院前使用不同剂量肾上腺素对心脏停搏患者的影响  

Effects of Prehospital Administration of Different Doses of Epinephrine in Patients With Cardiac Arrest

作　　者：梁国良 方军 莫东儒 香瑞嫦 LIANG Guoliang;FANG Jun;MO Dongru;XIANG Ruichang(Department of Emergency,Dongguan Hengli Hospital,Dongguan Guangdong 523460,China)

机构地区：[1]东莞市横沥医院急诊科,广东东莞523460

出　　处：《中国卫生标准管理》2024年第18期125-128,共4页China Health Standard Management

摘　　要：目的探讨不同剂量肾上腺素在心脏停搏院前急救中的影响。方法选取东莞市横沥医院2020年1月—2023年10月急诊救治的85例心脏停搏患者作为研究对象。将其按照肾上腺素使用剂量的不同分组,对照组(n=42)采用常规剂量肾上腺素治疗,观察组(n=43)采用大剂量肾上腺素治疗。比较2组复苏情况、抢救质量、不良反应。结果观察组复苏成功率为93.02%、自主循环恢复率为95.35%、自主呼吸恢复率为95.35%、急救后存活率为97.67%,均高于对照组的73.81%、76.19%、71.43%、73.81%,差异有统计学意义(P<0.05)。入院时,2组S100蛋白(recombinant S100 calcium binding protein,S100)、B型尿钠肽、血清降钙素原比较,差异无统计学意义(P>0.05);急救后2 h,2组指标下降,且观察组S100为(0.32±0.06)μg/L、B型尿钠肽为(172.12±6.32)pg/mL、血清降钙素原为(23.51±4.28)ng/mL,低于对照组的(0.57±0.11)μg/L、(203.14±52.24)pg/mL、(28.36±6.15)ng/mL,差异有统计学意义(P<0.05)。观察组不良反应总发生率为4.65%,低于对照组的21.43%,差异有统计学意义(P<0.05)。结论采用大剂量肾上腺素能够提高心脏停搏患者复苏率,改善自主循环及自主呼吸,并且能够快速提高患者抢救效果,具有较高的安全性,值得在院前急救中使用。Objective To explore the effect of different doses of epinephrine in prehospital emergency for cardiac arrest.Methods A total of 85 patients with cardiac arrest treated in the department of emergency,Dongguan Hengli Hospital from January 2020 to October 2023 were selected as the study objects,Which were grouped according to the different doses of epinephrine used,the control group(n=42)was treated with the conventional dose of epinephrine,and the observation group(n=43)was treated with the high dose of epinephrine.The resuscitation,rescue quality and adverse reactions of the two groups were compared.Results The success rate of resuscitation in the observation group was 93.02%,the recovery rate of autonomic circulation was 95.35%,the recovery rate of spontaneous respiration was 95.35%,and the survival rate after emergency was 97.67%,which were higher than 73.81%,76.19%,71.43%,73.81%in the control group,and the differences were statistically significant(P<0.05).At admission,there was no significant difference in recombinant S100 calcium binding protein(S100),B-type urinary natriuretic peptide and serum procalcitonin between 2 groups(P>0.05).2 h after first aid,the indexes of both groups decreased,S100 in observation group was(0.32±0.06)μg/L,B-type natriuretic peptide was(172.12±6.32)pg/mL,and serum procalcitonin was(23.51±4.28)ng/mL,which were lower than(0.57±0.11)μg/L,(203.14±52.24)pg/mL,(28.36±6.15)ng/mL in control group,and the difference was statistically significant(P<0.05).The total incidence of adverse reactions in the observation group was 4.65%,lower than 21.43%in the control group,and the difference was statistically significant(P<0.05).Conclusion The use of high-dose epinephrine can increase the resuscitation rate of patients with cardiac arrest,improve the autonomic circulation and autonomic respiration,and can rapidly improve the resuscitation effect of patients,with a high degree of safety,and is worthy of use in prehospital emergency.

关 键 词：不同剂量 肾上腺素 心脏停搏 院前急救 不良反应 复苏成功率 

分 类 号：R541[医药卫生—心血管疾病]