心脏骤停CPR后脑复苏期间ScVO_2和血乳酸水平联合预测其预后的价值  

Value of ScVO_2 and Blood Lactic Acid Level Jointly Predicting the Prognosis of Patients with Cerebral Resuscitation after CPR

作　　者：黄寿新[1] 徐招柱[1] 

机构地区：[1]广东省梅州市人民医院EICU,514031

出　　处：《岭南急诊医学杂志》2016年第1期7-9,37,共4页Lingnan Journal of Emergency Medicine

摘　　要：目的:探讨心脏骤停心肺复苏(CPR)后脑复苏期间中心静脉血氧饱和度(Sc VO2)和血乳酸水平联合预测其预后的价值。方法:选取心脏骤停CPR后恢复循环但意识不清需行脑复苏患者93例为研究对象。监测患者脑复苏前后的Sc VO2和脑氧供(DO2),并检测同期血乳酸水平和格拉斯哥匹兹堡昏迷评分(GCSP),统计患者生存情况。分析心脏骤停CPR后脑复苏患者Sc VO2和血乳酸水平与其GCSP评分和DO2的关系及心脏骤停CPR后脑复苏期间Sc VO2和血乳酸水平联合预测其预后的价值。结果:93例患者28 d病死率为9.68%,死亡患者脑复苏前后的Sc VO2、DO2和GCSP评分均较存活患者降低,同期血乳酸水平则升高(P<0.05)。与T0比较,死亡患者和存活患者T2、T3和T4的Sc VO2、DO2和GCSP评分均升高,同期血乳酸水平则降低(P<0.05)。心脏骤停CPR后脑复苏患者Sc VO2和血乳酸水平与其DO2和GCSP评分均相关(P<0.05)。且心脏骤停CPR后脑复苏期间Sc VO2和血乳酸水平联合预测其28 d病死率的价值良好。结论:心脏骤停CPR脑复苏患者Sc VO2和血乳酸水平可反映脑氧供和昏迷程度且两者联合预测预后的价值良好,Sc VO2和血乳酸可能作为心脏骤停CPR后脑复苏预后评估的参考指标。Objective： To investigate the value of center venous blood saturation（Sc VO2） and blood lactic acid level jointly predicting the prognosis of patients with cerebral resuscitation after cardiopulmonary resuscitation（CPR）.Methods： 93 cases of patients with cardiac arrest who restored spontaneous circulation unconsciously and needed brain recovery were selected as the research objects. Sc VO2 and cerebral oxygen supply（DO2） of the patient＇s before and after brain recovery and blood lactic acid level and Glasgow coma scale of Pittsburgh（GCSP） in the same period were detected. Survival in 28 days was observed. Relationship between Sc VO2 or blood lactic acid level and GCSP score or DO2 was analyzed. Value of Sc VO2 and blood lactic acid level joint predicting the prognosis of patients with cereloral resuscitation after CPR was analyzed. Results： 28 d death rate of 93 patients was 9.68%. Compared with survival patients, Sc VO2, DO2 and GCSP scores of death patients before and after brain recovery reduced, while blood lactic acid level of death patients in the same period increased（P〈0.05）. Compared with T0, Sc VO2, DO2 and GCSP score of patients at T2, T3, and T4 increased, while blood lactic acid level of the patients in the same period reduced（P〈0.05）. Sc VO2 and blood lactic acid level of patients after CPR who received brain resuscitation were correlated with DO2 and GCSP（P〈0.05）. The value of Sc VO2 and blood lactic acid level jointly predicting 28 d mortality of patients was high. Conclusion： Sc VO2 and blood lactic acid levels of patients after CPR who received brain rresuscitation can reflect cerebral oxygen supply deficiency and the level of consciousness patients. The value of the two above factors jointly predicting the prognosis is high. Therefore, the Sc VO2 and blood lactic acid may be the reference index of evaluation of prognosis of patients after CPR who received brain resuscitation.

关 键 词：心脏骤停 CPR 脑复苏 ScVO2 血乳酸 预后 

分 类 号：R541.78[医药卫生—心血管疾病]