作　　者： (刘致强）; (米伟）; (周雪）; (邓喜庚）;

机构地区： 西部空军第452医院急诊科,成都610065

出　　处： 《疑难病杂志》 2017年第9期919-921,926,共4页

摘　　要： 目的观察机械胸外心脏按压救治心脏骤停患者的有效性及其对心脑功能损伤的影响。方法纳入2014年5月—2016年7月西部空军第452医院急诊科救治心脏骤停患者119例作为研究对象,接受人工胸外心脏按压的59例为对照组,接受机械胸外心脏按压的60例为观察组。评估2组患者的抢救效果;存活病例的外周血心肌酶谱指标水平、血清神经功能损伤指标变化。结果经不同方式抢救后,观察组的自主循环恢复时间短于对照组(t=9.23,P=0.00),复苏首阶段自主心率存续时间长于对照组(t=10.51,P=0.00),短时间复苏成功率、总复苏成功率高于对照组(χ~2=14.38、13.25,P均<0.01)。复苏1h后,观察组外周血心肌肌钙蛋白Ⅰ(cTnⅠ)、乳酸脱氢酶(LDH)、肌酸激酶(CK)水平低于对照组(t=7.82、9.27、12.34,P均<0.05),血清神经元特异性烯醇化酶(NSE)、S100B蛋白(S100B)含量低于对照组,脑源性神经营养因子(BDNF)含量高于对照组(t=12.38、6.82、9.27 P<0.05)。结论机械胸外心脏按压可优化心脏骤停患者的抢救效果,减少按压过程中的心肌损伤并提升神经功能。 Objective To observe the effectiveness of mechanical chest compressions in the treatment of cardiac arrest and its effects on cardiac and cerebral function injuries.Methods From May 2014 to July 2016, in the 452 Air Force Hospital emergency department, 119 patients for treatment of cardiac arrest enrolled as the research object, 59 cases received chest compressions enrolled as control group, 60 cases received mechanical chest compressions as observation group.The rescue effects of the 2 groups were evaluated.The levels of myocardial enzymes in peripheral blood and the indexes of serum nerve function damage in patients with survival were measured.Results By different ways after the rescue, the observation group of spontaneous circulation recovery time shorter than the control group （t =9.23, P =0.00）, the first phase of recovery of spontaneous heart rate duration was longer than that of the control group （t =10.51, P =0.00）, short time recovery success rate, total recovery rate were higher than that of control group （χ^2=14.38,χ^2=13.25, P 〈0.01）.After 1 h of recovery, the observation group of peripheral blood myocardial enzyme spectrum index of cardiac troponin I （cTn I）, lactate dehydrogenase （LDH）, creatine kinase （CK） levels lower than the control group （t =7.82, t =9.27, t =12.34, P 〈0.05）, serum nerve injury index of neuron specific enolase （NSE）, S100B protein （S100B） were lower than control group, brain-derived neurotrophic factor （BDNF） was higher than that of the control group （t =12.38, t =6.82, t =9.27, P 〈0.05, P 〈0.01）.Conclusion Mechanical chest compressions can optimize the rescue effect of cardiac arrest patients, reduce myocardial injury during compression and improve neurological function.

关 键 词： 心脏骤停 机械胸外心脏按压 心肌损伤 神经功能