电击伤致心跳呼吸骤停98例院前急救分析

Analysis of pre-hospital first-aid for of 98 patients with cardiac and respiratory arrest caused by electrical injury

目的 探讨电击伤致心跳呼吸骤停患者的现场心肺复苏重要性,落实急救措施,提高急救的时效性以及成功率.方法 对2000年1月～2013年11月江门市人民医院急救中心接诊的98例电击伤致心跳、呼吸骤停患者的临床病历资料进行回顾性分析,研究不同的现场开始复苏时间、年龄及电压对复苏成功率、出院存活率的影响.结果 98例电击伤致心跳呼吸骤停患者经积极的现场复苏,自主循环恢复22例,生存出院15例,现场死亡76例,院内死亡6例,长期呈植物状态放弃治疗1例.事发＜5 min得到心肺复苏者,复苏成功率及出院存活率（57.14％,57.14％）明显高于5～＜11 min组（27.27％,15.90％）,差异有统计学意义（P＜0.05）;≤60岁患者复苏成功率及出院存活率（24.05％,17.72％）明显高于＞60岁的患者（15.78％,5.26％）,差异有统计学意义（P＜0.05）;高电压所致的复苏成功率及出院存活率（9.09％,0.00％）远低于低电压所致（24.13％,17.24％）,差异有统计学意义（P＜0.05）.结论 提高院前急救水平,对公众推广现场急救知识和基本心肺复苏技术,及早进行现场复苏,是电击伤患者自主循环恢复和生存出院的关键措施.

Objective To study the importance of cardiopulmonary resuscitation for patients with cardiac and respiratory arrest caused by the electrical injury,implement emergency measures,improve the efficiency and the success rate of the first aid.Methods 98 patients＇ clinical records,which were cardiac and respiratory arrest caused by electricity,from January 2000 to November 2013,and treated by the emergency center,were analyzed retrospectively,the effect of different site recovery time,age and voltage on the recovery success rate and survival rate were researched.Results 98 patients with cardiac and respiratory arrest caused by electrical injury were actualized active cardiopulmonary resuscitation.The results showed that 22 cases restored spontaneous circulation,15 survived and left hospital,76 died at the scene,6 died in hospital and 1 gave up treatment for long-term in the vegetative state.The recovery success rate and survival rate of the patients got CPR in 〈5 minutes （57.14%,57.14%） were higher than those of the patients got CPR in 5-〈11 minutes （27.27%,15.90%）,the differences were statistically significant （P 〈 0.05）.The recovery success rate and survival rate of patients ≤60 years （24.05%,17.72%） were higher than those of patients 〉60 years （15.78%,5.26%）,the differences were statistically significant （P 〈 0.05）.The recovery success rate and survival rate of patients hurt by the high voltage （9.09%,0.00%） were lower than those of patients hurt by the low voltage （24.13%,17.24%）,the differences were statistically significant （P 〈 0.05）.Conclusion The key measure of restoration of spontaneous circulation and survival to hospital discharge in electrical injury patients is improving the level of pre-hospital emergency,promoting the first aid knowledge and basic cardiopulmonary resuscitation techniques to the public,and CPR as soon as possible.