心脏骤停患者应用不同吸氧浓度心肺复苏术的预后影响分析

Effect of cardiopulmonary resuscitation with different oxygen concentration on prognosis in patients with cardiac arrest

目的分析心脏骤停患者应用不同吸氧浓度心肺复苏术的预后影响。方法选取90例心脏骤停患者作为研究对象,根据心肺复苏术过程中吸氧浓度的不同分为3组,各30例。A组给予高浓度吸氧,氧气浓度为100%;B组为中浓度吸氧,氧气浓度为75%;C组为低浓度吸氧,氧气浓度为21%。对比3组患者动脉血气指标、血清S100β蛋白及NSE水平、心肺复苏情况。结果心肺复苏术后,A组患者PaO_2为(259.85±10.05)mmHg、SaO_2值为(99.96±0.43)%均高于B组(126.69±6.87)mmHg、(95.87±1.27)%,且B组PaO_2、SaO_2值均高于C组(75.36±12.42)mmHg、(94.48±2.17)%,差异有统计学意义(P<0.05),但3组患者PaCO_2为(35.14±3.45)mmHg、(36.02±2.62)mmHg、(35.26±2.79)mmHg及p H值为(7.16±0.03)、(7.15±0.04)、(7.14±0.05),差异无统计学意义;B组患者血清S100β蛋白及NSE水平均低于A组及C组,差异有统计学意义(P<0.05);B组患者心肺复苏至ROSC时间为(14.49±2.43)min及ROSC后6 h患者神经功能评分为(78.26±12.73)分均高于A组(15.52±2.26)min、(70.14±2.85)分及C组(16.67±2.34)min、(54.49±13.38)分,差异有统计学意义(P<0.05)。结论对于心脏骤停患者而言,给予中浓度吸氧量有助于缓解患者脑组织损伤,同时促进神经功能的恢复,预后效果较好,在临床应用中值得推广。

Objective To analyze the effect of cardiopulmonary resuscitation(CPR) with different concentration of oxygen inhalation on prognosis in patients with sudden cardiac arrest(SCA). Methods 90 SCA patients were selected and divided into three groups according to different concentration of oxygen inhalation during CPR, with 30 cases in each group. A group was given 100% high concentration of oxygen inhalation; B group was given 75% middle concentration of oxygen inhalation; while C group was given 21% low concentration of oxygen inhalation. The arterial blood gas indexes, S100β protein, NSE level, CPR conditions were compared among the three groups. Results After CPR, the PaO_2 and SaO_2 in A group[(259.85±10.05)mmHg,(99.96±0.43)%] were higher than B group [(126.69±6.87)mmHg,(95.87±1.27)%], the PaO_2 and SaO_2 in B group were higher than C group [(75.36±12.42)mmHg,(94.48±2.17)%](P<0.05), but there was no statistical difference in the PaCO_2[(35.14±3.45)mmHg,(36.02±2.62)mmHg,(35.26±2.79)mmHg] and p H [(7.16±0.03),(7.15±0.04),(7.14±0.05)] among three groups; The S100β protein and NSE level in B group were lower than those in A and C group(P<0.05); The duration of CPR to ROSC and score of post-ROSC 6 h nerve function in B group [(14.49±2.43)min,(78.26 ± 12.73)points] were higher than A group [(15.52 ± 2.26)min,(70.14 ± 2.85)points] and C group [(16.67 ± 2.34)min,(54.49 ± 13.38)points](P<0.05). Conclusion Middle concentration of oxygen inhalation for SCA patients can relieve brain tissue injury, promote recovery of nerve function and have better prognosis, which is worthy of promotion in clinical application.