论文部分内容阅读
目的:探讨肾动脉超声检查对心肺复苏的指导价值及对抢救效果的影响。方法:收集浙江新安国际医院2017年2月至2019年12月抢救治疗的心脏骤停患者130例为研究对象，采用随机数字表法分为观察组、对照组各65例。对照组患者实施常规的心肺复苏，观察组在对照组基础上实施以床旁肾动脉超声检查为指导的心肺复苏。对两组患者的抢救效果、血气分析指标、心肌损伤指标、存活率等指标进行比较。结果:观察组自主心律恢复、呼吸恢复、意识恢复时间分别为(6.78±2.93)min、(12.09±3.93)min、(17.29±5.87)min，均短于对照组的(8.63±3.13)min、(14.12±4.17)min、(21.03±6.12)min，组间差异均有统计学意义(n t＝3.479、2.856、3.556，均n P<0.05)；观察组复苏后血氧分压(PaOn 2)、血氧饱和度(SaOn 2)、血二氧化碳分压(PaCOn 2)水平分别为(12.80±2.99)kPa、(92.33±5.81)%、(3.11±1.22)kPa，对照组分别为(10.45±2.86)kPa、(89.11±5.14)%、(3.98±1.35)kPa，两组差异均有统计学意义(n t＝4.579、3.347、3.855，均n P<0.05)；复苏后观察组患者的心肌损伤指标包括血乳酸(LA)、肌钙蛋白(cTnI)、肌酸激酶(CK-MB)水平分别为(2.45±0.73)mmol/L、(57.23±6.11)ng/L、(26.12±4.37)U/L，均低于对照组的(3.07±0.91)mmol/L、(60.85±6.13)ng/L、(29.32±4.23)U/L，两组差异均有统计学意义(n t＝4.285、3.272、4.242，均n P<0.05)；观察组24 h存活率、出院存活率分别为86.15%(55/65)、78.46%(51/65)，均高于对照组的70.77%(46/65)、61.54%(40/65)(χn 2＝4.552、4.432，均n P<0.05)。n 结论:床旁肾动脉超声检查指导心肺复苏术对心脏骤停的抢救具有较高的应用价值，有利于患者的自主心律、呼吸、意识恢复，提高患者的存活率。“,”Objective:To study the guiding value of renal artery ultrasound in cardiopulmonary resuscitation (CPR) for patients with cardiac arrest and its influence on the rescue effect.Methods:A total of 130 patients with cardiac arrest who were treated in Zhejiang Xin'an International Hospital from February 2017 to December 2019 were collected in the study.They were divided into observation group and control group according the random digital table method, with 65 cases in each group.The control group received routine CPR, while the observation group received CPR guided by bedside renal artery ultrasound.The rescue effect, blood gas index, myocardial injury index and survival rate of the two groups were compared.Results:The recovery time of spontaneous rhythm, respiration and consciousness in the observation group were (6.78±2.93)min, (12.09±3.93)min, (17.29±5.87)min, respectively, which were lower than those in the control group [(8.63±3.13)min, (14.12±4.17)min, (21.03±6.12)min], and there were statistically significant differences between the two groups(n t=3.479, 2.856, 3.556, all n P<0.05). The levels of PaOn 2, SaOn 2 and PaCOn 2 in the observation group were (12.80±2.99)kPa, (92.33±5.81)% and (3.11±1.22)kPa, respectively, which in the control group were (10.45±2.86)kPa, (89.11±5.14)% and (3.98±1.35)kPa, respectively, and the differences between the two groups were statistically significant(n t=4.579, 3.347 and 3.855, all n P<0.05). ).The 24-hour survival rate and discharge survival rate of the observation group were 86.15% (55/65) and 78.46% (51/65), respectively, which were higher than those of the control group [70.77% (46/65) and 61.54% (40/65)], and there were statistically significant differences between the two groups(χn 2=4.552 and 4.432, all n P<0.05).n Conclusion:CPR guided by bedside renal artery ultrasound has good rescue effect in patients with cardiac arrest.It can shorten the time of spontaneous rhythm, respiration and consciousness recovery, improve the blood gas index of patients, reduce the myocardial injury of patients, and improve the survival rate of patients.It can be widely used in emergency department.