院内心脏性猝死复苏结果及预后研究.docVIP

院内心脏性猝死复苏结果及预后研究【摘要】目的 统计院内心脏性猝死（SCD）的发生率及复苏结果，分析院内SCD的临床特点及影响预后相关的指标。方法 回顾2008年1月至2010年12月福建省立医院69例SCD患者的临床资料，分析性别、年龄及心律失常的类型等对SCD发生及复苏结果影响。结果 院内SCD年发生率47.3/100 000，出院率17.4%。男性比例高于女性（66.7% vs. 33.3%， P 0.05）。62例SCD心电记录不可除颤心律失常多于可除颤心律失常，后者自主循环恢复发生率高（24.5% vs. 54.5%， P 0.05）。结论 院内SCD以不可除颤心律失常多见，除颤对发生室颤或室速者的ROSC有改善，但高质量CPR及心搏骤停后综合治疗可能对远期生存更为关键。 【关键词】院内心脏性猝死；发生率；出院率；心律失常；心肺复苏 The outcomes and prognoses of in—hospital sudden cardiac death ZHAO Shen， CHEN Feng， WANG Xiao—ping， LIN Qing—ming， KE Jun. Fujian Provincial Hosptial Emergency Department，The Center of Fujian Provincial Emergency， Fuzhou 350001， China Corresponding author： CHEN Feng ， Email： cf9066@126.com 【Abstract】Objective To explore the incidence， features and outcomes of in—hospital sudden cardiac death （SCD） in order to determine the predictors of survival.Methods The clinical data of 69 patients with cardiac arrest hospitalized from January 2008 through December 2010 were retrospectively analyzed. Information on genders， age， types of arrhythmia was collected and further analyzed to determine these factors associated with the occurrence and outcomes of in—hospital cardiac arrest. Results The overall incidence of SCD was 47.3 / 100 000 per year and 17.4% of them survived at discharge. The occurrence rate was higher in male than that in female （66.7% vs. 33.3%， P 0.05）. Survivors from in—hospital cardiac arrest were significantly younger than non—survivors （man： 62.57±12.83 years vs. 75.56±10.55 years； women： 60.36±13.24 years vs. 69.53±11.72 years， P 0.05）. Conclusions Non—shockable rhythms were more common in patients suffering from in—hospital cardiac arrest. Although defibrillation treatment contributed benefit to ROSC among patients with ventricular fibrillation or pulseless ventricular tachycardia， high—quality CPR and post—cardiac arrest care may play a more critical role in the outcomes of in—hospital sudden cardiac death. 　　【Key words】Sudden cardiac death in—hospital； Incidence； Discharge ra