心肺复苏后多器官功能障碍综合征危险因素和预后分析

Analysis of risk factors and prognosis on the post-resuscitation multiple organ dysfunction syndrome after successful cardiopulmonary resuscitation

目的探讨心肺复苏后多器官功能障碍综合征(MODS)发病危险因素和预后。方法回顾分析53例心跳骤停(CA)心肺复苏自主循环恢复(ROSC)患者资料。结果48例发生MODS(90.6%),死亡35例(66.0%)。复苏前时间≥6 m in组10例均发生MODS和死亡。即刻复苏组43例,MODS38例,发病率和死亡率在CA-ROSC间期<10 m in组分别低于≥10 m in组(77.3%vs 100.0%、P<0.01;27.3%vs93.5%、P<0.005),ROSC后SIRS 48例均伴发MODS。发病率与年龄、既往慢性病、电除颤项目无关(P>0.05),肾上腺素用量≤5 mg组低于>5 mg组(P<0.005)。结论复苏后MODS发病危险因素包括ROSC间期≥6 m in、CA-ROSC间期≥10 m in、复苏后SIRS,应及时评估和防治患者器官功能。

Objective To investigate the risk factors and prognosis on the post-resuscitation multiple organ dysfunction syndrome （MODS） after successful cardiopulmonary resuscitation （CPR）. Methods Clinical data of 53 patients who were suffered with cardiac arrest （CA） and undergone successful CPR with return of spontaneous circulation （ROSC） were analyzed. Results There were 48 patients ac- companied with MODS （90. 6% ）, and among them, 35 patients died in hospital （66. 0% ）. All the 10 patients with CPR interval ≥6min were accompanied with MODS and they died in hospital. There were 43 patients who underwent CA immediately and of them, 38 patients were accompanied with MODS. The incidence and mortality of MODS in the patients with CA-ROSC interval 〈 10min were significantly lower than those of the patients with CA-ROSC interval ≥10min （77. 3% VS 100. 0%, P 〈0. 01 ;27. 3% VS 93. 5%, P 〈0. 005）. All of the 48 patients with SIRS were accompanied with MODS after ROSC. The incidence of MODS in the patients was not significantly correlated with the factors of age, chronic disease, and electric defibrillation （ P 〉0. 05）. Conclusion The risk factors such as ROSC interval ≥6 min, ACROSC interval ≥ 10min and the SIRS after ROSC are significantly associated with the incidence of MODS. The organic function of the patients should be evaluated promptly.