呼吸心跳骤停患者急诊心肺复苏的影响因素

Influencing Factors of Emergency Cardiopulmonary Resuscitation in Patients with Respiratory and Cardiac Arrest

目的 分析呼吸心跳骤停患者急诊心肺复苏的影响因素。方法 回顾性收集2017年3月-2020年11月山东省立第三医院急诊科收治的230例呼吸心跳骤停患者临床资料,根据患者急诊心肺复苏抢救情况分为存活组和死亡组。分析呼吸心跳骤停患者急诊心肺复苏抢救成功率,并采用单因素及多因素分析呼吸心跳骤停患者急诊心肺复苏失败的影响因素。结果 230例呼吸心脏骤停患者急诊肺复苏抢救成功率为19.57%;单因素分析显示,死亡组患有心源性疾病、复苏地点在院外、心肺复苏开始时间>6 min、肾上腺素用量>5 mg、未进行电击除颤的患者比例高于存活组(P<0.05);多因素Logistic回归分析显示,患有心源性疾病、复苏地点在院外、心肺复苏开始时间>6 min、肾上腺素用量>5 mg、未进行电击除颤是导致呼吸心脏骤停患者急诊复苏失败的主要危险因素。结论 导致呼吸心脏骤停患者急诊心肺复苏抢救失败的危险因素包括患有心源性疾病、复苏地点在院外、心肺复苏开始时间>6 min、肾上腺素用量>5 mg、未进行电击除颤,据此临床可对有以上特征的患者进行针对性治疗或干预,提高呼吸心脏骤停患者急诊心肺复苏抢救成功率,改善患者预后。

Objective To analyze the influencing factors of emergency cardiopulmonary resuscitation in patients with respiratory and cardiac arrest.Methods The clinical data of 230 patients with respiratory and cardiac arrest admitted to the emergency department of Shandong Provincial Third Hospital from March 2017 to November 2020 were retrospectively collected.According to the rescue situation of emergency cardiopulmonary resuscitation,the patients were divided into survival group and death group.The success rate of emergency cardiopulmonary resuscitation in patients with respiratory and cardiac arrest was analyzed,and the influencing factors of failure of emergency cardiopulmonary resuscitation in patients with respiratory and cardiac arrest were analyzed by single factor and multiple factors.Results The success rate of emergency lung resuscitation in 230patients with respiratory and cardiac arrest was 19.57%.Univariate analysis showed that the proportion of patients in the death group with cardiogenic diseases,outside the hospital where the resuscitation was performed,the start time of cardiopulmonary resuscitation >6 min,the dosage of epinephrine>5 mg,and the proportion of patients without electrical defibrillation was higher than that in the survival group( P <0.05).Multivariate Logistic regression analysis showed that the main risk factors for failure of emergency resuscitation in patients with respiratory and cardiac arrest were heart disease,resuscitation site outside the hospital,cardiopulmonary resuscitation start time >6 min,epinephrine dosage >5 mg,and no electric shock defibrillation.Conclusion The risk factors that lead to the failure of emergency cardiopulmonary resuscitation in patients with respiratory and cardiac arrest include cardiac diseases,the location of resuscitation outside the hospital,the start time of cardiopulmonary resuscitation >6 min,the dosage of epinephrine >5 mg,and the absence of electric shock defibrillation.Accordingly,targeted treatment or intervention can be carried out for patients with the above characteristics,so as to improve the success rate and prognosis of emergency cardiopulmonary resuscitation in patients with respiratory and cardiac arrest.