标题：院前心脏骤停患者心肺复苏抢救成功的影响因素

      作者：马剑飞，宋巧玲，屈纪富    陆军军医大学大坪医院急诊医学科，重庆 400042

      卷次： 2019年30卷1期

      【摘要】 目的 分析影响急诊科心脏骤停患者院前心肺复苏成功的因素。方法 回顾性分析2016年1月至2018年3月陆军军医大学大坪医院110例接受院前心肺复苏抢救的心脏骤停患者的临床资料，根据抢救结果将患者分为成功组(42例)和未成功组(68例)，比较两组患者的临床资料，采用Logistic回归分析对院前心肺复苏成功的影响因素进行分析。结果 在所有导致心脏骤停原因中，心源性原因患者复苏成功率最高，占45.12%，其次为中枢神经系统，占 27.27%；车祸所占比例较低，为 12.5%。成功组与未成功组患者心脏骤停绝对时间[(18.62±8.05) min vs(24.05±9.34) min]、开始抢救时间[(5.64±1.48) min vs (9.26±1.94) min]、气管插管时间[(6.18±2.94) min vs (10.14±4.16) min]和肾上腺素累积用量[(8.34±5.48) mg vs (18.38±9.64) mg ]比较，差异均有统计学意义(P<0.05)；Logistic回归分析结果显示，心源性疾病、心室纤颤、无脉搏电活动、应用电除颤和肾上腺素用量<4 mg是心肺复苏抢救成功的影响因素(P<0.05)。结论 院前心脏骤停患者心肺复苏成功的影响因素多且复杂，需要同时建立多项措施以减少各类危险因素的发生。
      【关键词】 心肺复苏；心脏骤停；急诊；因素
      【中图分类号】 R605.974 【文献标识码】 A 【文章编号】 1003—6350（2019）01—0032—03

Analysis of influencing factors for successful cardiopulmonary resuscitation in patients with pre-hospital cardiacarrest.
MA Jian-fei, SONG Qiao-ling, QU Ji-fu. Department of Emergency Medicine, Daping Hospital, Army MedicalUniversity, Chongqing 400042, CHINA
【Abstract】 Objective To analyze the factors affecting the success of pre-hospital cardiopulmonary resuscita-tion in emergency department. Methods A retrospective analysis was performed on clinical data of 110 patients withcardiac arrest who received pre-hospital cardiopulmonary resuscitation in Daping Hospital, the People's Liberation ArmyMedical University, from January 2016 to March 2018. According to the rescue results, these patients were divided into asuccessful group (42 cases) and an unsuccessful group (68 cases). The clinical data of the two groups were compared,and the factors influencing the success of pre-hospital cardiopulmonary resuscitation were analyzed by Logistic regres-sion analysis. Results Among all the causes of cardiac arrest, patients with cardiogenic diseases had the highest suc-cess rate of resuscitation (accounting for 45.12%), followed by the central nervous system (accounting for 27.27%), theproportion of car accidents was low, at 12.5%. Comparing the success group with unsuccessful group in absolute time ofcardiac arrest (18.62±8.05) min vs (24.05±9.34) min, initial rescue time (5.64±1.48) min vs (9.26±1.94) min, the time oftracheal intubation (6.18±2.94) min vs (10.14±4.16) min, and the cumulative dosage of epinephrine (8.34±5.48) mg vs(18.38±9.64) mg, the differences were statistically significant (P<0.05). Logistic regression analysis showed that car-diogenic diseases, ventricular fibrillation, pulseless electrical activity, application of defibrillation and adrenaline dos-age<4 mg were the factors influencing the successful cardiopulmonary resuscitation (P<0.05). Conclusion The factorsinfluencing the success of cardiopulmonary resuscitation in patients with pre-hospital cardiac arrest are various and com-plex. It is necessary to establish a number of measures at the same time to reduce the occurrence of various risk factors.
      【Key words】 Cardiopulmonary resuscitation; Cardiac arrest; Emergency; Factors