深圳市院前和急诊科心肺复苏单因素分析

Univariate analysis of out-of-hospital and emergency room cardiopulmonary resuscitation in Shenzhen

目的了解深圳市心肺复苏现状和影响因素。方法对照做过心肺复苏1630例患者的病历填写调查表,用Epidata建立数据库,用SPSS13.0统计学软件进行统计学分析。结果男∶女=2.61∶1,男女院前急救生存到院率分别为6.20%和8.73%(P>0.05),急诊科急救生存入院率分别为16.96%和21.10%(P>0.05);院前和急诊科生存率分别为7.00%和18.10%(P<0.001);患者平均(38.23±22.23)岁,有机会生存到达急诊科的患者较仅进行了院前急救的患者年轻(P<0.001);循环系统疾患和外伤是前两位病因;心肺复苏术前呼吸心搏停止平均(19.69±20.29)min,院前和急诊科患者分别为(21.51±19.02)min和(17.93±21.31)min(P<0.005);院前采用不同人工通气复苏效果比较差异有统计学意义(P<0.05),气管插管优于面罩给氧和口对口人工呼吸,但在急诊科未显示出差异有统计学意义;院前和急诊科均显示,复苏术前不同心电图复苏效果比较差异有统计学意义(P<0.001),以室颤最佳,无脉搏电活动次之,心室静止最差。结论深圳市院前和急诊科心肺复苏比较,复苏效果、年龄、通气方法和结果差异有统计学意义;复苏术前不同心电图患者复苏效果比较差异亦有统计学意义。

Objective To study the status quo and influencing factors of cardiopulmonary resuscitation （ CPR ） in Shenzhen. Methods The questionnaires were filled in according to 1630 files of out - of- hospital and emergency room （ ER ） resuscitation from 78 hospitals. The data base was set up with Epidata and the data were analyzed with SPSS13.0. Results Ratio of male to female was 2.61 ： 1. With out - of - hospital resuscitation, the survivals arrived at successfully hospital for the male was 6.20% and 8. 73% for the female （ P 〉 0.05 ） ; with ER resuscitation, the survivals admitted to successfully hospital for the male was 16. 96% and 21.10% for the female （P 〉 0.05 ）. The survival rates of out -of- hospital and ER resuscitation were 7.00% and 18.10% respectively （P 〈 0. 001 ）. The patients＇ average age was （ 38.23 ± 22.23 ） years old, and the patients arrived at hospital successfully were younger than those died out of hospital（ P 〈 0.001 ）. Circulation system diseases and trauma were the main 2 etiology factors. The average time from cardiac arrest to getting doctor＇s CPR operation was （ 19.69 ± 20.29 ） minutes, which in out- of-hospital and ER patients were （21.51 ± 19.02） and （ 17.93 ± 21.31 ） minutes （P 〈 0.005 ）. There were statistical significances in curative effect of resuscitation with different artificial ventilations out of hospital. Tracheal intubation was better than mask oxygen inhalation and mouth - to - mouth artificial respiration, but the differences was not found in ER. The patients in out of hospital or ER with different ECG had different CPR effects, the best was the patients with ventricular fibrillation （ VF）, then pulseless elective activity and ventricular asystole in order （ P 〈 0. 001 ）. Conclusion There were differences in CPR curative effect, patients age, artificial ventilations and outcomes between out -of- hospital and ER. The patients in out of hospital or ER with VF had the best curative effect of resuscitation.