儿童重症监护病房心搏骤停患儿心肺复苏短期预后影响因素分析  

Analysis on influencing factors of short-term prognosis of cardiopulmonary resuscitation among children with sudden cardiac arrest in Pediatric Intensive Care Unit

作　　者：李文艳[1] 刘淑芳[1] 张新春[1] 赵录利 孙艳萍[1] 赵敏[1] 

机构地区：[1]宝鸡市妇幼保健院,陕西宝鸡721000

出　　处：《中国妇幼保健》2018年第1期129-132,共4页Maternal and Child Health Care of China

摘　　要：目的探讨儿童重症监护病房(PICU)心搏骤停前和心肺复苏实施中的各种因素对心肺复苏短期预后的影响。方法选择2014年1月-2017年3月宝鸡市妇幼保健院儿童重症监护病房治疗的86例心搏骤停患儿为研究对象,收集系统因素、心搏骤停前干预措施和心肺复苏干预措施,以心肺复苏成功作为终点指标。采用多因素Logistic回归分析心肺复苏失败的相关因素。结果 86例心搏骤停患儿心肺复苏成功55例(64.0%),单因素分析显示,不同入住重症监护病房时间,心搏骤停前是否中应用镇静药物、心静脉通路,心肺复苏实施中是否接受气管插管、正压通气、胸外按压、补碱,不同心肺复苏工作时长患儿心肺复苏失败率比较,差异均有统计学意义(P<0.05)。通过多因素分析发现,心搏骤停前应用镇静药物,心肺复苏实施中接受正压通气、胸外按压、补碱,心肺复苏工作时长与心肺复苏失败有回归关系(P<0.05)。结论对于儿童重症监护病房心搏骤停患儿,其在心搏骤停前应用镇静药物以及心肺复苏过程中接受正压通气者心肺复苏失败率低,其在心肺复苏过程中接受补碱者、胸外按压者以及心肺复苏工作时长≥30 min者的心肺复苏失败率高;对于因为呼吸因素导致出现心搏骤停的患儿,应该及时进行正压通气,危重症患儿应该保持内环境的稳定,且临床医生尽可能进行长时间的心肺复苏。Objective To explore the effects of various factors on short-term prognosis of cardiopulmonary resuscitation among children with sudden cardiac arrest before onset of sudden cardiac arrest and in the course of cardiopulmonary resuscitation. Methods Eighty-six children with sudden cardiac arrest treated in Pediatric Intensive Care Unit of Baoji Municipal Maternal and Child Health Care Hospital from January 2014 to March 2017 were selected,the system factors,intervention measures before onset of sudden cardiac arrest,and intervention measures of cardiopulmonary resuscitation were collected,success of cardiopulmonary resuscitation was the end point indicator. Multivariate logistic regression analysis was used to analyze the relevant factors of cardiopulmonary resuscitation failure. Results Among 86 children with sudden cardiac arrest,cardiopulmonary resuscitation was successful in 55 children（ 64. 0%）. Univariate analysis showed that there were statistically significant differences in the failure rate of cardiopulmonary resuscitation among the children with different admission time of Pediatric Intensive Care Unit,using sedative drugs and heart venous access before sudden cardiac arrest or not,receiving endotracheal intubation,positive pressure ventilation,external chest compression,and alkali supplementation in the course of cardiopulmonary resuscitation or not,different time of cardiopulmonary resuscitation（ P0. 05）. Multivariate analysis showed that using sedative drugs before sudden cardiac arrest,receiving positive pressure ventilation,external chest compression,and alkali supplementation in the course of cardiopulmonary resuscitation,long time of cardiopulmonary resuscitation were correlated with cardiopulmonary resuscitation failure（ P 0. 05）.Conclusion For the children with sudden cardiac arrest in Pediatric Intensive Care Unit,cardiopulmonary resuscitation failure rates are low among the children using sedative drugs before sudden cardiac arrest and positive pressure ventilation in the course of

关 键 词：心搏骤停 心肺复苏 儿童重症监护病房 正压通气 机械通气 

分 类 号：R715.8[医药卫生—妇产科学]