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目的:评估血管加压素联合应用肾上腺素对心室颤动(室颤)犬模型心肺复苏(CPR)的作用。方法:选取健康杂种犬28只,成功建立室颤模型并给予基本生命支持心肺复苏(BLS-CPR)后,随机分为4组,每组7只。A组首剂应用肾上腺素45μg/kg,B1组首剂应用肾上腺素45μg/kg+血管加压素0.4U/kg,B2组首剂应用肾上腺素45μg/kg+血管加压素0.8U/kg,B3组首剂应用肾上腺素45μg/kg+血管加压素2.4U/kg。4组实验犬应用首剂药物后若未恢复自主循环,以后每3min静脉重复应用首次剂量,共静脉用药3次,期间仍进行持续心肺复苏,以自主循环、心脏停搏或持续室颤作为终点。成功达到自主循环后继续监测30min。结果:在实施BLS-CPR并行电除颤后,A组达到自主循环的仅2只(28.6%),B1组6只(85.7%),B2组和B3组均达到100%,且自主循环所需时间B1组为(74.9±6.52)s,B2组为(71.6±4.89)s,B3组为(70.4±5.66)s,均短于A组[(81.2±6.50)s](均P<0.01)。结论:在心肺复苏过程中,血管加压素和肾上腺素联合应用可以显著地增加冠状动脉灌注压,其中血管加压素的剂量以0.8U/kg最适宜。
Objective: To evaluate the effect of vasopressin combined with epinephrine on cardiopulmonary resuscitation (CPR) in a ventricular fibrillation (VF) model of canine. Methods: Totally 28 healthy mongrel dogs were selected. The model of ventricular fibrillation was established and basic life support cardiopulmonary resuscitation (BLS-CPR) was established. The rats were randomly divided into 4 groups (n = 7). The first dose of epinephrine 45μg / kg in group A, the first dose of epinephrine 45μg / kg + vasopressin 0.4U / kg in group B1, and the first dose of epinephrine 45μg / kg + vasopressin 0.8U / kg in group B2, Group first dose of epinephrine 45μg / kg + vasopressin 2.4U / kg. Four groups of experimental dogs, if the first dose of drug did not recover spontaneous circulation after the first intravenous infusion every 3min first dose, co-intravenous drug 3 times, during which continued CPR, with autonomic circulation, cardiac arrest or sustained ventricular fibrillation as the end point . After successful self-cycle to continue monitoring 30min. RESULTS: After BLS-CPR parallel defibrillation, only 2 (28.6%) in group A achieved spontaneous circulation, 6 (85.7%) in group B1 and 100% in groups B2 and B3 The time required for group B1 was (74.9 ± 6.52) s, group B2 was (71.6 ± 4.89) s, group B3 was (70.4 ± 5.66) s, which were shorter than group A [(81.2 ± 6.50) s, P <0.01 ). Conclusion: The combination of vasopressin and epinephrine can significantly increase the perfusion pressure of coronary artery during cardiopulmonary resuscitation. The best dosage of vasopressin is 0.8U / kg.