血氧饱和度引导下供氧对心搏骤停复苏自主循环恢复患者神经功能的影响

目的：观察血氧饱和度引导下供氧对心搏骤停复苏自主循环恢复（ROSC）患者神经功能的影响。方法：将ROSC患者102例随机分为对照组和试验组，各51例。复苏后在机械通气支持下，在10min内两组均给予100％FiO2，在随后的1h内．对照组和试验组分别实施继续纯氧供氧与根据脉冲血氧饱和度调整吸人氧浓度，使血氧饱和度达到94％～96％供氧，并比较两组复苏后血清SOD、MDA以及APACHEH评分和临床转归情况。结果：试验组复苏后第1、2周的SOD[（121．8±38．5）mU/L，（147．5±42．1）mU／L]显著高于对照组[（95．3±35．7）mU/L，（128．7±40．8）mU／L]（P〈0．05），而试验组MDA[（13．57±5．04）mmol／L，（11．12±3．89）mmol／L]显著低于对照组[（16．13±4．99）mmol／L，（13．59±4．20）mmol／L]（P〈0．05）；复苏后第3天试验组APACHEⅡ评分[（12．26±4．98）分]显著低于对照组[（16．34±5．12）分]（P〈0．05）；复苏第28天试验组神经功能恢复正常和轻度障碍率（23．53％、21．57％）显著高于对照组（9．80％、7．84％），而植物状态和死亡率（7．84％、37．25％）显著低于对照组（15．69％、56．86％），差异均有统计学意义（均P〈0．05）。结论：血氧饱和度引下供氧可改善心搏骤停复苏自主循环恢复患者神经功能预后。

Effects of oximetry-guided oxygenation on the neurological outcome of ROSC patients after cardiac arrest

Objective： To observe the effects of oximetry-guided oxygenation on the neurological outcome of ROSC patients after cardiac arrest. Methods： 102 cases of ROSC patients were randomly divided into control group and experiment group, with 51 cases in each group. After resuscitation, the control group and experiment group was respectively given 1-hour additional ventilation on 100% FiO2 and rapid lowering of arterial 02 saturation to 94%-96% with pulse oximeter guidance. The serum SOD, MDA, APACHE Ⅱ score and clinical outcomes were compared in the two groups. Results： The SOD of the experiment group at weekl and week2 after rescusitation [（121.8±38.5）mU/L, （147.5±42.1）mU/L] was significandy higher than that of the control group- [（95.3±35.7）mU/L, （128.7±40.8）mU/L] （P〈0.05）, and the MDA of the experiment group [（13.57±5.04）mmol/L, （ll.12±3.89）mmol/L] was significantly lower than that of the control group [（16.13±4.99） mmol/L, （13.59±4.20）mmol/L] （P〈0.05）. The APACHE Ⅱ score of the experiment group at Day3 after resuscitation （12.26± 4.98） was significantly lower than that of the eontrol group （16.34±5.12） （P〈0.05）. At Day28, the rate of patients in the experiment group who had normal or mild impaired neurological function （23.53%, 21.57%） was significantly higher than that in the control group （9.80%, 7.84%）, and the rate of patients in the experiment group who were vegetative state or dead （7.84%, 37.25%） was significantly lower than that in the control group （15.69%, 56.86%）. All the differences above had statistical significance （all P〈0.05）. Conelusion： Oximctry-guided oxygenation can improve the neurological prognosis of ROSC patients.