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参附注射液在心搏骤停心肺复苏患者中的应用研究.pdf.pdf

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参附注射液在心搏骤停心肺复苏患者中的应用研究.pdf.pdf
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现代中西医结合杂志 Modern Journal of Integrated Traditional Chinese and Western Medicine 2008 Jun,17(16) ·2433 · 参附注射液在心搏骤停心肺复苏患者中的应用研究许素彦,李喜林,陈 静,冯彩婷。(1.峰峰集团邯郸医院,河北邯郸 056200;2.峰峰集团总医院,河北邯郸 056200;3.河北省邯郸市第一医院,河北邯郸 056200) [摘要] 目的 探讨参附注射液对心搏骤停患者复苏过程中的心肌保护作用,并初步探讨其作用机制。方法将 80例患者随机分成 2组,均给予心肺复苏基本生命支持,并同时给予复苏常用药物治疗。治疗组在复苏即刻应用参附注射液 20mL加 5%葡萄糖注射液 20mL静脉推注,隔 30 min再推 1次,共 3次;同时用参附注射液 100 mL加生理盐水 450 mL于第 1次静脉推注后开始滴注,观察 2组患者复苏前、复苏即刻、再灌注后 10 min、再灌注后 30 min、再灌注后 6 h 心肌酶学(AST、LDH、CK、CK—MB)的情况,并运用迈瑞床旁心电监护仪动态监测复苏后心律失常及死亡等的发生率。结果 2组患者心脏恢复灌注后心肌酶学均呈上升趋势,但治疗组的升高幅度显著低于对照组(P<0.05);2组患者复苏后均有心律失常发生,治疗组的发生率远低于对照组。结论参附注射液能使 CK、CK~MB、LDH生成减少,保护缺血再灌注细胞,降低心肌再灌注后心律失常的发生率,提高复苏的成功率。[关键词] 心搏骤停;心肌再灌注损伤;参附注射液[中图分类号] R605.974 [文献标识码] A [文章编号] 1008—8849(2008)16—2433—03 Study on the application of Shenfu in,jection in patients with cardiac arrest treated with cardiopulmonary resuscitation Xu Suyan ,Li Xilin ,Chen Jing2,Feng Caking。(1.Handan Hospital of Fengfeng pany,Handan 056200,Hebei,China;2.The Total Hospital of Fen eng Group Co mpany,Handan 056200,Hebei,China;3.The First Hospital of Handan,Handan 056200,Hebei,China) Abstract:0bjective It is tO explore the heart protecting function of Shenfu injection on the patients with cardiac arrest treated with cardiopulmonary resuscitation(CPR),and tO explore the mechanism further.Methods 80 patients were random— ly divided into two groups and both were treated with CPR including basic life support and normal routine resuscitation drugs. On the basis of treatment above.treatment group was given Shenfu injection 20 mL+GS 20 mL by intravenous push when CRP began.After 30 min the drugs were given again,and the total times were three.At the same time,treatment group was given Shenfu injection 100 mL+ NS 450 mL by intravenous drip after the first intravenous push.Enzyme indexes (AST,LDH,CK,CK —MB)of myocardium in both groups were observed before CRP,at the beginning of CRP,10 min, 30min and 6 h after reperfusion.Arrhythmia and death were detected dynamically with M ary ECG.Results There was a ris— ing trend of enzyme indexes of myocardium after heart reperfusion in bo th groups,but the rising extent in treatment group was obviously lower than that in control group(P< 0.05).Arrhythmia occurred in both groups after resuscitation in both groups,but the occurring rate in treatment group was significantly lower than that in control group.Conclusion Shenfu injec— tion can decrease the production of CK,CK —M B,LDH,protect cells after ischemia—reperfusion,low down occurring rate of arrhythmia after myocardium reperfusion,and rise up the essful rate of resuscitation. Key words:cardiac arrest;myocardium injury of reperfusion;Shenfu injection 呼吸、心搏停止是急诊急救中的常见病例,其临床复苏效果不佳,成功率不高_l J。参附注射液(SF)是根据古方“回阳救逆”参附汤的中药配方,用红参、黑附子经科学加工提炼而成,其主要有效成分是人参皂甙和乌头类生物碱,具有扩张冠脉、增强心肌收缩力、改善心肌舒张功能、清除氧自由基、改善微循环、升高血压、增强机体免疫力、提高组织细胞对缺血缺氧的耐受性的作用,具有“多靶效应”而广泛应用于临床,在[作者简介] 许素彦(1966~ ),女,副主任医师,在职硕士研究生。抢救心搏骤停心肺复苏患者方面效果显著_1]。 内容来自淘豆网www.taodocs.com转载请标明出处.
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