急诊心搏骤停患者的临床特征及自主循环恢复的影响因素研究

doi:10.3761/j.issn.2096-7446.2026.02.002

摘要/Abstract

摘要：

目的探讨急诊心搏骤停患者的临床特征以及自主循环恢复（return of spontaneous circulation，ROSC）的影响因素。方法回顾性分析2021年1月—2023年12月浙江省某三级甲等医院325例急诊心搏骤停患者心肺复苏相关病历资料，通过单因素和多因素Logistic回归分析ROSC的相关影响因素。结果院外心搏骤停（out-of-hospital cardiac arrest，OHCA）患者ROSC率为30.14%；院内心搏骤停（in-hospital cardiac arrest，IHCA）患者ROSC率为55.17%。回归分析结果显示，与院内复苏时间≤15 min的心搏骤停患者相比，复苏时间越长，获得ROSC的概率越低，且差异具有统计学意义（P<0.001）。启动体外膜肺氧合（extracorporeal membrane oxygenation，ECMO）（β=4.709，P<0.001，OR=110.994，95%CI：23.763~518.452）与有代谢性疾病（β=1.594，P=0.004，OR=4.924，95%CI：1.685~14.387）为心搏骤停患者ROSC的保护性因素。结论临床应关注心搏骤停时间窗管理、合理选择并早期启动ECMO、重视有代谢性基础疾病患者的早期监测与干预，以优化心搏骤停患者的复苏结局。

关键词: 心搏骤停, 自主循环恢复, 心肺复苏, 影响因素, 代谢性疾病

Abstract:

Objective To investigate the clinical characteristics of patients with cardiac arrest（CA） in the emergency department and the factors influencing the return of spontaneous circulation（ROSC）. Methods A retrospective analysis was conducted on the 325 emergency CA cases who underwent cardiopulmonary resuscitation（CPR） at a tertiary hospital in Zhejiang Province from January 2021 to December 2023. The factors influencing ROSC were examined using univariate and multivariate logistic regression analyses. Results Among them，the rate of ROSC was 30.14% in patients with out-of-hospital cardiac arrest（OHCA） and 55.17% in those with in-hospital cardiac arrest（IHCA）. Furthermore，regression analysis demonstrated that，compared with patients whose in-hospital resuscitation time was less than 15 minutes，those with longer resuscitation time had a markedly lower probability of ROSC，and the difference was statistically significant（P<0.001）. Initiating ECMO（β=4.709，P<0.001，OR=110.994，95%CI：23.763-518.452） and metabolic disease（β=1.594，P=0.004，OR=4.924，95%CI：1.685-14.387） were protective factors influencing ROSC in all CA patients. Conclusion Initiation of ECMO and the presence of metabolic disorders were identified as independent protective factors for ROSC in patients with cardiac arrest，highlighting the need for reinforced blood glucose monitoring in individuals with metabolic disorders during resuscitation.

Key words: Cardiac Arrest, Return of Spontaneous Circulation, Cardiopulmonary Resuscitation, Influencing Factors, Metabolic Diseases

刘亚洁, 王钰炜, 王飒, 王美玲, 闫丹萍, 许书荣, 吴青峰. 急诊心搏骤停患者的临床特征及自主循环恢复的影响因素研究[J]. 中华急危重症护理杂志, 2026, 7(2): 141-147.

LIU Yajie, WANG Yuwei, WANG Sa, WANG Meiling, YAN Danping, XU Shurong, WU Qingfeng. A study on the clinical characteristics of emergency cardiac arrest patients and the factors affecting the restoration of normal circulation[J]. Chinese Journal of Emergency and Critical Care Nursing, 2026, 7(2): 141-147.

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