121例住院患者心室颤动的临床分析

目的探讨患者住院期间心室颤动（VF）的基础原因、复苏影响因素及随访结果，以对医院内、外猝死的抢救有所指导。方法2006年1月1日至12月31日，2所三级医院和12所二级医院住院期间共121例患者发生VF，对其临床资料进行回顾性分析。结果住院期间VF的复苏成功率51．2％；冠心病与非冠心病VF的复苏成功率分别为55．8％和23．5％（P=0．014）；监护区与无监护区VF的复苏成功率分别为80．6％和38．8％（P=0．001）；血钾正常与低钾血症VF复苏成功率58．6％和60．0％（P=0．932）；三级医院与二级医院VF复苏成功率为65．2％和42．7％（P=0．016）；62例复苏成功的VF患者中，住院期间死亡4例，平均随访时间（12±3）个月，随访期间死亡5例。结论住院期间VF的病死率较高；冠心病并发VF的复苏成功率高于非冠心病；直流电除颤是重要的抢救措施；低钾血症不影响VF的复苏成功率；三级医院的复苏成功率高于二级医院。

Clinical evaluation of 121 patients in-hospital ventricular fibrillation

Objective To investigate the rescue of sudden death in-hospital and out-hospital, we ana-lyzed the basic pathogeny of in-hospital ventricular fibrillation, influence factors of resuscitation and follow-up results. Methods One hundred and twenty-one patients with in-hospital ventricular fibrillation in 2 tertiary and 12 secondary hospitals were retrospectively analyzed from Jun. 1,2006 to Nov. 31,2006. Results The total success rate of recovery of in-hospital VF was 51.2%. The success rate of recovery of in-hospital VF in pa-tients with CHD was 55.8% and 23.5% in no-CHD patients(P=0.014). The success rate of recovery of in-hospital VF was 80.6% and 38.8% respectively in wards with and without monitoring facilities (P=0.001). The success rate of recovery of in-hospital VF was 58.6% and 60. 0% respectively in patients with normal po-tassemia and with hypopotassemia(P=0.932). The success rate of recovery of VF was 65.2% and 42.7% re-spectively in tertiary hospital and secondary hospital(P=0.016). In 62 patients of the successful recovery of VF, 4 patients died during the hospital stay, with an average follow-up time of (12±3) months, 5 cases died during follow-up. Conclusion In-hospital VF has relatively higher fatality rate. The success rate of recovery of in-hospital VF in patients with coronary heart disease is higher than non-coronary heart disease. Hypopotas-saemia do not affect the success rate of recovery of in-hospital VF. The success rate of recovery of in-hospital VF in tertiary hospital is higher than in secondary hospital.