影响院前心脏停搏患者心肺复苏成功的相关因素分析

Influencers on Success of Pre-hospital Cardiac Arrest Resuscitation

目的 分析影响院前心脏停搏患者心肺复苏成功的相关因素。方法 对2012年1月至2013年1月湖北医药学院附属东风医院急诊科接诊并进行心肺复苏的106例院前心脏停搏患者按照心肺复苏成功的标准进行分组,其中成功组55例、失败组51例,对比两组患者的相关临床资料,分析影响院前心脏停搏患者心肺复苏成功的相关因素。结果 影响心脏停搏患者恢复自主循环的因素主要有心脏按压开始时间、气管插管时间、电击除颤开始时间和肾上腺素使用剂量等。其中危险因素为：心脏按压开始时间（〉5 min）（OR=1.342,95%CI 1.124~1.741）和气管插管时间（〉2 min）（OR=1.998,95%CI 1.342~2.685）;保护因素为：电击除颤开始时间（≤5 min）（OR=1.532,95%CI 1.357~1.699）和肾上腺素使用剂量（标准量）（OR=2.142,95%CI 2.012~3.969）。结论 心脏按压开始时间、气管插管时间、电击除颤开始时间和肾上腺素使用剂量是影响院前脏停搏患者心肺复苏成功的主要因素。

Objective To analyze the impact of pre-hospital cardiac arrest resuscitation success related factors.Methods A total of 106 cases of cardiopulmonary resuscitation of cardiac arrest admitted to First Aid Center of Dongfeng Hospital Affiliated to Hubei Medical College from Jan .2012 to Jan.2013 were grouped according to the standard of successful cardiopulmonary resuscitation , 55 cases in the successful group,51 cases in the failure group,and the clinical data of the two groups were compared,the influencers of the successful pre-hospital cardiopulmonary resuscitation were analyzed .Results The influencing factors of successful cardiopulmonary resuscitation of cardiac arrest patients were mainly heart pressing start time ,dura-tion of tracheal intubation,defibrillation starting time and dose of epinephrine.The risk factors were：press start time （ 〉5 min）（OR=1.342,95%CI 1.124-1.741） and tracheal intubation time（ 〉2 min）（OR=1.998,95%CI 1.342-2.685）;the protective factors：defibrillation start time（≤5 min） （OR=1.532,95%CI 1.357-1.699） and epinephrine dose（standard）（OR=2.142,95%CI 2.012-3.969）.Conclusion Pre-hospital cardiac arrest resuscitation success factors are,timely cardiac compressions start,intubation time, timely defibrillation and epinephrine dosage .