心搏骤停复苏后综合征患者预后的影响因素  

Prognostic Factors of Post-resuscitation Syndrome after Cardiac Arrest

作　　者：蔡志仕 黄双莲 Cai Zhishi;Huang Shuanglian(Department of Emergency,Zhangzhou Hospital Affiliated to Fujian Medical University,Zhangzhou Fujian 363000,China)

机构地区：[1]福建医科大学附属漳州市医院急诊科

出　　处：《医疗装备》2019年第24期12-13,共2页Medical Equipment

摘　　要：目的探讨心搏骤停复苏后综合征患者预后的影响因素。方法回顾性分析医院2016年3月至2019年2月收治的128例心肺复苏成功患者的临床相关资料,观察其复苏成功24h后综合征及预后情况,分析心搏骤停复苏后综合征患者的预后相关影响因素。结果128例心肺复苏成功患者24h后心搏骤停复苏后综合征发生率为81.25%(104/128),其中死亡67例,死亡率为64.42%(67/104);剩余24例未发生综合征的患者均存活。单因素分析发现,动脉血乳酸水平>2mmol/L、APACHEⅡ评分>15分、昏倒至徒手心肺复苏时间>5min、昏倒至复苏药物使用时间>5min及自主循环恢复时间>10min均是造成心搏骤停复苏后综合征患者死亡的重要因素(P<0.05);经多因素logistic回归分析发现,APACHEⅡ评分>15分、自主循环恢复时间>10min是造成心搏骤停复苏后综合征患者死亡的独立危险因素(OR>1,P<0.05)。结论APACHEⅡ评分>15分、自主循环恢复时间>10min是造成心搏骤停复苏后综合征患者死亡的独立危险因素,心搏骤停发生后应尽可能缩短救治时间,促进自主循环恢复,预防复苏后综合征的发生,进而改善患者预后。ObjectiveTo analyze the prognostic factors of patients with post-resustrial resuscitation syndrome.MethodsThe clinical data of 128 patients with successful cardiopulmonary resuscitation admitted to the hospital from March 2016 to February 2019 were retrospectively analyzed,the occurrence of syndrome after cardiac arrest resuscitation 24 hours after successful resuscitation was observed,and the prognostic factors of patients with post-cardiac resuscitation syndrome were analyzed.ResultsThe incidence of syndrome after cardiac arrest resuscitation after 24 h in 128 patients with successful cardiopulmonary resuscitation was 81.25%(104/128),of which 67 patients died and the mortality rate was 64.42%(67/104).Patients who did not have cardiac arrest and resuscitation syndrome survived.Univariate analysis found that arterial blood lactate levels were>2 mmol/L,APACHEⅡscores were>15 points,fainted to freehand CPR time>5 min,and fainted to resuscitation medication time>5 min and autonomic circulation recovery time>10 min were important factors in the death of patients with syndrome after cardiac arrest(P<0.05).Multivariate logistic regression analysis showed that APACHEⅡscore>15 points,spontaneous circulation recovery time>10 min was an independent risk factor for death in patients with syndrome after cardiac arrest(OR>1,P<0.05).ConclusionAPACHEⅡscore>15 points and spontaneous circulation recovery time>10 min are independent risk factors for death in patients with syndrome after cardiac arrest.After cardiac arrest,the treatment time should be shortened as much as possible to promote the recovery of spontaneous circulation.Prevent the occurrence of post-resuscitation syndrome,and thus improve the prognosis of patients.

关 键 词：心搏骤停复苏后综合征 预后 相关影响因素 

分 类 号：R459.7[医药卫生—急诊医学]