255例院前心搏骤停患者心肺复苏影响因素分析

Clinical analysis of 255 cardiac arrest patients

目的了解6年来心肺复苏(CPR)现状,分析其影响因素,研究如何提高CPR水平。方法对本院2001-01～2007-01院前发生的255例心搏骤停(cardiacarrest,CA)患者的资料进行分析,比较自主循环恢复(ROSC)成功组和失败组的CPR开始时间、CPR持续时间、除颤次数、肾上腺素用量等。结果全部病例ROSC成功率为38.03%,脑复苏成功率仅为2.74%。两组CPR开始时间(从心脏停搏至CPR开始时间)、人工气道开始建立时间、是否安装临时起搏器、肾上腺素用量比较差异有统计学意义(P≤0.01),在CPR持续时间、除颤次数方面比较差异无统计学意义(P>0.05)。CPR成功率与CPR开始时间和急救水平高低有密切关系。结论CA患者CPR成功率较低,与"生命链"未彻底落实及急救水平低有关。普及全民急救知识,加强完善急救医疗体系建设,是提高CPR成功率的关键措施。

Objective To study the statusquo of 255 cardiac arrest （ CA ） patients from January 2001 to January 2007 in our hospital and to analyze its influencing factors in order to improve success rate of cardiopulmonary resuscitation （ CPR）. Methods A retrospective study was carried out in 255 CA patients. According as the restoration of spontaneous circulation （ ROSC ） was successful or not, the patients were divided into 2 groups. Many data such as the time of CPR, the starting time of establishing artificial ventilation, defibrillation times, adrenaline dose were compared. Results The total success rate of ROSC was 38.03%, but the cerebral resuscitation rate was only 2.74 %. There was significant difference in the starting time of establishing artificial ventilation and CPR, adrenaline dose and the implantation of temporary pacemaker or not. No significant difference was seen in age, the time of CPR, defibrillation times. Conclusion Success rate of the CPR is poor because the ＂survival chain＂ does not be carried out completely, and at the same time, we can not overlook the facts of our poor emergency level. The key way to improve success rate of CPR is to popularize emergency knowledge and perfect the emergency medical service system.