摘要
目的研究危重患者院前转运过程中发生心脏骤停时影响心肺复苏成功的相关因素,为院前安全转运危重患者提供参考。方法回顾性分析2014年1月1日至2021年12月31日上海市闵行区医疗急救中心收治的危重患者转运途中发生心脏骤停者的病例资料,对疾病种类、既往史、生命体征、心肺复苏措施及结局等数据进行统计分析。结果8年间共接诊出现途中心脏骤停的危重患者363例,心肺复苏成功100例,成功率为27.55%(100/363),复苏成功组与复苏失败组在年龄、接诊地址、既往病史、格拉斯昏迷评分、是否恶性心律失常、抢救措施以及现场停留时间及心脏骤停时间与上车时间的时间差存在差异(P<0.05)。接诊疾病分类为神经系统疾病、格拉斯昏迷评分表(Glasgow Coma Scale,GCS)、除颤、心脏骤停发生前使用多巴胺以及心脏骤停与上车时间的时间差是急救转运途中危重患者复苏的独立影响因素(P<0.05)。结论接诊病史主要为神经系统疾病,GCS越高,抢救过程中有除颤,心脏骤停前使用过多巴胺均有利于患者复苏,而患者在转运到急救车辆后越久出现心脏骤停则复苏成功越低。加强院前急救医务人员现场处置能力,现场转运前的充分准备,以及保障转运过程中发生心脏骤停时的高质量复苏至关重要。
Objective To study the related factors affecting the success of cardiopulmonary resuscitation(CPR)in critical patients with cardiac arrest during pre-hospital transport,and to provide reference for safe pre-hospital transport of critical patients.Methods The data of critical patients with cardiac arrest during transportation from January 1,2014 to December 31,2021 were retrospectively analyzed.The patients were divided into the successful resuscitation group and the failed resuscitation group.The data of case number,disease type,past history,vital signs,cardiopulmonary resuscitation measures,and outcomes were analyzed.Results During the 8 years,363 critical patients with sudden cardiac arrest during transportation were treated,while 100 patients were successfully resuscitated,and the successful rate was 27.55%(100/363).In the successful resuscitation group and the failed resuscitation group,there were significant differences in age,address,previous medical history,Grasse's coma score,malignant arrhythmia,rescue measures,on-the-spot stay time,cardiac arrest time,and on-the-train time(P<0.05).Neurological Disorder,GCS,defibrillation,use of dopamine before cardiac arrest,and the time between cardiac arrest and vehicle loading were independent predictors of resuscitation of critical patients during emergency transport(P<0.05).Conclusion A history of neurological disorder,higher GCS,defibrillation during resuscitation,and use of dopamine before cardiac arrest are important factors for resuscitation:the longer the patient was transported to an emergency vehicle,the less successful the resuscitation.It is very important to strengthen the capability of pre-hospital emergency medical staff to deal with the situation on the spot,to prepare the patients well before transportation,and to ensure the high-quality resuscitation during the transportation of cardiac arrest patients.
作者
姜志鹏
罗彩霞
施宇一
陈斐
刘涛
盛凯辉
JIANG Zhipeng;LUO Caixia;SHI Yuyi;CHEN Fei;LIU Tao;SHENG Kaihui(Emergency Department of Minhang District Medical Emergency Center,Shanghai 201199,China)
出处
《中华灾害救援医学》
2024年第2期129-133,共5页
Chinese Journal of Disaster Medicine
基金
2022年上海市闵行区科学技术委员会临床研究类科研课题项目(2022MHZ095)。
关键词
心脏停搏
急救医学
救护车
heart arrest
emergency medicine
ambulances
