亚低温治疗院外心脏骤停的临床分析

Clinical analysis on treating out-of-hospital cardiac arrest patients with induction of mild therapeutic hypothermia

目的探讨亚低温治疗对院外心脏骤停患者的救治效果。方法 60例院外心脏骤停患者均分为两组:A组为急诊科医生出诊到现场抢救,同时给予4℃冷林格氏液静脉滴注和冰袋外敷患者颈部两侧、枕部,到达医院后,采用电脑降温毯实施亚低温治疗。B组为在医院急诊科接诊的院外心脏骤停患者。比较两组达到目标温度的时间、自主循环恢复及存活率。结果 A组达到目标温度时间较B组短[(3.02±0.23)h vs.(5.64±1.12)h](P<0.05)。A组自主循环恢复率高于B组(36.7%vs.23.3%)(P<0.05)。A组存活率高于B组(20.0%vs.6.7%)(P<0.05)。结论在院外心脏骤停患者的院前急救中,实施亚低温治疗安全、可行,并可明显缩短患者达到目标体温的时间。

Objective To evaluate the outcomes of out-of-hospital cardiac arrest （OHCA） patients with induction of mild therapeutic hypothermia（MTH）. Methods Sixty OHCA patients were randomly divided into two groups with 30 cases each. The patients in group A were rescued by the emergency department team visited and the implements inducing hypothermia were carried out in the scene of the incident, which included intravenous dripping 4℃ Ringer solution, covering the neck and occipitalia with ice bags and applying computer cooling blanket. The patients in group B were sent in hospital and rescued by the same team. The outcomes of resuscitation were compared. Results The mean time reaching the target temperature was shorter in group A than that in group B[（3.02±0.23） h vs. （5.64±1.12） h]（P〈0. 05）. The restoration rate of spontaneous circulation was higher in group A than that in group B（36.7% vs. 23.3%）（P〈0. 05）. The survival rate was higher in group A than that in group B（20. 0% vs. 6.7%） （P〈0. 05）. Conclusion The implements inducing MTH can be safely applied to OHCA patients, which may shorten significantly the time reaching the target temperature in prehospital emergency resuscitation.