CAJ | 학술논문

目的探讨插入式腹主动脉按压心肺复苏法(IAAC-CPR)作为一种新的心肺复苏(CPR)方法,能否改善心搏骤停(CA)兔的复苏效果.方法 28只新西兰大白兔按随机数字表法分为标准心肺复苏组(STD-CPR,胸外按压)和IAAC-CPR组(于胸外按压间歇期给予腹主动脉按压),每组14只.冰氯化钾诱导CA模型,CA持续3 min后实施复苏.持续监测动物心电图、血流动力学指标,记录两组动物基础状态及复苏过程中主动脉收缩压、右房压直至实验结束；比较两组动物平均动脉压(MAP)、冠状动脉灌注压(CPP)和自主循环恢复(ROSC)等指标.结果与STD-CPR组比较,IAAC-CPR组复苏2 min内(无升压药物干预)MAP(mm Hg,1 mm Hg=0.133 kPa)明显升高(30 s:46.0±12.6比30.0±12.2,60 s:57.0±15.6比31.9±9.7,90 s:61.9±14.4比36.0±9.8,120 s:63.1±12.6比37.8±11.1,均P＜0.05)；CPP(mm Hg)也明显升高(30 s:29.9±17.4比14.1±11.0,60 s:43.1±22.4比14.3±9.8,90 s:46.7±20.1比15.9±7.7,120 s:50.5±21.0比17.3±9.9,均P＜0.05)；ROSC时间(s)明显提前(212.1±43.4比307.3±51.2,P＜0.05),复苏成功率明显升高(85.7％比42.8％,P＜0.05);ROSC率和24 h、48 h存活率也均升高,但差异均无统计学意义.所有动物实验后尸检未见明显腹部器官损伤.结论于胸外按压间歇期给予腹主动脉按压(即IAAC-CPR),能增加CA兔的MAP、CPP及复苏成功率,有效改善复苏预后.
목적 탐토삽입식복주동맥안압심폐복소법(IAAC-CPR)작위일충신적심폐복소(CPR)방법,능부개선심박취정(CA)토적복소효과.방법 28지신서란대백토안수궤수자표법분위표준심폐복소조(STD-CPR,흉외안압)화IAAC-CPR조(우흉외안압간헐기급여복주동맥안압),매조14지.빙록화갑유도CA모형,CA지속3 min후실시복소.지속감측동물심전도、혈류동역학지표,기록량조동물기출상태급복소과정중주동맥수축압、우방압직지실험결속；비교량조동물평균동맥압(MAP)、관상동맥관주압(CPP)화자주순배회복(ROSC)등지표.결과 여STD-CPR조비교,IAAC-CPR조복소2 min내(무승압약물간예)MAP(mm Hg,1 mm Hg=0.133 kPa)명현승고(30 s:46.0±12.6비30.0±12.2,60 s:57.0±15.6비31.9±9.7,90 s:61.9±14.4비36.0±9.8,120 s:63.1±12.6비37.8±11.1,균P＜0.05)；CPP(mm Hg)야명현승고(30 s:29.9±17.4비14.1±11.0,60 s:43.1±22.4비14.3±9.8,90 s:46.7±20.1비15.9±7.7,120 s:50.5±21.0비17.3±9.9,균P＜0.05)；ROSC시간(s)명현제전(212.1±43.4비307.3±51.2,P＜0.05),복소성공솔명현승고(85.7％비42.8％,P＜0.05);ROSC솔화24 h、48 h존활솔야균승고,단차이균무통계학의의.소유동물실험후시검미견명현복부기관손상.결론 우흉외안압간헐기급여복주동맥안압(즉IAAC-CPR),능증가CA토적MAP、CPP급복소성공솔,유효개선복소예후.
Objective To determine whether interrupted abdominal aorta compression-cardiopulmonary resuscitation (IAAC-CPR),as an new cardiopulmonary resuscitation (CPR) method,can improve resuscitation effects on rabbits with cardiac arrest (CA).Methods Twenty-eight New Zealand rabbits were randomly divided into two groups in equal number (n =14),and they were resuscitated either by standard CPR (STD-CPR,external chest compression) or by IAAC-CPR (abdominal aorta compression at intermission of external chest compression).CA model was reproduced by injection of iced-potassium chloride,and it was maintained for 3 minutes before resuscitation.Electrocardiogram (ECG),hemodynamic indexes were monitored continuously.Aortic systolic pressure and right atrial pressure at baseline and during resuscitation were recorded.Mean arterial pressure (MAP),coronary perfusion pressure (CPP) and recovery of spontaneous circulation (ROSC) indexes were compared between two groups.Results Compared with STD-CPR group,MAP (mm Hg,1 mm Hg=0.133 kPa) within 2 minutes of resuscitation (without drugs intervention) in the IAAC-CPR group was significantly increased (30 s:46.0 ± 12.6 vs.30.0 ± 12.2,60 s:57.0 ± 15.6 vs.31.9 ±9.7,90 s:61.9 ± 14.4 vs.36.0 ±9.8,120 s:63.1 ± 12.6 vs.37.8 ± 11.1,all P＜0.05),and CPP (mm Hg) was also significantly increased (30 s:29.9 ± 17.4 vs.14.1 ± 11.0,60 s:43.1 ± 22.4 vs.14.3 ± 9.8,90 s:46.7 ± 20.1 vs.15.9 ± 7.7,120 s:50.5 ± 21.0 vs.17.3 ± 9.9,all P＜0.05),the time of ROSC (s) was earlier (212.1 ± 43.4 vs.307.3 ± 51.2,P＜0.05),and successful resuscitation rate was significantly higher (85.7％ vs.42.8％,P＜0.05).However,there were no statistical differences in ROSC rate and the survivor rate at 24 hours and 48 hours between the two groups,though they were increased.No abdominal organs injury was found in all animals by postmortem study.Conclusion Abdominal aorta compression in the intermittent period of chest compression (IAAC-CPR) increases MAP,CPP and the successful rate of resuscitation,thus improves the outcome.