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日本的公用除颤设备和院外心脏停搏关系的研究
Public-Access Defibrillation and Out-of- Hospital Cardiac Arrest in Japan


Tetsuhisa Kitamura ... 心脑血管疾病 • 2016.10.27
相关阅读
• 旁观者实施的心肺复苏术和除颤与患者更好的远期结局相关 • 院外心脏停搏后旁观者施救与患者的1年结局研究

摘要


背景

早期除颤在改善院外因室颤而心脏停搏(室颤性心脏停搏)患者的生存中起着关键作用,并且使用公众可用的自动体外除颤器(automated external defibrillator,AED)有助于缩短此类患者的除颤时间。但是,公众可用AED的普及对于室颤性心脏停搏的效果在人群水平尚未得到深入研究。

 

方法

从日本全国范围的、前瞻性的、基于人群的院外心脏停搏患者注册系统中,我们确定了2005年至2013年间由旁观者目睹的假定心源性室颤性停搏发作并被尝试复苏的患者。主要结局指标是具有良好神经系统结局的1个月生存率(脑功能分类得分1或2,评分范围从1 [脑功能良好]到5 [死亡或脑死亡])。我们估计了因公众可用除颤而获得良好神经系统结局的生存患者数目。

 

结果

在43,762例旁观者目睹的心源性室颤性停搏患者中,4,499例(10.3%)接受了公众可用除颤。接受公众可用除颤的患者比例从2005年的1.1%增长至2013年的16.5%(趋势检验P<0.001)。接受公众可用除颤者中神经功能良好的1个月生存患者百分比显著高于未接受公众可用除颤者(38.5%对18.2%;倾向评分匹配后校正比值比,1.99;95%可信区间,1.80~2.19)。因使用公众可用除颤而获得良好神经系统结局的生存者的估计数目,从2005年的6例增加至2013年的201例(趋势检验P<0.001)。

 

结论

在日本,旁观者应用公众可用除颤的增加与院外室颤性心脏停搏后神经系统结局良好的生存者数量增加相关。





作者信息

Tetsuhisa Kitamura, M.D., D.P.H., Kosuke Kiyohara, D.P.H., Tomohiko Sakai, M.D., Ph.D., Tasuku Matsuyama, M.D., Toshihiro Hatakeyama, M.D., Tomonari Shimamoto, R.N., M.P.H., Junichi Izawa, M.D., Tomoko Fujii, M.D., Chika Nishiyama, R.N., D.P.H., Takashi Kawamura, M.D., Ph.D., and Taku Iwami, M.D., M.P.H., Ph.D.
From the Division of Environmental Medicine and Population Sciences, Department of Social and Environmental Medicine, Graduate School of Medicine, Osaka University, Osaka (T. Kitamura), the Department of Public Health, Tokyo Women’s Medical University, Tokyo (K.K.), the Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, Suita (T. Sakai), and the Department of Emergency Medicine, Kyoto Prefectural University of Medicine (T.M.), Kyoto University Health Service (T.H., T. Shimamoto, J.I., T.F., T. Kawamura, T.I.), and the Department of Critical Care Nursing, Graduate School of Medicine and School of Health Sciences, Kyoto University (C.N.), Kyoto — all in Japan. Address reprint requests to Dr. Iwami at Kyoto University Health Service, Yoshida-Honmachi, Sakyo-ku, Kyoto 606-8501, Japan, or at iwami.taku.8w@kyoto-u.ac.jp.

 

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