肾上腺素联合血管加压素在窒息家兔心肺复苏中的应用  

Application of the Combination of Epinephrine and Vasopressin in Asphyxial Rabbit Models of Cardiopulmonary Resuscitation

作　　者：欧好[1] 杨明施[1] 孙蓓[2] 彭玥[1] 

机构地区：[1]中南大学湘雅三医院ICU,湖南长沙410013 [2]中南大学湘雅医院麻醉科,湖南长沙410008

出　　处：《医学临床研究》2006年第7期1032-1035,共4页Journal of Clinical Research

摘　　要：【目的】观察心肺复苏(Cardiopulmonary resuscitation,CPR)时单独使用肾上腺素、血管加压素以及联合用药对冠脉灌注压(Coronary Perfusion Pressure,CPP)以及自主循环恢复(Restoration of SpontaneousCirculation,ROSC)的影响,比较不同血管升压药物对窒息型心跳停搏家兔心肺复苏的疗效。【方法】40只家兔均在呼气末夹闭气管8 min,制作窒息型心跳停搏模型后,开始心肺复苏。家兔分为4组,分别予生理盐水、肾上腺素(45μg/kg)、血管加压素(0.8 U/kg)和联合用药(肾上腺素45μg/kg+血管加压素0.8 U/kg)。【结果】ROSC家兔在复苏期间的CPP明显高于复苏失败组(P<0.01)。联合用药组的CPP在DA1后各时点均显著高于另3组(P<0.01);ROSC率及2 h生存率均显著高于对照组及血管加压素组(P<0.05)。在存活家兔中,肾上腺素组自主循环恢复时间及使用的肾上腺素平均剂量均显著高于联合用药组(P<0.05)。【结论】有效提高CPP对自主循环恢复意义重大。在窒息型心跳停搏家兔心肺复苏期间,联合使用肾上腺素与血管加压素能显著提高冠脉灌注压和复苏成功率;且有效减少肾上腺素的用量,缩短自主循环恢复时间。[Objective]To evaluate the coronary perfusion pressure （CPP）and restoration of spontaneous circulation （ROSC）after cardiopulmonary resuscitation with epinephrine, vasopressin and the combination of both agents in asphyxial rabbit models . [Methods]At about 8 minutes after the endotracheal tube had been clamped, cardiac arrest was present in 40 rabbits. After basic life support cardiopulmonary resuscitation , rabbits were randomly assigned to receive normal saline , epinephrine （45 μg/kg）, vasopressin（0.8 U/kg） and epinephrine（45 μg/kg） combination with vasopressin（0.8U/kg）. [Results]The CPP of the ROSC cases was significantly higher than of the failure cases during CPR（ P 〈0.01 ）. A statistical difference of CPP between combination group and the rest three groups after DA1 （ P 〈0. 01 ）. The rate of ROSC and two-hour survival in combination group were significantly higher than normal saline group and vasopressin group（ P 〈0.05）. In surviving cases, the time of ROSC and the average doses of epinephrine in epinephrine group were remarkably higher than combination group （ P 〈0.05）. [Conclusion]It is crucial to improve CPP effectively for ROSC. During CPR in asphyxial rabbit models, the administration of epinephrine combined with vasopressin can significantly increase CPP and the rate of survival. At the same time, it can decrease the dose of epinephrine effectively and shorten the time of ROSC.

关 键 词：心肺复苏术 窒息 肾上腺素 血管升压素类 兔 

分 类 号：R605.974[医药卫生—急诊医学]