院前心搏骤停患者自主循环恢复实现及神经功能恢复的影响因素

doi:10.3969/j.issn.1671-7171.2025.09.032

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Abstract 【Objective】 To investigate the factors influencing the return of spontaneous circulation(ROSC) and neurological recovery in patients with out-of-hospital cardiac arrest(OHCA).【Methods】 Clinical data of 90 OHCA patients were collected. Clinical characteristics were compared between the ROSC and non-ROSC groups, and risk factors for poor neurological recovery within 28 days were analyzed among ROSC patients.【Results】 Among the 90 patients, 69 achieved ROSC and 21 did not. The ROSC group had a higher proportion of initial shockable rhythms and epinephrine use, and a lower Acute Physiology and Chronic Health Evaluation Ⅱ(APACHEⅡ) score compared to the non-ROSC group(P<0.05). Multivariate logistic regression analysis showed that initial shockable rhythm and APACHEⅡ score were independent factors associated with ROSC(P<0.05). Among the 69 patients who achieved ROSC, 22 had good neurological outcomes(Group A) and 47 had poor neurological outcomes(Group B) after 28 days. Group A had higher proportions of initial shockable rhythms, antiarrhythmic drug use, and hemoglobin(Hb) level compared to Group B(P<0.05), while the use of epinephrine, vasopressors, and sodium bicarbonate in Group A was lower than those in Group B(P<0.05). Multivariate logistic regression analysis identified initial shockable rhythm and Hb level as independent risk factors for poor neurological outcomes in ROSC patients(P<0.05).【Conclusion】 The prognosis of OHCA patients after cardiopulmonary resuscitation is influenced by multiple factors. The main factors affecting ROSC are initial shockable rhythm and APACHEⅡ score, while independent risk factors for poor neurological recovery include initial shockable rhythm and hemoglobin level.

Key words： Death, Sudden, Cardiac Neurological Rehabilitation Return of Spontaneous Circulation Root Cause Analysis

Received: 29 May 2025

PACS:

R541.78

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	Articles by authors
	YANG Xintao
	DAI Yujing
	LI Suhui
	et al

Cite this article:

YANG Xintao,DAI Yujing,LI Suhui, et al. Influencing Factors of Return of Spontaneous Circulation and Neurological Recovery in Out-of-Hospital Cardiac Arrest Patients[J]. JOURNAL OF CLINICAL RESEARCH, 2025, 42(9): 1601-1604.

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http://journal07.magtech.org.cn/yxlcyj/EN/10.3969/j.issn.1671-7171.2025.09.032 OR http://journal07.magtech.org.cn/yxlcyj/EN/Y2025/V42/I9/1601

[1] 李振源,樊麦英,晏锡泉,等. 心搏骤停风险预测的研究进展[J].中华危重病急救医学,2024,36(3):320-325.
[2] 曾景,林月雄,金廷荣,等. 基于脑功能监测指标构建预测心搏骤停行心肺复苏后自主循环恢复患者神经功能预后不良的多因素Logistic回归模型[J].实用心脑肺血管病杂志,2021,29(12):28-34.
[3] 张晓东,罗丽,项涛. 心肺复苏辅助装置和团队心肺复苏的研究进展[J].心血管病学进展,2021,42(5):442-444.
[4] 刘曙艳,周雪红,陈洁. 胰岛素泵强化治疗糖尿病并重症肺部感染及对血清和肺泡灌洗液中炎症因子的影响[J].中国现代医学杂志,2018,28(3):107-112.
[5] 陈闪闪,蔡文伟,李恒杰,等. 浙江省院外心脏骤停患者的流行病学调查[J].中华急诊医学杂志,2024,33(7):979-982.
[6] SANDRONI C, DARRIGO S, CACCIOLA S, et al. Prediction of poor neurological outcome in comatose survivors of cardiac arrest:a systematic review[J].Intensive Care Med,2020, 46(10):1803-1851.
[7] ANDERSEN L W, HOLMBERG M J, BERG K M, et al. In-hospital cardiac arrest:a review[J].Jama,2019, 321(12):1200.
[8] PERKINS G D, CALLAWAY C W, HAYWOOD K, et al. Brain injury after cardiac arrest[J].Lancet,2021, 398(10307):1269-1278.
[9] CRONBERG T, GREER D M, LILJA G, et al. Brain injury after cardiac arrest:from prognostication of comatose patients to rehabilitation[J].Lancet Neurol,2020, 19(7):611-622.
[10] 黄燕梅,张婉婉,张永恕,等. 院外心脏骤停初始可除颤心律的流行病学预测因素分析[J].中华急诊医学杂志,2019,28(10):1296-1300.
[11] 舒延章,鲁利斌,岑颖欣,等. 郑州地区成人院外心搏骤停患者CPR与性别的相关性研究:2016年至2019年病例分析[J].中国中西医结合急救杂志,2021,38(5):535-540.
[12] HOU H X, PANG L, ZHAO L, et al. Hemoglobin as a prognostic marker for neurological outcomes in post-cardiac arrest patients:a meta-analysis[J].Sci Rep,2023, 13(1):18531.