两种方法制备心搏骤停兔模型的比较  

Comparison of cardiac arrest induced by electrical stimulation or intravenous potassium chloride in rabbits

作　　者：李湘民[1] 姚政彬 朱浙祥 佘长寿 粟枫[1] 黄国庆[1] LI Xiangmin;YAO Zhengbin;ZHU Zhexiang;SHE Changshou;SU Feng;HUANG Guoqing(Department of Emergency Medicine,Xiangya Hospital Central South University,Changsha 410008,China;Department of Emergency Medicine,Hunan Provincial People’s Hospital,Changsha 410005)

机构地区：[1]中南大学湘雅医院急诊科,长沙410008 [2]湖南省人民医院急诊科,长沙410005

出　　处：《中国比较医学杂志》2019年第9期87-91,113,共6页Chinese Journal of Comparative Medicine

基　　金：国家自然科学基金青年科学基金(81401024)

摘　　要：目的比较氯化钾致颤与经食道-胸壁电致颤两种心搏骤停(cardiac arrest,CA)兔模型在心肺复苏(cardiopulmonary resuscitation,CPR)过程中生理指标的特点。方法按随机数字表法将新西兰大白兔分为氯化钾致颤组(10%氯化钾0.3 mL/kg脉冲式静脉注射诱发心搏骤停)和电致颤组(经食道-胸壁用35 mA交流电诱发心搏骤停),每组10只。心搏骤停5 min后进行心肺复苏。比较两组诱发心搏骤停时间、心肺复苏时间、自主循环恢复(restoration of spontaneous circulation,ROSC)情况、自主循环恢复后1 h动脉血气和血乳酸(Lac)水平,以及复苏后72 h存活情况。结果20只动物均成功诱发心搏骤停。与电致颤组比较,氯化钾致颤组诱导心搏骤停时间[(9.90±2.47)s与(27.40±6.48)s比较]和心肺复苏时间[(61.61±26.51)s与(132.00±18.55)s比较]均明显缩短(P<0.01)。氯化钾致颤组和电致颤组均有9只动物自主循环恢复,72 h分别存活8只、5只。与电致颤组比较,氯化钾致颤组自主循环恢复后1 h动脉血气pH值[(7.38±0.06)与(7.29±0.11)相比]和HCO3^-浓度[(21.86±3.65)mmol/L与(18.32±2.61)mmol/L相比]均明显升高(P<0.05),Lac水平[(1.77±0.77)mmol/L与(5.39±3.40)mmol/L相比]明显降低(P<0.01),氧分压(PO2)、二氧化碳分压(PCO2)、K+浓度差异均无统计学意义。结论与经食道-胸壁交流电刺激方法相比,氯化钾脉冲式注射可更便捷诱发兔心搏骤停,且复苏后机体内环境更为稳定,存活率更高。Objective To compare the changes in physiological parameters after cardiac arrest(CA)caused by intravenous potassium chloride or transesophageal-chest wall electrical stimulation in rabbits.Methods According to a random number table,20 New Zealand white rabbits were divided into two different induction groups:a potassium chloride group with CA induced by bullet-type intravenous injection of 10%potassium chloride(0.3 mL/kg),and an electrical stimulation group with CA induced by transesophageal-chest wall electrical stimulation with 35 mA alternating current.Five minutes after CA,conventional cardiopulmonary resuscitation(CPR)was initiated.Time spent inducing CA,time spent on CPR,rate of restoration of spontaneous circulation(ROSC),blood gas and blood lactic acid levels 1 h after ROSC,and 72-h survival rate after resuscitation were compared.Results CA was successfully induced in all 20 rabbits.Compared with the electrical stimulation group,time spent inducing CA(9.90±2.47 vs.27.40±6.48 s,P<0.01)and time spent on CPR(61.61±26.51 vs.132.00±18.55 s,P<0.01)were significantly shorter in the potassium chloride group.Nine rabbits exhibited ROSC in each group.Seventy-two hours after ROSC,eight rabbits in the potassium chloride group survived,while five rabbits survived in the electrical stimulation group.Compared with the electrical stimulation group,pH(7.38±0.06 vs.7.29±0.11,P<0.05)and HCO3^-(21.86±3.65 vs.18.32±2.61 mmol/L,P<0.05)levels of the potassium chloride group were significantly increased,while the level of lactic acid(1.77±0.77 vs.5.39±3.40 mmol/L,P<0.01)was significantly reduced.Partial pressure of oxygen,partial pressure of carbon dioxide,and K+were not significantly different.Conclusions Compared with transesophageal-chest wall electrical stimulation,potassium chloride may be more convenient to induce CA in rabbits,as physiological parameters after ROSC are more stable and the long-term survival rate is higher.

关 键 词：心搏骤停 心肺复苏 自主循环恢复 电刺激 氯化钾 动物模型 

分 类 号：R-33[医药卫生]