本文選題：圍手術期 + 心肺復蘇　； 參考：《浙江大學》2013年碩士論文

【摘要】：目的： 為圍手術期實施有效的心肺復蘇提供指導作用。 方法： 回顧性分析2005年1月1日至2012年6月1日期間于浙江大學附屬邵逸夫醫(yī)院行手術治療并在圍手術期發(fā)生心跳驟停且遵照2005年麻醉醫(yī)師協(xié)會心肺復蘇指南進行積極搶救的病例69例(包括急診病例)1。根據(jù)心肺復蘇結果分為：復蘇成功組(27例)和復蘇失敗組(42例)。比較兩組間年齡、性別、ASA分級、BMI(體質指數(shù))、麻醉類型、心跳驟停發(fā)生時間、心跳驟停類型、出血量、心肺復蘇持續(xù)時間、低血壓持續(xù)時間、除顫時機、是否合并心血管疾病等因素,將計數(shù)資料進行卡方檢驗及Logistic回歸檢驗,分析影響心肺復蘇成功率的因素。 結果： 圍手術期發(fā)生心跳驟停并行心肺復蘇病例69例,Logistic分析顯示ASA分級Ⅳ～Ⅴ級(P=0.029,OR=1.956,CI=1.226～4.809)、心跳驟停發(fā)生在手術室外(P=0.014,OR=1.92,CI=1.478～3.513)、出血量在1500ml以上(P=0.023,OR=1.615,CI=1.245～2.313)、CPR時間持續(xù)30min以上(P=0.003,OR=3.54,CI=3.313～5.007)、低血壓時間持續(xù)30min以上(P=0.002,OR=2.782,CI=1.791～4.322)、心跳驟停表現(xiàn)為無脈性電活動(P=0.032,OR=1.419,CI=0.146～1.583)。 結論： ASA分級Ⅳ～Ⅴ級、心跳驟停發(fā)生于手術室外、驟停類型表現(xiàn)為無脈性電活動、出血量大于1500ml、CPR持續(xù)時間大于30min、低血壓持續(xù)時間大于30min為心肺復蘇失敗的危險因素。
[Abstract]:Objective: to provide guidance for perioperative cardiopulmonary resuscitation (CPR). Methods: from January 1, 2005 to June 1, 2012, we performed surgical treatment at Shaw Hospital, Zhejiang University. Cardiac arrest occurred during the perioperative period and followed the 2005 Anesthesiologist's Association of Cardiopulmonary Disease. Resuscitation guidelines for the active rescue of 69 cases (including emergency cases or 1. 5%). According to the results of cardiopulmonary resuscitation, there were 27 cases of successful resuscitation and 42 cases of failed resuscitation. Age, sex and ASA grade BMI (body mass index), anesthesia type, time of cardiac arrest, type of cardiac arrest, bleeding volume, duration of cardiopulmonary resuscitation, duration of hypotension, timing of defibrillation were compared between the two groups. The factors influencing the success rate of cardiopulmonary resuscitation were analyzed by chi-square test and logistic regression test. Results: logistic analysis of 69 patients with cardiac arrest and cardiopulmonary resuscitation during perioperative period showed that ASA grade 鈪，

本文編號：2011799