| 邹向阳1,2，崔华荣3，张世明1，张 琼1，高 路1多普勒血流探测法评价心肺复苏时血流动力学效果的可行性研究 |
| 论文编辑部-新丝路理论网 2011-03-31 16:02:51 作者:中华医学之家：http://www.xinxi85.com 来源: 文字大小:[大][中][小] |
|
Title:
Feasibility of evaluating hemodynamic effects based on the parameters measured by the Doppler ultrasonic blood stream detector during cardiopulmonary resuscitation
- 文章编号:
- 1671-8259(2011)02-0253-03
- 作者:
- 邹向阳1; 2; 崔华荣3; 张世明1; 张 琼1; 高 路1
- 1. 西安交通大学医学院第一附属医院急诊科，陕西西安 710061；2. 西安市急救中心，陕西西安 710004；3. 西安市儿童医院急诊科，陕西西安 710003
- Author(s):
- ZOU Xiang-yang1; 2; CUI Hua-rong3; ZHANG Shi-ming1; ZHANG Qiong1; GAO Lu1
- 1. Emergency Department, the First Affiliated Hospital, Medical School of Xi’an Jiaotong University, Xi’an 710061; 2. Xi’an First Aid Center, Xi’an 710004;
3. Emergency Department, Xi’an Children’s Hospital, Xi’an 710005, China
- 关键词:
- ; 心肺复苏; 多普勒血流探测; 主动脉舒张压; 冠脉灌注压; 舒张期血流速度
- Keywords:
- ; cardiopulmonary resuscitation; Doppler blood stream detection; aortic diastolic pressure(ADP); coronary perfusion pressure(CPP); diastolic flow velocity (Vd)
- 分类号:
- R459.7
- DOI:
- -
- 文献标识码:
- A
- 摘要:
- 摘要：目的 探讨用多普勒血流探测所测参数评价心肺复苏时血流动力学效果的可行性。方法 健康杂种犬12只，采用电击致犬室颤的动物模型，心跳停止及复苏前后进行主动脉内压(AOP)、中心静脉压(CVP)、犬右颈总动脉多普勒血流参数的连续有创同步监测记录，从所测参数中筛选出与主动脉舒张压(ADP)、冠脉灌注压(CPP)关系密切的参数，分析两者的相关性。结果 室颤前，犬右颈总动脉多普勒血流参数特征是：收缩期最大血流速度(Vs)为(85±25)cm/s，舒张期血流速度(Vd)为(27±15)cm/s；二者比值(S/D)为4.2±2.2；闭胸复苏时，Vs为(86±31)cm/s(P>0.05)，Vd为(7.9±5.7)cm/s(P<0.001)，S/D为14.2±6.5(P<0.001)。静脉注射肾上腺素后，Vd随着ADP、CPP的增大而增大，S/D随着ADP、CPP的增大而减小。直线相关分析显示，Vd与ADP相关系数为0.172(P>0.05)；Vd与CPP相关系数为0.204(P>0.05)；S/D与ADP相关系数为-0.109(P>0.05)；S/D与CPP相关系数为-0.191(P>0.05)。尚不能认为Vd、S/D与ADP、CPP的相关性成立。结论 多普勒血流参数中，Vd、S/D与ADP、CPP的关系密切，但其相关性尚不具有统计学意义。
- Abstract:
- ABSTRACT: Objective To explore the feasibility of evaluating hemodynamic effects based on the parameters measured by the Doppler ultrasonic blood flow detector during cardiopulmonary resuscitation. Methods Twelve healthy hybrid dogs were selected. The animal models of ventricular fibrillation were induced by electric shock on the chest. Before and after cardiac arrest and resuscitation, the intra-aortic pressure (AOP), central venous pressure (CVP) and blood flow parameters detected by the Doppler ultrasonic blood flow detector were monitored continuously and synchronously. The parameters related to aortic diastolic pressure (ADP) and coronary perfusion pressure (CPP) were screened out from all the parameters measured by the Doppler ultrasonic detector; the correlation between them was analyzed. Results The normal values of the dogs’ right common carotid artery blood flow velocity before ventricular fibrillation were as follows: peak systolic flow velocity (Vs) was 85±25cm/s, diastolic flow velocity (Vd) was 27±15cm/s, and the ratio of them (S/D) was 4.2±2.2. During closed-chest resuscitation, Vs was 86±31cm/s (P>0.05), Vd was 7.9±5.7cm/s (P<0.001), and S/D was 14.2±6.5 (P<0.001). After intravenous injection of adrenalin, Ad increased whereas S/D decreased with ADP and CPP. Linear regression analysis showed that the regression coefficient between Ad and ADP, between Vd and CPP as well as between S/D and ADP was 0.172 (P>0.05), 0.204 (P>0.05), and -0.109 (P>0.05), respectively. Yet the correlation of Vd and S/D with ADP and CPP could not be considered significant. Conclusion Among the Doppler blood flow parameters, Vd and S/D are closely related to ADP and CPP. However, our study shows that this correlation is not significant.
参考文献/References
[1]王一镗. 心肺复苏时积极正确地推行剖胸复苏术 [J]. 中国急救医学, 1989, 1(9):1-1
[2]SANDERS AB, OGLE M, EWY GA. Coronary perfusion pressure during cardiopulmonary resuscitation [J]. Am J Emerg Med, 1985, 3(1):4-11.
[3]BLUMENTHAL SR, VOORHEES WD. The relationship between airway carbon dioxide excretion and cardiac output during cardiopulmonary resuscitation [J]. Ann Emerg Med, 1989, 18(10):1111-1115.
[4]陈英杰，陈运立，吴贤仁. 心肺复苏期间潮气末二氧化碳(Pet-CO2)监测及临床意义 [J]. 河北医学, 2004, 1(10):56-58.
[5]王祥瑞，杭燕南. 循环功能监测学 [M]. 第1版. 北京：人民军医出版社, 2005:151-157.
[6]何素荣，刘世斌. 临床脉图诊断学 [M]. 第1版. 北京：人民军医出版社. 2004.
[7]王奎健，杜志民. 血容积变化无创血压测量方法的研究 [J]. 现代医学仪器与应用,
2000, 12(2):6-8.
[8]赵亚利，段云友，张焕喜，等. 胎儿肾、脑动脉的彩色多普勒监测及其意义 [J]. 第四军医大学学报, 1995, 16(2)120:122.
[9]王维治. 头颈部血管超声检查 [M]. 神经病学. 第5版. 北京:人民卫生出版社, 2004:6.
[10]李文春，何文，陈艳. 彩色多普勒超声检测颈动脉及椎动脉血流参数和血管内径的临床价值 [J]. 郧阳医学院学报, 2000, 19(3):139-141.
[11]李翔，李玉. 人体两侧颈总动脉及其血流状态的超声检测 [J]. 青岛大学医学院学报, 2000, 36(2):133-134.
[12]吕国荣，金鹏，吴怀阳. 多普勒超声评分体系在晚孕胎儿监护中的应用及意义 [J]. 中国医学影像技术, 2007, 23(9):1369.
[13]LEWIS LM, STOTHERT JC JR, GOMEZ CR, et al. A noninvasive method for monitoring cerebral perfusion during cardiopulmonary resuscitation [J]. J Crit Care, 1994, 9(3):169-174.
中华医学之家：http://www.xinxi85.com
投稿信箱：zhyxzj85@163.com
联系电话：029--85327298 主编QQ：693891972 |
|
|
|
|
百度百科
