亚低温治疗对心肺复苏患者预后的影响

The Impact of Mild Therapeutic Hypothermia on Neurologic Function and Prognosis in Patients with CPR

目的探讨亚低温治疗对心肺复苏（CPR）后幸存者神经功能和预后的影响。方法79例心跳呼吸骤停、心肺复苏后自主循环恢复患者，随机接受亚低温治疗（中心体温降至32℃～34℃，并维持24h）或常温治疗。比较两组患者复苏后当天及72hSOFA评分、乳酸水平、GCS评分，3个月统计病死率及按照格拉斯哥预后评分标准对大脑神经功能分级。结果心肺复苏后亚低温组与常温组相比较，第3天GCS评分明显增高，SOFA评分明显降低，乳酸水平明显降低，均P〈0．05；在复苏后3个月，亚低温组较常温治疗组病死率明显降低，P〈0．05，大脑神经功能分级分值明显降低，P〈0．05。结论亚低温治疗有助于心肺复苏后幸存者的神经功能恢复，并降低病死率。

Objective To assess the effect of mild therapeutic hypothermia of survivors of CPR on their neurologie function and prognosis. Methods 79 patients who had been resuscitated after cardiopulmonary arrest were randomly assigned to receive mild therapeutic hypothermia with the core body temperature reduced to 32℃ to 34℃ and maintained for 24 hours （hypothermia group） or normothermia （normothermia group）, and the two groups were compared on the Glasgow coma scale （GCS） score, SOFA, lactate within 72 hours after cardiopulmonary resuscitation（CPR）, a favorable neurologic outcome and mortality within 3 months after cardiac arrest were assessed. Results 72 hours after CPR, the GCS score of patients in hypothermia group was higher than that in normothermia group P 〈 0.05, while the lactate and SOFA score in the hypothermia group is lower （P 〈 0.05）. It seemed to have a favorable neurologic outcome and low mortality at 3 months in the hypothermia group. Conclusions The comparison demonstrated that mild therapeutic hypothermia helped improve the patients＇ neurologic outcomes and reduce the mortality.