近年来,众多临床医师在心脏复苏时均使用肾上腺素及电除颤,以提高心脏复苏成功率。对于肾上腺素的用量,国内外陆续有大剂量复苏成功的报道。近4年来,我们对心脏复苏采用早期重复使用大剂量紧上腺素并用电除颤成功地救治了2例心搏骤停患者。例1,女性,39岁,药物中毒致昏迷2小时,收住急诊科。就诊时深昏迷,肺水肿,立即给予洗胃、吸氧、纠正肺水肿等治疗,经测定胆碱脂酶活力为40%。考虑为有机磷类药物中毒,故加用解磷注射液、阿托品等治疗。抢救1小时后突然呼吸停止,立即给予气管插管人工呼吸,自主呼吸停止20分钟以后,心音消失。心电监护示室性自主节律,继之为“心室蠕动波”。立即行胸外心脏按压,首次静注肾上腺素5 mg,阿托品1 mg,3分钟后,心电监护显示仍为室性蠕动波。再次给肾上腺素5 mg,异丙肾上腺素1 mg,利多 In recent years, many clinicians use epinephrine and defibrillation during heart resuscitation to improve the success rate of heart resuscitation. For the amount of epinephrine, there have been reports of successful large-dose resuscitation at home and abroad. In the past 4 years, we successfully treated 2 patients with cardiac arrest by using early repeated high dose of epinephrine for cardiac resuscitation and defibrillation. Example 1, female, 39 years old, drug poisoning caused by coma for 2 hours, admitted to the emergency department. Treatment at a deep coma, pulmonary edema, immediately given gastric lavage, oxygen, correction of pulmonary edema and other treatment, the cholinesterase activity was measured 40%. Considered as organic phosphorus poisoning, it is added with phosphorus injection, atropine and other treatment. Resuscitation 1 hour after the sudden stop breathing, immediately give endotracheal tube artificial respiration, spontaneous breathing stopped after 20 minutes, the heart sounds disappear. ECG showed ventricular autonomic rhythm, followed by “ventricular peristalsis wave ”. Thoracic cardiac compression immediately, the first intravenous injection of epinephrine 5 mg, atropine 1 mg, 3 minutes later, ECG monitoring is still ventricular wave. Give epinephrine 5 mg again, isoproterenol 1 mg, much more