早期机械通气对心肺复苏患者血气指标及血流动力学的影响  

Effect of early mechanical ventilation on blood gas index and hemodynamics in patients with cardiopulmonary resuscitation

作　　者：张涛 杨惠芬[2] ZHANG Tao;YANG Huifen(Department of Critical Care Medicine,Lishui Central Hospital in Zhejiang Province,Lishui323000,China;Department of Obstetrics and Gynecology,Lishui Central Hospital in Zhejiang Province,Lishui323000,China)

机构地区：[1]浙江省丽水市中心医院重症医学科,浙江丽水323000 [2]浙江省丽水市中心医院妇产科,浙江丽水323000

出　　处：《中国现代医生》2020年第5期95-98,共4页China Modern Doctor

基　　金：浙江省丽水市科技局高层次人才培养项目(2015RC11);浙江省医药卫生科技计划项目(2018KY940)。

摘　　要：目的观察早期机械通气在心肺复苏患者中的应用效果,评价其对患者血气指标及血流动力学的影响。方法选择本院2017年2月~2019年3月收治的心脏骤停(CA)患者60例为本次研究对象,根据插管成功时机不同将其分为对照组与观察组,对照组为CA发生5 min后插管成功,观察组在5 min内插管成功,对比两组患者心肺复苏时间、复苏成功率、复苏后血气指标、血流动力学指标及7 d生存率。结果复苏效果:观察组复苏成功率为24.00%,明显高于对照组的6.67%,观察组复苏时间明显短于对照组,差异有统计学意义(P<0.05);血气指标情况:观察组复苏后血乳酸(BLA)含量、二氧化碳分压(PaCO2)低于对照组,酸碱值(pH)、动脉血氧分压(PaO2)高于对照组,差异有统计学意义(P<0.05);血流动力学:观察组心率(HR)、平均动脉压(MAP)数据与对照组比较,差异无统计学意义(P>0.05);7 d生存率:观察组7 d生存率为10.00%,高于对照组的3.33%,但差异无统计学意义(P>0.05)。结论早期机械通气在心肺复苏患者中应用效果肯定,能够有效改善患者血气指标,提升7 d生存率。Objective To observe the effect of early mechanical ventilation in patients with cardiopulmonary resuscitation and evaluate its influence on blood gas parameters and hemodynamics.Methods 60 patients with cardiac arrest(CA)who were admitted to our hospital from February 2017 to March 2019 were enrolled in this study.They were divided into control group and observation group according to the timing of successful intubation.The patients with successful intubation at more than 5 minutes after CA were set as the control group.The patients with successful intubation at less than 5 minutes after CA were set as the observation group.The cardiopulmonary resuscitation time,recovery success rate,blood gas index,hemodynamics and 7-day survival rate were compared between the two groups.Results Resuscitation effect:The recovery success rate of the observation group was 24.00%,which was significantly higher than that of the control group(6.67%).The recovery time of the observation group was significantly shorter than that of the control group,and the difference was statistically significant(P<0.05).The blood gas index status:The blood lactic acid(BLA)content and carbon dioxide partial pressure(PaCO2)after recovery in the observation group were lower than those in the control group,and the pH value and arterial oxygen partial pressure(PaO2)in the observation group were higher than those of the control group,and the difference was statistically significant(P<0.05).Hemodynamics:The heart rate(HR)and mean arterial pressure(MAP)data of the observation group were not significantly different from those of the control group(P>0.05).The survival rate of the 7 d survival rate was 10.00%in the observation group,higher than that(3.33%)of the control group,but the difference was not statistically significant(P>0.05).Conclusion Early mechanical ventilation is effective in patients with cardiopulmonary resuscitation,which can effectively improve the blood gas index and improve the 7 d survival rate.

关 键 词：心脏骤停 心肺复苏 机械通气 血气指标 血流动力学 生存率 

分 类 号：R541.6[医药卫生—心血管疾病]