血管加压素、肾上腺素联合纳洛酮在心肺复苏中的应用研究

The combination of vasopressin and epinephrine with naloxone in the application of cardiopulmonary resuscitation

目的:研究纳洛酮联合血管加压素、肾上腺素在心肺复苏中的疗效。方法:84例心跳骤停患者,随机分成3组:肾上腺素标准剂量组(A组)28例;血管加压素加肾上腺素组(B组)35例;血管加压素加肾上腺素加纳洛酮组(C组)21例,各组分别观察自主循环恢复率、自主呼吸恢复率、自主循环恢复时间、自主呼吸恢复时间、存活率。结果:3组自主循环恢复率C组、B组明显高于A组(P<0.05);3组自主呼吸恢复率C组、B组明显高于A组(P<0.05),C组自主呼吸恢复率高于B组(P<0.05);B组和C组自主循环恢复时间明显短于A组(P<0.05);B组和C组自主呼吸恢复时间明显短于A组(P<0.05),C组自主呼吸恢复时间短于B组(P<0.05);C组、B组存活率显著高于A组(P<0.05);C组自主循环恢复率、存活率高于B组,自主循环恢复时间短于B组,无统计学意义。结论:心肺复苏期间联合应用血管加压素、肾上腺素和纳洛酮比单独应用肾上腺素明显提高自主循环恢复率、自主呼吸恢复率和存活率,缩短自主循环恢复时间及自主呼吸恢复时间,比应用血管加压素和肾上腺素明显缩短自主呼吸恢复时间,提高自主呼吸恢复率。

Objective：To study the effect of combination of vasopressin and epinephrine with naloxone in the application of cardiopulmonary resuscitationMethod：84 patients with cardiac arrest were divided into three groups： standard dose epinephrine group （A group, n =28）, vasopressin ＋ epinephrine group （B group, n ：35）, vasopressin ＋ epinephrine ＋ naloxone group （C group, n = 21）. The rate of spontaneous circulation and respiration restoration,the average time of spontaneous circulation and respiration restoration, the survival rate were monitored in each group. Result：The rate of spontaneous circulation and respiration restoration and the survival rate were significantly higher in group C and group B than that in group A（ P 〈0.05）. The average time of spontaneous circulation and respiration restoration in group B and group C was significantly shorter compared with group A （ P 〈0.05）. Conclusion： Administration of vasopressin combined with epinephrine and naloxlne during cardiopulmonary resuscitation may significantly increase the survival rate and the rate of spontaneous circulation and respiration restoration. The average time of spontaneous circulation and respiration restoration may be shorted, the average time of respiration restorations and the rate of spontaneous respiration restoration may be increased by com bination of vasopressin and epinephrine with naloxone.