自主循环恢复心率对急诊心搏停止患者生存状况的影响

摘要

目的 探讨自主循环恢复心率对急诊心搏停止(Cardiac arrest,CA)患者生存状况的影响.方法 选择2014年3月～2016年3月期间因非外伤性心搏停止于陆军总医院急诊科和北京友谊医院急诊科救治的患者162例,其中男性77例,女性85例,平均年龄(62.85±20.21)岁.按患者预后生存情况分为死亡组和存活组.以24 h和90 d做为近、远期观察终点,分别比较基础心率和自主循环恢复心率对心搏停止患者24 h、90 d生存状况的影响.结果 心搏停止患者初始心律类型中以室速/室颤者自主循环恢复最多(67.65％),后依次为无脉电活动(36.21％)和心电静止(35.71％).基础心率对心搏停止患者近、远期预后均无影响,差异无统计学意义(P>0.05).自主循环恢复心率对心搏停止患者远期预后无影响,差异无统计学意义(P>0.05),但自主循环恢复心率明显影响心搏停止患者近期预后,差异有显著性统计学意义(P<0.001).结论 自主循环恢复心率的增加可提高心肺复苏成功患者的近期(24 h)存活率.%Objective To investigate the effect of heart rate on emergency cardiac arrest patients in return of spontaneous circulation.Methods A total of 162 patients of non-traumatic cardiac arrest the PLA Army General Hospital and Beijing Friendship Hospital from March 2014 to March 2016 were selected. There were 77 males and 85 females with an average age of (62.85±20.21 years). The patients were divided into death group and survival group. The 24 h and 90 d were used as the recent and long-term observation endpoints. Observation indexes include: CA initial rhythm, basal heart rate, ROSC heart rate, et al.Results With respect to initial rhythm types of patients, 67.65％ were ventricular tachycardia/ventricular fibrillation (VT/VF), 36.21％ were pulseless electrical activity (PEA), 35.71％ were asystole (ASY). The baseline heart rate had no effect on the proximal and long-term prognosis of patients with cardiac arrest, the difference was not statistically significant (P>0.05). Heart rate in return of spontaneous circulation (ROSC) significantly affected the short-term prognosis of patients with cardiac arrest, the difference was statistically significant (P<0.001).Conclusions The increase of heart rate in ROSC can improve the recent (24 h) survival rate of cardiopulmonary resuscitation patients.