CAJ | 학술논문

目的：分析心搏骤停（ CA）急诊患者心肺复苏术（ CPR）成功的影响因素。方法收集2010年1月—2014年10月在江门市人民医院急诊科开展CPR的582例患者，其中成功80例（成功组）、失败502例（失败组）。比较两组患者一般资料（年龄、性别、原发病）、院前急诊急救情况｛家庭急救、医院救护、院前救护时间、机械通气、短暂复苏、CPR 至短暂复苏时间、院前心电图表现〔心室纤颤（ VF ）、无脉性心电活动（ PEA ），电静止（ VA）〕｝、CA发生情况、入院时心电图及通气方式。结果两组患者性别、年龄及原发病比较，差异无统计学意义（P>0.05）。成功组患者家庭急救率、医院救护率、机械通气率、短暂复苏率高于失败组，院前救护时间及CPR至短暂复苏时间均短于失败组，院前心电图表现优于失败组（ P<0.05）。成功组患者医院救护前发生CA 21例，救护车送院途中发生CA 37例，急诊科发生CA 22例，失败组分别为137例、249例、116例，差异无统计学意义（ P>0.05）。成功组患者自主心率、VF、PEA发生率及气管插管率高于失败组（ P<0.05）。结论 CA患者急诊CPR是否成功与患者CA发生时间、院前急诊急救情况、院内CPR水平等有关，应建立院外CPR指导体系，提高患者送院途中CPR质量，尽可能保障院内CPR质量。
목적：분석심박취정（ CA）급진환자심폐복소술（ CPR）성공적영향인소。방법수집2010년1월—2014년10월재강문시인민의원급진과개전CPR적582례환자，기중성공80례（성공조）、실패502례（실패조）。비교량조환자일반자료（년령、성별、원발병）、원전급진급구정황｛가정급구、의원구호、원전구호시간、궤계통기、단잠복소、CPR 지단잠복소시간、원전심전도표현〔심실섬전（ VF ）、무맥성심전활동（ PEA ），전정지（ VA）〕｝、CA발생정황、입원시심전도급통기방식。결과량조환자성별、년령급원발병비교，차이무통계학의의（P>0.05）。성공조환자가정급구솔、의원구호솔、궤계통기솔、단잠복소솔고우실패조，원전구호시간급CPR지단잠복소시간균단우실패조，원전심전도표현우우실패조（ P<0.05）。성공조환자의원구호전발생CA 21례，구호차송원도중발생CA 37례，급진과발생CA 22례，실패조분별위137례、249례、116례，차이무통계학의의（ P>0.05）。성공조환자자주심솔、VF、PEA발생솔급기관삽관솔고우실패조（ P<0.05）。결론 CA환자급진CPR시부성공여환자CA발생시간、원전급진급구정황、원내CPR수평등유관，응건립원외CPR지도체계，제고환자송원도중CPR질량，진가능보장원내CPR질량。
Objective To analyze the influencing factors of successful CPR in emergency patients with sudden cardiac arrest. Methods A total of 582 patients undergoing CPR were selected in the Department of Emergency,People's Hospital of Jiangmen from January 2010 to October 2014,including 80 successful cases( A group),502 failed cases( B group). Age, gender,primary illness,family emergency,hospital emergency,pre -hospital rescue time,mechanical ventilation,time to short resuscitation,pre-hospital electrocardiogram manifestation( including ventricular fibrillation,pulseless electrical activity, electrical silence),incidence of sudden cardiac arrest,electrocardiogram at admission and ventilation models were compared between the two groups. Results No statistically significant differences of age,gender or primary illness was found between the two groups(P>0. 05). Family emergency rate,hospital emergency rate,mechanical ventilation rate,short resuscitation rate of A group was statistically significantly higher than that of B group,respectively(P<0. 05);pre-hospital rescue time and time to short resuscitation of A group was statistically significantly shorter than those of B group ( P <0. 05 );pre -hospital electrocardiogram manifestation of A group were statistically significantly better than that of B group(P<0. 05). Of A group, 21 case occurred sudden cardiac arrest before hospital emergency,37 cases occurred sudden cardiac arrest on the way to hospital, 22 cases occurred sudden cardiac arrest in the Department of Emergency,that of B group were 137 cases,249 cases,116 cases, respectively,no statistically significant differences of incidence of sudden cardiac arrest was found between the two groups( P>0. 05). The incidence of independent heart rate,ventricular fibrillation,pulseless electrical activity and tracheal intubation of A group was statistically significantly higher than that of B group,respectively(P<0. 05). Conclusion Occurrence time,pre-hospital emergency,hospital CRP level are influencing factors of successful CPR in emergency patients with sudden cardiac arrest,physicians should establish a pre-hospital CRP guiding system,improve the CRP level on the way tohospital and ensure the hospital CRP level.