心脏骤停后综合征的治疗进展

Treatment progress of post - cardiac arrest syndrome

心脏骤停（CA）是临床上最危急的病症之一，可在短时间内导致患者死亡。随着心肺复苏（CPR）技术的不断进步，越来越多的患者复苏后可达到自主循环恢复（ROSC）。但恢复自主循环的心脏骤停患者院内死亡率仍居高不下。心脏骤停患者ROSC后，机体发生一系列复杂的病理生理改变，包括心脏骤停后脑损伤、心肌功能异常、全身性缺血一再灌注损伤和持续诱发性病变，称之为心脏骤停后综合征（PCAS）。PCAS的防治已成为提高心脏骤停患者生存率的关键环节之一。心脏骤停后的治疗是高级生命支持的关键组成部分，系统性的治疗可提高患者的生存率，改善患者生存质量。全面的治疗应包括心血管干预措施、亚低温治疗、目标导向治疗、神经系统监测与治疗等。

Cardiac arrest is one of the most critical illness clinieally. It can lead to death within a short time. With the development of technology of cardiac pulmonary resuscitation （ CPR）, more and more patients can achieve resumption of spontaneous circulation （ROSC）. However, the hospital mortality of cardiac arrest patients who achieve ROSC remains high. When the patients achieve ROSC from cardiac arrest, the bodies go through a series of complex pathophysiological changes, including post -cardiac arrest brain injury, post- cardiac arrest myocardial dysfunction, the systemic ischemia - reperfusion response and persistent precipitating pathology, which is called post -cardiac arrest syndrome （PCAS）. The prevention and treatment of PCAS has become one of the most important key aspect for cardiac arrest patients. Treatment systematically can not only increase the survival rate, but also improve the life quality of cardiac arrest patients. Comprehensive treatments should include cardiovascular interventions, hypothermia, goal -directed therapy, monitoring and treatment of the nervous system.