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中华卫生应急电子杂志 ›› 2022, Vol. 08 ›› Issue (06) : 326 -330. doi: 10.3877/cma.j.issn.2095-9133.2022.06.002

论著

院前恢复自主循环的院外心脏骤停患者流行病学研究
章楠1, 盛雪立1,(), 邵俊1, 方诗园1, 王芳1, 朱娴1, 周斌捷1   
  1. 1. 214200 江苏宜兴,宜兴市急救中心急救科
  • 收稿日期:2022-06-25 出版日期:2022-12-18
  • 通信作者: 盛雪立
  • 基金资助:
    2021年宜兴市科技创新专项资金"陶都之光"科技攻关计划(社会发展类)(2021SF12)

Out-of-hospital cardiac arrest patients with prehospital recovery of spontaneous circulation: an epidemiological study

Nan Zhang1, Xueli Sheng1,(), Jun Shao1, Shiyuan Fang1, Fang Wang1, Xian Zhu1, Binjie Zhou1   

  1. 1. Department of Emergency, Yixing Emergency Center, Yixing 214200, China
  • Received:2022-06-25 Published:2022-12-18
  • Corresponding author: Xueli Sheng
引用本文:

章楠, 盛雪立, 邵俊, 方诗园, 王芳, 朱娴, 周斌捷. 院前恢复自主循环的院外心脏骤停患者流行病学研究[J/OL]. 中华卫生应急电子杂志, 2022, 08(06): 326-330.

Nan Zhang, Xueli Sheng, Jun Shao, Shiyuan Fang, Fang Wang, Xian Zhu, Binjie Zhou. Out-of-hospital cardiac arrest patients with prehospital recovery of spontaneous circulation: an epidemiological study[J/OL]. Chinese Journal of Hygiene Rescue(Electronic Edition), 2022, 08(06): 326-330.

目的

分析在院前恢复自主循环(ROSC)的院外心脏骤停(OHCA)患者流行病学特点。

方法

参照Utstein模式,收集2019年1月至2022年3月,宜兴市急救中心现场救治的OHCA在院前恢复ROSC的患者临床资料,根据流行病学数据特点应用SPSS 23.0软件分析。

结果

院前急救病例资料共纳入66例患者,其中ROSC≥4 h的有29例(43.94%),ROSC<4 h的有37例(56.06%)。两组患者在性别、年龄、发生地点、发生时间段、是否被第一目击者发现、是否提供心肺复苏(CPR)等方面差异均无统计学意义,在使用肾上腺素剂量有显著差异[4(3,6)mg比7(6,10)mg,P<0.001];ROSC≥4 h患者在CPR抢救时间明显低于ROSC<4 h患者[16(11,20)min比30(23.5,35.5)min,P<0.001];ROSC≥4 h的29例患者均收治住院,最终3例存活出院(4.54%);所有现场恢复ROSC患者的平均反应时间和所有现场恢复ROSC患者的返院时间相比[(8.33±4.30比7.30±4.02)min,P<0.05],平均反应时间耗时更长。

结论

院前恢复ROSC的OHCA患者出院生存率极低,OHCA患者的短期生存率不受一般基本情况影响,公众应早期预防OHCA的发生。

Objective

To analyze the epidemiological characteristics of out-of-hospital cardiac arrest(OHCA)patients with restoration of spontaneous circulation (ROSC).

Methods

According to the Utstein model, clinical data of patients with PRE-hospital ROSC recovery from OHCA treated on-site in Yixing Emergency Center from January 2019 to March 2022 were collected and analyzed by SPSS23.0 software.

Results

Among 66 patients, 29(43.94%)had ROSC ≥4 h, and 37(56.06%)had ROSC<4 h. There were no statistically significant differences between the two groups in gender, age, location, time of occurrence, whether the patient was found by the first witness, or whether the patient provided cardiopulmonary resuscitation(CPR). There was a significant difference in epinephrine dose[4(3, 6)mg vs 7(6, 10)mg, P<0. 001]. The CPR time of patients with ROSC≥4 h was significantly lower than that of patients with ROSC<4 h [16(11, 20)min vs 30(23. 5, 35. 5)min, P<0.001]. All 29 patients with ROSC≥4 h were hospitalized, and 3 patients were discharged alive (4.54%). The mean response time of all ROSC patients with on-site recovery was longer than that of hospital return [(8.33±4.30 vs 7.30±4.02) min, P<0.05].

Conclusions

The discharge survival rate of OHCA patients with prehospital ROSC recovery is extremely low, and the short-term survival rate of OHCA patients is not affected by general basic conditions. The public should be vigilant to prevent the occurrence of OHCA early.

表1 院前恢复ROSC的OHCA患者基本情况分析[例(%)]
表2 院前恢复ROSC的OHCA患者现场救治情况分析[例(%)]
表3 两组患者救治耗时比较的分析[min,M(P25P75)]
图1 平均反应时间与返院时间的比较
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