早期亚低温对复苏后家猪保护作用研究  

Early Therapeutic Hypothermia Improves Survival and Neurological Outcomes in a Prolonged Cardiac Arrest Porcine Model

作　　者：黄国孟[1] 保学明[1] 卢建华[1] 

机构地区：[1]广东省广州市第一人民医院,510180

出　　处：《岭南急诊医学杂志》2016年第2期93-94,105,共3页Lingnan Journal of Emergency Medicine

基　　金：广东省科技计划项目(2012B31800006)

摘　　要：目的:治疗性亚低温是目前被证明能够有效保护心跳骤停复苏后靶器官,改善生存预后的方法之一。本研究旨在研究早期亚低温对复苏后家猪的保护作用及其对生存预后的影响。方法:成年健康雄性家猪16头,体重35±5 kg,制作经右心室电极电诱发室颤动物模型。室颤诱发后持续8分钟,随后实施标准徒手心肺复苏6分钟。复苏成功后动物随机分为常温组和亚低温组。亚低温组动物采用4℃生理盐水快速输注(30 m L/Kg),降温毯等低温诱导方法快速(120分钟内)降温动物核心体温至32℃-34℃,维持2小时,之后2小时逐渐复温至38℃。常温组维持复苏后体温在38±0.5℃。连续观察复苏后6小时内动物心电图和血流动力学指标,记录复苏后生存时间及每24小时神经功能评分。结果:16头家猪均被成功复苏,亚低温组动物全部存活超过96小时,常温组动物仅2头存活超过96小时(P<0.05),6头存活超过24小时。复苏后24小时家猪神经功能缺损评分,亚低温组显著优于常温组(P<0.05)。结论:在长时间心跳骤停与复苏家猪模型中,早期亚低温治疗能够显著改善复苏后动物的生存预后及神经功能。Objective：To establish a porcine model with cardiac arrest and resuscitation to study the role of mild hypothermia in protecting the post-resuscitation neurological function and improving their survival outcomes. Methods Sixteen male porcine were enrolled in the study and randomly divided into control group （normal temperature） and mild hypothermia group. Ventricular fibrillation model was induced electrically and the resuscitated pigs were treated with mild hyperthermia. Neurological deficit score （NDS） was evaluated every 24 hours after resuscitation. The 24- hour and 96-hour survival rates were compared between two groups. Results：All 16 animals were successfully resuscitated. There were no significant differences in success rate of ROSC, resuscitation time and success rate of first defibrillation. The 96-hour survival animals in the mild hyperthermia group were significantly better than those in the control group. NDS at 24, 48 , 72 and 96hours after resuscitation in the mild hyperthermia group was significantly lower than that in the control group. Conclusion：In this model, mild hypothermia can improve the neurological and survival outcomes of the resuscitated pigs.

关 键 词：心脏骤停 心肺复苏 亚低温 心室颤动 

分 类 号：R459.7[医药卫生—急诊医学]