心脏骤停患者心肺复苏后影响自主循环及预后的因素

The factors influencing return of spontaneous circulation and prognosis after cardiopulmonary resuscitation in patients with cardiac arrest

目的探讨心脏骤停患者心肺复苏后影响自主循环恢复(ROSC)及预后的因素。方法回顾分析2015年11月至2019年10月因心脏骤停行心肺复苏术患者的临床资料,根据心肺复苏后ROSC结果分组,采用多因素logistic回归分析心脏骤停患者心肺复苏后影响ROSC及预后的影响因素。结果共98例心脏骤停患者行心肺复苏术,其中出现ROSC 27例(27.55%),未出现ROSC 71例(72.45%)。单因素分析结果显示,两组患者心肺复苏后心脏骤停病因、首次监测心律、心肺复苏持续时间、肾上腺素用量差异均有统计学意义(P<0.05或0.01)。多因素logistic回归分析显示,心脏骤停病因(OR=1.985,95%CI:1.025~3.844)、首次监测心律(OR=0.297,95%CI:0.094~0.938)、心肺复苏持续时间(OR=0.065,95%CI:0.009~0.469)、肾上腺素用量(OR=0.564,95%CI:0.357~0.891)是心脏骤停患者心肺复苏后ROSC的独立影响因素(P<0.05或0.01)。98例心脏骤停患者心肺复苏术后24h存活24例(24.49%),7d内存活16例(16.33%),出院存活12例(12.24%),神经功能恢复良好出院9例(9.18%)。结论心脏骤停病因、首次监测心律、心肺复苏持续时间、肾上腺素用量与ROSC及预后密切相关。

Objective To investigate the factors influencing return of spontaneous circulation(ROSC)and prognosis after cardiopulmonary resuscitation(CPR)in patients with cardiac arrest(CA).Methods The clinical data of patients with CA and CRP from November 2015 to October 2019 were analyzed retrospectively.They were grouped based on the results of ROSC.Multivariate Logistic regression analysis was used to analyze the influencing factors of ROSC and prognosis after CRP in patients with CA.Results A total of 98 patients with CA undergoing CRP.ROSC occurred in 27 patients(27.55%)and did not occur in 71 patients(72.45%).Univariate analysis showed that there were significant differences between the two groups in the causes of CA,the first recorded rhythm,CPR duration and epinephrine dosage(P<0.05 or 0.01).Multivariate logistic regression analysis showed that the causes of CA(OR=1.985,95%CI:1.025~3.844),the first recorded rhythm(OR=0.297,95%CI:0.094~0.938),CRP duration(OR=0.065,95%CI:0.009~0.469),and epinephrine dosage(OR=0.564,95%CI:0.357~0.891)were independent factors influencing ROSC after CA(P<0.05 or 0.01).Among the 98 patients with CA,24 patients survived 24h(24.49%),16 patients survived 7d(16.33%),12 patients survived discharge(12.24%),and 9 patients survived discharge with good recovery of neurological function(9.18%).Conclusion The causes of CA,the first recorded rhythm,CRP duration,and epinephrine dosage are closely relate to ROSC and prognosis.