肾上腺素对创伤性心搏骤停患者短期预后的影响  

Effect of epinephrine on short-term prognosis of patients with trau-matic cardiac arrest

作　　者：杨俊 谭淑英 陈麒麟 李志立[2] 蒲丽[3] YANG Jun;TAN Shuying;CHEN Qilin;LI Zhili;PU Li(department of Emergency,the Qianjiang Central Hospital in Chongqing City,Chongqing 409099,China)

机构地区：[1]重庆市黔江中心医院急诊科,重庆409099 [2]四川省人民医院神经外科,四川成都610072 [3]苏州大学附属第二医院急诊科,江苏苏州215004

出　　处：《中国急救复苏与灾害医学杂志》2021年第10期1114-1118,共5页China Journal of Emergency Resuscitation and Disaster Medicine

摘　　要：目的分析创伤性心搏骤停(traumatic cardiac arrest,TCA)患者入院5 d后的生存状况,并探讨院内心肺复苏过程中应用肾上腺素对TCA患者短期预后的影响。方法采用回顾性研究方法,选择2014年3月-2019年9月在医院进行急救的827例TCA患者作为研究对象。根据患者入院后应用肾上腺素状况将患者分为应用组和非应用组。应用组为入院后应用肾上腺素患者,非应用组为入院后没有应用过肾上腺素患者。分析对比两组患者创伤后5 d的生存状况。结果TCA患者5天生存率3.14%;TCA患者5 d自主循环恢复(return of spontaneous circulation,ROSC)发生率8.59%。倾向得分匹配法(propensity score matching,PSM)后应用组患者的5 d生存率为0.59%,未应用组患者的5天生存率为5.33%,两组患者生存率比较,差异有统计学意义(χ^(2)=6.576,P=0.010);PSM后应用组患者的5 d ROSC发生率为20.12%,未应用组患者的5 d ROSC发生率为11.83%。两组患者ROSC发生率比较,差异有统计学意义(P=0.038)。结论在患者入院后复苏期间应用肾上腺素会降低患者入院5 d内的生存率,但可以提高其ROSC率。Objective To analyze the survival status of traumatic cardiac arrest(TCA)patients after 5 days of admission and to explore the effect of epinephrine on the short-term prognosis of TCA patients during cardiopulmonary resuscitation in hospital.Methods 827 TCA patients who received first aid in hospital from March 2014 to September 2019 were selected as the research objects after admission by retrospective study method.Patients were divided into application group and non-application group according to the application status of epinephrine.The application group was treated with epinephrine,while the non-application group was not treated with epinephrine.The survival conditions of 5 days after trauma in two groups patients were analyzed and compared.Results The 5-day survival rate of TCA patients was 3.14%.The incidence of ROSC in TCA patients at 5 days was 8.59%.The 5-day survival rate of the patients in the application group after propensity score matching(PSM)was 0.59%,and that of the patients in the non-application group was 5.33%.The difference between the two groups was statistically significant(χ^(2)=6.576,P=0.010);After PSM,the incidence of return of spontaneous circulation(ROSC)was 20.12%in the application group and 11.83%in the non-application group.The difference in ROSC incidence between the two groups was statistically significant(P=0.038).Conclusion The application of epinephrine during the recovery period after admission can reduce the survival rate of patients within 5 days after admission,but can improve the ROSC rate.

关 键 词：创伤 心搏骤停 生存 

分 类 号：R541.7[医药卫生—心血管疾病]