心肺复苏后不同温度的亚低温治疗与肺部感染的相关性研究

Correlation between Temperature of Hypothermia Treatment and Pulmonary Infection after Cardiopulmonary Resuscitation

【目的】探讨对心脏骤停通过心肺复苏恢复心脏节律的患者采用不同温度的亚低温治疗与其肺部感染是否存在相关性。【方法】本院心肺复苏后的患者72例,随机分为A组、B组、C组,每组24例。其中A组采用非亚低温治疗,B组采用36℃低温治疗,C组采用33℃亚低温治疗。比较三组患者治疗后14 d和出院时存活率情况,并对比治疗3 d和7 d后临床肺部感染评分(CPIS)、痰培养阳性率、痰培养阳性致病菌谱、氧和指数和感染指标[C反应蛋白(CRP)和降钙素原(PCT)]。【结果】治疗14 d后、出院时三组患者存活率比较差异无统计学意义(P>0.05);治疗3 d和7 d,C组CPIS评分低于A组和B组(P<0.05);治疗3 d后,三组痰培养阳性率比较差异无统计学意义(P>0.05);治疗7 d后,C组痰培养阳性率低于A组和B组(P<0.05);三组治疗3 d和7 d,痰培养阳性致病菌谱比较差异无统计学意义(P>0.05);治疗3 d和7 d,C组氧和指数高于A组和B组,CRP、PCT水平低于A组和B组(P<0.05)。【结论】心肺复苏后给予33℃亚低温治疗能减轻患者肺部感染,降低痰培养阳性率,提高氧和指数,改善CRP、PCT水平。

【Objective】To explore the correlation between mild hypothermia treatment at different temperatures and pulmonary infection in patients with cardiac arrest and recovery of cardiac rhythm through cardiopulmonary resuscitation.【Methods】Seventy-two patients after cardiopulmonary resuscitation in our hospital were randomly divided into three groups:group A,group B and group C,with 24 cases in each group.Group A was treated with non-hypothermia,group B with 36℃hypothermia and group C with 33℃hypothermia.The survival rates at 2 weeks after treatment and at the time of hospital discharge in the three groups were compared,and the clinical pulmonary infection score(CPIS),sputum culture positive rate,sputum culture positive pathogenic bacteria spectrum,oxygen and index and infection indexes[Creactive protein(CRP)and procalcitonin(PCT)]on treatment 3 d and treatment 7 d were compared among the three groups.【Results】There was no significant difference in the survival rate between the three groups after 14 days of treatment and at the time of discharge(P>0.05).The CPIS score of group C on 3 d and 7 d of treatment was lower than that of group A and group B(P<0.05).There was no significant difference in the positive rate of sputum culture among the three groups on 3 d of treatment(P>0.05).The positive rate of sputum culture on 7 d of treatment in group C was lower than that in group A and group B(P<0.05).There was no significant difference in sputum culture positive pathogenic bacteria spectrum between the three groups on treatment day 3 and treatment day 7(P>0.05).On treatment 3 d and 7 d,the oxygen and index of group C were higher than those of group A and group B,and the levels of CRP and PCT were lower than those of group A and group B(P<0.05).【Conclusion】The mild temperature control,which is at 33℃hypothermia treatment after cardiopulmonary resuscitation,can reduce pulmonary infection,reduce the positive rate of sputum culture,increase oxygen and index,and improve the levels of CRP and PCT.