心脏直视手术中心脏复苏困难的处理  

The management of refractory cardiac resuscitation in open cardiac operation

作　　者：廖永德[1] 张本固[1] 葛酉新[1] 赵金平[1] 严华[1] 陈夏丰[1] 

机构地区：[1]同济医科大学附属同济医院

出　　处：《中国危重病急救医学》1997年第8期475-477,共3页Chinese Critical Care Medicine

摘　　要：目的：为提高心脏直视手术中心脏复苏率。方法：总结２０例心脏直视手术中心脏复苏困难的处理经验。结果：胸内心脏挤压和中等剂量心脏兴奋剂有利于心脏手术中的心脏复苏；心肌出现粗颤即应尽早除颤，不宜片面追求较高的心脏自动复跳率。对复苏困难病例，依其不同情况，在常规复苏方法的基础上，可采用一些特殊复苏措施，包括消除导致复苏困难的原因、长时间心脏挤压和长时间体外循环辅助、采用外科手段等。结论：有多种因素影响心脏直视手术中的心脏复苏，正确分析判断复苏困难的特殊原因，恰当地采用综合性措施（包括外科手段）进行复苏可收到良好效果。Objective:To improve cardiac resuscitation rate in patients with open cardiac operation.Methods:The subjects of this study were 20 patients with refractory cardiac resuscitation in open cardiac operation.Results:It showed that cardiac massage and administration of positively inotropic agents with moderate dose would be effective to the cardiac resuscitation in cardiac operation,and electric defibrillation should be taken when rough myocardial fibrillation appeared instead of waiting for spontaneous cardiac resuscitation.Special methods were taken when the cardiac resuscitation in open cardiac operation was refractory to the management of conventional resuscitative methods.The special methods included elimination the cause of refractory cardiac resuscitation,continuing the cardiac massage and the extracorporeal circulation support for a long time,and application of surgical methods.Conclusions:There are multiple factors to affect the cardiac resuscitation in open cardiac operation.It is important to early recognize causes of refractory cardiac resuscitation,and combined resuscitative methods,including surgical methods,should be taken in open cardiac operation correspondingly.

关 键 词：心脏直视手术 心脏复苏 复苏方法 

分 类 号：R654.2[医药卫生—外科学]