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find Keyword "脑复苏" 4 results
  • Analysis of Clinical Management in Patients with Severe Acute Pancreatitis

    目的 探讨5例特重型胰腺炎的特点及治疗方法。方法 我院2001年8月至2003年8月共收治特重型胰腺炎患者5例。其中入院后18 h内心跳、呼吸骤停3次的重症急性胰腺炎(SAP)1例,治疗以及时血液滤过和心、肺、脑复苏为重点; SAP并发胰性脑病2例,以大剂量维生素B1的补充,或足量补给浓缩红细胞为治疗重点; 并发多个器官功能障碍的暴发性胰腺炎(FAP)2例,治疗重点是血液滤过和防治多器官功能衰竭的级联放大反应,其中1例以高渗性糖昏迷为主要表现,治疗重点是内稳态的纠正,血液滤过,重要器官功能维护。结果 5例特重型胰腺炎患者均治愈,平均住院时间为32.2 d。结论 器官功能的复苏和维护、外科ICU监护、短时血液滤过、内稳态的纠正、中西药综合治疗及病因、对症的个体化治疗是特重型胰腺炎的重要治疗措施。

    Release date:2016-08-28 04:44 Export PDF Favorites Scan
  • 心肺转流术在犬心肺脑复苏中的应用

    目的 观察犬在高钾停搏10分钟后行心肺转流术(CPB)复苏,并与常规心肺复苏(CPR)比较其自主循环恢复和脑复苏的效果. 方法 将杂种家犬12只,以10%KCl静脉给药致心脏停搏(CA)10分钟后随机分为两组,每组6只.组1:用常规CPR法复苏;组2:用自行研制的心肺转流装置复苏. 两组于CA前、CA10分钟、复苏后5分钟、10分钟和30分钟监测平均动脉压(MAP)、心率(HR)、心脏复跳时间、瞳孔大小、72小时存活率和动静脉血气并计算脑氧摄取率(CEO2)和脑氧耗量(Ca-jvO2). 结果 组1中6只犬仅2只在CPR后10分钟、15分钟恢复自主心跳,但不稳定,并在60分钟内死亡;组 2均于CPB 后6~10分钟恢复自主心跳,CPB 10分钟后MAP>80mmHg,明显高于组1(P<0.05),其自主循环恢复率为100%,明显大于组1(P<0.05).两组CEO2和 Ca-jvO2在CA10分钟、复苏后5分钟和10分钟均明显升高(P<0.05),且复苏后5分钟、10分钟和30分钟时组1明显高于组2 (P<0.05).组2犬的瞳孔于复苏后第9~19分钟开始缩小,30分钟后恢复至正常,全组均存活72小时以上,72小时存活率为100%,明显高于组1(P<0.05). 结论 CA10分钟后,用CPB复苏其自主循环恢复明显优于常规CPR,并有益于脑复苏.

    Release date:2016-08-30 06:34 Export PDF Favorites Scan
  • Naloxone for Cardio - Pulmonary - Cerebral Resuscitation: A Systematic Review

    Objective To assess the efficacy of naloxone for cardio-pulmonary-cerebral resuscitation (CPCR). Methods Randomized controlled trials (RCTs) involving naloxone for CPCR were identified from MEDLINE (1966 – Jun.2006), EMbase (1974 - Jun.2006), PubMed, The Cochrane Library (Issue2,2006), CBM(1978 - Jun.2006) and CNKI (1994 - Jun.2006). The quality of the trials was assessed by two reviewers independently. RevMan 4.2.7 software provided by the Cochrane Collaboration was used for statistical analysis. Results Ten RCTs were included. The quality of included RCTs was low. All the patients were in-patients or out-patients receiving CPCR due to cardial arrest at the age of 18-75 years. Meta-analysis indicated that the resuscitation rate in naloxone group was significantly higher than the placebo group (Plt;0.00001). And the recovery of the brain function in naloxone group was better than in the placebo group(Plt;0.00001) Conclusions Naloxone is effective for CPCR and it may ameliorate its prognosis. Because of the low quality of included trials and the small sample size, more RCTs are required to assess the efficacy of naloxone for CPCR.

    Release date:2016-09-07 02:17 Export PDF Favorites Scan
  • 心搏骤停后的溶栓治疗

    心搏骤停是临床上常见的急症,病死率很高。任何原因导致的心搏骤停或其他急性事件引起的严重心肺损害发生后,由于脑组织失去系统循环及脑氧输送,将迅速导致不可逆性的缺氧-缺血性脑损伤,这也正是复苏后期患者死亡的主要原因。心肺复苏后,尽管存在足够的系统循环容量,但脑组织常发生微循环再灌注衰竭,使组织缺血延长,进而导致并加重继发性脑损伤,影响复苏治疗的远期预后。因此,心肺复苏成功的标志不仅仅是自主循环的恢复,其最终目的是保护并恢复完整的脑功能。溶栓治疗无论是对冠状动脉血栓形成或肺栓子的直接作用,还是对微循环再灌注的作用,均可能改善神经学后果,但由于惧怕严重出血并发症,溶栓治疗脑复苏长期被视为禁忌。现对心搏骤停后是否行溶栓治疗以及溶栓时机的选择等研究内容作一综述。

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