影响儿童院内心肺复苏预后的因素分析

目的：探讨儿童院内心肺复苏(cardiopulmonary resuscitation,CPR)预后的影响因素。方法通过回顾性观察研究,对2012年1月至2014年10月我院发生的281例心肺复苏病例进行单因素分析,以自主循环恢复﹥20 min 作为近期复苏成功标准,分析心肺复苏预后的影响因素。结果纳入的281例患儿中,男∶女为1.34∶1,年龄1～191个月,其中自主循环恢复﹥20 min 共129例(45.9%),出院存活20例(8.8%)。性别、年龄、体重、呼吸心跳骤停(cardiopulmonary arrest,CPA)发生时间、CPA 初始心电图、pH 值、乳酸水平对心肺复苏预后无明显影响。基础疾病、CPA 发生地点、CPR 组织人员、通气方式、CPR 总时间、初期复苏时使用肾上腺素的次数、使用碳酸氢钠及血糖情况对复苏成功率有影响。结论目前 CPR 成功率及出院存活率仍较低。呼吸系统疾病成功率相对较高。CPR 时间﹥20 min、需要使用碳酸氢钠以及初期复苏中使用肾上腺素大于3次是影响 CPR 成功的不利因素。

Univariate analysis of pediatric in-hospital cardiopulmonary resuscitation

Objective To study the influencing factors of pediatric in-hospital cardiopulmonary resuscitation(CPR).Methods It was a retrospective observational study.We studied a total of 281 children who suffered in-hospital cardiopulmonary arrest(CPA).The outcome was defined as sustained return of spon-taneous circulation ﹥20 min.Results A total of 281 patients met study entry criteria.In 129 children (45.9%),return of spontaneous circulation sustained ﹥20 min and 20 cases(8.8%)survived to hospital discharge.In the univariate analysis,gender,age,weight,time of CPA happened,first cardiac rhythm,pH, blood lactate had no obvious influence on the outcome.Underlying disease,the place of CPA,personnel fac-tors,airway support,the duration of CPR,doses of adrenaline,use of bicarbonate and blood glucose level were associated with outcome.Conclusion At present,the rate of successful CPR and discharge of hospital is still low.Respiratory disease has a higher survival rate.CPR ﹥20 min,use of bicarbonate and using adrenaline≥3 doses are associated with poor outcome and an increase in mortality.