安宫牛黄丸在心脏骤停患者心肺复苏术后的应用效果分析

目的 观察安宫牛黄丸在急诊心脏骤停(cardiac arrest,CA)患者心肺复苏术(cardiopulmonary resuscitation,CPR)后的应用价值,以期为CA的临床救治提供试验依据.方法 将2017年8月—2019年6月杭州师范大学附属医院收治的心脏骤停后恢复自主循环(cardiac arrest...

Application effect of Angong Niuhuang Pills in patients with cardiac arrest after cardiopulmonary resuscitation

  Objective  To observe the application value of Angong Niuhuang Pills in patients with emergency cardiac arrest (CA) after cardiopulmonary resuscitation (CPR).  Methods  Total 90 patients with CA and return of spontaneous circulation (CA-ROSC) who were admitted to the General Intensive Care Unit (GICU) of Affiliated Hospital of Hangzhou Normal University from August 2017 to June 2019 were equally divided into observation groups (n=45) and the control group (n=45) by random number table method. The control group was treated with intravenous drip of naloxone immediately after ROSC, while the observation group was treated with Angong Niuhuang Pills based on the treatment of control group. Both groups were treated for 1 week. The cerebral metabolic rate for oxygen (CMRO₂), oxidative stress injury, serum S100β and matrix metalloproteinase-9 (MMP-9) levels and prognosis were compared between the 2 groups.  Results  At 3 d and 7 d after treatment, CMRO₂ of the observation group was significantly higher than that of the control group (P < 0.05). After treatment, superoxide dismutase [(96.45±9.47) U/mL] and glutathione peroxidase [(82.58±11.49) U/L] of observation group were significantly higher, while malondialdehyde [(9.52±1.88) nmol/mL] was significantly lower, compared with those of the control group [(84.25±8.87) U/mL, (73.60±10.75) U/L, (11.03±3.06) nmol/mL, all P < 0.05]. After treatment, S100β and MMP-9 were significantly lower in the observation group than those in the control group. The proportion of successful cerebral resuscitation in the observation group was significantly higher than that in the control group, and successful cerebral resuscitation time was significantly shorter than the control group. After treatment, the Glasgow Coma Scale (GCS) scores of observation group were significantly higher but the Glasgow-Pittsburgh cerebral performance categories (CPC) scores were significantly lower, compared with the control group (all P < 0.05).  Conclusion  Angong Niuhuang Pills can effectively improve cerebral oxygen metabolism and reduce oxidative stress injury and brain injury in patients with CA after CPR, which is conductive to the prognosis.