人工亚低温在改善心肺复苏后多脏器功能障碍中的价值

摘要

目的探讨人工亚低温能否减轻心脏骤停患者多脏器功能损伤的程度。方法采取回顾性分析的方法，将符合入选标准的49例患者根据是否接受人工亚低温治疗分成治疗组和对照组，分析比较两组患者自主循环恢复72h内Glasgow评分、动脉血气分析、肌酸激酶同工酶、肌钙蛋白I、谷丙转氨酶、总胆红素、血肌酐、血小板计数、凝血酶原时间、部分凝血活酶时间水平的变化。结果自主循环恢复早期，两组患者各脏器均有不同程度的损伤；自主循环恢复后72h，治疗组患者神经系统功能轻度改善（P=0.33），而对照组患者神经系统功能轻度恶化（P=0.97）；心肌酶谱[CKMB（P=0.00）、TnI （P=0.00）]、肝功能[ALT（P=0.00）、TB（P=0.00）]和肺氧合功能（P=0.01）与对照组相比均显著改善。但是肾脏功能无明显差异（P＞0.05），且治疗组患者血小板计数较对照组显著减少（P=0.00）。结论人工亚低温可以改善心脏骤停患者多脏器功能。%Objective To investigate whether mild hypothermia can reduce the injury on multiple organ function on patients suffered from cardiac arrest.Methods 49 patients who suffered from cardiac arrest and return of spontaneous circulation(ROSC) are included.We evaluated function of different organs of the ifrst 72 hours after ROSC.According to whether the patients had been given mild hypothermia therapy,the 49 patients were divided into the treating group and the control group,and then we compared the differences between the two groups.Results After 72 hours,the nerve system function of the treating grou p turns out to be better than the control group,however,it makes no signiifcant difference.The treating group patients had signiifcantly better heart,lung and liver functions(P<0.05) than the control group.The renal function turned out to make no signiifcant difference between the two groups(P>0.05);the coagulate function was badly hurt in the treating group(P<0.05). Conclusion Mild hypothermia can reduce the injury on multiple organ function on patients suffered from cardiac arrest.