两种方法制备心搏骤停兔模型的比较
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(1.中南大学湘雅医院急诊科,长沙 410008; 2.湖南省人民医院急诊科,长沙 410005)

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R-33

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Comparison of cardiac arrest induced by electrical stimulation or intravenous potassium chloride in rabbits
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(1. Department of Emergency Medicine, Xiangya Hospital Central South University, Changsha 410008, China.2. Department of Emergency Medicine, Hunan Provincial People’s Hospital, Changsha 410005)

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    摘要:

    目的 比较氯化钾致颤与经食道-胸壁电致颤两种心搏骤停(cardiac arrest,CA)兔模型在心肺复苏(cardiopulmonary resuscitation,CPR)过程中生理指标的特点?方法 按随机数字表法将新西兰大白兔分为氯化钾致颤组(10%氯化钾0. 3 mL/ kg 脉冲式静脉注射诱发心搏骤停)和电致颤组(经食道-胸壁用35 mA 交流电诱发心搏骤停),每组10 只?心搏骤停5 min 后进行心肺复苏?比较两组诱发心搏骤停时间?心肺复苏时间?自主循环恢复(restoration of spontaneous circulation,ROSC)情况?自主循环恢复后1 h 动脉血气和血乳酸(Lac)水平,以及复苏后72 h 存活情况?结果 20 只动物均成功诱发心搏骤停?与电致颤组比较,氯化钾致颤组诱导心搏骤停时间[(9. 90±2. 47) s 与(27. 40±6. 48) s 比较]和心肺复苏时间[(61. 61±26. 51) s 与(132. 00±18. 55) s 比较]均明显缩短( P <0. 01)?氯化钾致颤组和电致颤组均有9 只动物自主循环恢复,72 h 分别存活8 只?5 只?与电致颤组比较,氯化钾致颤组自主循环恢复后1 h 动脉血气pH 值[(7. 38±0. 06)与(7. 29±0. 11)相比]和HCO3-浓度[(21. 86±3. 65) mmol/ L 与(18. 32±2. 61) mmol/ L 相比]均明显升高( P <0. 05),Lac 水平[(1. 77±0. 77) mmol/ L 与(5. 39±3. 40) mmol/ L 相比]明显降低( P <0. 01),氧分压(PO2 )?二氧化碳分压(PCO2 )?K+ 浓度差异均无统计学意义?结论 与经食道-胸壁交流电刺激方法相比,氯化钾脉冲式注射可更便捷诱发兔心搏骤停,且复苏后机体内环境更为稳定,存活率更高?

    Abstract:

    Objective To compare the changes in physiological parameters after cardiac arrest (CA) caused byintravenous potassium chloride or transesophageal-chest wall electrical stimulation in rabbits. Methods According to arandom number table, 20 New Zealand white rabbits were divided into two different induction groups: a potassium chloridegroup with CA induced by bullet-type intravenous injection of 10% potassium chloride (0. 3 mL/ kg), and an electricalstimulation group with CA induced by transesophageal-chest wall electrical stimulation with 35 mA alternating current. Fiveminutes after CA, conventional cardiopulmonary resuscitation (CPR) was initiated. Time spent inducing CA, time spent onCPR, rate of restoration of spontaneous circulation (ROSC), blood gas and blood lactic acid levels 1 h after ROSC, and72-h survival rate after resuscitation were compared. Results CA was successfully induced in all 20 rabbits. Comparedwith the electrical stimulation group, time spent inducing CA (9. 90 ± 2. 47 vs. 27. 40 ± 6. 48 s, P < 0. 01) and timespent on CPR (61. 61 ± 26. 51 vs. 132. 00 ± 18. 55 s, P < 0. 01) were significantly shorter in the potassium chloridegroup. Nine rabbits exhibited ROSC in each group. Seventy-two hours after ROSC, eight rabbits in the potassium chloridegroup survived, while five rabbits survived in the electrical stimulation group. Compared with the electrical stimulationgroup, pH (7. 38 ± 0. 06 vs. 7. 29 ± 0. 11, P < 0. 05) and HCO3-(21. 86 ± 3. 65 vs. 18. 32 ± 2. 61 mmol/ L, P < 0. 05)levels of the potassium chloride group were significantly increased, while the level of lactic acid (1. 77 ± 0. 77 vs. 5. 39 ±3. 40 mmol/ L, P < 0. 01) was significantly reduced. Partial pressure of oxygen, partial pressure of carbon dioxide, and K+were not significantly different. Conclusions Compared with transesophageal-chest wall electrical stimulation, potassiumchloride may be more convenient to induce CA in rabbits, as physiological parameters after ROSC are more stable and the long-term survival rate is higher.

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李湘民,姚政彬,朱浙祥,佘长寿,粟枫,黄国庆.两种方法制备心搏骤停兔模型的比较[J].中国比较医学杂志,2019,29(9):87~91.

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  • 收稿日期:2019-03-04
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  • 在线发布日期: 2019-10-10
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