[1]张晓东 罗丽 项涛.机械按压对心搏骤停患者自主循环恢复及预后的影响因素分析[J].心血管病学进展,2021,(8):737-741.[doi:10.16806/j.cnki.issn.1004-3934.2021.08.016]
　ZHANG Xiaodong,LUO Li,XIANG Tao.Analysis of Influence Factors for Mechanical Compressions on Return of Spontaneous Circulation and Prognosis in Patients with Cardiac Arrest[J].Advances in Cardiovascular Diseases,2021,(8):737-741.[doi:10.16806/j.cnki.issn.1004-3934.2021.08.016]
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机械按压对心搏骤停患者自主循环恢复及预后的影响因素分析()
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《心血管病学进展》[ISSN:51-1187/R/CN:1004-3934]

卷:
期数:
2021年8期
页码:
737-741
栏目:
论著
出版日期:
2021-08-25

文章信息/Info

Title:
Analysis of Influence Factors for Mechanical Compressions on Return of Spontaneous Circulation and Prognosis in Patients with Cardiac Arrest
作者:
张晓东 罗丽 项涛
(西南交通大学附属医院 成都市第三人民医院急诊科,四川 成都 610031)
Author(s):
ZHANG Xiaodong; LUO Li; XIANG Tao
( Emergency Department,The Third Peoples Hospital of Chengdu,The Affiliated Hospital of Southwest Jiaotong University,Chengdu 610031,Sichuan,China)
关键词:
心肺复苏; 心搏骤停; 自主循环恢复; 机械按压; Lucas
Keywords:
Cardiopulmonary resuscitationCardiac arrestReturn of spontaneous circulationMechanical compression sLucas
DOI:
10.16806/j.cnki.issn.1004-3934.2021.08.016
摘要:
目的 探讨 机械按压对急诊科非创伤心搏骤停患者自主循环恢复（ROSC）及预后的影响因素。方法 回顾性分析2018年6月1日 —2019年12月31日在急诊抢救室使用机械按压治疗的急性非创伤性心搏骤停患者的临床资料，根据心搏骤停患者心肺复苏（CPR）后是否发生ROSC，分为ROSC组和非ROSC组，采用多因素logistic回归分析影响心搏骤停患者机械按压后ROSC及预后的影响因素。结果 单因素分析显示 CPR持续时间≤30 min，肾上腺素用量≤5 mg，早期使用Lucas心肺复苏仪（≤4 min），入抢救室时pH＞7.05，Lucas使用后15 min呼气末二氧化碳分压（PETCO2）是心搏骤停患者使用机械按压后ROSC的独立影响因素（P＜0.05）。经过多因素logistic回归分析校正混杂因素后最终显示CPR持续时间≤30 min（OR 283.489，95%CI 14.474~5 552.565），早期使用Lucas（≤4 min）(OR 1.986，95%CI 0.298~13.223），入抢救室时pH＞7.05（OR 0.054，95%CI 0.005~0.589），Lucas使用后15 min PETCO2＞20 mm Hg（OR 0.005，95%CI 0.000~0.149）是机械按压后ROSC的保护因素（P＜0.05）。机械按压可以提高急诊科心搏骤停患者的ROSC率，早期使用Lucas（≤4 min）和晚期使用Lucas（＞4 min）两组相比ROSC恢复后最终存活入院率相似，但早期组4 h存活率较好。结论 对于急诊非创伤性 心搏骤停患者，早期使用机械按压可能提高急诊科非创伤心搏骤停患者的ROSC率和4 h存活率。复苏时间，早期使用Lucas，入抢救室时pH和Lucas使用15 min后PETCO2值与ROSC密切相关。
Abstract:
Objective To investigate the influencing factors for mechanical Compressions on return of spontaneous circulation(ROSC) and prognosis of patients with non-traumatic cardiac arrest(CA) in emergency department(ED). Methods Clinical data of patients with non-traumatic CA underwent mechanical Compressions from June 1,2018 to December 31,2019 were analyzed retrospectively. Patients were divided into ROSC and non-ROSC group based on the presence of ROSC or not after CPR. Multivariate logistic regression analysis was used to analyze influence factors for ROSC and prognosis. Result Results of univariate analysis showed CPR duration ≤30 min,epinephrine dosage≤5 mg,early use of Lucas(≤4 min),arterial blood pH＞7.05 on arriving at ED,PETCO2＞20 mm Hg after 15 mins use of Lucas(P＜0.05）were independent influence factors for ROSC in patients with CA underwent mechanical Compressions. After adjustment for confounding factors,multivariate Logistic regression analysis showed CPR duration≤30 min(OR 283.489,95%CI 14.474~5 552.565),early use of Lucas ( ≤4 min)(OR 1.986,95%CI 0.298~13.223),pH＞7.05 on arriving at ED(OR 0.054,95%CI 0.005~0.589)，PETCO2＞20 mm Hg after 15 mins use of Lucas(OR 0.005,95%CI 0.000~0.149) were protective factors for ROSC after mechanical Compressions(P＜0.05). Mechanical compression improved ROSC rate of CA patients in ED. Despite the final admission rates after survival for ROSC were similar between early(≤4 min) and late(＞4 min) use of Lucas group ,yet survival rate at 4 h was better in early group. Conclusion For patients with non-traumatic CA in ED,early use of mechanical compressions may improve ROSC rate and 4h survival rate. CPR duration ,early use of Lucas,arterial blood pH on arriving at ED and P ETCO2 after 15 mins use of Lucas are closely related to the ROSC rate.

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备注/Memo

备注/Memo:
基金项目：四川省卫生和计划生育委员会科研课题（18PJ323）通信作者：项涛，E-mail：1142752929@qq.com共同第一作者：罗丽收稿日期：2021-01-15
更新日期/Last Update: 2021-09-26