中华急诊医学杂志
中華急診醫學雜誌
중화급진의학잡지
CHINESE JOURNAL OF EMERGENCY MEDICINE
2012年
11期
1237-1241
,共5页
院内Utstein模式%心搏呼吸骤停%心肺复苏%儿童
院內Utstein模式%心搏呼吸驟停%心肺複囌%兒童
원내Utstein모식%심박호흡취정%심폐복소%인동
In-hospital Utstein style%Cardiorespiratory arrest%Cardiopulmonary resuscitation%Pediatric
目的 调查儿科急诊室内小儿心搏呼吸骤停情况,分析影响心肺复苏效果的因素,并对复苏效果做初步评估.方法 采用标准的院内Utstein格式(the in-hospital Utstein style)前瞻性收集数据,填写调查表,内容包括:心搏呼吸骤停的原因、影响心肺复苏效果的因素及复苏效果.用自主循环恢复(return of spontaneous circulation,ROSC)评估初步复苏效果.结果 2008年7月1日至2010年2月28日,北京儿童医院急诊室全部就诊患者(29 d至18岁)182 380例,心搏呼吸骤停237例(0.13％).实施心肺复苏169例,其中ROSC 88例(52.1％).性别和年龄对ROSC的影响差异无统计学意义.原发病和初始节律对ROSC的影响有显著性意义.有无院前转运的ROSC分别为64.1％和44.8％；CPR时间≤10 min、10 ～ 30 min及＞30 min的ROSC分别为67.5％、61.4％和30.5％,差异均具有统计学意义.多元逐步Logistic回归分析显示,初始节律和CPR持续时间对ROSC有明显影响.结论 急诊室内小儿心肺复苏的ROSC为52.1％.初始节律和CPR持续时间对ROSC有明显影响.
目的 調查兒科急診室內小兒心搏呼吸驟停情況,分析影響心肺複囌效果的因素,併對複囌效果做初步評估.方法 採用標準的院內Utstein格式(the in-hospital Utstein style)前瞻性收集數據,填寫調查錶,內容包括:心搏呼吸驟停的原因、影響心肺複囌效果的因素及複囌效果.用自主循環恢複(return of spontaneous circulation,ROSC)評估初步複囌效果.結果 2008年7月1日至2010年2月28日,北京兒童醫院急診室全部就診患者(29 d至18歲)182 380例,心搏呼吸驟停237例(0.13％).實施心肺複囌169例,其中ROSC 88例(52.1％).性彆和年齡對ROSC的影響差異無統計學意義.原髮病和初始節律對ROSC的影響有顯著性意義.有無院前轉運的ROSC分彆為64.1％和44.8％；CPR時間≤10 min、10 ～ 30 min及＞30 min的ROSC分彆為67.5％、61.4％和30.5％,差異均具有統計學意義.多元逐步Logistic迴歸分析顯示,初始節律和CPR持續時間對ROSC有明顯影響.結論 急診室內小兒心肺複囌的ROSC為52.1％.初始節律和CPR持續時間對ROSC有明顯影響.
목적 조사인과급진실내소인심박호흡취정정황,분석영향심폐복소효과적인소,병대복소효과주초보평고.방법 채용표준적원내Utstein격식(the in-hospital Utstein style)전첨성수집수거,전사조사표,내용포괄:심박호흡취정적원인、영향심폐복소효과적인소급복소효과.용자주순배회복(return of spontaneous circulation,ROSC)평고초보복소효과.결과 2008년7월1일지2010년2월28일,북경인동의원급진실전부취진환자(29 d지18세)182 380례,심박호흡취정237례(0.13％).실시심폐복소169례,기중ROSC 88례(52.1％).성별화년령대ROSC적영향차이무통계학의의.원발병화초시절률대ROSC적영향유현저성의의.유무원전전운적ROSC분별위64.1％화44.8％；CPR시간≤10 min、10 ～ 30 min급＞30 min적ROSC분별위67.5％、61.4％화30.5％,차이균구유통계학의의.다원축보Logistic회귀분석현시,초시절률화CPR지속시간대ROSC유명현영향.결론 급진실내소인심폐복소적ROSC위52.1％.초시절률화CPR지속시간대ROSC유명현영향.
Objective To investigate the incidence,etiology and risk factors of cardiorespiratory arrest (CRA) in pediatric emergency room and preliminarily evaluate the efficacy of cardiopulmonary resuscitation (CPR).Methods The unified,standard in-hospital Utstein style was used for data collection with filling answers in the questionnaire.The survey items included the causes of cardiorespiratory arrest and the factors influencing the efficacy of CPR.The restoration of spontaneous circulation (ROSC) was used to evaluate short-term efficacy of CPR.Results Totally 182 380 patients aged from 28 days to 18 years were admitted to emergency room of Beijing Children' s Hospital between July 1,2008 and February 28,2010.Of them,237 patients (0.13％) were subjected to cardiorespiratory arrest,of which 169 patients received CPR and 88 patients (52.1％) got sustained ROSC.Neither sex nor age distribution affected ROSC.The primary cause of CRA and kind of initial abnormal rhythm of heartbeat leading to CRA were associated with the rate of ROSC.The rates of ROSC occurred in patients with or without pre-hospital transport were 64.1％ and 44.8％,respectively.The rate of ROSC was closely related to time consumed for getting ROSC by CPR,and as CPR durations were ≤ 10 min,10 to 30 min,and ＞ 30 min,the rates of ROSC were 67.5％,61.4％ and 30.5％,respectively.Multiple stepwise logistic regression analysis showed that kind of initial abnormal rhythm and CPR duration were associated with the rate of ROSC.Conclusions The incidence of CRA in emergency was 0.13％,and the rate of ROSC after CPR was 52.1％.The kind of initial abnormal rhythm of heartbeat and CPR duration were independent factors associated with the rate of ROSC.
