绑带式胸廓挤压仪在心跳骤停小型猪心肺复苏中的作用

目的 观察新型绑带式胸廓挤压仪在心跳骤停小型猪心肺复苏(CPR)中的效果,并与传统人工按压的CPR结果进行比较.方法 26只小型猪随机分为机械按压组(n=13)和传统人工按压组(n=13),在电击诱发心室颤动(室颤)致心跳骤停4 min后分别实施机械胸外按压和人工胸外按压.比较两组动物CPR后的存活率；测定并比较两组动物诱导室颤前和恢复自主循环(ROSC)后1 min、5 min和1h时间点的血流动力学指标、主动脉血气参数和乳酸浓度；X线摄片观察CPR成功后动物肋骨的损伤情况.结果 两组动物在ROSC时和CPR后1h的存活率比较差异无统计学意义(P＞0.05).人工按压组在ROSC 1 min时的主动脉收缩压(AOS)、主动脉舒张压(AOD)和平均动脉压(MAP)均显著高于机械按压组(P＜0.05),而各时间点的冠状动脉灌注压(CPP)比较差异均无统计学意义(P＞0.05)；机械按压组在ROSC 1 min、15 min及1h时间点的血液乳酸浓度均明显低于人工按压组(P＜0.05).X线胸片显示,机械按压组的肋骨损伤发生率与人工按压组比较差异无统计学意义(33.3％和45.5％)(P＞0.05).结论 绑带式胸廓挤压仪在小型猪CPR中的效果与传统人工按压效果相似,可以作为代替CPR中人工按压的一种方法.

Role of band-type chest compression device in pig model of cardiac arrest

Objective To observe the effect of band-type chest compression device on cardiopulmonary resuscitation(CPR) in pig model of cardiac arrest by comparison with manual chest compression.Methods Twenty-six pigs were randomly divided into mechanical chest compression group(n=13) and conventional manual chest compression group(n=13),and mechanical chest compression and manual chest compression were performed respectively 4 min after cardiac arrest induced by ventricular fibrillation.The survival rates after CPR were determined,the hemodynamic parameters,blood gas of aorta and lactate concentrations before ventricular fibrillation and 1 min,5 min and 1 h after return of spontaneous circulation(ROSC) were measured,and the injury of ribs after successful CRP was examined with X-ray radiography.Results There was no significant difference in survival rates at ROSC and 1 h after CPR between two groups(P>0.05).The aortic systolic pressure,aortic diastolic pressure and mean aortic pressure 1 min after ROSC in conventional manual chest compression group were significantly higher than those in mechanical chest compression group(P<0.05),while there was no significant difference in coronary perfusion pressure at different time points between two groups(P>0.05).The lactate concentrations 1 min,15 min and 1 h after ROSC in mechanical chest compression group were significantly lower than those in conventional manual chest compression group(P<0.05).X-ray radiography revealed there was no significant difference in the injury rates of ribs between mechanical chest compression group and conventional manual chest compression group(33.3% vs 45.5%,P>0.05).Conclusion Band-type chest compression device may yield similar effect of CPR in pigs with conventional manual chest compression,and band-type chest compression device can be a substitute for manual compression in CPR.