家猪心搏骤停后濒死呼吸规律的探讨  

Regularity of agonal respiration after untreated cardiac arrest in a swine model

作　　者：刘同英[1] 王立祥[3] 刘亚华[3] 崔晔[2] 陈婵[2] 江愿丽[2] 周满红[2] 

机构地区：[1]遵义医学院附属医院急诊科,贵州遵义563003 [2]遵义医学院附属医院干部保健科,贵州遵义563003 [3]武警总医院急救医学中心,北京100039

出　　处：《中华危重病急救医学》2015年第12期989-992,共4页Chinese Critical Care Medicine

基　　金：全军医学科技“十二五”课题（BSW11J077）

摘　　要：目的探讨心搏骤停（CA）家猪模型心室纤颤（VF）后濒死呼吸（AR）的发生情况及濒死呼吸频率（ARFR）的规律。方法雄性健康家猪10只，体质量（25．0±3．0）kg。采用经心内膜交流电刺激诱发VF致CA，制模后观察8min。记录8min内每分钟出现AR的动物数及每分钟的ARFR，采用SPSS19．0软件进行统计学分析。结果VF致CA后8min内所有动物均出现AR。1min时有1只动物出现AR，ARFR为（0．2±0．1）次／min；2min时有4只动物出现AR，ARFR为（1．2±1．0）次／min；3min时有7只动物出现AR，ARFR为（2．7±1．4）次／min；4～5min时全体动物均出现AR，4min时ARFR为（3．7±1．6）次／min，5min时ARFR为（3．2±1．9）次／min；6min时有7只动物出现AR，ARFR为（1．3±1．0）次／min；7min时全部动物均未出现AR；8min时仅1只动物出现AR，ARFR为（0．2±0．1）次／min。10只动物平均于VF后（2．02±0．84）min首次出现AR，（5．21±1．12）min出现末次AR；4～5min时为AR出现的高峰期，7min后AR基本停止。CA后ARFR呈渐增-渐减模式，从（0．2±0．1）次／min逐渐升至（3．7±1．6）次／min，再降至（0．2±0．1）次／min。结论AR是CA后的标志性征象之一。VF后均出现AR，且频发于CA后4—5min，ARFR呈渐增-渐减模式。及时识别、有效处理AR将有助于提高心肺复苏成功率及复苏后存活率。Objective To explore the regularity of incidence of agonal respiration （AR） and agonal respiration frequency rate （ARFR） during untreated cardiac arrest （CA） after ventricular fibrillation （VF） in a swine model. Methods Ten healthy male domestic pigs weighing （25.0± 3.0 ） kg were employed in this experiment. VF was induced by intraventricular shock with alternating current without treatment for 8 minutes. The incidence of AR and ARFR per minute were recorded for 8 minutes. Statistical analysis was performed using SPSS 19.0 system software. Results AR occurred in all animals after VF induced CA within 8 minutes. There was 1 animal showed AR at the first minute with ARFR （0.2± 0.1 ） times/min, 4 animals showed AR at the second minute with ARFR （ 1.2 ± 1.0 ） times/min, 7 animals showed AR at the third minute with ARFR （ 2.7 ±1.4 ） times/rain, all animals showed AR at the fourth to fifth minute with ARFR （ 3.7 ±1.6） times/rain and （ 3.2± 1.9） times/min, 7 animals showed AR at the sixth minute with ARFR （1.3±1.0 ） times/min, no animal showed AR at the seventh minute, and 1 animal showed AR at the eighth minute with ARFR （0.2±0.1） times/min. The first and the last AR were observed at （2.02±0.84） minutes and （5.21±1.12） minutes respectively. Occurrence of AR reached its peak at the fourth to fifth minute, and it was absent at the seventh minute. ARFR after CA showed a crescendo-decrescendo pattern, which increased from （0.2±0.1） times/rain to （3.7±1.6） times/rain followed by a fall to （0.2±0.1） times/rain. Conclusions AR is one of the symbolic signs after CA. AR occurred in all animals during untreated VF, and it reaches its peak at the fourth to fifth minute, with a crescendo-decrescendo pattern of ARFR. Effective identification and treatment in victim with AR timely can help to improve the success rate of cardiopulmonary resuscitation and survival rate.

关 键 词：心室颤动 心搏骤停 心肺复苏 濒死呼吸 

分 类 号：R541.78[医药卫生—心血管疾病]