【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～2006年间142例心肺复苏病例。2004年、2005年病例按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。这些因素在两组组间的比较均有显著性差异(均P<0.05);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、小剂量应用肾上腺素、胺碘酮、纳络酮是提高心肺复苏成功率的有利因素。更多还原

【Abstract】 Objective To investigate the influencing factors of the success of cardiopulmonary resuscitation(CPR) in emergency room and to identify the ways to further improve the emergency treatment.Methods When the patients to undergo CPR arrived the emergency room of Hangzhou Red Cross Hospital,52 relevant items were recorded by the nurses.At last 35 indicators with potential influences on the success of CPR were selected to analyze among 142 patients with complete data.The patients admitted 2004 and 2005 were treated according to the 2000 American Heart Association Guidelines for CPR,and the patients admitted in 2006 were treated according to the 2005 American Heart Association guidelines for CPR.Results The trauma rate was higher,and the rates of precursory signs,past medical history of more than two diseases,and onset in winter and early spring were lower in the failure group than in the success group(all P<0.05).The dose of adrenaline used and the rates of amiodarone and aloxane application of the failure group were all significantly higher than those of the success group(P <0.05 or P<0.01)..Logistic regression showed that total amount of adrenaline was an independent risk factor of failure of CPR(OR= 1.2994),and using naloxane was an independent favorable factor of failure of CPR(OR=0.2894).Conclusion Timely identification of precursory signs,VPR begun as early as possible,hypothermic treatment of the head,application of low amount of adrenalin,and distraction of amiodarone and naloxane are all favorable factors of success of CPR.更多还原