院外医疗监护下心脏骤停318例病例分析  

Analysis on 318 cases of cardiac arrest occurring under pre-hospital medical monitor.

作　　者：陈志[1] 张雁[1] 蒋小燕[1] 罗怡[1] 吴贺君[1] 

机构地区：[1]北京急救中心,100031

出　　处：《中国急救复苏与灾害医学杂志》2012年第6期524-527,共4页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：北京市科技计划基金资助项目（D0905002000011）

摘　　要：目的分析在院外医疗监护条件下心脏骤停患者临床表现特点，探讨影响此类患者抢救成功率的相关因素。方法对2006年-2010年间北京急救中心直属急救站出诊过程中医疗监护下发生心脏骤停的318例病例进行回顾性分析。结果本组病例男203例，女105例，男女比值为1．97。其中心脏骤停发生在现场的占80．82％，发生在转运途中的占19．19％。出院存活者为41例，占12．9％；仅脑复苏成功者35例，占11．01％；持续植物生存状态者3例，占0．95％；现场自主循环恢复者67例，占38．96％；无效172例，占54．09％。去除无效患者，总有效率为45．92％，其中脑复苏总体成功率为23．9％。心脏骤停四种即刻心律中，以室颤、无脉性室速组抢救成功率明显高于无脉性电活动和心室停搏组（P〈O．01）。结论院外急救人员应将各种复苏措施综合成一个整体系统，针对不同情况优化团队复苏策略，多路径提高院外心脏骤停抢救成功率。Objective To analysis the clinical characteristics of 318 cases of cardiac arrest occurring under pre-hospital medical monitor, research and explore the factors on rescue success rate. Methods 318 cases of cardiac arrest during 2006-2010 in Beijing emergency medical center were analzed. Results In 318 cases, there were 203 males, 105 females. The ratio of CA occurred in the scene was 80.82%, occurred in transit was 19.19%. There were 41 cases（12.9%） survival; 35 cases（11.01%） were only successful brain recovery;3 cases （0.95%） were persistent vegetative status; 67 cases（38.96%） were restoration of spontaneous circulation; Invalid in 172 cases（54.09%）, the total effective rate was 45.92%, and brain recovery success rate was 23.9%. The success rate of ventricular fibrillation and pulseless ventrieular tachycardia group were higher than the PEA （pulseless electrical activity） and asystole group （P〈 O.01）in these study. Conclusion Medical rescue team should integrate all resorts of recovery measures into a whole system according to different situations optimization team recovery strategy for improving the success rescue rate for cardiac arrest.

关 键 词：院外急救 心脏骤停 医疗监护 

分 类 号：R459.7[医药卫生—急诊医学]