291例院外心肺复苏成功病例生存出院相关因素分析

目的：探讨院外心肺复苏成功后生存出院病例的特点，为提高院外心肺复苏成功率及生存出院率寻找科学依据。方法回顾分析2011年1月~2012年12月2年时间内上海中心城区院外心肺复苏成功送院病例和生存出院病例，对院外能够影响患者心肺复苏成功率和生存出院率的各因素进行统计学分析。结果①291例院外心肺复苏成功患者中，生存出院病例35例，出院率为12.03%。②生存出院率在0~20岁年龄组最高，随着年龄的增加，生存出院率有明显降低的趋势，P＜0.0001。③生存出院率在导致心搏聚停的各基础病因中有显著差异，P〈0.0001，其中电击伤的生存出院率最高。④生存出院率与急救反应时间差别无统计学意义，P=0.5421。⑤复苏前心电图表现对生存出院率有显著差异，P〈0.0001，以室颤（VF）的生存出院率最高。⑥生存出院率随着转复用时的增加有显著降低的趋势，P〈0.0001。⑦生存出院率随着肾上腺素的使用剂量的增加有显著降低的趋势，P〈0.0001。⑧生存出院率与除颤次数无显著差异，P=0.2119。结论缩短急救反应时间和转复用时，合理使用肾上腺素和电击，积极处理心源性猝死和电击伤对于提高复苏成功患者的生存出院率有非常重要的意义。

Analyses on 291 successful cardiopulmonary resuscitation cases in pre-hospital for their related factors

Objective To explore the characteristics of the survival cases to discharge after cardiopulmonary resuscitation （CPR） performed in pre-hospital stage and provide a scientific basic for improving the successful rate of CPR and survival. Methods The CPR successful cases and the survival to discharge cases in central urban area of Shanghai in between January 2011 and December 2012 were analyzed retrospectively. Rusults①In the 291 CPR successful cases, there were 35 survival to discharge cases, 12.03%. ② A highest survival rate was reflected in the age of between 0 to 20-year old group with a descent along with an increase of age,P〈0.0001. ③ Difference in the causes of breath and cardiac arrest in the survival group was significant,P〈0.0001, and the highest survival rate was found in electric injury group. ④ No significant difference in every group on emergency responding time ,P=0.5421.⑤A significant difference was found in electrocardiogram performance before CPR was performed ,P〈0.0001, and the hightest survival rate was ventricular fibrillation （VF）. ⑥ With increase of the cardioversion time, the survival rate to discharge demonstrated a significant tendency of decrease,P〈0.0001. ⑦ With the increase of epinephrine dose, the survival rate to discharge showed a significant tendency of decrease ,P〈0.0001.⑧No significant difference was found in the times of defibrillation,P=0.2119. Conclusion It is critical to shorten the time of emergency＆nbsp;response and cardioversion, use epinephrine and defibrillation reasonably, and handle sudden cardiac death and electric injury actively. They are considered being effective in improving the successful rate of CPR and survival to discharge.