两种不同复苏方式的早期复苏成功率比较

Comparison of the early successful rate of cardiac resuscitation between closed chest cardiopulmonary resuscitation and open chest cardiopulmonary resuscitation

目的:探讨心跳停止4min内,即在大脑发生不可逆转的坏死前开始复苏,开胸与闭胸复苏在自主循环恢复率(ROSC)、心肺脑复苏成功率方面的差异。方法:健康杂种犬24只,随机分为:闭胸复苏组(CCCPR组),开胸复苏组(OCCPR组)。闭胸复苏组采用国际心肺复苏指南2005的标准及体外除颤的方法进行复苏;开胸复苏组,采用开胸直接挤压心脏及心外膜除颤方法进行复苏。按压(或挤压)2min后,静脉注射肾上腺素1mg,继续复苏2min后,电击除颤。如自主循环未恢复,则继续以上复苏,复苏30min无效则放弃。结果:自主循环恢复率:CCCPR组4/12(33.3%),OCCPR组12/12(100%),两组比较差异有统计学意义(P<0.001)。心肺脑复苏成功率:CCCPR组4/12(33.3%),OCCPR组11/12(91.7%),两组比较差异有统计学意义(P<0.001)。自主循环恢复时间:CCCPR组15～30min,平均21min;OCCPR组4～10min,平均8min。结论:对发生在院内及有急救人员在现场的心跳停止者,宜及早采用开胸心肺复苏,以确保大脑复苏成功。

Objective：To explore the deference in the early successful rate and ROSC rate of cardiopulmonary resuscitation（CPR） between closed chest CPR and open chest CPR within 4min after cardiac arrest（That is to say,the dogs,brain haven＇t been damaged permanently）.To provide a basis for choosing the correct methods of resuscitation in the clinical work.Methods：Twenty-four healthy and hybrid dogs were selected.They were randomly divided into two groups： closed chest cardiopulmonary pulmonary resuscitation（CCCPRgroup） and open chest CPR（OCCPRgroup）.CCCPRgroup was carried according to the 2005 American Heart Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Car and defibrillated in the chest.And OCCPR group was carried through compressing the hearts directly and defibrillated on the surface of the heart.Two minutes after CPR,1mg epinephrine was injected.Then continuing CPR for two minutes.A defibrillation was carried.If the spontaneous circulation didn＇t recover,The steps were repeated.Having resuscitated for 30 minutes,the spontaneous circulation hadn＇t recovered,we gave up resuscitating.the restoration of spontaneous circulation and the successful rate of cardiac-pulmonary resuscitation were calculated.Results：In CCCPR group,the restoration of spontaneous circulation was 33.3%（4/12）,and the successful rate of cardiopulmonary cerebral resuscitation was 33.3%（4/12）.In OCCCPR group,the restoration of spontaneous circulation（ROSC） was 100%（12/12）,and the cardiac-pulmonary cerebral resuscitation rate was 91.7%（11/12）.All P〈0.001.The time of ROSC in CCCPR group was 15~30min,the average time was 21min.And in OCCPRgroup,They were respectively 4~15min and 8min.Conclusion：Deferent methods of CPR should be adopted.To the cases with cardiac arrest in the hospital or when they attack cardiac arrest,the dispatchers are on the spot,OCCCPR should be adopted.But to the bystander who isn＇t a doctor,CCCPR should be adopted.