摘要
目的回顾自主循环恢复（ROSC）的心肺复苏（CPR）患者的出院时生存率，脑功能分级（CPC）状况，分析影响该类患者预后的因素。方法对2009年1月至2016年12月中国医科大学航空总医院重症医学科收治的ROSC的CPR患者（以下简称ROSC—CPR）的基本临床资料进行分析，从中找出影响其预后的相关因素。结果共纳入185例ROSC—CPR患者，男110例（59．5％），年龄（67．15±17．64）岁，急性生理与慢性健康评分Ⅱ（APACHEII）评分（28．80±7．16）分。总体出院生存率30．3％（56／185）。存活组和死亡组相比，在机械通气、血液净化以及目标温度管理使用的比率方面差异均无统计学意义（P〉0．05）。总体出院生存患者的病因构成以心源性因素最多见，但CPC功能恢复良好者（1级＋2级）仅为16例（8．6％）。Logistic回归分析结果显示，APACHEⅡ评分越高、CPR至ROSC的恢复时间≥10min、复苏地点为院外者是患者出院生存的不利因素（P〈0．05）。而发生在后4年、病因为心源性者是患者出院生存的有利因素（P〈0．05）。结论本院ICU中ROSC-CPR患者出院生存率，尤其CPC达到较好状态的比例仍然低下。缩短CPR至ROSC的时间，加强复苏术后亚低温治疗对本院未来改善该类患者的预后可能有一定帮助。
Objective To investigate the survival rate and status of cerebral performance category in patients who received cardiopulmonary resuscitation （CPR） with return of spontaneous circulation （ROSC） （abbreviated by ROSC-CPR） after discharge, and to analyze the risk factors which influencing the prognosis of these patients. Methods A retrospective analysis of the clinic data coming from the patients who received cardiopulmonary resuscitation with return of spontaneous circulation and admitted to the Department of Intensive Care Unit from January 2009 to December 2016 was carried out to find corresponding risk factors influencing the prognosis. Results A total of 185 patients who received ROSC-CPR with 59. 5% male , the average age of （67.15±17.64）years old and the average Acute Physiology and Chronic Health Evaluation 11 （APACHE 11 ） score （28.80 ±7.16） were divided into two groups, the survival group （n =56） and the death group （n = 129）. The total survival rate was 56/185 （30. 3% ）. Compared to the death group, the usage rate of ventilation, blood purification and target temperature management in survival group was no significant （ P 〉 0. 05 ）. The most common aetiology of the survival patients was cardiogenic disease, but the number of those patients with the good cerebral performance category （ CPC 1/2 ） discharged from hospital were 16 cases （8.6%）. According to logistic analysis, high value of APACHE l/ score, the duration from CPR to ROSC over 10 minutes, admission took place out-of-hospital were unfavor-able predictors for the prognosis （P 〈 0. 05）, while admission took place in the second four years and cases with cardiogenic aetiology were favorable predictors for the prognosis of these patients who suffered from ROSC-CPR. Conclusions The survival rate of the patients who received CPR with ROSC after discharge was still low, especially the rate of good status of CPC was very low. To shorten the duration from CPR to ROSC as possible as we can, and to strengthen target temperature management would improve the prognosis of the patients who received CPR with ROSC in our hospital in future days.
作者
李喜元
安建雄
李灯凯
马加贵
陈丽
Li Xiyuan An Jianxiong Li Dengkai Ma Jiagui Chen Li(Department of Intensive Care Unit, Aviation General Hospital, China Medical University, Beijing 100012, China)
出处
《中国医师杂志》
CAS
2017年第6期868-871,共4页
Journal of Chinese Physician
关键词
心肺复苏术
存活率
Cardiopulmonary resuscitation
Survival rate
