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[摘要]
目的 探討參附注射液改善心肺復(fù)后患者的療效。方法 選取2015年1月—2016年6月天津中醫(yī)藥大學(xué)第一附屬醫(yī)院收治的心臟驟停復(fù)蘇成功患者57例,按照隨機(jī)數(shù)表法將患者分為對(duì)照組(28例)和治療組(29例)。對(duì)照組給予機(jī)械通氣、心臟除顫及腎上腺素、多巴胺、鹽酸胺碘酮、碳酸氫鈉等搶救治療,恢復(fù)自主心搏后積極維持循環(huán)、亞低溫治療。治療組在對(duì)照組基礎(chǔ)上于搶救早期靜脈滴注參附注射液,100 mL加入到5%葡萄糖250 mL中,1次/d。兩組均連續(xù)治療1周。比較兩組的心臟指數(shù)、血乳酸、格拉斯哥昏迷(GCS)評(píng)分和28 d死亡率。結(jié)果 治療后,兩組24、48、72 h心臟指數(shù)明顯高于1 h時(shí),而12、24、48、72 h血乳酸明顯低于1 h時(shí),同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義(P< 0.05);且治療組48、72 h心臟指數(shù)升高程度明顯優(yōu)于對(duì)照組,24、48、72 h血乳酸降低程度明顯優(yōu)于對(duì)照組,兩組比較差異有統(tǒng)計(jì)學(xué)意義(P< 0.05)。治療后,對(duì)照組第5、7天GCS評(píng)分明顯高于第1天,治療組第3、5、7天GCS評(píng)分明顯高于第1天,同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義(P< 0.05);且治療組第3、5、7天GCS評(píng)分升高程度明顯優(yōu)于對(duì)照組,兩組比較差異具有統(tǒng)計(jì)學(xué)意義(P< 0.05)。對(duì)照組和治療組的28 d死亡率分別為46.43%、37.93%,兩組比較差異有統(tǒng)計(jì)學(xué)意義(P< 0.05)。結(jié)論 參附注射液可改善心肺復(fù)蘇的療效,升高心臟指數(shù),降低血乳酸,改善腦損傷,降低死亡率,具有一定的臨床推廣應(yīng)用價(jià)值。
[Key word]
[Abstract]
Objective To investigate the clinical efficacy of Shenfu Injection in improvement of cardiopulmonary resuscitation. Methods Patients (57 cases) with successful resuscitation of cardiac arrest in the First Teaching Hospital of Tianjin University of TCM from January 2015 to June 2016 were randomly divided into control group (28 cases) and treatment group (29 cases). Patients in the control group were given salvage therapy, including mechanical ventilation, cardiac defibrillation and drug (epinephrine, dopamine, amiodarone hydrochloride, and sodium bicarbonate), after the recovery of spontaneous heartbeat, and given actively maintain circulatory and mild hypothermia therapy. Patients in the treatment group were iv administered with Shenfu Injection on the basis of the control group at the early stage of rescue, 100 mL added into 5% glucose solution 250 mL, once daily. Patients in two groups were treated for 1 week. After treatment, the cardiac index and blood lactate, GCS scores, and mortality rate in two groups were compared. Results After treatment, the cardiac indexes at 24, 48, and 72 h in two groups were higher than those at 1 h in the same group, but the blood lactate at 12, 24, 48, and 72 in two groups were lower than those at 1 h in the same group, and the difference was statistically significant in the same group (P < 0.05).The cardiac indexes at 48 and 72 h in the treatment group were higher than that at the same time in the control group, the blood lactates at 24, 48, and 72 in the treatment group were lower than those at the same time in the control group, with significant difference between two groups (P < 0.05). After treatment, the GCS scores at 5th and 7th day in the control group were higher than those at the first day in the same group, the GCS scores on day 3, 5 and 7 in the treatment group were higher than those on day 1 in the same group, and the difference was statistically significant in the same group (P < 0.05). And the GCS scores on day 3, 5 and 7 in the treatment group were higher than those at the same time in the control group,with significant difference between two groups (P < 0.05). After treatment, the 28 d mortality rates in the control and treatment groups were 46.43% and 37.93%, respectively, and there was difference between two groups (P < 0.05). Conclusion Shenfu Injection can improve the curative effect of cardiopulmonary resuscitation, increase cardiac index, decrease blood lactate, improve brain damage, and induce mortality rate, which has a certain clinical application value.
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