Objective To analyze the influencing factors of prognosis in sudden cardiac arrest patients undergoing cardiovascular emergency survival chain rescue.Methods A total of 280 patients with sudden cardiac arrest were selected in the People's Hospital of Xichang from March 2015 to March 2016 were selected as the research objects.Cardiovascular emergency survival chain can divided into 3 stages:in the first stage,119 patients with restoration of spontaneous circulation were served as A group,other 89 dead patients were served as B group,sudden cardiac arrest scene,finder of sudden cardiac arrest,duration between sudden cardiac arrest and finding,duration between finding sudden cardiac arrest and cardiopulmonary resuscitation,the first rescuer of cardiopulmonary resuscitation,standstill situation between cardiopulmonary resuscitation and professional rescuer taking over were compared between the two groups;in the second stage of the 119 patients with restoration of spontaneous circulation,22 survived discharged patients were served as C group,97 dead patients were served as D group,duration between defibrillation feasible heart rhythm and electrical conversion,defibrillation methods and usage of resuscitation drugs were compared between the two groups;in the three stage of the 22 survived discharged patients,11 patients with good recovery of cerebral function were served as E group,11 patients with poor recovery of cerebral function were served as F group,end expiratory carbon dioxide partial pressure monitoring situation,respiratory support situation,circulation support status,received mild hypothermia therapy or not,blood glucose control status and usage of neuroprotective drugs were compared between the two groups.Results There were statistically significant differences of sudden cardiac arrest scene,finders of sudden cardiac arrest,duration between finding sudden cardiac arrest and cardiopulmonary resuscitation,the first rescuers of cardiopulmonary resuscitation,or standstill situation between cardiopulmonary resuscitation and professional rescuer taking over between A group and B group (P ＜ 0.05),while no statistically significant differences of duration between sudden cardiac arrest and finding was found between the two groups (P ＞ 0.05).There were statistically significant differences of duration between defibrillation feasible heart rhythm and electrical conversion and usage rate of epinephrine between C group and D group,while no statistically significant differences of defibrillation methods,usage rate of amiodarone,lidocaine,magnesium preparation or sodium bicarbonate was found between the two groups (P ＞ 0.05).No statistically significant differences of end expiratory carbon dioxide partial pressure monitoring situation,respiratory support situation,circulation support status,received mild hypothermia therapy or not,blood glucose control status or usage of neuroprotective drugs was found between E group and F group (P ＞ 0.05).Conclusion Timely effective cardiopulmonary resuscitation,early electric defibrillation and usage of epinephrine may improve the prognosis in sudden cardiac arrest patients undergoing cardiovascular emergency survival chain rescue.%目的 分析心血管急救生存链抢救心搏骤停患者预后的相关因素,以期更好地改善心搏骤停患者预后.方法 选取2015年3月—2016年3月西昌市人民医院收治的心搏骤停患者208例作为研究对象.心血管急救生存链分为3个阶段,第一阶段自主循环恢复者119例(A组)、死亡者89例(B组),比较两组患者心搏骤停发生地点、心搏骤停发现者、心搏骤停至发现时间、发现心搏骤停至实施心肺复苏时间、首次实施心肺复苏人员、心肺复苏至专业救治人员接手间停顿情况;第二阶段119例自主循环恢复患者中存活出院者22例(C组)、死亡者97例(D组),比较两组患者可除颤心律-电复律时间、除颤方式及复苏药物使用情况;第三阶段22例存活出院患者中脑功能恢复良好者11例(E组)、脑功能恢复不良者11例(F组),比较两组患者呼气末二氧化碳分压监测、呼吸支持、循环支持、亚低温治疗、控制血糖及神经保护药物使用情况.结果 A组和B组患者心搏骤停发生地点、心搏骤停发现者、发现心搏骤停至实施心肺复苏时间、首次实施心肺复苏人员、心肺复苏至专业救治人员接手间停顿情况比较,差异有统计学意义(P＜0.05);A组和B组患者心搏骤停至发现时间比较,差异无统计学意义(P＞0.05).C组和D组患者可除颤心律出现-电复律时间和肾上腺素使用率比较,差异有统计学意义(P＜0.05);C组和D组患者除颤方式及胺碘酮、利多卡因、镁剂、碳酸氢钠使用率比较,差异无统计学意义(P＞0.05).E组和F组患者呼气末二氧化碳分压监测、呼吸支持、循环支持、亚低温治疗、控制血糖及神经保护药物使用情况比较,差异无统计学意义(P＞0.05).结论 及时有效进行心肺复苏、尽早电除颤及使用肾上腺素可能提高心血管急救生存链抢救心搏骤停患者预后.
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