FEEL流程在EICU心肺复苏患者中的临床应用效果

Clinical Application Effect of Focused Echocardiographic Evaluation in Life-Support on Patients with Cardiopulmonary Resuscitation in EICU

目的:对EICU心搏骤停的患者应用床旁超声心动图评估生命支持(FEEL)流程,分析其在心肺复苏患者中的临床应用效果。方法:选取2020年1月-2021年6月宜昌市中心人民医院EICU收治的心肺复苏患者118例,分为超声组(n=58)和对照组(n=60),所有患者均采用《2015国际心肺复苏与心血管急救指南》的常规治疗流程,超声组在此基础上应用重症超声FEEL流程管理方案。分析两组患者突发心脏停搏的病因、临床诊断、治疗时间及临床转归等指标。结果:与对照组相比,超声组的初步确定治疗时间、确定正确治疗时间、自主循环恢复时间缩短,初步诊断准确率、确定诊断准确率、首次心肺复苏成功率和28天存活率提高,脑功能评分>2分的患者数量及癫痫发生率降低(均P<0.05)。结论:利用FEEL流程对EICU心脏骤停患者进行快速管理,可以实现病因的早期排查,使患者尽快得到正确的治疗,并可能改善其临床预后。

Objective:To analyze the application value of focused echocardiographic evaluation in life-support(FEEL)management on patients with cardiopulmonary resuscitation in EICU.Methods:A total of 118 patients with cardiopulmonary resuscitation(CPR)admitted to Yichang Central People's Hospital from January 2020 to June 2021 were selected and divided into the ultrasound group(n=58)and the control group(n=60).All patients were treated according to the routine treatment procedures of“2015 International Guidelines for Cardiopulmonary Resuscitation and Cardiovascular First Aid”.Patients in the ultrasound group were treated with the critical care ultrasound of FEEL flow management program in addition to the routine treatment procedures.The etiology,clinical diagnosis,treatment time and clinical outcome of sudden cardiac arrest in two groups were analyzed.Results:Compared to the control group,the preliminary determined treatment time,determinate correct treatment time and spontaneous circulation recovery time were shortened in the ultrasound group(all P<0.05).The accuracy rate of preliminary diagnosis and determinate diagnosis,the success rate of CPR for the first time and survival rate for 28 days were all higher,and the number of patients with cerebral performance category scale(CPC)score>2 and the incidence of epilepsy were significantly lower in the ultrasound group than those of the control group(all P<0.05).Conclusion:Rapid management of EICU cardiac arrest patients using the FEEL process enables early identification of etiology,immediately correct treatment and improving outcomes.