摘要
目的 探讨超声辅助心肺复苏在心搏骤停中的应用效果。方法 回顾性分析成都市第三人民医院2022年3月—2024年10月心搏骤停患者的临床资料,以患者入院时间为分组依据,2023年6月及之前入院的心搏骤停患者为常规急救组(n=53,接受常规心肺复苏),2023年6月之后入院的心搏骤停患者分为超声辅助组(n=54,接受床旁超声辅助下的心肺复苏)。比较两组患者心肺复苏过程的自主循环恢复(ROSC)率和10 s内可逆性病因识别率,接受心肺复苏后24 h时(T_(1))、接受心肺复苏后48 h时(T_(2))、接受心肺复苏后72 h时(T_(3))时的存活率,入院时、T_(1)、T_(2)、T_(3)时的心肌损伤标志物[脑钠肽(BNP)、血清肌钙蛋白I(cTnI)]水平以及T_(3)时两组患者的神经功能[神经功能良好率、神经元特异性烯醇化酶(NSE)、S100钙结合蛋白S100B]。结果 超声辅助组急救过程的ROSC率、10 s内可逆性病因识别率、T_(3)时的存活率、T_(3)时的神经功能良好率高于常规急救组(χ^(2)=4.376、4.592、4.387、5.855,P<0.05);T_(2)、T_(3)时,超声辅助组BNP水平低于常规急救组(F_(组间)=15.320,P_(组间)<0.001),T_(1)、T_(2)、T_(3)时,超声辅助组cTnI水平低于常规急救组(F_(组间)=467.311,P_(组间)<0.001);T_(3)时,超声辅助组NSE、S-100B蛋白水平均明显低于常规急救组(t=3.257、2.515,P=0.003、0.019)。结论 床旁超声辅助下的心肺复苏可明显提升心搏骤停患者的复苏效果、抢救效率、存活率,有助于减轻心肌损伤,促进神经功能恢复。
Objective To explore the application effect of ultrasound-assisted cardiopulmonary resuscitation in cardiac arrest.Methods The clinical data of 107 cardiac arrestpatients admitted to the emergency department of the Third People´s Hospital of Chengdu from March 2022 to October 2024 were retrospectively analyzed,and the cardiac arrestpatients admitted in June 2023 before were in the routine emergency group(n=53)and received routine cardiopu lmonary resuscitation,and the cardiac arrestpatients admitted later June 2023 were divided into the ultrasound-assisted group(n=54)and received bedside ultrasound-assisted cardiopu lmonary resuscitation.The rate of spontaneous circulation recovery(ROSC)and the reversible etiology identification rate within 10 s,the survival rate at 24 hours after cardiopu lmonary resuscitation(T_(1)),48 hours after cardiopu lmonary resuscitation(T_(2)),and 72 hours after cardiopu lmonary resuscitation(T_(3))were compared between the two groups,the levels of myocardial injury markers[brain natriuretic peptide(BNP),serum troponin I(cTnI)]at admission,T_(1),T_(2),and T_(3),and the neurological function[good neurological function rate,Neuron-specific enolase(NSE),S-100B protein].Results The ROSC rate during emergency process,reversible etiology recognition rate within 10 s,survival rates at T_(3) and good neurological function rate at T_(3) in ultrasound-assisted group were significantly higher than those in conventional emergency group(χ^(2)=4.376、4.592、4.387、5.855,all P<0.05).At T_(2) and T_(3),the level of BNP in ultrasound-assisted group was significantly lower than that in conventional emergency group(F_(between-group)=15.320,P_(between-group)<0.001).At T_(1),T_(2) and T_(3),the level of cTnI in ultrasound-assisted group was significantly lower than that in conventional emergency group(F_(between-group)=467.311,P_(between-group)<0.001).At T_(3),the levels of NSE and S-100B protein in ultrasound-assisted group were significantly lower than those in conventional emergency group(t=3.257,2.515,P=0.003,0.019).Conclusion cardiopu lmonary resuscitation assisted by bedside ultrasound can significantly improve the resuscitation effectiveness,rescue efficiency,survival rates of cardiac arrestpatients,help reduce myocardial damage,promote neurological function recovery.
作者
刘旭阳
王中
徐慈
LIU Xuyang;WANG Zhong;XU Ci(Department of Emergency Medicine,Affiliated Hospital of Southwest Jiaotong University/The Third People's Hospital of Chengdu,Chengdu Sichuan 610031,China)
出处
《中国急救复苏与灾害医学杂志》
2025年第8期981-985,共5页
China Journal of Emergency Resuscitation and Disaster Medicine
基金
四川省自然科学基金项目(2024NSFSC0488)。
关键词
超声
心肺复苏
心搏骤停
急救
预后
Ultrasound
Cardiopulmonary resuscitation
Cardiac arrest
Emergency
Prognosis
