TCCD、ONSD监测下治疗对脑复苏患者血液生化指标、APACHEⅡ评分及预后价值  

The value of TCCD and ONSD on blood biochemical indexes,APACHEⅡscore and prog⁃nosis of cerebral resuscitation patients

作　　者：熊首辉 印伟 钟娇 刘笋[1] 但勇[1] XIONG Shouhui;YIN Wei;ZHONG Jiao;LIU Sun;DAN Yong(Emergency EICU,Changde First Peoples Hospital,Wuling District,Changde,Hunan,China,415003)

机构地区：[1]常德市第一人民医院急诊EICU,湖南常德415003

出　　处：《分子诊断与治疗杂志》2024年第8期1497-1501,共5页Journal of Molecular Diagnostics and Therapy

基　　金：常德市科技创新引导项目(一般){常科函【2022】51号13}。

摘　　要：目的分析研究经颅彩色多普勒超声(TCCD)、视神经鞘直径(ONSD)监测下治疗对脑复苏患者血液生化指标、急性生理与慢性健康状况评分Ⅱ(APACHEⅡ)及预后的价值。方法选取2023年1月至2023年12月常德市第一人民医院接受TCCD联合ONSD监测治疗的心脏骤停脑复苏患者(n=100)作为研究对象为联合组,另选同期接受常规措施监测治疗的心脏骤停脑复苏患者(n=100)为对照组。比较两组入院后第1天及出院前1天的血液生化指标[白细胞计数(WBC)、血红蛋白(HGB)、肌酸激酶(CK)、肌酸激酶同工酶(CK⁃MB)、脑钠肽(BNP)、血肌酐(Scr)、总胆红素(TBIL)、谷丙转氨酶(ALT)及凝血酶原时间(PT)]水平;比较两组入院后第1天及出院前1天的APACHEⅡ评分、序贯性器官功能衰竭评分(SOFA)及格拉斯哥昏迷评分(GCS)。结果联合组与对照组入院后第1天的WBC、HGB、CK、CK⁃MB、BNP、Scr、TBIL、ALT、PT水平及APACHEⅡ、SOFA、GCS评分比较差异无统计学意义(P>0.05);联合组出院前1天的WBC、HGB、CK、CK⁃MB、BNP、Scr、TBIL、ALT、PT水平及APACHEⅡ、SOFA、GCS评分均优于对照组,差异有统计学意义(P<0.05);联合组预后不良事件发生率低于对照组,差异有统计学意义(χ^(2)=5.307,P<0.05)。结论TCCD联合ONSD监测治疗有利于改善心脏骤停脑复苏患者的血液生化指标与危重症状,改善患者预后。Objective To analyze the value of transcranial color Doppler ultrasound(TCCD)and optic nerve sheath diameter(ONSD)monitoring on blood biochemical indexes,acute physiology and chronic health evaluationⅡ(APACHEⅡ)and prognosis of cerebral resuscitation patients.Methods Cerebral resuscitation patients with cardiac arrest who received TCCD combined with ONSD monitoring treatment at Changde First People's Hospital from January 2023 to December 2023 were selected as the study subject and categorized as the combination group(n=100).The control group(n=100)consisted of patients who received routine monitoring treatment during the same period.The blood biochemical parameters[white blood cell count(WBC),hemoglobin(HGB),creatine kinase(CK),creatine kinase isoenzyme(CK⁃MB),brain natriuretic peptide(BNP),serum creatinine(Scr),total bilirubin(TBIL),alanine aminotransferase(ALT)and prothrombin time(PT)]of the two groups were compared on the 1st day after admission and the 1st day before discharge.The APACHEⅡscore,sequential organ failure score(SOFA)and Glasgow Coma Score(GCS)on the first day after admission and the day before discharge were compared between the two groups.Results There were no significant differences in WBC,HGB,CK,CK⁃MB,BNP,Scr,TBIL,ALT,PT,APACHEⅡ,SOFA,and GCS scores between the combination group and the control group on the first day after admission(P>0.05).However,the WBC,HGB,CK,CK⁃MB,BNP,Scr,TBIL,ALT,PT levels and APACHEⅡ,SOFA,GCS scores of the combined group were better than those of the control group one day before discharge,and the difference was statistically significant(P<0.05).The incidence of adverse events in the combination group was lower than that in the control group,and the difference was statistically significant(χ^(2)=5.307,P<0.05).Conclusion TCCD combined with ONSD monitoring can improve the blood biochemical indexes and critical symptoms of patients undergoing cerebral resuscitation after cardiac arrest.This combination can also enhance the prognosis of patients.

关 键 词：脑复苏 经颅彩色多普勒超声 生化指标 急性生理与慢性健康状况评分Ⅱ 

分 类 号：R459.7[医药卫生—急诊医学]