创伤性心搏骤停急诊早期开胸心肺复苏转运与院内无缝隙连接一体化研究附20例报告

Emergency Open Chest CPR for Chest Injuny

目的创伤性心搏骤停患者早期应用开胸心肺复苏术(OCCPR)及高效安全转运和与院内无缝隙连接进一步诊治对提高复苏成功率是至关重要的。方法120疑似求救电话,OCCPR手术组随综合急救车赴现场,气管插管控制通气,左前外侧第Ⅳ肋间进胸,膈神经前纵形切开心包,单手按压。结果2004年4月～2006年10月连续对20例胸部及复合外伤致心搏骤停患者施行了OCCPR,其中11例恢复循环,9例复苏失败,恢复循环11例中6例住院死亡,5例完全康复。结论急诊早期OCCPR对于外伤性心博骤停患者是一个效果肯定的复苏方法,尽早施行是成功的关键,在充分条件支持下现场Ⅰ期OCCPR可大大提高胸心穿透开放伤致心搏骤停的抢救成功率。

Objective It is beneficial to increase resuscitation succeed rate by applying OCCPR activity at emergency treatment room or at local space if it is necessary.Methods Control ventilation by endotracheal intubation,open chest at Ⅳ intercostals external.Location,cut pericardial length ways before diaphragm nerve,com-press the heart by 100.Results 20 cases of patients received OCCPR whose cardiac arrest time beyond 20 minutes at April 2004 to October 2006,11 cases recover circulation,9 cases fail.Conclusion OCCPR in emergency department still is effective resuscitation method.The successful point is carrying out OCCPR as soon as possible.Local early period OCCPR could largely increase succeed rate of saving chest and heart perforation trauma under the support of enough conditions.