ECPR急救流程在急诊呼吸心搏骤停患者中的应用价值  

Application value of ECPR emergency procedure in emergency respiratory and cardiac arrest patients

作　　者：虢涛 吕军毅 GUO Tao;LYU Junyi(Xianyang Central Hospital,Xianyang 712000,China)

机构地区：[1]咸阳市中心医院,陕西咸阳712000

出　　处：《临床医学研究与实践》2022年第32期25-28,共4页Clinical Research and Practice

摘　　要：目的探讨体外心肺复苏(ECPR)急救流程在急诊呼吸心搏骤停患者中的应用价值。方法选取2019年1月至2020年12月本院收治的64例急诊呼吸心搏骤停患者作为研究对象,根据心肺复苏形式不同将其分为参照组和研究组,各32例。参照组开展人工心肺复苏急救流程,研究组开展ECPR急救流程。比较两组的急救效果。结果研究组的血压、呼吸、心搏恢复正常时间短于参照组,差异具有统计学意义(P<0.05)。研究组的血乳酸、超敏心肌肌钙蛋白T(hs-cTnT)、N-末端脑钠肽原(NT-proBNP)水平低于参照组,差异具有统计学意义(P<0.05)。心肺复苏后1、12、24 h,研究组的心肌肌钙蛋白-I(cTnI)、肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)水平低于参照组,差异具有统计学意义(P<0.05)。心肺复苏后1、12、24 h,研究组的心输出量(CO)、平均动脉压(MAP)、心脏指数(CI)高于参照组,肺毛细血管楔嵌压(PCWP)低于参照组,差异具有统计学意义(P<0.05)。研究组恢复自主循环48 h时的舒张压、收缩压、心率、血氧饱和度高于参照组,差异具有统计学意义(P<0.05)。研究组恢复自主循环48 h时的运动反应、睁眼反应、呼吸、脑干反射评分高于参照组(P<0.05)。心肺复苏后1 h,两组的动脉血氧分压(PaO_(2))、氧合指数升高,动脉血二氧化碳分压(PaCO_(2))降低,且观察组优于参照组,差异具有统计学意义(P<0.05)。结论ECPR急救流程在急诊呼吸心搏骤停患者中的应用价值较高,可提高急救效果,改善心肌功能及血流动力学指标,促进意识状态恢复,值得临床推广及应用。Objective To explore the application value of extracorporeal cardiopulmonary resuscitation(ECPR)emergency procedure in emergency respiratory and cardiac arrest patients.Methods A total of 64 emergency respiratory and cardiac arrest patients admitted in our hospital from January 2019 to December 2020 were selected as the research object,and the patients were divided into reference group and study group according to the different cardiopulmonary resuscitation forms,with 32 cases in each group.The reference group carried out artificial cardiopulmonary resuscitation emergency procedure,and the study group carried out ECPR emergency procedure.The emergency effects of the two groups were compared.Results The recovery time of blood pressure,respiration and heart beat in the study group were shorter than those in the reference group,and the differences were statistically significant(P<0.05).The levels of blood lactic acid,hypersensitive cardiac troponin T(hs-cTnT)and N-terminal pro-brain natriuretic peptide(NT-proBNP)in the study group were lower than those in the reference group,and the differences were statistically significant(P<0.05).At 1,12 and 24 h after cardiopulmonary resuscitation,the levels of cardiac troponin I(cTnI),creatine kinase(CK)and creatine kinase isoenzyme(CK-MB)in the study group were lower than those in the reference group,and the differences were statistically significant(P<0.05).At 1,12 and 24 h after cardiopulmonary resuscitation,the cardiac output(CO),mean arterial pressure(MAP)and cardiac index(CI)in the study group were higher than those in the reference group,and the pulmonary capillary wedge pressure(PCWP)was lower than that in the reference group,and the differences were statistically significant(P<0.05).At 48 h after restoration of autonomous circulation,the diastolic blood pressure,systolic blood pressure,heart rate and blood oxygen saturation in the study group were higher than those in the reference group,and the differences were statistically significant(P<0.05).At 48 h after restorati

关 键 词：体外心肺复苏 急诊 呼吸心搏骤停 心肌损伤标志物 血流动力学 

分 类 号：R459.7[医药卫生—急诊医学]