亚低温治疗对心搏骤停心肺复苏患者预后影响

Outcomes of moderate hypothermia treatment in patients with cardiac arrest survivors

目的 探讨亚低温治疗对心搏骤停后心肺复苏患者的临床疗效,寻找一种切实可行的亚低温治疗的监测指标.方法 选取2005年1月至2010年2月中国医科大学附属盛京医院急诊科收治的心搏骤停患者40例,经心肺复苏（PCR）达到自主循环恢复后随机分为常规治疗组与亚低温治疗组各20例.随访3个月观察其临床疗效,同时监测局部脑组织的氧饱和度（rSO2）在亚低温治疗各时点的变化.结果 亚低温治疗组治愈率显著高于常规治疗组;亚低温治疗组的致残率显著低于常规治疗组.亚低温治疗12 h后rS02明显上升,24 h后rSO2持续维持在稳定状态,与对照组相比差异具有统计学意义（P＜0.01）.结论 对心搏骤停后心肺复苏患者实行亚低温治疗能减轻脑组织氧代谢紊乱,改善预后.无创持续监测rSO2对亚低温治疗具有指导意义.

Objective To study clinical effect of moderate hypothennia treatment in patients with cardiac arrest survivors and search a practical monitoring way during moderate hypothennia treatment. Method A total of 40 patients of CPR following the restoration of spontaneous circulation were randomly divided into the hypothermia therapy group （ n= 20） and the routine therapy group （ n= 20）, the clinical effect on patient followed for three months is evaluated. At the same time regional cerebral oxygen saturation （rSO2） was detected at different times after moderate hypothennia treatment in two groups. Results The recovery rate were higher and the mutilation rate was lower in hypothermia therapy group than that of the routine therapy group. rSO2 obviously increased after 12 hours of hypothermic treatment, and continuing kept stable level after 24 hours of hypothermic treatment, but it was also higher than routine therapy group （P〈0.01）. Conclusions Moderate hypothermia can alleviate the metabolic disorder of the brain tissue and improve the prognosis in patients with cardiac arrest survivors. Noninvasire continuously monitoring of rSO2 has important significance for instructing moderate hypothermia treatment in clinic.