姜椿法?刘远山?刘刚?黄子通?余涛?张新斌?黄春艳?伍远辉

[摘要] 目的 探讨珠三角地区城镇心源性心脏骤停的流行病学特点和提高复苏成功率的方法。 方法 整理我院急诊科2013年1月～2016年12月接诊的236例心源性心脏骤停患者的院前院内临床资料，回顾性分析患者发病的年龄、性别、户籍以及发病时间、地点、到院方式和救治效果。 结果 236例患者平均年龄为（50.4±15）岁，男/女比例为4：1，外地户籍/本地户籍为1.84：1，发病月份以1月份最多，日时间以8：00～10：00最多，在居住地发病者占61.4%，由救护车接回者占62.7%，抢救成功率为22.033%，与复苏失败组相比，有目击者启动EMSS和由最初发现者送院的患者抢救成功率明显要高，差异有统计学意义（P<0.05）。 结论 珠三角地区城镇心源性心脏骤停以外地户籍、青壮年男性居多，院前急救系统的进一步完善和在群众中大力普及心肺复苏技术是提高城镇心源性心脏骤停抢救成功率的关键。

[关键词] 珠三角地区；院前；心源性心脏骤停；流行病学

[中图分类号] R541.78 [文献标识码] A [文章编号] 2095-0616（2017）09-163-04

Epidemiological analysis of 236 out-of-hospital cardiogenic sudden cardiac arrest patients in town

JIANG Chunfa1 LIU Yuanshan2，3 LIU Gang1 HUANG Zitong2，3 YU Tao2，3

ZHANG Xinbin1 HUANG Chunyan1 WU Yuanhui1

1.Department of Emergency，Houjie Hospital，Dongguan 523945，China；2.Institute of Cardiopulmonary Cerebral Resuscitation，Sun Yat-sen University，Guangzhou 510120，China；3.Department of Emergency，Sun Yat-sen Memorial Hospital of Sun Yat-sen University，Guangzhou 510120，China

[Abstract] Objective To explore the epidemiological characteristics and the methods to improve the ROSC rate. Methods The clinical data of 236 out-of-hospital cardiogenic sudden cardiac arrest patients from January 2013 to June 2016 in Houjie Hospital were gathered.Age，sex，household register，the time and place of onset，the way to hospital and the effect of treatment of the patients were retrospectively analyzed. Results The mean age of the patients was （50.4±15），male/female proportion was 4/1，the immigrants/residences was 1.84/1.The maximum incidence of the disease was in January，from 8am to 10am. 61.4% happened on patients living places，62.7% were delivered by the ambulances.The ROSC rate in this study was 22.03%. Compared to the NROSC group，the ROSC rates of patients with witnesses called the EMSS and patients sent to the hospital by the first witnesses were much higher，it was significant difference（P<0.05）. Conclusion Young male immigrants are the most common field of out-of-hospital cardiogenic sudden cardiac arrest in the town of Pearl River delta.EMSS improving and promoting the CPR，first aid knowledges in the residents are the key to raise the ROSC rate in town.

[Key words] Pearl River delta；Out-of-hospital；Cardiogenic sudden cardiac arrest；Epidemiological analysis

心臟骤停（cardiac arrest，CA）是全世界最重要的死亡原因之一，而心源性是其主要的病因，如果抢救不及时或抢救失败会发展成心脏性猝死[1]。在我国，院外心脏骤停患者的生存率仍低于2%[2]，据最新统计，北京大城市的院外心脏骤停的出院生存率仅为1.3%[3]。对于医疗水平和环境相对落后的城镇来说，心脏骤停的抢救将更为艰难。本研究通过回顾性分析广东省东莞市厚街医院从2013年1月～2016年12月急诊科接诊的236例心源性心

脏骤停患者的数据，探讨珠三角地区城镇心源性心脏骤停的流行病学特点和提高复苏成功率的方法。

1 资料与方法

1.1 一般资料

本研究资料来源为广东省东莞市厚街医院急诊科从2013年1月～2016年12月接诊的心源性心脏骤停患者的临床资料。……