院内实施心肺复苏的临床预后情况及相关因素分析
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摘要
目的:分析院内实施心肺复苏的临床预后情况及相关因素。方法:采用回顾性分析方法,观察2015-01—2016-12期间院内实施心肺复苏的患者86例,根据抢救时间是否超过30min,分为短时程救治组(n=41)及长时程救治组(n=45)。观察两组患者的心肺复苏的临床预后情况,并分析影响预后的相关因素。结果:短时程救治组的复苏时间为(24.36±5.62)min,自主恢复循环共18例,明显高于长时程救治组,差异具有统计学意义(P<0.05)。年龄<60岁、第一目击者为医务工作者、意外发生在白天、抢救时间<0.5h均是影响院内实施心肺复苏预后的独立危险因素(P<0.05)。结论:院内实施心肺复苏的预后情况较差,心脏停搏的及时发现具有重要的临床意义,并且患者年龄超过60岁、第一目击者为医务工作者、意外发生在白天、抢救时间<0.5h均是影响心肺复苏预后的相关因素。
Objective:To analyze the related factors and clinical prognosis of cardiopulmonary resuscitation in hospital.Method:There were 86 patients who underwent cardiopulmonary resuscitation from January 2015 to December 2016.According to the rescue time(more than half an hour or not),the patients were the patients divided into short-term treatment group(n=41)and long-term treatment group(n=45).The clinical prognosis of cardiopulmonary resuscitation in both groups was observed and the related factors affecting prognosis were analyzed.Result:The dosage of adrenaline,recovery time,autonomic recovery cycle in the short-term treatment group were(7.34±2.36)mg,(24.36±5.62)min and 18 cases respectively.The age(no more than 60 years old),the first witnesses(medical workers),the time of the accidents(during the day),the rescue time(less than 0.5 h)are the impacts of the implementation of cardiopulmonary resuscitation in the independent prognostic factors(P<0.05).Conclusion:The prognosis of cardiopulmonary resuscitation in the hospital is poor,the timely detection of cardiac arrest has important clinical significance,and the age of patients,the first witnesses,the time of the accidents,the rescue time are factors affecting the prognosis of cardiopulmonary resuscitation.
Objective:To analyze the related factors and clinical prognosis of cardiopulmonary resuscitation in hospital.Method:There were 86 patients who underwent cardiopulmonary resuscitation from January 2015 to December 2016.According to the rescue time(more than half an hour or not),the patients were the patients divided into short-term treatment group(n=41)and long-term treatment group(n=45).The clinical prognosis of cardiopulmonary resuscitation in both groups was observed and the related factors affecting prognosis were analyzed.Result:The dosage of adrenaline,recovery time,autonomic recovery cycle in the short-term treatment group were(7.34±2.36)mg,(24.36±5.62)min and 18 cases respectively.The age(no more than 60 years old),the first witnesses(medical workers),the time of the accidents(during the day),the rescue time(less than 0.5 h)are the impacts of the implementation of cardiopulmonary resuscitation in the independent prognostic factors(P<0.05).Conclusion:The prognosis of cardiopulmonary resuscitation in the hospital is poor,the timely detection of cardiac arrest has important clinical significance,and the age of patients,the first witnesses,the time of the accidents,the rescue time are factors affecting the prognosis of cardiopulmonary resuscitation.
引文
[1]景建成,何光辉,俞作发.实施心肺复苏后临床预后及危险因素分析[J].临床急诊杂志,2017,24(6):41-43.
[2]丁旻珺,谢娟.心肺复苏自主循环恢复患者预后相关因素分析[J].实用医学杂志,2012,28(23):3956-3959.
[3]董扬.心肺复苏后自主循环恢复患者预后相关因素分析[J].中国医师进修杂志,2011,34(18):55-56.
[4]Anselmi A,Flécher E.Extracorporeal cardiopulmonary resuscitation for out-of-hospital refractory cardiac arrest:A word of caution[J].J Thorac Cardiovasc Surg,2016,151(4):1217-1218.
[5]王玉莹.影响ICU住院患者心搏骤停后综合征预后相关因素分析[J].中外医学研究,2017,15(5):116-117.
[6]胡杰,陈俊希,明政,等.重症医学科患者心搏骤停后综合征的预后相关因素分析[J].现代医药卫生,2015,14(12):1826-1827.
[7]Imataka G,Tsuboi Y,Kano Y.Treatment with mild brain hypothermia for cardiopulmonary resuscitation after myoclonic seizures in infant with robertsonian type of trisomy 13[J].Eur Rev Med Pharmacol Sci,2015,19(15):2852-2855.
[8]陈亮,余震,梅爱红,等.经心肺复苏后自主循环恢复的心搏骤停患者预后危险因素及对策[J].中华全科医学,2017,15(7):1268-1270.
[9]Bergan HA,Halvorsen PS,Skulstad H.Successful ECMO-cardiopulmonary resuscitation with the associated post-arrest cardiac dysfunction as demonstrated by MRI[J].Intensive Care Med Exp,2015,3(1):61.
[10]田建广,陆峰,解炯,等.心脏骤停患者现场心肺复苏成功影响因素分析[J].中国急救复苏与灾害医学杂志,2011,6(4):292-294.
[11]周海林.80例心肺复苏患者的抢救体会及其影响因素分析[J].中国急救医学,2015,13(12):37-38.
[12]Fink K,Moebes M,Vetter C.Selenium prevents microparticle-induced endothelial inflammation in patients after cardiopulmonary resuscitation[J].Crit Care,2015,19(1):774.
[13]张宁,董致郅,赵景成,等.71例心搏骤停患者急诊心肺复苏成功率的影响因素分析[J].北京医学,2017,39(1):48-51.
[14]孔庆钻,陈光丑,林久座,等.老年患者心肺复苏成功率影响因素分析[J].中国乡村医药,2015,14(2):62-63.
[15]廖正寿,唐云,唐诚江,等.院前心脏骤停患者心肺复苏成功相关影响因素分析[J].中国临床研究,2014,27(3):279-280.
[16]吴德军,张国辉.老年人心肺复苏影响因素分析[J].中国医药导报,2013,10(30):88-90.
[17]马坚.院前急救心肺复苏效果的影响因素分析[J].中国医药指南,2016,14(21):90-91.
[18]Arntz HR,Mochmann HC.Prognostic assessment as the basis for limiting therapy in unconscious patients after cardiopulmonary resuscitation[J].Med Klin Intensivmed Notfmed,2015,110(7):537-44.
[19]廖文权.院前急救心肺复苏效果的影响因素分析[J].中外医学研究,2011,9(19):40-41.
[20]王小刚,高丁.院前心脏骤停患者505例心肺复苏的临床体会及其成功影响因素分析[J].中国临床医生杂志,2015,28(4):39-41.
[2]丁旻珺,谢娟.心肺复苏自主循环恢复患者预后相关因素分析[J].实用医学杂志,2012,28(23):3956-3959.
[3]董扬.心肺复苏后自主循环恢复患者预后相关因素分析[J].中国医师进修杂志,2011,34(18):55-56.
[4]Anselmi A,Flécher E.Extracorporeal cardiopulmonary resuscitation for out-of-hospital refractory cardiac arrest:A word of caution[J].J Thorac Cardiovasc Surg,2016,151(4):1217-1218.
[5]王玉莹.影响ICU住院患者心搏骤停后综合征预后相关因素分析[J].中外医学研究,2017,15(5):116-117.
[6]胡杰,陈俊希,明政,等.重症医学科患者心搏骤停后综合征的预后相关因素分析[J].现代医药卫生,2015,14(12):1826-1827.
[7]Imataka G,Tsuboi Y,Kano Y.Treatment with mild brain hypothermia for cardiopulmonary resuscitation after myoclonic seizures in infant with robertsonian type of trisomy 13[J].Eur Rev Med Pharmacol Sci,2015,19(15):2852-2855.
[8]陈亮,余震,梅爱红,等.经心肺复苏后自主循环恢复的心搏骤停患者预后危险因素及对策[J].中华全科医学,2017,15(7):1268-1270.
[9]Bergan HA,Halvorsen PS,Skulstad H.Successful ECMO-cardiopulmonary resuscitation with the associated post-arrest cardiac dysfunction as demonstrated by MRI[J].Intensive Care Med Exp,2015,3(1):61.
[10]田建广,陆峰,解炯,等.心脏骤停患者现场心肺复苏成功影响因素分析[J].中国急救复苏与灾害医学杂志,2011,6(4):292-294.
[11]周海林.80例心肺复苏患者的抢救体会及其影响因素分析[J].中国急救医学,2015,13(12):37-38.
[12]Fink K,Moebes M,Vetter C.Selenium prevents microparticle-induced endothelial inflammation in patients after cardiopulmonary resuscitation[J].Crit Care,2015,19(1):774.
[13]张宁,董致郅,赵景成,等.71例心搏骤停患者急诊心肺复苏成功率的影响因素分析[J].北京医学,2017,39(1):48-51.
[14]孔庆钻,陈光丑,林久座,等.老年患者心肺复苏成功率影响因素分析[J].中国乡村医药,2015,14(2):62-63.
[15]廖正寿,唐云,唐诚江,等.院前心脏骤停患者心肺复苏成功相关影响因素分析[J].中国临床研究,2014,27(3):279-280.
[16]吴德军,张国辉.老年人心肺复苏影响因素分析[J].中国医药导报,2013,10(30):88-90.
[17]马坚.院前急救心肺复苏效果的影响因素分析[J].中国医药指南,2016,14(21):90-91.
[18]Arntz HR,Mochmann HC.Prognostic assessment as the basis for limiting therapy in unconscious patients after cardiopulmonary resuscitation[J].Med Klin Intensivmed Notfmed,2015,110(7):537-44.
[19]廖文权.院前急救心肺复苏效果的影响因素分析[J].中外医学研究,2011,9(19):40-41.
[20]王小刚,高丁.院前心脏骤停患者505例心肺复苏的临床体会及其成功影响因素分析[J].中国临床医生杂志,2015,28(4):39-41.
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