中国危重病急救医学
中國危重病急救醫學
중국위중병급구의학
CHINESE CRITICAL CARE MEDICINE
2008年
12期
713-716
,共4页
宋维%莫德番%蓝宝琼%高允锁
宋維%莫德番%藍寶瓊%高允鎖
송유%막덕번%람보경%고윤쇄
心肺复苏%Utstein模式%注册研究
心肺複囌%Utstein模式%註冊研究
심폐복소%Utstein모식%주책연구
cardiopulmonary resuscitation%Utstein Style%registry investigation
目的 应用心肺复苏(CPR)Utstein指南模式原则评价CPR效果与影响因素.方法 按照CPRUtstein评价指南设计CPR注册登记表,应用注册研究方法,研究院内463例(包括成人和儿童)CPR患者流行病学特征,CPR效果与影响因素.结果 心搏、呼吸骤停患者中男320例,占69.1%,女143例,占30.9%;依次以45～54岁、55～64岁、65～74岁为3个高发年龄组.既往史中以心血管系统、脑血管系统为主,分别占36.3%(168例)和9.9%(46例).心搏、呼吸骤停初始心律为心室纤颤74例,占16.O%;院内CPR患者自主循环恢复(ROSC)率为34.6%(160例)、成功复苏率为16.6%(77例),存活出院率为10.4%(48例).273例急诊室(院内)出现心搏、呼吸骤停并启动CPR者ROSC率[47.6%(130例)]、存活出院率[13.9%(38例)]明显高于190例入急诊室前(院前)已发生心搏、呼吸骤患者[15.8%(30例),5.3%(10例),P均<0.013]结论CPR评价Utstein指南模式的运用能较好地评价CPR效果与影响因素.其研究结果能与国际CPRUtstein模式注册研究结果进行横向比较,但院内CPR存活出院率仍偏低,需进一步提高CPR的效果.
目的 應用心肺複囌(CPR)Utstein指南模式原則評價CPR效果與影響因素.方法 按照CPRUtstein評價指南設計CPR註冊登記錶,應用註冊研究方法,研究院內463例(包括成人和兒童)CPR患者流行病學特徵,CPR效果與影響因素.結果 心搏、呼吸驟停患者中男320例,佔69.1%,女143例,佔30.9%;依次以45～54歲、55～64歲、65～74歲為3箇高髮年齡組.既往史中以心血管繫統、腦血管繫統為主,分彆佔36.3%(168例)和9.9%(46例).心搏、呼吸驟停初始心律為心室纖顫74例,佔16.O%;院內CPR患者自主循環恢複(ROSC)率為34.6%(160例)、成功複囌率為16.6%(77例),存活齣院率為10.4%(48例).273例急診室(院內)齣現心搏、呼吸驟停併啟動CPR者ROSC率[47.6%(130例)]、存活齣院率[13.9%(38例)]明顯高于190例入急診室前(院前)已髮生心搏、呼吸驟患者[15.8%(30例),5.3%(10例),P均<0.013]結論CPR評價Utstein指南模式的運用能較好地評價CPR效果與影響因素.其研究結果能與國際CPRUtstein模式註冊研究結果進行橫嚮比較,但院內CPR存活齣院率仍偏低,需進一步提高CPR的效果.
목적 응용심폐복소(CPR)Utstein지남모식원칙평개CPR효과여영향인소.방법 안조CPRUtstein평개지남설계CPR주책등기표,응용주책연구방법,연구원내463례(포괄성인화인동)CPR환자류행병학특정,CPR효과여영향인소.결과 심박、호흡취정환자중남320례,점69.1%,녀143례,점30.9%;의차이45～54세、55～64세、65～74세위3개고발년령조.기왕사중이심혈관계통、뇌혈관계통위주,분별점36.3%(168례)화9.9%(46례).심박、호흡취정초시심률위심실섬전74례,점16.O%;원내CPR환자자주순배회복(ROSC)솔위34.6%(160례)、성공복소솔위16.6%(77례),존활출원솔위10.4%(48례).273례급진실(원내)출현심박、호흡취정병계동CPR자ROSC솔[47.6%(130례)]、존활출원솔[13.9%(38례)]명현고우190례입급진실전(원전)이발생심박、호흡취환자[15.8%(30례),5.3%(10례),P균<0.013]결론CPR평개Utstein지남모식적운용능교호지평개CPR효과여영향인소.기연구결과능여국제CPRUtstein모식주책연구결과진행횡향비교,단원내CPR존활출원솔잉편저,수진일보제고CPR적효과.
Objective Assessment of outcomes and outcome-related factors of in-hospital cardiopul-monary resuscitation (CPR) based on the " Utstein Style". Methods The study was designed as a prospective, single-institution, registry investigation of 463 patients (included adult and pediatric patients) for whom a CPR was attempted. Results The study population consisted of 320 (69.1 %) male patients and 143 (30. 9%) female patients. The age range of 45- 54, 55- 64, 65- 74 were ranked the first, the second and third highest. In the past medical history, cardiovascular disease and cerebrovascular disorder were two main disorders, accounting for 36. 30% (168/463) and 9. 9% (46/463), respectively. Ventricular fibrillation (VF) was the initial electrocardiographic (ECG) change in 74 patients (16.0%). Two hundred and seventy-three patients received the in-hospital CPR, and 190 patients received the pre-hospital CPR. Spontaneous circulation returned in 34. 6% (160/273) of the in-hospital patients after CPR, and 16. 60% (77/273) survived for 24 hours and 10. 4% (48/273) survived up to the time of discharge. The rates of restoration of spontaneous circulation (ROSC) and survival of the in-hospital CPR were higher than those of the pre-hosptial CPR [47. 6% (130/273) vs. 15. 8% (30/190), 13. 9% (38/273) vs. 5. 3% (10/190), both P<0. 013. Conclusion Prospective "Utstein Style" data collection for CPR is proved to be a valuable tool for the evaluation of management and outcome following in-hospital cardiopulmonary arrest, but the rate of survival for in-hospital resuscitation still seems to be too low. The further improvement of CPR outcome is necessary.
