多次体外电除颤复苏救治心脏性猝死的效果及其对患者血清因子水平的影响分析
- Author:
- No author available
- Journal Title:
- Prevention and Treatment of Cardio-Cerebral-Vascular Disease
- Issue:
- 5
- DOI:
- 10.3969/j.issn.1009-816x.2019.05.029
- Key Word:
- 体外电除颤;心脏性猝死;神经元特异性烯醇化酶;心肌肌钙蛋白;氨基末端脑钠肽前体
Abstract： 目的 观察多次体外电除颤复苏救治心脏性猝死的效果及其对患者血清神经元特异性烯醇化酶(NSE)、心肌肌钙蛋白(cTnI)、氨基末端脑钠肽前体(NT-proBNP)的影响.方法 整理我院收治的133例心脏性猝死患者的临床资料,按照其救治方式,将接受徒手心肺复苏者纳入对照组(69例),将接受徒手心肺复苏联合多次体外电除颤复苏者纳入观察组(64例).回顾性分析患者临床资料,对比两组患者救治成功率、动脉血气指标、并发症发生率及NSE、cTnI、NT-proBNP变化,观察两种复苏方案对患者预后与血清学指标的影响.结果 观察组自主循环恢复(ROSC)率、入院存活率均高于对照组,差异有统计学意义(x2 =6.95、5.17,P＜0.05).观察组ROSC患者救治时间、自主心跳恢复时间及脑缺血缺氧时间均低于对照组,差异有统计学意义(t=14.81 ～30.11,P＜0.05).观察组复苏相关并发症发生率为4.69％,低于对照组的20.29％,差异有统计学意义(x2=7.25,P＜0.05).两组患者救治30min后动脉氧分压(PaO2)、氧饱和度(SaO2)均较救治5min后升高,二氧化碳分压(PaCO2)、血乳酸均较救治5min后下降,观察组救治30min后PaO2、SaO2高于对照组,其PaCO2、血乳酸低于后者,差异有统计学意义(P＜0.05).两组患者ROSC后24h血清NSE、cTnI、NT-proBNP均较ROSC即刻升高,观察组ROSC后24h血清NSE、cTnI、NT-proBNP低于对照组,差异有统计学意义(P＜0.05).结论 在徒手心肺复苏的基础上,结合体外电除颤复苏救治心脏性猝死的效果确切,能够有效提高抢救成功率、降低复苏相关并发症发生率.
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