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目的分析影响急诊科心肺复苏(CPR)成功的因素,并寻找影响自主循环恢复(ROSC)的独立影响因素。方法以2009年3月至2012年5月院前发生的240例心脏骤停(CA)患者为研究对象,比较ROSC组和Non-ROSC组的CPR开始时间、CPR持续时间、除颤次数和肾上腺素用量等。结果全部病例ROSC成功率为42.08%,脑复苏成功率仅为3.33%。两组在年龄、性别、CPR持续时间、除颤次数上比较差异无统计学意义(P>0.05),在开始CPR时间、气管插管时间、肾上腺素累计用量方面比较差异有统计学意义(P<0.01);影响CA患者ROSC的因素有心室纤颤、无脉搏电活动、电除颤次数、肾上腺素累积剂量以及CA绝对时间。结论 CPR成功率与开始CPR时间和人工气道建立的早晚有密切关系。CA绝对时间、除颤、肾上腺素累积剂量是CA患者ROSC的独立影响因素。
Objective To analyze the factors influencing the success of emergency department cardiopulmonary resuscitation (CPR) and to find out the independent influencing factors of spontaneous circulation recovery (ROSC). Methods From March 2009 to May 2012, 240 patients with cardiac arrest (CA) before hospital were enrolled in this study. The CPR start time, CPR duration, defibrillation frequency and adrenal gland in ROSC group and Non-ROSC group were compared. Such as the amount of prime. Results The success rate of ROSC in all cases was 42.08%, and the success rate of brain resuscitation was only 3.33%. There were no significant differences in age, sex, duration of CPR and number of defibrillation between the two groups (P> 0.05). There were significant differences in CPR duration, endotracheal intubation time and total adrenaline dosage (P <0.01). Factors affecting ROSC in patients with CA included ventricular fibrillation, pulseless electrical activity, number of defibrillation, cumulative dose of adrenaline, and absolute time of CA. Conclusion The success rate of CPR is closely related to the time of onset of CPR and the establishment of artificial airway. CA absolute time, defibrillation, cumulative dose of adrenaline ROS patients with CA independent factors.