无锡地区儿童心搏骤停院前流行病学特点及救治情况分析

Epidemiology and treatment analysis of children with out-of-hospital cardiac arrest

目的分析儿童心搏骤停院前救治的薄弱环节，探寻提高儿童心搏骤停院前复苏成功率的方法。方法分析2005至2011年，无锡市急救中心救治的133例8岁以下院外心搏骤停（outofhospitalcardiacarrest，OHCA）病例。结果儿童OHCA以男童（84例，63．2％）为主，既往史多为“体健”（65例，48．9％），心搏骤停病因以溺水（52例，39．1％）和创伤（30例，22．5％）等意外伤害为主，发病地点以公共场所（60例，45．1％）最多，发病以冬夏季居多；院前急救平均反应时间为（13．21±8．09）min，第一目击者救治率为3．91％；院前气管插管率为11．11％，静脉开通率为23．15％，自主循环恢复1例。结论院前儿童心搏骤停的自主循环恢复（recoveryofspontaneouscirculation，ROSC）率明显低于院内。对儿童意外事件的防范性干预措施和院前急救人员的儿童高级心脏生命支持（pediatricadvancedlifesuppo~，PALS）相关急救技能亟待提高。

Objective To study the weak loop in the treatment of children with out-of-hospital cardiac arrest （OHCA） and the treatment strategy for improvement. Method Data of a total of 133 patients with OHCA who were rescued by Wuxi pre-hospital care center during the 2005-2011 were analyzed. Result The main causes of pediatric OHCA were drowning （52/133）and accidental injury disease（30/133 ）. The cases of OHCA were mainly located in public places （60/133） and the majority occurred in winter and summer. The emergency rescue response time was （13.21 ± 8.09） rain, the rate of first witness treatment was 3.91% , intubations was performed in 11.11% , opening of vein access was 23.15% and one case got restoration of spontaneous circulation （ ROSC ）. Conclusion The rate of ROSC of pre-hospital cardiac arrest in children was significantly lower than that of hospital cardiac arrest. Preventive interventions on children＇s accidents and the skills of pre-hospital staff on pediatric advanced life support （PALS） need to be urgently improved.