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    根因分析法在急诊心肺复苏中的应用效果及其对患者预后的影响

    Application effectiveness of root cause analysis in emergency cardiopulmonary resuscitation and its impact on the prognosis of patients

      摘要
    • 摘要: 目的：探究根因分析法在急诊心肺复苏中的应用效果及其对患者预后的影响。方法：选取2020年1月至2022年1月梧州市工人医院急诊科收治的112例心脏骤停（CA）患者，分为对照组和观察组，每组56例。对照组采取常规治疗，观察组采取常规治疗和基于根因分析法的干预策略。比较两组心肺复苏后存活率、呼吸机维持时间、入住ICU时间以及复苏前、后的心率（HR）、平均动脉压（MAP）、动脉血氧分压（PaO2）、动脉二氧化碳分压（PCO2）、呼吸频率。评估清醒后1 d、5 d、7 d抑郁—焦虑—压力量表（DASS-21）评分，并观察并发症发生情况。结果：观察组心肺复苏后存活率为48.21%，与对照组（41.07%）比较无统计学意义（P> 0.05）。观察组呼吸机维持时间和入住ICU时间短于对照组，复苏后HR、MAP、PaO2和呼吸频率高于对照组，PCO2低于对照组（均P< 0.05）。清醒后5 d、7 d，观察组DASS-21量表各维度评分均低于对照组（P< 0.05）。观察组与对照组并发症发生率（11.11%vs.26.09%）比较差异无统计学意义（P> 0.05）。结论：基于根因分析法的干预策略应用于急诊心肺复苏，可提升急救效果，改善患者心理状态、血气和血流动力学参数。

       

      Abstract: Objective:To investigate the application effectiveness of root cause analysis in emergency cardiopulmonary resuscitation and its impact on the prognosis of patients, and to further provide ideas to improve the outcome of emergency medicine departments.Methods:A total of 112 patients with cardiac arrest(CA)admitted to the Emergency Department of Wuzhou Workers’Hospital from January 2020 to January 2022 were selected and divided into control group and observation group, with 56 cases in each group.In the control group, conventional intervention was adopted, and in the observation group, an intervention strategy based on root cause analysis was adopted, The survival rate after cardiopulmonary resuscitation, the ventilator maintenance time, ICU stay time, as well as heart rate (HR), mean arterial pressure (MAP), arterial partial pressure of oxygen (PaO2), arterial partial pressure of carbon dioxide (PCO2) and respiratory rate before and after resuscitation were compared between the two groups.The Depression Anxiety Stress Scale-21(DASS-21)score was evaluated at 1 d, 5 d and 7 d after waking up, and the occurrence of complications was observed.Results:The survival rate after cardiopulmonary resuscitation in the observation group was 48.21%, which was not significantly different from that in the control group (41.07%) (P> 0.05).The ventilator maintenance time and ICU stay time in the observation group were shorter than those in the control group, HR, MAP, PaO2 and respiratory rate after resuscitation were higher than those in the control group, and PCO2 was lower than that in the control group (all P< 0.05).The DASS-21 scale scores of all dimensions were lower in the observation group than in the control group at 5 d and 7 d after waking up (P< 0.05); the complication rate of 11.11% in the observation group was not significantly different from that of 26.09% in the control group (P> 0.05).Conclusion:The intervention strategy based on root cause analysis applied in emergency cardiopulmonary resuscitation can significantly enhance the salvage effect, and improve the psychological status, body blood gas and hemodynamic parameters of patients.

       

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