急诊院前心脏骤停患者心肺复苏成功的相关因素分析

Analysis of factors related to successful cardiopulmonary resuscitation in patients with emergency pre-hospital cardiac arrest

目的了解影响急诊院前心脏骤停患者心肺复苏成功的相关因素,以期为提高院前急救成功率提供参考。方法回顾急诊收治的院前心脏骤停且均行心肺复苏治疗的92例患者的临床资料,采用单因素和多因素Logistic回归分析心肺复苏成功的影响因素。结果92例心脏骤停患者中,复苏治疗成功27例,复苏成功率为29.35%,复苏是否成功与心脏骤停病因、心肺复苏开始时间、心肺复苏持续时间、肾上腺素用量、目击者是否现场进行心肺复苏、是否合并心肺疾病、是否应用电除颤有关(P<0.05)。Logistic回归分析结果显示,目击者现场进行心肺复苏(OR=0.2)、心肺复苏持续时间<15 min(OR=0.1)、应用电除颤(OR=0.3)是心脏骤停患者心肺复苏成功的保护因素,合并心肺疾病(OR=4.1)、非心源性心脏骤停(OR=19.0)是其危险因素,均P<0.05。结论目击者现场进行心肺复苏、心肺复苏持续时间<15min、应用电除颤,可提高心脏骤停患者心肺复苏的成功率。

Objective To explore the factors influencing the success of cardiopulmonary resuscitation in patients with emergency pre-hospital cardiac arrest in the hope of providing reference for improving the success rate of pre-hospital emergency treatment.Methods The clinical data of 92 patients with pre-hospital cardiac arrest who were admitted to the emergency department and received cardiopulmonary resuscitation were reviewed.Univariate and multivariate Logistic regression were used to analyze the factors affecting the successful cardiopulmonary resuscitation.Results Among the 92 patients with cardiac arrest,27 cases were successfully resuscitated,and the success rate of resuscitation was 29.35%.Successful resuscitation was related to the cause of cardiac arrest,the start time of cardiopulmonary resuscitation,the duration of cardiopulmonary resuscitation,adrenaline dosage,whether the witness performed cardiopulmonary resuscitation at the scene,whether there was cardiopulmonary disease,and whether electric defibrillation was applied(P<0.05).Logistic regression analysis showed that on-site cardiopulmonary resuscitation(OR=0.2),duration of cardiopulmonary resuscitation<15min(OR=0.1)and application of electrical defibrillation(OR=0.3)were protective factors for successful cardiopulmonary resuscitation in patients with cardiac arrest.The co-existence of cardiopulmonary disease(OR=4.1)and non-cardiogenic cardiac arrest(OR=19.0)were risk factors(all P<0.05).Conclusions On-sitecardiopulmonary resuscitation by the witness,duration of cardiopulmonary resuscitation<15min and application of electrical defibrillation could improve the success rate of cardiopulmonary resuscitation in patients with cardiac arrest.