急诊科心肺复苏后患者自主循环恢复的影响因素  

Multiple factors analysis on the spontaneous circulation recovery after cardiopulmonary resuscitation in emergency department

作　　者：张春艳[1] 孟宇 池菲[1] 梁建琴 安慧茹 李香兰[1] ZHANG Chunyan;MENG Yu;CHI Fei(Emergency Department,Hebei Chest Hospital,Hebei,Shijiazhuang 050041,China;不详)

机构地区：[1]河北省胸科医院急诊科,石家庄市050041 [2]河北省石家庄市急救中心 [3]中国人民解放军总医院第八医学中心

出　　处：《河北医药》2021年第7期1009-1012,1017,共5页Hebei Medical Journal

基　　金：河北省医学科学研究重点课题计划(编号:20191017)。

摘　　要：目的探讨急诊科呼吸心跳骤停(CA)患者自主循环恢复的多因素分析。方法回顾分析急诊科2018年1月至2019年12月CA患者病例,收集相关病例中患者资料包括患者性别、年龄、既往病史、CA发生地点、CA发生时间、CPR距CA时间、首次监测心律、CPR持续时间、肾上腺素累积剂量、是否使用胺碘酮/利多卡因;一线复苏医生工作年限及复苏结果,对相关因素进行单因素和多因素logistic回归分析,从而确定影响自主循环恢复的影响因素。结果152例患者中自主循环恢复38例,单因素分析结果显示,性别、年龄、是否合并有心脏疾病、CA发生的时间、CPR持续时间、是否使用胺碘酮/利多卡因;一线复苏医生工作年限差异无统计学意义(P>0.05),而CA地点、CA可能病因、CPR开始时间、首次监测心律、肾上腺素累积剂量五项指标差异有统计学意义(P<0.05),可能影响其成功率。多因素logistic回归分析结果显示,CPR发生地点、CPR开始时间、首次监测心律、肾上腺素累积剂量四项指标是自主循环恢复的独立预测因素(P<0.05)。结论CPR发生地点、CPR开始时间、首次监测心律、肾上腺素累计剂量是影响自主循环恢复的因素。Objective To perform the multiple factors analysis on the spontaneous circulation recovery after cardiopulmonary resuscitation in patients with respiratory and cardiac arrest(CA)in emergency department.Methods The clinical data about the patients with CA who were treated in our hospital from January 2018 to December 2019 were retrospectively analyzed,including patient’s gender and age,past medical history,location of CA,occurrence time of CA,time from CPR to CA,first monitored heart rate,duration of CPR,cumulative dose of adrenaline,and amiodarone/lidocaine application as well as working years of first-line resuscitation doctors and resuscitation results.The related factors were analyzed by singlefactor and multifactor Logistic regression analysis to explore the influencing factors on the spontaneous circulation recovery.Results Of the 152 patients,there were 38 cases of spontaneous circulation recovery.The single factor analysis results showed that there were no significant differences in patient’s gender and age,combined heart disease,and time of occurrence of CA,duration of CPR,cumulative dose of adrenaline,and amiodarone/lidocaine application,as well as the working years of first-line resuscitation doctors(P>0.05),however,the CA location,possible cause of CA,time of initiation of CPR,cumulative dose of adrenaline and first monitoring of heart rhythm might affect the success rate of cardiopulmonary resuscitation(P<0.05).The results of multivariate logistic regression analysis showed that the three indicators of the place of CPR,the time of CPR initiation,cumulative dose of adrenaline and the first heart rate monitoring were independent predictive factors of spontaneous circulation recovery(P<0.05).Conclusion The location of CPR,the start time of CPR,cumulative dose of adrenaline and the first monitoring of heart rhythm are the factors that affect the spontaneous circulation recovery after cardiopulmonary resuscitation in patients with CA in emergency department.

关 键 词：心肺复苏 自主循环恢复 呼吸心跳骤停 

分 类 号：R605.974[医药卫生—急诊医学]