体外心肺复苏技术救治成人心搏骤停患者的临床体会

Clinical experience in successful treatment of cardiac arrest in adult patients using extracorporeal cardiopulmonary resuscitation

目的分析体外心肺复苏技术救治成人心搏骤停患者的临床效果。方法回顾性分析我院2011年1月至2013年6月收治的20例心搏骤停成人患者的临床资料。结果成年心搏骤停患者最主要的发病原因是心血管系统疾病,其次为外伤,分别占总发病人数的40%和25%;ROSC具有较高的成功率,为50%,而脑复苏成功则具有较低的成功率,仅为10%;成功组患者的心肺复苏开始时间、建立人工气道时间均明显比失败组短,肾上腺素用量明显比失败组多,二者相比具有显著的统计学差异(P<0.01);但是在心肺复苏持续时间、除颤次数方面,二者相比不具有统计学差异(P>0.05)。结论体外心肺复苏技术救治心搏骤停患者时尽可能短的心肺复苏开始时间、人工气道建立时间及较多的肾上腺素用量能够提高救治成功率。

Objective To evaluate the clinical efficacy of extracorporeal cardiopulmonary resuscitation （CPR） for treatment of adult cardiac arrest patients. Methods The clinical records of 20 adult cardiac arrest patients who were admitted to our hospital from January 2011 to June 2013 were retrospectively analyzed. Results The most common cause of cardiac arrest in these patients was cardiovascular disease （40%）, followed by trauma （25%）. Return of spontaneous circulation had a high success rate of 50%, while cerebral resuscitation was associated with a low success rate of 10% only. Patients who underwent successful CPR had a significantly shorter time to CPR and establishment of an artificial airway and significantly higher epinephrine usage than those who underwent unsuccessful cardiopulmonary resuscitation （P〈0.01）. However, no statistically significant difference was noted between the two groups with respect to CPR duration and defibrillation times （P〉0.05）. Conclusion The shorter time to CPR and establishment of an artificial airway and higher adrenaline usage can improve the success rate of treatment for cardiac arrest patients.