胸内心脏挤压器的初步研究

Intra thoracic heart presser : a preliminary study

为取得心脏直接挤压的良好复苏效果，同时避免常规开胸手术，我们设计了胸内心脏挤压器。该挤压器可经剑突下小切口放到心包前、胸骨后，用外接驱动囊控制挤压器的张驰，使心脏受压和舒张。在６只幼猪室颤模型中，与常规闭胸心肺复苏比较，结果：室颤前放入挤压器，对自主循环没有显著影响。室颤２ｍｉｎ后，开始用常规闭胸心肺复苏，冠状循环灌注压（ＣＰＰ）２．３１±０．９６ｋＰａ；改用挤压器心肺复苏，ＣＰＰ４．７７±０．８３ｋＰａ，提高到前者的２０７％。６只幼猪全部复苏成功，并长期正常存活。

In search of the effect of direct eardiac compression and the exemption of conventional thoracotomy for cardiopulmonary resuscitation at the same time,we have invented intra Thoracic Heart Presser (ITHP).ITHP was designed to be inserted via a small subxiphoid incision into thorax between sternum and pericardium. With the inflation and deflation of external driving bag connected to ITHP,ITHP is enabled to perform cardiac compression and decompression.In six piglets with ventricular fibrillation,conventional closed-chest CPR (CC-CPR) and ITHP-CPR were sequently carried out for 2 min in each. We found that the plantation of ITHP had little effect on spontaneous circulation. During CPR,however,coronary perfusion pressure (CPP) in ITHP-CPR was much higher than CC-CPR (4.77 ± 0. 83 kpa vs 2.31 ± 0.96 kpa,P＜0.01 ).All animals were successfully resuscitated and normally survived.No severe complication was found.