赵晶 陈苗妙 吴跃明

[摘要] 目的 研究重癥监护室（Intensive care unit，ICU）心脏停搏患者心肺复苏的危险因素。 方法 回顾性分析2016年1月～2019年9月在我院ICU收治的心脏停搏患者，其中心肺复苏失败的患者60例为观察组，心肺复苏成功的患者60例为对照组，比较和分析两组患者的临床资料，对导致心脏停搏患者心肺复苏失败的危险因素进行单因素分析、多因素Logistic回归分析。 结果 在单因素分析中，观察组与对照组的年龄、合并脑血管病变、合并呼吸系统疾病、合并创伤性疾病、心肺复苏开始时间比较，差异均有统计学意义（P<0.05）;两组性别方面比较，差异无统计学意义（P>0.05）。多因素Logistic回归分析结果显示，合并脑血管病变、合并呼吸系统疾病、合并创伤性疾病、心肺复苏开始时间是导致心脏停搏患者心肺复苏失败的危险因素（P<0.05）。 结论 心脏停搏患者受到合并脑血管病变、合并呼吸系统疾病、合并创伤性疾病、心肺复苏开始时间等因素的影响，心肺复苏易失败，临床应根据心脏停搏患者心肺复苏失败的危险因素制订针对性预防对策。

[关键词] 重症监护室;心脏停搏;心肺复苏;危险因素

[中图分类号] R541.6          [文献标识码] B          [文章编号] 1673-9701（2020）31-0092-04

[Abstract] Objective To research the risk factors of cardiopulmonary resuscitation in patients with cardiac arrest in intensive care unit（ICU）. Methods Patients with cardiopulmonary resuscitation failure（n=60， the observation group） and patients with successful cardiopulmonary resuscitation（n=60， the control group） admitted to ICU of our hospital from January 2016 to September 2019 were selected for retrospective analysis. The clinical data of the two groups were compared and analyzed， and univariate analysis and multivariate logistic regression analysis were carried out on the risk factors leading to the failure of cardiopulmonary resuscitation in patients with cardiac arrest. Results In univariate analysis， there were statistically significant differences in age， complicated cerebrovascular diseases， complicated respiratory diseases， complicated traumatic diseases and the start time of cardiopulmonary resuscitation between the observation group and the control group（P<0.05）， but there was no statistically significant difference in gender between the observation group and the control group（P>0.05）. Multivariate logistic regression analysis showed that complicated cerebrovascular diseases， complicated respiratory diseases， complicated traumatic diseases and the start time of cardiopulmonary resuscitation were the risk factors leading to the failure of cardiopulmonary resuscitation in patients with cardiac arrest（P<0.05）. Conclusion Patients with cardiac arrest are impacted by complicated cerebrovascular diseases， complicated respiratory diseases， complicated traumatic diseases and the start time of cardiopulmonary resuscitation， so cardiopulmonary resuscitation is easy to fail. Therefore， targeted preventive measures should be formulated according to the risk factors of failure of cardiopulmonary resuscitation in patients with cardiac arrest.

[Key words] Intensive care unit; Cardiac arrest; Cardiopulmonary resuscitation; Risk factor

心脏停搏是指心脏完全丧失电活动、处于静止的一种状态，是导致心源性猝死的主要原因，患者发生心脏停搏后，其生命安全受到严重威胁，需立即进行抢救治疗[1-3]。心肺复苏是心脏停搏患者的主要治疗手段，心肺复苏后患者自主循环逐渐恢复，但也有部分患者心脏复苏失败，预后差[4-5]。为提高心脏停搏患者的心肺复苏成功率，明确心肺复苏失败的危险因素成为医学工作者不断探寻的课题，本研究根据ICU心脏停搏后心肺复苏成功患者与心脏停搏后心肺复苏失败患者的临床资料进行回顾性分析和比较，明确导致ICU心脏停搏患者心肺复苏失败的危险因素，为临床预防提供数据支撑，现报道如下。……