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本文报告1例长时间心跳骤停复苏成功病例,其心跳骤停达50min(心电图记录时间)。病历摘要男,24岁,电工。1992年7月19日上午7:10触电(380V,交流电),当时呼吸、心跳骤停,约20Sec 后切断电源,立即施以人工呼吸、心脏按摩。7:40心电图示持续性室颤及心室停搏。瞳孔散大,右上颌软组织电烧伤呈焦痂状,其中央见洞状(2×3cm)软组织缺损,清晰可见白色骨质。诊断电击伤心跳骤停。按ABC 原则处理,持续心脏按摩、人工呼吸,反复静注5%碳酸氢钠、利多卡因、肾上腺素、东莨菪碱、可拉明、地塞米松等疗效不明显,遂用纳络酮0.4mg 加入5%葡萄糖液10ml稀释后静注,2min 注射完毕,连续两次。数分钟后迅即出现深大的自主呼吸,通气、换气功能迅速改善。8:30
This article reports a successful long-term cardiac arrest resuscitation case, the cardiac arrest for 50min (ECG recording time). Medical summary male, 24 years old, electrician. July 19, 1992 at 7:10 am An electric shock (380V, AC), then breathing, cardiac arrest, about 20Sec cut off the power, artificial respiration, heart massage immediately. 7:40 ECG shows persistent ventricular fibrillation and ventricular arrest. Mydriasis, right maxillary soft tissue lesions were eschar, the central hole (2 × 3cm) soft tissue defects, clearly visible white bone. Diagnosis electric shock heart arrest. According to ABC principles, continuous cardiac massage, artificial respiration, repeated intravenous injection of 5% sodium bicarbonate, lidocaine, epinephrine, scopolamine, cocaine, dexamethasone and other curative effect is not obvious, then use naloxone 0.4mg 5ml dextrose solution 10ml diluted intravenous injection, 2min injection is completed, two consecutive times. A few minutes after the deep spontaneous breathing, ventilation, ventilation quickly improve the function. 8:30