有效人工通气在心脏疾患致心搏骤停心肺脑复苏中价值的探讨  

Study about the value of artificial ventilation in cardiac pulmonary cerebral resuscitation (CPCR)for patients with cardiogenic cardiac arrest

作　　者：宋志芳[1] 郭晓红[1] 潘祝平[1] 王树云[1] 顾茵[1] 朱赟琳[1] 谢伟[1] 殷娜[1] 谢伟霖[1] 张悦[1] 单慧敏[1] 陈列彬[1] 李文华[1] 

机构地区：[1]上海第二医科大学附属新华医院内科ICU,上海200092

出　　处：《中国急救医学》2002年第3期135-137,共3页Chinese Journal of Critical Care Medicine

基　　金：上海市卫生局科技发展基金资助项目 (No 0 0 40 9)

摘　　要：目的　评价A(airway)、B(breath)、C(circulation)抢救步骤在心脏疾患致心搏骤停患者心肺脑复苏 (CPCR)中的价值。方法　收集因心脏疾患致心搏骤停行CPCR患者的临床资料 (4 4例 ,男 2 9例 ,女 15例 ,年龄 40～ 85岁 ,平均 70 .0± 11.6岁 ) ,按照CPCR实际操作过程中所采取的ABC先后顺序不同 ,将患者分为C、CAB、AB、ABC组。CAB组中 ,按照C与AB步骤采取的间隔时间不同 ,分 <5min、5～ 10min、>10min组。统计各组Ⅰ、Ⅱ、Ⅲ期复苏成功率 (% ) ,χ2 检验统计各组复苏成功率差异显著性。结果　C组 (32例次 ,11例 )中 ,各期复苏成功率均 >87.5 % ,显著高于其它各组 (P <0 .0 1)。CAB组 (2 4例 )C -AB间隔时间不等 ,各期复苏成功率不等 ,C -AB <5min组各期复苏成功率明显高于 >5min组 (P <0 .0 5～ 0 .0 1)。AB组 (3例 )与ABC组 (6例 )各期复苏成功率 33.3%～ 10 0 % ,显著高于CAB组 (P <0 .0 1)。结论　CAB是心脏疾患致心搏骤停患者CPCR中可取的抢救步骤 ,但Objective To evaluate the value of the rescue steps of ABC or other orders of them for patients with cardiac arrest from cardiac diseases and undergone CPCR(cardiac pulmonary cerebral resuscitation).Methods The clinical data from 44 cases,male/female 29/15,40～85(70.0±11.6)y. All of them were organic cardiac diseases. The patients had been divided into four groups of C?CAB?AB?ABC according to the different order for ABC steps during CPCR.On group of CAB patients were divided to another three groups of<5 min?5～10 min?>10 min according to the different periods between C and AB steps.The successful rate(%)of three stages for every grorp of them were analyzed respectively by χ 2 of statistic analysis in order to evaluate the significance of difference among them.Results On group of C(32 times for 11 cases)the successful rates for every stage was more than 87.5% and significant higher than others ( P <0.01).On group of CAB(24 cases)were made different duration for C-AB and the successful rates for different stages were different.Among them the successful rates of three stages for group of C-AB<5 min was higher than the group of patients with >5 min(P<0.05～0.01).On group of AB(3 cases)and ABC(6 cases)the successful rates for different stages were 33.3%～100% and significant higher than the group of CAB( P <0.01).Conclusions For the patients with cardiogenic cardiac arrest the order of CAB rescue steps is a useful way during CPCR.But when C step could not been successful during 5 min the effective ventilation should be taken without hesitate.

关 键 词：心搏骤停 心肺脑复苏 A(airway) B(breath) C(circulation) 人工气道 通气 

分 类 号：R459.7[医药卫生—急诊医学]