CAJ | 학술논문

目的探讨影响心肺复苏(cardiopulmonary resuscitation,CPR)效果的独立影响因素.方法研究对象为做过CPR的1376例心搏骤停(cardiac arrest,CA)患者,行回顾性调查,用EpiData软件建数据库,用SPSS 13.0软件行两分类Logistic回归分析,选取变量为单因素分析有意义的影响CPR效果的因素.结果对恢复自主循环(return of spontaneous circulation,ROSC)--第一目击者急救是保护因素,OR=2.21(P<0.01,95.0%C/=1.356～3.602);与女性比较男性是危险因素,OR=0.515(P<0.01,95.0%CI=0.320～0.826);20～29岁组较≥81岁组ROSC可能性大,OR=3.241(P<0.05,95.0%CI=1.146～9.138);CPR术前心跳骤停时间是危险冈素,OR=0.913(P<0.01,95.0%CI=0.887～0.948);与心脏静止比较,室颤是保护因素,OR=5.092(P<0.01,95.0%CI=2.927～8.861);电击是保护因素,OR=3.384(P<0.01,95.0%CI=2.033～5.635);肾上腺素0～4 mg组ROSC可能性高于≥5 mg组,OR=3.255(P<0.01,95.0%CI=1.606～6.597).对生存到院--2～12岁和13～19岁组生存到院可能性分别比≥81岁组高,OR=12.818(P<0.05,95.0%CI=1.299～126.508)和OR=10.505(P<0.05,95.0%CI=1.161～95.058);CPR前CA时间是危险因素,OR=0.862(P=<0.01,95.0%CI=0.82～0.906);室颤患者生存到院的可能性较心脏静止患者高,OR=7.330(P=<0.01,95.0%CI=3.962～13.560).结论院前CA患者ROSC的独立影响因素有CPR前ECG、第一目击者急救、电击、CPR前CA时间、肾上腺素剂量、性别、年龄分组.院前CA患者生存到院独立影响冈素有CPR前ECG、CPR前CA时间、年龄分组.
목적 탐토영향심폐복소(cardiopulmonary resuscitation,CPR)효과적독립영향인소.방법 연구대상위주과CPR적1376례심박취정(cardiac arrest,CA)환자,행회고성조사,용EpiData연건건수거고,용SPSS 13.0연건행량분류Logistic회귀분석,선취변량위단인소분석유의의적영향CPR효과적인소.결과 대회복자주순배(return of spontaneous circulation,ROSC)--제일목격자급구시보호인소,OR=2.21(P<0.01,95.0%C/=1.356～3.602);여녀성비교남성시위험인소,OR=0.515(P<0.01,95.0%CI=0.320～0.826);20～29세조교≥81세조ROSC가능성대,OR=3.241(P<0.05,95.0%CI=1.146～9.138);CPR술전심도취정시간시위험강소,OR=0.913(P<0.01,95.0%CI=0.887～0.948);여심장정지비교,실전시보호인소,OR=5.092(P<0.01,95.0%CI=2.927～8.861);전격시보호인소,OR=3.384(P<0.01,95.0%CI=2.033～5.635);신상선소0～4 mg조ROSC가능성고우≥5 mg조,OR=3.255(P<0.01,95.0%CI=1.606～6.597).대생존도원--2～12세화13～19세조생존도원가능성분별비≥81세조고,OR=12.818(P<0.05,95.0%CI=1.299～126.508)화OR=10.505(P<0.05,95.0%CI=1.161～95.058);CPR전CA시간시위험인소,OR=0.862(P=<0.01,95.0%CI=0.82～0.906);실전환자생존도원적가능성교심장정지환자고,OR=7.330(P=<0.01,95.0%CI=3.962～13.560).결론 원전CA환자ROSC적독립영향인소유CPR전ECG、제일목격자급구、전격、CPR전CA시간、신상선소제량、성별、년령분조.원전CA환자생존도원독립영향강소유CPR전ECG、CPR전CA시간、년령분조.
Objective To investigate the independent factors influencing the efficacy of pre-hospital CPR effect. Method The data base with 1376 cases was set up with EpiData software by means of questionnaires and the information was provided by the survivals from cardiopulmonary arrest( CA)saved with cardiopulmonary resuscitation(CPR), and the data were analyzed with SPSS 13.0 software to carry out binary logistic regression. Through single factor analysis, the factors with emerged statistical significance were chosen as variances. Results With regard to the restoration of spontaneous circulation(ROSC), the rescue did by the first witness was the protective factor(PF)( OR = 2.21, P = 0.001, 95.0% CI=1.356-3.602); the male was the risk factor(RF) contrasted with the female( OR = 0. 515, P =0. 006, 95.0%0 CI = 0.320 - 0. 26) ; ages between 20 and 29 years old had higher likelihood of ROSC than group ≥81 years old( OR = 3.241, P = 0.026, 95.0%CI = 1.146 -9.138); the length of CA time before CPR was RF(OR = 0.913, P = 0.000, 95.0%CI = 0.887-0.948);ventricular fibrillation(VF) was PF compared with asystole( OR = 5.092, P = 0.000, 95.0%CI=2.927 -8.861); electric shock was PF(OR = 3.384, P = 0.000, 95.0%CI = 2.033 - 5.635); epinephrine dosage 0 - 4 mg had higher likelihood of ROSC than > 5 nag dosage( OR = 3. 255, P = 0. 001, 95.0% CI = 1. 606 -6.597). In respect of probability about victims at the tittle reached hospital alive, ages of 2- 12 and 13 - 19 years old had higher rations than ≥81 years old( OR = 12.818, P = 0.029, 95.0% CI = 1.299 - 126.508)( OR = 10.505, P = 0.036, 95.0% CI = 1.161-95.058); the length of CA time before CPR was RF(OR =0.862, P = 0.000, 95.0%CI = 0.821-0.906); VF was PF compared with asystole(OR = 7.330, P =0.000, 95.0%CI = 3.962 - 13.560). Conclusions ECG change before CPR, rescue by the first witness,electric shock, the length of CA time before CPR, epinephrine dosage, gender and age were independent influencing factors of pre-hospital CPR for the emergency of ROSC. Age, the length of CA time before CPR and ECG before CPR were influencing factors of pre-hospital CPR for patients at the time transferred to hospital alive.