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目的:比较心肺复苏后不同觉醒状态患者颅脑MR的变化。方法:选择2014-2016年内院前收入中山大学附属东莞东华医院ICU/EICU的心搏骤停患者,自主循环恢复后评估GCSP以及行颅脑MRI检查。比较不同觉醒状态组间患者的颅脑损伤部位以及ADC值。结果:自2014年6月1日至2016年1月1日,共纳入患者43人,其中男性27人,女性16人。其中达到神志清/微小意识状态13人,持续植物状态30人。其中神志清/微小意识状态组患者的总复苏时间、肾上腺素用量均小于持续植物状态组,有统计学差异。颅脑MR结果显示复苏后以丘脑、额顶叶皮质损伤最明显。神志清以及微小意识状态组不同脑区的ADC值均显著高于植物状态组。结论:MRI可以作为判断心肺复苏后患者脑损伤范围的一项重要手段,通过测定不同脑区的ADC值对评估患者预后有一定帮助。
Objective: To compare the changes of brain MR in patients with different awakening status after cardiopulmonary resuscitation. METHODS: Patients with ICU / EICU cardiac arrest at Sun Yat-sen University Affiliated Sun Yat-sen University from 2014 to 2016 were enrolled in this study. GCSP was assessed after spontaneous circulation recovery and brain MRI was performed. The brain injury and ADC values were compared between different groups. Results: From June 1, 2014 to January 1, 2016, a total of 43 patients were enrolled, including 27 males and 16 females. Among them, 13 were attained in the state of consciousness / minor consciousness and 30 were in continuous state of plant. Among them, the total recovery time and the dosage of epinephrine in the patients with state of consciousness / slight consciousness were all less than those in the group of continuing plants, with statistical difference. Brain MR results showed that the recovery of the thalamus, frontal cortex damage the most obvious. The ADC values of different brain regions in conscious group and small conscious group were significantly higher than those in plant state group. Conclusion: MRI can be used as an important measure to determine the extent of brain injury in patients after cardiopulmonary resuscitation. To assess the prognosis of patients by measuring the ADC value of different brain regions is helpful.