摘要
目的探讨序贯性气道开放联合依达拉奉在急诊心肺复苏中的应用效果。方法选取需急诊心肺复苏患者100例,随机分为对照组和观察组各50例。对照组给予序贯性气道开放,观察组在对照组的基础上,于自主循环恢复后给予静脉注射依达拉奉。观察两组患者气道有效开放时间、恢复自主呼吸时间以及复苏前和复苏2 h后血浆渗透压、血钾、血糖、血钠、尿素钠等血生化指标的变化。采用格拉斯哥昏迷量表(GCS)评估两组患者复苏前及复苏后1 d、3 d、 7 d、14 d的昏迷情况。比较两组患者复苏前及复苏后0.5 h、2 h、12 h、24 h外周血神经元特异性烯醇化酶(NSE)和脑钠肽水平,并记录两组患者复苏有效率及死亡率。结果观察组患者恢复自主呼吸时间、气道有效开放时间均短于对照组,复苏有效率高于对照组,死亡率低于对照组(均P<0.05)。复苏后2 h,两组患者血浆渗透压及各生化指标均较复苏前下降,且观察组患者均低于对照组(均P<0.05);复苏后各时间点观察组GCS评分均高于对照组,NSE及脑钠肽水平均低于对照组(均P<0.05)。结论序贯性气道开放联合依达拉奉用于急诊心肺复苏具有良好疗效,可减轻患者的缺血再灌注损伤、脑损伤及心肌损伤。
Objective To investigate the efficacy of sequential airway opening combined with edaravone applied to emergency cardiopulmonary resuscitation. Methods A total of 100 patients requiring emergency cardiopulmonary resuscitation were selected and randomly divided into control group(50 cases) and observation group(50 cases).The control group was given sequential airway opening therapy,and the observation group was given intravenous injection of edaravone following the restoration of spontaneous circulation on the basis of the therapy performed in the control group.Duration of effective airway opening and duration for restoration of spontaneous respiration,as well as changes in plasma osmotic pressure and blood biochemical parameters such as serum potassium,blood glucose,blood sodium and urea sodium before and 2 hours after resuscitation,were observed in the two groups.The Glasgow Coma Scale(GCS) was used to evaluate patients′ coma state in the two groups before and 1,3,7 and 14 days after resuscitation.Peripheral blood levels of neuron-specific enolase(NSE) and brain natriuretic peptide were compared between the two groups before and 0.5,2,12 and 24 hours after resuscitation,and the effective rate of resuscitation and mortality in the two groups were recorded. Results The observation group had a shorter duration for restoration of spontaneous respiration,a shorter duration of effective airway opening,a higher rate of effective resuscitation,and a lower mortality as compared with the control group(all P <0.05).Two hours after resuscitation,plasma osmotic pressure and each biochemical parameter decreased in the two groups compared with those before resuscitation,which were lower in the observation group than in the control group(all P <0.05);at each time point after resuscitation,the observation group had a higher GCS score as well as lower NSE and brain natriuretic peptide levels compared with the control group(all P <0.05). Conclusion Sequential airway opening combined with edaravone applied to emergency cardiopulmonary resuscitation has a favorable efficacy,which can alleviate ischemia-reperfusion injury,brain injury and myocardial injury in the patients.
作者
苏运安
潘忠义
胡勇
王伟佳
卢峰
SU Yun-an;PAN Zhong-yi;HU Yong;WANG Wei-jia;LU Feng(Department of Emergency,Suzhou Mingji Hospital,Suzhou 215100,China;Department of Neurology,Suzhou Mingji Hospital,Suzhou 215100,China;Department of Emergency,Wuxi Huishan District People′s Hospital,Wuxi 214187,China)
出处
《广西医学》
CAS
2019年第13期1629-1633,共5页
Guangxi Medical Journal
基金
江苏省无锡市科协软科学研究项目(KX15-B-22)
关键词
心肺复苏
序贯性气道开放
依达拉奉
神经元特异性烯醇化酶
脑钠肽
急诊
Cardiopulmonary resuscitation
Sequential airway opening
Edaravone
Neuron-specific enolase
Brain natriuretic peptide
Emergency
