摘要
目的分析院前救治的心搏骤停患者流行病学特点及救治情况。方法采用多分站回顾性分析研究方法,以珠海市22家不同等级医院2017年1月1日至2019年12月31日院前救治的心搏骤停患者为研究对象,分析患者性别、年龄、发病季节、既往史、发病地点、病因、急救反应时间、心电图表现、有无目击者、有无目击者心肺复苏(CPR)、有无院前除颤、有无院前气管插管、有无院前开通静脉通路、有无院前使用肾上腺素,以及自主循环恢复、存活住院、存活出院和出院时的神经功能状态等相关资料。结果院前心搏骤停病例1612例,其中男性1116例,女性496例,男女比为7∶3,年龄37~67岁,平均(50±5)岁,且65.69%发生在家中,现场心电图多为心室停搏,发生心搏骤停病例中,既往史为体健41例(2.54%),有明确心脑血管病史者754例(46.77%),不明原因者212例(13.15%);院前心搏骤停主要发生于春冬季节,病因主要为心源性疾病66.38%,呼吸系统疾病2.42%,创伤12.22%,溺水1.55%等;平均急救反应时间为(13±5)min,第一目击者救治率为1.99%;主要救治措施:院前除颤率为20.72%,院前气管插管率为16.32%,院前静脉开通率为51.36%,院前肾上腺素使用率为41.07%。院前心搏骤停患者在现场/途中自主循环恢复率为2.54%、0%,存活住院率为0.81%;存活出院率为0.19%,存活出院且神经功能良好为0.12%。结论根据院前心搏骤停流行病学的特点,完善急救体系的建立,加快普及现场第一目击者行心肺复苏的意识和技能,发病时及早实施有效的急救措施,最大限度地缩短急救反应时间,对提高院前心搏骤停患者复苏存活率具有重要意义。
Objective To analyze the epidemiological characteristics and treatment of patients with cardiac arrest treated before hospitalization in Zhuhai.Methods A multi-station retrospective analysis method was conducted on subjects with cardiac arrest treated before hospitalization selected in 22 hospitals of different grades in Zhuhai(from January 1,2017 to December 31,2019).The data of sex,age,season of onset,past history,location of onset,etiology,first aid response time,electrocardiogram(ECG),eyewitness,cardiopulmonary resuscitation(CPR),pre-hospital defibrillation,pre-hospital tracheal intubation,pre-hospital venous access,pre-hospital use of epinephrine,recovery of autonomic circulation,survival in hospital,survival and discharge,and neurological function at discharge were analyzed.Results There were 1612 cases of pre-hospital cardiac arrest,including 1116 males and 496 females.The average age was(50±5)years old,and 65.69%occurred at home.The electrocardiogram on the spot was mostly ventricular arrest.Among the cases of cardiac arrest,41 cases(2.54%)had a past history of physical health,754 cases(46.77%)had a definite history of cardio-cerebrovascular disease,and 212 cases(13.15%)had unknown causes.Pre-hospital cardiac arrest mainly occurred in spring and winter,and the main causes were cardiogenic diseases(66.38%),respiratory diseases(2.42%),trauma(12.22%)and drowning(1.55%),etc.The average first aid response time was(13±5)minutes,and the first eyewitness treatment rate was 1.99%.Among the main treatment measures,the pre-hospital defibrillation rate was 20.72%,the pre-hospital endotracheal intubation rate was 16.32%,the pre-hospital vein opening rate was 51.36%,and the pre-hospital epinephrine utilization rate was 41.07%.In patients with pre-hospital cardiac arrest,the recovery rate of spontaneous circulation on the spot/on the way was 2.54%and 0%,respectively.The survival hospitalization rate was 0.81%,the survival discharge rate was 0.19%,and the survival discharge with good neurological function rate was 0.12%.Conclusion According to the epidemiological characteristics of pre-hospital cardiac arrest,it is of great significance to improve the survival rate of patients with pre-hospital cardiac arrest by improving the establishment of first aid system,speeding up the popularization of CPR consciousness and skills of the first eyewitness at the scene,implement effective first aid measures as early as possible at the onset of the disease and minimize the first aid response time.
作者
周瑞云
李方航
杨丽娟
Zhou Ruiyun;Li Fanghang;Yang Lijuan(Zhuhai Medical Emergency Center,Guangdong 519000,China)
出处
《山西医药杂志》
CAS
2020年第24期3382-3384,共3页
Shanxi Medical Journal
基金
珠海市科技项目(20191207A010063)。
关键词
医院外心搏骤停
心肺复苏术
急救反应时间
急救治疗
流行病学研究特征
预后
Out-of-hospital cardiac arrest
Cardiopulmonary resuscitation
Emergency response time
Emergency treatment
Epidemiologic characteristics
Prognosis
