68例心肺复苏术后患者生命支持治疗效果分析  

Analysis of the effect of life support treatment on 68 patients after cardiopulmonary resuscitation

作　　者：陈兰春[1] 杜慧君 唐玮欣 李展汉 余雪涛[1] CHEN Lan-chun;DU Hui-jun;TANG Wei-xin(ICU Department,Longgang District People’s Hospital,Shenzhen 518172,China)

机构地区：[1]深圳市龙岗区人民医院重症医学科,518172

出　　处：《中国实用医药》2020年第20期35-37,共3页China Practical Medicine

摘　　要：目的分析心肺复苏术(CPR)后患者实施生命支持的情况及其效果,为下一步提出改进措施提供依据。方法回顾性分析68例CPR后患者的临床资料,根据预后神经功能恢复情况将患者分为A组(不良神经功能结局组,55例)和B组(良好神经功能结局组,13例)。分析比较两组患者的一般资料、各项生命支持治疗情况、体温及院外心脏骤停(OHCA)和院内心脏骤停(IHCA)发生情况。结果两组患者的性别、年龄比较差异无统计学意义(P>0.05)。68例患者CPR后24 h内最高体温为(37.3±1.5)℃,其中29例(42.6%)体温>37.5℃;CPR后7 d内最高体温为(38.0±1.5)℃,其中36例(52.9%)出现中度发热(腋温>38.0℃)。良好神经功能结局组患者CPR后24 h内最高体温为(37.6±0.7)℃,与不良神经功能结局组的(37.3±1.6)℃比较,差异无统计学意义(t=0.658,P=0.513>0.05)。良好神经功能结局组患者中,OHCA患者3例(23.1%),IHCA患者10例(76.9%);不良神经功能结局组患者中,OHCA患者14例(25.5%),IHCA患者41例(74.5%);两组患者OHCA和IHCA发生情况比较,差异无统计学意义(P>0.05)。结论虽然对心脏骤停(CA)行CPR后患者实施了各种生命支持措施进行综合救治,但其死亡率仍然很高。早期体温管理尚有待进一步加强与规范,院前急救时及早建立人工气道可能有助于改善预后。Objective To analyze the status of life support treatment on patients after cardiopulmonary resuscitation(CPR),so as to provide the evidence for further improving.Methods A total of 68 patients after CPR were divided into poor neurological outcome group(55 cases)and good neurological outcome group(13 cases)by recovery of neurological function.The general data,life support treatment status,body temperature,and occurrence of out-of-hospital cardiac arrest(OHCA)and in-hospital cardiac arrest(IHCA)were analyzed and compared between the two groups.Results There was no statistically significant difference in gender and age between the two groups(P>0.05).The highest temperature of 68 patients within 24 h after CPR was(37.3±1.5)℃,of which 29 cases(42.6%)had a temperature>37.5℃;the highest temperature within 7 d after CPR was(38.0±1.5)℃,of which 36 cases(52.9%)had moderate fever(axillary temperature>38.0℃).The highest body temperature of good neurological outcome group within 24 h after CPR was(37.6±0.7)℃,which had no statistically significant difference compared with that of patients with poor neurological outcome group(37.3±1.6)℃(t=0.658,P=0.513>0.05).In good neurological outcome group,there were 3 patients with OHCA(23.1%),10 patients with IHCA(76.9%);In poor neurological outcome group,there were 14 patients with OHCA(25.5%),41 patients with IHCA(74.5%).There was no statistically significant difference in the occurrence of OHCA and IHCA between the two groups(P>0.05).Conclusion Although patients underwent comprehensive life support measures after CPR for cardiac arrest(CA),the mortality rate is still high.Early body temperature management needs to be further strengthened and standardized,and early artificial airways in pre-hospital rescue maybe improve the prognosis of CA patients eventually.

关 键 词：心脏骤停 心肺复苏术 生命支持 预后 

分 类 号：R459.7[医药卫生—急诊医学]