摘要
目的研究徒手复苏和心肺复苏仪对心搏骤停患者心脑缺血性损伤的影响效果。方法 80例心搏骤停患者按随机数字表法分成研究组和对照组,每组各40例;选择同期健康体检人群40例为健康组。研究组采用心肺复苏仪进行心肺复苏,对照组采用徒手复苏方案。检测并记录2组患者心肺复苏后,即刻以及24h后神经损伤因子[血清S100蛋白质(S1OO)、神经元特异性烯醇化酶(NSE)]以及心脏损伤因子[血清肌钙蛋白Ⅰ(cTnⅠ)、心型脂肪酸结合蛋白(H-FABP)]含量水平,并与健康组进行比较;检测并记录2组患者各时间段血气分析结果和预后情况[自主循环恢复(ROSC)维持>24h的发生率、自主心跳恢复时间、存活率、复苏成功率]。结果 2组患者心肺复苏即刻的血清S100、NSE、H-FABP以及cTnⅠ含量均明显高于健康组(P<0.05),且研究组患者心肺复苏即刻的血清S100、NSE、H-FABP以及cTnⅠ含量低于对照组患者(P<0.05)。研究组患者在心肺复苏后24h血清S1OO、NSE、H-FABP以及cTnⅠ含量均明显低于对照组患者(P<0.01)。心肺复苏5min时,2组患者的血气指标比较差异无统计学意义(P>0.05);心肺复苏15、30min时,研究组患者的PaO_2、SaO_2明显高于对照组,PaCO_2明显低于对照组(P<0.01);心肺复苏后30min血气指标改善明显优于心肺复苏后15min(P<0.05)。研究组患者的自主心跳恢复时间明显短于对照组,而ROSC维持>24h的发生率、存活率、复苏成功率明显高于对照组(P<0.05或P<0.01)。结论利用心肺复苏仪对心搏骤停患者进行心肺复苏,患者的血气指标改善明显,可以更有效持久地使心脑血管再灌注,改善与减轻心脑组织的缺血性损伤。
Objective To study the effects of cardiopulmonary resuscitator and manual cardiopulmonary resuscitation（CPR）on ischemic cardiac/cerebral injury in patients with sudden cardiac arrest.Methods Eighty patients with sudden cardiac arrest were randomly given cardiopulmonary resuscitation with resuscitator（study group,n=40）or manual resuscitation regimen（control group,n=40）.In addition,40 healthy subjects were selected as the healthy group.Serum levels of S100 protein（S100）,neuronspecific enolase（NSE）,troponin Ⅰ（cTnⅠ）and heart-type fatty acidbinding protein（H-FABP）were measured immediately and 24 hours after CPR.Blood gas indexes,incidence of restoration of spontaneous circulation（ROSC）〉24 hours,recovery time of spontaneous heartbeat,survival rate,and success rate of resuscitation were recorded in all patients.Results Serum SI00,NSE,H-FABP and cTnl levels in patients with sudden cardiac arrest were higher than those in healthy subjects immediately after cardiopulmonary resuscitation（P〈0.05）,and those in study group were lower than those in control group immediately and 24 hours after cardiopulmonary resuscitation（P〈0.05 or P〈0.01）.There were no significant differences in blood gas indexes at 5 minutes after CPR（P〉0.05）.Compared with control group,PaO2 and SaO2 increased and PaCO2 decreased in study group at 15 and 30 minutes after CPR（P〈0.01）.The blood gas indexes measured at 30 minutes after CPR were better than those measured at 15 minutes after CPR（P〈0.05）.The recovery time of spontaneous heartbeat in study group was shorter than that in control group,and the incidence of ROSC〉 24 hours,survival rate and success rate of resuscitation in study group were higher than those in control group（P〈0.05 or P〈0.01）.Conclusion The cardiopulmonary resuscitator can effectively improve blood gas indexes,maintain cardio-cerebrovascular reperfusion and alleviate ischemic cardiac/cerebral injury in patients with sudden cardiac arrest.
作者
段斌
刘菊英
肖敏
郭辉
DUAN Bin;LIU Ju-ying;XIAO Min;GUO Hui(Department of Emergency,Shiyan Taihe Hospital,the Affiliated Hospital of Hubei Medical College, Shiyan 442000, Chin)
出处
《南昌大学学报（医学版）》
CAS
2018年第2期32-36,共5页
Journal of Nanchang University：Medical Sciences
基金
2010年湖北省自然科学基金(2010CDB09103)
关键词
徒手复苏
心肺复苏仪
心搏骤停
心脑缺血性损伤
manual resuscitation
cardiopulmonary resuscitator
sudden cardiac arrest
ischemic cardiac/cerebral injury
