基于Utstein模式下的院内心脏骤停原因评价  

An analysis of the factors of in - hospital cardiac arrest based on ＂The Utstein Style＂

作　　者：王微[1] 宋维[1] 陈文腾[1] 杜育刚[1] 刘裕芬[1] 

机构地区：[1]海南省人民医院急诊科,海南海口570102

出　　处：《中国急救医学》2015年第1期24-28,共5页Chinese Journal of Critical Care Medicine

基　　金：2012年度海南省自然科学基金（812150）

摘　　要：目的以心肺复苏乌斯坦因（Utstein）评估模式评价院内心脏骤停病因、危险因素及临床特点，以期减少院内心脏骤停发生率，提高心肺复苏存活出院率。方法评价2010—01～2012—12我院院内心脏骤停心肺复苏Utstein注册登记表中的心脏骤停病例及其病种、发生时间、年龄、性别及原因等因素的分布规律。结果282例心脏骤停患者中，心源性心脏骤停123例，非心源性心脏骤停159例，医源性心脏骤停32例；其中急性心肌梗死是院内心源性心脏骤停的主要原因；创伤、低血压／休克、呼衰与低氧血症、急性中风是院内非心源性心脏骤停的主要原因；围手术期与院内转运是医源性心脏骤停的主要组成部分；既往有三种及以上系统疾病史患者更容易发生心脏骤停（P〈0．01）；夜间（23：00～05：00时段）更容易发生心脏骤停。结论急性心肌梗死是院内心源性心脏骤停的主要原因；创伤、低血压／休克、呼衰与低氧血症、急性中风是院内非心源性心脏骤停的主要原因；年龄大于60岁且具有三种及以上系统疾病史的住院男性患者易发生院内心脏骤停；加强对住院高危患者的病情监测与评估，预防和降低医源性心脏骤停，尤其是可预防性的医源性心脏骤停，对降低院内心脏骤停发生有重要作用。Objective The study mainly aims to analyze and evaluate the cause of illness, risk factors and clinical features of in - hospital cardiac arrest. Therefore, hopefully we can reduce the incidence of hospital cardiac arrest, improve cardiopulmonary resuscitation （CPR） survival rate of discharge. Methods We retrospectively analyzed and evaluated the cardiac arrest cases with Utstein registration form occurring in People＇s Hospital of Hainan Province during January 2010 and December 2012, especially the distribution regularities of entity, occurrence time, age, gender and risk factors. Results In the 282 cases, 123 cases of cardiogenic arrest, 159 cases of non - cardiogenic cardiac arrest, 32 case of iatrogenic cardiac arrest. Acute myocardial infarction is the main reason of in - hospital cardiogenic arrest. Trauma, hypotension or shock, respiratory failure and yoxemia, acute stroke are the main reasons of in - hospital non - cardiogenic cardiac arrest. Peri - operative cardiac arrest and hospital transport is the main reasons of iatrogenic cardiac arrest. Those patients who have three or more system diseases are more prone to sudden cardiac arrest （P 〈 0.01 ）. At night, especially at 23：00 to 05：00 hours are more prone to sudden cardiac arrest. Conclusion Acute myocardial infarction is the main reason of in - hospital cardiogenic arrest. Trauma, hypotension or shock, respirator）, failure and yoxemia, acute stroke are the main reasons of in - hospital non - cardiogenic cardiac arrest. Those patients who are older than 60 years and have three or more system diseases are more prone to sudden cardiac arrest. It is important to reduce the incidence rate of hospital cardiac arrest that strengthen the condition monitoring and evaluation of high - risk patients, prevent and reduce iatrogenic cardiac arrest,especially preventable iatrogenic cardiac arrest.

关 键 词：Utstein评估模式 院内心脏骤停 心肺复苏 医源性心脏骤停 可预防性 

分 类 号：R541.78[医药卫生—心血管疾病]