论文部分内容阅读
目的探明心肺复苏后亚低温治疗最佳的目标温度设置,从而改善CA患者的生存率及神经功能。方法本研究为观察性研究,纳入2014年10月至2016年10月的心脏骤停后自主循环恢复的病例165例,依据入院时目标温度设置分为34~36℃组(实验组)与32~34℃组(对照组),比较两组间不良事件发生率、出院时存活率、良好神经功能预后率之间的差异。结果两组相比出院时存活率差异无统计学差异(χ~2=0.29 df=1 P=0.35);出院时神经功能预后良好率之间差异无统计学意义(χ~2=0.67 df=1 P=0.25);34~36℃组有更低的低钾血症发生率(χ~2=2.38 df=1 P=0.09);而在心律失常及肺炎的发生率方面的差异无统计学意义。结论心脏骤停患者自主循环恢复后的亚低温治疗中,目标温度设置为34~36℃与32~34℃相比对预后的影响没有差异但有更低的低钾血症发生率。
Objective To investigate the optimal target temperature setting for mild hypothermia after cardiopulmonary resuscitation (CPR) to improve the survival rate and neurological function in CA patients. Methods This study was an observational study enrolled 165 cases of spontaneous circulation recovery after cardiac arrest from October 2014 to October 2016. According to the target temperature setting at admission, the subjects were divided into 34 ~ 36 ℃ group (experimental group) and 32 ~ 34 ℃ group (control group), the differences between the two groups in the incidence of adverse events, the survival rate at discharge, the good prognosis of neurological function were compared. Results There was no significant difference in the survival rate between the two groups when discharged from hospital (χ ~ 2 = 0.29 df = 1 P = 0.35). There was no significant difference between the two groups in the good prognosis of neurological function (χ ~ 2 = 0.67 df = 1 P = 0.25). The incidence of hypokalemia was lower in 34 ~ 36 ℃ group (χ ~ 2 = 2.38 df = 1 P = 0.09), but there was no significant difference in the incidence of arrhythmia and pneumonia significance. Conclusions In mild hypothermia after spontaneous circulation recovery in patients with cardiac arrest, the target temperature setting is 34-36 ° C with no difference in prognosis but with a lower incidence of hypokalemia compared with 32-34 ° C.