[1]樊菲菲,徐云云,李小亮,等.优化治疗对我院急诊心脏骤停后综合征患者预后的影响[J].医学信息,2018,31(21):79-82.[doi:10.3969/j.issn.1006-1959.2018.21.021]
　FAN Fei-fei,XU Yun-yun,LI Xiao-liang,et al.The Effect of Optimized Treatment on the Prognosis of Patients with Emergency Cardiac Arrest Syndrome in our Hospital[J].Journal of Medical Information,2018,31(21):79-82.[doi:10.3969/j.issn.1006-1959.2018.21.021]
点击复制

优化治疗对我院急诊心脏骤停后综合征患者预后的影响()
分享到：

医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
31卷
期数:
2018年21期
页码:
79-82
栏目:
论著
出版日期:
2018-11-01

文章信息/Info

Title:
The Effect of Optimized Treatment on the Prognosis of Patients with Emergency Cardiac Arrest Syndrome in our Hospital
文章编号:
1006-1959（2018）21-0079-04
作者:
樊菲菲; 徐云云; 李小亮; 高新星; 尹 文
空军军医大学第一附属医院急诊科，陕西 西安 710032
Author(s):
FAN Fei-fei; XU Yun-yun; LI Xiao-liang; GAO Xin-xing; YIN Wen
Department of Emergency,the First Affiliated Hospital of Medical University of the Air Force,Xi′an,710032,Shaanxi,China
关键词:
心脏骤停后综合征; 优化治疗; 缺血再灌注; 靶向体温管理; 脉压变异率
Keywords:
Post-cardiac arrest syndrome; Optimized treatment; Ischemia reperfusion; Targeted temperature management; pulse pressure variation
分类号:
R541.7+8
DOI:
10.3969/j.issn.1006-1959.2018.21.021
文献标志码:
A
摘要:
目的 比较优化治疗和常规ICU治疗对急诊心脏骤停后综合征患者预后及生活质量的影响。方法 选取2012年8月~2016年4月空军军医大学第一附属医院急诊科尚未开展心肺复苏后优化治疗，进行常规ICU治疗的院内心肺复苏术后的患者38例设为对照组；2016年4月~2018年7月开展优化治疗的院内心肺复苏术后的患者36例设为实验组。比较两组患者复苏后心脏及循环功能的恢复程度，神经功能恢复程度，同时对比两组患者肺部感染、心律失常等并发症的发生率。结果 实验组CI、CO较对照组升高，差异有统计学意义（P＜0.05），PPV较对照组下降，统计学意义显著（P＜0.01）；神经功能恢复程度优于对照组（P＜0.01），实验组患者肺部感染、肾功能衰竭、电解质紊乱、癫痫及心律失常的疾病总发生率低于对照组（P＜0.05）。结论 对心脏骤停后综合征的患者进行优化治疗，可改善患者神经功能、心脏功能及自主循环的恢复，减少并发症的发生率，对提高生存质量意义重大。
Abstract:
Objective To compare the effect of optimized and conventional ICU treatment on the prognosis and quality of life of patients with acute cardiac arrest syndrome.Methods 38 cases of patients after CPR were set as control group when the emergency department of the the first affiliated hospital of medical university of the air force did not carry out optimal treatment after cardiopulmonary resuscitation from August 2012 to April 2016.36 cases of patients after cardiopulmonary resuscitation CPR in our hospital were set as the experimental group from April 2016 to July 2018.The recovery of cardiac and circulatory function and neurological function after resuscitation were compared between the two groups, and the incidence of complications such as pulmonary infection and arrhythmia were also compared between the two groups.Results CI and CO were increased in the experimental group compared with the control group, and the difference was statistically significant(P＜0.05).PVV was decrease compared with control group,the stastistical significant was significant(P＜0.01);The recovery degree of neurological function was better than that of the control group(P＜0.01), and the total incidence rate of pulmonary infection, renal failure, electrolyte disturbance, epilepsy and arrhythmia in the experimental group was lower than that of the control group(P＜0.05).Conclusion The optimal treatment for patients with post-cardiac arrest syndrome can improve the recovery of neurological function, cardiac function and autonomic circulation, reduce the incidence of complications and improve the quality of life.

参考文献/References:

[1]Randhawa VK,Grunau BE,Debicki DB,et al.Cardiac Intensive Care Unit Management of Patients After Cardiac Arrest: Now the Real Work Begins[J].Can J Cardiol,2018,34(2):156-167. [2]Wiberg S,Hassager C,Stammet P,et al.Single versus Serial Measurements of Neuron-Specific Enolase and Prediction of Poor Neurological Outcome in Persistently Unconscious Patients after Out-Of-Hospital Cardiac Arrest-A TTM-Trial Substudy[J].PLoS One,2017,12(1):e168894. [3]卢中秋,赵光举.心脏骤停后综合征治疗策略[D].第17届世界灾难与急救医学学术会议暨第14次全国急症医学学术年会论文汇编,2011. [4]Cronberg T,Lilja G,Horn J,et al.Neurologic Function and Health-Related Quality of Life in Patients Following Targeted Temperature Management at 33 degrees C vs 36 degrees C After Out-of-Hospital Cardiac Arrest:A Randomized Clinical Trial[J].JAMA Neurol,2015,72(6):634-641. [5]Gruenewald M,Meybohm P,Koerner S,et al.Dynamic and volumetric variables of fluid responsiveness fail during immediate postresuscitation period[J].Crit Care Med,2011,39(8): 1953-1959. [6]Wijdicks EF,Hijdra A,Young GB,et al.Practice parameter: prediction of outcome in comatose survivors after cardiopulmonary resuscitation (an evidence-based review):report of the Quality Standards Subcommittee of the American Academy of Neurology[J].Neurology,2006,67(2):203-210. [7]Dallimore J,Ebmeier S,Thayabaran D,et al.Effect of active temperature management on mortality in intensive care unit patients[J].Crit Care Resusc,2018,20(2):150-163. [8]Lee DH,Lee SH,Oh JH,et al.Optic nerve sheath diameter measured using early unenhanced brain computed tomography shows no correlation with neurological outcomes in patients undergoing targeted temperature management after cardiac arrest[J].Resuscitation,2018(128):144-150. [9]Harmon M,van Meenen D,van der Veen A,et al.Practice of mechanical ventilation in cardiac arrest patients and effects of targeted temperature management:A substudy of the targeted temperature management trial[J].Resuscitation,2018(129):29-36. [10]Nielsen N,Wetterslev J,Cronberg T,et al.Targeted temperature management at 33 degrees C versus 36 degrees C after cardiac arrest[J].N Engl J Med,2013,369(23):2197-2206. [11]Deye N,Vincent F,Michel P,et al.Changes in cardiac arrest patients' temperature management after the 2013 "TTM" trial: results from an international survey[J].Ann Intensive Care,2016, 6(1):4. [12]Hovdenes J,Roysland K,Nielsen N,et al.A low body temperature on arrival at hospital following out-of-hospital-cardiac-arrest is associated with increased mortality in the TTM-study[J]. Resuscitation,2016(107):102-106. [13]Yamada T,Shojima N,Noma H,et al.Glycemic control,mortality,and hypoglycemia in critically ill patients:a systematic review and network meta-analysis of randomized controlled trials[J]. Intensive Care Med,2017,43(1):1-15. [14]Buchleitner AM,Martinez-Alonso M,Hernandez M,et al.Perioperative glycaemic control for diabetic patients undergoing surgery[J].Cochrane Database Syst Rev,2012(9):CD007315.

更新日期/Last Update: 2018-11-20