中华急诊医学杂志
中華急診醫學雜誌
중화급진의학잡지
CHINESE JOURNAL OF EMERGENCY MEDICINE
2013年
10期
1142-1146
,共5页
朱建良%张艳%杨林%刘励军
硃建良%張豔%楊林%劉勵軍
주건량%장염%양림%류려군
心脏骤停%心肺复苏%早期目标治疗%治疗性亚低温%平均动脉血压%末梢血氧饱和度%二氧化碳分压%末梢血糖
心髒驟停%心肺複囌%早期目標治療%治療性亞低溫%平均動脈血壓%末梢血氧飽和度%二氧化碳分壓%末梢血糖
심장취정%심폐복소%조기목표치료%치료성아저온%평균동맥혈압%말소혈양포화도%이양화탄분압%말소혈당
Cardiac arrest%Cardio-pulmonary resuscitation%Early goal-directed therapy%Mild therapeutic hypothermia%Mean arterial pressure%Peripheral oxygen saturation%Partial pressure of carbon dioxide%Blood glucose
目的 评估苏州地区心肺复苏术后患者早期目标化治疗的状况,为今后完善复苏后规范化治疗提供临床资料.方法 采用回顾性队列研究的方法,调查2009-2010年期间苏州地区10家二级甲等及以上综合性医院,其ICU内收治的院内或院外心脏骤停恢复自主循环患者的资料.采集心脏骤停后48 h内主要目标化治疗指标:体温(T)、平均动脉血压(MAP)、末梢血氧饱和度(SpO2)、二氧化碳分压(PaCO2)和末梢血糖(Glu)的测定值,比较分析上述指标达到目标值的情况.结果 共有101例心脏骤停患者进入本研究.在目标化治疗指标达标率中,SpO2和MAP的达标率分别为90.1％和81.4％；Glu和PaCO2的达标率分别为55.4％和32.8％；而治疗性亚低温(MTH)的达标率最低,仅为10％；上述目标化治疗指标达标率之间的差异具有统计学意义(P＜0.01).结论 苏州地区心肺复苏术后患者的目标治疗质量仍需提高,尤其应强化对PaCO2和体温的管理力度.
目的 評估囌州地區心肺複囌術後患者早期目標化治療的狀況,為今後完善複囌後規範化治療提供臨床資料.方法 採用迴顧性隊列研究的方法,調查2009-2010年期間囌州地區10傢二級甲等及以上綜閤性醫院,其ICU內收治的院內或院外心髒驟停恢複自主循環患者的資料.採集心髒驟停後48 h內主要目標化治療指標:體溫(T)、平均動脈血壓(MAP)、末梢血氧飽和度(SpO2)、二氧化碳分壓(PaCO2)和末梢血糖(Glu)的測定值,比較分析上述指標達到目標值的情況.結果 共有101例心髒驟停患者進入本研究.在目標化治療指標達標率中,SpO2和MAP的達標率分彆為90.1％和81.4％；Glu和PaCO2的達標率分彆為55.4％和32.8％；而治療性亞低溫(MTH)的達標率最低,僅為10％；上述目標化治療指標達標率之間的差異具有統計學意義(P＜0.01).結論 囌州地區心肺複囌術後患者的目標治療質量仍需提高,尤其應彊化對PaCO2和體溫的管理力度.
목적 평고소주지구심폐복소술후환자조기목표화치료적상황,위금후완선복소후규범화치료제공림상자료.방법 채용회고성대렬연구적방법,조사2009-2010년기간소주지구10가이급갑등급이상종합성의원,기ICU내수치적원내혹원외심장취정회복자주순배환자적자료.채집심장취정후48 h내주요목표화치료지표:체온(T)、평균동맥혈압(MAP)、말소혈양포화도(SpO2)、이양화탄분압(PaCO2)화말소혈당(Glu)적측정치,비교분석상술지표체도목표치적정황.결과 공유101례심장취정환자진입본연구.재목표화치료지표체표솔중,SpO2화MAP적체표솔분별위90.1％화81.4％；Glu화PaCO2적체표솔분별위55.4％화32.8％；이치료성아저온(MTH)적체표솔최저,부위10％；상술목표화치료지표체표솔지간적차이구유통계학의의(P＜0.01).결론 소주지구심폐복소술후환자적목표치료질량잉수제고,우기응강화대PaCO2화체온적관리력도.
Objective To evaluate the implementation of the early goal-directed therapy after cardiopulmonary resuscitation in Suzhou area,in order to provide clinical data for standardized post resuscitation care.Methods This retrospective study included comatose survivors of CA,admitted into intensive care units (ICU) of 10 hospitals in Suzhou area between January 2009 and December 2010.the parameters,mean arterial pressure (MAP),peripheral oxygen saturation (SpO2),partial pressure of carbon dioxide (PaCO2),blood glucose (Glu) and body temperature (T),were collected for 48 h after CA.The percentage of parameters achieving recommended goals was compared.Results A total of 101 CA patients were enrolled in this study.Among the parameters of GDT,the percentage of achieving recommended goals for SpO2 and MAP was 90.1％ and 81.4％ ; the percentage of achieving recommended goals for Glu and PaCO2 was 55.4％ and 32.8％ ; however,mild therapeutic hypothermia (MTH) reached the lowest percentage,only 10％ ; there were significant differences in the percentage of achieving recommended goals for these parameters,P ＜0.01.Conclusions The quality of early goal-directed therapy in the CA patients should be improved,especially in the management of body temperature and partial pressure of carbon dioxide.
