摘要目的 探讨发生心跳呼吸骤停(CRA)住院儿童复苏后存活率的预测因素.方法 回顾性分析PICU发生CRA患儿的临床及心肺复苏(CPR)、复苏后资料,并进行单因素分析以及多因素非条件Logistic回归分析,探讨近期和远期存活率的预测因素.结果 2006年1月至2008年12月烟台毓璜顶医院PICU发生CRA并接受CPR的87例患儿中,43例恢复自主循环,复苏成功率为48.3%,24 h存活31例(35.6%);存活出院19例(21.8%).单因素分析结果显示:原发病、合并症以及发生骤停类型、气管插管、有效复苏时问、应用肾上腺素的剂量、复苏后24 h内体温、复苏后6 h血糖值、复苏后合并症均影响复苏后24 h存活率和出院存活率;Logistic回归分析示原发病、复苏时间为24 h存活率的预测因素;原发病、复苏时间、复苏后24 h体温为出院存活率的预测因素.结论 住院患儿发生CRA后近期、远期存活率均低,原发病及合并症、CPR质量以及复苏后管理均影响存活率,其中原发病、复苏时间为近期存活率预测因素,原发病、复苏时间、复苏后24 h体温为远期存活率的预测因素.

abstractsObjective To identify predictive factors of survival to in-hospital children with post-cardiorespiratory arrest.Methods Eighty-seven patients who had cardiorespiratory arrest(CRA)and received cardiopulmonary resuscitation(CPR)were reviewed from January 2006 to December 2008.The clinical data was analyzed to identify predictive factors of survival by Pearson X~2 test and multivariate and unconditioned Logistic regression analysis.Results Forty-three of eighty-seven cases received return of spontaneous circulation,the initial sunvival rate was 48.3%,31(35.6%)cases survived for 24 hours,19(21.8%)cases survived to hospital discharge.Primary diseases and complications,the type of arrest,tracheal intubation or not,the duration of CPR,the dose of adrenaline,the body temperature post-resuscitation for 24 hours,the glucose post resuscitation for 6 hours and complications were obviously associated with both initial and long-term survival.Logistic regression analysis revealed that primary diseases and the duration of CPR were predictive factors of both survival for 24 hours and hospital discharge,additionally,the body temperature post-resuscitation for 24 hours were predictive factor of survival to hospital discharge.Conclusion Initial and long-term survival rate of in-hospital children with post-resuscitation was both low.Primary diseases and complications,good quality CPR and management of post-resuscitation affect survival,especially primary diseases and the duration of CPR may predict initial survival and primary diseases,the duration of CPR and the body temperature post-resuscitation for 24 hours may predict long-term survival.