心脏骤停后综合征相关急性胃肠损伤的研究进展

Research progress in post cardiac arrest syndrome associated with acute gastrointestinal injury

我国心脏骤停(cardia arrest,CA)现状严峻,每年约有54.4万人发生心源性猝死,由心脏骤停导致的猝死人数高居世界之首,严重危害国民健康[1]。近年来,尽管心肺复苏(cardiopulmonary resuscitation,CPR)领域相关理论和技术取得了巨大进步,有效改善了自主循环恢复率,但是并未改善患者长期生存率[2];在美国,CA出院生存率仅有10.6%[3],而我国院前心脏骤停的生存率甚至不到1%[4]。

Post-cardiac arrest syndrome(PCAS),formerly known as"post-resuscitation syndrome",is consisted of acute ischemia-reperfusion injury and a series of complex pathobiological changes,which occur simultaneously in patients with restoration of spontaneous circulation by cardiopulmonary resuscitation(CPR).Studies have shown that gastrointestinal tract is one of the earliest and most serious damaged organs in the pathophysiological process of PCAS.It is another common organ injury second only to heart and brain injury after resuscitation.Moreover,it is also considered as the"power"source for the progression of PCAS to multiple organ dysfunction syndrome.Therefore,how to carry out early prevention,diagnosis and clinical intervention is vital for curbingthe occurrence and development of acute gastrointestinal injury(AGI)afterresuscitation.This article reviews the epidemiological status,pathophysiological mechanism,grading system,evaluation methods and treatment of AGI after CPR,so as to provide some reference for the early diagnosis and treatment of PCAS-related AGI.