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目的探讨氨茶碱与肾上腺素联合应用在心肺复苏中的临床价值。方法将90例心跳骤停(CA)患者随机分成三组:标准剂量肾上腺素(SDE)组30例、大剂量肾上腺素(HDE)组30例、氨茶碱与肾上腺素联合应用(ADE)组30例。采用肘静脉推注氨茶碱与肾上腺素:SDE组采用首次1mg肾上腺素静脉推注,无效则每隔3min重复1次首次剂量;HDE组采用0.1mg/kg-1.bw肾上腺素作为首次剂量,无效则每隔3min重复1次首次剂量;ADE组采用首次1mg肾上腺素和氨茶碱10mg/kg-1.bw静脉推注,无效则每隔3min重复1次首次剂量。同时监测心率、节律、平均动脉压和自主循环恢复的时间,并进行复苏效果的评价。结果(1)HDE组和ADE组首剂自主循环恢复率、24h存活率、出院存活率与SDE组比较均显著增高;(2)ADE组肾上腺素平均用量明显低于HDE组,且首剂自主循环恢复率、24h存活率、出院存活率明显增高。结论氨茶碱与肾上腺素联合应用在心肺复苏中能明显提高心肺复苏自主循环恢复率、24h存活率、出院存活率,是提高心肺复苏成功率的新的方法和途径。
Objective To investigate the clinical value of aminophylline combined with epinephrine in cardiopulmonary resuscitation. Methods Ninety patients with cardiac arrest (CA) were randomly divided into three groups: standard dose epinephrine (SDE) group (30 cases), high dose epinephrine (HDE) group and aminophylline combined with epinephrine (ADE) 30 cases. The use of elbow vein injection of aminophylline and epinephrine: SDE group with the first intravenous injection of 1mg epinephrine, the first dose was repeated every 3min invalid; HDE group with 0.1mg / kg-1.bw epinephrine as the first dose , And the first dose was repeated once every 3 minutes when the first dose was invalid. The ADE group received the first intravenous injection of 1 mg epinephrine and aminophylline 10 mg / kg-1.bw, and the first dose was repeated once every 3 minutes when the dose was invalid. At the same time, heart rate, rhythm, mean arterial pressure and spontaneous circulation recovery time were monitored, and the effect of resuscitation was evaluated. Results (1) The rate of spontaneous circulation recovery, 24h survival rate and discharge survival rate of HDE group and ADE group were significantly higher than those of SDE group. (2) The average dosage of epinephrine in ADE group was significantly lower than HDE group Circulation recovery rate, 24h survival rate, discharge survival rate was significantly higher. Conclusion The combination of aminophylline and epinephrine can significantly improve CPR recovery rate, 24h survival rate and discharge survival rate in cardiopulmonary resuscitation (CPR), which is a new way and method to improve CPR success rate.