王良兵 张朝贵

【摘  要】目的：探讨超长时间心肺复苏成功的不同病因影响因素及远期预后。方法：选取我院超长时间心肺复苏患者74例，观察不同病因患者的自主循环恢复率、24h存活率和存活出院率。结果：74例超长时间心肺复苏患者自主循环恢复率39.19%，24h存活率22.97%，存活出院率12.16%，其中心脑血管疾病、电击伤、麻醉患者成功率较高，恶性肿瘤晚期、慢性肾功衰竭、多器官衰竭等患者成功率较低。结论：对于心脑血管疾病、电击伤、麻醉等患者，超长时间心肺复苏是十分必要的，建议常规进行，使更多的心搏骤停患者受益。对于恶性肿瘤晚期、慢性肾功衰竭、多器官衰竭等患者可以根据患者家属要求或者器官衰竭程度选择合适的抢救时间。

【关键词】心肺复苏;超长时间;自主循环恢复率;24h存活率;存活出院率;临床观察

【中图分类号】R47      【文献标识码】A      【文章编号】1672-3783（2019）01-0013-02

【Abstract】 Objective： To explore the different etiological factors and long-term prognosis of successful cardiopulmonary resuscitation  for extra-long-time. Method： 74 patients with extra-long-time cardiopulmonary resuscitation in our hospital were selected to observe the recovery rate of autonomic circulation， 24-hour survival rate and survival and discharge rate of patients with different causes. Result： The recovery rate of spontaneous circulation was 39.19%， the 24-hour survival rate was 22.97%， and the survival and discharge rate was 12.16%. The success rate of patients with cardiovascular and cerebrovascular diseases， electric injury and anesthesia was higher， while the success rate of patients with advanced malignant tumors， chronic renal failure and multiple organ failure was lower. Conclusion： For patients with cardiovascular and cerebrovascular diseases， electric injury and anesthesia， it is necessary to have extra-long-time cardiopulmonary resuscitation. It is suggested that routine extra-long-time cardiopulmonary resuscitation should be carried out to benefit more patients with cardiac arrest. For patients with advanced malignant tumors， chronic renal failure and multiple organ failure， the appropriate rescue time should be selected according to the requirements of the patients' families or the degree of organ failure.

【Key word】Cardiopulmonary resuscitation; Extra-long-time; Autonomic circulation recovery rate; 24-hour survival rate; Survival and discharge rate; Clinical observation

随着重症医学的不断发展壮大，医院的整体救治水平的不断提高，医务人员对心肺复苏指南的依从性不断提高，抢救能力不断提升，在临床实践工作中我们发现超长时间心肺复苏成功的病例越来越多，不少病例告诫我们应当重视超长时间心肺复苏[1]，笔者收集我院急诊科和重症医学科超长时间心肺复苏患者74例，分析抢救成功经验，现报告如下。

1 资料与方法

1.1基本资料

选取我院急诊科和重症医学科2015年11月～2018年10月超长时间心肺复苏患者74例，其中男41例，女33例，年龄2岁～73岁，平均年齡（41.3±2.4）岁，其中心血管疾病12例，脑血管疾病12例，术中麻醉患者5例，电击伤3例，慢性肾功能衰竭5例，呼吸系统疾病10例，消化系统疾病10例，恶性肿瘤9例，多器官功能衰竭8例。……