心源性院内心搏骤停患者自主循环恢复的现状及影响因素研究

doi:10.3761/j.issn.2096-7446.2025.12.003

摘要/Abstract

摘要：

目的探讨心源性院内心搏骤停患者自主循环恢复的相关影响因素，为预防心源性院内心搏骤停和提高抢救成功率提供参考。方法采用回顾性分析方法，连续收集镇江市某三级甲等医院2019年5月—2024年5月收治的95例心源性院内心搏骤停患者的临床资料，根据抢救结局将患者分为自主循环恢复组和自主循环未恢复组，进行多因素Logistic回归分析探讨各影响因素。结果 95例患者中，恢复自主循环患者61例，未恢复自主循环患者34例，成功率为64.2%。Logistic回归分析显示，心搏骤停前合并期前收缩（OR=4.924，95%CI：1.368~17.723，P=0.015）、心搏骤停发生在夜间（OR=4.805，95%CI：1.258~18.357，P=0.022）、心肺复苏时长>15 min（OR=13.049，95%CI：1.424~119.602，P=0.023）是心源性院内心搏骤停患者自主循环恢复的危险因素，首发症状为胸闷胸痛（OR=0.222，95%CI：0.057~0.864，P=0.030）、气管插管（OR=0.051，95%CI：0.009~0.282，P=0.001）是心源性院内心搏骤停患者自主循环恢复的保护因素。结论心源性院内心搏骤停患者自主循环恢复成功率较低，护理人员应重视首发症状有胸闷胸痛、心搏骤停前合并期前收缩的患者，加强夜班护士专业力量，增加巡视频率，及时发现心搏骤停的症状及心律失常，并启动快速急救团队，提高心源性院内心搏骤停患者自主循环恢复成功率。

关键词: 心源性, 院内心搏骤停, 自主循环恢复, 影响因素, 院内急救

Abstract:

Objective To explore the relevant influencing factors of spontaneous circulation recovery in patients with cardiogenicin-hospital cardiac arrest，and provide reference for preventing cardiac arrest and improving the success rate of rescue. Methods A retrospective analysis was conducted to continuously collect clinical data of 95 patients with cardiogenic in-hospital cardiac arrest admitted to a tertiary class A hospital in Zhenjiang City from May 2019 to May 2024. Based on the rescue outcomes，the patients were divided into a group with return of spontaneous circulation（ROSC） and a group without ROSC. Multivariate logistic regression analysis was conducted to explore the influencing factors. Results Among the 95 patients，61 recovered spontaneous circulation and 34 did not，with a success rate of 64.2%. Logistic regression analysis showed that premature contractions（OR=4.924，95% CI：1.368-17.723，P=0.015），nighttime（OR=4.805，95%CI：1.258-18.357，P=0.022），and cardiopulmonary resuscitation duration>15 minutes（OR=13.049，95%CI：1.424-119.602，P=0.023） were risk factors for spontaneous circulation recovery in patients with in-hospital cardiac arrest. Initial chest tightness and chest pain symptoms（OR=0.222，95% CI：0.057-0.864，P=0.030），tracheal intubation（OR=0.051，95%CI：0.009-0.282，P=0.001） were protective factors for the recovery of spontaneous circulation in patients with in-hospital cardiac arrest. Conclusion The success rate of ROSC in patients with cardiogenic in-hospital cardiac arrest is relatively low. Nursing staff should pay attention to patients with initial symptoms such as chest tightness and chest pain，and premature contractions before cardiac arrest. The professional strength of night shift nurses should be strengthened to increase the frequency of patrols，timely detect symptoms and arrhythmias of cardiac arrest，and activate rapid emergency teams to improve the success rate of ROSC for cardiogenic in-hospital cardiac arrest patients.

Key words: Cardiogenic, In-Hospital Cardiac Arrest, Return of Spontaneous Circulation, Influencing Factors, In-Hospital Emergency Treatment

李提提, 王明明, 任抒文, 王鹏, 吴正男, 陈红芳. 心源性院内心搏骤停患者自主循环恢复的现状及影响因素研究[J]. 中华急危重症护理杂志, 2025, 6(12): 1431-1436.

LI Titi, WANG Mingming, REN Shuwen, WANG Peng, WU Zhengnan, CHEN Hongfang. Analysis of influencing factors on the recovery of spontaneous circulation in patients with cardiogenic in-hospital cardiac arrest[J]. Chinese Journal of Emergency and Critical Care Nursing, 2025, 6(12): 1431-1436.

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