68例院前体外电除颤病例临床分析  

Analysis of the defibrillation in sixty-eight patients in pre-hospital first aid

作　　者：李国明[1] 彭玉维[1] 邹剑 Li Guoming;Peng Yuwei;Zou Jian(Department of Emergency,Central Hospital of Jiangmen,Jiangmen,Guangdong 529030,China)

机构地区：[1]江门市中心医院急诊科,广东江门529030

出　　处：《医药前沿》2020年第17期18-20,共3页Journal of Frontiers of Medicine

基　　金：江门市科技局项目(2019A090)。

摘　　要：目的:分析院前急救时影响体外电除颤成功的因素,提高院前急救心肺复苏的质量。方法:对自2016年1月—2017年12月68例院外心搏骤停(SCA)施行体外电除颤的患者进行分析。记录心搏骤停至急救人员到达时间、心搏骤停至心肺复苏启动时间、心搏骤停至电除颤时间;记录是否有目击者进行及时心肺复苏、电除颤前后心电图、胺碘酮运用,记录除颤成功率、自主循环恢复(ROSC)率。结果心搏骤停至急救人员到达时间>10min组与5~10min组相比,除颤成功率和ROSC率明显降低,差异有统计学意义(P<0.05);心搏骤停至急救人员到达时间5~10min组与<5min组相比,除颤成功率和ROSC率也明显降低,差异有统计学意义(P<0.05)。SCA至CPR、SCA至电除颤>10min组与5~10min组相比,除颤成功率和ROSC率明显降低,差异有统计学意义(P<0.05);SCA至CPR、SCA至电除颤5~10min组与<5min组相比,除颤成功率和ROSC率也明显降低,差异有统计学意义(P<0.05)。室颤的波幅大于0.5mV,除颤成功率高于≤5mv者(P<0.01);除颤成功后运用胺碘酮,自主循环恢复率高于不同者(P<0.01)。结论:心肺复苏启动越早,电除颤越早,电除颤效果越好,自主循环恢复率越高;室颤波的振幅越高,除颤成功率越高;除颤成功后运用胺碘酮,自主循环恢复率可能提高。Objective To analyse the influence factors of defibrillation in Pre-hospital first aid so as to improve the quality of pre-hospital cardio-pulmonary resuscitation(CPR).Methods 68 patients who were treated by defibrillation in Pre-hospital first aid were selected from January 1st,2016 to December 31st,2017.recording the time from sudden cardiac arrest(SCA)to the arrival of first-aid personnel,the time from SCA to beginning of CPR,the time from SCA to beginning of defibrillation.recording the patients with eyewitness who were involved in Pre-hospital first aid.Recording the electrocardiogram before and after defibrillation.recording the patients used amiodarone.recording the patients with success in defibrillation and restoration of spontaneous circulation(ROSC).Results The outcome was different when the different time(>10min、5~10min)from SCA to the arrival of first-aid personnel(P<0.05);The outcome was different when the different time(5~10min、<5min)from SCA to the arrival of first-aid personnel(P<0.05);The outcome was different when the different time(>10min、5~10min)from SCA to beginning of CPR(P<0.05);The outcome was different when the different time(5~10min、<5min)from SCA to beginning of CPR.The same outcome was found at the different time from SCA to beginning of defibrillation.The chance of success in defibrillation was higher when the VF amplitude was more than 0.5mV.ROSC was probably higher if the patients were used amiodarone during CPR.Conclusion The effect was better when the time from SCA to beginning of CPR and defibrillation was shorter.The chance of success in defibrillation was higher when the VFamplitude was more than 0.5mV.ROSC was probably higher if the patients were used amiodarone during CPR.

关 键 词：心脏骤停 心肺复苏 室颤 电除颤 自主循环恢复 

分 类 号：R541[医药卫生—心血管疾病]