472例心脏骤停患者院前急救的调查分析

Investigation and Analysis of Pre-hospital Medical Care of 472 Patients with Cardiac Arrest

目的：评估普及心肺复苏（CPR）培训和对目击者电话胸外按压指导后我镇心脏骤停患者的流行病学特征和复苏情况,探讨早期目击者CPR的意义。方法：对我院急诊科及院前救治的5年472例心脏骤停患者进行回顾性多因素分析,2012年1月∽2014年12月我院院前心脏骤停患者315例为培训组,2010年1月∽2011年12月未普及心肺复苏培训时我院院前心脏骤停患者157例为对照组。结果 ：与对照组比较,培训组从患者心脏骤停至启动急救医疗系统（EMSS）的时间、急救车到达时间明显缩短（P〈0.05）,复苏成功率也明显提高（P〈0.05）,目击者进行CPR人数明显增多（P〈0.01）,出院生存率虽然比以往提高,但差异无统计学意义（P〉0.05）。结论 ：普及全民急救基本技术,提高第一目击者的现场基本急救,缩短从发病到启动EMSS的时间,尽早启动急救生存链,是提高复苏成功率的关键。

Objective ： To evaluate clinic and epidemiological features of patients with cardiac arrest after cardiopulmonary resuscitation（CPR）training and guidance for witnesses in order to investigate the value of early CPR.Methods ：The clinical data of 472 patients with cardiac arrest were analyzed retrospectively for 5 years in our emergency department and prehospital. Among the 472 patients, 315 patients with cardiac arrest from January 2012 to December 2014 were classed as training group, while 157 cases were in control group from January 2010 to December2011, when lack of CPR training and guidance for witnesses. Results ： Compared with the control group, time for action of the emergency medical system（EMSS） and ambulance arrive time significantly shortened（P〈0.05） in the training group, the successfut rate of resussition was improved obviously（P〈0.05）,and the number of bystanders CPR was significantly increased（P〈0.01）, while the hospital survival rate was more than control group, there was no statistically significant difference（P〈0.05）. Conclusion ： To improve the success rate of recovery, spreading emergency basic technology in public and popularising the basic first aid for the first witnesses may shorten the time from onset to start EMSS and initiate emergency chain of survival as soon as possible.