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目的探讨不同吸氧浓度心肺复苏术对心脏骤停患者预后的影响。方法选取2010年1月—2015年1月南京军区南京总医院收治的心脏骤停患者60例,均采用多功能心肺复苏仪进行心肺复苏,复苏过程中辅以机械通气。根据心肺复苏术过程中吸氧浓度将所有患者分为高浓度组、中浓度组及低浓度组,各20例,比较3组患者预后。结果心肺复苏术后3.0 h,高浓度组患者氧分压(PaO_2)、血氧饱和度(SaO_2)高于中浓度组,中浓度组高于低浓度组(P<0.05);3组患者二氧化碳分压(PaCO_2)、pH值比较,差异无统计学意义(P>0.05)。中浓度组患者心肺复苏至自主循环恢复(ROSC)时间、ROSC后6.0 h神经功能缺陷(NDS)评分高于低浓度组和高浓度组(P<0.05)。中浓度组患者血清S100β蛋白和神经烯醇化酶(NSE)水平低于低浓度组和高浓度组(P<0.05);不同时间点比较,差异有统计学意义(P<0.05),二者间存在交互作用,差异有统计学意义(P<0.05)。心肺复苏术后7 d,高、中、低浓度组患者存活率分别为20.0%、35.0%、15.0%,差异无统计学意义(P>0.05)。结论中浓度吸氧有利于心脏骤停患者心肺复苏后的神经功能恢复,可在一定程度上提高患者存活率。
Objective To investigate the effects of cardiopulmonary resuscitation with different oxygen concentrations on the prognosis of patients with cardiac arrest. Methods Sixty patients with cardiac arrest admitted to Nanjing General Hospital of Nanjing Military Command from January 2010 to January 2015 were enrolled in this study. Cardiopulmonary resuscitation was performed with a multifunction cardiopulmonary resuscitation device supplemented with mechanical ventilation. According to the concentration of oxygen during cardiopulmonary resuscitation, all patients were divided into high concentration group, medium concentration group and low concentration group, with 20 cases in each group. The prognosis of 3 groups was compared. Results After 3.0 h of cardiopulmonary resuscitation, PaO_2 and SaO_2 were higher in the high concentration group than in the middle concentration group and higher in the middle concentration group than in the low concentration group (P <0.05). In the third group, the carbon dioxide Partial pressure (PaCO_2), pH value, the difference was not statistically significant (P> 0.05). In the moderate concentration group, the time from cardiopulmonary resuscitation to spontaneous circulation recovery (ROSC) was increased. The score of neurological deficit (NDS) at 6.0 h after ROSC was higher than that of the low concentration and high concentration groups (P <0.05). Serum levels of S100β protein and neuronenoenzyme (NSE) were lower in the moderate concentration group than those in the low and high concentration groups (P <0.05). The difference was statistically significant at different time points (P <0.05) There was interaction, the difference was statistically significant (P <0.05). At 7 days after cardiopulmonary resuscitation, the survival rates of patients in high, medium and low concentration groups were 20.0%, 35.0% and 15.0%, respectively, with no significant difference (P> 0.05). Conclusion The moderate oxygen inhalation is beneficial to the recovery of neurological function after cardiopulmonary resuscitation in patients with cardiac arrest, which can improve the survival rate of patients to a certain extent.