有效人工通气在心肺脑复苏中的价值探讨  

The evaluation of effective artificial ventilation in cardiacpulmonarycerebral resuscitation

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：《中国危重病急救医学》2002年第4期213-216,共4页Chinese Critical Care Medicine

基　　金：上海市医药卫生科研发展基金资助项目 ( No.0 0 40 9)

摘　　要：目的 :评价 A (气道 )、B(呼吸 )、C(循环 )抢救步骤在心肺脑复苏 (CPCR)中的价值。方法 :收集 70例心搏、呼吸骤停行 CPCR患者临床资料 ,分析单纯心脏疾患致心搏、呼吸骤停 (4 4例 )和非单纯心脏疾患致心搏、呼吸骤停 (2 6例 )患者在实施 CPCR过程中采取的 A、B、C顺序及 CAB组依 C AB间隔时间 (<5分钟、5～ 10分钟和 >10分钟 )所分组的各期复苏成功率。结果 :单纯心脏疾患致心搏、呼吸骤停患者中 ,C组 (11例32例次 )各期复苏成功率均 >87.5 %,显著高于其它各组 (P均 <0 .0 1) ;CAB组 (2 4例 )依 C AB间隔时间不等 ,各期复苏成功率不同 ,<5分钟组各期复苏成功率均明显高于 >5分钟组 (P<0 .0 5或 P<0 .0 1) ;AB组(3例 )各期复苏成功率均≥ 6 6 .7%,ABC组 (6例 )各期复苏成功率均≥ 33.3%,均显著高于 CAB组 (P均 <0 .0 1)。非单纯心脏疾患致心搏、呼吸骤停患者中 ,ABC组各期复苏成功率与 CAB组总体成功率比较无显著差异 (P均 >0 .0 5 ) ;CAB组依 C AB间隔时间不等 ,一、二期复苏成功率间均无显著差异 (P均 >0 .0 5 ) ,三期复苏成功率差异显著 ,>10分钟组明显低于 <10分钟组 (P均 <0 .0 1)。结论 :CAB可能是各种原因致心搏骤停患者 CPCR中可取的抢救步骤 ,但 5分钟可能是进行有效人工通气的极限。Objective:To evaluate the clinical value of the rescue steps of A(airway),B(breath),as well as C(circulation) in patients undergone cardiacpulmonarycerebral resuscitation(CPCR).Methods:Seventy cases were divided into C,CAB,AB and ABC groups according to the different order of ABC steps.Among them 44 cases were organic cardiac disease and 26 cases were nonsimple cardiac disease.In CAB group patients were divided to 3 groups of <5 minutes,510 minutes,>10 minutes according to the different periods between CAB steps.The successful rate of three stages in each group were analyzed respectively by χ 2 analysis in order to evaluate the significance of difference among them.Results:For patients with organic cardiac diseases,in C group (32 times for 11 cases) the successful rates for each stage were more than 87.5% and they were significant higher than others(all P<0.01).In CAB group (24 cases),the duration for CAB was different and the successful rates in different stages were also different.The successful rate in CAB group with <5 minutes was higher than that with >5 minutes(P<0.05 or P<0.01).In AB(3 cases)and ABC(6 cases) groups,the successful rate were equal or more than 33.3%66.7%,and they were significant higher than CAB group(all P<0.01).For patients with nonsimple cardiac diseases,among groups of CAB (12 cases) the internal time between C and AB were different too.There were no significant differences in successful rates between ABC and CAB groups in three stages(P>0.05).Among groups of CAB<5 minutes,510 minutes and >10 minutes successful rates were not significantly different between the first and second stages(all P>0.05),and the successful rates on groups of CAB<5 minutes and 510 minutes were significantly higher than the group of CAB >10 minutes during the third stage(P<0.01 or P<0.05).Conclusions:The order of CAB rescue steps may be a useful way for all kinds of patients during CPCR.But when C step could not be successful up to 5 minutes the effective ventilation should be taken without hesitate.

关 键 词：心搏骤停 心肺脑复苏步骤 人工气道 通气 心脏复苏 

分 类 号：R459.7[医药卫生—急诊医学]