关键词： 心脏骤停   急诊科   心肺复苏   心脏复苏   电击除颤   患者病历   因素分析   危急重症   对光反射   胸外心脏按压  

摘要： 心脏骤停是急诊科常见的危急重症,死亡率极高,积极有效的心脏复苏(CPR)对于挽救心脏骤停患者生命具有极为重要的意义,如何提高急诊心脏骤停患者CPR的成功率成为急诊科医师重点关注问题。本研究通过分析我院急诊科CPR患者病历资料,探讨影响急诊心脏骤停CPR成功的相关因素,总结经验,以提高急诊CPR的成功率。1材料与方法1.

关键词： bone marrow mesenchymal stem cells   global cerebral ischemic injury   cerebral resuscitation   cardiac arrest   transplantation  

摘要： In the present study, mesenchymal stem cells (MSCs) were transplanted into the brain of rats following cardiopulmonary resuscitation (CPR) by three different methods: Direct stereotaxic injection into the lateral cerebral ventricle (LV), intra-carotid administration (A), and femoral venous infusion (V). The three different methods were compared by observing the effects of MSCs on neurological function following global cerebral hypoxia-ischemia, in order to determine the optimum method for MSC transplantation. MSCs were transplanted in groups A, V and LV following the restoration of spontaneous circulation. Neurological deficit scale scores were higher in the transplantation groups, as compared with the control group. Neuronal damage, brain water content and serum levels of S100 calcium-binding protein B were reduced in the hippocampus and temporal cortex of the transplantation groups, as compared with the control rats following resuscitation. MSCs were able to migrate inside the brain tissue following transplantation, and were predominantly distributed in the hippocampus and temporal cortex where the neurons were vulnerable during global cerebral ischemia. These results suggest that transplantation of MSCs may notably improve neurological function following CPR in a rat model. Of the three different methods of MSC transplantation tested in the present study, LV induced the highest concentration of MSCs in brain areas vulnerable to global cerebral ischemia, and therefore, produced the best neurological outcome.

关键词： 电针刺激   后脑损伤   心肺复苏   心脏骤停   百会穴   小鼠   局灶性脑缺血损伤   脑保护作用  

摘要： 心脏骤停／心肺复苏（CA／CPR）脑损伤已成为导致患者最终死亡或残疾的主要原因。电针刺激百会穴对局灶性脑缺血损伤的疗效受到国际主流医学的关注和肯定。我们将观察电针百会穴对CA／CPR后小鼠是否具有脑保护作用。

关键词： 妊娠   心脏骤停  

摘要： 妊娠期心脏骤停是最具有挑战性的临床情景之一,虽然对妊娠期女性复苏的大多数特征与标准的成人复苏相似,但在若干方面有其独特之处,最明显的不同点是有两个患者:母亲和胎儿.为了更好地对妊娠期心脏骤停作好预防和治疗,医护应该对母亲的死亡率有一个全面的了解.母亲的死亡指妊娠期间和分娩后或终止妊娠后42天以内的死亡,死亡的原因和妊娠相关或妊娠使之恶化.从全美住院患者样本的最新资料提示,在住院分娩的患者中,心脏骤停的发生情况为1:12000,全球每天有800位母亲死亡.根据美国疾病控制和预防中心报告,母亲死亡从1987~2009年呈稳定增长的趋势,从1987年每100000个活产儿中有7.2例死亡到2009年每100000个活产儿有17.8例的死亡.然而,母亲死亡率仅是母亲严重事件的少数代表,应考虑相近差错(near-miss)的问题.1位母亲的相近差错是指在妊娠期,婴儿出生时或终止妊娠42天内一位接近死亡的女性没有死亡,但伴有并发症.来自荷兰的资料表明,在分娩病房,母亲差错的发生率为1:141,在严重母亲并发症中全部病例的致命率为1:53.一旦发生了心脏骤停,缺乏知识和低水平的复苏技术是导致不良结果的主要原因.最新的资料表明,尽管存在这些问题,在母亲心脏骤停后,出院的生存率高达58.9% ,远高于大多数心脏骤停的人群.

关键词： 心脏性猝死   心肺复苏   影响因素   应对措施  

摘要： 目的分析影响心脏性猝死复苏成功的相关因素并分析应对措施。方法分析106例心脏性猝死患者心肺复苏成功率、原发疾病类型、心脏性猝死发生至实施心肺复苏间隔时间、心肺复苏实施场所等,记录相关数据并经统计学分析后获得结论。结果 106例心脏性猝死患者中仅28例心肺复苏成功(心肺复苏成功率26.42%);院外实施、实施心肺复苏人员专业素质较差、心脏性猝死发生至实施心肺复苏间隔时间较长、未使用急救药物、年龄较大、女性、存在除心脏以外其他重要脏器病变及未使用除颤器等因素降低了心肺复苏成功率(P<0.05)。结论抢救人员应熟练掌握心肺复苏技术,接诊心脏性猝死患者后尽快给予心肺复苏处理,采取多种方式有效提高心肺复苏成功率,保障患者生命安全。

关键词： 心脏骤停   心肺复苏术   抢救流程   成功率  

摘要： 目的：探讨心脏骤停的临床表现和治疗要点，制定合理抢救流程，并总结经验，提高抢救成功率。方法：收治心脏骤停并心肺复苏抢救成功患者5例，回顾性分析其临床资料。结果：本组病例中，5例患者均在1～4min内复苏成功。结论：熟练的高质量的心肺复苏术是抢救成功的关键，有条不紊的抢救流程是基本保障。

关键词： 心血管急救   心肺复苏   美国心脏协会   持续质量改进   指南   生存链   复苏后处理   生命支持  

摘要： 急救概念的更新（1）持续质量改进：通过架构（如人员、器材、教育）、过程（如操作规范）、系统（如文化）及患者成效（如存活率）等方式提高心肺复苏（cardiopulmonary resuscitation,CPR）的质量。（2）生存链：生存链分为院前生存链及院内生存链。院前生存链：识别、启动应急反应系统和实时生命支持及复苏后处理,建议在院内建立快速反应小组（rapid response team,

关键词： 心肺复苏术   指南   共识   急救  

摘要： 前两讲,我们分别解读了2015美国心脏协会（AHA）心肺复苏与心血管急救更新指南（简称2015指南）的概论和基础心肺复苏、高级心肺复苏[1-2]。本节解读2015指南第三章《心脏骤停后治疗》[3-5]。2010指南强调心脏骤停可由许多不同疾病所致。不管何种病因,在心脏骤停期间均发生低氧血症、缺血与再灌注,复苏可引起多器官系统损伤。

关键词： 林格氏液   心脏骤停   亚低温   护理  

摘要： 目的探讨低温林格氏液对心脏骤停复苏后患者进行亚低温治疗的效果及安全性。方法选取2011年1月至2014年12月本院急诊科心脏骤停复苏后患者36例，按照随机数字排列表进行随机分组，分别为对照组和观察组。对照组采用常规冰帽方法降温，观察组采用林格液诱导亚低温，比较两组患者各项基本生命体征、降温成功率、IH-TT及三个月随访的脑功能。结果观察组的SpQ2高于对照组；降温成功率（94．44％）高于对照组（33．33％）；IH-TT值低于对照组，脑功能恢复较好（44．44％）的患者多于对照组（27．78％），且P〈0．05，差异具有统计学意义。结论静脉输注低温林格液诱导亚低温对患者进行脑组织保护治疗安全有效，是心脏骤停后心肺复苏的重要措施。而密切观察患者生命体征、预防肺水肿，降温过程中防治寒颤、缓慢复温是保证治疗实施的护理重点。

关键词： cardiac arrest   registry   resuscitation  

摘要： The existence of the International Liaison Committee on Resuscitation (ILCOR) has permitted the collaboration regarding resuscitation at an international level. The first definitions and recommendations regarding the report of cardiac arrest cases were developed in 1991 for the Out of Hospital Cardiac Arrest, and in 1997 for the In Hospital Cardiac Arrest. The Utstein definitions, which are in their revised and commonly adopted shape by the work group of ILCOR in 2002, at Melbourne, were translated and are available for anyone who wants to involve in the resuscitation study. Several registries of cardiac arrest are presented in this paper, The European registry of the cardiac arrest, the Belgian, the Swedish, the German, the Spanish, the Dutch, the French, and the registries from the United States of America. Last but not least, the Romanian Registry of the Cardiac Arrest is presented as it represents an initiative of the Romanian National Counsel of Resuscitation. The perspectives of a unique European register for the cardiac arrest has inspired this initiative, which has as a base the example of other European registers and the Utstein reporting model. In the first stage, the register participation was limited to the Emergency Departments of the Emergency Hospitals. Because the European purpose was to develop a smooth system of reporting the cardiac arrests that took place out of hospital, an integration of the pre-hospital events has followed, by collaborating with the Ambulance Services. Other characteristics, as the graphic representation of the Register data, are in progress of development, testing and implementing. [ABSTRACT FROM AUTHOR]