本文關(guān)鍵詞： 氣管插管時機(jī) 心臟驟停 心肺復(fù)蘇 預(yù)后　出處：《鄭州大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的評價ICU內(nèi)心臟驟�；颊咝姆螐�(fù)蘇過程中氣管插管時機(jī)對患者預(yù)后的影響,為ICU內(nèi)心臟驟�；颊邭夤懿骞軙r機(jī)的選擇提供參考。方法回顧性分析2014-2016年收住我院ICU內(nèi)發(fā)生心臟驟停患者的病例資料。以心臟驟停至氣管插管完成時間6min為界,分為早期氣管插管組和延遲氣管插管組,主要結(jié)局指標(biāo)為院內(nèi)生存率;次要結(jié)局指標(biāo)為自主循環(huán)恢復(fù)、24h生存、良好神經(jīng)功能預(yù)后。運(yùn)用SPSS軟件,根據(jù)既往研究及單因素Logistic回歸分析結(jié)果,構(gòu)建多因素Logistic回歸分析模型探討氣管插管時機(jī)對心臟驟�；颊哳A(yù)后的影響。結(jié)果本研究共納入736例ICU內(nèi)發(fā)生心臟驟停的患者。其中早期氣管插管組357例,延遲氣管插管組379例。兩組基線資料在性別、年齡、心臟驟停原因等方面無統(tǒng)計(jì)學(xué)差異。所有患者中院內(nèi)生存68例,占研究人群的9.20%;自主循環(huán)恢復(fù)233例,占研究人群的31.70%;24h生存135例,占研究人群的18.30%;患者出院時神經(jīng)功能預(yù)后良好11例,占研究人群的1.50%。早期氣管插管組與延遲氣管插管組在院內(nèi)生存率上無統(tǒng)計(jì)學(xué)意義(11.35%vs 7.12%,χ~2=4.135p=0.055);延遲氣管插管組自主循環(huán)恢復(fù)更多,有統(tǒng)計(jì)學(xué)意義(21.83%vs14.57%χ~2=9.093 p=0.003);延遲氣管插管組24h生存更多,有統(tǒng)計(jì)學(xué)意義(21.83%vs 14.57%χ~2=6.602 p=0.013);神經(jīng)功能預(yù)后良好無統(tǒng)計(jì)學(xué)意義(2.70%vs 2.19%χ~2=0.042 p=0.838)。多因素Logistic回歸分析在控制年齡、心臟驟停病因、CPR持續(xù)時間等影響預(yù)后的因素后顯示:延遲氣管插管是ROSC、24h生存的保護(hù)性因素。結(jié)論延遲氣管插管并未改善患者的院內(nèi)生存率及良好神經(jīng)功能預(yù)后,可提高心臟驟停患者自主循環(huán)恢復(fù)及24h生存。延遲氣管插管是患者ROSC、24h生存的保護(hù)性因素。
[Abstract]:Objective to evaluate the influence of tracheal intubation time on the prognosis of patients with cardiac arrest during cardiopulmonary resuscitation (CPR) in ICU. Methods the data of patients with cardiac arrest in ICU from 2014 to 2016 were retrospectively analyzed. The time from cardiac arrest to tracheal intubation was 6 minutes. The patients were divided into early tracheal intubation group and delayed endotracheal intubation group, the main outcome index was in-hospital survival rate, the secondary outcome index was spontaneous circulation recovery 24 h survival, good nerve function prognosis. SPSS software was used. According to previous studies and univariate Logistic regression analysis, A multivariate Logistic regression model was established to investigate the influence of tracheal intubation timing on the prognosis of patients with cardiac arrest. Results 736 patients with cardiac arrest in ICU were included in this study. There were no statistical differences in sex, age and cause of cardiac arrest between the two groups in terms of baseline data. 68 patients survived in hospital, accounting for 9.20% of the study population, 233 patients recovered their autonomic circulation. In the study group, 135 patients lived in 31.70g and 18.30 in 24 hours, 11 patients had good prognosis at discharge. There was no significant difference in the in-hospital survival rate between the early tracheal intubation group and the delayed tracheal intubation group. There was no significant difference in the in-hospital survival rate between the early tracheal intubation group and the delayed tracheal intubation group. There was no significant difference in the in-hospital survival rate between the early tracheal intubation group and the delayed tracheal intubation group (蠂 ~ (11.35) vs 7.12, 蠂 ~ (24.135) p0. 055). There was no significant difference in the prognosis of nerve function between 2.70 vs 2.19% 蠂 ~ 2 0.042 p ~ (0.838). Multivariate Logistic regression analysis was used to analyze the age of control. The cause of cardiac arrest and the duration of CPR showed that delayed tracheal intubation was the protective factor for roche survival in 24 hours. Conclusion delayed tracheal intubation does not improve the in-hospital survival rate and the prognosis of neurologic function. Delayed tracheal intubation was the protective factor for the survival of patients with cardiac arrest.
【學(xué)位授予單位】：鄭州大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R459.7
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本文編號：1536321