关键词： 心脏复苏   患者   护理体会   脑死亡   监护室   静脉用药   呼吸骤停   过程   支持   意识  

摘要： 例：患者，女，因在眼底造影过程中，对造影剂荧光素钠过敏而导致心跳、呼吸骤停，立即对其进行心肺脑复苏抢救，50分钟后心跳复苏，自主呼吸及意识未恢复。在呼吸机支持下，心脏监护过程中，静脉用药及留置导尿过程中，以“心脏复苏后”转入我科监护室。

关键词： ADVANCED LIFE-SUPPORT   FREQUENCY   PROBABILITY   CPR  

摘要： Background - Early defibrillation is considered the most important factor for restoring spontaneous circulation in cardiac arrest patients with ventricular fibrillation. Recent studies have shown that, after prolonged ventricular fibrillation, the rates of return of spontaneous circulation (ROSC) and survival are improved if defibrillation is delayed so that CPR can be given first. To examine whether CPR improves myocardial readiness for defibrillation, we analyzed whether CPR causes changes in predictors of defibrillation success calculated from the ventricular fibrillation waveform. Methods and Results - ECG recordings were retrieved for 105 patients from an original study of 200 patients receiving CPR or defibrillation first. Altogether, 267 CPR sequences from 77 patients were identified on which the effect of CPR could be evaluated. Five predictors of ROSC ( spectral flatness measure, energy, centroid frequency, amplitude spectrum relationship, and estimated probability of ROSC) were determined from a spectral analysis of the ventricular fibrillation waveform immediately before and immediately after each of the 267 sequences. CPR increased spectral flatness measure, centroid frequency, and amplitude spectrum relationship (P < 0.05, P < 0.001, P < 0.01). In an analysis of the effect of the duration of CPR, the probability of ROSC and amplitude spectrum relationship showed a positive change for CPR sequences lasting >3 minutes (P < 0.001, P < 0.05). Conclusions - During resuscitation from ventricular fibrillation, changes in the predictors calculated from the ventricular fibrillation waveform indicated a positive effect of CPR on the myocardium.

关键词： 胸外心脏按压   心脏复苏   脑死亡   心脏骤停  

摘要： 为了使心脏骤停病人得救，避免脑死亡，以便在心跳、呼吸恢复后，神志意识也能恢复，就须在心脏停跳后4分钟以内进行有效的心肺复苏，复苏得越早，效果越好。胸外以及按压就是在现场徒手抢救的最好办法。

关键词： 心脏复苏   存活率   心脏骤停   呼吸衰竭  

关键词： cardiac arrest   active compression-decompression   cardiopulmonary resuscitation (CPR)   impedance threshold device   outcome   INSPIRATORY IMPEDANCE   VENTRICULAR-FIBRILLATION   ABDOMINAL COMPRESSION   PNEUMATIC VEST   PORCINE MODEL   VALVE   CPR   CHEST   PRESSURE   SURVIVAL  

摘要： Aims: The purpose of this multicentre clinical randomized controlled blinded prospective trial was to determine whether an inspiratory impedance threshold device (ITD), when used in combination with active compression-decompression (ACD) cardiopulmonary resuscitation (CPR), would improve survival rates in patients with out-of-hospital cardiac arrest. Methods and results: Patients were randomized to receive either a sham (n = 200) or an active impedance threshold device (n = 200) during advanced cardiac life support performed with active compression-decompression cardiopulmonary resuscitation. The primary endpoint of this study was 24 h survival. The 24 h survival rates were 44/200 (22%) with the sham valve and 64/200 (32%) with the active valve (P = 0.02). The number of patients who had a return of spontaneous circulation (ROSC), intensive care unit (ICU) admission, and hospital discharge rates was 77 (39%), 57 (29%), and 8 (4%) in the sham valve group versus 96 (48%) (P = 0.05), 79 (40%) (P = 0.02), and 10 (5%) (P = 0.6) in the active valve group. Six out of ten survivors in the active valve group and 1/8 survivors in the sham group had normal neurological function at hospital discharge (P = 0.1). Conclusion: The use of an impedance valve in patients receiving active compression-decompression cardiopulmonary resuscitation for out-of-hospital cardiac arrest significantly improved 24 h survival rates. (C) 2004 Elsevier Ireland Ltd. All rights reserved.

关键词： 肾上腺素   纳络酮   心脏复苏   心跳骤停   自主循环   诊断标准  

摘要： 目的 探讨纳络酮和肾上腺素联合应用在心脏停搏病人中的疗效是否优于单纯使用肾上腺素。方法 24例心脏骤停病人给予纳络酮和肾上腺素联合用药，30例心跳骤停病人单用肾上腺素作为对照组。比较2组病人的心脏电活动和自主循环恢复情况以及存活率。结果 ①合用组19例(79．2%，19／24)病人恢复心电活动，高于肾上腺素组16例53．3％(16／30)，差异接近显著(P=0.0827)。②用组1，3，6的生成率分别为87.5％(21／24),54．2％(13／24)和37.5％(9／24)，也分别高于肾上腺素组(1h56．7％,36.20％,6h13．3％)。差异也具有显著意义(P<0．05)。④合用组有12例(50%)的病人恢复自主循环，也高于肾上腺素组(40.0％，12／30)，但差异不显著(P=0．462)。④合用组有2例（8.3%）病人出院，高于肾上腺素组(33％，1／30)，差异不显著(P=0．579)。结论 纳络酮与肾上腺素联合用药在心脏停搏病人的疗效可能优于单纯使用肾上腺素。

关键词： 肾上腺素   心脏停搏   多巴胺   合用   患者   复苏   心跳骤停   自主   结论   显著性  

摘要： 目的　探讨多巴胺和肾上腺素联合应用在心脏停搏复苏中的作用。方法　 2 0例心跳骤停患者给予多巴胺和肾上腺素联合用药 ,2 6例心跳骤停患者单用肾上腺素作为对照组。比较两组患者的心脏电活动和自主循环恢复情况。结果　合用组恢复心电活动 16例 (80 %) ,高于单肾上腺素组 46.15 %(12 /2 6) ,差异有显著性 (P <0 .0 5 ) ;合用组恢复自主循环 15例 (75 %) ,也高于单用肾上腺素组 42 .3 %(11/2 6) ,差异也有显著性 (P<0 .0 5 )。结论　较大剂量多巴胺与肾上腺素联合用药在心脏停搏患者中的疗效优于单纯使用肾上腺素。

关键词： 心脏骤停   复苏   急救护理   体会   护理问题   患者   抢救   99年   正确  

摘要： 心脏骤停的预后取决于及时发现和正确有效的处理，本文对我院1999年以来抢救的31例心脏骤停患者进行分析，讨论复苏急救的几个护理问题。

关键词： 心脏骤停   心肺复苏   甲状腺   功能变化   血液循环   神经内分泌   细胞因子  

摘要： 心脏骤停(CA)及心肺复苏(CPR)过程中,机体经历完全血液循环停止、严重缺氧、酸中毒和缺血/再灌注等一系列的应激过程,大量神经内分泌及细胞因子参与这一过程,这些因子相互作用,对CA的病理生理改变、复苏药物的应用效果及CPR的预后产生重要影响,而CA及CPR后甲状腺功能变化及其应对策略却没有得到足够重视.

关键词： 开胸   胸外心脏按压   心跳停止   手术中   心肺复苏   非心脏手术   结果报告   ECC   中心  

摘要： 本院自1985～2003年12月在非心脏手术麻醉期间发生心跳骤停28例,除3例为开胸手术外,其余25例均首先采用胸外心脏按压(external chest compression,ECC),其中10例在ECC无效情况下改为开胸心脏按压(open chest cardiac compression,OCC),现将结果报告如下.