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抗凝治疗可改善接受心肺复苏的住院患者的窦性心律恢复和自主循环。

Anticoagulation therapy could improve the restoration of sinus rhythm and spontaneous circulation in hospital patients with CPR.

作者信息

Wang Hai, Bai Zheng-Hai, Lv Jun-Hua, Sun Jiang-Li, Shi Yu, Pei Hong-Hong, Zhang Zheng-Liang

机构信息

Emergency Department & Emergency Intensive Care Unit, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, China.

出版信息

J Int Med Res. 2019 Dec;47(12):5957-5966. doi: 10.1177/0300060519878005. Epub 2019 Oct 8.

Abstract

OBJECTIVE

To analyse the role of anticoagulation therapy in cardiopulmonary resuscitation (CPR) following an in-hospital cardiac arrest.

METHODS

This single-centre retrospective cohort study enrolled patients treated with in-hospital CPR that met the inclusion and exclusion criteria. The patients were divided into a without anticoagulation group and an anticoagulation group. The main outcome measures were the restoration of spontaneous respiration, restoration of sinus rhythm (ROSR), restoration of spontaneous circulation (ROSC) and the hospital mortality.

RESULTS

The study analysed 344 patients: 272 in the without anticoagulation group and 72 in the anticoagulation group. Multiple logistic regression analyses demonstrated that anticoagulation therapy improved ROSR (adjusted odds ratio [OR] 2.21, 95% confidence interval [CI] 1.23, 3.96) and ROSC (adjusted OR 1.91, 95% CI 1.08, 3.40), but it did not improve the restoration of spontaneous respiration (adjusted OR 1.64, 95% CI 0.72, 3.76) and hospital survival (adjusted OR 0.90, 95% CI 0.40, 1.99).

CONCLUSION

Anticoagulation therapy improved ROSR and ROSC, but did not decrease the mortality rate of hospitalized patients undergoing CPR following in-hospital cardiac arrest.

摘要

目的

分析抗凝治疗在院内心脏骤停后心肺复苏(CPR)中的作用。

方法

这项单中心回顾性队列研究纳入了符合纳入和排除标准的接受院内心肺复苏治疗的患者。患者被分为非抗凝组和抗凝组。主要观察指标为自主呼吸恢复、窦性心律恢复(ROSR)、自主循环恢复(ROSC)及医院死亡率。

结果

该研究分析了344例患者:非抗凝组272例,抗凝组72例。多项逻辑回归分析表明,抗凝治疗可改善ROSR(调整优势比[OR]2.21,95%置信区间[CI]1.23,3.96)和ROSC(调整OR 1.91, 95% CI 1.08, 3.40),但不能改善自主呼吸恢复(调整OR 1.64, 95% CI 0.72, 3.76)及医院生存率(调整OR 0.90, 95% CI 0.40, 1.99)。

结论

抗凝治疗可改善ROSR和ROSC,但不能降低院内心脏骤停后接受心肺复苏的住院患者的死亡率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4fcc/7045655/b6d77dff57f7/10.1177_0300060519878005-fig1.jpg

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