脑死亡病人声门前输氧对自主心律与心电变化的影响  

Effect of oxygen therapy by nasal cannula at preglottis on spontaneous cardiac rhythm and changes of ECG in patients with brain death

作　　者：苏雪娥[1] 林俊敏[1] 曾量波[1] 苏桂彪[1] 吴少巧[1] 李平[1] 潘卫红[1] 

机构地区：[1]广州医学院第一附属医院急诊科,广州510120

出　　处：《岭南心血管病杂志》2006年第2期115-117,共3页South China Journal of Cardiovascular Diseases

摘　　要：目的观察脑死亡病人经鼻导管声门前输氧对自主心律的影响,探索呼吸停止后经鼻导管声门前供氧在心肺复苏术中的作用。方法脑死亡患者15例,因大量脑出血或心性猝死在院外延缓复苏所致,经积极抢救12h以上,应其亲属要求,终止人工通气,立即插鼻导管至声门前输氧,氧流量10L/min,听心音,观察心电监护仪心律及心电变化至等电线。结果从窦性心动过速至心脏停搏时间7～47(26±9)min。心电活动从窦性心律至心电静止12例,无脉电活动2例,短暂心室颤动1例。结论脑死亡患者停止人工通气经鼻导管声门前输氧,自主心搏可继续维持7min以上。Objectives To obverse the influence of oxygen therapy by nasal eannula at preglottis on spontaneous cardiac rhythm in the patients with brain death and to investigate its effects on the above patients followed with respiratory arrest during eardiopulmonary resuscitation （CPR）. Methods Through more than 12h positive rescue, at the request of their relatives, the patients （15 eases） with brain death due to delayed-resuscitation in pre-hospital suffered from massive cerebral hemorrhage or sudden cardiac death, were given up artificial ventilation and supplied with oxygen （10 L/min）by nasal cannulation at preglottis immediately. Special doctors were assigned to listen to the heartbeat and the other to observe the variation of the heart rhythm by ECG monitor until it get down to the isoeleetrie line. All the results were taken down carefully. Results The duration from sinus taehyeardia to cardiac arrest was 7 minutes at least and 47 minutes at most. The mean was （26±9） minutes. In the course of ECG evolution into electro-cardiac arrest, 12 eases showed slower and slower sinus rhythm, 2 eases showed electrical activity with pulseless, and 1 case showed transient ventricular fibrillation. Conclusions Given up artifieial ventilation and supplied with oxygen by nasal cannula at pre glottis, the spontaneous heartbeat in the patients with brain death can maintain more than 7 minutes.

关 键 词：呼吸停止 脑死亡 心脏停搏 心肺复苏 输氧 声门前 

分 类 号：R605.974[医药卫生—急诊医学]