摘要
目的评估初始心律对院内心搏骤停患者预后的影响。方法回顾2011年5月至2016年4月福建省立医院62例院内心搏骤停患者临床资料，采用Logistic回归对影响自主循环恢复（ Restoration of spontaneous circulation, ROSC）成功率的因素进行筛选。以患者发生心搏骤停时初始心律分为可除颤心律（包括心室颤动及无脉室性心动过速）及不可除颤心律组（包括无脉性电活动及心电静止），比较组间ROSC率、出院存活率及出院神经功能良好率。结果Logistic回归显示仅不可除颤初始心律对ROSC成功有不利影响。可除颤心律组较不可除颤心律组ROSC率（χ2=6．90，P=0．01）、出院存活率（χ2=10．49，P=0．00）及出院神经功能良好率（χ2=14．70，P=0．00）均较高。心室颤动与无脉室性心动过速、无脉电活动与心电静止之间比较差异无统计学意义。结论初始心律为可除颤心律的院内心搏骤停患者其ROSC率、出院存活率及出院神经功能良好率均较高。
Objective To evaluate the prognostic value of the first documented rhythm in patients with in-hospital cardiac arrest. Methods The clinical data of 62 in-hospital cardiac arrest patients collected from May 2011 to April 2016 were reviewed. Multiple regression analysis was performed for determination of the factors relevant to ROSC. The patients were divided into defibrillative rhythm group [ ventricular fibrillation （VF） /ventricular tachycardia （VT）] and non-defibrillative rhythm group [ pulseless electrical activity （PEA） /asystole ] according to the first documented rhythm after cardiac arrest. The differences in rate of restoration of spontaneous circulation, number of survival at hospital discharge and those discharged with favorable neurological outcome were compared between groups. Results Logistic regression analysis showed that non-defibrillative rhythm was related to low rate of ROSC. Rate of ROSC （ χ2 = 6. 90, P = 0. 01 ）, number of survival at hospital discharge （ χ2 = 10. 49, P = 0. 00 ） and those discharged with favorable neurological outcome （ χ2 = 14. 70, P = 0. 00 ） were higher in the defibrillative rhythm group, while there was no difference in outcomes between the VF and VT groups. There was no difference in consequence found between the PEA and asystole groups. Conclusion Rate of restoration of spontaneous circulation, number of survival at hospital discharge and those discharged with favorable neurological consequence were higher with defibrillative initial rhythm.
出处
《中华急诊医学杂志》
CAS
CSCD
北大核心
2017年第2期202-205,共4页
Chinese Journal of Emergency Medicine
基金
2017年福建省科技厅引导类项目资助
关键词
院内心搏骤停
心律
可除颤心律
不可除颤心律
预后
自主循环恢复
出院存
活
神经功能
In-hospital cardiac arrest
Rhythm
Shockable rhythm
Non-shockable rhythm
Prognosis
ROSC
Survival to discharge
Neurological function
