Effect of bundles of care on cerebral resuscitation after cardio-pulmonary resuscitation
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摘要:
目的 研究院内心肺复苏患者进行集束化管理后脑复苏中的临床疗效及相关脑脊液生化指标差异评价。 方法 将我院2015年3月~2018年3月住院期间发生的160例心跳骤停患者在心肺复苏成功后根据后续管理方法随机分为对照组（常规管理）和实验组（集束化管理），比较两组患者脑复苏情况满意度，并在复苏后第2周时检查患者脑脊液NSE、S-100β、ICAM-1、FIB以评价两组间患者的脑复苏效果差异。 结果 集束化管理组患者的脑复苏疗效满意度明显优于常规管理组（满意：χ2=6.328，P=0.012；较满意：χ2=3.999，P=0.046）；集束化管理组患者的经过治疗2周时脑脊液生化指标NSE、S-100β、ICAM-1、FIB均低于常规管理组（P<0.001）。 结论 集束化管理在心肺复苏患者的管理中有良好的临床应用价值，能够提高患者脑复苏效果的满意度，能改善患者脑脊液中相关生化指标水平。 Abstract:Objective To explore the clinical value of bundles of care in cerebral resuscitation after cardio-pulmonary resuscitation and some related biochemical index of cerebrospinal fluid difference. Method A total of 160 cardiac arrest cases from 2015 to 2018 were divided into two groups based on different management method after cardio-pulmonary resuscitation: control group (normal management) and experimental group (bundles of care). The satisfaction degree of cerebral resuscitation between two groups was compared. The clinical value of bundles of care in clinical practicing was evaluated. The NSE、S-100β、ICAM-1、FIB level in cerebrospinal fluid in two groups were checked after treatment. Results The satisfaction degree of experimental group was significantly higher than that of control group (Well satisfied: χ2=6.328, P=0.012; More satisfied: χ2=3.999, P=0.046). The level of NSE、S-100β、ICAM-1、FIB of cerebrospinal fluid were lower than that of control group. Conclusion Bundles of care is worthy of using in clinical cardio-pulmonary resuscitation. It could increase the satisfaction degree of cerebral resuscitation after cardio-pulmonary resuscitation. Bundles of care can improve the circumstance of related biochemical index in cerebrospinal fluid. -
Key words:
- bundles of care /
- cardio-pulmonary resuscitation /
- cerebral resuscitation
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表 1 实验组和对照组不同脑复苏疗效情况比较（n=80，%）
分组 满意 较满意 欠佳 不满意 死亡 对照组 14（17.50） 17（21.25） 18（22.50） 15（18.75） 10（12.50） 实验组 28（35.00） 29（36.25） 13（16.25） 8（10.00） 4（5.00） χ2 6.328 3.999 1.000 9.001 3.606 P 0.012 0.046 0.317 0.003 0.058 
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表 2 治疗后第2周时实验组和对照组脑脊液相关生化指标比较（n=80，Mean±SD）
分组 NSE（g/L） S-100β（ug/L） ICAM-1（ng/L） FIB（g/L） 对照组 21.54±4.74 1.38±0.47 3.74±0.55 2.92±0.59 实验组 17.92±3.91 0.55±0.30 1.83±0.37 2.09±0.54 t 5.274 13.401 25.916 9.354 P <0.001 <0.001 <0.001 <0.001
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