目的 观察心肺复苏后输注4 ℃盐水降温对心肌组织超微结构的影响.方法 12只实验用北京长白猪,在朝阳医院动物实验室进行实验,直流电击诱导心室颤动,在室颤4 min后进行心肺复苏.复苏成功的猪10只,随机(随机数字法)分为2组:低温组(n=5)(4 ℃生理盐水静脉输注降温)与对照组(n=5),监测血流动力学指标,并在电镜下观察心肺复苏后24 h心肌组织超微结构.统计方法采用两个样本的秩和检验.结果 复苏前后两组HR,MAP,CO差异无统计学意义(P>0.05);心肺复苏后24 h,对照组心肌肌丝断裂,线粒体空泡样变、嵴断裂;低温组心肌肌丝排列整齐,肌节清楚,线粒体结构清晰.结论 心肺复苏后静脉输注4 ℃盐水对心肌具有保护作用.
Objective To observe the myocardial injury attributed to cardiopulmonary resuscitation, and to evaluate the impact of 4 ℃ saline perfusion on the ultra structure of myocardium. Method Twelve Pekimg white swine were induced to make models of ventricular fibrillation by direct current shock. Cardiopulmonary resuscitation was initiated 4 minutes after ventricular fibrillation established, and 10 swine survived from resuscitation. These swine were randomly(random number ) divided into hypothermia group ( n = 5) ( 4 ℃ saline infusion to lower the temperature) and control group ( n = 5). Haemodynamics were monitored. And ultra structure of myocardium was observed under electron microscope 24 hours later. The Mann-Whitney test was used to compare the consecutive variables of 2 samples. Results The damage to the ultra structure of myocardium, myofilaments and mitochondria, was found in the control group, while that to a much lesser extent in the hypothermia group was observed. Conclusions After cardiopulmonary resuscitation, 4 ℃ saline infusion has a protective effect on myocardium.