精细调控血压联合乌司他丁对心肺复苏后脑复苏的疗效观察  

Effects of fine blood pressure regulation combined with Ulinastatin on cerebral resuscitation after cardiopulmonary resuscitation

作　　者：王群[1] 刘斌[1] 李奇林[1] 王华[1] 郑彦涛[1] 韩瑞彩 

机构地区：[1]南方医科大学珠江医院急诊科,广东广州510280

出　　处：《中国急救医学》2014年第6期502-505,共4页Chinese Journal of Critical Care Medicine

摘　　要：目的 探讨精细调控血压联合乌司他丁治疗心肺复苏（CPR）后脑复苏的疗效.方法 将61例CPR后自主循环恢复（ROSC）的患者分为对照组（A组）31例和试验组（B组）30例,A组采用常规治疗,B组在常规治疗基础上精细调控血压,于CPR后30 min内行血压管理,使平均动脉压（MAP）维持稍低水平（90～100 mm Hg）.随后逐渐升高血压,使MAP维持在140～150 mm Hg,每1h重复一次至48 h.另CPR同时予以乌司他丁30万U＋葡萄糖20 mL静注,CPR成功后予以20万U＋5％葡萄糖230 mL静滴,12 h一次,连续48 h.比较两组格拉斯哥评分（GCS）和神经功能缺损评分（NFI）及治疗后的痊愈、显著进步率和总有效率.结果 B组复苏后48 h的GCS评分高于A组,复苏后4、8、12周NFI评分低于A组,痊愈、显著进步率和总有效率亦高于A组（P均＜0.05）.结论 精细调控血压联合乌司他丁治疗可有效改善CPR后患者的神经功能情况及提高临床治愈率.Objective To explore the effects of fine blood pressure regulation combined with Ulinastatin on cerebral resuscitation after cardiopulmonary resuscitation.Methods 61 cases of patients in recovery of automatic circulation （ROSC） after the cardiopulmonary resuscitation （CPR） were divided into the Control Group （Group A） including 31 cases and the Test Group （Group B） including 30cases,respectively.The Group A was treated with conventional therapy; based on conventional therapy,the Group B was treated with fine blood pressure regulation.The blood pressure of patients in Group B was managed 30 min after CPR,namely,maintaining the MAP at a relatively low level （90 ～ 100 mm Hg）.Along with the gradual increase of blood pressure,the managed blood pressure level was maintained at 140 ～ 150 mm Hg.This was repeated once an hour till 48 hours.In addition,the Ulinastatin 300 000 U ＋ GS 20 mL was intravenously injected during the CPR,and the Ulinastatin 200 000 U ＋5％ GS 230 mL intravenously dripped after the CPR,which was repeated every 12 h in the following 48 hours.The scores of Glasgow Coma Scale （GCS） and Nerve Function Impairment （NFI） of these two groups,as well as their markedly effective rate and total effective rate after the treatment were compared.Results The value of GCS of Group B was higher than that of Group A at the 48th hour after the CPR; at 4 w,8 w,12 w after CPR,the NFI of Group B was lower than that of Group A.The cure rate,markedly effective rate and total effective rate in group B were also higher than those in Group A.Among these results,all the P values are less than 0.05,which was statistically significant.Conclusion The fine blood pressure regulation combined with Ulinastatin can effectively improve the neurological condition of patients and enhance the clinical cure rate after CPR.

关 键 词：心肺复苏(CPR) 脑复苏 血压 乌司他丁 神经功能情况 

分 类 号：R473.5[医药卫生—护理学]