心肺复苏中机械通气时机选择对急诊心博骤停患者预后的影响  

Effects of mechanical ventilation timing during cardiopulmonary resuscitation on the prognosis of patients with cardiac arrest in emergency

作　　者：付乐章[1] 

机构地区：[1]四川省都江堰市人民医院急诊科,611183

出　　处：《检验医学与临床》2013年第17期2240-2241,2243,共3页Laboratory Medicine and Clinic

摘　　要：目的探讨心肺复苏的机械通气时机选择对急诊心博骤停患者预后影响。方法选取在本院接受心博骤停自动循环恢复机械通气的50例患者为研究对象,按照机械通气的时间分为早期上机组24例,以及晚期上机组26例,统计两组患者的年龄、性别、心博骤停心率类型以及心博骤停的原因,同时统计两组患者心肺复苏成功效率、心博骤停24h、有无角膜性反射、有无瞳孔反射、疼痛躲避反应、运动反应、出院时神经功能分类以及治愈出院率。对两组患者的各项指标进行相应比较。结果两组患者的年龄、性别、心博骤停心率类型以及心博骤停原因,两者差异无统计学意义(P>0.05);两组患者的心肺复苏率、24h角膜反射(+)、24h瞳孔反射(+)、24h疼痛躲避反应(+)、24h运动反应(+)以及其出院时神经功能分类等,其指标差异有统计学意义,早期上机组明显优于晚期上机组(P<0.05);两组患者成活出院率(45.5%∶40.0%)之间差异无统计学意义(P>0.05),其总成活出院率为33.41%。结论对心博骤停的患者应及早给予机械通气呼吸支持,从而促进患者心脏的恢复,以提高心博骤停疾病患者的治疗效果,提高心博骤停患者心肺复苏的成功率,并且对其神经功能的预后进行改善。Objective To investigate the effects of mechanical ventilation timing during cardiopulmonary re-suscitation on the prognosis of patients with cardiac arrest in emergency .Methods 50 patients with cardiac arrest , receiving automatic cycle recovery of mechanical ventilation were divided into early treated group （24 cases） and later treated group （26 cases） according to the time of mechanical ventilation .Age ,gender ,type of heart rate ,etiological factor of cardiac arrest ,achievement ratio of cardiopulmonary resuscitation and corneal reflex ,pupillary reflex ,pain avoidance responses and motor response 24 h after cardiac arrest ,neurological function and cure rate of the two groups were analyzed .Results There were no significant differences of age ,gender ,type of heart rate and etiological factor of cardiac arrest between the two groups （P〉0 .05） .Cardiopulmonary resuscitation rate ,24 h corneal reflex （＋ ） ,24 h pupillary reflex （＋ ） ,24 h pain avoidance responses （＋ ） ,24 h motor response （＋ ） and neural func-tions classification at the time of discharge in early group was better than later group （P〈0 .05） .Cure rates of the two groups were 45 .5% and 40 .0% ,without statistical difference （P〉0 .05） ,and the total cure rate was 33 .41% . Conclusion Cardiac arrest patients should be given mechanical ventilation as soon as possible to promote the recover-y of heart function ,improve the therapeutic effect and achievement ratio of cardiopulmonary resuscitation and prog-nosis of neurological function .

关 键 词：心博骤停 心肺复苏 机械通气 

分 类 号：R442.8[医药卫生—诊断学]