在院前心肺复苏中血管加压素的临床研究

Study on Administration of Vasopressin during Cardiopulmonary Resuscitation Prehospital

目的:研究血管加压素在院前心肺复苏(CPR)中的疗效。方法:在103例心脏骤停患者中随机分为3组,标准肾上腺素组(A组)38例,血管加压素组(B组)34例,肾上腺素+血管加压素组(C组)31例,各组分别观察自主循环恢复率、24h存活率、出院存活率、脑复苏率、自主循环恢复时间及复苏后心肌酶变化。结果:B组(44%)、C组(42%)自主循环恢复率明显高于A组(16%),B组(38%)、C组(39%)24h存活率也明显高于A组(13%),C组出院存活率(23%)高于A组(8%)、B组(12%);脑复苏率3组无差异;B组、C组自主循环恢复时间明显短于A组;复苏后心肌酶变化3组无差异。结论:在心肺复苏期间应用血管加压素比用肾上腺素可明显提高自主循环恢复率、24h存活率,缩短自主循环恢复时间,与肾上腺素联合应用还可提高出院存活率。

Objective： To study the effect of administrating vasopressin on cardiopulmonary resuscitation （CPR） before enter the hospital. Methods： 103 patients with cardiac arrest were divided into 3 groups（A,B,C group）. A group was 38 eases used standard dose epinephrine. B group was 34 cases used vasopressin. C group was 31 cases used vasopressin and epinephrine. The rate of spontaneous circulation restoration, the rate of survival over 24 hours, the rate of survival released from hospital, cerebral resuscitation rate, the average time of spontaneous circulation restoration and the change in value of myocardial enzyme after resuscitation were monitored in each group. Results： The rates of spontaneous circulation restoration in B group（44%） and C group（42%） were significantly higher than in A group（16%）. The rate of survival over 24 hours in B group（38%） and C group（39%） were significantly higher than in A group（13%） too. The rate of survival released from hospital in C group（23%） were higher than in A group（8%）and B group（12%）. The cerebral resuscitation rates in 3 groups had no difference. In 3 groups, the average time of spontaneous circulation restoration in B group and C group were significantly shorter than in A group. The change in value of myocardial enzyme after resuscitation had no difference in 3 groups. Conclusions： Comparing with the administration of epinephrine, the administration of vasopressin may significantly increase the rate of spontaneously circulation restoration and the rate of survival over 24 hours, shorten the average time of spontaneous circulation restoration during CPR. Combined with the administration of epinephrine during CPR even can increase the rate of survival released from hospital .