心肺复苏培训与溺水患者抢救成功率的相关性

目的：通过心肺复苏的培训,提高溺水患者的抢救成功率。方法：强化急救人员心肺复苏培训;加强公众心肺复苏培训,强调急救人员接到溺水呼救后,先电话指导呼救者互救,争取第一时间开放气道,及时对患者进行心肺复苏。结果：通过开展不同形式的心肺复苏培训、演练及电话指导心肺复苏自救。溺水患者抢救成功率由2009年的4.5％上升为2010年的15％。结论：掌握心肺复苏技能及专业急救人员及时、有效的心肺复苏是提高溺水患者抢救成功率的关键。     

Hypertonic saline resuscitation reduces apoptosis of intestinal mucosa in a rat model of hemorrhagic shock

Objective: To investigate the early effects of hypertonic and isotonic saline solutions on apoptosis of intestinal mueosa in rats with hemorrhagic shock. Methods: A model of rat with severe hemorrhagic shock was established in 21 Spragne-Dawley (SD) rats. The rats were randomly divided into the sham group, normal saline resuscitation (NS) group, and hypertonic saline resuscitation (HTS) group, with 7 in each group. We detected and compared the apoptosis in small intestinal mucosa of rats after hemorrhagic shock and resuscitation by terminal deoxynucleotidyl transferase dUTP nick end labelling (TUNEL), FITC (fluo-rescein-iso-tbiocyanate)-Annexin V/PI (propidium iodide) double staining method, and flow cytometry. Results: In the early stage of hemorrhagic shock and resuscitation, marked apoptosis of small intestinal mucosa in the rats of both NS and HTS groups was observed. The numbers of apoptotic cells in these two groups were significantly greater than that in the sham group (P＜0.01). In the HTS group, the apoptic cells significantly decreased, compared with the NS group (P＜0.01). Conclusion: In this rat model of severe hemorrhagic shock, the HTS resuscitation of small volume is more effective than the NS resuscitation in reducing apoptosis of intestinal mucosa in rats, which may improve the prognosis of trauma.     

心肺复苏的教学改革探讨

目的：探讨CPR教学改革后学生的成绩变化,为护理教学改革提供资料。方法：对2007级护理专业学生进行教学改革。结果：2007级学生成绩高于2006年学生成绩（P〈0．05）,提高了学生的CPR操作能力,培养了教师队伍。结论：通过教学改革提高了护理专业学生的教学质量。     

Hypertonic saline resuscitation maintains a more balanced profile of T-lymphocyte subpopulations in a rat model of hemorrhagic shock

Objective： To investigate the potential and early effect of hypertonic saline resuscitation on T-lymphocyte subpopulations in rats with hemorrhagic shock. Methods： A model of rat with severe hemorrhagic shock was established in 18 Sprague-Dawley （SD） rats. The rats were randomly divided into Sham group, HTS group （hypertonic saline resuscitation group） and NS group （normal saline resuscitation group）. Each group contained 6 rats. The CD4~ and CD8~ subpopulations of T-lymphocytes in peripheral blood were detected respectively before shock and after resuscitation by double antibody labelling and flow cytometry. Results： In the early stage after hemorrhagic shock, fluid resuscitation and emergency treatment, the CD4^＋ lymphocytes of peripheral blood in HTS and NS groups markedly increased. Small volume resuscitation with HTS also induced peripheral CD8^＋ lymphocytes to a certain extent, whereas NS resuscitation showed no effect in this respect. Consequently, compared with Sham and HTS groups, CD4^＋/CD8^＋ ratio of peripheral blood in NS group was obviously increased, and showed statistically differences. Conclusion： In this model of rat with severe hemorrhagic shock, small volume resuscitation with HTS is more effective than NS in reducing immunologic disorders and promoting a more balanced profile of T-lymphocyte subpopulations regulating network.     

Effects of three fluid resuscitation methods on apoptosis of visceral organs in rats with hemorrhagic shock

Objective: To observe the effects of three fluid resuscitation methods on apoptosis of visceral organs in rats with hemorrhagic shock. Methods: A model of rat with severe hemorrhagic shock and active bleeding was established in 32 SD (Sprague-Dawley) rats. The rats were randomly divided into control group, no fluid resuscitation group (NF group), controlled fluid resuscitation group (NS40 group) and rapid large scale fluid resuscitation group (NS80 group). Each group contained 8 rats. The curative effects were compared. At the same time, the apoptosis in liver, kidney, lung and small intestinal mucosa of survivors after hemorrhage and resuscitation was detected by light microscopy in HE (hematoxylin and eosin) stained tissue sections, flow cytometry and terminal deoxynucleotidyl transferase dUTP nick end labelling (TUNEL). Results: The survival rate of early fluid resuscitation (14/16) was markedly higher than that of NF group (3/8). There was some apoptosis in liver, kidney, lung and small intestinal mucosa of all survivors. Compared with NF and NS40 groups, the apoptosis of liver, kidney and small intestinal mucosa of NS80 group was obviously increased. Conclusions: Among three fluid resuscitation methods, controlled fluid resuscitation can obviously improve the early survival rate and the apoptosis of liver, kidney and small intestinal mucosa in rats with severe and uncontrolled hemorrhagic shock, and may benefit improvement of prognosis.     

Effects of three fluid resuscitation methods on apoptosis of visceral organs in rats with hemorrhagic shock

INTRODUCTION Hemorrhagic shock is a common clinic emer- gency case. Successful treatment includes surgical control of hemorrhage and restoration of tissue per- fusion. Current guidelines for presurgical treatment of patients with hemorrhagic shock recommend rapid volume resuscitation to normal blood pressure as quickly as possible. The practice is controversial because aggressive restoration of intravascular vol- ume and rapid increasing of blood pressure before securing hemostasis may ex…