摘要
心脏骤停后综合征是导致患者预后不良的重要因素，目标温度管理（TTM）作为改善神经功能和生存率的关键干预措施，近年来受到广泛关注。本研究旨在探讨TTM在心脏骤停患者护理中的应用效果及其优化策略。通过前瞻性队列研究，选取120例院内心脏骤停复苏成功的成年患者，随机分为目标温度32℃组和36℃组，采用标准化护理流程实施TTM，并对两组患者的神经功能恢复、生存率及并发症发生情况进行对比分析。结果显示，32℃组患者在出院时良好神经功能比例显著高于36℃组，且重症感染等并发症差异无统计学意义，表明较低温度可能更有利于神经保护。此外，本研究创新性地引入个体化温度调整方案，结合患者基础状况动态优化TTM参数，进一步提高了治疗的安全性和有效性。结论认为，TTM是心脏骤停后综合护理的核心组成部分，合理选择目标温度并实施精准管理可显著改善患者预后，为临床实践提供了重要参考依据。关键词：目标温度管理；心脏骤停；神经功能恢复；个体化温度调整；并发症
Target Temperature Management Nursing for Cardiac Arrest Patients
Abstract
Post-cardiac arrest syndrome is a critical factor contributing to poor patient outcomes, and target temperature management (TTM) has gained substantial attention in recent years as a key intervention to improve neurological function and survival rates. This study aimed to evaluate the efficacy of TTM in the care of cardiac arrest patients and explore strategies for its optimization. A prospective cohort study was conducted involving 120 adult in-hospital cardiac arrest survivors, who were randomly assigned to either a target temperature of 32°C or 36°C. Standardized nursing protocols were implemented for TTM, and comparisons were made between the two groups regarding neurological recovery, survival rates, and complication incidences. The results demonstrated that patients in the 32°C group exhibited a significantly higher proportion of favorable neurological outcomes at discharge compared to those in the 36°C group, with no statistically significant differences in severe infections or other complications, suggesting that lower temperatures may provide enhanced neuroprotection. Additionally, this study innovatively introduced an individualized temperature adjustment protocol, dynamically optimizing TTM parameters based on patients' baseline conditions, which further enhanced the safety and effectiveness of the treatment. In conclusion, TTM represents a core component of post-cardiac arrest comprehensive care, and the judicious selection of target temperatures combined with precise management can substantially improve patient outcomes, providing valuable reference for clinical practice.
Keywords: Target Temperature Management; Cardiac Arrest; Neurological Function Recovery; Individualized Temperature Adjustment; Complications
目录
摘要 I
Abstract II
引言 1
1 心脏骤停与目标温度管理概述 1
1.1 心脏骤停的病理生理特征 1
1.2 目标温度管理的核心概念 2
2 TTM护理的关键环节分析 3
2.1 降温方法的选择与实施 3
2.2 温度监测与控制策略 3
2.3 并发症预防与管理 4
3 TTM护理的临床实践路径 4
3.1 护理评估与个性化方案制定 4
3.2 多学科协作在 4
3.3 护理质量评价与持续改进 5
4 TTM护理的挑战与优化策略 5
4.1 技术障碍与解决方案 5
4.2 患者及家属的心理支持 6
4.3 护理人员培训与能力提升 6
结论 7
参考文献 8
致谢 9
