近年来,一些动物实验与临床观察表明,某些传统的心肺复苏观点与事实并不符合,因而相应的一些传统治疗措施也值得商榷。本文就近年来心肺复苏及除颤的新进展作一扼要的介绍。 1.胸外按压的机理并不完全是按压心脏。既往认为,胸外按压的治疗机理在于挤压处于胸骨与脊椎之间的心脏,从而驱使血流前向流动,以供应脑与心脏。一些学者发现,对一部分心脏骤停患者行胸外按压时,其所有的心腔内压力是相等的,左室内径并无明显改变,二尖瓣也未发生关闭。而另有一些肺气肿患者,其X线胸片所见心脏与胸壁之间有相当的距离,但复苏也可以成功。对于这些患者,是何种因素引起压力梯差以促使血液流动呢?约翰霍布金斯大学的学者们提出“胸泵”的学说,即在胸外按压时胸腔内压力普遍提高,从而驱使血液流动。动物实验表明,胸外按压时心腔、胸腔及胸腔 In recent years, some animal experiments and clinical observations have shown that some of the traditional CPR perspectives are not in conformity with the facts, and some corresponding traditional treatment measures are also debatable. This article gives a brief introduction of recent advances in cardiopulmonary resuscitation and defibrillation. 1. The mechanism of chest compressions is not exactly pressing the heart. In the past that the treatment of chest compressions lies in the compression of the heart between the sternum and spine, which drives the flow of blood flow to the brain and heart supply. Some scholars found that when chest compressions were applied to some patients with cardiac arrest, all intracardiac pressures were equal, there was no significant change in left ventricular diameter, and mitral valve closure did not occur. Some patients with emphysema, chest X-ray showed a considerable distance between the chest and chest, but the recovery can be successful. For these patients, what factors caused the pressure gradient to promote blood flow? Johns Hopkins scholars put forward the theory of “chest pump”, that is, chest compressions generally increase intrathoracic pressure, thus driving the blood flow. Animal experiments show that the heart chest cavity, thorax and chest compression