急诊抢救心肺复苏成功率提高的原因分析

目的：探讨影响院前及急诊抢救室心肺复苏成功率的因素。方法：分析2008年6月至2012年6月间723例心肺复苏病例。将病例组分为成功组（117例）和失败组（606例），用t检验和卡方检验，logistic回归分析心肺复苏抢救过程中对成功率的影响因素。进一步对比分析我院2010年前后在影响抢救成功率因素上的变化。结果：120的响应时间在小于3min的情况下、反应时间在小于10min的情况下和在抢救现场积极应用高级生命支持技术可以有效的降低心肺复苏抢救失败率，分别为OR：0．65，95％CI：0．43-0．99；OR：0．64，95％CI：0．42-0．98；OR：0．6l，95％CI：0．39—0．96。，2010年后较2010年以前相比心肺复苏的成功率达到18．2％，且出车时间（大于3rain率降为24．8％）、到达现场时间（大于10min率降为17．1％）和现场应用高级生命支持技术（达到82．9％：气管插管率69．9％、电击除颤率50．1％、复苏药物使用率89．2％）等影响心肺复苏成功率的因素均有明显的改善。结论：实施专业化院前急救可提高院前心肺复苏成功率，同时需要全社会共同关心、共同参与、大力普及心肺复苏知识。

Analysis the Reasons for the Increase in Cardiopulmonary Resuscitation Success Rate Pre-hospital and Emergency Department

Objective： To investigate the influencing tactors of the success ot carnlopulmonary resuscita- tion （ CPR） in emergency room. Method： We analysed 723 cases cardiopulmonary resuscitation from June 2008 to June 2012. They were divided into successful group （ 117 cases） and failure group （606 cases） , Used t-test and chi-square test, logistic regression analysed influencing factors of cardiopulmonary resuscitation success rate. Further comparative analysis the changes of these factors in our hospital before and after 2010. Result： 120 response time less than 3min, reaction time less than 10rain and the positive application of advanced life support technology can effectively reduce cardiopulmonary resuscitation failure rate, respec- tively, OR： 0.65, 95% CI：0.43-0.99; OR： 0.64, 95% CI ：0.42-0.98; OR： 0.61,95% CI ：0.39- 0.96. The cardiopulmonary resuscitation success rate was 18.2% compared before 2010, and dispatch （ greater than 3min rate dropped to 24.8% ） or arrival time of medical personnel （ greater than 10rain rate dropped to 17.1% ） and emergency care facilities and on-site first- aid measures （82.9% } ,the rate of in- tubation was 69.9%, defibrillation rate was 50.1%, recovery in drug utilization rate of 89.2% ） were also improved significantly. Conclusion： Professional pre-hospital emergency care can improve the success rate of pre-hospital cardiopulmonary resuscitation, while common concern of the whole society to participate vig- orously popularizes the knowledge of cardiopulmonary resuscitation.