| 亚低温联合瑞芬太尼对家兔心肺复苏后早期心功能影响的实验研究 |
| Alternative Title | Remifentanil combined with mildhypothermia protectscardiac function at early stage of postresuscitafion in rabbits
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| 李帅 |
| Thesis Advisor | 李培杰
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| 2011-05-18
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| Degree Grantor | 兰州大学
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| Place of Conferral | 兰州
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| Degree Name | 硕士
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| Keyword | 心肺复苏
心脏骤停后综合征
亚低温
瑞芬太尼
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| Abstract | 目的 研究亚低温联合瑞芬太尼对家兔心肺复苏后心功能的保护作用，同时探讨其相关保护机制。方法 通过体外致颤法建立家兔心肺复苏模型。30只清洁级家兔随机分为对照组(A组)，仅行麻醉、手术、气管插管，但不致颤；常规复苏组(B组)，仅采用常规方法复苏；亚低温复苏组(C组)，自主循环恢复即刻给予亚低温治疗；瑞芬太尼复苏组(D组)，自主循环恢复即刻给予瑞芬太尼；亚低温联合瑞芬太尼复苏组(E组)，自主循环恢复即刻给予瑞芬太尼及亚低温处理。动态观察左室舒张末压(LVEDP)、左室内压上升和下降最大速率( peak±dp /dt)及血清H-FABP和8-iso-PGF2α浓度的变化。结果 ①与A组比较，其余四组LVEDP与peak±dp/dt在复苏成功30min后差异有统计学意义（P均<0.01）；与B组比较，C、D二组LVEDP与peak±dp/dt在复苏成功120min后差异均有统计学意义（P均<0.05），但C、D两组比较无统计学差异，而E组LVEDP与peak±dp/dt在复苏成功60min后差异有统计学意义（P均<0.05），且E组LVEDP升高幅度及peak±dp/dt下降幅度也小于C、D二组（P均<0.05）；②与A组比较，其余四组血清H-FABP与8-iso-PGF2α值明显升高（P均<0.01）；与B组比较，C、D、E组血清H-FABP与8-iso-PGF2α值明显降低（P均<0.05），但E组下降幅度最为明显（P<0.05）。结论 亚低温及瑞芬太尼干预均可改善复苏后心功能不全，两者联用具有协同作用，能进一步提高疗效，其机制可能与自由基清除有关。 |
| Other Abstract | Objective To observe the effects of Remifentanil combined with mild hypothermia on postresuscitation myocardial dysfunction in rabbits，and further explore the partly underlying mechanism of action.Methods After setting up rabbit model of cardiopulmonary resuscitation,30 rabbits were randomly divided into five groups. group A:The control group, only anesthesia,surgeuy,endotracheal intubation,but not flutter; group B:Conventional CPR group; group C:in which rabbits were given hypothermia after successful ROSC; group D: in which rabbits were given Remifentanil after successful ROSC; group E: in which rabbits were given Remifentanil combined with mild hypothermia after successful ROSC. The left ventricular end-diastolic pressure(LVEDP),left ventricular pressure rise and fall rate(peak±dp／dt), serum concentrations of H-FABP and 8-iso-PGF2a were continuously observed．Result Compared with group A, LEVDP and peak±dp/dt were significantly lower/higher than in group C,D and E at 120min,120min,and 60min after complete resuscitation, respectively; however, the increase of LVEDP and decrease of peak±dp/dt in group E was minor to that in group C and there was no significant difference between group C and D. Compared with group A, H-FABP and 8-iso-PGF2αin the serum significantly increased in other four groups. H-FABP and 8-iso-PGF2αin the serum in group C, D and E were significantly lower in comparison with those in group B, furthermore, they reached a minimum in group E. Conclusions Mild hypothermia and Remifentanil can both improve postresuscitation myocardial dysfunction，and a combination of both has even stronger protective effect against brain damage, The cardioprotective effect is possible associated with the reduction of radical. |
| URL | 查看原文
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| Language | 中文
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| Document Type | 学位论文
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| Identifier | https://ir.lzu.edu.cn/handle/262010/222397
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| Collection | 学院待认领
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| Affiliation | 临床医学院
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Recommended Citation
GB/T 7714 |
李帅. 亚低温联合瑞芬太尼对家兔心肺复苏后早期心功能影响的实验研究[D]. 兰州. 兰州大学,2011.
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