早期应用低温生理盐水协同诱导亚低温对心肺复苏后昏迷患者脑电图的影响  

Influence of early application of hypothermic normal saline as a cooperative induction for mild hypothermia on electroencephalogram in coma patients after cardio-pulmonary resuscitation

作　　者：邱婷[1] 郑维红[1] 陆程翔[2] 

机构地区：[1]厦门大学附属中山医院神经内科,厦门361004 [2]厦门大学附属中山医院重症医学科,厦门361004

出　　处：《中国当代医药》2015年第33期63-65,68,共4页China Modern Medicine

摘　　要：目的了解早期应用低温生理盐水协同诱导亚低温对心肺复苏后昏迷患者脑电图（EEG）的影响,为心肺复苏的临床诊治提供参考依据。方法选择2008年2月-2014年1月本院ICU发生的心肺复苏后持续昏迷患者50例,随机分为实验组（26例）和对照组（24例）。两组均于自主循环功能恢复0.5 h即开始进行常规亚低温治疗,至72 h观察期结束。实验组在常规亚低温治疗基础上于心肺复苏自主循环恢复后0.5 h内经外周静脉输注4℃生理盐水行早期诱导亚低温治疗。对照组于同时点仅输注等量常温生理盐水。两组患者均于心肺复苏后5-7 d行EEG检查,记录分析EEG异常程度及异常EEG模式。结果实验组与对照组EEG异常程度不相同,且实验组EEG重度异常者所占比例（7.7%）明显低于对照组（33.3%）,差异有统计学意义（P〈0.05）。两组EEG波形特点不同,且实验组提示患者预后改善的慢波增多型患者所占比例（38.5%）明显高于对照组（8.3%）,差异有统计学意义（P〈0.05）。结论心肺复苏早期应用经外周快速输注4℃生理盐水协同诱导亚低温能对患者EEG产生有益的影响。Objective To get known the influence of hypothermic normal saline as a cooperative induction for mild hypothermia on electroencephalogram（EEG） in coma patients after cardio-pulmonary resuscitation（CPR） in order to provide reference for clinical diagnosis and treatment of CPR. Methods From February 2008 to January 2014,50 patients with continued coma after CPR in our intensive care unit（ICU） were randomly divided into experimental group（n=26）and control group（n =24）.The regular mild hypothermia was applied for treatment 0.5 h after recovery of spontaneous circulation and was terminated in the 72-（nd） hours between two groups.In experimental group,on the basis of regular mild hypothermia therapy,4℃ normal saline was infused by peripheral vein for induction of mild hypothermia at an early stage half an hour after recovery of spontaneous circulation.In control group,the same volume of normal saline in room temperature was infused at the same time.EEG was examined 5 to 7 days after CPR between two groups,and abnormality of EEG and pattern of abnormal EEG were recorded and statistically analyzed. Results The abnormality of EEG in experimental group and control group was not the same,and the percentage of severe abnormal EEG in experimental group was 7.7%,much less than that in control group accounting for 33.3%,which displayed a statistical difference（P〈0.05）.In the examination of reflection of EEG waveform characteristics,the characteristics of waveforms between two groups were different.The proportion of patients in increased slow waves indicating prognosis improvement was 38.5%in experimental gorup,greatly higher than that in control group（8.3%）.The difference was in statistical significance（P〈0.05）. Conclusion Application of 4℃ normal saline by peripheral vein in rapid infusion as a cooperative induction for mild hypothermia at an early stage of CPR can play an beneficial impact on patient′s EEG.

关 键 词：低温生理盐水 亚低温 脑电图 心肺复苏 

分 类 号：R318.52[医药卫生—生物医学工程]