局部亚低温治疗对心肺复苏后患者外周血白细胞的影响及研究

Effect of local mild hypothermia on peripheral blood leukocyte of the patients after CPR

目的研究局部亚低温治疗对心肺复苏患者的疗效及外周血白细胞、电解质的影响。方法61例心搏骤停的患者,经急诊科或院内复苏后转入ICU,随机分为治疗组和对照组。治疗组患者入ICU后立即给予局部亚低温治疗,2～4h内将鼓膜温度降至32～35℃,共治疗72h。分别于治疗后第1天、第7天对两组患者外周血白细胞、中性粒细胞及血清电解质进行检测,并对患者预后进行评估。结果治疗组与对照组在复苏成功后第1天的外周血白细胞与中性粒细胞差异无统计学意义。第7天两组间差异有统计学意义(P=0．02,P=0．036)。而两组患者电解质间差异无统计学意义,局部亚低温组预后明显优于对照组,死亡率降低21．1%。结论局部亚低温治疗心肺复苏患者同样能保护脑神经功能,提高存活率,降低外周血白细胞及中性粒细胞,同时对血清电解质影响甚小。

Objective To study the effect of local mild hypothermia on peripheral blood leukocyte and electrolyte of the patients after eardio - pulmonary resuscitation （ CPR）. Methods 61 cardiac arrest patients, transferred into ICU after CPR at emergency room or in hospital, were divided into therapy group and controlgroup randomly. Local mild hypothermia was given immediately to the patients of therapy group after they entered ICU. The tympanic membrane temperature were cooled to 32℃ - 35℃ in 2 ~ 4 hours for 72 hours. Peripheral blood leukocyte, neutrophil and electrolyte of the patients in two groups were tested on 1st day and 7th day after therapy, and the prognosis was evaluated. Results. There were no significant differences in peripheral blood leukocyte and neUtrophil between therapy group and control group on 1st day after CPR. There＇ were significant differences between two groups （ P = 0. 02, P = 0. 036） on 7th day. There was no difference in electrolyte between two groups, and the prognosis of local mild hypothermia therapy group was obviously better than that of control group, mortality was lower in local mild hypothermia therapy group than in the control group. Condusion Treatment of patients after CPR with local mild hypothermia can pr0tect the function of cranial nerve, increase the survival rate, decrease peripheral blood leukocyte and neutrophil and have little influence on serum eletrolyte.