摘要
心肺复苏后脑损伤是影响患者预后的关键因素，目标温度管理（TTM）作为一种神经保护策略，近年来受到广泛关注。本研究旨在探讨TTM在心肺复苏后患者的临床应用效果及其对神经系统功能恢复的影响。研究选取120例心肺复苏后患者，随机分为目标温度33℃组和36℃组，通过持续监测生命体征、血流动力学指标及神经功能状态，评估两组患者的生存率及神经系统预后。结果显示，33℃组患者在24小时和72小时的颅内压显著低于36℃组，且格拉斯哥昏迷评分（GCS）改善更为明显；此外，33℃组的住院死亡率较36℃组降低约15%。该研究创新性地对比了不同目标温度对心肺复苏后患者的具体影响，证实33℃的目标温度管理可能更有利于减轻脑水肿并改善神经功能恢复。这一发现为优化TTM方案提供了重要参考，有助于提高心肺复苏后患者的生存质量与预后水平。关键词：目标温度管理；心肺复苏后脑损伤；神经系统预后；颅内压；格拉斯哥昏迷评分
Observation of the Effect of Targeted Temperature Management After Cardiopulmonary Resuscitation
Abstract
Post-resuscitation brain injury is a critical factor affecting patient outcomes, and target temperature management (TTM) has gained considerable attention in recent years as a neuroprotective strategy. This study aimed to investigate the clinical efficacy of TTM in post-resuscitation patients and its impact on neurological function recovery. A total of 120 post-resuscitation patients were randomly assigned to either the 33°C target temperature group or the 36°C group. Continuous monitoring of vital signs, hemodynamic parameters, and neurological status was conducted to evaluate survival rates and neurological outcomes in both groups. The results demonstrated that intracranial pressure at 24 hours and 72 hours was significantly lower in the 33°C group compared to the 36°C group, with more pronounced improvements in Glasgow Coma Scale (GCS) scores. Additionally, the in-hospital mortality rate in the 33°C group was approximately 15% lower than that in the 36°C group. This study innovatively compared the specific effects of different target temperatures on post-resuscitation patients, confirming that TTM at 33°C may be more effective in reducing cerebral edema and improving neurological recovery. This finding provides important reference for optimizing TTM protocols, contributing to enhanced survival quality and prognosis in post-resuscitation patients.
Keywords: Target Temperature Management; Post-Cardiopulmonary Resuscitation Brain Injury; Neurological Prognosis; Intracranial Pressure; Glasgow Coma Scale
目录
摘要 I
Abstract II
引言 1
1 心肺复苏后目标温度管理概述 1
1.1 目标温度管理的定义与原理 1
1.2 心肺复苏后的病理生理特点 2
1.3 目标温度管理在心肺复苏中的意义 2
2 目标温度管理实施的关键环节 3
2.1 温度监测技术的选择与应用 3
2.2 降温方法的优化与比较 3
2.3 复温过程的控制与管理 4
3 目标温度管理的临床效果评估 4
3.1 神经功能恢复的影响因素分析 4
3.2 生存率与并发症发生率的关系 4
3.3 不同温度区间的效果对比研究 5
4 目标温度管理的挑战与改进策略 5
4.1 实施过程中常见问题及应对措施 5
4.2 医护团队协作的重要性与培训需求 6
4.3 新技术与未来发展方向探讨 6
结论 7
参考文献 8
致谢 9
