围手术期心跳骤停的危险因素分析

目的 探讨围手术期心跳骤停的危险因素,为有效预防围手术期心跳骤停提供科学依据.方法 采用病例对照研究,选取1996-2006年菏泽市立医院16例围手术期心脏骤停病人为病例组,同时选择同期、性别、年龄匹配的60例未发生心跳骤停的病人作为对照组,对相关危险因素进行单因素和多因素Logistic回归分析.结果 术前心脏功能差、术中缺氧、失血性休克、电解质紊乱、迷走神经反射是围手术期病人发生心跳骤停的危险因素,OR值分别为2.625、1.055、1.901、6.337和6.507.结论 在围手术期心跳骤停的预防工作中,改善择期手术病人的心脏功能;术中注意给氧,输血,维持电解质平衡,避免牵拉迷走神经是有效的预防措施.

Risk Analysis on Perioperative Cardiac Arrest

Objective To explore the risk factors for perioperative cardiac arrest, and to provide scientific evidence to prevent perioperative cardiac arrest. Method A case-controlled study was conducted to examine the risk factors. 16 perioperative cardiac arrest patients were selected from 1996 to 2006 year in Heze municipal hospital. The corresponding time period, sex and age matched subjects were selected as control. The risk factors were analyzed by single and multivariate Logistic regression. Result Poor condition of cardiac function at preoperative, oxygen deficiency, hemorrhagic shock, electrolyte disturbances, and vagus nerve reflex during the operation were the major risk factors of perioperative cardiac arrest. The OR value for these 5 factors was 2.625, 1.055, 1.901, 6.337, and 6.507, respectively. Conclusion Promoting cardiac function at preoperative in a selected group of patients; supplying oxygen and blood transfusion, keeping the electrolyte balance, and avoiding dragging the vagus nerve during the operation are the effective measures to prevent perioperative cardiac arrest.