心肺复苏时紧急经静脉临时心脏起搏的临床疗效分析

目的探讨应用紧急经静脉临时心脏起搏对心肺复苏(CPR)成功率及出院率的影响。方法回顾性分析院内常规组和起搏组CPR病人的临床资料。结果常规组和起搏组间年龄、性别、心肺复苏所需时间、复苏成功率及出院率在统计学上无明显差异,右颈内静脉穿刺所用时间较锁骨下静脉及股静脉耗时显著减少(P<0.05);两组循环维持时间有显著性差异(P<0.05)。结论紧急经静脉临时心脏起搏对维持循环稳定有帮助,以右颈内静脉置入更佳,但对CPR成功率及出院率的影响不大。

The Clinical Analysis of Using Emergency Transvenous Cardiac Pacing in Cardiaopulmonary Resuscitation

OBJECTIVE:A REFLECT TRIAL OF EMERGENCY TRANSVENOUS CARDIAC PACING(ETCP) WAS TAKEN IN PATIENTS SUFFERED FROM CARDIAC ARREST. THE RATE OF SUCCESSFULLY RESUSCITATION AND DISCHARGE WERE OBSERVED. METHOD:PATIENTS IN THE CONTROL GROUP (N=50) RECEIVED STANDARD ADVANCED CARDIAC LIFE SUPPORT (ACLS) CARE. PATIENTS IN THE PACING GROUP (N=50) WERE TO RECEIVE ETCP IN ADDITION TO STANDARD ACLS TREATMENT; 48 PATIENTS WERE ACTUALLY PACED. THE TWO GROUPS WERE COMPARABLE IN TERMS OF AGE, SEX, MEAN TIMES TO CARDIOPULMONARY RESUSCITATION (CPR) AND THE RATE OF SUCCESSFULLY RESUSCITATION AND DISCHARGE. RESULTS:THERE WERE NOT DIFFERENCES BETWEEN TWO GROUPS. TIME OF CANNULIZATION FROM RIGHT INTERNAL JUGULAR VEIN WAS SHORTER THAN THAT FROM SUBCLAVIAN VEIN AND FEMORAL VEIN, P < 0.05. CONCLUSION:THE USE OF A TRANSCUTANEOUS PACING DEVICE IN THE ARREST SETTING WAS ASSOCIATED WITH GENERALLY LONG TIMES UNTIL PACING AND DID NOT APPRECIABLY IMPROVE OUTCOME. RIGHT INTERNAL JUGULAR VEIN CANNULIZATION IS THE BEST WAY.