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目的:探讨影响心跳呼吸骤停患者急诊科心肺复苏(cardiopulmonary resuscitation,CPR)预后的相关因素,以期提高急诊科CPR的成功率。方法:回顾性分析泉州市第一医院急诊科2010年12月至2014年2月期间的CPR病例,对影响CPR效果的相关因素进行单因素和多因素logistic回归分析。结果:298例病例中,自主循环恢复(restoration of spontaneous circulation,ROSC)75例(25.2%),24 h存活41例(13.8%),出院存活19例(6.4%),神经功能预后较好出院存活9例(3.0%)。相关因素分组比较显示,CPR起始时间≤5 min、CPR连续时间≤10 min、肾上腺素总量≤5 mg、可除颤心律组,ROSC率、24 h存活率、存活出院率、神经功能预后较好,出院存活率相对较高(P<0.05);院内(cardiopulmonary arrest,CA)组,ROSC率、24 h存活率、存活出院率相对较高(P<0.05);心源性、医务人员目击者ROSC率和24 h存活率相对较高(P<0.05);非脏器功能不全、白天抢救者ROSC率相对较高(P<0.05)。结论:影响心跳呼吸骤停患者急诊科CPR预后的相关因素主要有CPR起始时间和连续时间,可除颤心率以及年龄。期中可除颤心律是影响神经功能预后较好的有利因素。
Objective: To investigate the related factors that affect the prognosis of emergency department cardiopulmonary resuscitation (CPR) in patients with heartbeat and respiratory arrest, in order to improve the success rate of emergency department CPR. Methods: The CPR cases of emergency department of Quanzhou No.1 Hospital from December 2010 to February 2014 were analyzed retrospectively. Univariate and multivariate logistic regression analysis were performed on the related factors that affect the effect of CPR. Results: In 298 cases, 75 cases (25.2%) recovered spontaneous circulation (ROSC), 41 cases (13.8%) survived 24 h, 19 cases (6.4%) survived discharge, and the prognosis of neurological function was better Survival in 9 cases (3.0%). Correlation analysis showed that CPR onset time was less than 5 min, CPR duration was less than 10 min, total epinephrine was less than 5 mg, defibrillation-induced cardiac rhythm group, ROSC rate, 24 h survival rate, survival rate, neurological outcome (P <0.05). The ROSC rate, 24 h survival rate and survival and discharge rate were higher in cardiopulmonary arrest (CA) group (P <0.05). Cardiac and medical staff Eyewitness ROSC rate and 24 h survival rate was relatively high (P <0.05); non-visceral dysfunction, day rescue resuscitation ROSC rate was relatively high (P <0.05). Conclusion: The main factors influencing CPR prognosis in emergency department of CPR patients are CPR start time and continuous time, defibrillation heart rate and age. Midterm defibrillation can affect the prognosis of neurological function better favorable factors.