关键词： 急救   事故   交通   心肺复苏术   胸廓切开术   人类  

摘要： 随着城市化、交通化、机械化的发展,意外伤害、交通事故等造成的创伤逐年增多。120急救工作的迅速发展,亦使复苏工作的开展逐渐进入更新的领域。开胸心脏挤压复苏的重要性。有关专家曾强调应把它培训到医院医师。逐年来我院对几例意外伤害进行复苏时。采用了开胸心脏挤压。均使心脏复跳。现就其施救过程成败原因进行分析,探讨如何提高复苏成功率。[第一段]

关键词： 心脏骤停   心肺复苏   模型   心脏起搏   窒息   动物  

摘要： 背景和目的： 由于临床研究受多种因素干扰，深入研究心脏骤停（Caridac arrest，CA）和心肺复苏（Cardiopulmonary resuscitation，CPR）的病理生理机制受到一定限制。动物实验的优势之一是能够严格控制各种混杂因素，使实验结果具有重复性，为研究疾病的发生机制、验证各种治疗药物或治疗手段创造了条件。由于小动物（如家兔、大鼠和小鼠等）的许多生理特性与大动物、甚至人类非常相似，采用小动物进行CPR的实验研究已经引起人们的广泛重视。 建立CA动物模型是进行CPR研究的前提条件。用交流电经右心室心内膜电击诱导大鼠和小鼠发生室颤是目前建立CA动物模型的主要方法。由于操作复杂，其应用受到限制。本研究的目的之一是寻找较为简便的、复制小动物室颤模型的方法。 心脏起搏在缓慢型心律失常的治疗中具有肯定的疗效，但在CPR中是否有效仍有争议。本研究的目的之二是观察经食道心脏起搏在窒息性CA大鼠CPR中的疗效，探讨其作用机制和影响因素。 药物在CPR中起重要作用。由于纳络酮和加压素在CPR中的疗效仍有争议，不同剂量的肾上腺素在大鼠CPR中的疗效如何尚未见有文献报导。本研究的目的之三是观察纳络酮和加压素在窒息性CA动物模型中的疗效，以及不同剂量加压素与肾上腺素对复苏疗效的影响，并对神经内分泌系统的变化与CPR疗效的关系进行探讨。

关键词： 心肺复苏术   心脏停搏/外科学   人类  

摘要： 心脏骤停(cardiac arrest,CA)是临床上常见的最紧急的危险情况,心肺复苏(CPR)是临床上棘手的问题之一。不管CA原因如何,其处理大致相同。复苏学起始于20世纪50年代,50年代末开展肺脏复苏,60年代开展心脏复苏,70年代开展心肺复苏,80年代又发展为心脏脑复苏(CPCR)。复苏学研究的目的不仅要使患者呼吸心跳恢复,还要使患者智力恢复,即脑功能恢复,最后使整个机体功能活动恢复正常。目前复苏术正在普及与规范化,其研究仍在进一步深化,其方法和机制有了很大进展,同时也有许多争论。[第一段]

关键词： 病例报告   手术后出血/并发症   危重病   心肺复苏术   心脏瓣膜假体植入   心脏停搏/治疗   心脏停搏/病因学   人类  

关键词： heart disease   myocardial infarction   reperfusion   nervous system   TRPV1 protein, mouse   ISCHEMIA-REPERFUSION INJURY   GUINEA-PIG HEART   SUBSTANCE-P RECEPTORS   NITRIC-OXIDE   MYOCARDIAL-INFARCTION   CAPSAICIN RECEPTOR   VANILLOID RECEPTOR   NERVE-FIBERS   RAT-HEART   PEPTIDE  

摘要： Background - Although pharmacological studies suggest that the transient receptor potential vanilloid type 1 (TRPV1) channels expressed in sensory nerve fibers innervating the heart may exert a cardioprotective effect, definitive evidence supporting such a notion is lacking. In addition, function and regulation of sensory neuropeptides, namely, calcitonin gene-related peptide (CGRP) and substance P (SP), in the face of challenges induced by cardiac injury in the presence or absence of the TRPV1 are largely unknown. Methods and Results - The hearts of gene-targeted TRPV1-null mutant (TRPV1(-/-)) mice or wild-type (WT) mice were perfused in a Langendorff apparatus in the presence or absence of capsazepine (a TRPV1 receptor antagonist), CGRP, CGRP(8-37) (a CGRP receptor antagonist), SP, or RP67580 (a neurokinin-1 [NK1] receptor antagonist) when hearts were subjected to 40 minutes of ischemia and 30 minutes of reperfusion. Hemodynamic alterations and SP release measured by radioimmunoassay were assessed before and after ischemia/reperfusion injury of the heart. Expression of the NK1 receptor in the hearts of TRPV1(-/-) and WT mice were determined with the use of Western blot analyses. Impairment of postischemic recovery, defined by increased left ventricular end-diastolic pressure (LVEDP) and decreased left ventricular developed pressure (LVDP) and coronary flow (CF), was more severe in TRPV1(-/-) hearts than in WT hearts. Although it had no effect on postischemic recovery of TRPV1(-/-) hearts, blockade of the TRPV1 with capsazepine caused a most severe impairment of postischemic recovery in WT hearts compared with untreated WT and TRPV1(-/-) hearts. Exogenous CGRP and SP produced a significant improvement in postischemic recovery in both TRPV1(-/-) and WT hearts, and the maximal functional improvement in TRPV1(-/-) hearts was not different from that of WT hearts except that SP-induced increases in LVDP were larger in the former than in the latter. Blockade of the NK1 receptor with RP67580, but not blockade of the CG

关键词： 休克   失血性   心脏   左旋精氨酸   大鼠   保护作用  

摘要： 目的探讨失血性休克再灌注心脏损伤氧自由基变化及左旋精氨酸的保护作用。方法健康 SD 大鼠30只,随机均分成正常对照组(NC 组)、失血性休克再灌注组(HS 组)和左旋精氨酸治疗组(L-Arg 组)。实验结束时,取心脏组织测定超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-PX)和黄嘌呤氧化酶(XO)活性。结果与 NC 组相比较,HS 组心脏组织 SOD、GSH-PX 活性显著下降,XO 活性明显增高,而 L-Arg 组心脏组织的 SOD、GSH-PX 活性无显著下降,XO 活性亦无显著升高;L-Arg 组 XO 活性明显低于 HS 组,而 SOD、GSH-PX 活性明显高于 HS 组。结论大鼠失血性休克复苏后,心功能下降,氧自由基参与心脏的损伤过程,L-Arg 通过抑制氧自由基的产生,增加冠脉血流量,减轻脂质过氧化反应,有助于减轻心肌缺血再灌注损伤,从而起到保护心脏的作用。

关键词： 复苏   心脏骤停   阵发性心房颤动   经导管消融治疗   参脉注射液   心房纤颤   疗效评价   索他洛尔   伊贝沙坦   评估研究  

摘要： 葛根素和参脉注射液治疗心房纤颤；小剂量索他洛尔治疗阵发性心房颤动的疗效评价；伊贝沙坦对心房颤动复发率的影响；阵发性心房颤动经导管消融治疗40例报告；心肺复苏后昏迷的评估研究。

关键词： 窒息   心脏骤停   心肺复苏术  

摘要： 患者,男,50岁,因窒息30分钟入院.30分钟前饮白酒144 g(60 V/V,300 ml),吞咽馒头时出现呼吸停止、面部发绀、呼之不应,家属见咽部被馒头堵塞,用手指抠出部分,并将头部倒立,反复拍背,无好转.既往有高血压病史20年,支气管哮喘病史10年,糖尿病史5年,冠心病心绞痛4年.查体:无呼吸,无心跳,颈动脉搏动消失,面部发绀,双侧瞳孔散大且固定,各种反射消失.心电图示直线.诊断:①窒息;②心脏骤停.立即给予心脏按压、气管插管机械通气、头部置冰帽、吸氧,静脉注射肾上腺素1 mg、地塞米松10 mg、呋塞米40 mg,静脉滴注20%的甘露醇125 ml、5%的碳酸氢钠100 ml.气管插管时,发现咽喉部已被馒头全部堵塞,并迅速取出.肾上腺素每隔3～5分钟1 mg静脉注射,共用5次.

关键词： birth asphyxia   glutathione   oxidative stress   room-air resuscitation   CARDIAC TROPONIN-T   OXIDATIVE STRESS   NEWBORN-INFANTS   SUPEROXIDE-DISMUTASE   OXIDIZED GLUTATHIONE   INJURY   ASPHYXIA   HYPOXIA   BLOOD  

摘要： Rationale: Pure oxygen causes more oxidative stress than room air in resuscitation of asphyctic neonates, and consequently could be associated with increased tissue damage. Objectives: To compare damage caused to heart and kidneys on reoxygenation in severely asphyctic term neonates resuscitated with room air (RAR) or 100% oxygen (OxR). Nonasphyctic term newborn infants served as a control group. Methods and Measurements: This is a prospective randomized clinical trial masked for the gas mixture. Reduced glutathione (GSH), oxidized glutathione (GSSG), and superoxide dismutase (SOD) activity were measured to assess oxidative stress. Plasma cardiac troponin T (cTnT) and urinary N-acetyl-glucosaminidase (NAG) assessed cardiac and renal damage, respectively. Daily determinations of NAG for a 2-wk period were performed to monitor postasphyctic renal damage. Main Results: Both asphyctic groups showed oxidative stress when compared with the control group as evidenced by diminished GSH/ GSSG ratios, adaptive increases in SOD activity, and higher values of NAG and cTnT (markers of tissue damage). However, the OxR group showed significantly higher values of NAG and cTnT, lower GSH/GSSG ratios, and higher SOD activity than the RAR group. Moreover, NAG values persisted in being higher than normal in the OxR group for 2 wk after birth, whereas NAG in the RAR group dropped to normal within the first week. A linear correlation between cTnT or NAG and GSSG was found. Conclusions: The use of room air on resuscitation causes less oxidative stress and damage to heart and kidney than pure oxygen.