到院前心肺功能停止病患恢復自發性循環之到院前相關因素探討-以嘉義某區域教學醫院為例

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到院前心肺功能停止病患恢复自发性循环之到院前相关因素探讨-以嘉义某区域教学医院为例

Prehospital Factors Associated with Return of Spontaneous Circulation in Out-of-Hospital Cardiac Arrest Patients of One Chiayi's Regional Teaching Hospital

张惠娟 , 硕士　　导师：黄伟尧　　

繁体中文

到院前心肺功能停止；恢复自发性循环；专责救护队；到院前处置； Out-of-Hospital Cardiac Arrest(OHCA) ； Return of Spontaneous Circulation(ROSC) ； designated ambulance crew ； pre-hospital emergency treatment

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摘要 │ 参考文献 (61) │ 国际计量

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Background：A 4-minute prime time to rescue sudden cardiac arrest patients, every minute survival rate will be reduced by 10-12%. In order to successfully save the patient, we have to understand what is effective emergency treatment is necessary.
Objective：The hospital transport and pre-hospital emergency treatment of out-of-hospital cardiac arrest (OHCA) patients affect return of spontaneous circulation (ROSC) in Chiayi region.
Methods：The secondary data analysis is adopted as the basis of this study, the related medical data from January 2009 to December 2014 were collected in a regional teaching hospital emergency room OHCA patients over 20 years old situating in Chiayi region. OHCA patients were 636 people have been executed in the exclusion of non-implementation of cardiopulmonary resuscitation, trauma, drowning, poisoning, burns, ROSC transferred immediately, this study were 435 people. The ROSC as the dependent variable, hospital transport and pre-hospital emergency treatment, including automated external defibrillator, laryngeal mask airway, bystander CPR, pre-hospital shock as independent variables. Capture the pre-hospital emergency treatment, the hospital emergency treatment, hospital transport, survival situation, basic patient information as variables to do Descriptive statistics, Chi-square test, independent samples t-test, and logistic regression analysis.
Results：The pre-hospital cardiopulmonary function stopping patients with an average age of 72 years old, Most accompanied by people with medical background were 380 people (87.3%), the pre-hospital emergency treatment, including using the laryngeal mask airway were 27 people(6.2%), bystander cardiopulmonary resuscitation were 34 people(7.8%), and pre-hospital electric shock were 27 people(6.2%). The chi-square test between every independent variable and ROSC show that gender (p=0.147), age(p=0.015), chronic diseases (p=0.572), automated external defibrillator(p=0.682), laryngeal mask airway(p=0.836), bystander cardiopulmonary resuscitation(p=0.263), the pre-hospital electric shock(p=0.430), transport(p=0.305), heart rhythm is shockable in hospital(p=1.000), electric shock in hospital (p=0.004), injection Epinephrine times(p=0.059), designated ambulance crew(p=0.778). The pre-hospital stopping cardiopulmonary function patients in pre-hospital emergency treatment, designated ambulance crew, and ROSC were no significant differences by logistic regression test.
Conclusion：The pre-hospital emergency treatment, including patients accompanied by people with medical background to the emergency, using automated external defibrillators, using laryngeal mask airway, sent by designated ambulance crew, and shockable heart rhythm were no significant effect on ROSC in this regional teaching hospital of Chiayi.

参考文献 ( 61 ) 〈TOP〉

吴荣平、余岐育(2011)·消防机关执行 OHCA 患者到院前紧急救护之调查研究·危机管理学刊，8(1)，9-18。
连结：
李文辉、廖训祯、陈日昌、卜乐得(1996)·急重症病患使用紧急医疗救护系统送医之意愿调查·中华民国急救加护医学会杂志，7(2)，61-68。
连结：
李建国(2010)·宜兰地区到院前心跳停止病患之分析·国立中山大学高阶经营硕士学程在职专班硕士论文。
连结：
李建璋(2006)·到院前呼吸心跳停止的流行病学与预後·当代医学(391)，394-399。
连结：
李建璋、马惠明、陈文锺(2008)·心肺复苏後存活患者脑神经预後之预测因子·当代医学，35(1)，23-27。
连结：

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使用DOI作为永久连结

引用含有DOI的文献

DOI可强化引用精确性、增强学术圈连结，并给予使用者跨平台的良好使用经验，目前在全世界已有超过五千万个对象申请DOI。 如想对DOI的使用与概念有进一步了解，请参考 （ ） 。

DOI可强化引用精确性、增强学术圈连结，并给予使用者跨平台的良好使用经验，目前在全世界已有超过五千万个对象申请DOI。如想对DOI的使用与概念有进一步了解，请参考（）。