心肺转流进行心肺脑复苏的实验研究

Experimental sutdy on Cardiopulmonary and Cerebral resuscitation by Cardiopulmonary bypass

目的:观察心肺转流(CBP)对狗心脏停搏30分钟后的心肺复苏效果。方法:用静脉注射10％氯化钾溶液使狗心搏、呼吸骤停30分钟后,分两组进行心肺复苏,每组6只。对照组用常规法,实验组用CPB法,进行心电图、动脉压、静脉压、动脉血气监测和观察瞳孔,30分钟后观察复苏效果。结果:对照组仅1例于第15分钟后恢复自主循环,瞳孔开始缩小,其余均未能复苏(20％)。实验组于2—3分钟后全部恢复自主循环(100％),瞳孔缩小。复苏30分钟后,实验组平动脉压、PaO2明显高于对照组(P<0.05)。实验组静脉压和PaCO2明显低于对照组。大脑皮层及海马区脑组织Ca-Mg-ATP酶活性实验组也高于对照组。结论:心脏呼吸骤停30分钟后,用心肺转流法复苏能有地恢复自主循环,并可能有益于脑复苏,其复苏效果明显优于常规法。

Objective: To evaluate the effect of cardiopulmonary cerebral resuscitation by CPB after cardiac and respiration arrest 30 minutes in dog. Methods: After cardiac and respiration arrest 30 minutes, a total of 10 dogs were divided into two groups, control group and experimental group. The control group was started cardiopulmonary and cerebral resuscitation by usually method, the experimental group by CPB. Two groups were observed ECG, ABP, CVP, PaO2, PaCO2 and the change of pupil. Result: After resuscitation 30 minutes, only one dog in the control group recovered circulation and pupil began changing small. After resuscitation 3 minutes,all dogs in the experimental group recovered circulation and pupil began changing small. After resuscitation 30 minutes,the MABP and PaO2 in experiment group were significantly higher than it in control group and the CVP and PaCO2 were lower than it in poster. The Ca-Mg-ATPase activity of brain cortex and hippocampal gyrus in the experi- mental group were significantly higher than it in control group too. Conclusions; After cardiac and respiration arrest 30 minutes, the effect of cardiopulmonary resuscitation by CPB is significantly better than it by usually method and the CPB may be better for cerebral resuscitation.