影响患者围手术期心肺复苏成功率的因素分析

发布时间：2018-06-13 00:35

  本文选题：围手术期 + 心肺复苏　； 参考：《浙江大学》2013年硕士论文

【摘要】：目的： 为围手术期实施有效的心肺复苏提供指导作用。 方法： 回顾性分析2005年1月1日至2012年6月1日期间于浙江大学附属邵逸夫医院行手术治疗并在围手术期发生心跳骤停且遵照2005年麻醉医师协会心肺复苏指南进行积极抢救的病例69例(包括急诊病例)1。根据心肺复苏结果分为：复苏成功组(27例)和复苏失败组(42例)。比较两组间年龄、性别、ASA分级、BMI(体质指数)、麻醉类型、心跳骤停发生时间、心跳骤停类型、出血量、心肺复苏持续时间、低血压持续时间、除颤时机、是否合并心血管疾病等因素,将计数资料进行卡方检验及Logistic回归检验,分析影响心肺复苏成功率的因素。 结果： 围手术期发生心跳骤停并行心肺复苏病例69例,Logistic分析显示ASA分级Ⅳ～Ⅴ级(P=0.029,OR=1.956,CI=1.226～4.809)、心跳骤停发生在手术室外(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时间持续30min以上(P=0.003,OR=3.54,CI=3.313～5.007)、低血压时间持续30min以上(P=0.002,OR=2.782,CI=1.791～4.322)、心跳骤停表现为无脉性电活动(P=0.032,OR=1.419,CI=0.146～1.583)。 结论： ASA分级Ⅳ～Ⅴ级、心跳骤停发生于手术室外、骤停类型表现为无脉性电活动、出血量大于1500ml、CPR持续时间大于30min、低血压持续时间大于30min为心肺复苏失败的危险因素。
[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，

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