创伤性心搏骤停的流行病学特征及预后研究

发布时间：2018-03-09 17:01

本文选题：心搏骤停　切入点：创伤　出处：《中国全科医学》2017年31期 　论文类型：期刊论文

【摘要】：目的了解创伤性心搏骤停(TCA)的流行病学特征、预后情况并探讨影响其预后的因素。方法选取2012年1月—2016年9月浙江省人民医院急诊科、绍兴市急救中心及宁波市急救中心接诊的544例院外心搏骤停(OHCA)患者,其中TCA患者186例,非TCA患者358例。参照Utstein模式收集临床资料,回顾性分析其年龄、性别、发作地点、被目击情况、目击者心肺复苏(CPR)、急救反应时间、初始心律、院外除颤、院外气管插管、院外使用肾上腺素、院外开通静脉通路、自主循环恢复(ROSC)、存活入院及存活出院等信息,并比较TCA患者与非TCA患者上述特征及转归的差异。结果 TCA患者与非TCA患者在年龄、发作地点、初始心律、院外使用肾上腺素及开通静脉通路等流行病学特征上差异有统计学意义(P0.05)。非TCA患者与TCA患者的ROSC比较,差异有统计学意义(P0.05)。非TCA患者与TCA患者的存活住院、存活出院比较,差异均无统计学意义(P0.05)。被目击、初始心律为心室停搏、急救反应时间10 min、目击者CPR及院外除颤是TCA患者ROSC的影响因素(P0.05)。结论TCA与非TCA患者的复苏存活率均不高,TCA患者的ROSC率更低,改善院外生存链的一系列因素如增加目击者CPR、院外除颤及减少急救反应时间有助于增加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.
【作者单位】：浙江省人民医院急诊科;绍兴市急救中心;宁波市急救中心;
【分类号】：R181.3;R541.78

【相似文献】