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目的比较低能量和高能量双相方波(BSW)体外除颤的效能和电击引起的心肌损伤程度,以探讨RBW体外除颤的更理想的能量水平。方法建立成年猪闭胸电诱发室颤模型,将18只猪随机分为三组,每组6只,用BSW 50-50-50 J、30-50-75 J和120-150-200 J三种能量方案分别体外除颤治疗持续3 min无干预室颤。结果30 J不能体外除颤成功,50 J和120 J的首次成功比例为5/6,三组总的除颤成功率都为100%,所有动物除颤后立即恢复自主循环,存活超过24 h,低能量较高能量除颤后的心电图损伤性ST-T改变较少,复苏后心功能下降,但血流动力学参数组间比较差异无统计学意义。结论在本研究中,30 J不能体外除颤成功,BSW的低能量50 J和120 J有相似的体外除颤效能,BSW比较理想的首次体外除颤能量为50 J。
Objective To compare the efficacy of defibrillation in vitro with low-energy and high-energy biphasic square wave (BSW) and the extent of myocardial damage induced by electric shock in order to investigate the more ideal energy level of RBW defibrillation in vitro. Methods The closed-chest model of adult pig induced by ventricular fibrillation was established. Eighteen pigs were randomly divided into three groups with 6 mice in each group. BSW 50-50-50 J, 30-50-75 J and 120-150-200 J Three kinds of energy programs were defibrillation treatment for 3 min without interventional ventricular fibrillation. Results 30 J was not successful in defibrillation in vitro. The first success rate was 5/6 at 50 J and 120 J, and the overall defibrillation success rate was 100% in all three groups. All animals returned to autonomic circulation immediately after defibrillation and survived more than 24 h , Low-energy high-energy defibrillation of electrocardiographic lesion less ST-T changes, cardiac function decreased after resuscitation, but no significant difference in hemodynamic parameters between groups. Conclusions In this study, 30 J was not successful in defibrillation in vitro. The low-energy 50 J and 120 J BSW had similar defibrillation efficacy in vitro, and the ideal initial defibrillation energy for BSW was 50 μ.