苏州地区心肺复苏术后早期目标治疗状况  

A survey on the implementation of the early goal-directed therapy after cardio-pulmonary resuscitation in Suzhou area

作　　者：朱建良[1] 张艳[1] 杨林[1] 刘励军[1] 

机构地区：[1]苏州大学附属第二医院急诊科,江苏省苏州215004

出　　处：《中华急诊医学杂志》2013年第10期1142-1146,共5页Chinese Journal of Emergency Medicine

基　　金：江苏省科技厅2009年科技支撑计划一社会发展项目（BE2009605）;苏州市科技局2009年科技支撑计划一社会发展项目（SS0919）

摘　　要：目的评估苏州地区心肺复苏术后患者早期目标化治疗的状况，为今后完善复苏后规范化治疗提供临床资料。方法采用回顾性队列研究的方法，调查2009-2010年期间苏州地区10家二级甲等及以上综合性医院，其ICU内收治的院内或院外心脏骤停恢复自主循环患者的资料。采集心脏骤停后48h内主要目标化治疗指标：体温（T）、平均动脉血压（MAP）、末梢血氧饱和度（SpO2）、二氧化碳分压（PaCO2）和末梢血糖（Glu）的测定值，比较分析上述指标达到目标值的情况。结果共有101例心脏骤停患者进入本研究。在目标化治疗指标达标率中，SpO2和MAP的达标率分别为90．1％和81．4％；Glu和PaCO2的达标率分别为55．4％和32．8％；而治疗性亚低温（MTH）的达标率最低，仅为10％；上述目标化治疗指标达标率之间的差异具有统计学意义（P〈0．01）。结论苏州地区心肺复苏术后患者的目标治疗质量仍需提高，尤其应强化对PaCO2和体温的管理力度。Objective To evaluate the implementation of the early goal-directed therapy after cardio- pulmonary resuscitation in Suzhou area, in order to provide clinical data for standardized post resuscitation care. Methods This retrospective study included comatose survivors of CA, admitted into intensive care units （ICU） of 10 hospitals in Suzhou area between January 2009 and December 2010. the parameters, mean arterial pressure （ MAP）, peripheral oxygen saturation （ SpO2 ）, partial pressure of carbon dioxide （PaCOz）, blood glucose （Glu） and body temperature （T）, were collected for 48 h after CA. The percentage of parameters achieving recommended goals was compared. Results A total of 101 CA patients were enrolled in this study. Among the parameters of GDT, the percentage of achieving recommended goals for SpO2 and MAP was 90. 1% and 81.4% ; the percentage of achieving recommended goals for Glu and PaCO2 was 55.4% and 32. 8%; however, mild therapeutic hypothermia （MTH） reached the lowest percentage, only 10% ; there were significant differences in the percentage of achieving recommended goals for these parameters, P 〈 0. 01. Conclusions The quality of early goal-directed therapy in the CA patients should be improved, especially in the management of body temperature and partial pressure of carbon dioxide.

关 键 词：心脏骤停 心肺复苏 早期目标治疗 治疗性亚低温 平均动脉血压 末梢血氧饱 和度 二氧化碳分压 末梢血糖 

分 类 号：R459.7[医药卫生—急诊医学]