127053例手术室内非心脏手术16例心肺复苏术的回顾性分析

摘要

Objective To identify the high-risk factors of cardiac arrest during non-cardiac surgery and to provide experience for the effective cardiopulmonary resuscitation (CPR).Method The baseline data,co-morbidities,causes of cardiac arrest,treatment responsees,and survivals of 16 patients undergoing CPR among 127 053 patients receiving non-cardiac surgeries in our center from January 2013 to December 2016 were retrospectively analyzed.Results The main causes of intraoperative CPR included the co-existing cardiovascular diseases,massive intraoperative blood loss/high-risk surgical procedures,and allergy-related factors.Nine patients survived after immediate CPR in the operating room,with a 30-day survival rate of 77.8％.Conclusions Intraoperative cardiac arrest is a rare but potentially catastrophic event during non-cardiac surgeries.The success rate of CPR decreases in elderly patients undergoing high-risk emergency surgeries,especially when massive blood loss occurs during the surgery.%目的 识别手术室内非心脏手术心搏骤停的高危因素,为实施有效的心肺复苏术提供救治经验.方法 回顾性分析北京协和医院2013年1月至2016年12月127 053例手术室内非心脏手术术中16例因心搏骤停实施心肺复苏术患者的基本资料、合并疾病、心搏骤停原因、心肺复苏过程及预后情况.结果 术中因心搏骤停实行心肺复苏术的原因主要为:合并心血管系统等多系统基础疾病、术中大出血及手术操作风险高、过敏相关因素、其他因素等.16例患者中心肺复苏成功9例,复苏成功后30 d存活率77.8％.结论 非心脏手术术中心搏骤停发病率较低,但死亡率较高.高龄患者行急诊高风险手术、术中发生大出血时心肺复苏的成功率降低.