影响儿童心肺复苏成功率的八项因素分析

发布时间：2018-03-01 17:26

本文关键词： 心脏骤停心肺复苏影响因素成功率　出处：《山东大学》2012年硕士论文　论文类型：学位论文

【摘要】：研究目的：笔者对2009-2012年3年中我院的235例CPR儿童患者进行回顾性研究,以客观反映目前CPR的现状,探讨心跳骤停患者的临床特点及救治经验,总结分析影响心肺复苏成功率的因素,以进一步提高儿童心肺复苏的水平。研究对象： 2009年3月至2012年2月3年间,本院急诊室、手术室、普通病房内以及院外抢救的心搏骤停患者,235例实施的患者中男130例,女105例。根据自己的经验,选择八项影响儿童心肺复苏成功率的因素,每一种因素再进行分类,然后统计每一分类的CPR成功率,应用SPSS13.0软件进行统计学分析,根据结果进行讨论,最后得出结论。八项影响因素分类分别见表1至表8。研究方法：对我院2009年3月——2012年2月235例心跳呼吸骤停的患者进行的心肺复苏急救的过程与结果进行了回顾性的分析。对以上八项因素的成功率进行统计分析,采用SPSS13.0(?)勺统计学软件进行。以P0.05具有统计学意义,差异显著。结果与分析：采用以上资料、分组,进行统计学分析,总体复苏结果：心肺复苏235例,成功49例,失败186例,总体成功率为20.85% 1.性别对复苏成功率无影响。男性和女性儿童心肺复苏成功率几乎一致,均接近总体复苏成功率20.85%。 2.年龄对心肺复苏成功率有影响。年龄越小,心肺复苏成功率越低,年龄越大,心肺复苏成功率越高。 3.引起心脏骤停患者的原发性基础疾病对心肺复苏成功率有影响。与心脏骤停有关的的原发性心脏疾病心肺复苏的成功率较低,重要脏器如脑的疾病引起的心脏骤停患者心肺复苏的成功率也较低,重症肺炎、误吸窒息等非心脑重要脏器的损害引起的心脏骤停患者心肺复苏的成功率较高。 4.对心脏骤停患者抢救开始的时间与成功率有显著的影响。在心脏骤停患者发生的1-4分钟内对患者进行心肺复苏的成功率最高,达到60.8%,超过10分钟进行的心肺复苏的成功率最低。 5.心脏骤停患者发生的地点对心肺复苏成功率有影响。发生在医院内的CPR成功率较高,院外的CPR成功率较低。 6.心脏骤停患者现场第一人员知识、水平对心肺复苏成功率有着显著的影响。心脏骤停患者现场第一人员知识、水平越高,心肺复苏的成功率越高。 7.CPR持续时间超过《国际心肺复苏指南》标准时间30min以上,对心肺复苏成功率并未有显著的影响。CPR持续时间达到30min的抢救成功率比较高,超过30min以上者,如持续35min、45min、55min三种情况,心肺复苏成功率几乎一致。 8.应用标准剂量与大剂量的肾上腺素对心肺复苏的成功率无影响。给CA患者用标准剂量与大剂量的肾上腺素,心肺复苏的成功率一致,都接近于总体成功率20.85%。结论：近年来,复苏方法学的研究较多,它们与指南推荐的标准法相比,脑复苏率的优势并不明显。我们认为,寻求更有效的复苏方法当然重要,如何推行标准CPR,并把它运用到临床复苏中去则是务实的作法。提高CPR成功率的切行可效的途径,总结为两大思想： 1.在未发生CA的情况下,大力提倡“治未病”的思想。 2.发生CA的情况下,以下三项是最有效的提高CPR成功率的途径： ①急救反应通道的完善； ②急救医护人员的CPR专业水平的规范、提高； ③大众急救知识的普及。采取的措施：例如,对于“治未病”的思想,可以进行更高层次的物质、精神文化的更高建设。对于第三项大众急救知识的普及,可以以每个家庭为准,印制发行急救最基本知识的通俗宣传手册,每个家庭发放一本；每个电视台每周一分钟的急救知识的宣传；社区墙壁、报纸急救知识的宣传。
[Abstract]:The purpose of the study is:
The author of the 2009-2012 years in our hospital for 3 years in 235 children with CPR were studied retrospectively, to objectively reflect the current status of CPR, to explore the clinical features and treatment experience of cardiac arrest patients, summarize and analyze the factors influencing the success rate of cardiopulmonary resuscitation, in order to further improve the children's level of cardiopulmonary resuscitation.
Research object:
From March 2009 to February 2012 3 years, the hospital emergency room, operation room, general ward within and outside the hospital to rescue the patients with cardiac arrest, 235 cases of the implementation of the patients with male 130 cases, female 105 cases. According to their own experience, choose eight factors affecting children's success rate of cardiopulmonary resuscitation, every kind of factors for classification then, statistics of each classification success rate of CPR, SPSS13.0 software was used for statistical analysis, are discussed according to the results, finally draw the conclusion. Eight factors were classified in Table 1 to table 8.
Research methods:
Cardiopulmonary resuscitation in our hospital in March 2009 February 2012, 235 cases of respiratory and cardiac arrest patients in the process and results of first aid were analyzed retrospectively. Statistical analysis of the above eight factors of the success rate of the SPSS13.0 (?) the statistical software. P0.05 has statistical significance, the difference was significant.
Results and analysis:
Using the above data, grouping, statistical analysis, the overall results of resuscitation: 235 cases of cardiopulmonary resuscitation, 49 cases of success, 186 cases of failure, the overall success rate is 20.85%.
1. sex has no effect on the success rate of resuscitation. The success rate of CPR in male and female children is almost identical, which is close to the overall success rate of recovery 20.85%..
The 2. age has an effect on the success rate of cardiopulmonary resuscitation. The younger the age, the lower the success rate of cardiopulmonary resuscitation, the older the age, the higher the success rate of cardiopulmonary resuscitation.
3. patients with cardiac arrest caused by primary disease on the basis of the success rate of cardiopulmonary resuscitation of cardiac arrest. And the primary heart disease cardiopulmonary resuscitation success rate is low, the important organs such as brain disease caused by cardiac arrest cardiopulmonary resuscitation in the patients with a lower success rate, severe pneumonia. Aspiration asphyxia and other non cardiovascular and major organ damage caused by cardiac arrest cardiopulmonary resuscitation in patients with high success rate.
4., there was a significant impact on the time and the success rate of rescue for patients with cardiac arrest. The success rate of cardiopulmonary resuscitation in patients within 1-4 minutes after cardiac arrest was 60.8%, and the success rate of cardiopulmonary resuscitation was the lowest in 10 minutes.
5. the location of the patients with cardiac arrest has an impact on the success rate of cardiopulmonary resuscitation. The success rate of CPR in the hospital is higher, and the CPR success rate outside the hospital is low.
6., the knowledge level of the first person in the cardiac arrest patients has a significant impact on the success rate of cardiopulmonary resuscitation. The higher the knowledge level of the first person in cardiac arrest is, the higher the success rate of cardiopulmonary resuscitation.
The duration of 7.CPR more than < above international CPR > 30min standard time, the success rate of cardiopulmonary resuscitation did not have a significant effect of.CPR rescue duration to achieve the success rate of 30min is relatively high, more than 30min, such as 45min, 55min for 35min, three cases, the success rate of cardiopulmonary resuscitation is almost the same.
8., standard dose and large dose of epinephrine had no effect on the success rate of cardiopulmonary resuscitation. For CA patients, the success rate of cardiopulmonary resuscitation was consistent with standard dose and large dose of epinephrine, which were close to the overall success rate of 20.85%..
Conclusion:
In recent years, more research on recovery method study, compared them with the standard method recommended, the recovery rate of brain advantage is not obvious. We believe that to seek more effective methods of recovery is very important, how to carry out the standard of CPR, and apply it to clinical recovery is a pragmatic approach.
The effective way to improve the success rate of CPR is summed up in two main ideas:
1. in the absence of CA, the idea of "treating no disease" was strongly advocated.
2. in the case of CA, the following three are the most effective ways to improve the success rate of CPR:
(1) the improvement of emergency response channel;
The standard of CPR professional level of first aid medical staff is improved.
The popularization of the knowledge of the public first aid.
Measures taken:
For example, for "zhiweibing" thought, can be carried out at higher levels of material, the higher the construction of spiritual culture. The popularity of third public knowledge of first aid, with each family as the standard, the basic knowledge of first aid printing and issuing of popular brochures, every family put a book; every TV propaganda every Monday minutes of first aid; community walls, newspaper first aid knowledge propaganda.

【学位授予单位】：山东大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R720.597

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