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院外心脏骤停CPR患者自主循环恢复的影响因素分析

Analysis of factors influencing recovery of spontaneous circulation in patients with CPR after out-of-hospital cardiac arrest

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目的 探究院外心脏骤停心肺复苏术(cardiopulmonary resuscitation,CPR)患者自主循环恢复的影响因素,为提高院外心脏骤停患者的抢救成功率提供参考.方法 回顾 300 例院外心脏骤停且行CPR抢救的患者病历资料,根据抢救结果将患者分为有效组42 例和无效组258 例.比较2 组的临床资料,采用多因素Logistic回归,分析院外心脏骤停CPR患者自主循环恢复的影响因素.结果 2 组的性别、吸烟、饮酒、体重指数、除糖尿病外的既往病史、气道管理类型比较,差异无统计学意义(P>0.05);2 组的年龄、糖尿病史、目击者情况、初始心律类型、肾上腺素使用情况,以及亚低温治疗(MTH)开始时间、急救反应时间和CPR开始时间比较,差异均有统计学意义(P<0.05).多因素分析结果显示,年龄、目击者情况、肾上腺素用量、首次肾上腺素使用时间、MTH开始时间、急救反应时间和CPR开始时间,均是影响院外心脏骤停CPR患者自主循环恢复的独立因素(P<0.05).结论 急救知识的普及,以及临床注意肾上腺素使用情况、MTH开始时间、急救反应时间、CPR开始时间,或可改善院外心脏骤停患者的预后.
Objective To explore the influencing factors of return of spontaneous circulation(ROSC)in out-of-hospital cardiac arrest(OHCA)patients undergoing cardiopulmonary resuscitation(CPR),providing references for improving the success rate of resuscitation in OHCA patients.Methods A retrospective review of the medical records of 300 OHCA patients who underwent CPR was conducted,and patients were divided into an effective group of 42 cases and an ineffective group of 258 cases based on the resuscitation outcome.Clinical data of the two groups were compared,and multiple Logistic regression analysis was used to identify the influencing factors of ROSC in OHCA patients undergoing CPR.Results There was no statistically significant difference in gender,smoking,alcohol consumption,BMI,medical history(except for diabetes),and airway management type between the two groups(P>0.05).However,there were statistically significant differences in age,history of diabetes,witness status,initial rhythm type,epinephrine use,the start time of mild therapeutic hypothermia(MTH),emergency response time,and CPR start time(P<0.05).Multivariate analysis showed that age,witness status,epinephrine dosage,time of first epinephrine administration,start time of MTH,emergency response time,and CPR start time were all independent factors affecting ROSC in OHCA patients undergoing CPR(P<0.05).Conclusions The popularization of emergency knowledge,along with attention to epinephrine use,start time of MTH,emergency response time,and CPR start time in clinical practice,may improve the prognosis of OHCA patients.

out-of-hospital cardiac arrestcardiopulmonary resuscitationautonomic circulation recoveryinfluencing factor

唐传凤、韩丽云、薄喜龙

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浙江省中西医结合医院 急诊科,浙江 杭州 310022

杭州市急救中心,浙江 杭州 310009

院外心脏骤停 心肺复苏术 自主循环恢复 影响因素

2024

健康研究
杭州师范大学

健康研究

影响因子:0.823
ISSN:1674-6449
年,卷(期):2024.44(6)