發(fā)布時間：2018-03-09 17:01

  本文選題：心搏驟停　切入點(diǎn)：創(chuàng)傷　出處：《中國全科醫(yī)學(xué)》2017年31期 　論文類型：期刊論文

【摘要】：目的了解創(chuàng)傷性心搏驟停(TCA)的流行病學(xué)特征、預(yù)后情況并探討影響其預(yù)后的因素。方法選取2012年1月—2016年9月浙江省人民醫(yī)院急診科、紹興市急救中心及寧波市急救中心接診的544例院外心搏驟停(OHCA)患者,其中TCA患者186例,非TCA患者358例。參照Utstein模式收集臨床資料,回顧性分析其年齡、性別、發(fā)作地點(diǎn)、被目擊情況、目擊者心肺復(fù)蘇(CPR)、急救反應(yīng)時間、初始心律、院外除顫、院外氣管插管、院外使用腎上腺素、院外開通靜脈通路、自主循環(huán)恢復(fù)(ROSC)、存活入院及存活出院等信息,并比較TCA患者與非TCA患者上述特征及轉(zhuǎn)歸的差異。結(jié)果 TCA患者與非TCA患者在年齡、發(fā)作地點(diǎn)、初始心律、院外使用腎上腺素及開通靜脈通路等流行病學(xué)特征上差異有統(tǒng)計學(xué)意義(P0.05)。非TCA患者與TCA患者的ROSC比較,差異有統(tǒng)計學(xué)意義(P0.05)。非TCA患者與TCA患者的存活住院、存活出院比較,差異均無統(tǒng)計學(xué)意義(P0.05)。被目擊、初始心律為心室停搏、急救反應(yīng)時間10 min、目擊者CPR及院外除顫是TCA患者ROSC的影響因素(P0.05)。結(jié)論TCA與非TCA患者的復(fù)蘇存活率均不高,TCA患者的ROSC率更低,改善院外生存鏈的一系列因素如增加目擊者CPR、院外除顫及減少急救反應(yīng)時間有助于增加TCA患者的ROSC。
[Abstract]:Objective to investigate the epidemiological characteristics and prognosis of traumatic cardiac arrest (TCA) and to explore the factors affecting the prognosis. Methods the emergency department of Zhejiang Provincial people's Hospital from January 2012 to September 2016 was selected. 544 patients with sudden cardiac arrest (OHCA) received treatment in Shaoxing first aid center and Ningbo emergency center, including 186 patients with TCA and 358 patients without TCA. The clinical data were collected according to the Utstein model, and their age, sex and location of attack were analyzed retrospectively. By eyewitness, CPR, first aid reaction time, initial rhythm, defibrillation, tracheal intubation outside hospital, use of epinephrine out of hospital, opening of venous access outside hospital, recovery of autonomic circulation, survival and discharge from hospital, etc. The characteristics and outcome of TCA patients and non-#en1# patients were compared. Results the age, location of onset, initial rhythm of TCA patients and non-#en3# patients were compared. There were statistically significant differences in the epidemiological characteristics of the use of epinephrine and the opening of vein pathway between non-hospital and TCA patients. The difference in ROSC between non-#en3# patients and TCA patients was statistically significant. The survival of non-#en3# patients and TCA patients was compared with that of TCA patients. The difference was not statistically significant (P 0.05). The initial cardiac rhythm was ventricular arrest. CPR and defibrillation were the influencing factors of ROSC in TCA patients (P 0.05). Conclusion the survival rate of resuscitation in both TCA and non-#en4# patients is lower than that in TCA patients. A series of factors to improve the out-of-hospital survival chain, such as increasing eyewitness CPR, defibrillation outside the hospital and reducing the emergency response time, will help to increase the ROSC of TCA patients.
【作者單位】： 浙江省人民醫(yī)院急診科;紹興市急救中心;寧波市急救中心;
【分類號】：R181.3;R541.78

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本文編號：1589432