应用自动体外除颤器现场急救54例病案分析  

Clinical record analysis of 54 cases with automatic external defibrillator in public of China's Mainland

作　　者：陈志[1] 张元春 何小军[2] 张文中[1] 曹昱 张华 王小刚[1] 韩鹏达[1] 刘扬[1] 王坤[1] 向珍君[1] 马岳峰[2] Chen Zhi;Zhang Yuanchun;He Xiaojun;Zhang Wenzhong;Cao Yu;Zhang Hua;Wang Xiaogang;Han pengda;Liu yang;Wang Kun;Xiang Zhenjun;Zhu hong;Ma Yuefeng(Beijing Emergency Medical Center,Beijing 100031)

机构地区：[1]北京急救中心,100031 [2]浙江大学医学院附属第二医院,杭州310009

出　　处：《中华急诊医学杂志》2020年第4期608-614,共7页Chinese Journal of Emergency Medicine

基　　金：国家卫生健康委医政医管局2019年委托课题;北京市人民代表大会、北京市卫生健康委员会2018年委托专项课题。

摘　　要：目的通过分析在社会环境下使用自动体外除颤器(automated external defibrillation AED)进行现场急救的54例危重患者的临床特点,探讨在国内公共场所应用AED的可行性和有效性。方法对2014年1月至2019年4月5年间国内公共场所使用AED现场急救54例临床病案从患者和AED使用者属性、AED临床性能三个方面进行回顾性分析。结果经现场应用AED分析后,54例患者未发生院外发生心博骤停患者9例;发生心博骤停患者45例,脑复苏出院40例(88.9%),死亡5例(11.1%),其中1例为现场恢复自主循环在院内死亡。AED对可除颤节律识别及除颤建议的正确率为100%。对室颤电击成功率为97.22%,无脉性室速成功率为100%。数据显示不同品牌的AED在工作核心指标上均表现出临床有效性。施救者的操作水平影响着AED的电击关键时间,这些关键时间与患者的预后关系密切(P<0.05)。结论AED的电击决策和电击性能可靠、有效。加强人群培训,缩短电击关键时间,优化社会配置,加强运维管理可提高AED应用的整体效能。Objective To analysis the clinical characteristics of The clinical characteristics of using automated external defibrillation in the public place,To explore the feasibility and effectiveness of AED application in public places in China.Methods From January 2014 to April 5,2019,54 cases of on-site emergency medical records of AED use in public places in China were analyzed retrospectively from three aspects:patient and AED user attributes,and AED clinical performance.Results After field application of AED analysis,54 patients did not have out of hospital cardiac arrest in 9 patients;cardiac arrest in 45 patients,cerebral resuscitation in 40 patients(88.9%),death in 5 patients(11.1%),one of them died in hospital.The accuracy of AED for defibrillation rhythm recognition and defibrillation recommendations was 100%.The success rate of shock to VF was 97.22%,and that of non pulse VT was 100%.The data shows that AEDs of different brands show clinical effectiveness in the core indicators of work.The operation level of the rescuer determines the critical time of AED shock,which is closely related to the prognosis of the patient(P<0.05).Conclusions AED is reliable and effective in electric shock decision and performance.The overall efficiency of AED application can be improved by strengthening training,shortening the critical time of electric shock,rational configuration and effective management.

关 键 词：院前急救院外心搏骤停 自动体外除颤器 公共场所 

分 类 号：R45[医药卫生—治疗学]