摘要
目的探讨胸外按压和经膈肌下抬挤心肺复苏(cardiopulmonary resuscitation,CPR)方法对开腹术中心搏骤停猪通气和循环的影响。方法健康家猪14只,麻醉后气管插管,行开腹术后用窒息法建立猪心搏骤停模型,随机分组后进行胸外按压和经膈肌下抬挤CPR,测定并比较两种方法复苏时心搏骤停猪的潮气量(VT)、呼气末二氧化碳分压(PETCO2)、经皮血氧饱和度(SpO2)、按压期动脉压(AOS)、放松期动脉压(AOD)、右房压(RAP)和冠状动脉灌注压(CPP)。结果与胸外按压CPR比较,经膈肌下抬挤CPR法所测得的VT较大,差异有统计学意义[53.8±4.02)vs(40.61±2.58),P<0.01];经膈肌下抬挤CPR比胸外按压产生更高的CPP,差异有统计学意义[(39.37±1.79)vs(25.66±1.73),P<0.01]。结论经膈肌下抬挤CPR比标准CPR产生较高的冠脉灌注压和肺通气。
Objective To compare the hemodynamic response and ventilation after standard cardiopulmonary resuscitation（S-CPR） and cardiac massage under the diaphragmatic muscle（D-CPR）during laparotomy in cardiac arrest of swine.Methods Fourteen healthy domestic pigs were anesthetized and intubated.After preoperotive preparation and the hemodynamics was stable for 5 minutes,the readings of aortic systolic pressure（AOS）,aortic diastolic pressure（AOD）,and right atrial pressure（RAP） were recorded consecutively.Pigs were randomized to receive either S-CPR（n=7） or D-CPR（n=7）.Cardiac arrest was induced with overdosed bupivacaine.After 2 min of untreated time,they were resuscitated,and hemodynamic variables,PETCO2,VT and ECG were continuously recorded.Coronary perfusion pressure（CPP） was calculated as arterial diastolic pressure minus right atrial diastolic pressure.Results D-CPR during cardiac massage,compared with S-CPR,resulted in a significant increase in VT,DAP and CPP.Conclusions D-CPR can provide higher arterial pressure and ventilation;D-CPR is superior to S-CPR.
出处
《武警医学》
CAS
2012年第12期1017-1019,共3页
Medical Journal of the Chinese People's Armed Police Force
关键词
胸外按压
经膈肌下抬挤
潮气量
冠脉灌注压
cardiopulmonary resuscitation
diaphragmatic muscle
tidal volume
coronary perfusion pressure
