气管插管时机对ICU内心脏骤停患者预后的影响

发布时间：2018-02-26 03:21

  本文关键词： 气管插管时机 心脏骤停 心肺复苏 预后　出处：《郑州大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的评价ICU内心脏骤停患者心肺复苏过程中气管插管时机对患者预后的影响,为ICU内心脏骤停患者气管插管时机的选择提供参考。方法回顾性分析2014-2016年收住我院ICU内发生心脏骤停患者的病例资料。以心脏骤停至气管插管完成时间6min为界,分为早期气管插管组和延迟气管插管组,主要结局指标为院内生存率;次要结局指标为自主循环恢复、24h生存、良好神经功能预后。运用SPSS软件,根据既往研究及单因素Logistic回归分析结果,构建多因素Logistic回归分析模型探讨气管插管时机对心脏骤停患者预后的影响。结果本研究共纳入736例ICU内发生心脏骤停的患者。其中早期气管插管组357例,延迟气管插管组379例。两组基线资料在性别、年龄、心脏骤停原因等方面无统计学差异。所有患者中院内生存68例,占研究人群的9.20%;自主循环恢复233例,占研究人群的31.70%;24h生存135例,占研究人群的18.30%;患者出院时神经功能预后良好11例,占研究人群的1.50%。早期气管插管组与延迟气管插管组在院内生存率上无统计学意义(11.35%vs 7.12%,χ~2=4.135p=0.055);延迟气管插管组自主循环恢复更多,有统计学意义(21.83%vs14.57%χ~2=9.093 p=0.003);延迟气管插管组24h生存更多,有统计学意义(21.83%vs 14.57%χ~2=6.602 p=0.013);神经功能预后良好无统计学意义(2.70%vs 2.19%χ~2=0.042 p=0.838)。多因素Logistic回归分析在控制年龄、心脏骤停病因、CPR持续时间等影响预后的因素后显示:延迟气管插管是ROSC、24h生存的保护性因素。结论延迟气管插管并未改善患者的院内生存率及良好神经功能预后,可提高心脏骤停患者自主循环恢复及24h生存。延迟气管插管是患者ROSC、24h生存的保护性因素。
[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.
【学位授予单位】：郑州大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R459.7
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本文编号：1536321