院前心脏停搏与院内心脏停搏复苏存活率的比较

Comparisive study on the survival rate of CPR in patients with cardiac arrest between pre-hospital and within-hospital

目的:分析我院急诊中心心脏停搏患者心肺复苏(CPR)存活率及其影响因素,并比较院前发生心脏停搏与院内发生心脏停搏复苏存活率。方法:对我院急诊中心78例心搏骤停(cardiac arrest,CA)患者的资料进行回顾性分析,比较院前发生心搏骤停组和院内发生心搏骤停组的CPR开始时间(从心脏停搏至CPR开始时间)、气管插管时间、CPR持续时间、开始除颤时间、除颤次数、肾上腺素用量及存活率。结果:院前组复苏存活率2.86%,院内组复苏存活率11.62%。两组CPR开始时间、气管插管时间、存活率比较差异有统计学意义(P<0.01),CPR持续时间、除颤次数及肾上腺素用量比较差异无统计学意义。结论:院前心脏停搏较院内心脏停搏复苏存活率低,与"生命链"未彻底落实及急救水平低有关。普及全民急救知识,加强完善急救医疗体系建设,早期除颤及早期亚低温治疗,是提高CPR成功率及复苏存活率的重要措施。

Objective：To analyze the survival rate of CPR and its influencing factors in cardiac arrest（CA） patients in emergency center and compare the survival rate between pre-hospital and within hospital. Method： The clinical data of 78 cases with CA were analyzed retrospectively. They were divided into the pre-hospital group and within hospital group according to the scene of CA. The starting time of CPR, duration time of CPR,endotracheal intubation time, the starting time of defibrillation, defibrillation times, adrenaline dose and survival rate were com- pared between the two groups. Result： The total survival rate of within hospital group was 11.62 %, but the prehospital group was only 2.86 %. There is no difference in duration time of CPI~, defibrillation times and adrenaline dose between the pre-hospital group and within hospital group,but the starting time of CPR, endotraeheal intubation time,the starting time of defibrillation and survival rate show significant difference （P〈0.05） between the two groups. Conclusion：The survival rate of the pre-hospital group is poorer than the within hospital group. The main reason is that the ＂survival chain＂ does not be carried out completely. And at the same time,we can not over-look the facts of our poor emergency level. The key way to improve survival rate of CPR is to popularize emergency knowledge and perfect the emergency medical service system, early defibrillation and early mild hypothermia therapy.