基于Utstein模式的EICU心肺复苏成功相关因素分析  

Correlation Factors Influencing the Success Rate of Cardiopulmonary Resuscitation by Utstein Style Analysis in Emergency Intensive Care Unit

作　　者：王微[1] 杜育刚[1] 陈文腾[1] 宋维[1] 

机构地区：[1]海南省人民医院急诊科,海口570102

出　　处：《临床误诊误治》2014年第7期4-7,共4页Clinical Misdiagnosis & Mistherapy

基　　金：海南省自然科学基金(812150)

摘　　要：目的：应用心肺复苏（cardiopulmonary resuscitation, CPR）Utstein 模式评价急诊重症监护病房（EICU）住院患者 CPR 成功的相关影响因素。方法按照心肺复苏 Utstein 评价指南设计 CPR 注册登记表,对2011年9月—2013年9月在我院 EICU 出现心脏骤停（cardiac arrest, CA）并行 CPR 的82例进行注册登记,根据复苏结果分为自主循环恢复（ROSC）组37例和自主循环未恢复（Non-ROSC）组45例,分析影响 ROSC 成功率的相关因素。结果影响ROSC 成功率的因素有：年龄〈60岁（χ2=4．90,P =0．027）；心源性 CA（χ2=4．40,P =0．036）；CA 发生时间6：00-18：00（χ2=4．23,P =0．040）；CA 初始心率为心室颤动/室性心动过速（χ2=4．48,P =0．034）；人工通气开始时间≤5 min（χ2=4．70,P =0．030）；行气管插管（χ2=4．04,P =0．044）；肾上腺素累积用量≤5 mg（χ2=6．51,P =0．011）。结论年龄、CA 病因、CA 发生时间及形式、CPR 抢救措施是 EICU 住院患者 CPR 成功与否的重要因素。Objective To evaluate the correlation factors influencing the success rate of cardiopulmonary resuscitation （CPR） by Utstein style in inpatients in the emergency intensive care unit （EICU）. Methods The registration form was de-signed based on Utstein cardiac arrest （CA） evaluation guidelines, and 82 CA patients undergoing CPR in EICU between Sep-tember 2011 and September 2013 were registered. The patients were divided into the restoration of spontaneous circulation （ROSC） group （n = 37） and the non-ROSC group （n = 45） according to recovery results, and correlation factors influencing the ROSC success rate were also analyzed. Results The correlation factors influencing the ROSC success rate were： patient＇s age was under 60 years of ago （χ2 = 4. 90; P = 0. 027）; the CA was cardiogenic （χ2 = 4. 40; P = 0. 036）; onset time of CA was from 6：00 to 18：00 （χ2 = 4. 23; P = 0. 040）; ventricular fibrillation or ventricular tachycardia was as initial rhythm （χ2 = 4. 48; P = 0. 034）; onset time of artificial ventilation was within 5 min （χ2 = 4. 70; P = 0. 030）; endotracheal intuba-tion was performed （χ2 = 4. 04; P = 0. 044）, and accumulated epinephrine dosage was less than or equal to 5 mg （χ2 = 6. 51;P = 0. 011）. Conclusion The important factors influencing the CPR success rate of patients in EICU are age, cause of CA, onset time and form of CA and related methods of CPR rescue.

关 键 词：心脏停搏 心肺复苏术 UTSTEIN模式 重症监护病房 影响因素分析 

分 类 号：R459.7[医药卫生—急诊医学]