摘要
目的统计院内心脏性猝死（SCD）的发生率及复苏结果，分析院内SCD的临床特点及影响预后相关的指标。方法回顾2008年1月至2010年12月福建省立医院69例SCD患者的临床资料，分析性别、年龄及心律失常的类型等对SCD发生及复苏结果影响。结果院内SCD年发生率47．3／100000，出院率17．4％。男性比例高于女性（66．7％vs33．3％，P〈0．01），生存出院者较死亡者年轻[男性：（62．57±12．83）岁vs．（75．56±10．55）岁；女性：（60．36±13．24）岁vs．（69．53±11．72）岁，P〈0．01]，差异具有统计学意义；性别对出院率差异无统计学意义（P〉0．05）。62例SCD心电记录不可除颤心律失常多于可除颤心律失常，后者自主循环恢复发生率高（24．5％vs．54．5％，P〈0．05），差异具有统计学意义；但两者出院率差异无统计学意义（18．2％VS．18．4％，P〉0．05）。结论院内SCD以不可除颤心律失常多见，除颤对发生室颤或室速者的ROSC有改善，但高质量CPR及心搏骤停后综合治疗可能对远期生存更为关键。
Objective To explore the incidence, features and outcomes of in-hospital sudden cardiac death （SCD） in order to determine the predictors of survival. Methods The clinical data of 69 patients with cardiac arrest hospitalized from January 2008 through December 2010 were retrospectively analyzed. Information on genders, age, types of arrhythmia was collected and further analyzed to determine these factors associated with the occurrence and outcomes of in-hospital cardiac arrest. Results The overall incidence of SCD was 47.3 / 100 000 per year and 17.4% of them-survived at discharge. The occurrence rate was higher in male than that in female （66. 7% vs. 33.3%, P 〈0. 01 ）, whereas difference in gender did not affect the discharge rate （ P 〉 0. 05 ）. Survivors from in-hospital cardiac arrest were significantly younger than non-survivors （man： 62. 57 -＋ 12. 83 years vs. 75.56 ＋ 10. 55 years; women： 60. 36 ＋ 13.24 years vs. 69.53 ＋ 11.72 years, P 〈 0. 01 ）. From 62 ECG records of SCD patients, the incidence of non- shockable rhythms was higher than that of shockable rhythms. Compare to the non-shockable rhythms, the shockable rhythms brought a higher rate of restoration of spontaneous circulation （ROSC） （54. 5% vs. 24. 5%, P 〈 0. 05）, whereas survival rates at discharge between two groups were not statistically different （ 18. 2% vs. 18.4%, P 〉 0.05 ）. Conclusions Non-shockable rhythms were more common in patients suffering from in-hospital cardiac arrest. Although defibrillation treatment contributed benefit to ROSC among patients with ventricular fibrillation or pulseless ventricular tachycardia, high-quality CPR and post-cardiac arrest care may play a more critical role in the outcomes of in-hospital sudden cardiac death.
出处
《中华急诊医学杂志》
CAS
CSCD
北大核心
2012年第9期1022-1025,共4页
Chinese Journal of Emergency Medicine
基金
基金项目：福建省科技重点项目（2010y0011）
