急诊早期开胸心肺复苏术26例临床研究

目的探讨积极应用开胸心肺复苏术及必要时现场开胸心肺复苏术（OCCPR）对复苏成功率的影响。方法气管插管控制通气，左前外侧第Ⅳ肋间进胸，膈神经前纵形切开心包，单手按压。结果2004年4月～2009年8月连续对26例停循环时间大于20min患者施行了OCCPR，14例复苏失败；12例恢复循环，其中7例住院死亡，5例完全康复。结论急诊OCCPR对于不宜或闭式复苏术无效的患者仍是一个效果肯定的复苏方法，尽早施行是成功的关键，在充分条件支持下现场早期OCCPR可大大提高胸心穿透开放伤抢救成功率。

Study:26 cases of Open Chest Cardiopulmonary Resuscitation in early stage

Objective To discuss the effect of adopting open chest cardiopulmonary resuscitation （OCCPR） method in field to the successful resuscitation rate. Methods 26 patients received OCCPR whose cardiac arrest went beyond 20 minutes between April 2004 and Aug 2009. Control ventilation by endotracheal intubation, open chest at IV intercostals external, cut pericardial length ways before the diaphragm nerve, and compress the heart. Results Among 26 patients, 14 cases failed; 12 of them recovered circulation- seven of them died during their hospitalization later and five fully recovered. Conclusion OCCPR in emergency room is still considered as an effective resuscitation method. The key point is to carrying out OCCPR in early stage as possible. The on-site OCCPR is also considered as increasing successful resuscitation rate on chest and heart perforation trauma with adequate medical support.