猪开腹心搏骤停两种复苏方法效果比较  

Comparison of two cardiopulmonary resuscitation methods during laparotomy in cardiac arrest of swine

作　　者：刘亚华[1] 梁立武[1] 李小萍[2] 李秀满[1] 郭晓东[1] 陈充抒[1] 王立祥[1] 

机构地区：[1]武警总医院,北京00039 [2]武警医学编辑部,北京00039

出　　处：《武警医学》2012年第12期1017-1019,共3页Medical Journal of the Chinese People's Armed Police Force

摘　　要：目的探讨胸外按压和经膈肌下抬挤心肺复苏(cardiopulmonary resuscitation,CPR)方法对开腹术中心搏骤停猪通气和循环的影响。方法健康家猪14只,麻醉后气管插管,行开腹术后用窒息法建立猪心搏骤停模型,随机分组后进行胸外按压和经膈肌下抬挤CPR,测定并比较两种方法复苏时心搏骤停猪的潮气量(VT)、呼气末二氧化碳分压(PETCO2)、经皮血氧饱和度(SpO2)、按压期动脉压(AOS)、放松期动脉压(AOD)、右房压(RAP)和冠状动脉灌注压(CPP)。结果与胸外按压CPR比较,经膈肌下抬挤CPR法所测得的VT较大,差异有统计学意义[53.8±4.02)vs(40.61±2.58),P<0.01];经膈肌下抬挤CPR比胸外按压产生更高的CPP,差异有统计学意义[(39.37±1.79)vs(25.66±1.73),P<0.01]。结论经膈肌下抬挤CPR比标准CPR产生较高的冠脉灌注压和肺通气。Objective To compare the hemodynamic response and ventilation after standard cardiopulmonary resuscitation（S-CPR） and cardiac massage under the diaphragmatic muscle（D-CPR）during laparotomy in cardiac arrest of swine.Methods Fourteen healthy domestic pigs were anesthetized and intubated.After preoperotive preparation and the hemodynamics was stable for 5 minutes,the readings of aortic systolic pressure（AOS）,aortic diastolic pressure（AOD）,and right atrial pressure（RAP） were recorded consecutively.Pigs were randomized to receive either S-CPR（n=7） or D-CPR（n=7）.Cardiac arrest was induced with overdosed bupivacaine.After 2 min of untreated time,they were resuscitated,and hemodynamic variables,PETCO2,VT and ECG were continuously recorded.Coronary perfusion pressure（CPP） was calculated as arterial diastolic pressure minus right atrial diastolic pressure.Results D-CPR during cardiac massage,compared with S-CPR,resulted in a significant increase in VT,DAP and CPP.Conclusions D-CPR can provide higher arterial pressure and ventilation;D-CPR is superior to S-CPR.

关 键 词：胸外按压 经膈肌下抬挤 潮气量 冠脉灌注压 

分 类 号：R605.974[医药卫生—急诊医学]