现代医院
現代醫院
현대의원
MODERN HOSPITAL
2015年
4期
13-16
,共4页
邓活清%徐翔%梁凤桃%许卓谦%叶家骏%李东华
鄧活清%徐翔%樑鳳桃%許卓謙%葉傢駿%李東華
산활청%서상%량봉도%허탁겸%협가준%리동화
心脏骤停%心肺复苏%存活率
心髒驟停%心肺複囌%存活率
심장취정%심폐복소%존활솔
cardiac arrest%cardiopulmonary resuscitation%epidemiology%survival rate%Logistic regression analysis
目的：了解院内心肺复苏现状和影响复苏效果的因素，探讨改进方法。方法回顾2013年广州市花都区人民医院非新生儿院内心脏骤停（IHCA）病例，按 Utstein 模型进行资料登记，共纳入统计187例，分析其流行病学特征和复苏效果影响因素。结果非新生儿 IHCA 发生率为5．2‰。男性多于女性，性别比例1．67：1（p ＜0．01）。2～96岁，平均年龄（58．96±19．45）岁。普通病房的 IHCA 病例最多。创伤是≤30岁和31～60岁 IHCA 病例的最常见病因，分别占50．0％和38．6％，＞60岁的最常见病因则是心血管疾病（占33．3％）。初始心律为室颤者占7．0％，无脉性室速占1．1％。全部病例自主循环恢复（ROSC）率32．1％，24小时存活率9．1％，存活出院率5．3％。 Logistic 回归分析显示，获得除颤者的24小时存活率和存活出院率均显著高于未除颤者（p ＜0．01）。结论IHCA 多见于中老年人，男性为主，普通病房病例最多，不同年龄段主要病因不同。 IHCA 存活率仍较低，除颤是重要影响因素。在院内推广心肺复苏尤其是 ACLS 技术并加强管理，对提高医院整体复苏水平有重要意义。
目的：瞭解院內心肺複囌現狀和影響複囌效果的因素，探討改進方法。方法迴顧2013年廣州市花都區人民醫院非新生兒院內心髒驟停（IHCA）病例，按 Utstein 模型進行資料登記，共納入統計187例，分析其流行病學特徵和複囌效果影響因素。結果非新生兒 IHCA 髮生率為5．2‰。男性多于女性，性彆比例1．67：1（p ＜0．01）。2～96歲，平均年齡（58．96±19．45）歲。普通病房的 IHCA 病例最多。創傷是≤30歲和31～60歲 IHCA 病例的最常見病因，分彆佔50．0％和38．6％，＞60歲的最常見病因則是心血管疾病（佔33．3％）。初始心律為室顫者佔7．0％，無脈性室速佔1．1％。全部病例自主循環恢複（ROSC）率32．1％，24小時存活率9．1％，存活齣院率5．3％。 Logistic 迴歸分析顯示，穫得除顫者的24小時存活率和存活齣院率均顯著高于未除顫者（p ＜0．01）。結論IHCA 多見于中老年人，男性為主，普通病房病例最多，不同年齡段主要病因不同。 IHCA 存活率仍較低，除顫是重要影響因素。在院內推廣心肺複囌尤其是 ACLS 技術併加彊管理，對提高醫院整體複囌水平有重要意義。
목적：료해원내심폐복소현상화영향복소효과적인소，탐토개진방법。방법회고2013년엄주시화도구인민의원비신생인원내심장취정（IHCA）병례，안 Utstein 모형진행자료등기，공납입통계187례，분석기류행병학특정화복소효과영향인소。결과비신생인 IHCA 발생솔위5．2‰。남성다우녀성，성별비례1．67：1（p ＜0．01）。2～96세，평균년령（58．96±19．45）세。보통병방적 IHCA 병례최다。창상시≤30세화31～60세 IHCA 병례적최상견병인，분별점50．0％화38．6％，＞60세적최상견병인칙시심혈관질병（점33．3％）。초시심률위실전자점7．0％，무맥성실속점1．1％。전부병례자주순배회복（ROSC）솔32．1％，24소시존활솔9．1％，존활출원솔5．3％。 Logistic 회귀분석현시，획득제전자적24소시존활솔화존활출원솔균현저고우미제전자（p ＜0．01）。결론IHCA 다견우중노년인，남성위주，보통병방병례최다，불동년령단주요병인불동。 IHCA 존활솔잉교저，제전시중요영향인소。재원내추엄심폐복소우기시 ACLS 기술병가강관리，대제고의원정체복소수평유중요의의。
Objective To understand the current situation of cardiopulmonary resuscitation in hospital and influence factors of recovery effect,and to discuss ways to improve.Methods The in -hospital cardiac arrest(IHCA) cases of non -neonatal patients in the People's Hospital of Huadu district Guangzhou were reviewed and registered in the Utstein -style.187 cases were included in the statistics,and the epidemiological characteristics and influence factors of recovery effect were analyzed .Results The incidence rate of IHCA in non -neonatal patients was 5.2‰.There was a male predominance with a sex ratio of 1.67:1(p <0.01).The mean age was 58.96 ±19.45 years old (most ranged from 2 to 96 years).There were most cases of IHCA in general wards.Trauma was the major cause of IHCA cases of less than 30 and 31 to 60 years old, with the rate 50.0% and 38.6%, respectively.While in the cases of over 60 years old, cardiovascular disease was the major cause(33.3%).The cases with an initial rhythm of ventricular fibrillation accounted for 7.0% and those with pulseless ventricular tachycardia accounted for 1.1%.Of all cases, 32.1% had the return of spontaneous circulation (ROSC), 9.1% survived for 24 hours,and 5.3% survived to hospital discharge.Logistic regression analysis showed that the survival rates for 24 hours and to hospital discharge were both significantly higher in the cases being defibrillated than in those not defibrillated (p <0.01).Conclusion IHCA occurs most often in middle -aged and elderly patients.Male is in the ma-jority.Most cases occur in general wards.The major causes are variant in different age paragraphs.The survival rate of IHCA is still low, and fibrillation is a important influence factor.It is significantly important to improve the whole resuscitation level of the hospital including popularizing cardiopulmonary resuscitation especially the ACLS technologies in hospital and strengthening management .
