标题：纳美芬联合亚低温治疗对心肺脑复苏患者预后的影响

      作者：张晓磊 1，廉富 1，王冠 2，安伟伟 1
    (天津中医药大学第二附属医院重症医学科 1、神经外科 2，天津 300150)

      卷次： 2016年27卷6期

      【摘要】 目的 探讨纳美芬联合亚低温治疗对心肺脑复苏患者预后的影响。方法 选取2013年1月至2014
年12月本院急诊及临床科室转入我科 ICU的80例心肺复苏成功患者，按照不同病因分别采用随机数字表法分为
观察组对照组各40例，观察组应用纳美芬联合亚低温治疗，对照组仅应用亚低温治疗，观察两组患者的预后情况。
结果 两组心肺复苏患者即刻血乳酸、格拉斯哥昏迷指数(GCS评分)、急性生理与慢性健康-Ⅱ评分(APACHEⅡ)
比较差异无统计学意义(P>0.05)；两组患者治疗72 h均能明显改善心肺复苏患者的血乳酸水平及APACHEⅡ评分，
并能提高GCS评分，差异均有统计学意义(P<0.05)，且治疗后观察组与对照组比较，血乳酸[(3.72±1.02) mmol/L vs
(4.00±0.84) mmol/L]，GCS评分[(7.12±2.14)分 vs (5.03±1.62)分]，APACHEⅡ评分[(16.00±3.73)分 vs (18.90±2.54)分]
的治疗效果更佳，差异均有统计学意义(P<0.05)；7 d内观察组病死率为20.0% (8/40)，低于对照组的40.0% (16/40)，
差异有统计学意义(P<0.05)。结论 纳美芬联合亚低温治疗能改善心肺脑复苏患者的神经功能和组织脏器功能衰
竭状态，降低神经系统的后遗症，提高患者短期预后。

      【关键词】 心肺复苏；纳美芬；亚低温治疗；预后

      【中图分类号】 R605.97 【文献标识码】 A 【文章编号】 1003—6350（2016）06—0901—03


Effect of nalmefene combined with mild hypothermia therapy on the prognosis of patients with cardiopulmonary
resuscitation.
ZHANG Xiao-lei 1, LIAN Fu 1, WANG Guan 2, An Wei-wei 1. Intensive Care Unit 1, Department of
Neurosurgery 2, the Second Affiliated Hospital of Tianjin University of TCM, Tianjin 300150, CHINA

【Abstract】 Objective To investigate the effects of nalmefene combined with mild hypothermia therapy on the
prognosis of patients with cardiopulmonary resuscitation (CPR). Methods Eighty patients with successful cardiopul-
monary resuscitation who were transferred from clinical departments and Emergency Department into ICU from January
2013 to Dec. 2014 were included in the study. The patients were divided into the observation group and the control
group according to a random number table, with 40 cases in each group. The observation group applied nalmefene com-
bined with mild hypothermia therapy for treatment, while the control group only used mild hypothermia therapy. The
prognosis of the patients in the two groups was observed. Results After CPR, blood lactic acid, Glasgow Coma Scale
(GCS) score, acute physiology and chronic health evaluation (APACHEⅡ) score showed no statistically significant dif-
ference between the two groups (P>0.05). 72 h treatment can significantly improve the blood lactate level and APACHE
Ⅱ score, as well as the GCS score (P<0.05). Compared with control group, the observation group had significantly better
blood lactic acid [(3.72±1.02) vs (4.00±0.84)], GCS score [(7.12±2.14) vs (5.03±1.62)], APACHEⅡ score [(16.00±3.73)
vs (18.90±2.54)], P<0.05. The mortality within 7 days of the observation group (20.0%, 8/40) was significantly lower
than that of the control group (40.0%, 16/40), P<0.05. Conclusion Nalmefene combined with mild hypothermia thera-
py can improve cardiopulmonary cerebral resuscitation in patients with neurological function and organ failure, reduce
neurological sequelae, and improve the short-term prognosis.

      【Key words】 Cardiopulmonary resuscitation; Nalmefene; Mild hypothermia therapy; Prognosis
·论 著·
6350.2016.06.014