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目的 观察狗心脏停搏 15min后深低温 (2 6℃～ 2 7℃ )和浅低温 (33℃～ 34℃ )关胸心肺转流 (CPB)对心肺复苏(CPR)的影响。方法 10只麻醉狗 ,分 2组 ,每组各 5只。第 1组为浅低温组 ,第 2组为深低温组 ,用 10 %氯化钾静注后 ,使心脏停搏 15min ,然后用动静脉插管方法立即行关胸心肺转流。第 1组食道温度降至 33℃～ 34℃ ,第 2组降至 2 6℃～ 2 7℃ ,15min后逐渐升温至正常范围 (36℃～ 37℃ )。复苏期间监测心电图、平均动脉压、中心静脉压和瞳孔直径 ,3h后观察颅内压和最终效果。结果 第 1组全部恢复自主循环 (10 0 % ) ,第 2组仅 3只 (6 0 % )恢复自主循环 ;第 1组的自主循环恢复时间为 (4 44±192 2 )sec ,明显短于第 2组 (1980± 6 81 5 )sec(P <0 0 5 ) ,其复苏后 3h颅内压为 (2 4± 0 44 )cmH2 O ,明显低于第 2组 (11 2±3 76 )cmH2 O(P <0 0 5 )。结论 狗心脏停搏 15min后 ,立即用浅低温 (33～ 34℃ )关胸心肺转流行心肺复苏 ,其对自主循环恢复的作用明显优于深低温 (2 6～ 2 7℃ )法
Objective To observe the effects of cardiopulmonary bypass (CPB) on cardiopulmonary resuscitation (CPR) after deep hypothermia (26 ℃ -27 ℃) and mild hypothermia (33 ℃ ~ 34 ℃) after 15min of cardiac arrest in dogs. Methods Ten dogs were anesthetized and divided into 2 groups, 5 in each group. The first group was hypothermia group, the second group was deep hypothermia group, after intravenous injection of 10% potassium chloride, the heart was stopped for 15 minutes, then thoracic and pulmonary bypass was performed immediately by arteriovenous intubation. Group 1 esophageal temperature dropped to 33 ℃ ~ 34 ℃, the second group fell to 26 ~ 27 ℃, 15min and gradually warmed to the normal range (36 ℃ ~ 37 ℃). During the recovery ECG, mean arterial pressure, central venous pressure and pupil diameter, 3h after intracranial pressure and the final effect. Results All the patients in group 1 recovered all autonomic circulation (10 0%) and only 3 patients (60%) in group 2 recovered their autonomic circulation. The recovery time of autonomic circulation in group 1 was (44 44 ± 192 2) sec, significantly shorter than In group 2 (1980 ± 6 81 5) sec (P 0 05), the intracranial pressure at 3 h after resuscitation was (24 ± 0 44) cmH 2 O, significantly lower than that in group 2 (11 2 ± 3 76) cmH2O (P <0 05). Conclusions Cardiopulmonary resuscitation with chest heart and lungs immediately after hypothermia (33 ~ 34 ℃) is performed immediately after the dog is stopped for 15 minutes, and its effect on spontaneous circulation recovery is better than that of deep hypothermia (26 ~ 27 ℃)