关键词： 亚低温治疗   心脏骤停   心肺复苏   全程保温护理  

摘要： 目的 探讨全程保温措施对于心脏骤停心肺复苏后患者康复的影响.方法 选取2008年1月至2014年4月我院ICU收治的院内心搏骤停且行心肺复苏成功患者35例,采用数字随机分组方法将其分为观察组及对照组.观察组18例采用全程保温护理治疗（将中心体温降至32℃～34℃,并应用电脑降温毯维持24h）;对照组17例采用传统的降温保温法（如头部冰帽,颈部、腹股沟冰敷）诱导降温.观察并比较两组患者24h、72 h、l周的GCS评分及APACHEⅡ评分,比较两组复苏后的血乳酸水平及6h、24h血乳酸清除率.结果 在心肺复苏术后7d,观察组患者GCS评分为7.19±1.72,明显高于对照组,APACHE评分为10.81±2.53,低于对照组,24h后的血乳酸清除率观察组为49.02±12.37,高于对照组.结论 应用亚低温治疗并配合积极的全程保温护理措施,有利于促进心肺复苏患者的自主循环恢复及脑功能的改善,降低病死率.

关键词： 心肺复苏   AHA   美国心脏学会   胸外按压   自动体外除颤   急救体系   心搏骤停   院外急救   加压素   团队协作  

摘要： 快速反应,团队协作由多名施救者形成综合小组,同时完成多个步骤和评估（分别由施救者实施急救反应系统;胸外按压、通气或取得球囊面罩进行人工呼吸、取回并设置好除颤器同时进行）。生存链一分为二成人生存链分为两链：一链为院内急救体系,另一链为院外急救体系。先电击或先按压？当施救者可以立即取得自动体外除颤器（AED）时,对于成人心搏骤停患者,应尽快使用除颤器;

关键词： 心肺复苏术   心脏骤停   日常工作   患者   重返工作岗位   血液循环   大脑缺氧   研究人员  

摘要： 根据2015年5月12日发表于《循环》杂志上的研究显示，心肺复苏术（CPR）不仅可以拯救生命，还可以帮助幸存者在心脏骤停复苏后重返工作岗位。 研究人员在丹麦研究了超过4300名发生心脏骤停前的人员。在心脏骤停的时候，心脏会突然停止跳动。超过75％在医院外发生心脏骤停的幸存者都能够在平均时间四个月内重新回到工作岗位。较没有获得培训过心肺复苏术抢救的患者而言，有在旁者进行心肺复苏术（CPR）的患者有接近40％的可能性回归工作。因为通过心肺复苏术进行的胸部按压可以保持血液循环至大脑，减少了因大脑缺氧所致的损害。

关键词： 心脏病   绝经后   急性大面积心肌梗死   呼吸心跳停止   小学教师   面色苍白   昏迷不醒   心脏复苏  

摘要： 年过六旬的张女士退休前是一名乡镇小学教师，既往身体“健康”，无高血压和心脏病史。前不久的一个夜晚，她在家洗澡后突然感到胸口疼痛，并逐渐加剧，痛甚时双手紧握拳头，伴面色苍白，出汗多。丈夫以为是小毛病，扶她到床上，用风油精涂在她胸前，但症状无缓解，过了一会儿，她突然昏迷不醒，家属急忙拨打“120”，当救护车到达时，患者已呼吸心跳停止。医生立即给予心脏复苏，结果回天无术。事后尸解证实，张老师死干冠心病合并急性大面积心肌梗死。

关键词： 心脏性猝死   照料人员   心肺复苏知识  

摘要： 目的:调查了解心脏性猝死(SCD)高危者照料人员心肺复苏(CPR)知晓、培训等情况,为采取相应措施提供依据。方法:采用自制调查问卷,对北京地区12家军队干休所SCD高危者照料人员206例CPR知识掌握情况进行调查,了解CPR知识的知晓、获取CPR知识的途径、参加CPR培训等情况。结果:SCD高危者照料人员CPR知晓率为84.7%,获取CPR知识的途径最多为网络(65.1%),参加过CPR培训者占20.8%,89.7%的照料人员愿意参加CPR知识培训,98.6%的照料人员希望得到理论讲授结合模拟人练习。结论:加强SCD高危者照料人员CPR培训非常必要,应采取措施提高照料人员CPR的技能。

关键词： 心肺复苏   B型利钠肽   心力衰竭   近期临床预后  

摘要： 目的：检测血清B型利钠肽（BNP）水平在心脏骤停患者心肺复苏成功后不同时间点的变化，探讨血清BNP水平的变化与近期预后的关系。方法：检测60例患者心脏骤停心肺复苏成功后即刻、3h、12．24h的血清BNP水平，根据血清BNP水平分为3组，A组16例：为心肺复苏成功后即刻、3h、12～24h血清BNP水平一直〈200pg／ml的患者；B组22例：为心肺复苏成功后3h和12～24hBNP水平持续升高，且一直〉200pg／ml的患者；C组22例：为心肺复苏成功后3h和12-24hBNP水平持续升高，但12～24h较3h时降低的患者。三组患者均随访6个月。结果：随访6个月，A组患者无死亡，B组患者死亡11例，C组患者死亡3例，A组患者6个月生存率高于B组（x^2=11．337，P=0．001），A组和C组6个月生存率差异无统计学意义（x^2=2．330，P=0．127），B组生存率较C组生存率降低（x^2=7．435，P=0．006）。结论：心脏骤停心肺复苏成功后患者的血清BNP水平持续增高，提示患者出现心功能不全，预后不良。为了改善患者近期预后，治疗上应积极改善心功能不全，提高心排出量，改善重要脏器的血液灌注。

关键词： Buffers   cardiopulmonary resuscitation   heart arrest   treatment outcome  

摘要： Objective: To report the use of sodium bicarbonate (SB) in out-of-hospital cardiac arrest (OHCA) and to explore the role of sodium bicarbonate in resuscitation of OHCA in terms of restoration of spontaneous circulation (ROSC) and survival, and existence of dose-dependent relationship, especially in those with prolonged arrest. Design: Retrospective cohort study. Setting: Emergency department of two regional hospitals in a cluster of Hong Kong. Methods: Adult patients aged at least 18 years old who presented to the study centres with non-traumatic OHCA in the period between March 2013 and December 2013 were included. Cases in which resuscitations were considered medically futile or not actually performed were excluded. Those with do-not-resuscitate (DNR) order or advance directives, those who were death before arrival with postmortem changes, and those who developed ROSC before or within 15 minutes of arrival were excluded from the study. Patients with known poisoning from tricyclic antidepressant or other sodium channel blockers were excluded from analysis if any. The primary outcome of this study was ROSC. Other outcome variables included survival to hospital admission (STA) and survival to hospital discharge (STD). Results: A total of 489 patients were included during the study period for analysis. We found that patients who received sodium bicarbonate injection (SB group) during CPR had a higher percentage of ROSC than those who did not (no-SB group) (60.8% vs 22.5%;p<0.001). The survival-to-admission rate was higher in the SB group (56.8%) compared with the contrary (21.4%). The difference of survival-to-discharge between the two groups did not reach statistical significance (4.1% in SB group and 2.9% in the no-SB group;p=0.484). The rate of ROSC was found to be dose dependent, being higher in higher dose of SB administration. The ROSC rate increased from no-SB (22.4%) to 57.1% if given 50 ml SB, and further to 64.1% if given >= 100 ml SB. Conclusions: Our study

关键词： Cardiopulmonary resuscitation (CPR)   in-hospital cardiac arrest (IHCA)   internal cardiacmassage   returnof spontaneous circulation (ROSC)  

摘要： Cardiopulmonary resuscitation (CPR) is a life-saving skill involving chest compressions & ventilation to pump oxygenated blood through the vital organs of the body. Among different techniques and devices for chest compression, no single method has been definitively shown to produce the best outcome and hence, direct comparisons between them are not possible. Internal cardiac massage is the manual squeezing of the heart through a surgical incision into the chest cavity, when the chest is already open for cardiac surgery. Unlike the usual cardiac arrest scenarios, internal cardiac massage is employed mostly in cardiothoracic surgical patients and will have more chance for survival and favorable neurologic outcomes across all durations of CPR. We describe two cases of return of spontaneous circulation (ROSC) after prolonged CPR with internal cardiac massage performed in hospital setting.

关键词： cardiac arrest   cardiopulmonary resuscitation   resuscitation  

摘要： This paper describes the major findings in a descriptive study on factors that lead to an unexpected cardiac arrest in a general population served by a major public hospital and factors that influence the outcome of the cardiopulmonary resuscitation. The cases collected over a period of 2 years in the Emergency Department of “Saint Pantelimon” Hospital, were analysed. There were 164.670 presentations, 195 being patients who developed cardiac arrest and were included in the study. The return of the spontaneous circulation occurred in 40% of the cases and 11.53% of them survived to discharge. In younger patients, the outcome was poor due to the long delays in making the call for help. It was noted that none of the patients who underwent post-traumatic cardiac arrest survived. The limits of the study are primarily related to the single-centre status of the study, but the results encourage further studies. [ABSTRACT FROM AUTHOR]

关键词： ICU   心脏骤停   心肺复苏   CCRRT  

摘要： 目的:分析影响ICU心脏骤停患者心肺复苏的相关因素。方法:收集我院内科ICU收住的116例心脏骤停进行心肺复苏抢救的患者,分为自主循环恢复组和未恢复组两组,对其临床资料进行统计分析。结果:原发疾病中心脑血管疾病、呼吸系统疾病及意外中毒三项,心脏骤停形式中快速型心律失常,以及存在目击觉察,恢复组所占百分比大于未恢复组,差异均有统计学意义。结论:对自主循环恢复产生影响的因素主要有心脑血管疾病、呼吸系统疾病及意外中毒为原发疾病,快速型心律失常的心脏骤停形式,以及存在目击觉察。