上海交通大学学报（医学版）

›› 2012, Vol. 32 ›› Issue (5): 605-.doi: 10.3969/j.issn.1674-8115.2012.05.016

• 论著（基础研究） • 上一篇    下一篇

绑带式胸廓挤压仪在心跳骤停小型猪心肺复苏中的作用

马霄雯1, 赵颖莹1, 闻大翔1, 杭燕南1, 沈 坚2   

  1. 1.上海交通大学 医学院附属仁济医院麻醉科, 上海 200001； 2.上海金怡医疗科技有限公司, 上海 201204
  • 出版日期:2012-05-28 发布日期:2012-06-01
  • 通讯作者: 闻大翔, 电子信箱: wdxrwj@126.com。
  • 作者简介:马霄雯（1986—）, 女, 硕士生；电子信箱: qiji8628@163.com。

Role of band-type chest compression device in pig model of cardiac arrest

MA Xiao-wen1, ZHAO Ying-ying1, WEN Da-xiang1, HANG Yan-nan1, SHEN Jian2   

  1. 1.Department of Anesthesiology, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200001, China；2.Shanghai Jinyi Medical Technologic Co., Ltd, Shanghai 201204, China
  • Online:2012-05-28 Published:2012-06-01

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摘要：

目的 观察新型绑带式胸廓挤压仪在心跳骤停小型猪心肺复苏（CPR）中的效果，并与传统人工按压的CPR结果进行比较。方法 26只小型猪随机分为机械按压组（n=13）和传统人工按压组（n=13），在电击诱发心室颤动（室颤）致心跳骤停4 min后分别实施机械胸外按压和人工胸外按压。比较两组动物CPR后的存活率；测定并比较两组动物诱导室颤前和恢复自主循环（ROSC）后1 min、5 min和1 h时间点的血流动力学指标、主动脉血气参数和乳酸浓度；X线摄片观察CPR成功后动物肋骨的损伤情况。结果 两组动物在ROSC时和CPR后1 h的存活率比较差异无统计学意义（P>0.05）。人工按压组在ROSC 1 min时的主动脉收缩压（AOS）、主动脉舒张压（AOD）和平均动脉压（MAP）均显著高于机械按压组（P<0.05），而各时间点的冠状动脉灌注压（CPP）比较差异均无统计学意义（P>0.05）；机械按压组在ROSC 1 min、15 min及1 h时间点的血液乳酸浓度均明显低于人工按压组（P<0.05）。X线胸片显示，机械按压组的肋骨损伤发生率与人工按压组比较差异无统计学意义（33.3%和45.5%）（P>0.05）。结论 绑带式胸廓挤压仪在小型猪CPR中的效果与传统人工按压效果相似，可以作为代替CPR中人工按压的一种方法。

关键词: 绑带式胸廓挤压仪, 心室颤动模型, 传统人工按压, 血流动力学

Abstract:

Objective To observe the effect of band-type chest compression device on cardiopulmonary resuscitation (CPR) in pig model of cardiac arrest by comparison with manual chest compression. Methods Twenty-six pigs were randomly divided into mechanical chest compression group (n=13) and conventional manual chest compression group (n=13), and mechanical chest compression and manual chest compression were performed respectively 4 min after cardiac arrest induced by ventricular fibrillation. The survival rates after CPR were determined, the hemodynamic parameters, blood gas of aorta and lactate concentrations before ventricular fibrillation and 1 min, 5 min and 1 h after return of spontaneous circulation (ROSC) were measured, and the injury of ribs after successful CRP was examined with X-ray radiography. Results There was no significant difference in survival rates at ROSC and 1 h after CPR between two groups (P>0.05). The aortic systolic pressure, aortic diastolic pressure and mean aortic pressure 1 min after ROSC in conventional manual chest compression group were significantly higher than those in mechanical chest compression group (P<0.05), while there was no significant difference in coronary perfusion pressure at different time points between two groups (P>0.05). The lactate concentrations 1 min, 15 min and 1 h after ROSC in mechanical chest compression group were significantly lower than those in conventional manual chest compression group (P<0.05). X-ray radiography revealed there was no significant difference in the injury rates of ribs between mechanical chest compression group and conventional manual chest compression group (33.3% vs 45.5%, P>0.05). Conclusion Band-type chest compression device may yield similar effect of CPR in pigs with conventional manual chest compression, and band-type chest compression device can be a substitute for manual compression in CPR.

Key words: band-type thoracic compression device, ventricular fibrillation model, conventional manual compression, hemodynamics