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目的探讨经心肺复苏(CPR)后自主循环恢复(ROSC)的心搏骤停患者预后的危险因素,以指导患者的抢救。方法回顾性分析同济大学附属第十人民医院2010年1月—2015年12月间收治的149例行心肺复苏后自主循环恢复心搏骤停患者资料,依据预后情况分为复苏成功组(44例)和复苏失败组(105例)。制作危险因素调查表,收集患者年龄、性别、病史、CPR公众科普、心搏骤停地点、CRP时间、ROSC间期、瞳孔、器官功能衰竭、复苏后APACHEⅡ评分、血压、D-二聚体水平等,通过单因素和多因素危险因素分析探讨患者预后的危险因素。结果单因素分析结果显示:年龄、基础病史、CPR公众科普、心搏骤停地点、CRP时间、ROSC间期、瞳孔、器官功能衰竭、复苏后APACHEⅡ评分、血压、D-二聚体水平是影响患者预后复苏成功的危险因素。Logistic回归分析显示:年龄、基础病史、CPR公众科普、心搏骤停地点、CRP时间、ROSC间期、瞳孔、器官功能衰竭、复苏后APACHEⅡ评分、血压、D-二聚体水平是影响患者预后复苏成功的危险因素。结论经心肺复苏后自主循环恢复的心搏骤停患者预后与多种因素密切相关,临床应依据患者临床状况给予积极的治疗和护理。
Objective To investigate the risk factors of prognosis in patients with spontaneous circulation recovery (ROSC) after cardiopulmonary resuscitation (CPR) to guide the rescue of patients. Methods The data of 149 patients who underwent cardiopulmonary arrest after cardiopulmonary resuscitation (CPR) were retrospectively analyzed from January 2010 to December 2015 in Tenth People’s Hospital of Tongji University. According to the prognosis, 44 patients ) And recovery failure group (105 cases). The questionnaire of risk factors was collected and the patients’ age, gender, medical history, CPR public science, place of cardiac arrest, CRP time, ROSC interval, pupil, organ failure, APACHEⅡ score after resuscitation, blood pressure, D-dimer level And so on, through single factor and multivariate risk factors analysis to explore the prognosis of patients with risk factors. Results The results of univariate analysis showed that age, basic medical history, CPR public science, place of cardiac arrest, CRP time, ROSC interval, pupil, organ failure, APACHE II score after resuscitation, blood pressure, D-dimer level The prognosis of patients with successful risk factors for recovery. Logistic regression analysis showed that age, basic medical history, CPR public science, place of cardiac arrest, CRP time, ROSC interval, pupil, organ failure, APACHE II score after resuscitation, blood pressure, D-dimer level were the prognosis of patients The risk factors for successful recovery. Conclusion The prognosis of patients with cardioversion after cardiopulmonary resuscitation after cardiopulmonary resuscitation is closely related to many factors. Clinical treatment should be based on the clinical treatment of patients with active treatment and care.