心肺复苏时限与预后的探讨

Relationship between the limit time and prognosis on cardiopulmonary resuscitation

目的：探讨心肺复苏的复苏时限与预后的关系。方法：选择2012-01-01-2014-12-31在本院院前、院内急诊抢救的393例心脏骤停（CA）患者,复苏时间≤30min者为常规CPR组（190例）;复苏时间〉30min者为超长CPR组（203例）。根据预后分为CPR成功组72例和失败组321例。回顾性统计和分析复苏时限与预后的关系。结果：常规CPR组与超长CPR组性别、年龄之间比较差异无统计学意义,而2组复苏时间比较差异有统计学意义（t=-17.429,P〈0.01）,预后自主循环恢复（ROSC）率、出院存活率、30d神经功能良好恢复率比较差异有统计学意义（P〈0.01）,显示常规CPR组复苏时间较短,预后优于超长CPR组。CPR成功组与失败组停博时间、复苏时间比较差异有统计学意义（P〈0.01）,显示停博时间长、复苏时间长,预后不良。观察不同复苏时间（≤15min、16-30min、31-60min、〉60min）患者预后,显示随着复苏时间的延长,总体预后明显下降,特别复苏时间≤15min者预后明显高于其他患者。结论：CPR复苏时间≤15min预后明显优于〉15min者,对CPR预后是有利的因素;随着复苏时间的延长,复苏的预后明显降低。

Objective：To investigate the relationship between the limit time and prognosis on cardiopulmonary resuscitation.Method：The 393 cases with cardiac arrest（CA）were selected in pre-hospital and hospital emergency from January 01,2012 to December 31,2014 in our hospital.According to the resuscitation time,the cases were divided into two groups：the routine CPR group of 190 cases whose resuscitation time was less than 30 min,and the long CRP group of 203 case whose resuscitation time was more than 30 min.According to the prognosis of CPR,the cases were separated into successful group of 72 cases and failure group of 321 cases.The relationship between the limit time and prognosis was analyzed by the retrospective statistics and analysis.Result：There was no significant difference in the sex and age between the routine CPR group and the long CRP group.There was statistically significance between the two groups in resuscitation time（t=-17.429,P〈0.01）,prognosis of ROSC,rate of survival,rate of better recovery in neurological function within 30d（P〈0.01）.The resuscitation time in routine CPR group was short and its prognosis was better than that of long CPR group.There was statistically significant（P〈0.01）between successful and failure group in arrest time and recovery time,which appeared that the longer the arrest time,the longer the resuscitation time,and the prognosis was not good.To observe respectively the prognosis among less than 15 min,16-30min,31-60min and more than 60 min according to resuscitation time,the overall prognosis was significantly decreased with prolonged resuscitation time,especially that of the resuscitation time less than 15 min which was better than that of the others.Conclusion：The prognosis in the group with resuscitation time less than 15 min was better than that of more than 15 min,which was favorable factors for CPR.The prognosis was significantly decreased with prolonged resuscitation time.