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目的对不同频率插入式腹部按压心肺复苏及标准心肺复苏产生的血流动力学参数进行比较,探讨IAC-CPR的最佳按压频率。方法选12条健康杂种犬,每条实验犬均接受S-CPR和80IAC-CPR、100IAC-CPR、120IAC-CPR四种复苏方法,每只犬四种复苏方法的顺序由随机法确定,每种按压方法进行5min。体外电击法制作犬室颤模型,采用6F猪尾导管及压力换能器,测量中心静脉压(CVP)、升主动脉收缩和舒张压、颈动脉收缩(CAS)和舒张压(CAD),并通过公式计算获得冠状动脉灌注压(CPP)、平均主动脉压(MAP)及平均颈动脉压(CMAP)。结果100IAC-CPR产生的MAP、CMAP、CVP均大于其他三种按压方法(P<0·05),产生的CPP和120IAC-CPR相当(P>0·05),优于其余两种按压方法(P<0·05)。结论100IAC-CPR能产生最好的血流动力学效果,主要表现为能产生更好的CPP和CMAP,预示可能产生更好的复苏成功率,而且易于操作和维持。
Objective To compare the hemodynamic parameters of cardiopulmonary resuscitation (CPR) and standard cardiopulmonary resuscitation (CPR) at different frequencies and discuss the optimal compressive frequency of IAC-CPR. Methods Twelve healthy mongrel dogs were selected. Each experimental dog received four resuscitation methods of S-CPR, 80IAC-CPR, 100IAC-CPR and 120IAC-CPR. The order of the four resuscitation methods in each dog was determined by random method. Press the method for 5min. The canine ventricular fibrillation model was made by electric shock in vitro. Central venous pressure (CVP), ascending aorta systolic and diastolic pressure, carotid artery systole (CAS) and diastolic pressure (CAD) were measured by 6F pigtail catheter and pressure transducer. The formula was calculated coronary perfusion pressure (CPP), mean aortic pressure (MAP) and mean carotid pressure (CMAP). Results The MAP, CMAP and CVP produced by 100IAC-CPR were higher than those of the other three methods (P <0.05), and the CPP and 120IAC-CPR produced were similar (P> 0.05), which was better than the other two methods P <0 · 05). Conclusions 100IAC-CPR produces the best hemodynamic response with the predominant effect of producing better CPP and CMAP, predicting a better chance of successful recovery and being easier to handle and maintain.