影响急诊科心肺复苏成功率的因素.docVIP

影响急诊科心肺复苏成功率的因素 隋向前邓旻周燕华朱仕兵徐颖 马伟 吕菁【摘要】 目的 分析影响急诊科心肺复苏成功率的因素，探讨提高急诊抢救效率的方法。方法 分析2004年至2006年间142例心肺复苏病例。2004、2005年病例2000AHA 心肺复苏指南抢救；2006年病例按2005AHA 心肺复苏指南抢救。病例被分为成功组（42例）和失败组（100例）。用t检验、χ2 检验、Logistic回归分析复苏过程中35项因素对复苏结果的影响。结果 失败组外伤病例比例高，2种或以上疾病史少，有先兆病例比例低，冬春季节发病比例低，非递增法用肾上腺素比例低，用肾上腺素总量大，胺碘酮及纳络酮的使用率低。两组比较有显著性差异（P0.05）； Logistic回归分析显示肾上腺素总量是复苏失败的独立危险因子；用纳络酮是复苏失败的独立保护因子。结论 掌握先兆、小量用肾上腺素、用胺碘酮、用纳络酮是提高心肺复苏成功率的有利因素。【关键词】心肺复苏；心脏按压 Factors on successful emergency cardiopulmonary resuscitation in emergency department DENG Min , SUI Xiangqian , ZHOU Yanhua, et al . Emergency Department, raditional Chinese Medicine University, Hangzhou310003, China 【Abstract】Objective To analyze the factors on successful cardiopulmonary resuscitation (CPR) in emergency department and to study the methods of raising the efficiency of the emergency salvage. Methods 142 cases of CPR between January 2004～December 2006 were analyzed . The cases in 2004 and 2005 were treated according to 2000 American Heart Association guidelines for CPR ,and the cases in 2006 were treated according to 2005American Heart Association guidelines for CPR. The cases were divided into the success group (42 cases) and the failure group(100cases).The effect of 35 factors on the result of CPR were analyzed by t test , χ2 test and Logistic regression. Result There were higher rate of external trauma, lower rate of history more than one disease , lower rate of omen, lower rate of getting sick in the winter and the spring , lower rate of using 1 mg of adrenaline each time, using greater quantities of adrenaline , lower rate of using amiodarone , lower rate of using naloxane in the failure group. There were obvious differences between the two groups (P0.05). Logistic regression showed that total amount of adrenaline was the independent risk of the failure of CPR（OR=1.2994） and using naloxane was the independent benefit of the failure of CPR （OR=0.2894）. Conclusion To control omen, to use small quantity of