中国中西医结合急救杂志
中國中西醫結閤急救雜誌
중국중서의결합급구잡지
INTEGRATED TRADITIONAL CHINESE AND WESTERN MEDICINE IN PRACTICE OF CRITICAL CARE MEDICINE
2014年
3期
229-231
,共3页
穆昌军%李文强%周永明%万曦%杨河欣
穆昌軍%李文彊%週永明%萬晞%楊河訢
목창군%리문강%주영명%만희%양하흔
氢化可的松%心搏骤停%自主循环恢复
氫化可的鬆%心搏驟停%自主循環恢複
경화가적송%심박취정%자주순배회복
Hydrocortisone%Cardiac arrest%Return of spontaneous circulation
目的：观察氢化可的松琥珀酸钠对心肺复苏（CPR）患者自主循环恢复（ROSC）率及预后的影响。方法采用队列研究方法，将78例非创伤性院外心搏骤停患者分为氢化可的松组（31例）和对照组（47例）。两组入院后均给予常规治疗，氢化可的松组在常规治疗基础上静脉注射100 mg氢化可的松琥珀酸钠；比较两组的ROSC率及预后，多元回归分析预测ROSC的影响因素。结果氢化可的松组ROSC率、24 h存活率均显著高于对照组（ROSC率：58.1%比40.4%，24 h存活率：48.4%比36.2%，均P＜0.05）。氢化可的松组与对照组CPR持续时间〔min：17.1（6～45）比15.8（7～48）〕、存活者急性生理学与慢性健康状况评分系统Ⅱ（APACHEⅡ）评分（分：37.2±8.2比36.1±8.2）、7 d存活率（12.9%比12.8%）和出院率（6.5%比6.4%）比较差异均无统计学意义（均P＞0.05）。氢化可的松和目击者是ROSC的独立预测因子，优势比（OR）分别为3.12和4.24，95%可信区间（95%CI）分别为-1.18～8.29（P＝0.017）和-1.87～12.43（P＝0.008）。结论复苏过程中使用氢化可的松可增加CA患者的ROSC率。
目的：觀察氫化可的鬆琥珀痠鈉對心肺複囌（CPR）患者自主循環恢複（ROSC）率及預後的影響。方法採用隊列研究方法，將78例非創傷性院外心搏驟停患者分為氫化可的鬆組（31例）和對照組（47例）。兩組入院後均給予常規治療，氫化可的鬆組在常規治療基礎上靜脈註射100 mg氫化可的鬆琥珀痠鈉；比較兩組的ROSC率及預後，多元迴歸分析預測ROSC的影響因素。結果氫化可的鬆組ROSC率、24 h存活率均顯著高于對照組（ROSC率：58.1%比40.4%，24 h存活率：48.4%比36.2%，均P＜0.05）。氫化可的鬆組與對照組CPR持續時間〔min：17.1（6～45）比15.8（7～48）〕、存活者急性生理學與慢性健康狀況評分繫統Ⅱ（APACHEⅡ）評分（分：37.2±8.2比36.1±8.2）、7 d存活率（12.9%比12.8%）和齣院率（6.5%比6.4%）比較差異均無統計學意義（均P＞0.05）。氫化可的鬆和目擊者是ROSC的獨立預測因子，優勢比（OR）分彆為3.12和4.24，95%可信區間（95%CI）分彆為-1.18～8.29（P＝0.017）和-1.87～12.43（P＝0.008）。結論複囌過程中使用氫化可的鬆可增加CA患者的ROSC率。
목적：관찰경화가적송호박산납대심폐복소（CPR）환자자주순배회복（ROSC）솔급예후적영향。방법채용대렬연구방법，장78례비창상성원외심박취정환자분위경화가적송조（31례）화대조조（47례）。량조입원후균급여상규치료，경화가적송조재상규치료기출상정맥주사100 mg경화가적송호박산납；비교량조적ROSC솔급예후，다원회귀분석예측ROSC적영향인소。결과경화가적송조ROSC솔、24 h존활솔균현저고우대조조（ROSC솔：58.1%비40.4%，24 h존활솔：48.4%비36.2%，균P＜0.05）。경화가적송조여대조조CPR지속시간〔min：17.1（6～45）비15.8（7～48）〕、존활자급성생이학여만성건강상황평분계통Ⅱ（APACHEⅡ）평분（분：37.2±8.2비36.1±8.2）、7 d존활솔（12.9%비12.8%）화출원솔（6.5%비6.4%）비교차이균무통계학의의（균P＞0.05）。경화가적송화목격자시ROSC적독립예측인자，우세비（OR）분별위3.12화4.24，95%가신구간（95%CI）분별위-1.18～8.29（P＝0.017）화-1.87～12.43（P＝0.008）。결론복소과정중사용경화가적송가증가CA환자적ROSC솔。
Objective To observe the effects of hydrocortisone on the rate of return of spontaneous circulation(ROSC)and the outcome of patients with cardiac arrest(CA)and cardiopulmonary resuscitation(CPR). Methods A cohort study was conducted,78 non-traumatic patients with CA were divided into hydrocortisone group (31 cases)and control group(47 cases). Conventional treatments were given in the two groups after admission,and additionally intravenous 100 mg hydrocortisone was given to the hydrocortisone group during resuscitation. The ROSC rate and prognosis were compared between the two groups. Multivariate logistic regression analysis was used to predict the impact factor of ROSC. Results The ROSC rate and 24-hour survival rate in the hydrocortisone group were significantly higher than those of the control group(ROSC rate:58.1% vs. 40.4%,24-hour survival rate:48.4%vs. 36.2%,both P<0.05). There were no significant differences between the hydrocortisone and the control groups in duration of CPR〔minute:17.1(6-45)vs. 15.8(7-48)〕,acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)score in survivors(37.2±8.2 vs. 36.1±8.2),the survival rate(12.9% vs. 12.8%)and hospital discharge rate(6.4%vs. 6.4%)in 7 days. Hydrocortisone〔odds ratio(OR)=3.12,95%confidence interval(95%CI)-1.18-8.29, P=0.017〕and witness(OR=4.24, 95%CI -1.87-12.43,P=0.008) were independent predictors for an increased ROSC rate after multiple logistic regression analysis. Conclusion Giving hydrocortisone during resuscitation may increase ROSC rate in CA patients.
