腹部提压法对窒息性心搏骤停猪复苏效果的实验研究

A Experimental Study on the Effect of Rhythmic Abdominal Lifting and Compression During Cardiopulmonary Resuscitation in a Swine Model of Asphyxia

目的：比较胸外按压心肺复苏（CC-CPR）与腹部提压心肺复苏（ALc-CPR）对窒息性心搏骤停猪复苏时血流动力学指标和通气指标的影响。初步评价腹部提压法对窒息性心搏骤停猪的复苏效果。方法：健康家猪30只，建立窒息性心搏骤停模型。随机分为两组。每组15R，分别实施cc-cPR和ALc-cPR。窒息前10min开始连续记录心电圈（ECG）、经皮脉搏氧饱和度（Sp02）．呼气宋二氧化碳分压（PETC02），主动脉收缩压（SBP）．舒张压（DBP）、中心静脉压（CVP）和潮气量（VT）直至试验结束；计算主动脉平均动脉压（MAP）、冠脉灌注压（CPP）和每分通气量（MV）；分别在窒息前10min（TI），窒息后10min（T2）、复苏后5min（T3）、复苏后10mii3（T4）、复苏后20min（T5）抽取动脉血查血气。观察两组动物的自主循环恢复（ROSC）率，24h存活率和24h后神经功能缺损评分。结果：CC-CPR组MAP和CPP高于ALC-CPR组．两组间的差异有统计学意义；ALC-CPR组的VT和MV高于CC-CPR组，差异有统计学意义；CC-CPR组ROSC率为26．7％，ALC-CPR组为80％，差异有统计学意义；24h存活率CC-CPR组为13．3％，ALC-CPR组为60％。差异有统计学意义；24h神经功能评分ALC-CPR组优于CC-CPR组。结论：在窒息性心搏骤停猪的复苏早期，ALC-CPR较cc-CPR更具优势。

Objective： This study was designed to compare the hemodynamic and ventilational influences of chest compression- cardiopulmonary resuscitation （CC-CPR） and rhythmic abdominal lifting and compression- cardiopulmonary resuscitation （ALC-CPR） in a swine model of asphyxial cardiac arrest （CA）, and evaluate the effectiveness of rhythmic abdominal lifting and compression. Method： The swine cardiac arrest was induced by asphyxia as a result of clamping the trachea .Thirty pigs were divided into two groups equally. One group used chest compression to perform CPR, and the other one used rhythmic abdominal lifting and compression. Electrocardiogram （ECG）, tidal volume （VT）, transcutaneous oxygen saturation （SPO2） and end-tidal partial pressure of carbondioxide （PETCO2） was monitored continuously. Hemodynamic monitoring of aortic and right atrial pressure was performed continuously. Then, calculate the mean arterial pressure （MAP）, coronary perfusion pressure （CPP）, minute ventilation （MV）. the restoration of spontaneous circulation （ROSC）, 24-hour survival rate and 24-hour scoring of neurological function deficiency. Result： In the 2 minutes after the CPR started, the MAP of CC-CPR was （43.60±12.91） mmHg and CPP is （21.67±11.28） mmHg, the MAP of LAC- CPR was （33.40±6.59） mmHg and CPP was （11.80±4.16） mmHg. The MAP and CPP of ALC-CPR was significantly lower than CC-CPR. But the ROSC and MV of ALC-CPR was significantly higher than CC-CPR. The ROSC was 26.7% in CC-CPR, and 80% in ALC-CPR, the MV of CC-CPR was （5.54±0.79）L/ min, the MV of LAC-CPR was （11.17：1：1.81）L/min. Conclusion： In the incipient stage of cardiopulmonary resuscitation of the swine model of asphyxia, compared with CC-CPR, ALC-CPR can be more effective.