【摘要】：目的：觀察心臟驟停(cardiac arrest, CA)家豬模型心室顫動(ventricular fibrillation, VF)后瀕死呼吸的發(fā)生率、瀕死呼吸頻率分布及瀕死呼吸對冠狀動脈灌注壓(coronary perfusion pressure, CPP)的影響。深入探討瀕死呼吸及其與CPP之間的關(guān)系和意義。 方法：健康家豬10頭,雄性,體重(25.0±1.5)kg。常規(guī)麻醉、氣管插管。經(jīng)右股動脈置管至胸主動脈實時監(jiān)測主動脈壓力(AOP)。經(jīng)右頸外靜脈置管至右心房實時監(jiān)測右心房壓力(RAP)。經(jīng)心內(nèi)膜交流電刺激誘發(fā)VF致心臟驟停。未處理時間8分鐘。采集單位時間內(nèi)出現(xiàn)瀕死呼吸動物數(shù)、瀕死呼吸頻率,采集瀕死呼吸前后AOP、RAP,計算CPP。進行統(tǒng)計學分析。 結(jié)果：心臟驟停后所有動物均出現(xiàn)瀕死呼吸。第1分鐘,1只動物(10%),第2分鐘,4只(40%),第3分鐘7只(70%),第4-5分鐘,所有動物(100%)均出現(xiàn)瀕死呼吸,第6分鐘7只(70%),第7分鐘0只(0%)。瀕死呼吸頻率分布呈漸增-漸減模式。平均首次瀕死呼吸出現(xiàn)時間為VF后2.02±0.84min。VF后第1分鐘瀕死呼吸頻率0.2±0.6次/分；第2分鐘1.2±1.7次/分；第3分鐘2.7±2.4次/分；第4分鐘3.7±1.6次/分；第5分鐘VF后3.2±1.9次/分；第6分鐘1.3±1.3次/分；第7分鐘0.0±0.0次/分。平均末次呼吸出現(xiàn)時間為5.21±1.12min。瀕死呼吸吸氣前1秒CPP7.18±4.22mmHg；呼氣后5秒8.75±4.38mmHg,與吸氣前1秒比較p=0.02(p0.05)；呼氣后6秒8.23±4.55mmHg,與吸氣前1秒比較p=0.10(p0.05)。 結(jié)論：瀕死呼吸是心臟驟停的伴隨癥狀,高發(fā)于心臟驟停后4-5分鐘,呈漸增-漸減模式。瀕死呼吸后CPP升高,持續(xù)至呼氣末5秒,有利于心肺復(fù)蘇。
[Abstract]:Aim: to observe the incidence of near-death respiration after ventricular fibrillation (ventricular fibrillation, VF), the distribution of near-death respiration frequency and the effect of near-death respiration on coronary perfusion pressure (coronary perfusion pressure, CPP) after ventricular fibrillation (ventricular fibrillation, VF) in (cardiac arrest, CA) pig model of cardiac arrest. To explore the relationship and significance of near-death respiration and CPP. Methods: ten healthy domestic pigs, male, weight (25.0 鹵1.5) kg. Routine anesthesia, tracheal intubation. Real-time Monitoring of Aortic pressure (AOP). Through right femoral artery Catheter to Thoracic aorta Real-time Monitoring of right Atrial pressure (RAP). Through right external jugular vein Catheter to right Atrial Cardiac arrest was induced by endocardial alternating current stimulation (VF). Unprocessed 8 minutes. The number of animals with near-death respiration and the rate of near-death respiration were collected in unit time. The CPP. was calculated by AOP,RAP, before and after the acquisition of near-death respiration. Statistical analysis was carried out. Results: all animals had near-death breathing after cardiac arrest. In the first minute, 1 animal (10%), 2 minutes, 4 (40%), 3 minutes 7 (70%), 4-5 minutes, all animals (100%) had near-death respiration, 7 animals (70%) at the sixth minute, 0 (0%) in the 7th minute. The distribution of near-death respiratory frequency was gradually increasing and decreasing. The mean onset time of first near-death respiration was 0.2 鹵0.6 / min, 1.2 鹵1.7 / min, 2.7 鹵2.4 / min after 2. 02 鹵0.84min.VF, 2. 2 鹵1. 7, 2. 7 鹵2. 4 / min after VF, 2. 2 鹵1. 7, 2. 2 鹵1. 7 / min after VF. 3. 7 鹵1. 6 times / min, 3. 2 鹵1. 9 times / min after VF at 5 min, 1. 3 鹵1. 3 times / min at 6 min, 0. 0 鹵0. 0 times / min at 7 min. The mean time of last respiration was 5.21 鹵1.12 min. CPP7.18 鹵4.22mmHg before inspiratory, 5.75 鹵4.38mmHg after exhale, p0.02vs 1 second before inspiratory, 8.23 鹵4.55mmHgafter exhalation, and 0.10 (p0.05) compared with 1 second before inhale. Conclusion: Near-death respiration is a concomitant symptom of cardiac arrest, which occurs 4-5 minutes after cardiac arrest in a gradual increasing-decreasing pattern. CPP increased after near-death respiration and lasted until the end of expiratory for 5 seconds, which was beneficial to cardiopulmonary resuscitation.
【學位授予單位】：遵義醫(yī)學院
【學位級別】：碩士
【學位授予年份】：2012
【分類號】：R-332

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