本文關(guān)鍵詞： 心臟驟停 心肺復(fù)蘇 影響因素 成功率　出處：《山東大學(xué)》2012年碩士論文　論文類型：學(xué)位論文

【摘要】：研究目的： 筆者對2009-2012年3年中我院的235例CPR兒童患者進(jìn)行回顧性研究,以客觀反映目前CPR的現(xiàn)狀,探討心跳驟停患者的臨床特點及救治經(jīng)驗,總結(jié)分析影響心肺復(fù)蘇成功率的因素,以進(jìn)一步提高兒童心肺復(fù)蘇的水平。 研究對象： 2009年3月至2012年2月3年間,本院急診室、手術(shù)室、普通病房內(nèi)以及院外搶救的心搏驟停患者,235例實施的患者中男130例,女105例。根據(jù)自己的經(jīng)驗,選擇八項影響兒童心肺復(fù)蘇成功率的因素,每一種因素再進(jìn)行分類,然后統(tǒng)計每一分類的CPR成功率,應(yīng)用SPSS13.0軟件進(jìn)行統(tǒng)計學(xué)分析,根據(jù)結(jié)果進(jìn)行討論,最后得出結(jié)論。八項影響因素分類分別見表1至表8。 研究方法： 對我院2009年3月——2012年2月235例心跳呼吸驟停的患者進(jìn)行的心肺復(fù)蘇急救的過程與結(jié)果進(jìn)行了回顧性的分析。對以上八項因素的成功率進(jìn)行統(tǒng)計分析,采用SPSS13.0(?)勺統(tǒng)計學(xué)軟件進(jìn)行。以P0.05具有統(tǒng)計學(xué)意義,差異顯著。 結(jié)果與分析： 采用以上資料、分組,進(jìn)行統(tǒng)計學(xué)分析,總體復(fù)蘇結(jié)果：心肺復(fù)蘇235例,成功49例,失敗186例,總體成功率為20.85% 1.性別對復(fù)蘇成功率無影響。男性和女性兒童心肺復(fù)蘇成功率幾乎一致,均接近總體復(fù)蘇成功率20.85%。 2.年齡對心肺復(fù)蘇成功率有影響。年齡越小,心肺復(fù)蘇成功率越低,年齡越大,心肺復(fù)蘇成功率越高。 3.引起心臟驟�；颊叩脑l(fā)性基礎(chǔ)疾病對心肺復(fù)蘇成功率有影響。與心臟驟停有關(guān)的的原發(fā)性心臟疾病心肺復(fù)蘇的成功率較低,重要臟器如腦的疾病引起的心臟驟�；颊咝姆螐�(fù)蘇的成功率也較低,重癥肺炎、誤吸窒息等非心腦重要臟器的損害引起的心臟驟�；颊咝姆螐�(fù)蘇的成功率較高。 4.對心臟驟�；颊邠尵乳_始的時間與成功率有顯著的影響。在心臟驟�；颊甙l(fā)生的1-4分鐘內(nèi)對患者進(jìn)行心肺復(fù)蘇的成功率最高,達(dá)到60.8%,超過10分鐘進(jìn)行的心肺復(fù)蘇的成功率最低。 5.心臟驟�；颊甙l(fā)生的地點對心肺復(fù)蘇成功率有影響。發(fā)生在醫(yī)院內(nèi)的CPR成功率較高,院外的CPR成功率較低。 6.心臟驟�；颊攥F(xiàn)場第一人員知識、水平對心肺復(fù)蘇成功率有著顯著的影響。心臟驟�；颊攥F(xiàn)場第一人員知識、水平越高,心肺復(fù)蘇的成功率越高。 7.CPR持續(xù)時間超過《國際心肺復(fù)蘇指南》標(biāo)準(zhǔn)時間30min以上,對心肺復(fù)蘇成功率并未有顯著的影響。CPR持續(xù)時間達(dá)到30min的搶救成功率比較高,超過30min以上者,如持續(xù)35min、45min、55min三種情況,心肺復(fù)蘇成功率幾乎一致。 8.應(yīng)用標(biāo)準(zhǔn)劑量與大劑量的腎上腺素對心肺復(fù)蘇的成功率無影響。給CA患者用標(biāo)準(zhǔn)劑量與大劑量的腎上腺素,心肺復(fù)蘇的成功率一致,都接近于總體成功率20.85%。 結(jié)論： 近年來,復(fù)蘇方法學(xué)的研究較多,它們與指南推薦的標(biāo)準(zhǔn)法相比,腦復(fù)蘇率的優(yōu)勢并不明顯。我們認(rèn)為,尋求更有效的復(fù)蘇方法當(dāng)然重要,如何推行標(biāo)準(zhǔn)CPR,并把它運(yùn)用到臨床復(fù)蘇中去則是務(wù)實的作法。 提高CPR成功率的切行可效的途徑,總結(jié)為兩大思想： 1.在未發(fā)生CA的情況下,大力提倡“治未病”的思想。 2.發(fā)生CA的情況下,以下三項是最有效的提高CPR成功率的途徑： ①急救反應(yīng)通道的完善； ②急救醫(yī)護(hù)人員的CPR專業(yè)水平的規(guī)范、提高； ③大眾急救知識的普及。 采取的措施： 例如,對于“治未病”的思想,可以進(jìn)行更高層次的物質(zhì)、精神文化的更高建設(shè)。對于第三項大眾急救知識的普及,可以以每個家庭為準(zhǔn),印制發(fā)行急救最基本知識的通俗宣傳手冊,每個家庭發(fā)放一本；每個電視臺每周一分鐘的急救知識的宣傳；社區(qū)墻壁、報紙急救知識的宣傳。
[Abstract]:The purpose of the study is:
The author of the 2009-2012 years in our hospital for 3 years in 235 children with CPR were studied retrospectively, to objectively reflect the current status of CPR, to explore the clinical features and treatment experience of cardiac arrest patients, summarize and analyze the factors influencing the success rate of cardiopulmonary resuscitation, in order to further improve the children's level of cardiopulmonary resuscitation.
Research object:
From March 2009 to February 2012 3 years, the hospital emergency room, operation room, general ward within and outside the hospital to rescue the patients with cardiac arrest, 235 cases of the implementation of the patients with male 130 cases, female 105 cases. According to their own experience, choose eight factors affecting children's success rate of cardiopulmonary resuscitation, every kind of factors for classification then, statistics of each classification success rate of CPR, SPSS13.0 software was used for statistical analysis, are discussed according to the results, finally draw the conclusion. Eight factors were classified in Table 1 to table 8.
Research methods:
Cardiopulmonary resuscitation in our hospital in March 2009 February 2012, 235 cases of respiratory and cardiac arrest patients in the process and results of first aid were analyzed retrospectively. Statistical analysis of the above eight factors of the success rate of the SPSS13.0 (?) the statistical software. P0.05 has statistical significance, the difference was significant.
Results and analysis:
Using the above data, grouping, statistical analysis, the overall results of resuscitation: 235 cases of cardiopulmonary resuscitation, 49 cases of success, 186 cases of failure, the overall success rate is 20.85%.
1. sex has no effect on the success rate of resuscitation. The success rate of CPR in male and female children is almost identical, which is close to the overall success rate of recovery 20.85%..
The 2. age has an effect on the success rate of cardiopulmonary resuscitation. The younger the age, the lower the success rate of cardiopulmonary resuscitation, the older the age, the higher the success rate of cardiopulmonary resuscitation.
3. patients with cardiac arrest caused by primary disease on the basis of the success rate of cardiopulmonary resuscitation of cardiac arrest. And the primary heart disease cardiopulmonary resuscitation success rate is low, the important organs such as brain disease caused by cardiac arrest cardiopulmonary resuscitation in the patients with a lower success rate, severe pneumonia. Aspiration asphyxia and other non cardiovascular and major organ damage caused by cardiac arrest cardiopulmonary resuscitation in patients with high success rate.
4., there was a significant impact on the time and the success rate of rescue for patients with cardiac arrest. The success rate of cardiopulmonary resuscitation in patients within 1-4 minutes after cardiac arrest was 60.8%, and the success rate of cardiopulmonary resuscitation was the lowest in 10 minutes.
5. the location of the patients with cardiac arrest has an impact on the success rate of cardiopulmonary resuscitation. The success rate of CPR in the hospital is higher, and the CPR success rate outside the hospital is low.
6., the knowledge level of the first person in the cardiac arrest patients has a significant impact on the success rate of cardiopulmonary resuscitation. The higher the knowledge level of the first person in cardiac arrest is, the higher the success rate of cardiopulmonary resuscitation.
The duration of 7.CPR more than < above international CPR > 30min standard time, the success rate of cardiopulmonary resuscitation did not have a significant effect of.CPR rescue duration to achieve the success rate of 30min is relatively high, more than 30min, such as 45min, 55min for 35min, three cases, the success rate of cardiopulmonary resuscitation is almost the same.
8., standard dose and large dose of epinephrine had no effect on the success rate of cardiopulmonary resuscitation. For CA patients, the success rate of cardiopulmonary resuscitation was consistent with standard dose and large dose of epinephrine, which were close to the overall success rate of 20.85%..
Conclusion:
In recent years, more research on recovery method study, compared them with the standard method recommended, the recovery rate of brain advantage is not obvious. We believe that to seek more effective methods of recovery is very important, how to carry out the standard of CPR, and apply it to clinical recovery is a pragmatic approach.
The effective way to improve the success rate of CPR is summed up in two main ideas:
1. in the absence of CA, the idea of "treating no disease" was strongly advocated.
2. in the case of CA, the following three are the most effective ways to improve the success rate of CPR:
(1) the improvement of emergency response channel;
The standard of CPR professional level of first aid medical staff is improved.
The popularization of the knowledge of the public first aid.
Measures taken:
For example, for "zhiweibing" thought, can be carried out at higher levels of material, the higher the construction of spiritual culture. The popularity of third public knowledge of first aid, with each family as the standard, the basic knowledge of first aid printing and issuing of popular brochures, every family put a book; every TV propaganda every Monday minutes of first aid; community walls, newspaper first aid knowledge propaganda.

【學(xué)位授予單位】：山東大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2012
【分類號】：R720.597

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