上海市2013至2015年可除颤室性心律失常院前急救分析

Analysis out-of-hospital emergency treatment of shockable ventricular arrhythmias between 2013 and 2015 in Shanghai

目的:本研究回顾性分析了2013年至2015年上海市医疗急救中心接诊的可除颤性室性心律失常患者的院前急救情况,探讨提高复苏成功率的措施。方法:纳入2013年至2015年上海市医疗急救中心接诊的可除颤性室性心律失常患者71例。收集患者临床资料、急救呼救时段、目击者有无行心肺复苏术(CPR)、响应时间、现场时间、转运时间、复苏成功用时、院前复苏成功率、及最终成功出院率,分析复苏成功相关因素。结果:可除颤室性心律失常男性出现的比例更高(占71.8%),白天时段(占63.38%)较夜间更易被发现。在上海CPR实施率低,仅有25.35%,但呈现逐年上升趋势(P>0.05)。2013年至2015年间上海市可除颤室性心律失常最终复苏成功率从28%上升至46%,然而响应时间、现场时间和转运时间无明显差异(P>0.05)。最终复苏成功与院前复苏成功用时相关(P<0.05)。结论:2013年至2015年间上海市院前可除颤室性心律失常最终成功率逐年上升,最终复苏成功与院前复苏成功用时相关。在我国普及CPR及减少响应时间等是提高复苏成功率的重要举措。

Objective：In order to improve the success rate of resuscitation,this thesis did a retrospective observational study of all individuals who suf ered from ventricular arrhythmias out-of-hospital and accepted Shanghai medical emergency center rescue between 2013 and 2015 in Shanghai.Methods：A total of 71 cases of shockable ventricular arrhythmias who accepted Shanghai medical emergency center rescue between 2013 and 2015 were included.Data recorded included patient demographics,alert time,availability of witnesses CPR,response time,scene time,time to hospital arrival,time to recovery of spontaneous circulation,initial resuscitation success rates,and finally,rates of successful discharge from hospital.Statistical analysis was performed to find the related factors of successful resuscitation.Results：the incidence of shockable ventricular arrhythmia was significantly higher in males（71.8%） than in females,and it was more likely to be found during daytime（63.38%） than at night.In Shanghai,witnesses CPR rate was only 25.35%,but showed a rising trend（P0.05）.We observed an increase in rates of successful discharge from hospital from 28% to 46%.This increase was observed whilst many other factors including response times site times and transport times remained relatively unchanged（P0.05）.The survival to hospital discharged was related with return of spontaneous circulation time（P0.05）.Conclusion：the rate of successful discharge from hospital of out-of-hospital shockable ventricular arrhythmia increased year by year during 2013 to 2015,and was related with recovery of spontaneous circulation time.In our country,it is an important measure to improve the success rate by popularizing CPR and reducing the response time.