心脏术后心肺复苏的预后指标与规范管理.pdf

上海交通大学医学院硕士学位论文
术,4名针对解剖问题,20名为止血或床边开胸。2名患儿心脏骤停
后成功建立左心辅助循环。,p=;
,p=;主动脉阻断大于50min的OR
,p=;,p=;
,p=;青紫型先天性心脏病的
,p=;,p=;正性
,p=;1h内正性肌力药物
剂量增加大于50%,p=;舒张压低于30mmHg
,p=;1h内5%SB用量大于4ml/kg的OR为
,p=;,p=;心脏骤停发
,p=。
结论:,但仍低于国际先
进水平。体重小于5kg、术前监护史、主动脉阻断大于50min、体
外循环大于120min、心源性心脏骤停、青紫型先天性心脏病、大血
管错位、正性肌力药物评分大于20、1h正性肌力药物剂量增加50%、
舒张压低于30mmHg、1h内5%SB用量大于4ml/kg、腹膜透析、心
脏骤停发生于医护人员夜班时间均为先天性心脏病术后死亡的独立
危险因素。

关键词:预后指标,心脏骤停,心肺复苏,
先天性心脏病,规范管理
上海交通大学医学院硕士学位论文



PREDICTORS AND STRATEGIES
OF CARDIOPULMONARY RESUSCITATION
AFTER CARDIAC SURGERY

ABSTRACT


Purpose: To determine the incidence and e of
cardiopulmonary resuscitation, and the predictors of survival
following in-hospital cardiopulmonary resuscitation in children
after cardiac surgery.
Methods: Hospital admission records were reviewed at
Shanghai Children’s Medical Center from 2005 to 2007. Patients
who sustained cardiac arrest that required cardiopulmonary
resuscitation were identified from the records. The medical chart
were reviewed to obtain the following variables: patients’
gender, age, weight, diagnosis, procedure, time of
cardiopulmonary bypass, laboratory data before and after
surgery, hemodynamic profile, inotrope score, arterial blood gas,
time, place and cause of cardiac arrest, cardiopulmonary
resuscitation index and etc. SPSS was used to do statistics.
上海交通大学医学院硕士学位论文
Results: There were y-seven patients who had totally
one hundred and eighteen cardiac arrests after surgery
required cardiopulmonary resuscitation during the three years.
And the cardiopulmonary resuscitation index decreased from
to . In 2007, the incidence of cardiac arrest was %,
the essful rate of c