与胸外心脏按压同时和非同时机械通气对心肺复苏影响的比较

目的：探讨与胸外心脏按压同时和非同时机械通气在心肺复苏中应用的效果。方法：将12例心跳呼吸骤停患者随机分为与胸外心脏按压同时控制机械通气组和与胸外按压非同时手控机械通气组。采用控制通气模式机械通气与持续循手胸外心脏按压同时进行；后者采用手控通气模式机械通气（MAMV）与间断徒手胸外心脏按压非同时配配合进行心肺复苏，胸外心脏按压每5次后暂停1次，在暂停间期给予MAMV1次，之后通气与按压依此比例进行。2组均进行无创动脉血压、心电、经皮氧饱和度（SpO2)、潮气量（VT)、气道峰压（Ppeak)等监测。结果：与胸外心脏按压非同时手控机械通气组的SpO2、VT均明显高于与胸外心脏按压同时模式通气组的SpO2和VT，P均＜0．05；而peak则明显低于后者，P＜0．05；2组的平均动脉压无显著差别。结论：与胸外心脏按压非同时手控机械通气在提高SpO2、VT，降低Ppeak，恢复窦性心律及提高心肺复苏成功率等方面明显优于与胸外心脏按压同时控制机械通气。

Comparison of mechanical ventilation with synchronous and asynchronous extrasternum heart compression on cardiopulmonary resuscitation

Objective:To investigate the effects of mechanical ventilation with synchronous and asynchronous extrasternum heart compression on cardiopulmonary resuscitation.Methods:Twelve cases with sudden cardiacrespiration arrest were divided into two groups:ventilation with synchronous extrasternum heart compression (SESHC) group and ventilation with asynchronous extrasternum heart compression (ASESHC) group.In SESHC group,cardiopulmonary resuscitation with mechanical ventilation by control mode and persistent extrasternum heart compression were made at the same time.In ASESHC group,cardiopulmonary resuscitation with mechanical ventilation by manual mode and coordinate barehanded extrasternum heart compression were made,i.e.mechanical ventilation was given after every 5 extrasternum heart compression.In two groups,patients′ blood pressure and electrocardiogram and saturation of oxygen from skin (SpO2) and tidal volume(VT),airway peak press (Ppeak) were monitored.Results:SpO2 and VT in ASESHC group were significantly higher than that in SESHC group(both P<0.05).The peak value in ASESHC group was significantly lower than that in SESHC group (P<0.05).Their mean artery blood pressure had no significant difference.Conclusions:ASESHC has better effects on increasing VT,SpO2 and decreasing Ppeak,the recovery of sinus heart rhythm and the success rate of resuscitation than SESHC.