2025 年第 9 期 第 20 卷

胃容积对院外心脏骤停患者心肺复苏期间自主循环恢复的影响

The effect of gastric volume on the recovery of spontaneous circulation during cardiopulmonary resuscitation in patients with out of hospital cardiac arrest

作者：李超韩小琴韦梅夏敏张盼杨飞聂时南

英文作者：Li Chao Han Xiaoqin Wei Mei Xia Min Zhang Pan Yang Fei Nie Shinan

单位：中国人民解放军东部战区总医院急诊医学科，南京210002

英文单位：Department of Emergency Medicine General Hospital of Eastern Theater Command of the Chinese People′s Liberation Army Nanjing 210002 China

关键词：心脏骤停；胃容积；心肺复苏术；自主循环恢复

英文关键词：Cardiacarrest;Gastricvolume;Cardiopulmonaryresuscitation;Recoveryofspontaneouscirculation

• 摘要：

• 目的 探讨胃容积对院外心脏骤停（OHCA）患者心肺复苏过程中自主循环恢复（ROSC）的影响。方法 回顾性分析2021年7月至2023年1月中国人民解放军东部战区总医院急诊医学科抢救室收治的106例OHCA患者的临床资料。根据来院后胃管负压吸引盘中胃内容物（含气体）的中位数百分比（≥75%的定义为胃膨胀）将患者分为胃膨胀组（28例）和非胃膨胀组（78例）。比较2组患者的基线临床资料和ROSC情况、30 d生存情况。分析相关临床因素与ROSC的关系、胃容积与相关临床因素的关系。结果 2组患者年龄、性别分布、院前急救方面、院前时间比较差异均无统计学意义（均P＞0.05）。胃膨胀组与非胃膨胀组ROSC率和30 d生存率比较差异均无统计学意义［28.6%（8/28）比25.6%（20/78）、7.1%（5/28）比3.8%（3/78）］（P=0.441、0.993）。多因素Logistic回归分析结果显示旁人实施心肺复苏、气道管理、肾上腺素管理均为OHCA患者发生死亡事件的独立危险因素（均P<0.05）；胃容积与ROSC结局无关（P=0.280）。结论 在心肺复苏的过程中，胃内容物过多并不影响自主循环的恢复。

• Objective To investigate the effect of gastric volume on the recovery of spontaneous circulation (ROSC) during cardiopulmonary resuscitation in patients with out of hospital cardiac arrest (OHCA). Methods The clinical data of 106 OHCA patients admitted to the Resuscitation Room of the Department of Emergency Medicine, Eastern Theater General Hospital of the Chinese People′s Liberation Army from July 2021 to January 2023 were retrospectively analyzed. Patients were divided into a gastric distension group (28 cases) and a non gastric distension group (78 cases) based on the median percentage of gastric contents (including gas) in the negative pressure suction tray of the gastric tube after arrival at the hospital (defined as gastric distension if ≥ 75%). Baseline clinical data, ROSC and 30 d survival were compared between the two groups. The relationship between related clinical factors and ROSC, and the relationship between gastric volume and related clinical factors were analyzed. Results There was no significant difference in age, gender distribution, pre-hospital emergency care and pre-hospital time between the two groups (all P>0.05). There was no significant difference in ROSC rate and 30 d survival rate between gastric distension group and nongastric distension group ［28.6%(8/28) vs 25.6%(20/78), 7.1%(5/28) vs 3.8%(3/78)］(P=0.441, 0.993). Multivariate Logistic regression analysis showed that cardiopulmonary resuscitation, airway management and epinephrine management were independent risk factors for death events in OHCA patients (all P<0.05). Gastric volume was not associated with ROSC outcome (P=0.280). Conclusion Excessive gastric contents do not affect ROSC during cardiopulmonary resuscitation.