基于Utstein模式的1270例院外心脏骤停患者心肺复苏结果分析  

Analysis of cardiopulmonary resuscitation outcome of 1270 cases of out-of-hospital cardiac arrest based on Utstein resuscitation registry templates

作　　者：董蓓蕴 陈志科 罗瑞明 潘满冬[2,4] 林吉怡 邓龙华 纪实现 寇鹏飞 DONG Beiyun;CHEN Zhike;LUO Ruiming;PAN Mandong;LIN Jiyi;DENG Longhua;JI Shixian;KOU Pengfei(Xiamen Emergency Medical Center,Xiamen Fujian 361021,China)

机构地区：[1]厦门市医疗急救中心,福建厦门361021 [2]厦门大学附属第一医院,福建厦门361003 [3]厦门大学附属心血管病医院,福建厦门361016 [4]厦门市急诊急救质量控制中心,福建厦门361021 [5]厦门市胸痛质量控制中心,福建厦门361016

出　　处：《中国急救复苏与灾害医学杂志》2024年第12期1568-1571,共4页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：福建省自然科学基金面上项目(编号:2021J011357);厦门市科技计划项目(编号:3502Z20224008)。

摘　　要：目的分析厦门地区院外心脏骤停(OHCA)患者行心肺复苏(CPR)的结果,为提高本地区OHCA患者心肺复苏(CPR)成功率提供依据。方法参照Utstein模式设计电子病历模板,回顾性收集2024年2月1日—2024年7月31日厦门地区发生并由120诊治的1270例OHCA患者相关临床资料。依据是否尝试做CPR分为尝试CPR组(n=677)与未尝试CPR组(n=593)。在尝试CPR组中,根据是否有自主循环恢复(ROSC)分为两个亚组:ROSC组(n=62)与无ROSC组(n=615)。收集患者临床资料、中心信息调派系统、电子病历及院内就诊记录,相关资料参照Utstein模式进行分组统计,采用两样本t检验、多个样本率比较χ^(2)检验统计学方法,了解OHCA流行病学特征,分析复苏成功的影响因素。结果1270例OHCA患者纳入研究,其中男性863例(67.95%)、女性407例(32.05%),平均年龄(60.50±18.60)岁;行CPR 677例(53.31%),心肺复苏ROSC成功率为9.16%(62/677),出院存活率6.79%(46/677),有较好神经功能(CPC)表现(CPC 1~2级)的出院存活率2.51%(17/677)。尝试CPR组院前急救反应时间显著小于未尝试CPR组(t=5.009,P<0.05),男性患者比例高于未尝试CPR组(χ^(2)=5.787,P=0.016);但在尝试CPR组中,ROSC组与无ROSC组急救反应时间、男性患者比例均无统计学意义(t=1.034,P=0.301;χ^(2)=2.116,P=0.146)。OHCA患者尝试CPR主要病因为内科疾病(76.96%)和创伤(9.60%),发生地点主要在居住地(64.99%)和公共场所(7.83%)。OHCA患者ROSC旁观者参与CPR比例为64.51%,旁观者使用AED比例为6.45%,EMS首次监测到的心律为窦性停搏(直线)(53.33%)。结论厦门地区OHCA患者CPR成功率稍高于国内其他地区,但较发达国家还有很大的差距。Objective To study the epidemiological characteristics of patients with out-of-hospital cardiac arrest(OHCA)in Xiamen and the factors affecting successful resuscitation,in order to provide comparative evidence for improving the ROSC rate of OHCA Patients cardiopulmonary resuscitation(CPR)in Xiamen region.Methods Design an electronic medical record(EMR)collection template based on the Utstein model,and collect the OHCA patients’information treated by EMS,that occurred from February 1,2024 to July 31,2024 in Xiamen.To study the epidemiological characteristics of 1270 patients with out-of-hospital cardiac arrest(OHCA)in Xiamen and the factors affecting successful resuscitation.The data was obtained from the dispatch information system EMR and in-hospital medical records.Relevant data is grouped and analyzed using the Utstein model,and statistical methods such as two sample T-test and multiple sample rate comparison chi-square-test are used to analyze the influencing factors of ROSC in OHCA.Results A total of 1270 patients with OHCA were included in the study,including 863 males(67.95%)and 407 females(32.05%),with an average age of(60.50±18.60)years.CPR was performed in 677 patients(53.31%).The success rate of ROSC was 9.16%(62/677).The survival rate at discharge was 6.79%(46/677).The pre-hospital emergency response time of the attempted CPR group was significantly shorter than that of the non-attempted CPR group(t=5.009,P<0.05),and the proportion of male patients was higher than that of the non-attempted CPR group(χ^(2)=5.787,P=0.016).However,in the CPR group,there was no significant difference in the first aid response time and the proportion of male patients between the ROSC group and the non-ROSC group(t=1.034,P=0.301;χ^(2)=2.116,P=0.146).The survival rate at discharge with good neurological function(CPC 1-2)was 2.51%(17/677).The main causes of attempted CPR in OHCA patients were medical diseases(76.96%)and trauma(9.60%),and the main sites were residence(64.99%)and public places(7.83%).The proportion of ROSC

关 键 词：UTSTEIN模式 院外心脏骤停 心肺复苏 结果 分析 

分 类 号：R541.78[医药卫生—心血管疾病] R459.7[医药卫生—内科学]