儿科院外心跳停止的流行病学特点与预后

目的 总结儿科院外心跳停止(OHCA)病例的流行病学特点与预后.方法 回顾性研究2001年1月至2009年12月我院急诊创伤中心(EDTC)收治的OHCA患儿的临床资料,分析与预后相关的因素年龄、性别、转运工具、有无目击者、是否现场给予心肺复苏(CPR)、OHCA发生地点、OHCA可能原因及治疗等].结果 9年中共收治221例OHCA患儿,男女之比为1.15:1,经急诊抢救恢复自主循环(ROSC)77例(34.84%),出院时存活21例(9.50%).OHCA发生时有目击者、现场给予CPR、初始复苏时使用.肾上腺素使用次数、OHCA发生场所、救护车转运是急诊复苏成功的良好预测指标.初始复苏时肾上腺素使用次数、目击者现场CPR及OHCA发生地点是OHCA患儿最终存活的独立预测因子.意外伤害性疾病(69/221,31.22%)与复杂先天性心脏病(46/221,20.82%)是儿科OHCA主要原因.小于1岁年龄组是儿科OHCA的最好发年龄段(145/221,65.61%).结论 儿科OHCA患者存活率低,预后差,加强意外伤害预防、早期目击者CPR,能减少DHCA的发生率及改善预后.

Epidemiology and outcomes of children with out-of-hospital cardiac arrest

Objective To summarize the outcomes and epidemiology of pediatric out-of-hospital cardiac arrest(OHCA).Methods We retrospectively analyzed the clinical and epidemiological characteristics of 221 OHCA cases from emergency department trauma center(EDTC) of our hospital between Jan 2001 and Dec 2009.Multivariate analysis of epidemiological variables,age,sex,transport,witnessed or nonwitnessed attest,bystander cardiopulmonary resuscitation(CPR),location of arrest,cause of arrest and treatment WaS performed to find factors that were predictive for outcome.Results A total of 221 patients met study entry criteria in 9 years.Return of spontanecus circulation(ROSC)in EDTC Was achieved 34.84% of patients and the survival rate to hospital discharge was 9.50% of patients.Pediatric OHCA patients who got witnessed,bystander CPR,low amount of epinephrine,and who were transported by ambulance showed the higher successful rate of resuscitation in EDTC.Independent predictors of good outcome were early bystander CPR.amount of epinephrine.The main causes of pediatric OHCA were accidental injury disease and complicated congenital heart disease.The most incident age of pediatric OHCA Was less than 1 year old.Conclusion This study demonstrates that there are poor prognosis and high mortality in pediatric patients of OHCA.The implementation of accident prevention,early bystander CPR have the potential to further improve survival rates following pediatric out-of-hospital cardiac arrest.