摘要
目的筛选预测心肺复苏自主循环恢复昏迷患者预后相关指标。方法回顾性收集心肺复苏自主循环恢复昏迷患者143例的病例资料,对其可能与预后相关指标分别进行单因素分析和多因素分析。结果年龄、基础疾病、心脏骤停场所不能预测患者预后,复苏开始时间、复苏持续时间、心搏骤停前的心律、复苏中有无室颤或室速、复苏后第3天的APACHEⅡ评分、复苏后有无肌阵挛或抽搐、有无脑干反射等与患者预后密切相关。它们对患者预后的预测价值排序为:脑干反射>肌阵挛或抽搐>复苏开始时间>心搏骤停前的心律>APACHEⅡ评分>复苏中有无室颤或室速>复苏持续时间。结论复苏后3d的脑干及皮质神经功能对患者预后预测的准确性最高。复苏后有无肌阵挛或抽搐、3d后有无脑干反射、复苏开始时间、复苏持续时间、心搏骤停前的心律、复苏中有无室颤或室速、复苏后第3天的APACHEⅡ评分等指标是建立心肺复苏自主循环恢复昏迷患者预后预测系统的基本指标。
Objective To explicit the prediction factors of return of spontaneous circulation （ROSC） after cardiopulmonary resuscitation （CPR）.Methods 143 of patients with CPR-ROSC were enrolled in study and clinic data were collected.The factors which possibly predict outcomes of CPR-ROSC were analyzed by single factor analysis and multivariate analysis respectively.Results Age,basic disease,site of cardiac arrest couldn′t predict the outcome of patients with CPR-ROSC;but the arrest times,rescuing times,rhythm of the heart before arrest and during rescue cause,APACHEⅡscore,hyperspasmia or myoclonus and neural reflex of brainstem after 3 days of CPR-ROSC could predict the outcome.The value sort order of prediction factors from maximum to minimum were neural reflex of brainstem,hyperspasmia or myoclonus,rhythm of the heart before arrest,arrest times,APACHEⅡscore,rescuing times and rhythm of the heart during rescue cause.Conclusion The neural reflex of brainstem and cerebral cortex functions after 3 days of CPR-ROSC have the superem veracity for predict the outcome of patients with CPR-ROSC.The following factors incloude aneural reflex of brainstem,hyperspasmia or myoclonus,rhythm of the heart before arrest,arrest times,APACHEⅡscore,rescuing times and rhythm of the heart during rescue cause may be the basic factors which used to build up outcome prediction system for patients with CPR-ROSC.
出处
《实用心脑肺血管病杂志》
2010年第9期1205-1207,共3页
Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease
关键词
心肺复苏
自主循环恢复
预后
预测
Cardiopulmonary resuscitation
Return of spontaneous circulation
Outcome
Prediction
