急诊复苏患者心脏停搏前的高危临床征象

High Risk Symptoms before Cardiac Arrest in Cardiopulmonary Resuscitation Patients

目的探讨急诊复苏患者心脏停搏前的高危征象,为可能发生心脏停搏患者的急救提供诊治依据。方法通过收集急诊科194例急诊复苏患者心脏停搏前的临床资料,对其进行回顾性分析,重点是基础疾病、心脏停搏前主诉、症状、体征等资料。结果急诊心脏停搏复苏患者以内科基础疾病占绝大多数(89.18%),所有复苏患者复苏成功率为6.70%;内科基础疾病中,心脏停搏者以突然发生且无可采集主诉者最多,约占40.46%;有可采集主诉患者中以呼吸困难、胸闷者最多,其次为胸痛、心慌。呼吸困难、胸闷主诉者基础疾病以呼吸系统疾病为主,胸痛、心慌主诉者以循环系统疾病为主。结论心脏停搏患者以突然发病、无明显可采集主诉最常见;有可采集主诉者中,呼吸困难、胸闷加重是发生心脏停搏前的最高危征象,其次为胸痛、心慌、头晕等症状。

Objective To investigate high risk symptoms before cardiac arrest in cardiopulmonary resuscitation （CPR） patients, in order to provide the diagnostic and treating basis for the first aid of the patients with possible cardiac arrest. Methods One hundred ninety - four CPR patients were include in the research, their clinical data, including the basic diseases, the com- plaint, symptoms and signs before cardiac arrest, were investigated retrospectively. Results The basic internal diseases accoun- ted foUrthe overwhelming majority （89. 18% ）, the total CPR successful ratio for all patients was 6. 70%. In basic internal disea- ses, there were almost 40. 46% patients whose cardiac arrest suddenly attacks and with no available complaints, and in the pa- tients with available complaints, dyspnea and suffocation were the most frequent, and chest pain and palpitation were the next. In patients with dyspnea and suffocation as the complaint the main basic diseases were respiratory system, and in patients with chest pain and palpitation as the complaint the main basic diseases were circulatory system. Conclusion Sudden attack with no obvi- ously available complaints is the most common in cardiac arrest. In patients with available complaints, dyspnea and suffocation are the highest risk symptoms, and chest pain, palpitation and dizziness are the next.