中枢、非中枢原因心脏骤停患者心肺复苏后72 h内循环功能对比观察

发布时间：2019-07-25 16:42

【摘要】：目的对比观察中枢原因与非中枢原因心脏骤停患者自主循环恢复(ROSC)后72 h内循环功能变化。方法选择中枢原因心脏骤停ROSC的患者20例纳入A组,非中枢原因心脏骤停ROSC的患者17例纳入B组。收集两组ROSC后0、6、12、24、36、48、72 h的心率(HR)、血压、尿量、使用血管活性药种类等资料。收集各时间点的动脉血气分析结果(含乳酸值),进一步计算乳酸清除率及氧合指数(OI)。结果所有病例ROSC后72 h血乳酸水平基本恢复正常,ROSC后0~6 h血乳酸清除率最高。A组ROSC后0~6 h、0~24 h乳酸清除率小于B组,36~48 h乳酸清除率大于B组(P均0.05)。A组ROSC后6~12 h、12~24 h、24~36 h、36~48 h、48~72 h尿量均大于B组(P均0.05)。ROSC后72 h A组使用血管活性药物12例,B组为4例,A组使用血管活性药物比例大于B组(P0.05)。结论心脏骤停患者ROSC后72 h内越早期循环功能改善越明显;中枢原因心脏骤停患者较非中枢原因患者循环功能恢复相对滞后。
[Abstract]:Objective to observe the changes of circulatory function within 72 hours after spontaneous circulation was restored to (ROSC) in patients with cardiac arrest caused by central and non-central causes. Methods 20 patients with central cardiac arrest (ROSC) and 17 patients with non-central cardiac arrest (ROSC) were enrolled in group B. The heart rate, (HR), blood pressure, urine volume and the type of vasoactive drugs were collected at 0, 6, 12, 24, 36, 48, 72 h after ROSC in two groups. The results of arterial blood gas analysis (including lactic acid value) at each time point were collected, and the lactic acid clearance rate and oxygenation index (OI). Were further calculated. Results the blood lactic acid level of all cases returned to normal at 72 h after ROSC, and the clearance rate of blood lactic acid was the highest at 0: 6 h after ROSC. The lactic acid clearance rate at 0: 24 h after ROSC in group A was lower than that in group B, and the lactic acid clearance rate in group B was higher than that in group B (P < 0.05). The lactic acid clearance rate in group B was higher than that in group B at 6 h, 12 h, 24 h, 36 h, 48 h and 72 h, respectively. Group A (n = 12) was treated with vasoactive drugs at 72 h after ROSC, and group B was treated with vasoactive drugs at 72 h after ROSC (P < 0.05). The proportion of vasoactive drugs in group A was higher than that in group B (P 0.05). Conclusion the early improvement of circulatory function in patients with cardiac arrest within 72 hours after ROSC is more obvious, and the recovery of circulatory function in patients with central cardiac arrest is relatively lagging behind that in patients with non-central causes.
【作者单位】：安徽医科大学第一附属医院;
【基金】：安徽省软科学研究专项基金项目(1607a0202044)
【分类号】：R541.78

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