院外心脏骤停患者预警症状分析及预后价值评估的临床研究  

Clinical study on early warning symptoms and prognostic value evaluation of out-of-hospital cardiac arrest patients

作　　者：隗沫 顾伟[1] 钟洁 潘兴邦 Wei Mo;Gu Wei;Zhong Jie;Pan Xingbang(Emergency Medicine Center,Chuiyangliu Hospital Affiliated to Tsinghua University,Beijing,China)

机构地区：[1]清华大学附属垂杨柳医院急诊科

出　　处：《实用休克杂志（中英文）》2023年第6期342-345,共4页Journal of Practical Shock

基　　金：首都临床特色诊疗技术研究及转化应用(项目编号:Z221100007422129);北京市临床重点专科培育项目资助(2023)。

摘　　要：目的院外心脏骤停前的预警症状分析及预后价值评估。方法回顾性收集2019年1月至2022年12月清华大学附属垂杨柳医院急诊科收治的200例院外心脏骤停患者,对预警症状类型特点、发作时间进行比较。按发病前4周内有无预警症状,分为A、B两组,分析两组危险因素、基础病史的关系。按出现预警症状后是否拨打120分成C、D两组,比较两组症状特点、获得现场心肺复苏情况及与预后的关系。结果在院外心脏骤停发生前1h和1~24h内发生的预警症状例数较多,其中胸痛和呼吸困难在不同时间段的发生比例均较高,差异有统计学意义(P<0.05)。A组存在糖尿病、高脂血症、吸烟史及冠心病史的例数高于B组,差异有统计学意义(P<0.05)。比较C组以胸痛为预警症状的患者数、获得现场CPR的例数及CPR成功率均高于D组,差异有统计学意义(P<0.05)。结论院外心脏骤停发生前常有预警症状,由以胸痛症状多见,并与心脏基础疾病及心血管疾病危险因素相关。早期识别预警症状,尽快启动应急救助系统并有效干预可改善患者预后。Objective To explore the analysis of early warning symptoms before out-of-hospital cardiac arrest(OHCA)and the evaluation of prognostic value.Methods A retrospective study was conducted to collect 200 patients with OHCA admitted to the emergency department of the Chuiyangliu Hospital affiliated to Tsinghua University from January 2019 to December 2022,and to compare the characteristics of the early warning symptoms and the onset time.Divide the patients into two groups based on whether they had warning symptoms within 4 weeks before the onset of OHCA,and analyze the relationship between risk factors and basic medical history in the two groups.Divide the patients into two groups based on whether they called 120 after experiencing the warning symptoms,and compare the characteristics of the symptoms,the availability of on-site cardiopulmonary resuscitation,and the relationship between the symptoms and prognosis in the two groups.Results The number of early warning symptoms occurring within 1 hour and 1~24 hours before the onset of OHCA was higher,with a higher proportion of chest pain and dyspnea occurring at different time periods,with significant differences(P<0.05).The number of cases with diabetes,hyperlipidemia,smoking history,and history of coronary heart disease in group A was higher than that in group B,with a statistically significant difference(P<0.05).The number of patients with chest pain as a warning symptom,the number of cases receiving on-site CPR,and the success rate of CPR in group C were higher than those in group D,with significant differences(P<0.05).Conclusions There are often early warning symptoms before OHCA occurs,with chest pain being the most common symptom,and it is associated with underlying heart disease and cardiovascular risk factors.Early recognition of early warning symptoms before OHCA,as well as the prompt activation of emergency rescue systems and effective intervention can improve patient outcomes.

关 键 词：院外心脏骤停 预警症状 胸痛 预后 

分 类 号：R541.78[医药卫生—心血管疾病]