頁籤選單縮合
題 名 | Out-of-Hospital Cardiac Arrest in Taipei, Taiwan=臺北市到院前心跳停止患者之特性與處置之新進展 |
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作 者 | 黃建華; 馬惠明; 陳文鍾; | 書刊名 | Acta Cardiologica Sinica |
卷 期 | 22:2 民95.06 |
頁 次 | 頁53-57 |
分類號 | 419.53 |
關鍵詞 | 到院前心跳停止; 心室纖維顫動; 自動體外電擊器; 心肺復甦急救; 臺北市; Out-of-hospital cardiac arrest; Ventricular fibrillation; Automatic external defibrillation; Cardiopulmonary resuscitation; Taipei city; |
語 文 | 英文(English) |
中文摘要 | 雖然近年來對於冠狀動脈心臟病的治療及心肺急救復甦的實務操作有許多的進展,然而院外心跳停止的發生還是伴隨著高死亡率及嚴重的後遺症,根據世界各地的報告,發生院外心跳停止的患者其存活率仍小於百分之五。以台北市內發生院外心跳停止的患者為對象,近來的研究顯示此類患者以心室纖維顫動為首先被紀錄到心律的比例較西方國家為低,此現象可能與國人罹患冠狀動脈心臟病比率較西方國家為低有關,不過此類以心室纖維顫動為首先被紀錄到心律的患者其預後較其他心律者較佳。台北市於西元2000年開始全面使用150焦耳固定能量之雙向自動體外電擊器做為院外心跳停止患者的標準治療之一,與過去的研究相比,此治療方式提高了整體患者存活至出院的機會。由於實證醫學觀念的影響,治療院外心跳停止患者及急救的概念仍持續進步改變中,足夠的心肺復甦急救,特別是有效的胸部按壓,是改善急救患者預後最重要的因素之一。而對於心室纖維顫動已持續較久的患者,優先電擊或優先心肺復甦急救及胸部按壓的觀念也已被重新評估及思考。在復甦後症候群的治療上,改善患者復甦後的治療及照護,特別是治療性低溫的運用,可使急救患者的長期預後更佳。 |
英文摘要 | The occurrence of out-of-hospital cardiac arrest (OHCA) carries high mortality and morbidity even though treatments for coronary heart disease and the practice of cardiopulmonary resuscitation (CPR) have been improving for decades. The survival rate of all OHCA patients is still poor and is estimated to be below 5% from most reports throughout the world. The prevalence of ventricular fibrillation as the initial rhythm recorded is lower in Taipei City compared to western countries. The lower chance of coronary heart disease in Taiwan may account for it. Those OHCA patients with initial rhythm of ventricular fibrillation have better prognosis. The community-wide use of automatic external defibrillator was launched in 2000, utilizing the model of biphasic 150 joules of fixed energy. The survival-to-discharge rate of the OHCA patients has been improved after the introduction of automatic external defibrillators in Taipei City. The concepts of treating OHCA patients have been changing recently. The adequate quality of cardiopulmonary resuscitation, especially effective cardiac compression, has been proved to be the key to improving the outcomes of resuscitated patients. The concept of defibrillation first for patients with prolonged VF has been challenged. The optimum in post-resuscitation care, including hypothermia treatment, is beneficial to the long-term outcomes of the OHCA patients. |
本系統中英文摘要資訊取自各篇刊載內容。