插入式腹主动脉按压对心搏骤停兔复苏效果的观察  

The impact of interrupted abdominal aorta compression on resuscitation effects of cardiac arrest rabbit

作　　者：郭成成[1] 王立祥[2] 刘惠亮[3] 窦微微[2] 刘亚华[2] 马立芝[2] 孙鲲[2] 马文君[2] 郭晓东[2] 

机构地区：[1]徐州医学院,江苏221006 [2]武警总医院急救医学中心,北京100039 [3]武警总医院心内科,北京100039

出　　处：《中华危重病急救医学》2013年第2期96-98,共3页Chinese Critical Care Medicine

摘　　要：目的探讨插入式腹主动脉按压心肺复苏法（IAAC—CPR）作为一种新的心肺复苏（CPR）方法，能否改善心搏骤停（CA）兔的复苏效果。方法28只新西兰大白兔按随机数字表法分为标准心肺复苏组（STD—CPR，胸外按压）和IAAC—CPR组（于胸外按压间歇期给予腹主动脉按压），每组14只。冰氯化钾诱导CA模型，CA持续3min后实施复苏。持续监测动物心电图、血流动力学指标，记录两组动物基础状态及复苏过程中主动脉收缩压、右房压直至实验结束；比较两组动物平均动脉压（MAP）、冠状动脉灌注压（CPP）和自主循环恢复（ROSC）等指标。结果与STD—CPR组比较，[AAC—CPR组复苏2min内（无升压药物干预）MAP（mmHg，1mmHg=0．133kPa）明显升高（30S：46．0±12．6比30．0±12．2，60s：57．0±15．6比31．9±9．7，90s：61．9±14．4比36．0±9．8，120s：63．1±12．6比37．8±11．1，均P〈0．05）；CPP（mmHg）也明显升高（30s：29．9±17．4比14．1±11．0，60S：43．1±22．4比14．3±9．8，90S：46．7±20．1比15．9±7．7，120s：50．5±21．0比17．3±9．9，均P〈0．05）；ROSC时间（S）明显提前（212．1±43．4比307．3±51．2，P〈0．05），复苏成功率明显升高（85．7％比42．8％，P〈0．05）；ROSC率和24h、48h存活率也均升高，但差异均无统计学意义。所有动物实验后尸检未见明显腹部器官损伤。结论于胸外按压间歇期给予腹主动脉按压（即IAAC—CPR），能增加CA兔的MAP、CPP及复苏成功率，有效改善复苏预后。Objective To determine whether interrupted abdominal aorta compression-cardiopulmonary resuscitation （IAAC-CPR）, as an new cardiopulmonary resuscitation （CPR） method, can improve resuscitation effects on rabbits with cardiac arrest （CA）. Methods Twenty-eight New Zealand rabbits were randomly divided into two groups in equal number （n = 14）, and they were resuscitated either by standard CPR （STD-CPR, external chest compression ） or by IAAC-CPR （ abdominal aorta compression at intermission of external chest compression ）. CA model was reproduced by injection of iced-potassium chloride, and it was maintained for 3 minutes before resuscitation. Electrocardiogram （ECG）, hemodynamic indexes were monitored continuously. Aortic systolic pressure and right atrial pressure at baseline and during resuscitation were recorded. Mean arterial pressure （MAP）, coronary peffusion pressure （CPP） and recovery of spontaneous circulation （ROSC） indexes were compared between two groups. Results Compared with STD-CPR group, MAP （ram Hg, 1 mm Hg=0.133 kPa） within 2 minutes of resuscitation （without drugs intervention） in the IAAC-CPR group was significantly increased （30 s： 46.0 ± 12.6 vs. 30.0 ± 12.2, 60 s： 57.0 ± 15.6 vs. 31.9 ±9.7, 90 s： 61.9 ± 14.4 vs. 36.0 ±9.8, 120 s： 63.1 ± 12.6 vs. 37.8 ± 11.1, all P〈0.05）, and CPP （mm Hg） was also significantly increased （30 s： 29.9 ± 17.4 vs. 14.1 ± 11.0, 60 s： 43.1 ± 22.4 vs. 14.3 ± 9.8, 90 s： 46.7 ±20.1 vs. 15.9 ±7.7, 120 s： 50.5 ±21.0 vs. 17.3 ±9.9, all P〈0.05）, the time of ROSC （s） was earlier （212.1 ± 43.4 vs. 307.3 ± 51.2, P〈0.05 ）, and successful resuscitation rate was significantly higher （ 85.7% vs. 42.8%, P〈0.05 ）. However, there were no statistical differences in ROSC rate and the survivor rate at 24 hours and 48 hours between the two groups, though they were increased. No abdominal organs injury was found in all animals by postmortem study. Conclusion Abdominal aorta com

关 键 词：插入式腹主动脉按压 平均动脉压 冠状动脉灌注压 心肺复苏 

分 类 号：R541.78[医药卫生—心血管疾病]