Sarver Heart Center at the University of Arizona College of Medicine, Tucson, Arizona 85724, USA.
Catheter Cardiovasc Interv. 2010 Mar 1;75(4):616-24. doi: 10.1002/ccd.22192.
Long-term survival rates even after successful resuscitation from out-of-hospital cardiac arrest are dismal. Most of those initially resuscitated expired during their hospitalization. Recent reports have suggested that a more aggressive approach to postresuscitation care is the key to better outcome. Waiting for the evidence of neurological recovery before acting can result in missed opportunity to improve such recovery. Immediate induction of mild therapeutic hypothermia for all resuscitated victims who remain comatose offers the best hope for neurological recovery. Numerous reports suggest that early coronary angiography and PCI also improve outcome among those resuscitated from cardiac arrest whose postresuscitation ECG show evidence of ST elevation myocardial infarctions. Most promising is combining these two postresuscitation therapies, namely immediate induction of hypothermia and early coronary angiography and PCI. Combining these therapies has resulted in long-term survival rates of 70% with more than 80% of all such survivors neurologically functional. Even those without ST elevation on their postresuscitation ECG can greatly benefit from timely induction of hypothermia and early angiography/PCI.
即使在院外心脏骤停复苏成功后，长期生存率仍然不容乐观。大多数最初复苏的患者在住院期间死亡。最近的报告表明，更积极的复苏后护理方法是改善预后的关键。等待神经功能恢复的证据后再行动可能会错失改善神经功能恢复的机会。对所有仍处于昏迷状态的复苏患者立即诱导轻度治疗性低温，为神经功能恢复提供最佳希望。大量报告表明，对于那些复苏后心电图显示 ST 段抬高型心肌梗死证据的心脏骤停患者，早期冠状动脉造影和 PCI 也能改善预后。最有前途的是将这两种复苏后治疗方法结合起来，即立即诱导低温和早期冠状动脉造影和 PCI。将这些疗法结合起来，可使长期生存率达到 70%，其中超过 80%的幸存者具有神经功能。即使在复苏后心电图上没有 ST 段抬高的患者，也能从及时诱导低温和早期血管造影/PCI 中获益匪浅。
