关键词： 肺结核   心肺复苏   心脏骤停   体会  

摘要： 目的:总结18例肺结核患者心脏骤停复苏经过,探讨呼吸道传染患者心肺复苏规律。方法:采用2005版"CPR"国际指南规定的双人心肺复苏法,其中将口对口人工呼吸改为面罩简易呼吸器手动换气,应用头部降温、脱水、血管活性药物、呼吸兴奋剂、电击除颤等方法进行规范的心肺复苏。结果:18例心脏骤停患者,复苏成功6例,其中4例为局限的侵润性肺结核,2例为咳血人;死亡12例,其中广泛性肺结核病变11例,大咯血1例。结论:肺结核合并心脏骤停患者在心肺复苏过程中,在实践工作中总结了独特的操作方法和用药规律,其有效地使用,可以提高心肺复苏的成功率。

关键词： 心脏骤停   心肺复苏   早期  

摘要： 心脏骤停是各种原因所致的循环和呼吸突然停止及意识丧失最紧迫的急诊。临床表现为：（1）血压、脉搏及心音突然消失；（2）呼吸突然消失；（3）神志不清，意识消失；（4）瞳孔散大；（5）面色苍白或青紫、口唇发绀；（6）皮肤黏膜灰暗或紫绀。心肺复苏是针对这一急诊采取的一系列急救措施。

关键词： 伤患者   心肺复苏后   大失血   抢救   穿通   心脏   2009年   病历资料  

摘要： 病历资料 患者,男,28岁。2009年6月19日凌晨1：00左右被杀伤左胸部,当时即感伤处疼痛、流血,随即出现呼吸困难,呼之不应,受伤20分钟后被朋友送入就诊。入院查体：体重约55kg,急性失血面容,四肢厥冷,颈动脉搏动微弱,双侧瞳孔等大等圆,对光反射消失,呼之不应。双肺呼吸音消失,左胸部第7肋处可见5cm的刀口,有血液渗出。

关键词： 18F-fluorothymidine   cetuximab   lung cancer   PET/CT  

摘要： We investigated whether 18F-fluorothymidine- positron-emission tomography/computed tomography (18F-FLT-PET/CT) is useful for the evaluation of the very early response to anti-epidermal growth factor receptor (EGFR) antibody cetuximab therapy in human lung cancer xenografts. A human tumor xenograft model was established with a human non-small cell lung cancer cell line. The mice were randomly assigned to four groups: tumor growth follow-up, ex vivo study, PET/CT imaging and non-treated control. Mice were administered saline as control or cetuximab on day 1. An immunohistochemical study with Ki-67 was performed. Tumor volume treated with cetuximab was kept significantly smaller than control after day 8, although there was no differ- ence on day 3. On day 3, 18F-FLT distribution was higher in the tumor than in other tissues, and was significantly decreased by treatment with cetuximab. On PET/CT imaging, 18F-FLT distribution in the tumor was clearly visualized, and the maximum standardized uptake value (SUV) was significantly decreased after treatment with cetuximab (p<0.01). Ki-67 expression was also significantly decreased on day 3 (p=0.01). These results suggest that 18F-FLT-PET/CT can be a useful predictor to determine the response to molecular targeted drugs such as cetuximab at an earlier time point than the change of tumor size.

关键词： 美国心脏学会   心血管急救   心肺复苏   指南   解读   中华医学会   主任委员   新证据  

摘要： 《2010美国心脏学会（AHA）心肺复苏（CPR）与心血管急救（ECC）指南》吸引了多学科学者的关注，专家们结合5年来的新证据对指南进行了更新，全文共17章。本刊转发中华医学会急诊分会主任委员李春盛教授等，对《指南》的解读，以飨读者。

关键词： 参附注射液   心搏骤停   心肺复苏术   超微结构   心肌组织  

摘要： 目的研究参附注射液对新西兰兔心搏骤停心肺复苏后心肌组织超微结构的影响,评价其对复苏后心肌组织的保护作用。方法采用窒息法制作新西兰兔心肺复苏模型,24只新西兰兔随机分为参附注射液组(A组)、正常复苏组(B组)、假手术模型组(C组)。A组在复苏后予静脉参附注射液2.1 mL/kg(生理盐水稀释至5mL),B组予生理盐水5 mL,每隔30 min缓慢静脉注射1次,连续3次;C组静脉仅进行插管等手术操作。观察复苏后三组动物M AP等变化。自主循环恢复后8 h处死动物,取心肌组织,光镜观察心肌组织变化,电镜观察超微结构改变。结果光镜下各组动物光镜下形态学特征相似。电镜:B组心肌组织超微结构有明显损害,C组无明显损害,A组损害较轻,明显好于B组。结论心肺复苏时应用参附注射液可以减轻心肌组织超微结构损害,对复苏后心肌组织有一定的保护作用。

关键词： audit   cardiac arrest   documentation   medicolegal   proforma   AMERICAN-HEART-ASSOCIATION   HEALTH-CARE PROFESSIONALS   STROKE FOUNDATION   STATEMENT   COUNCIL   CANADA  

摘要： The aim of this study was to audit cardiac arrest documentation within a UK teaching hospital, survey the regional use of proformas for data collection, and consider the need for a standardised national template. A prospective audit comparing cardiac arrest documentation to General Medical Council (GMC) professional standards and the 'Utstein' fields was carried out, along with a survey of regional resuscitation officers for the use of standardised templates. The main outcome measures were the design of 'best practice' template using GMC guidelines and the 'Utstein' fields. An audit of medical notes involving a cardiac arrest call against the template was performed. There was limited documentation concerning process, events and outcome of arrest calls, as well as minimal regional use of standard templates or consensus on the essential content of medical documentation. Documentation of cardiac arrests in the Leeds Teaching Hospitals does not meet the 'Utstein' recommendations to provide enough information for audit of cardiac arrest procedure. The regional survey indicates that this problem is likely to be widespread.

关键词： in-hospital cardiac arrest   Life Support Course for Nurses   life support instructors   nurse defribrillation   resuscitation officers   AUTOMATED EXTERNAL DEFIBRILLATORS   CARDIOPULMONARY-RESUSCITATION   SURVIVAL   STRATEGY   ADULTS  

摘要： Survival rates for in-hospital cardiac arrests are disappointing. Even though such arrests are often witnessed by a nurse, inadequate training may cause these first responders to have to wait for Advanced Cardiac Life Support trained personnel to arrive to perform defibrillation. The introduction of automated external defibrillator (AED) use by nurses was designed to address this problem, but studies have revealed that AED use is associated with a lower rate of survival after in-hospital cardiac arrest compared with no AED use. Interruption to cardiopulmonary resuscitation during the AED advisory mode is the likely reason for these unexpected results. Hence, courses like the Life Support Course for Nurses, which trains nurses to recognise collapse rhythms and to institute manual defibrillation, are extremely important. Barriers to the practice of advanced life support by nurses and recommendations for the prevention and management of in-hospital cardiac arrest are discussed.

关键词： 心脏猝死   心肺复苏   成功率  

摘要： 目的探讨心脏猝死患者心肺复苏中心脏按压在心肺复苏中的时间及顺序的选择,以便进一步指导临床治疗和抢救。方法回顾分析2008年1月至2010年10月到我院紧急实施心肺复苏的患者120例,根据不同的心肺复苏顺序分为选择顺序组(n=61)及常规组(n=59),对两组复苏成功率进行分析。结果选择顺序组窦性心率、自主呼吸恢复和复苏成功人数高于常规组,两组比较差异有统计学意义(P<0.05)。选择顺序组复苏死亡人数(35例)低于常规组(45例),两组比较差异有统计学意义(P<0.05)。结论即时发现心脏猝死首选心脏按压,较首选开通气道所进行的心肺复苏,将有助于提高心肺复苏的成功率。

关键词： 临时心脏起搏   心肺复苏   临床疗效   疗效分析   静脉   心肺脑复苏   心脑复苏   呼吸机  

摘要： 目前在心肺脑复苏中，肺的复苏因有呼吸机的支持已取得进展，但心脑复苏还未取得突破性进展，成功率很低。为探讨应用紧急经静脉临时心脏起搏对心肺复苏的临床疗效，本文对30例心肺复苏患者进行紧急临时心脏起搏，并与常规组30例进行比较，分析其对心肺复苏（CPR）成功率的影响。报道如下。