院内心肺复苏Utstein模式注册研究

摘要

Objective To evaluate the etiology of cardiac arrest and the outcomes of cardiopulmonary resuscitation (CPR), using the intemational Utstein template for cardiac arrest and CPR. Methods According to the Utstein templates for cardiac arrest and CPR, an Utstein CPR registry form was designed and a prospective observational study was employed to evaluate the epidemiological characteristics and outcomes of patients with resuscitation attempt. Results 295 patients, 137 out-of-hospital cardiac arrest (OHCA) patients and 158 in-hospital cardiac arrest (IHCA) patients,were enrolled into this study. For the etiology of OHCA andIHCA patients; the cardiogenic cardiac arrest were 49 (35.7％) and 63 (39.9％) respectively. OHCA patients have a higher rate of trauma, drowning, and acute poisoning compared toIHCA patients (P＜0.05); the hypoxia or respiratory failure, hypotension or shock, electrolyte disturbances was higher forIHCA compared with those for OHCA patients (P＜0.05). ROSC rates and survival rates of IHCA patients were 50.7％, 13.9％. In the IHCA group, the ROSC rates and survival discharge rates of cardiogenic cardiac arrest was higher than non-cardiac (P＜0.05). Conclusion OHCA andIHCA patients have significantly different etiology of cardiac arrest.%目的 应用心肺复苏Utstein指南模式评价心脏骤停原因及其心肺复苏复苏结果.方法 按照心肺复苏Utstein评价指南设计心肺复苏注册登记表,在2008年1月至2009年12月期间,对海南省人民医院急诊科、重症医学科、心内科、海南省医疗保健中心心肺复苏和心脏骤停患者及其结果进行前瞻性描述性研究.结果 在295例心脏骤停中,院外心脏骤停与院内心脏骤停分别为137例、158例,其心脏骤停心脏原因分别为49例(35.7%)、63例(39.9%);院外心脏骤停非心脏原因中因创伤、淹溺、急性中毒引起心脏骤停高于院内心脏骤停组(P＜0.05);而院内心脏骤停组因低氧血症/呼吸衰竭、低血压/休克、电解质紊乱引起心脏骤停高于院外心脏骤停组(P＜0.05).院内心脏骤停复苏ROSC率、成活出院率分别为50.7%、13.9%,院内心源性心脏骤停的ROSC率、成活出院率高于非心源性心脏骤停(P＜0.05).结论 院外、院内心脏骤停原因有明显的差异,院内心源性心脏骤停的ROSC率、成活出院率高于非心源性心脏骤停.