住院患儿发生心跳呼吸骤停的死亡危险因素分析

Analysis on fatal risk factors to in-hospital children with cardiorespiratory arrest

目的探讨发生心跳呼吸骤停（CRA）住院儿童的死亡危险因素。方法回顾性分析2006年1月至2008年12月入住烟台毓璜顶医院儿童重症监护室（PICU）的CRA的87例患儿临床及心肺复苏（CPR）资料，并进行单因素分析以及多因素非条件Logistic回归分析，分析影响死亡率的危险因素。结果2006年1月至2008年12月人住烟台毓璜顶医院PICU发生CRA的87例患儿实施CRP，45例未恢复自主循环，初步死亡率为51．7％。单因素分析结果显示：年龄、原发病、血气分析、合并症以及发生CRA至CPR开始的时间（TCRA-CPR）、CRA发生时有无气管插管、应用肾上腺素的剂量、CPR持续时间（TCPR）与死亡率有关，Logistic回归分析示TCRA-CPR、TCPR为影响死亡率的独立危险因素。结论住院患儿发生CRA后死亡率较高，年龄、原发病及合并症、动脉血气及CPR质量影响死亡率，其中TCRA—CPR、TCPR为独立危险因素。

Objective To investigate the fatal risk factos to in-hospital children with cardiorespiratory arrest （CRA）. Methods Eighty-seven patients admited to PICU of Yantai Yuhuang-ding Hospital who occurred CRA and received cardiopulmonary resuscitation （CPR）were reviewed from January 2006 to December 2008. The clinical and CPR data was analyzed to explore fatal risk factors by Pearson）（2 test and multivariate and unconditioned Logistic regression analysis. Results Forty-five of eighty-seven cases did not received return of spontaneous circulation （ ROSC ）, the initial mortality was 51.7%. Age, primary diseases and complications, blood gas analysis, the interval of CRA to CPR（TCRA-CPR） ,tracheal intubation or not, the dose of adrenaline, the duration of CPR（TCPR）were obviously associated with mortality. Logistic regression analysis revealed that TCRA-CPR and TCPR were independent fatal risk factors. Conclusion Mortality of in-hospital children with CRA was high. Age, primary diseases and comphcations, blood gas analysis and good quality CPR affect mortality, especially the interval of CRA to CPR and duration of CPR.