关键词： 心肺复苏仪   胸外心脏按压   CPR   临床资料   急诊心脏停搏   CA  

摘要： 目的:探讨心肺复苏仪胸外心脏按压对心肺复苏成功的影响。方法:将42例心跳呼吸骤停患者随机分为徒手胸外心脏按压组(A组)和心肺复苏仪胸外心脏按压组(B组)。二组均进行无创动脉血压、心电、经皮氧饱和度sPO2等监测。结果:B组的自主循环恢复率和24小时存活率均明显高于A组(P<0.05和P<0.01),但二组的出院存活率无显著性差异。B组的经皮氧饱和度明显高于A组(P<0.05),而自主循环恢复时间则明显短于后者(P<0.01);二组的平均动脉压无显著性差异。结论:心肺复苏仪胸外心脏按压在提高自主循环率,缩短自主循环恢复时间,改善患者生存机会等方面明显优于徒手胸外心脏按压。

关键词： bystander CPR   cardiac arrest   emergency medical services   out-of-hospital CPR   return of spontaneous circulation   Utstein template   ONE-YEAR SURVIVAL   OUTCOME REPORT  

摘要： Objective: The British National Service Framework (NSF) for heart disease commended the 'Utstein style' for auditing out-of-hospital cardiac arrests. The NSF also set standards for pre-hospital treatment and response times. To increase the flexibility of Utstein, an 'event tree' technique is proposed as an audit tool. Event trees consist of nodes and branches on which numbers, percentages or probability values are entered. Methods: Using the London Ambulance Service's (LAS) 1997 database on 3759 out-of-hospital cardiac arrests, 2772 arrests witnessed by lay bystanders or unwitnessed were analysed focusing on bystander cardiopulmonary resuscitation (BCPR) and response times. Results: The Utstein template showed that witnessed arrests in ventricular fibrillation (VF) or ventricular tachycardia (VT) who had received BCPR achieved a return of spontaneous circulation (ROSC) in the field significantly more often than non-BCPR recipients-26 versus 16% (P = 0.006). But the likelihood of being admitted to a hospital bed, and discharged alive, was only marginally better for BCPR recipients. To examine the influence of BCPR on the presenting rhythm an event tree showed that in 48% of witnessed BCPR cases the presenting rhythm was VF/VT, whereas, for witnessed non-BCPR cases, 27% were in VF/VT (P < 0.0001). With unwitnessed arrests, 31% of BCPR cases were in VF/VT compared with 18% for non-BCPR cases (P < 0.0001). Call to scene time was less than 8 min for 66% of all VF/VT arrests. Conclusion: The event trees, when combined with the Utstein template, demonstrated the importance of examining comprehensively datasets for both witnessed and unwitnessed cardiac arrests when monitoring performance standards. The analyses also emphasised the relevance of community programmes in Greater London for teaching basic life saving skills. (C) 2002 Elsevier Science Ireland Ltd. All rights reserved.

关键词： 心脏骤停   心肺复苏   临时起搏  

摘要： 目的　研究心肺复苏 (CPR)应用临时心脏起搏治疗对心肺复苏成功率及临床效果的影响。　方法　采用回顾性分析。　结果　心肺复苏成功 32例 ,失败 4例 ,成功率为 88 89% ,P <0 0 1。　结论　证明心肺复苏应用临时心脏起搏治疗可以提高心肺复苏成功率及减少心脏猝死的死亡率 ,具有重要临床价值。

关键词： Utstein style analysis   out-of-hospital cardiac arrest   cardiopulmonary resuscitation   SURVIVAL   CITIES   TRIAL  

摘要： Objective: Survival after out-of-hospital cardiac arrest (OOHCA) in an urban environment is directly proportional to speed of defibrillation and effective bystander cardiopulmonary resuscitation (CPR). We hypothesized that the hospital discharge rate from rural OOHCA was affected by the same factors. Methods: We studied all OOHCAs in 1998 for rural Alachua County, Florida, with one emergency medical system (EMS) transport provider and three hospitals. All EMS identified OOHCA were reviewed retrospectively, as were EMS and hospital records. The 1998 County population was 211403; 1495 deaths from all causes occurred (70.7/10(4) pop). Of 167 OOHCAs (7.9/10(4) pop), 145 were of cardiac etiology; 22 were excluded (13 scene deaths, four traumatic, one intraoperative and three respiratory arrests, one arrest during a hospital-to-hospital transfer) and in eight outcome data were not available in any form. A total of 137/145 (94.5%) OOHCA patients had analyzable data. Data were analyzed using Student's t-test and ANOVA. Alpha was set at 0.05. Results: Of 25 patients (18.2% of OOHCA) with restoration of spontaneous circulation (ROSC), six survived (4.4% of total, 24% of those with ROSC) to discharge from hospital (four to a skilled nursing facility, one each home with and without assistance). Four patients were still alive at greater than or equal to 1 year post arrest. Asystole as the initial rhythm (P = 0.014), and emergency department (ED) CPR time (8 vs. 15.5 min, P = 0.042 for survivors vs. non-survivors) were the only factors statistically affecting survival. While bystander CPR was not significantly different between groups, there was a significantly higher proportion of patients surviving in the ED who had ROSC, and a higher proportion who had ROSC after bystander CPR. Time to defibrillation in nonsurvivors, while not statistically different between city and county patient groups, was clinically different. Statistical significance would likely have been achieved with a larger study population. Conclusion: Our data

关键词： 心律失常   辨证分型   中药疗法   开心胶囊  

关键词： 回顾性研究   急救   心肺复苏术/方法   心脏停搏/治疗   人类  

摘要： 目的:通过对院内34例心脏骤停(CA)患者心肺复苏(CPR)抢救的回顾和总结,进一步提高医院内CPR成功率。方法:回顾性分析34例在院内CA患者的临床抢救资料,分析抢救治疗,病因处理对复苏的影响。结果:34例中27例成功,7例死亡。死亡原因与诱因未去除、复苏后再发CA的先兆处理不力或延误抢救时间有关。结论:抢救中病因处理,先兆心律失常的处理以及再发CA的预防应予高度重视。

摘要： 我院120急诊内科从1999年12月至2002年12月,对6例急性心肌梗死心脏骤停复苏后的患者进行尿激酶静脉溶栓治疗,通过间接判断再通标准判定,5例患者再通,1例患者未通,但均获得良好的治疗效果,现总结如下:

关键词： 肾上腺素/投药和剂量   复苏术   心脏停搏/治疗   人类  

摘要： 10例心脏骤停病人,在进行常规复苏过程中应用大剂量肾上腺素,7例获得成功,作者认为大剂量肾上腺素在心脏骤停复苏过程中的应用,有利于复苏成功。

关键词： 病例报告   呼吸暂停/治疗   呼吸暂停/病因学   流产   人工/副作用   心肺复苏术   心脏停搏/治疗   心脏停搏/病因学   女(雌)性   人类   妊娠  

摘要： 1 病例资料孕妇,29岁,因G3P2宫内孕63天,于2002年10月29日到本院门诊妇科行人流术终止妊娠,既往无心脏病、高血压及晕厥史.术后半分钟孕妇突然出现意识丧失,呼之不应,大动脉搏动消失,呼吸消失,血压测不到,颜面口唇青紫,立即请我科抢救,1min后急诊医师到达给予现场心肺复苏(CPR),畅通气道,持续胸外心脏按压,高流量吸氧,静注肾上腺素1mg、可拉明0.375mg,洛贝林3mg,静注生脉40ml,经抢救5min后患者心跳呼吸恢复,大动脉搏动出现,神志清楚,颜面口唇青紫消失,血压60/40mmHg,心率52次/min,遂转急诊科留观半天,生命体征平稳后出院.

关键词： 心肌梗死/药物疗法   心肌梗死/并发症   心脏停搏/药物疗法   心脏停搏/病因学   血栓溶解疗法   心肺复苏术   人类