高压氧联合人工心肺复苏对呼吸心跳骤停患者心脑缺血性损伤的影响

Effect of Hyperbaric Oxygen Combined with Artificial Cardiopulmonary Resuscitation on Cardiac and Cerebral Ischemic Injury in Patients with Respiratory Cardiac Arrest

目的探讨高压氧联合人工心肺复苏(Cardiopulmonary Resuscitation,CPR)对呼吸心跳骤停患者心脑缺血性损伤的影响。方法回顾性分析2021年3月—2023年6月期间上海天佑医院收治的60例呼吸心跳骤停患者的临床资料,根据救治方法分为对照组和观察组,其中单纯应用人工CPR治疗的30例患者为对照组,增用高压氧治疗的30例患者为观察组。比较两组患者的CPR治疗相关情况、格拉斯哥昏迷量表(Glasgow Coma Scale,GCS)评分、振幅整合脑电图(Amplitude Integrated Electroencephalogram,aEEG)评分、血压、动脉血氧分压(Arterial Partial Pressure of Oxygen,PaO_(2))、血氧饱和度(Oxygen Saturation,SaO_(2))、血乳酸水平。结果治疗后,观察组患者的GCS评分、aEEG评分依次为(9.31±0.66)分、(4.35±0.56)分,高于对照组的(8.85±0.62)分、(3.98±0.67)分,差异有统计学意义(t=2.782、2.321,P均<0.05)。观察组患者的PaO_(2)、SaO_(2)水平高于对照组,血乳酸水平低于对照组,差异有统计学意义(P均<0.05)。结论在呼吸心跳骤停患者应用人工CPR过程中,增用高压氧能够影响患者的GCS评分、aEEG评分,促进PaO_(2)、SaO_(2)指标的升高,并可降低血乳酸水平,对心脑缺血性损伤具有一定的改善作用。

Objective To explore the effect of hyperbaric oxygen combined with artificial cardiopulmonary resuscita⁃tion(CPR)on cardiac and cerebral ischemic injury in patients with respiratory cardiac arrest.Methods A retrospec⁃tive analysis was conducted on the clinical data of 60 patients with respiratory cardiac arrest admitted to Shanghai Tianyou Hospital from March 2021 to June 2023.They were grouped into control group and observation group accord⁃ing to the treatment methods:30 patients with the application of manual CPR alone were in the control group,and 30 patients with the addition of hyperbaric oxygen were in the observation group.The two groups were compared in terms of CPR treatment-related conditions,Glasgow Coma Scale(GCS)scores,amplitude integrated electroencephalogram(aEEG)scores,blood pressure,arterial partial pressure of oxygen(PaO_(2)),blood oxygen saturation(SaO_(2)),and blood lac⁃tate levels.Results After treatment,the GCS score and aEEG score of the observation group were(9.31±0.66)points and(4.35±0.56)points in order,which were higher than those of the control group[(8.85±0.62)points and(3.98±0.67)points],and the differences were statistically significant(t=2.782,2.321,both P<0.05).The levels of PaO_(2) and SaO_(2) of the observation group were higher than those of the control group,and the levels of blood lactate was lower than that of the control group,and the differences were statistically significant(all P<0.05).Conclusion During the application of artificial CPR in patients with respiratory cardiac arrest,the additional use of hyperbaric oxygen can affect the pa⁃tients'GCS score and aEEG score,promote the increase of PaO_(2) and SaO_(2) indexes,and reduce the level of blood lac⁃tic acid,which has a certain improvement effect on cardio-cerebral ischemic injury.