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心室颤动导致院外心脏骤停后低温治疗的效果

Effect of hypothermia therapy after outpatient cardiac arrest due to ventricular fibrillation.

作者信息

Takeuchi Ichiro, Takehana Hitoshi, Satoh Daisuke, Fukaya Hidehira, Tamura Yujin, Nishi Mototsugu, Shinagawa Hisahito, Imai Hiroshi, Yoshida Toru, Tojo Taiki, Inomata Takayuki, Aoyama Naoyoshi, Soma Kazui, Izumi Tohru

机构信息

Department of Emergency and Critical Care Medicine, Kitasato University School of Medicine, Sagamihara, Japan.

出版信息

Circ J. 2009 Oct;73(10):1877-80. doi: 10.1253/circj.cj-09-0088. Epub 2009 Aug 7.

Abstract

BACKGROUND

Several investigators have emphasized the positive effect of hypothermia therapy on patients who have suffered from cardiac arrest. Salvaging patients from circulatory collapse is a pivotal task, but it is unclear whether additional hypothermia can practically contribute to an improvement in the neurological outcome.

METHODS AND RESULTS

Since December 2005, our hospital has been using hypothermia therapy. Forty-six comatose patients after recovery of spontaneous circulation were consecutively enrolled in the present study. Twenty-five of the enrolled patients received hypothermia therapy and 21 did not because they were treated prior to 2005. The time from collapse to spontaneous circulation (P=0.09), the rates of performance of bystander CPR (P=0.370) and presence of a witnessed collapse (P=0.067) were not significantly different between the recovery group (n=28) and the non-recovery group (n=18). The additional hypothermia therapy was an independent predictor of neurological recovery (P=0.005, OR 6.5, 95%CI 1.74-24.27). The recovery rate was significantly higher in patients who received hypothermia therapy (80%) compared to those who did not (38%).

CONCLUSIONS

Hypothermia therapy is very useful for treating patients who have had an out-of-hospital cardiac arrest; it should be induced rapidly and smoothly.

摘要

背景

几位研究者强调了低温疗法对心脏骤停患者的积极作用。将患者从循环衰竭中抢救过来是一项关键任务,但尚不清楚额外的低温疗法是否真的有助于改善神经学预后。

方法与结果

自2005年12月起,我院开始使用低温疗法。本研究连续纳入了46例自主循环恢复后仍昏迷的患者。其中25例患者接受了低温疗法,21例未接受,因为他们是在2005年之前接受治疗的。复苏组(n = 28)和未复苏组(n = 18)在从心脏骤停到自主循环恢复的时间(P = 0.09)、旁观者进行心肺复苏的比例(P = 0.370)以及心脏骤停有目击者在场的比例(P = 0.067)方面差异均无统计学意义。额外的低温疗法是神经功能恢复的独立预测因素(P = 0.005,比值比6.5,95%可信区间1.74 - 24.27)。接受低温疗法的患者恢复率(80%)显著高于未接受低温疗法的患者(38%)。

结论

低温疗法对于治疗院外心脏骤停患者非常有用;应迅速且平稳地诱导低温。

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