心搏骤停心肺复苏中若干问题的探讨

目的探讨影响心搏骤停(CA)心肺复苏(CPR)有效率的因素。方法回顾性分析87例CA患者心肺复苏的临床资料,包括年龄、心搏骤停前基础疾病、电除颤开始时间、CPR开始时间、CPR持续时间、人工呼吸开始时间等。结果87例CA行心肺复苏患者中,49例复苏有效(56.3%),38例复苏失败(43.7%);复苏有效组与复苏失败组患者的病因分布、年龄、电除颤开始时间、CPR开始时间、CPR持续时间间差别均有显著性意义(P<0.05),人工呼吸开始时间间差别无显著性意义(P>0.05);肾上腺素首次应用剂量为1mg,以后重复时增加剂量,复苏有效组中有21例应用,复苏失败组中有9例应用。结论原发疾病、患者年龄、电除颤开始时间、CPR开始时间、CPR持续时间是影响CA患者CPR有效率的重要因素;立即建立人工循环并将肾上腺素用量与用药时机有效结合是提高CPR有效率的关键措施。

The Discussion of Several Problems about Cardiopulmonary Resuscitation in Cardiac Arrest

Objective To explore the factors raising the effective ratio of cardiopulmonary resuscitation (CPR) in cardiac arrest (CA).Methods A retrospective analysis was done on the clinical data of CPR in 87 CA patients.The clinical data included the age,the basic disease before CA,the starting time of electric defibrillation and CPR,the duration of CPR,the starting time of artificial respiration.Results In 87 cases,49 were successfully resuscitated(56.3%),while 38 were unsuccessful(43.7%).There were significant differences between the patients who were successfully resuscitated and those who were unsuccessful in the distribution of etiological factor,the age,the starting time of electric defibrillation and CPR,the duration of CPR (P<0.05),but the starting time of artificial respiration were similar(P>0.05).Adrenalin of 1mg was used at first,then the dosage of adrenalin was added,which was applied to 21 patients who were successfully resuscitated,and to 9 patients who were not.Conclusion The major factors affecting the effective rate of CPR are the primary disease,the age,the starting time of electric defibrillation and CPR and the duration of CPR;Building the artificial circulation immediately and the effective combination of the dosage and the time of using adrenaline are the key measures to raise the effective rate of cardiopulmonary resuscitation.