中华急诊医学杂志
中華急診醫學雜誌
중화급진의학잡지
CHINESE JOURNAL OF EMERGENCY MEDICINE
2011年
9期
904-910
,共7页
宋维%刘元税%吴世畅%符家传%邢柏%覃少强%吴国平%王丽艳%王龙%曾德伟%李相生%王秀川%黄韬%王林明%吴开毅%林春海%高允锁
宋維%劉元稅%吳世暢%符傢傳%邢柏%覃少彊%吳國平%王麗豔%王龍%曾德偉%李相生%王秀川%黃韜%王林明%吳開毅%林春海%高允鎖
송유%류원세%오세창%부가전%형백%담소강%오국평%왕려염%왕룡%증덕위%리상생%왕수천%황도%왕림명%오개의%림춘해%고윤쇄
心搏骤停%院内心搏骤停%院外心搏骤停%心室纤颤%无脉性室性心动过速%心肺复苏%Utstein模式%自主循环恢复%成活出院
心搏驟停%院內心搏驟停%院外心搏驟停%心室纖顫%無脈性室性心動過速%心肺複囌%Utstein模式%自主循環恢複%成活齣院
심박취정%원내심박취정%원외심박취정%심실섬전%무맥성실성심동과속%심폐복소%Utstein모식%자주순배회복%성활출원
Cardiac arrest%In-hospital cardiac arrest%Out of hospital cardiac arrest%Ventricularfibrillation%Pulseless ventricular tachycardia%Cardiopulmonary resuscitation%Utstein templates%Return ofspontaneous circulation%Survival to discharge
目的 本研究以心肺复苏乌斯坦因(Utstein)评估模式评价海南省13家医院心搏骤停患者流行病学特征、心肺复苏结果及其影响因素。方法 在Utstein指南基础上设计“海南省心肺复苏Utstein注册登记表”,在2007年1月1日至2010年12月31日期间对海南省13家医院急诊科心搏骤停心肺复苏患者实施注册登记。通过方差分析等统计学方法,对心肺复苏患者实施前瞻性描述性研究。结果 1125例心搏骤停患者男性占73.8％,女性26.2％,年龄为(53.9±13.1)岁,既往病史以冠心病最为多见,其次为高血压病;自主循环恢复率为23.8％,成活出院为7.4％。自主循环恢复和成活出院的患者中发病l min内获得心肺复苏患者所占比例分别为41.8％和49.4％。院内心搏骤停(IHCA)患者和院外心搏骤停(OHCA)患者ROSC率分别为36.3％,11.6％,成活出院率分别为11.5％,3.3％。心室纤颤/无脉性室性心动过速患者188例(16.7％),其自主循环恢复率及成活出院率分别为58.0％,21.8％。心源性心搏骤停448例(39.8％);其中院内与院外心搏骤停患者自主循环恢复率分别为36.3％,11.6％,成活出院率分别为11.5％,3.3％。非心源性心搏骤停677例(60.2％)。三级医院和二级医院自主循环恢复率分别为69.8％和30.2％,成活出院率分别为7.4％和7.3％。结论 心搏骤停更常见于男性。慢性疾病在本组患者中普遍存在,其中以冠心病和高血压病最为多见。院内心搏骤停患者自主循环恢复和成活出院率均明显高于院外心搏骤停患者。心室纤颤/无脉室性心动过速患者心肺复苏自主循环恢复及成活出院率高于其他类型初始心律的患者。缩短心肺复苏启动时间有助于提高自主循环恢复率及成活出院率。
目的 本研究以心肺複囌烏斯坦因(Utstein)評估模式評價海南省13傢醫院心搏驟停患者流行病學特徵、心肺複囌結果及其影響因素。方法 在Utstein指南基礎上設計“海南省心肺複囌Utstein註冊登記錶”,在2007年1月1日至2010年12月31日期間對海南省13傢醫院急診科心搏驟停心肺複囌患者實施註冊登記。通過方差分析等統計學方法,對心肺複囌患者實施前瞻性描述性研究。結果 1125例心搏驟停患者男性佔73.8％,女性26.2％,年齡為(53.9±13.1)歲,既往病史以冠心病最為多見,其次為高血壓病;自主循環恢複率為23.8％,成活齣院為7.4％。自主循環恢複和成活齣院的患者中髮病l min內穫得心肺複囌患者所佔比例分彆為41.8％和49.4％。院內心搏驟停(IHCA)患者和院外心搏驟停(OHCA)患者ROSC率分彆為36.3％,11.6％,成活齣院率分彆為11.5％,3.3％。心室纖顫/無脈性室性心動過速患者188例(16.7％),其自主循環恢複率及成活齣院率分彆為58.0％,21.8％。心源性心搏驟停448例(39.8％);其中院內與院外心搏驟停患者自主循環恢複率分彆為36.3％,11.6％,成活齣院率分彆為11.5％,3.3％。非心源性心搏驟停677例(60.2％)。三級醫院和二級醫院自主循環恢複率分彆為69.8％和30.2％,成活齣院率分彆為7.4％和7.3％。結論 心搏驟停更常見于男性。慢性疾病在本組患者中普遍存在,其中以冠心病和高血壓病最為多見。院內心搏驟停患者自主循環恢複和成活齣院率均明顯高于院外心搏驟停患者。心室纖顫/無脈室性心動過速患者心肺複囌自主循環恢複及成活齣院率高于其他類型初始心律的患者。縮短心肺複囌啟動時間有助于提高自主循環恢複率及成活齣院率。
목적 본연구이심폐복소오사탄인(Utstein)평고모식평개해남성13가의원심박취정환자류행병학특정、심폐복소결과급기영향인소。방법 재Utstein지남기출상설계“해남성심폐복소Utstein주책등기표”,재2007년1월1일지2010년12월31일기간대해남성13가의원급진과심박취정심폐복소환자실시주책등기。통과방차분석등통계학방법,대심폐복소환자실시전첨성묘술성연구。결과 1125례심박취정환자남성점73.8％,녀성26.2％,년령위(53.9±13.1)세,기왕병사이관심병최위다견,기차위고혈압병;자주순배회복솔위23.8％,성활출원위7.4％。자주순배회복화성활출원적환자중발병l min내획득심폐복소환자소점비례분별위41.8％화49.4％。원내심박취정(IHCA)환자화원외심박취정(OHCA)환자ROSC솔분별위36.3％,11.6％,성활출원솔분별위11.5％,3.3％。심실섬전/무맥성실성심동과속환자188례(16.7％),기자주순배회복솔급성활출원솔분별위58.0％,21.8％。심원성심박취정448례(39.8％);기중원내여원외심박취정환자자주순배회복솔분별위36.3％,11.6％,성활출원솔분별위11.5％,3.3％。비심원성심박취정677례(60.2％)。삼급의원화이급의원자주순배회복솔분별위69.8％화30.2％,성활출원솔분별위7.4％화7.3％。결론 심박취정경상견우남성。만성질병재본조환자중보편존재,기중이관심병화고혈압병최위다견。원내심박취정환자자주순배회복화성활출원솔균명현고우원외심박취정환자。심실섬전/무맥실성심동과속환자심폐복소자주순배회복급성활출원솔고우기타류형초시심률적환자。축단심폐복소계동시간유조우제고자주순배회복솔급성활출원솔。
Objective To study the Hainan Utstein templates used for cardiac arrest and resuscitation registries to evaluate the epidemiological characteristics and outcomes of the patients with CPR by multi-center study. Methods ccording to the Utstein templates for cardiac arrest and CPR set by International Liaison Committee on resuscitation in 2004, a Hainan Utstein CPR registry chart was designed and a prospective descriptive study was carried out to evaluate the epidemiological characteristics, impact factors and outcomes of the patients with resuscitation attempt in emergency departments of thirteen hospitals in Hainan Island between January 2007 and December 2010. Results Of 1125 patients with cardiac arrest, male accounted for 73. 8％ and female was 26. 2％. The mean ( ± S. D) age of the cardiac arrest patients was 53.9 ± 13. 1 years old. Coronary heart diseases and hypertension were the most common preexisting chronic diseases in the studied patients. The ROSC rate and discharge rates after survival in 1125 patients with CPR were 23. 8％ and 7.4％ respectively. The ROSC rate and discharge rates after survival were 36. 3％ and 11.6％ in the in-hospital cardiac arrest (IHCA) group, respectively whereas 11.5％ and 3. 3％ in out-hospital cardiac arrest (OHCA) group. Of 188 patients with ventricular fibrillation/Pulseless ventricular tachycardia, the ROSC rate and discharge rate after survival were 58.0％ and 21.8％,respectively. Of them, 448 (39. 8％ ) of the cardiac arrest patients had underlying cardiac causes, and the ROSC rate and discharge rate after survival were 36. 3％ and 11.5％ respectively in IHCA group whereas 11.6％ and 3. 3％ in OHCA group. The ROSC rate and discharge rate after survival were 69. 8％ and 7. 4％respectively in the tertiary hospitals whereas 30. 2％ and 7. 3％ in the secondary hospitals. Conclusions Patients experienced cardiac arrest were predominantly male. Coronary heart disease and hypertension were the two most common preexisting chronic diseases. The ROSC rate and discharge rate of patients with IHCA were higher than those with OHCA. ROSC rate and discharge rate after survival were higher in the ventriculat fibrillation/Pulseless ventricular tachycardia group than the other cardiac rhythms first witnessed groups. The time delayed of starting CPR after onset of cardiac arrest had a critical impact on survival and discharge rate in both IHCA and OHCA groups.
