中国成人心搏骤停后综合征中西医结合诊治专家共识(2023)  

Expert consensus for diagnosis and treatment of post-cardiac arrest syndrome in adults by combining traditional Chinese and Western medicine in China(2023)

作　　者：中国中西医结合学会急救医学专业委员会 国家卫健委危重病急救医学重点实验室 李海林[2] 李银平 陈明显 傳睿 丁邦晗 Emergency Medicine Professional Committee of the Chinese Society of Integrated Chinese;Western Medicine Key Laboratory of Critical Ilness Emergency Medicine of the National Health Commission;Li Hailin;Li Yinping;Chen Mingxian;Fu Rui;Ding Banghan(不详;Department of Emergen Zhejiang China)

机构地区：[1]不详 [2]浙江省立同德医院急诊科,杭州310012

出　　处：《中华危重病急救医学》2023年第10期1009-1025,共17页Chinese Critical Care Medicine

摘　　要：心搏骤停(CA)患者自主循环恢复(ROSC)后发生再灌注损伤,导致机体出现多器官功能障碍,称为心搏骤停后综合征(PCAS)。PCAS与CA患者预后密切相关,是影响复苏患者存活率的独立危险因素,中西医结合诊治是改善PCAS预后的重要手段。为指导和规范我国临床医师、护理人员、相关教学和研究人员对PCAS中西医结合诊治的认识和使用,中国中西医结合学会急救医学专业委员会成立专家组,经临床调研确定中西医结合诊治PCAS的14个临床问题,对每个临床问题按照PICO原则制定检索策略,检索CNKI、万方、维普、SinoMed、PubMed、Embase、Cochrane Library相关的中英文文献,借鉴推荐分级的评估、制订与评价(GRADE)指南意见形成证据等级和推荐级别。当文献证据不足时,经专家讨论形成推荐建议及推荐级别,结合可推广性、适宜性和资源利用等方面,围绕PCAS患者早期循环、呼吸支持及可逆病因解除,中期神经保护、改善凝血、防治感染、肾与胃肠保护及控制血糖,后期康复等3期14个方面形成28条推荐意见,为现阶段PCAS中西医结合诊治提供参考和依据。Reperfusion injury occurs after return of spontaneous circulation(ROSC)in patients with cardiac arrest(CA),which leads to multiple organ dysfunction,called post-cardiac arrest syndrome(PCAS).PCAS is closely related to the prognosis of CA patients,and is an independent risk factor of survival.Integrated traditional Chinese and Western medicine diagnosis and treatment is critical for improving prognosis of PCAS.In order to guide and standardize integrated traditional Chinese and Western medicine diagnosis and treatment in PCAS among clinicians,nurses and research personnel in China,the Emergency Medicine Professional Committee of the Chinese Society of Integrated Chinese and Western Medicine has established an expert group to determine 14 clinical issues related to the diagnosis and treatment of PCAS with integrated traditional Chinese and Western medicine through clinical survey.The working group formulates a search strategy for each clinical issue according to the PICO principle.Chinese and English literature were searched from CNKI,Wanfang,VIP,SinoMed,PubMed,Embase,and Cochrane Library.The grade of recommendations assessment,development and evaluation(CRADE)were used to form the level of evidence and recommendation.When the literature evidence was insufficient,the recommendations and level of recommendation were formed after expert discussion.Combined with the aspects of generalizability,suitability,and resource utilization,the expert consensus developed 28 recommendations around the 14 aspects of three stages of PCAS,including early circulation,respiratory support and reversible cause relief,mid-term neuroprotection,improvement of coagulation,prevention and treatment of infection,kidney and gastrointestinal protection and blood sugar control,post rehabilitation treatment,providing references for the integrated traditional Chinese and Western medicine of the diagnosis and treatment for PCAS.

关 键 词：心搏骤停后综合征 心搏骤停 成人 中西医结合诊治 共识 

分 类 号：R541.78[医药卫生—心血管疾病]