急诊心脏骤停病例自主循环恢复预后相关因素分析  

Analysis of Prognostic Factors in Cases of Restoration of Spontaneous Circulation after Cardiopulmonary Resuscitation in Emergency Department

作　　者：齐守罡[1] QI Shou-gang(Emergency Department,DaTong Third People's Hospital,DaTong,ShanXi,037008)

机构地区：[1]山西省大同市第三人民医院急诊科,037008

出　　处：《岭南急诊医学杂志》2022年第4期310-313,共4页Lingnan Journal of Emergency Medicine

摘　　要：目的:探讨急诊心肺复苏病例自主循环恢复(restoration of spontaneous circulation,ROSC)后两种不同预后(神经功能较好出院)、预后不良(死亡+神经功能预后不良)的相关因素比较。方法:回顾性分析我院急诊科心肺复苏后ROSC病例49例,比较康复组(17例)与预后不良组(32例)在CA发生地点、CA至CPR开始时间、CPR持续时间、可除颤心律、肾上腺素用量等方面的差异,找出神经功能较好出院的影响因素。结果:两组比较,在CA发生地点、CA至CPR开始时间、CPR持续时间、可除颤心律、肾上腺素用量、心源性病因、急诊PCI、CPR时间等方面存在统计学差异(P<0.05),二元logistic回归分析显示急诊PCI为神经功能较好出院的独立影响因素(P<0.05)。结论:CA病例,早期心肺复苏,有利于良好预后;CPR持续时间长、肾上腺素用量大,可能与不良预后相联系;可除颤心律、ACS病例自主循环恢复后更容易预后良好;急性心梗CA病例,ROSC后及时行PCI(急诊经皮冠状动脉介入治疗)治疗,有利于康复出院。Objective:To explore the comparison of two different outcomes after restoration of spontaneous circulation(ROSC)in emergency cardiac arrest(CA)cases.Methods:Retrospective analysis on 49 cases of restoration of spontaneous circulation(ROSC)after cardiopulmonary resuscitation(CPR)in emergency department of Datong Third People’s Hospital was conducted. To compare the difference of two groups(rehabilitation group)(good neurological discharge,17cases)and poor prognosis group(32 cases)in CA location,CA to CPR start time,CPR duration,defibrillable heart rhythm,adrenaline dosage,cardiogenic etiology and emergency PCI. The relevant factors of CPR were analyzed.Results:Two groups differ(P<0.05)in CA location,CA to CPR start time,CPR duration,defibrillable heart rhythm,adrenaline dosage,cardiogenic etiology and emergency PCI. Binary logistic regression analysis showed that emergency PCI was an independent impacting factor for better neurological discharge in ROSC cases.Conclusion:The earlier cardiopulmonary resuscitation,the better the prognosis after CA. CPR duration,adrenaline dosage,may be associated with poor prognosis. Defibrillable heart rhythm,cardiac etiology,ACS cases may be more good neurological survival after ROSC,especially ventricular fibrillation caused by acute myocardial infarction. Timely PCI treatment can make more patients of acute myocardial infarction suffering CA after defibrillation and ROSC rehabilitation discharge.

关 键 词：心肺复苏 自主循环恢复 二元logistic回归分析急诊PCI 

分 类 号：R459.7[医药卫生—急诊医学]