心肺复苏中肾上腺素用量与预后的探讨

Relationship between adrenaline used dose and prognosis on cardiopulmonary resuscitation

目的：探讨心肺复苏（CPR）中肾上腺素用量与预后的关系。方法：选择2012-01-01-2014-12-31我院急救中心抢救的心搏骤停（CA）患者393例,按CPR时间分为常规CPR组190例,超长CPR组203例。根据CPR的结果分为成功组72例和失败组321例。常规肾上腺素1mg静脉注射,每间隔3-5min重复给药1次,直到CPR成功或终止。对肾上腺素用量与预后进行回顾性统计分析。结果：常规CPR组与超长CPR组性别、年龄比较差异无统计学意义（P〉0.05）;常规CPR组肾上腺素用量明显低于超长CPR组,差异有统计学意义（t=-12.227,P〈0.01）。而常规CPR组预后[自主循环恢复（ROSC）率、出院存活率、30d良好神经功能恢复率]明显优于超长CPR组（P〈0.01）,提示常规CPR组低的肾上腺素用量优于高用量的超长CPR组预后;成功组肾上腺素用量明显低于失败组（t=-9.041,P〈0.01）,提示低的肾上腺素用量是CPR预后的有利因素;肾上腺素用量≤5mg组ROSC、存活出院、30d良好神经功能恢复者比例较高。结论：在CPR中肾上腺素用量≤5mg是预后的有利因素,超过10mg是不利因素。

Objective：To investigate the relationship between adrenaline used dose and prognosis on cardiopulmonary resuscitation.Method：The 393 patients were recruited with cardiac arrest（CA）from January 1,2012 to December 31,2014 in our emergency center.They were divided into conventional CPR group（190cases）and long time CPR group（203cases）according to cardiopulmonary resuscitation（CPR）time,and were also into success group（72cases）and failure group（321cases）.Routine adrenaline administration was given 1mg intravenously every 3-5min repeatedly until CPR succeeded or terminated.Adrenaline used dose and prognosis on cardiopulmonary resuscitation were analyzed by retrospective statistical analysis.Result：The difference of sex and age in conventional CPR group was not statistically significant compared to that in long time CPR group（P〉0.05）.The adrenaline used dose in conventional CPR group was significantly lower than that in long time CPR group（t=12.227,P〈0.01）.The Prognosis on conventional CPR group was superior to that on the long time CPR group in restoration of spontaneous circulation（ROSC）rate,the survival to hospital discharge and 30 dgood neurological recovery（P〈0.01）.The Prognosis on lower dose adrenaline in conventional CPR group was superior to that on the higher dose in long time CPR group.The dose of adrenaline in success group was significantly lower than that in the failure group（t=9.041,P〈0.01）.The lower dose of adrenaline was favorable to CPR prognosis.The rate in adrenaline dose≤5mg group was higher in restoration of spontaneous circulation（ROSC）,survival to hospital discharge and 30 dgood neurological recovery.Conclusion：The adrenaline dose less than 5mg was a favorable factor in CPR while more than 10 mg a negative factor.