基于Utstein模式的院内不同地点心肺复苏结果对照研究

摘要

目的 应用心肺复苏(cardiopulmonary resuscitation,CPR)结果评估Utstein模式指南评价并对比院内不同地点心脏骤停患者实施CPR的结果.方法 按照CPR结果评估Utstein模式指南设计CPR注册登记表,选择2008年1月-2010年12月在我院急诊室、普通内科病房及重症监护病房(ICU)出现心脏骤停行CPR的患者注册登记,并进行对比研究.结果 同期共280例在医院内因心脏骤停实施CPR,其中急诊室60例(急诊室组),普通内科病房78例(普通病房组),ICU 142例(ICU组).自主循环恢复(ROSC)率急诊室组36.67％(22/60)、普通病房组42.31％ (33/78)、1CU组57.75％ (82/142),ICU组显著高于其他两组(P＜0.05),而急诊室组和普通病房组比较无统计学差异(P＞0.05).成活出院率急诊室组21.67％(13/60)、普通病房组17.95％(14/78)、ICU组26.76％(38/142),3组比较差异无统计学意义(P＞0.05).结论 医院内不同地点心脏骤停的CPR效果有所差异,在ICU内发生心脏骤停并行CPR者ROSC率更高,但成活出院率无显著提高.%Objective To evaluate and compare the outcomes after in-hospital cardiopulmonary resuscitation (CPR) in different locations based on the Utstein Style. Methods Clinical data of patients with cardiopulmonary resuscitation after cardiac arrest during January 2008 and December 2010 in our hospital were collected, categorized in the emergency room (ER), general wards and intensive care unit (ICU); the cardiopulmonary resuscitation registration data designed with the guide of Utstein style were compared. Results During the same period, a total of 280 patients underwent cardiopulmonary resuscitation after cardiac arrest in our hospital; 60 patients in ER group, 78 patients in general wards group and 142 patients in ICU group. The ROSC rates of the three groups were 36.67% (22/60) in emergency group, 42.31% (33/78) in general wards group and 57.75% (82/142) in ICU group respectively, and the rate of ICU group was significantly higher than those of ER group or general wards group (P 0. 05). The survival hospital discharge rates of the three groups were 21.67% (13/60) in emergency group, 17.95% (14/78) in general wards group and 26.76% (38/142) in ICU group respectively. There was no significant difference in the survival hospital discharge rates among the three groups (P >0. 05). Conclusion In-Hospital cardiopulmonary resuscitation after cardiac arrest in different locations show significant differences: Patients with cardiopulmonary resuscitation after cardiac in ICU may have higher rates of restoration of spontaneous circulation ( ROSC) , but there was no statistical difference in the rates of survival hospital discharge among different locations.