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目的观察家兔心搏骤停(CA)后心肺复苏(CPR)的基本生命支持(BLS)阶段血流动力学变化特点及抗凝溶栓药物对其影响。方法24只家兔随机分为实验组和对照组,在交流电诱发CA后对照组只进行BLS,实验组在此基础上给予尿激酶和肝素进行干预,分别于诱发CA前(0min),CA后5、10、15、20、25和30min时测定颈内动脉血压和血流速度,于诱发CA前(0min),CA后3、6、9、12、15、18、21、24、27和30min时测定兔耳的微循环血流量,分析比较各时点的变化。结果CA发生后,动脉收缩压、舒张压和颈内动脉血流速度、兔耳微循环血流量均急剧下降,然后随时间延长逐渐降低;两组间收缩压、舒张压和颈内动脉血流速度变化的差异均无统计学意义(P=0.779、0.297和0.244)。两组间兔耳微循环血流量变化差异有统计学意义(P<0.001),CA发生后血流量下降曲线陡直,随后趋缓,约在9min时两条曲线相交,其后实验组的下降曲线趋于平坦,而对照组仍持续下降。结论在CPR的BLS阶段,溶栓、抗凝药物干预对交流电诱发CA动物的大动脉血压和血流速度变化无明显影响,但能在一定程度上延缓组织微循环血流灌注的恶化。
Objective To observe the hemodynamic changes during essential life support (BLS) of cardiopulmonary resuscitation (CPR) after cardiac arrest (CA) in rabbits and the effect of anticoagulant thrombolytic drugs on them. Methods Twenty-four rabbits were randomly divided into experimental group and control group. Only BLS was induced in the control group after AC induced by CA. Intervention with urokinase and heparin was given to the experimental group. At 5, 10, 15, 20, 25 and 30 min, the internal carotid artery blood pressure and blood flow velocity were measured before induction of CA (0min), 3,6,9,12,15,18,21,24,27 and CA The microcirculation blood flow of rabbit ear was measured at 30min, and the changes at different time points were analyzed and compared. Results After CA occurred, systolic blood pressure, diastolic blood pressure, blood flow velocity of internal carotid artery and microcirculation of rabbit ear decreased sharply and then decreased with the prolongation of time. Systolic blood pressure, diastolic blood pressure and internal carotid artery blood flow There was no significant difference in speed changes (P = 0.779, 0.277 and 0.244). There was significant difference between the two groups in the changes of blood flow in rabbit ear microcirculation (P <0.001). After the CA, the decline of blood flow was steep and then slowed down. The two curves intersected at about 9 min, The curve tends to be flat, while the control group continues to decline. Conclusion In the BLS stage of CPR, thrombolytic and anticoagulant interventions have no significant effect on changes of aorta blood pressure and blood flow velocity in AC animals induced by AC, but can delay the deterioration of perfusion of tissue microcirculation to a certain extent.