患者;而低蛋白血症及贫血、水电酸碱平衡紊乱、慢性心血管系统疾病及意识障碍的比例明显低于放弃抢救组(P<0.05);其他疾病在抢救组与放弃抢救组之间差异无统计学意义(P>0.05).慢性神经系统疾病患者抢救成功比例明显高于整体抢救成功比例(5/13 vs.40/302,P<0.05),其他疾病成功比例与整体抢救成功比较差异无统计学意义(P>0.05).结论年龄、性别、创伤、心血管系统急症、低蛋白血症、贫血、� Objective To analysis the effect and rationality of gender,age and basic diseases on the rescue decision of critical patients in emergency department.Methods We collected the clinical information about the critical patients with different causes occurred cardiac arrest during treatment in rescue room of emergency department in PLA general hospital from May 2015 to July 2017.Patients were divided into rescue group and abandoned rescue group according to whether the patient was rescued.Patients in rescue group were divided into rescue success group and rescue failure group according to whether the rescue was successful.The age,gender,number of diseases and each type of disease in each group were analyzed.Results 302 patients received rescue,of which 40 patients were successfully rescued,the proportion was 13.24%.The ages of the rescue group and the abandonment rescue group were(56.98±18.04)years old and(69.12±17.23)years old,respectively,the difference was statistically significant(P<0.05).The patients in the success group and the failure group were(64.33±17.95)years old and(58.41±18.13)years old,respectively,the difference was statistically significant(P>0.05).64.24%of the male and 48.53%of the female patients were rescued,the difference was statistically significant(P<0.05);13.00%of the male and 12.38%of the female were successfully rescued,the difference was not statistically significant(P>0.05).The number of underlying diseases in the rescue group and the abandonment rescue group were(2.12±1.56)and(2.53±1.66),respectively,the difference was statistically significant(P<0.05).The number of underlying diseases in the success group and failure groups were(2.42±1.74)and(2.07±1.52),respectively,the difference was not statistically significant(P>0.05).The proportion of patients with trauma and cardiovascular system emergencies was 74.36%and 71.67%,respectively,which was significantly higher than abandonment rescue group.The proportions of hypoproteinemia and anemia,hydroelectric acid-base balance disorder,chro

作者刘志伟刘晓莉叶欣王欣杨煜清黄予刘晓鸿刘思琦陈鹏宇赵斌 Liu Zhi-wei;Liu Xiao-li;Ye Xin;Wang Xin;Yang Yu-qing;Huang Yu;Liu Xiao-hong;Liu Si-qi;Chen Peng-yu;Zhao Bin(Beijing Jishuitan Hospital,Beijing 100035,China)