心肺复苏成功患者发生心血管衰竭的影响因素研究  

Influence Factors for Cardiovascular Failure Following Successful Cardiopulmonary Resuscitation

作　　者：薛乾隆[1] 贺英[2] 岳秉宏[1] 韩树池[1] 陈艳梅[1] 高继英[1] 张秀谦[1] 

机构地区：[1]河北北方学院附属第一医院急诊科,张家口市075000 [2]河北北方学院附属第一医院妇产科,张家口市075000

出　　处：《广西医学》2014年第6期733-735,共3页Guangxi Medical Journal

基　　金：河北省张家口市科学技术研究与发展指导计划(1221078D)

摘　　要：目的探讨心肺复苏成功患者发生心血管衰竭的影响因素,以期为患者的预后提供理论依据。方法根据心肺复苏自主循环恢复(ROSC)后是否出现心血管衰竭将患者分为心血管衰竭组75例和非心血管衰竭组31例。收集两组患者年龄、性别、心血管病史、心肺复苏时间以及复苏前生命体征等资料,对两组患者临床资料进行对比分析。结果两组患者年龄、性别及心血管病史差异无统计学意义(P均>0.05);心血管衰竭组患者死亡率明显高于非心血管衰竭组(P<0.05);心血管衰竭组患者APACHEⅡ评分为(30.54±8.49)分、SOFA评分为(14.65±5.14)分,均明显高于非心血管衰竭组的(19.74±9.76)分及(6.49±4.56)分(P<0.05)。心血管衰竭组发病初始可除颤心律比例明显低于非心血管衰竭组(P<0.05)。logistic回归分析显示,复苏持续时间、复苏前存在全身炎症反应综合征(SIRS)、复苏前血糖紊乱均为患者发生早期心血管衰竭的独立影响因素。结论复苏持续时间、复苏前存在SIRS以及复苏前血糖紊乱均是患者发生早期心血管衰竭的独立影响因素。Objective To explore the influence factors for cardiovascular failure following successful cardiopulmonary resuscitation to provide a theoretical basis for the patients′prognosis .Methods The patients with cardiovascular failure following resumption of spontaneous circulation （ ROSC ） were enrolled in cardiovascular failure group,and the patients without cardiovascular failure following ROSC were enrolled in non -cardiovascular failure group . The data of patient′s age ,gender ,history of cardiovascular disease ,cardiopulmonary resuscitation duration and vital signs before recovery were collected in both groups ,and the clinical data were analyzed .Results Age,gender and history of cardiovascular disease showed no significant difference between two groups （all P〉0.05）.The mortality in the cardiovascular failure group was significantly higher than that in the non-cardiovascular failure group （ P〈0.05）.The APACHEⅡscore and SOFA score in the cardiovascular failure group were significantly higher than those in the non -cardiovascular failure group[（30.54 ±8.49） vs.（19.74 ±9.76）,（14.65 ±5.14） vs.（6.49 ±4.56）,P〈0.05].The proportion of patients in initial onset of correctable cardiac dysrhythmia in the cardiovascular failure group was lower than that in the non-cardiovascular failure group （ P〈0.05） .Logistic regression analysis suggested that recovery duration ,systemic inflammatory response syndrome （ SIRS ） before recovery , blood glucose disorders before recovery were independent influence factors for early cardiovascular failure .Conclusion Recovery duration , SIRS and blood glucose disorders before recovery are independent risk factors for early cardiovascular failure .

关 键 词：心肺复苏 心脏停搏 心血管衰竭 危险因素 

分 类 号：R541.7[医药卫生—心血管疾病]