目的：分析心搏骤停（ CA）急诊患者心肺复苏术（ CPR）成功的影响因素。方法收集2010年1月—2014年10月在江门市人民医院急诊科开展CPR的582例患者，其中成功80例（成功组）、失败502例（失败组）。比较两组患者一般资料（年龄、性别、原发病）、院前急诊急救情况｛家庭急救、医院救护、院前救护时间、机械通气、短暂复苏、CPR 至短暂复苏时间、院前心电图表现〔心室纤颤（ VF ）、无脉性心电活动（ PEA ），电静止（ VA）〕｝、CA发生情况、入院时心电图及通气方式。结果两组患者性别、年龄及原发病比较，差异无统计学意义（P>0.05）。成功组患者家庭急救率、医院救护率、机械通气率、短暂复苏率高于失败组，院前救护时间及CPR至短暂复苏时间均短于失败组，院前心电图表现优于失败组（ P<0.05）。成功组患者医院救护前发生CA 21例，救护车送院途中发生CA 37例，急诊科发生CA 22例，失败组分别为137例、249例、116例，差异无统计学意义（ P>0.05）。成功组患者自主心率、VF、PEA发生率及气管插管率高于失败组（ P<0.05）。结论 CA患者急诊CPR是否成功与患者CA发生时间、院前急诊急救情况、院内CPR水平等有关，应建立院外CPR指导体系，提高患者送院途中CPR质量，尽可能保障院内CPR质量。%Objective To analyze the influencing factors of successful CPR in emergency patients with sudden cardiac arrest. Methods A total of 582 patients undergoing CPR were selected in the Department of Emergency,People's Hospital of Jiangmen from January 2010 to October 2014,including 80 successful cases( A group),502 failed cases( B group). Age, gender,primary illness,family emergency,hospital emergency,pre -hospital rescue time,mechanical ventilation,time to short resuscitation,pre-hospital electrocardiogram manifestation( including ventricular fibrillation,pulseless electrical activity, electrical silence),incidence of sudden cardiac arrest,electrocardiogram at admission and ventilation models were compared between the two groups. Results No statistically significant differences of age,gender or primary illness was found between the two groups(P>0. 05). Family emergency rate,hospital emergency rate,mechanical ventilation rate,short resuscitation rate of A group was statistically significantly higher than that of B group,respectively(P<0. 05);pre-hospital rescue time and time to short resuscitation of A group was statistically significantly shorter than those of B group ( P <0. 05 );pre -hospital electrocardiogram manifestation of A group were statistically significantly better than that of B group(P<0. 05). Of A group, 21 case occurred sudden cardiac arrest before hospital emergency,37 cases occurred sudden cardiac arrest on the way to hospital, 22 cases occurred sudden cardiac arrest in the Department of Emergency,that of B group were 137 cases,249 cases,116 cases, respectively,no statistically significant differences of incidence of sudden cardiac arrest was found between the two groups( P>0. 05). The incidence of independent heart rate,ventricular fibrillation,pulseless electrical activity and tracheal intubation of A group was statistically significantly higher than that of B group,respectively(P<0. 05). Conclusion Occurrence time,pre-hospital emergency,hospital CRP level are influencing factors of successful CPR in emergency patients with sudden cardiac arrest,physicians should establish a pre-hospital CRP guiding system,improve the CRP level on the way tohospital and ensure the hospital CRP level.
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