早期气管插管对成人院内心搏骤停患者自主循环恢复及存活出院率的影响  

Early endotracheal intubation affects the return of spontaneous circulation and survival rate in adult patients with in-hospital cardiac arrest

作　　者：丁智颖 朱甜甜 赵勇[1] 张阿芳[1] 包华瑞 潘琳琳 何媛媛 方芳[1] 张泓[1] DING Zhiying;ZHU Tiantian;ZHAO Yong;ZHANG Afang;BAO Huarui;PAN Linlin;HE Yuanyuan;ZHANG Hong;FANG Fang(Emergency Department,the First Affiliated Hospital of Anhui Medical University,Hefei 230022,China)

机构地区：[1]安徽医科大学第一附属医院急诊科,安徽合肥230022

出　　处：《安徽医学》2024年第7期836-841,共6页Anhui Medical Journal

基　　金：中央财政专项经费(编号:2018FY100600)。

摘　　要：目的分析早期气管插管对成人院内心搏骤停(IHCA)患者自主循环恢复(ROSC)及存活出院率的影响。方法选取2019年11月至2020年10月在安徽医科大学第一附属医院发生院内心搏骤停的423例患者,根据抢救期间是否行气管插管分为气管插管组(263例)和非气管插管组(160例),其中气管插管组又分为15分钟内气管插管组(118例)和超过15分钟气管插管组(145例)。采用单因素比较和多因素logistic回归分析15分钟内气管插管组、超过15分钟气管插管组与非气管插管组患者ROSC和存活出院率的差异及相关影响因素。结果15分钟内气管插管组118例患者中ROSC的患者为36例,恢复率为30.51%;超过15分钟气管插管组145例患者中ROSC的患者为43例,恢复率为29.65%;而非气管插管组160例患者中ROSC的患者为30例,恢复率为18.75%,15分钟内气管插管组、超过15分钟气管插管组与非气管插管组患者恢复率比较,差异均有统计学意义(P<0.05)。15分钟内气管插管组118例患者中存活出院为55例,存活出院率为46.61%;超过15分钟气管插管组145例患者中存活出院为48例,存活出院率为33.10%;而非气管插管组160例患者中存活出院为49例,存活出院率为30.63%,15分钟内气管插管组与非气管插管组患者存活出院率比较,差异有统计学意义(P<0.05)。多因素logistic回归分析显示患者的初始心率、是否有旁观者、15分钟内气管插管、长期居住地、有无入住ICU、是否存在低血压/休克、是否存在严重创伤,均是影响患者存活出院率的因素。结论气管插管时机影响成人IHCA患者ROSC及存活出院率,其中15分钟内气管插管组的ROSC率和存活出院率均高于非气管插管组。Objective To analyze the effects of early endotracheal intubation on the return of spontaneous circulation(ROSC)and sur⁃vival rate in adult patients with cardiac arrest in hospital.Methods A total of 423 patients with cardiac arrest in the First Affiliated Hospital of Anhui Medical University from November 2019 to October 2020 were divided into the endotracheal intubation group(263 cases)and nonendotracheal intubation group(160 cases).The endotracheal intubation group was also divided into the endotracheal intubation group within 15 minutes(118 cases)and the endotracheal intubation group more than 15 minutes(145 cases).Univariate comparison and multivariate logis⁃tic regression were used to analyze the differences in ROSC,survival rate and related influencing factors between the tracheal intubation group and non-tracheal intubation group.Results Altogether 36 of 118 patients in the endotracheal intubation group within 15 minutes achieved ROSC,and the recovery rate was 30.51%;43 of 145 patients in the endotracheal intubation group within more than 15 minutes achieved ROSC,and the recovery rate was 29.65%.In comparison,30 of 160 patients in the non-endotracheal intubation group achieved ROSC,with a recovery rate of 18.75%.The difference between the tracheal intubation groups within 15 minutes,endotracheal intubation group more than 15 minutes and non-tracheal intubation group were statistically significant(P<0.05).In the tracheal intubation group within 15 minutes,55 of the 118 pa⁃tients survived,with a survival rate of 46.61%;48 of 145 patients in the endotracheal intubation group more than 15 minutes survived,with a survival rate of 33.10%.Among the 160 patients in the non-tracheal intubation group,49 patients survived,with a survival rate of 30.63%.There was significant difference between the tracheal intubation group within 15 minutes and non-tracheal intubation group(P<0.05).Multi⁃variate logistic regression analysis showed that initial heart rate,presence of bystanders,tracheal intubation group within

关 键 词：院内心搏骤停 气管插管 自主循环恢复 预后 回顾性队列研究 

分 类 号：R459.7[医药卫生—急诊医学]