急诊科心肺复苏患者临床特征及复苏失败的危险因素分析

Analysis of Clinical Characteristics and Risk Factors for Resuscitation Failure in Emergency Department Cardiopulmonary Resuscitation Patients

目的探究急诊科心肺复苏患者的临床特征和复苏结局的影响因素。方法选取2020年2月至2023年2月于南阳市第一人民医院急诊行心肺复苏术治疗的190例心脏骤停患者为研究对象。按抢救结局分为心肺复苏成功组(n=26)和心肺复苏失败组(n=164)。收集患者临床资料(年龄、性别、心脏骤停原因、心肺复苏起始时间、心肺复苏持续时间、肾上腺素剂量、电除颤次数、是否气管插管通气)。单因素分析和多因素logistic回归分析用于探究心肺复苏失败的影响因素。结果190例心脏骤停患者共有26例(13.68%)患者心肺复苏成功,164例(86.32%)患者心肺复苏失败。单因素分析结果显示,两组心肺复苏起始时间、心肺复苏持续时间、肾上腺素剂量和电除颤次数差异具有统计学意义(P<0.05),多因素分析结果显示,心肺复苏起始时间(P<0.001,OR=1.722,95%CI:1.408~2.105)心肺复苏持续时间(P<0.001,OR=1.647,95%CI:1.339~2.026)、肾上腺素剂量(P=0.031,OR=1.365,95%CI:1.241~1.897)和电除颤次数(P=0.004,OR=1.256,95%CI:1.184~1.526)是心肺复苏失败的独立危险因素。结论急诊科目前对心脏骤停患者的心肺复苏抢救成功率仍较低,快速有效的心肺复苏对于抢救成功至关重要,应采取相应措施提高抢救的相应时间和质量。

Objective To explore the clinical characteristics and influencing factors of resuscitation outcomes in emergency department cardiopulmonary resuscitation patients.Methods A total of 190 cardiac arrest patients who underwent cardiopulmonary resuscitation in the emergency department of The First People’s Hospital of Nanyang City from February 2020 to February 2023 were selected as the research subjects.According to the rescue outcome,they were divided into the cardiopulmonary resuscitation success group(n=26)and the cardiopulmonary resuscitation failure group(n=164).Clinical data of patients(age,gender,cause of cardiac arrest,start time of cardiopulmonary resuscitation,duration of cardiopulmonary resuscitation,dose of adrenaline,number of defibrillations,whether tracheal intubation ventilation was performed)were collected.Univariate analysis and multivariate logistic regression analysis were used to explore the influencing factors of cardiopulmonary resuscitation failure.Results Among the 190 cardiac arrest patients,26 patients(13.68%)were successful in cardiopulmonary resuscitation,and 164 patients(86.32%)failed in cardiopulmonary resuscitation.The results of univariate analysis showed that there were statistically significant differences in the start time of cardiopulmonary resuscitation,duration of cardiopulmonary resuscitation,dose of adrenaline,and number of defibrillations between the two groups(P<0.05).The results of multivariate analysis showed that the start time of cardiopulmonary resuscitation(P<0.001,OR=1.627,95%CI:1.141~2.365),duration of cardiopulmonary resuscitation(P<0.001,OR=2.160,95%CI:1.581~2.614),dose of adrenaline(P=0.031,OR=1.365,95%CI:1.241~1.897),and number of defibrillations(P=0.004,OR=1.256,95%CI:1.184~1.526)were independent risk factors for cardiopulmonary resuscitation failure.Conclusion The current success rate of cardiopulmonary resuscitation for cardiac arrest patients in the emergency department is still low.Rapid and effective cardiopulmonary resuscitation is crucial for successful rescue.Appropriate measures should be taken to improve the response time and quality of rescue.