院前心肺复苏器抢救心脏性猝死的临床研究  

作　　者：陆首玲[1] 姜椿法[1] 胡文彩[1] 胡怀岭[1] 邱全煌[1] 

机构地区：[1]广东省东莞市厚街医院急诊科,523945

出　　处：《浙江临床医学》2016年第7期1222-1223,1226,共3页Zhejiang Clinical Medical Journal

基　　金：广东省东莞市科技计划医疗卫生类科研一般项目（2014105101106）

摘　　要：目的探讨心肺复苏器院前抢救心脏性猝死（SCD）的临床价值。方法SCD患者80例随机分为2组，观察组（n=40）采用WFS-01A便携式“自动胸外按压心肺复苏机”进行复苏，对照组（n=40）采用徒手心肺复苏术进行复苏。比较两组患者心肺复苏5min、15min及30min时PaO2、PaCO2、SaO2等动脉血气指标变化；比较两组患者自主循环恢复率（ROSC）和入院存活率；比较两组患者心肺复苏后并发症发生情况；检测两组患者自主循环恢复即刻及自主循环恢复24h时血清神经特异性烯醇化酶（NSE）、N末端B型利钠肽原（NT-proBNP）、心肌肌钙蛋白I（cTnI）和心型脂肪酸结合蛋白（H—FABP）水平。结果两组患者心肺复苏5min时PaO2、PaCO2、SaO2等动脉血气指标比较差异无统计学意义（P〉0．05），观察组心肺复苏15min、30min时动脉血气指标明显优于对照组（P〈0．05）；观察组心肺复苏后ROSC、入院存活率明显高于对照组（P〈0．05），且并发症发生率明显低于对照组（P〈0．05）；两组自主循环恢复即刻NSE、NT-proBNP、cTnI、H—FABP等指标比较差异无统计学意义（P〉0．05），观察组自主循环恢复24h时各指标明显低于对照组（P〈0．05）。结论心肺复苏器抢救SCD患者的效果明显优于徒手心肺复苏术，值得临床推广应用。Objective To explore the clinical value of cardiopulmonary resuscitation machine rescue of sudden cardiac death （ SCD ） before hospital. Methods 80 patients with SCD were randomly divided into 2 groups according to the digital table method. The observation group （ n=40 cases ） was recovery by using WFS-01A portable ＂automatic chest compression cardiopulmonary resuscitation＂, and the control group （ n=40 cases ） was recovery by free hand CPR. The changes of arterial blood gas such as PaO2, PaCO2, SaO2 of two groups at the 5 min, 15 min and 30 min of CPR were compared. The return of spontaneous circulation （ ROSC ） and hospital survival rate of two groups were compared. The occurrence of complications after CPR of two groups was compared. The levels of serum NSE, NT-proBNP, eTnI andH-FABP in two groups at spontaneous circulation immediate recovery and spontaneous circulation restoration 24 h were detected. Results There was no significantly different about arterial blood gas indexes such as PaO：, PaCO2, SaO2 between the two groups at the 5min ofCPR （P〉0.05） . The arterial blood gas indexes at the 15min, 30min of observation group were significantly higher than those in the control group （ P〈0.05 ） . The ROSC, hospital survival rate after CPR of observation group were significantly higher than that in control group （ P〈0.05 ） , and the incidence of complications was significantly lower than that in control group （ P〈0.05 ） . There were no significant difference about NSE, NT-proBNP, cTnI, H-FABP at the spontaneous circulation immediate recovery between the two groups （ P〉0.05 ） , and the indexes at the spontaneous circulation restoration 24h of observation group was significantly lower than the control group （ P〈0.05 ） .Conclusion The effect of cardiopulmonary resuscitation machine rescue of patients with SCD was significantly better than that of bare handed CPR, and it is worthy of clinical application.

关 键 词：心脏性猝死 心肺复苏术 自主循环恢复率 

分 类 号：R541.78[医药卫生—心血管疾病]