关键词： 心脏骤停   心脏复苏   除颤心电监护仪   第一时间  

摘要： 随着科学技术的发展,越来越多的医疗仪器应于临床,使临床诊疗工作更加科学、有效.为了探究除颤心电监护仪这一电技术仪器在心脏骤停第一时间内对心肺复苏成功率的影响.我们用进口除颤心电监护仪对34例心脏骤停患者进行电击除颤,并与单纯人工通气加胸外心脏按压及药物复苏组进行比较,其结果报道如下.

关键词： 肾上腺素   心脏复苏   冠状动脉   抢救措施  

关键词： 医院内心脏停搏   心肺复苏   CPR   复苏成功率   心搏骤停  

摘要： 我院自1996年10月至2002年10月共抢救心搏呼吸骤停患者282例,除肿瘤晚期124例,急性脑血管病60例,现将其余98例行心肺复苏(CPR)情况分析如下.

关键词： 心脏骤停   临床资料   护理   人工冬眠  

摘要： 心脏骤停可发生于各种器质性心脏病、药物中毒、休克、严重外伤、药物过敏等,多无特异性先兆而突然发病,及时复苏至关重要.现将我科近年来复苏成功的病例报告如下.

关键词： heart arrest   epidemiology   mortality   survival   ACUTE MYOCARDIAL-INFARCTION   AUTOMATED EXTERNAL DEFIBRILLATORS   ANTIARRHYTHMIC-DRUG THERAPY   EMERGENCY MEDICAL-SERVICES   CORONARY HEART-DISEASE   IMPLANTABLE DEFIBRILLATORS   VENTRICULAR ARRHYTHMIAS   CARDIOPULMONARY-RESUSCITATION   TRENDS   DEATH  

摘要： Background - During the past quarter century, advances in treatment of cardiovascular disease have occurred that might potentially benefit survivors of sudden cardiac arrest (SCA). Little is known, however, about the temporal patterns in long-term survival among persons resuscitated from SCA. We hypothesized that long-term survival would improve over time and that this temporal pattern would be most evident for cardiac causes of death. Methods and Results - The investigation was a retrospective cohort study of survival among persons who were discharged alive from the hospital after resuscitation from out-of-hospital SCA due to heart disease in King County, Wash, between May 1, 1976, and December 31, 2001 (n = 2035). Calendar time was divided into four 5- year intervals: 1976 to 1980, 1981 to 1985, 1986 to 1990, and 1991 to 1995, and one 6-year interval, 1996 to 2001. Age-adjusted survival curves were constructed, and Cox proportional-hazards regression was used to compute hazard ratios (HRs) for the association between mortality and time period. During 11 201 person-years of follow-up, 1334 persons died. Compared with the initial time period, the HR for total mortality was 0.86 (95% confidence interval, 0.73 to 1.01) for 1981 to 1985, 0.82 (0.69 to 0.96) for 1986 to 1990, 0.66 (0.55 to 0.79) for 1991 to 1995, and 0.58 (0.47 to 0.71) for 1996 to 2001 ( HR for trend = 0.87 [0.84 to 0.91] for each successive time period). In analyses that assessed cardiac mortality, an even stronger temporal association was evident ( HR for trend = 0.79 [ 0.75 to 0.84]). Conclusions - Long-term survival after resuscitation from SCA improved steadily over time in this cohort. To continue this trend, future studies should identify circumstances in which proven treatments are underutilized as well as investigate new therapies that might benefit survivors of SCA.

关键词： 二尖瓣瓣膜替换手术   体外循环   心脏复苏   电解质   酸碱平衡  

摘要： 为探讨二尖瓣瓣膜替换手术体外循环中心脏不能自动复苏的原因,以提高心脏自动复苏率。对我院自1993年1月至2002年12月收治并行二尖瓣瓣膜替换手术体外循环中心脏不能自动复苏的58例临床资料,以及体外循环术中情况做一回顾性总结分析。结果,全组病例在开放升主动脉或心内操作结束后,在心脏未自动复苏时经使用辅助药物、调整灌注流量等处理,电击除颤后心脏复跳。提示58例心脏未能自动复苏的原因主要与体外循环中温度的控制、电解质及酸碱平衡的维持、心肌保护等方面的因素有关。

关键词： 体外循环   心脏复苏困难   原因分析   控制性温血灌注  

摘要： 目的探讨再阻断控制性温血灌注在心脏复苏障碍时应用。方法回顾性分析35例发生心脏复苏困难患者。(1)体外循环(CPB)方法:采用中度低温,中度血液稀释,4:1血停搏液灌注心肌保护。(2)控制性温血再灌注方法:对21例主动脉开放后ST段抬高患者实施再阻断不停跳温血灌注,14例发生心脏复跳困难患者给予再阻断高钾温血停搏液灌注。结果所有患者均顺利脱离CPB。结论解决主动脉开放后心脏复苏困难,再阻断控制性温血灌注是简单而有效的方法。

关键词： 急性心肌梗死   心脏骤停   心肺复苏   溶栓治疗   心室颤动   心律失常  

摘要： 患者男,60岁.以胸骨后压榨样疼痛1h急诊入院.心电图示广泛前壁AMI,入院后10min心电监护示室颤,立即行人工呼吸、胸外按压、静脉推注利多卡因100mg无效.以200J电击除颤成功,恢复窦性心律,心肺复苏约15min.患者自主呼吸恢复、意识转清,血压90/60mmHg,心率90次/min,即给予静脉点滴尿激酶溶栓,滴入约75万单位时,患者突然意识不清、四肢抽搐,心电监护示室颤.

关键词： 心脏骤停   呼吸停止   抢救   心脏复苏   脑复苏   呼吸复苏  

摘要： 目的:观察不同程序复苏时心脏骤停或伴呼吸停止的抢救成功率。方法:对14例单纯心脏骤停者,按心脏按压,药物、电复苏技术进行心脏复苏;9例伴呼吸停止者,按常规呼吸、心脏、药物、电技术程序进行复苏,所有病例均行脑复苏。结果:23例心肺复苏成功21例(91.30％),心肺脑复苏成功16例(69.57％)。结论:根据是否呼吸停止决定复苏程序有望提高复苏成功率,早期进行脑复苏是心肺脑复苏成功的关键。

关键词： 重症瓣膜病   心脏复苏困难   心肌保护   升主动脉   温血灌注   体外循环  

摘要： 目的总结9例复苏困难的重症瓣膜病患者成功复苏经验,尝试心肌保护新方法。方法对经多次除颤不能复苏的重症瓣膜病患者,采用再次阻断升主动脉,行4:1半钾温冷血停搏液诱停加纯温血持续灌注,待心脏复苏后再开放升主动脉的方法。结果9例复苏困难的重症瓣膜病患者均自动复苏。结论再次阻断升主动脉,行4:1半钾温冷血停搏液诱停加纯温血(不含停搏液)持续灌注,待心脏复苏后再开放升主动脉的方法为复苏困难的心脏直视手术患者成功复苏提供了新方法。