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目的 :回顾分析超长时心肺复苏成功后患者的人口学特征及最终结局。 方法 :回顾分析 1996年 1月至 2 0 0 2年 12月在我院心跳骤停心肺复苏持续 30 min以上、自主循环恢复并维持 6 h以上后收入我科 ICU进一步救治的病例 ,共 12例 ,男性 10例 ,女性 2例。平均年龄 (5 3.5± 19.7)岁。 结果 :本组 12例患者 ,心肺复苏持续时间的中位数时间为 4 5 min(31～ 12 0min)。出院时死亡者 (CPC评分 5分 ) 4例 ,分别死于循环衰竭和多器官功能衰竭 ;严重脑功能障碍者 (CPC评分 3分或 4分 ) 3例 ;痊愈或轻微中枢神经系统缺陷者 (CPC评分 1分或 2分 ) 5例。年龄和心肺复苏持续时间未显示出与出院结局有显著相关关系 (P>0 .0 5 )。心肺复苏成功后 4 8h内患者是否清醒与出院结局有非常显著关系 (P<0 .0 1)。结论 :在自主循环建立后 ,超长时心肺复苏患者的出院结局并不总是很糟糕 ,应慎重对患者家属或相关人员作出放弃进一步救治的建议。在自主循环建立4 8h后对患者出院结局进行预测将更加可靠 ,对家属作出的建议也更有价值。
Objective: To retrospectively analyze the demographic characteristics and the final outcome of patients after long-term cardiopulmonary resuscitation. Methods: From January 1996 to December 2002 in our hospital cardiopulmonary arrest cardiopulmonary resuscitation for 30 min or more, spontaneous circulation recovery and maintenance of more than 6 h income our department ICU further treatment of cases, a total of 12 cases , 10 males and 2 females. The average age (53.5 ± 19.7) years old. Results: The median duration of cardiopulmonary resuscitation in 12 patients in this group was 45 min (31-1200 min). Four patients died at discharge from the hospital (CPC score 5 points), died of circulatory failure and multiple organ failure respectively; 3 patients with severe brain dysfunction (CPC score 3 or 4); 3 patients with recovered or mild central nervous system defects CPC score 1 or 2) 5 cases. Age and CPR duration did not show a significant correlation with discharge outcomes (P> 0.05). There was a significant relationship between patients’ wakefulness and discharge at 48 h after cardiopulmonary resuscitation (P <0.01). CONCLUSIONS: After the establishment of spontaneous circulation, the outcome of long-term cardiopulmonary resuscitation patients is not always very poor. We should give caution to the patients’ relatives or relatives to give up their suggestions for further treatment. Predicting patient discharge outcomes after 48 hours of spontaneous circulation will be more reliable and more valuable to family members.