急诊科心搏骤停患者心肺复苏预后影响因素

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1、急诊科心搏骤停患者心肺复苏预后影响素【摘要】目的探讨急诊科心搏骤停(CA)患者心肺复苏(CPR)预后的相关影响因素。方法按Utstein模式要求登记温州医学院附属第一医院急诊科2005年1月至2011年12月期间的CPR病例，比较不同因素分组的CPR效果，对可能影响CPR预后的相关因素进行单因素和多因素Logistic回归分析。结果725例CPR病例中，自主循环恢复(R0SC)、24h存活、出院存活、神经功能良好出院存活分别为187例(25.8%)、100例(13.8%)、48例(6.6%)、23例(3.2%)。创伤性、首次监测心律、CPR

2、持续时间、肾上腺素使用剂量是影响ROSC的独立预测因素；创伤性、心源性、首次监测心律、CPR持续时间是影响24h存活的独立预测因素；CA前状态、心源性、首次监测心律、CPR持续时间是影响出院存活和神经功能良好出院存活的独立预测因素。结论可除颤心律、CPR持续时间彡15min、肾上腺素使用剂量彡5mg是影响ROSC的有利因素，创伤性是不利因素。心源性、可除颤心律、CPR持续时间彡15min是24h存活的有利因素，创伤性是不利因素。心源性、可除颤心律、CPR持续时间＜15min是出院存活和神经功能良好出院存活的有利因素，CA前为疾病终末期/多脏

3、器功能衰竭(M0F)是不利因素。【关键词】心搏骤停；心肺复苏；Utstein模式；Logistic回归分析；预后FactorsinfluencingoutcomesaftercardiopulmonaryresuscitationinemergencydepartmentXUEJi-ke*，LENGQiao-yun，GAOYu-zhi,CHENShou-quan,LIZhang-ping,LIHui-ping，HUANGWei-jia，CHENGJun-yan,ZHANGJie，HEAi~wen.*DeprtmentofEmergency,

4、TheFirstAffiliatedHospitalofWenzhouMedicalCollege,Wenzhou325000，ChinaCorrespndingauthor:CHENShou-quan,Email:csq@hospl.ac.cn【Abstract】ObjectiveToassessthefactorsimpactingoutcomesofcardiopulmonaryresuscitation(CPR)aftercardiacarrest(CA)indepartmentofemergency.MethodsACPRregi

5、stryfollowedtheUtsteintemplatewascarriedoutinDepartmentofEmergencyofTheFirstAffiliatedHospitalofWenzhouMedicalCollegefromJanuary2005throughDecember2011.TheoutcomesofCPRwerecomparedamonggroupswithvariousfactors.Theprimaryoutcomeswereratestoreturnofspontaneouscirculation(ROS

6、C)，24-hoursurvival,survivalatdischargeandsurvivalwithoutneurologicaldeficitatdischarge.Univariateandmultivariablelogisticregressionanalysiswereperformedtoevaluatefactorsassociatedwithsurvival.ResultsAtotalof725patientswithCPRattemptswereenrolledforanalysis.Ofthem,187(25.8%

7、)hadROSC，100(13.8%)survivedover24hours,48(6.6%)survivedtodischarge,and23(3.2%)survivedtodischargewithfavorableneurologicoutcome.Fromalogisticregressionanalysis，theindependentpredictorsofROSCincludedtraumatogenicCA，kindofcardiacrhythmsobservedatfirstmonitoring,CPRdurationan

8、dtotaladrenalinedose.Theindependentpredictorsof24-hoursurvivalincludedtraumatogenicCA，car