无锡地区心搏骤停患者院前急救现况分析

Analysis of Cardiac Arrest Patients with Pre-hospitial Cardiopulmonary Resuscitation in Wuxi

目的分析无锡地区心搏骤停患者院前复苏水平和存在的问题。方法对无锡市急救中心2008—2009年共接诊的1 637例心搏骤停患者进行回顾性调查和分析。结果心搏骤停以不明原因最多,占69.09%,其次是车祸、溺水、坠落伤,分别占10.31%、3.60%、3.20%。在实行心肺复苏的1 067例患者中,自主循环恢复(成功组)34例,成功率为3.19%。成功组发病至至呼救时间为(5±6)min,较未成功组的(16±25)min明显缩短,差异有统计学意义(P<0.05);成功组呼救反应时间为(9±8)min,较未成功组的(11±7)min明显缩短,差异有统计学意义(P<0.05)。气管插管组550例,复苏成功30例(5.45%),未气管插管组517例,复苏成功4例(0.77%),两组比较差异有统计学意义(P<0.05)。现场充分复苏组132例,复苏成功18例(13.64%),未充分复苏组935例,复苏成功16例(1.71%),两组比较差异有统计学意义(P<0.05)。结论心搏骤停不明原因者居多,目击者对心搏骤停发生前危重症状识别知识缺乏,未成功组发病至呼救时间和呼救反应时间明显较长,因此加强公众对常见危重病的识别知识、判断能力和"只需动手"的心肺复苏的培训,注重气管插管和现场充分复苏是进一步提高本地区院前心肺复苏成功率的重要措施。

Objective to evaluate and analyze the cardiac arrest resuscitation level and problems in Wuxi. Methods 1637 pre - hosptial cases of cardiac arrest from 2008-2009 were retrospectively investigated. Results The most common cause of death among 1637 cases were unknown cause （69. 1% ） , traffic trauma （ 10. 3% ） , drown （3.6%） and fall trauma （3.2%）. Among the 1067 cases those were given CPR, ROSC 34 cases, the effective rate was 3.2% ; the average time to onset to call for help （5 ± 6 ） rain in effective group was significantly shorter as compared with that （16 ± 25 ） min in no -effective group （ P 〈 0. 05 ） ; the average time of pre - hosptial care response （ 9 ± 8min） in effective group was significantly shorter as compared with that （11 ± 7min） in no- effective group （P 〈 0.05 ） ; Tracheal intubation group of 550 cases, 30 cases of effective, a effective rate of 5.45%, no tracheal intubation group of 513 cases, the effective of 4 cases, a effective rate of 0. 77% （P 〈0. 05） ; full resuscitation on the scene group of 132 cases, 18 cases of effective, a effective rate of 13.64% , no full resuscitation group of 935 cases, 16 cases of effective, a effective rate of 1.71% （ P 〈 0.05 ）. Conclusion To enhance public recognition ability of the knowledge of critical illness and the ＂ hands only＂ in CPR training, focusing on tracheal intubation and full resuscitation on the scene are the important measures to further improve the effective rate of cardiopulmonary resuscitation in this region.