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目的:通过对天津市急救中心31例心脏性猝死病例院外现场复苏(CPR)成功原因分析说。方法:回顾性分析31例心脏猝死患者的临床资料及现场处置过程。结果:本组病例,其中10例一次除颤成功,21例两次除颤成功。除颤后患者出现室上性心动过速心电图型,心率110～150次/min,BP80/40mmHg(1mmHg=0.133kPa),经进一步人工呼吸支持、可拉明、洛贝林静脉注入后,恢复自主呼吸,心电图亦转为窦性心律。其中2例患者现场即恢复神志。结论:现场复苏成功不仅仅取决于复苏开始时间,急救半径,急救反应时间等时间因素,还取决于投入的急救资源、急救设备的质量、所采用的急救手段、急救药品等因素。并认为,进一步提高院前急救成功率必须关注患者的原发疾病控制,关注第一目击者培训及政府对急救事业的投入。
Objective: To analyze the successful causes of sudden resuscitation (CPR) in 31 cases of sudden cardiac death in Tianjin Emergency Center. Methods: A retrospective analysis of 31 cases of sudden cardiac death in patients with clinical data and field disposal process. Results: In this group of patients, defibrillation was successful in 10 cases and defibrillation in 21 cases was successful. After defibrillation patients with supraventricular tachycardia ECG, heart rate 110 ~ 150 times / min, BP80 / 40mmHg (1mmHg=0.133kPa), after further artificial respiratory support, cocaine, Luo Bei Lin intravenous injection, recovery Spontaneous breathing, ECG is also converted to sinus rhythm. Two of the patients recovered their consciousness at the scene. CONCLUSIONS: The success of on-site resuscitation depends not only on the time of resuscitation, the radius of emergency rescue, and the response time of first aid, but also the factors such as first aid resources, quality of first aid equipment, first aid methods and first aid drugs. And that, to further improve the success rate of pre-hospital emergency must pay attention to the patient’s primary disease control, pay attention to the first witness training and government investment in emergency services.