初始节律对院内心搏骤停患者出院存活的影响  

Influence of first documented rhythms on patients survived to discharge with in-hospital cardiac arrest

作　　者：陈育苗[1] 王涛 王静 赵立坤[1] 王玉霞[1] Chen Yumiao;Wang Tao;Wang Jing(Aerospace 731 Hospital,Beijing 100074)

机构地区：[1]中国航天科工集团七三一医院心内科,北京100074

出　　处：《中国现代医药杂志》2018年第6期36-38,共3页Modern Medicine Journal of China

摘　　要：目的评估初始节律对院内心搏骤停(IHCA)心肺复苏(CPR)出院存活的影响。方法采用标准的心肺复苏Utstein模式注册登记表收集我院2010年1月~2017年12月发生的IHCA患者59例,根据患者心脏骤停(CA)时监测到的心律分为可除颤心律组[室颤(VF)、无脉性室性心动过速(VT)]和不可除颤性心律组[无脉性心电活动(PEA)、心电静止(ASY)],利用χ2检验比较不同分组及不同亚组间自发循环恢复(ROSC)率及出院存活率。结果 59例IHCA并行CPR患者中,28例初始节律为可除颤心律,其中VF 27例(45.8%),VT 1例(1.7%),31例不可除颤心律中PEA 14例(23.7%),ASY 17例(28.8%),可除颤心律自主循环恢复、出院存活分别为25例(89.3%)、22例(78.6%),不可除颤心律ROSC及出院存活分别为11例(35.5%)、3例(9.7%)。χ2检验显示:可除颤心律是影响出院存活的预测因素,但可除颤心律组及不可除颤心律的亚组之间比较差异无明显统计学意义(P>0.05)。结论初始节律为可除颤心律是预测出院存活的指标,但不同亚组间对出院存活预后无明显影响。Objective To evaluate the influence of the first documented rhythm on patients survived to discharge with in-hospital cardiac arrest. Methods The clinical data of 59 in-hospital cardiac arrest patients collected fi＇om Jan 2010 to Dec 2017 were reviewed. The patients were divided into defibrillative rhythm group [ventricular fibrillation（VF）/ventricular tachyeardia（VT）] and non defibrillative rhythm group[pulseless electrical activity（PEA）/ asystole（ASY）] according to the first documented rhythm after cardiac arrest.The differences in rate of restoration of spontaneous circulation（ROSC）, number of survival at hospital discharge were compared between groups. Chi-square test was performed between two groups and subgroups. Results Of 59 indexed cardiac arrests,first documented pulseless rhythm was ventricular fibrillation（VF） in 27（45.8%）, ventricular tachyeardia（VT） in 1 （1.7%） , pulseless electrical activity（PEA） in 14（23.7%）and asystole in 17（28.8%）. Of 28 defibrillative rhythm patients,25（89.3%） had ROSC,22（78.6%） survived to discharge. Of 31 non defibrillative rhythm patients,11（35.5%） had ROSC,3（9.7%） survived to discharge. Chi-square test showed that defibrillative rhythm was related to high of ROSC rate of survived to discharge, numbers of survival at hospital discharge were higher in the defibrillative rhythm group, while there was no diference in outcomes between the VF and VT groups. There was no difference between the PEA and asystole groups. Conclusion Rate of survival at hospital discharge is higher with defibrillative initial rhythm, no difference is found between subgroups.

关 键 词：院内心搏骤停 可除颤心律 UTSTEIN模式 出院存活 

分 类 号：R541.78[医药卫生—心血管疾病]