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欧洲英国复苏学会近期已对进展型心力支持进行了简化和现代化改进,如无法经静脉注射肾上腺素时,可用2～3倍的剂量经气管内给予.病人和方法 研究对象不包括不稳定或严重心绞痛、心律失常、严重高血压、近期1年内心肌梗塞发作、充血性心力衰竭、左心室功能不良(射出部分<50%)或明显瓣膜病变等病人.16例拟行常规冠状动脉转流手术,在芬太尼等诱导麻醉下气管插管,给异氟烷和氧气吸入以维持麻醉.术后在重症监护室观察.将病人随机分成两组,给肾上腺素作为心力支持,组1先给3次静脉剂量,随后给2次气管内剂量,均开始以最小剂量,随后递增;组2光给2次气管内剂量,随后给3次静脉剂量.头3例病人的肾上腺素剂量,静脉为 0.03～0.07和 0.1μg/kg,气管内为1.0和3.0μg/kg(小剂量组).最后4例的剂量,静脉为0.07、0.10和0.12μg/kg,气管内为4.0和10μg/kg(属大剂量组).余5例给气管内剂量2.0和5.0μg/kg(属中剂量组).注入每次肾上腺素后,测动脉压和心率,每隔20分钟测定10分钟,算出用药后收缩压和心率平均增加数,绘出Log剂量 反应曲线.
The European Society of Resuscitation in Europe has recently simplified and modernized improvements in cardiac support for cardiac function, such as 2 or 3 times the dose of endotracheal intubation if intravenous epinephrine can not be administered.Patients and Methods Subjects not included are unstable or severe Angina pectoris, arrhythmia, severe hypertension, myocardial infarction in the recent one year, congestive heart failure, left ventricular dysfunction (injection part of <50%) or obvious valvular disease and other patients .16 cases underwent conventional coronary artery bypass surgery, Induction of anesthesia in fentanyl and other endotracheal intubation, inhalation of isoflurane and oxygen to maintain anesthesia in postoperative observation in intensive care unit.The patients were randomly divided into two groups, giving epinephrine as heart support, group 1 give 3 The second intravenous dose, followed by two tracheal doses, began with the minimum dose, followed by increasing; Group 2 light to the second tracheal dose, followed by three intravenous doses.The first three patients with epinephrine dose, 0.03 ~0.07 and 0.1 μg / kg in the trachea and 1.0 and 3.0 μg / kg in the trachea (small dose group) .The last 4 doses were 0.07, 0.10 and 0.12 μg / kg intravenously and 4.0 and 10 μg / kg in the trachea High-dose group), more than 5 cases to the trachea After the injection of each epinephrine, the arterial pressure and heart rate were measured at 20 minute intervals for 10 minutes to calculate the mean systolic blood pressure and heart rate increase after administration, and the Log dose was plotted Reaction curve.