|
|
|
| Clinical effect of Shenfu Injection combined with mild hypothermia in the treatment of patients with cardiac arrest |
| WANG Jun HE Yaping AN Pengpeng QIU Zhipeng LU Zhaoxin ZHANG Sen ZHANG Yi SONG Yongxin |
| Department of Emergency, Qingdao Haici Medical Group, Shandong Province, Qingdao 266033, China |
|
|
|
Abstract Objective To observe the clinical effect of Shenfu Injection combined with mild hypothermia in the treatment of patients with cardiac arrest (CA). Methods A total of 138 patients with CA who admitted to Qingdao Haici Medical Group, Shandong Province from January 2015 to December 2018 were selected as research objects, and they were randomly divided into control group and observation group according to the random number table method, with 69 patients in each group. The control group was treated with mild hypothermia (32 - 34℃), and the observation group was given 100 mL Shenfu Injection intravenously on the basis of the control group. Superoxide dismutase (SOD), nitric oxide (NO), malondialdehyde (MDA), neuron specific enolase (NSE), human S100B protein (S-100B) were detected by enzyme-linked immunoassay at 30 min, 2 h, 12 h and 24 h after cardiopulmonary resuscitation. Cerebral oxygen metabolism indexes of patients were detected at 12, 24, 48 and 72 h after CA respectively, including arteriovenous oxygen content difference (Ca-jvO2), jugular bulb blood oxygen saturation (SjvO2) and cerebral oxygen uptake rate (CERO2). The Glasgow coma scale (GCS) was used to assess the coma status of the patients. The recovery efficiency and case fatality rate were calculated. Results Compared with 30 min after resuscitation, the levels of SOD and NO significantly decreased and the level of MDA significantly increased in the control group at 2, 12 and 24 h after resuscitation, with statistically significant differences (all P ＜ 0.05). Compared with 30 min after resuscitation, the level of SOD significantly decreased and the levels of NO and MDA significantly increased in the observation group at 2, 12 and 24 h after resuscitation, with statistically significant differences (all P ＜ 0.05). Compared with 30 min after resuscitation, the levels of NSE and S-100B in the two groups were significantly increased at 2, 12 and 24 h after resuscitation, and the differences were statistically significant (all P ＜ 0.05). At 2, 12 and 24 h after resuscitation, the levels of SOD and NO in the observation group were significantly higher than those in the control group, while the levels of MDA, NSE and S-100B in the observation group were significantly lower than those in the control group, with statistically significant differences (all P ＜ 0.05). Compared with CA at 12 h, the level of SjvO2 and GCS score were significantly increased at 24, 48 and 72 h after CA, while the level of Ca-jvO2 were significantly decreased in both groups, with statistically significant differences (all P ＜ 0.05). The level of CERO2 at 24 h after CA was significantly higher than that at 12 h, and that at 48 and 72 h after CA was significantly lower than that at 12 h. with statistically significant differences (all P ＜ 0.05). The levels of Ca-jvO2, CERO2 and GCS score in the observation group at 48 and 78 h after CA were significantly higher than those in the control group, while the level of SjvO2 were significantly lower than those in the control group, with statistically significant differences (all P ＜ 0.05). The effective rate of treatment in the observation group was significantly higher than that in the control group, while the case fatality rate was significantly lower than that in the control group, with statistically significant differences (all P ＜ 0.05). Conclusion Shenfu Injection combined with mild hypothermia has a significant protective effect on cardiopulmonary resuscitation myocardial tissue and brain tissue in patients with CA, and can significantly improve the prognosis.
|
|
|
|
|
|
[1] Lemaitre RN，King IB，Raghunathan TE，et al. Cell Membrane Trans-Fatty Acids and the Risk of Primary Cardiac Arrest [J]. Circulation，2002，105（6）：697-701.
[2] Correction To: Part 8: Post-Cardiac Arrest Care: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care [J]. Circulation，2017，136（10）：e197.
[3] 杜昌，余剑波.院外心搏骤停患者心肺复苏时间对其生存率的影响[J].中国老年学杂志，2018，38（3）：644-646.
[4] Newell C，Grier S，Soar J. Airway and ventilation management during cardiopulmonary resuscitation and after successful resuscitation [J]. Crit Care，2018，22（1）：190.
[5] G?觟kalp O，Be■ir Y，Iner H，et al. Extracorporeal cardiopulmonary resuscitation after pediatric cardiac surgery [J]. Anatol J Cardiol，2017，17（5）：414.
[6] Oh TK，Park YM，Do SH，et al. ROSC rates and live discharge rates after cardiopulmonary resuscitation by different CPR teams-a retrospective cohort study [J]. BMC Anesthesiol，2017，17（1）：166.
[7] 朱美华，张家敏，牛聪，等.参附注射液对止血带引起的下肢缺血-再灌注肺损伤的影响[J].临床麻醉学杂志，2017， 33（7）：680-682.
[8] 复旦大学上海医学院.《实用内科学》第13版[J].中国医刊，2009，44（12）：43.
[9] 姜良铎.中医急诊学[M].北京：人民卫生出版社，2012.
[10] 陈沛剑.2010年心肺复苏和心血管急救国际指南解读[J].中外健康文摘，2011，8（37）：76-77.
[11] 马立鑫，陈海滨.术前GCS在高血压基底节区脑出血术式选择中的意义[J].中国临床神经外科杂志，2010， 15（2）：110-112.
[12] 李浩浩.血必净注射液在心脏骤停心肺复苏后多器官功能障碍综合征治疗中的应用效果评价[J].内蒙古中医药，2018，37（12）：29-30.
[13] 杨梅.参附注射液对心脏骤停患者心脏功能影响的研究[J].陕西中医，2018，39（6）：717-719.
[14] 曾瑞峰，丁邦晗，赖芳，等.电针针刺足三里治疗复苏后综合征患者的临床研究[J].中国中医急症，2018，18（9）：1560-1563，1566.
[15] 李娟，张志明，雍文兴，等.补阳还五汤治疗心脏骤停后综合征40例[J].西部中医药，2015，28（2）：85-87.
[16] 杨勇，任长虹，吴晓丹.参附汤“心脑同治”理论初探[J].世界中医药，2014，9（10）：1286-1288.
[17] 朱金墙，梁钰彬，华声瑜，等.参附注射液的成分及其对心血管系统的药理作用研究进展[J].中成药，2014，36（4）：819-823.
[18] Nagase M，Sakurai A，Sugita A，et al. Oxidative stress and abnormal cholesterol metabolism in patients with post-cardiac arrest syndrome [J]. J Clin Biochem Nutr，2017， 61（2）：108-117.
[19] Vedovato N，Proks P，Rorsman OH，et al. Differential Met-abolic and Nucleotide Sensitivity of Beta-Cell and Cardiac K ATP Channels [J]. Biophysical Journal，2018，114（3）：203a-204a.
[20] Münzel T，Gori T，Keaney JF Jr，et al. Pathophysiological role of oxidative stress in systolic and diastolic heart failure and its therapeutic implications [J]. Eur Heart J，2015，36（38）：2555-2564.
[21] 于泽奇，江继鹏，董晓煜，等.颅脑创伤后脑脊液S100β、NSE动态变化与颅内压、脑灌注压的关系分析[J].中华神经创伤外科电子杂志，2017，3（3）：132-135.
[22] 张杰，王恩任，张列，等.尼莫地平在脑动脉瘤手术中的应用价值[J].疑难病杂志，2018，17（1）：42-45.
[23] 蔡珺，孙海云，沈宁，等.不同程度肝功能损害肝硬化患者肝移植围手术期脑氧代谢观测[J].中华移植杂志：电子版，2009，3（4）：298-301. |
|
|
|
