实用医学杂志2024，Vol.40Issue(24)：3446-3451,6.DOI:10.3969/j.issn.1006-5725.2024.24.003
体外心肺复苏在急诊难治性心脏骤停的应用及预后因素分析
Analysis of the application and prognostic factors of extracorporeal cardiopulmonary resuscitation(ECPR)in patients with refractory cardiac arrest in the emergency department
摘要
Abstract
Objective To analyze the clinical application of Extracorporeal Cardiopulmonary Resuscita-tion(ECPR)in patients with refractory cardiac arrest in the emergency department and to investigate the factors affecting survival and neurological outcomes.Methods A retrospective analysis was conducted on the clinical data of 61 patients who underwent Extracorporeal Membrane Oxygenation(ECMO)for cardiopulmonary resuscitation at the emergency department from January 2021 to March 2024.The hospital discharge survival rate,favorable neuro-logical outcome rate,and incidence of complications were summarized.Factors affecting survival and neurological outcomes were also analyzed.Results In a study of 61 patients,the ECMO weaning success rate was 55.7%,the hospital discharge survival rate was 29.5%,the favorable neurological prognosis rate was 21.3%,and the incidence of complications was 47.5%.The proportion of initial cardiac rhythm being shockable was significantly higher in the survival group compared to the mortality group.The ECMO establishment time,low-flow time,and pre-ECMO blood lactate levels were all significantly lower in the survival group than in the mortality group.The pre-ECMO blood pH level was higher in the survival group.The ECMO maintenance time and ICU stay were significantly longer in the survival group than in the mortality group,with all P-values being less than 0.05,indicating statistically significant differences.Patients with an initial shockable cardiac rhythm and low-flow time≤60 minutes had a better favorable neurological prognosis rate.Conclusions Extracorporeal cardiopulmonary resuscitation can provide effective life support for patients with refractory cardiac arrest.Patients with an initial shockable rhythm,lower blood lactate levels and higher pH levels before ECMO support,and shorter low-flow time have a better prognosis.关键词
体外膜肺氧合/心肺复苏/心脏骤停Key words
extracorporeal membrane oxygenation/cardiopulmonary resuscitation/cardiac arrest分类
医药卫生引用本文复制引用
韦耿周,黄国戈,朱创志,江稳强,胡北..体外心肺复苏在急诊难治性心脏骤停的应用及预后因素分析[J].实用医学杂志,2024,40(24):3446-3451,6.基金项目
国家自然科学基金资助项目(编号:82072139) （编号:82072139）
