老年心脏骤停患者心肺复苏前后PetCO_(2)、POP、乳酸水平变化及其与预后的关系  

Changes in PetCO_(2),POP and lactate levels in elderly patients with cardiac arrest before and after cardiopulmonary resuscitation and their relationship with the prognosis

作　　者：徐伟强 王媛媛[2] 刘淑萍 于晓伟 XU Weiqiang;WANG Yuanyuan;LIU Shuping;YU Xiaowei(Emergency Department,Qinhuangdao Integrated Traditional Chinese and Western Medicine Hospital(Port Hospital),Qinhuangdao,Hebei,China,066000;Department of Gastroenterology,Qinhuangdao Hospital,Peking University Third Hospital Qinhuangdao Hospital,Qinhuangdao,Hebei,China,066000;Department of Neurology,Oriental Hospital,Beijing University of Chinese Medicine,Qinhuangdao Hospital,Qinhuangdao,Hebei,China,066000;Medical Affairs Department,Qinhuangdao Public Security Hospital,Qinhuangdao,Hebei,China,066000)

机构地区：[1]秦皇岛中西医结合医院(港口医院)急诊科,河北秦皇岛066000 [2]北京大学第三医院秦皇岛医院消化科,河北秦皇岛066000 [3]北京中医药大学东方医院秦皇岛医院神经内科,河北秦皇岛066000 [4]秦皇岛市公安医院医政科,河北秦皇岛066000

出　　处：《分子诊断与治疗杂志》2024年第9期1747-1750,共4页Journal of Molecular Diagnostics and Therapy

基　　金：秦皇岛市科学技术研究与发展计划(202101A210)。

摘　　要：目的分析老年心脏骤停患者心肺复苏(CPR)前后呼气末二氧化碳分压(PetCO_(2))、脉搏血氧波形(POP)、乳酸水平变化及其与预后的关系。方法选取2023年1月至2023年12月期间秦皇岛中西医结合医院接收的80例老年心脏骤停患者为调查对象,分别监测CPR前及CPR后30 min、24 h不同时间段PetCO_(2)、POP、乳酸水平变化,并根据预后情况分为良好组与不良组,分析两组CPR前PetCO_(2)、POP、乳酸之间的差异,以患者预后结局作为因变量,采用Logistic回归分析CPR前PetCO_(2)、POP、乳酸水平与临床预后的关系,并分析各指标对预后的预测价值。结果80例老年心脏骤停患者乳酸:CPR前>CPR后30min>CPR后24 h,PetCO_(2)、POP:CPR前<CPR后30 min<CPR后24 h,差异有统计学意义(P<0.05);经CPR治疗后预后不良24例(30.00%),其中22例发生不良心血管事件、2例死亡;与预后良好组比较,预后不良患者CPR前PetCO_(2)、POP明显低,乳酸水平明显高,差异有统计学意义(P<0.05)。以患者预后结局作为因变量,经Logistic回归分析显示,CPR前PetCO_(2)、POP、乳酸均为心搏骤停CPR临床预后的影响因素(P<0.05);ROC曲线分析显示,CPR前PetCO_(2)、POP、乳酸预测不良预后的曲线下面积分别为0.938、0.978、0.999(P<0.05),均有一定预测价值。结论老年心脏骤停患者CPR前PetCO_(2)、POP、乳酸与CPR后预后密切相关,对预后预测有一定的价值。经CPR治疗后PetCO_(2)、POP、乳酸水平均可得到不同程度改善,建议予以密切监测。Objective To analyze the changes in PetCO_(2),POP and lactate levels in elderly pa-tients with cardiac arrest before and after cardiopulmonary resuscitation(CPR),and their relationship with the prognosis.Methods From January to December 2023,80 elderly patients with cardiac arrest admitted to Qin-huangdao Integrated Traditional Chinese and Western Medicine Hospital were selected as the subjects.The changes in PetCO_(2),POP and lactate levels before CPR and at 30 min and 24 h after CPR were monitored.Based on their prognosis,the subjects were divided into a good prognosis group and a poor prognosis group.Differences in PetCO_(2),POP and lactate levels between the groups before CPR were analyzed.The relationship between PetCO_(2),POP and lactate level before CPR and clinical prognosis was discussed.The prognostic value of each indicator was evaluated.Results In the 80 elderly patients with cardiac arrest,lactate levels before CPR,at 30 min after CPR,and at 24 h after CPR showed a decreasing trend.PetCO_(2) and POP before CPR,at 30 min after CPR,and at 24 h after CPR showed an increasing trend.The differences were statistically signifi-cant(P<0.05).After CPR,there was a poor prognosis in 24(30.00%)cases.Compared with the good prog-nosis group,the poor prognosis group had significantly lower PetCO_(2) and POP,and significantly higher lac-tate levels before CPR(P<0.05).Logistic regression analysis results indicated that PetCO_(2),POP and lactate before CPR were factors influencing the clinical prognosis of CPR for cardiac arrest(P<0.05).ROC curves in-dicated that the areas under the curves of PetCO_(2),POP and lactate before CPR for predicting poor prognosis were 0.938,0.978 and 0.999(P<0.05),indicating a certain predictive value.Conclusion PetCO_(2),POP and lactate levels before CPR are closely related to the prognosis after CPR.All of them have certain prognostic value.PetCO_(2),POP and lactate in elderly patients with cardiac arrest are improved to varying degrees after CPR.It is recommended to closely monitor thes

关 键 词：老年心脏骤停 心肺复苏 呼气末二氧化碳分压 脉搏血氧波形 乳酸 

分 类 号：R459.7[医药卫生—急诊医学]