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临床上经心肺复苏自主呼吸与循环恢复的患者仍有较高的死亡率,复苏后心功能障碍是复苏后早期患者死亡的重要原因。目前认为全心缺血-再灌注损伤是导致复苏后心肌收缩和舒张功能不全的主要因素。而除了缺血-再灌注损伤,窒息缺氧、复苏时的药物与机械损害也造成心肌损伤,现就心肺复苏后心肌损伤的研究进展综述如下。1 再灌注损伤心跳骤停后机体处于一个严重的全身的缺血、缺氧状态,而心肺复苏的过程就相当于缺血再灌注的过程,随着自主循环的建立就会出现再灌注损伤。心肌纤维能量代谢障碍、氧自由基、钙超载、
Clinically, patients with spontaneous breathing and circulatory recovery after cardiopulmonary resuscitation still have higher mortality, and cardiac dysfunction after resuscitation is an important cause of death in the early stage after resuscitation. At present, it is thought that global ischemia-reperfusion injury is the main factor leading to myocardial contractility and diastolic dysfunction after resuscitation. In addition to ischemia-reperfusion injury, asphyxia, hypoxia, recovery of the drug and mechanical damage caused by myocardial injury, myocardial injury after cardiopulmonary resuscitation are reviewed. 1 Reperfusion injury after a sudden cardiac arrest in a serious systemic ischemia, hypoxia, and the process of cardiopulmonary resuscitation is equivalent to the process of ischemia-reperfusion, with the establishment of autonomic reperfusion injury will occur. Myocardial energy metabolism disorders, oxygen free radicals, calcium overload,