院内成人心脏骤停患者心肺复苏抢救成功率的影响因素及与预后关系的分析  

Analyze the factors influencing the success rate of cardiopulmonary resuscitation in adult patients with cardiac arrest in hospital and the relationship with prognosis

作　　者：张杰[1] 李波[1] 吴海鹰[1] 板相换 豆晓宁 刘敏[1] ZHANG Jie;LI Bo;WU Haiying;BAN Xianghuan;DOU Xiaoning;LIU Min(Department of Emergency,the First Affiliated Hospital of Kunming Medical University,Kunming,650032,China)

机构地区：[1]昆明医科大学第一附属医院急诊医学科EICU,昆明650032

出　　处：《临床急诊杂志》2024年第11期574-578,共5页Journal of Clinical Emergency

基　　金：云南省高层次卫生技术人员(领军人才)(No:KYWHY20210617)。

摘　　要：目的:分析院内成人心脏骤停患者心肺复苏抢救成功率的影响因素以及与预后的关系。方法:收集本院2023年1月1日-12月31日成人心脏骤停患者资料,根据ROSC是否恢复分为ROSC有效组和无效组,分析两组患者的心脏骤停发生率、ROSC率、24 h存活率、7 d及28 d神经功能恢复情况;同时分析影响ROSC恢复的因素。结果:230例年龄≥14岁的院内心脏骤停患者中,按照纳入及排除标准,最终110例纳入研究,64例ROSC成功,ROSC恢复率为58.18%;与ROSC无效组相比,ROSC有效组基础疾病(尤其是呼吸系统疾病)占比更低[14(21.88%)vs.19(41.3%)],复苏持续时间更短[14.50(5.00,23.00) vs.48.50(32.25,64.50)],发生院内心脏骤停次数更少,心脏骤停发生及实施地点主要在ICU,差异均有统计学意义(P<0.05)。经二分类logistic回归分析:心脏骤停发生地点及实施地点、呼吸系统疾病、复苏持续时间、院内心脏骤停次数是心肺复苏抢救成功率的影响因素(P<0.05)。结论:基础疾病(尤其是呼吸系统疾病)、心脏骤停发生地点及实施地点、复苏持续时间、院内心脏骤停次数均影响IHCA患者心肺复苏抢救成功率。同时应加强处理重症监护病房以外的临床科室CPR质量和团队抢救效率,以提高抢救成功率。Objective:To analyze the factors affecting the success rate of cardiopulmonary resuscitation in adult patients with cardiac arrest in hospitals and the relationship with prognosis.Methods:The data of adult patients with cardiac arrest in our hospital from January 1 to December 31,2023 were collected and divided into ROSC effective group and ineffective group according to whether ROSC was recovered.The incidence of cardiac arrest,ROSC rate,24-hour survival rate,7-day and 28-day recovery of neurological function of the two groups were analyzed.The factors affecting the recovery of ROSC were analyzed.Results:Among 230 patients with in-hospital cardiac arrest aged ≥14 years,110 cases were included in the study according to inclusion and exclusion criteria,64 cases were ROSC successful,and the ROSC recovery rate was 58.18%.Compared with the ROSC ineffective group,the ROSC effective group had a lower proportion of underlying diseases(especially respiratory diseases) [14 cases(21.88%) vs.19(41.3%) ],and the duration of resuscitation was shorter[14.50(5.00,23.00) vs.48.50(32.25,64.50) ].The number of in-hospital cardiac arrest was less,and the place of occurrence and implementation of cardiac arrest were mainly in ICU,the difference was statistically significant(P<0.05).Binary logistic regression analysis showed that the place of occurrence and execution of cardiac arrest,respiratory disease,duration of resuscitation and number of cardiac arrest in hospital were the factors influencing the success rate of cardiopulmonary resuscitation(P<0.05).Conclusion:Underlying diseases(especially respiratory diseases),place of occurrence and execution of cardiac arrest,duration of resuscitation and number of cardiac arrest in hospital all affect the success rate of cardiopulmonary resuscitation in patients with IHCA.At the same time,the quality of CPR and the efficiency of team rescue in clinical departments other than intensive care units should be strengthened to improve the success rate of rescue.

关 键 词：心脏骤停 心肺复苏 发生率 存活率 自主循环恢复率 

分 类 号：R541.7[医药卫生—心血管疾病]