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Cardiopulmonary cerebral resuscitation using emergency cardiopulmonary bypass, coronary reperfusion therapy and mild hypothermia in patients with cardiac arrest outside the hospital.
院外心脏骤停患者使用紧急体外循环、冠状动脉再灌注治疗和亚低温的心肺脑复苏。

摘要

OBJECTIVES:The purpose of this study was to evaluate the efficacy of an alternative cardiopulmonary cerebral resuscitation (CPCR) using emergency cardiopulmonary bypass (CPB), coronary reperfusion therapy and mild hypothermia.
BACKGROUND:Good recovery of patients with out-of-hospital cardiac arrest is still inadequate. An alternative therapeutic method for patients who do not respond to conventional CPCR is required.
METHODS:A prospective preliminary study was performed in 50 patients with out-of-hospital cardiac arrest meeting the inclusion criteria. Patients were treated with standard CPCR and, if there was no response, by emergency CPB plus intra-aortic balloon pumping. Immediate coronary angiography for coronary reperfusion therapy was performed in patients with suspected acute coronary syndrome. Subsequently, in patients with systolic blood pressure above 90 mm Hg and Glasgow coma scale score of 3 to 5, mild hypothermia (34 C for at least two days) was induced by coil cooling. Neurologic outcome was assessed by cerebral performance categories at hospital discharge.
RESULTS:Thirty-six of the 50 patients were treated with emergency CPB, and 30 of 39 patients who underwent angiography suffered acute coronary artery occlusion. Return of spontaneous circulation and successful coronary reperfusion were achieved in 92% and 87%, respectively. Mild hypothermia could be induced in 23 patients, and 12 (52%) of them showed good recovery. Factors related to a good recovery were cardiac index in hypothermia and the presence of serious complications with hypothermia or CPB.
CONCLUSIONS:The alternative CPCR demonstrated an improvement in the incidence of good recovery. Based upon these findings, randomized studies of this hypothermia are needed.

译文

目的: 本研究的目的是评估使用紧急体外循环 (CPB) 、冠状动脉再灌注治疗和亚低温的替代性心肺脑复苏 (CPCR) 的疗效。
背景: 院外心脏骤停患者的良好恢复仍然不足。需要一种对常规 CPCR 无反应的患者的替代治疗方法。
方法: 对 50 例符合入选标准的院外心脏骤停患者进行了前瞻性初步研究。患者接受标准 CPCR 治疗,如果没有反应,通过紧急 CPB 加主动脉内气囊泵。对疑似急性冠状动脉综合征患者进行即刻冠状动脉造影,进行冠状动脉再灌注治疗。随后,在收缩压高于 90毫米汞柱和格拉斯哥昏迷评分为 3 至 5 分的患者中,通过线圈冷却诱导亚低温 (34 ℃ 至少两天)。神经系统结果通过出院时的大脑表现类别进行评估。
结果: 50 例患者中有 36 例接受了紧急 CPB 治疗,39 例接受血管造影的患者中有 30 例发生了急性冠状动脉闭塞。自发循环的恢复和成功的冠状动脉再灌注分别达到 92% 和 87%。23 例患者可诱导亚低温,其中 12 例 (52%) 恢复良好。与良好恢复相关的因素是低体温时的心脏指数以及低体温或 CPB 出现严重并发症。
结论: 替代 CPCR 显示了良好恢复发生率的改善。基于这些发现,需要对这种低温进行随机研究。

Cardiopulmonary cerebral resuscitation

儿科 重症 临床研究术语
概述  :  

使呼吸心脏停搏的病人迅速恢复呼吸、循环和脑功能采取的抢救措施称为心肺脑复苏(CPCR),简称复苏。目的是保护脑和心脏等重要脏器,尽快恢复机体的自主呼吸和循环功能,挽救病人的生命。 在心跳呼吸完全停止后一段时间内生命器官的细胞还有代谢活动存在,称为临床死亡期,此时如急救措施得 当,病人尚有回生的希望。一般认为大脑缺血缺氧超过4-6分钟,即可遭受不可逆的损伤。因此,对心跳呼吸骤停病人的复苏应在4-6分钟内进行,避免脑细胞死亡。 心搏骤停的原因1、心脏疾患,如冠心病、急性心肌梗塞。2、手

cardiopulmonary 英 /,kɑːdɪəʊ'pʌlmən(ə)rɪ/ 美 /,kɑrdɪo'pʌlmənəri/

释    义   adj. 心肺的;与心肺有关的

例    句   The probability of survival decreases by 10% for every minute of hesitation, and by 5% even ifcardiopulmonary resuscitation, better known as CPR, is performed. 每耽误一分钟,病人幸存的概率就降低10%,而即使实施了心肺复苏(也被称为CPR),幸存概率也同样会降低5%。

 

cerebral 英 /səˈriːbrəl; ˈserəbrəl/ 美 /səˈriːbrəl,ˈserəbrəl/

释    义   adj. 大脑的,脑的

例    句   Morbidity and mortality of cerebral apoplexy. 脑卒中的发病率和死亡率。

 

resuscitation 英 /rɪˌsʌsɪˈteɪʃn/  美 /rɪˌsʌsɪˈteɪʃn/

释    义   n. 复苏;复兴;复活

例    句   Fluid resuscitation could improve the lymph circulation. 液体复苏能够改善淋巴循环。

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