中华实验和临床感染病杂志（电子版）
中華實驗和臨床感染病雜誌（電子版）
중화실험화림상감염병잡지（전자판）
CHINESE JOURNAL OF EXPERIMENTAL AND CLINICAL INFECTIOUS DISEASES(ELECTRONIC VERSION)
2014年
6期
781-784
,共4页
毕宝林%田昭涛%苏延峰%李士华%仲薇薇%李金辉
畢寶林%田昭濤%囌延峰%李士華%仲薇薇%李金輝
필보림%전소도%소연봉%리사화%중미미%리금휘
临床路径%心脏呼吸骤停%心肺复苏%感染性休克
臨床路徑%心髒呼吸驟停%心肺複囌%感染性休剋
림상로경%심장호흡취정%심폐복소%감염성휴극
Clinical pathways%Cardiac and respiratory arrest%Cardiopulmonary resuscitation%Septic shock
目的：探讨临床路径对感染性休克患者心肺复苏效果的影响，为心跳呼吸骤停患者复苏提供一定的临床依据。方法选择2011至2013年于本院实施救治的感染性休克所致心脏骤停的患者共90例为研究对象，其中对照组30例，实施常规救治，观察组60例，实施临床路径救治；比较两组患者的救治程序，包括基础生命支持复苏程序（BLS）和高级生命支持复苏程序（ALS），以及救治疗效。结果两种复苏方法全部进行胸外按压，差异无统计学意义，其中实施人工呼吸常规方法者27例，占90.0%，临床路径全部实施，差异具有统计学意义（χ2=4.143，P=0.043），实施开放通道和置口咽管临床路径均显著高于常规复苏方法，差异具有统计学意义（χ2=17.244、54.784， P=0.000、0.000）；常规方法对伴有急性肾功能衰竭、急性心功能不全、急性肺功能衰竭及其他疾病患者成功的例数分别为1、1、0和1例，临床路径成功复苏的例数为12、5、2和2例；对治疗伴有急性肾功能衰竭方面，两种方法疗效差异具有统计学意义（χ2=5.121，P=0.027）；两种方法在伴有急性心功能不全及急性肺功能衰竭方面，具有显著性统计学意义（χ2=12.070、11.224，P=0.001、0.001），其他疾病复苏成功率一致；两种方法在立即复苏、5 min以内及5～8 min以内复苏方面比较差异具有统计学意义（χ2=24.982、10.244、6.772，P=0.000、0.002、0.009），8 min以上成功率一致，均无复苏成功者。结论按临床路径实施救治能显著提高感染性休克所致心脏骤停的患者复苏成功率。
目的：探討臨床路徑對感染性休剋患者心肺複囌效果的影響，為心跳呼吸驟停患者複囌提供一定的臨床依據。方法選擇2011至2013年于本院實施救治的感染性休剋所緻心髒驟停的患者共90例為研究對象，其中對照組30例，實施常規救治，觀察組60例，實施臨床路徑救治；比較兩組患者的救治程序，包括基礎生命支持複囌程序（BLS）和高級生命支持複囌程序（ALS），以及救治療效。結果兩種複囌方法全部進行胸外按壓，差異無統計學意義，其中實施人工呼吸常規方法者27例，佔90.0%，臨床路徑全部實施，差異具有統計學意義（χ2=4.143，P=0.043），實施開放通道和置口嚥管臨床路徑均顯著高于常規複囌方法，差異具有統計學意義（χ2=17.244、54.784， P=0.000、0.000）；常規方法對伴有急性腎功能衰竭、急性心功能不全、急性肺功能衰竭及其他疾病患者成功的例數分彆為1、1、0和1例，臨床路徑成功複囌的例數為12、5、2和2例；對治療伴有急性腎功能衰竭方麵，兩種方法療效差異具有統計學意義（χ2=5.121，P=0.027）；兩種方法在伴有急性心功能不全及急性肺功能衰竭方麵，具有顯著性統計學意義（χ2=12.070、11.224，P=0.001、0.001），其他疾病複囌成功率一緻；兩種方法在立即複囌、5 min以內及5～8 min以內複囌方麵比較差異具有統計學意義（χ2=24.982、10.244、6.772，P=0.000、0.002、0.009），8 min以上成功率一緻，均無複囌成功者。結論按臨床路徑實施救治能顯著提高感染性休剋所緻心髒驟停的患者複囌成功率。
목적：탐토림상로경대감염성휴극환자심폐복소효과적영향，위심도호흡취정환자복소제공일정적림상의거。방법선택2011지2013년우본원실시구치적감염성휴극소치심장취정적환자공90례위연구대상，기중대조조30례，실시상규구치，관찰조60례，실시림상로경구치；비교량조환자적구치정서，포괄기출생명지지복소정서（BLS）화고급생명지지복소정서（ALS），이급구치료효。결과량충복소방법전부진행흉외안압，차이무통계학의의，기중실시인공호흡상규방법자27례，점90.0%，림상로경전부실시，차이구유통계학의의（χ2=4.143，P=0.043），실시개방통도화치구인관림상로경균현저고우상규복소방법，차이구유통계학의의（χ2=17.244、54.784， P=0.000、0.000）；상규방법대반유급성신공능쇠갈、급성심공능불전、급성폐공능쇠갈급기타질병환자성공적례수분별위1、1、0화1례，림상로경성공복소적례수위12、5、2화2례；대치료반유급성신공능쇠갈방면，량충방법료효차이구유통계학의의（χ2=5.121，P=0.027）；량충방법재반유급성심공능불전급급성폐공능쇠갈방면，구유현저성통계학의의（χ2=12.070、11.224，P=0.001、0.001），기타질병복소성공솔일치；량충방법재립즉복소、5 min이내급5～8 min이내복소방면비교차이구유통계학의의（χ2=24.982、10.244、6.772，P=0.000、0.002、0.009），8 min이상성공솔일치，균무복소성공자。결론안림상로경실시구치능현저제고감염성휴극소치심장취정적환자복소성공솔。
Objective To explore the clinical pathway in patients with septic shock caused by the effects of cardiopulmonary resuscitation (CPR), to provide clinical basis for patients with cardiopulmonary resuscitation. Methods Total of 90 patient with treatment of septic shock caused by cardiac arrest from 2011 to 2013 in our hospital were sellected, there were 30 cases in control group with the implementation of routine treatment;while 60 cases in observation group with the implementation of clinical pathway treatment. The treatment procedures, including basic life support (BLS) recovery program and advanced life support (ALS) recovery program, as well as the treatment effect were compared in the two groups. Results Chest compressions were carried out in all the patients with septic shock, there was no signiifcant difference;the implementation of artificial respiration to conventional methods in 27 (90.0%) cases, all clinical pathway implementation, with signiifcant difference (χ2=4.143, P=0.043), the chest compressions and placement oropharyngeal tube of clinical path were signiifcantly higher than the conventional recovery methods, with significant differences (χ2= 17.244, 54.784; P = 0.000, 0.000). Conventional methods for associated with acute renal failure, acute cardiac insufifciency, acute pulmonary function failure and other diseases in patients with successful cases were 1, 1, 0 and 1 case, respectively, clinical pathway of successful recovery cases were 12, 5, 2 and 2 cases. On acute renal failure in two ways, there was signiifcant differences (χ2=5.121, P=0.027);on acute cardiac insufifciency and the acute pulmonary function failure, there were signiifcant differences (χ2=12.070, 11.224;P=0.001, 0.001), and other diseases on success rate of recovery were the same. Two methods in immediate recovery, recovery within 5 minutes and 5-8 minutes were compared, with signiifcant difference (χ2=24.982, 10.244, 6.772;P=0.000, 0.002, 0.009);the success rate of more than 8 minutes, no cases with successful recovery. Conclusion According to the clinical pathway implementation treatment could signiifcantly increase the success rate of recovery in patients with septic shock caused by the sudden cardiac arrest.
