心肺复苏中自主循环恢复预测及识别方法研究进展  

Research progress of prognosis and recognition methods for return of spontaneous circulation during cardiopulmonary resuscitation

作　　者：李晨[1] 徐军[2] 刘小禾[1] 柴艳芬[1] 于学忠[2] 

机构地区：[1]天津医科大学总医院急诊科,天津300052 [2]北京协和医院急诊科,北京100730

出　　处：《中华急诊医学杂志》2016年第1期122-127,共6页Chinese Journal of Emergency Medicine

基　　金：首都发展基金（2011-4001-04）;国家临床重点专科建设项目（2012-650）;卫计委行业基金（201502019）

摘　　要：心肺复苏（cardiopulmonary resuscitation，CPR）是心搏骤停时最常用的抢救方法。2010年CPR指南强调高质量胸外按压，建议除颤后继续按压2rain后再判断循环以减少按压中断时间。然而，临床中自主循环恢复（return of spontaneous circulation，ROSC）多发生在按压过程中，此时持续按压不利于自主循环稳定。因此在CPR中识别ROSC十分重要。目前临床上可用于CPR中ROSC的预测和识别方法包括：触及脉搏搏动、波幅谱面积、呼气末二氧化碳分压、冠脉灌注压、中心静脉氧饱和度、胸外按压分数、局部脑氧饱和度、光学容积描记图、结膜氧张力、经胸阻抗容积描记术及超声心动图。本文对以上CPR过程中ROSC预测及识别方法做一综述。Cardiopulmouary resuscitation is the most commonly used method facing cardiac arrest. The 2010 CPR guidelines emphasized high quality chest compressions and recommended continuous compression for 2 minutes after defibrillation to minimize interruptions in compressions. However, starting chest compressions immediately after a defibrillation shock may be harmful, if the heart is providing spontaneous beats and being subjected to external compressions at the same time. So it is very important to recognize ROSC during CPR, the methods of which include touching the pulse, amplitude spectral area, partial pressure end-tidal carbon dioxide, coronary perfusion pressure, central venous oxygen saturation, chest compression fraction, regional cerebral oxygen saturation, photoplethysmography, eonjunctival oxygen tension, transthoraeic-impedanee plethysmography and echocardiography. This paper gives a review of the ROSC prognosis and recognition methods during CPR.

关 键 词：心肺复苏 自主循环恢复 预测 识别 进展 

分 类 号：R459.7[医药卫生—急诊医学]