2015年至2019年盐田区院外心脏骤停患者救治成功的影响因素分析和应对策略  

Influencing factors and countermeasures for successful resuscitation of out-of-hospital cardiac arrest patients in Yantian District, Shenzhen from 2015 to 2019

作　　者：郭子宾 柯学锋 余琳潇 张伟艺 张军 汪娟 Guo Zibin;Ke Xuefeng;Yu Linxiao;Zhang Weiye;Zhang Jun;Wang Juan(Emergency Department,Yantian District People's Hospital,Shenzhen 518081,China)

机构地区：[1]深圳市盐田区人民医院急诊科,广东深圳518081

出　　处：《中华卫生应急电子杂志》2024年第4期199-202,共4页Chinese Journal of Hygiene Rescue(Electronic Edition)

基　　金：深圳市盐田区科技计划项目(医疗卫生类)(YTWS2020020205)。

摘　　要：目的分析院前复苏成功的影响因素,探索本地区提高院外心脏骤停(OHCA)复苏成功率的策略。方法回顾性分析2015 年1 月1 日至2019 年12 月31 日深圳市盐田区人民医院院前出诊的所有OHCA 并行心肺复苏(CPR)的63 例患者临床资料,分析其人口统计学指标、病因、急救反应时间、初始心律、有无目击者、旁观者CPR、旁观者自动体外除颤器(AED)使用、院前高级生命支持情况等数据,分析院外生存链关键环节各因素对复苏效果的影响并探索相应应对策略。结果共纳入63 例OHCA患者,急救反应时间(14.09±6.72)min,CPR持续时间(49.40±10.61)min。院前复苏成功[恢复自主循环(ROSC)]6 例(9.5%)。与复苏无效组比较,院前ROSC 成功组在平均年龄、OHCA 发生地点、病因、初始心律、急救反应时间、目击者CPR、肾上腺素使用等方面差异有统计学意义(P<0.05)。结论盐田区OHCA 急救医疗服务体系尚欠完善,有必要进一步强化公众急救意识、加强公众急救技能培训,从而为心脏骤停患者者实施早期CPR 及早期除颤,同时科学配置AED,以进一步提升盐田区OHCA患者的抢救成功率。Objective To analyze the influencing factors of successful pre hospital recovery and to explore strategies for improving the success rate of OHCA recovery in the local area.Methods The clinical data from all out-of-hospital cardiac arrest (OHCA) patients who underwent cardiopulmonary resuscitation(CPR) were retrospectively collected during pre hospital visits at Yantian District People&apos;s Hospital in Shenzhen from January 1, 2015 to December 31, 2019. Analyses of demographic indicators, etiology,emergency response time, initial heart rate, presence or absence of witnesses, bystander CPR, use of automatic external defibrillators (AED) by bystanders, and pre hospital advanced life support status were carried out. The impact of various factors in key links of the out of hospital storage chain on resuscitation effectiveness was investigated and the corresponding response strategies were explored.Results This study included 63 patients with respiratory and cardiac arrest, with an emergency response time of (14.68 sses, bystander CPR, use of automatic external defibd expiratory volume (FEV1)), asthma control loud platform video anics and airway clearaaneous circulation (ROSC). Compared with the ineffective resuscitation group, the pre hospital ROSC successful group showed statistically significant differences in average age, location of OHCA, etiology, initial heart rhythm, emergency response time, eyewitness CPR,adrenaline use, and other aspects (P<0.05).Conclusions The emergency medical service system for OHCA in Yantian District is not perfect yet.It is necessary to further strengthen public awareness of first aid,enhance public training in first aid skills, and implement early CPR and defibrillation for patients with cardiac arrest.At the same time,AEDs should be scientifically configured to further improve the success rate of rescue for OHCA patients in the local area.

关 键 词：心脏骤停 心肺复苏 生存链 自主循环恢复 

分 类 号：R541.78[医药卫生—心血管疾病]