心搏驟停后的溶栓治療_West China Medical Journal

Authors：

 唐艷 ¹ ,  王健 ²

1. ;
2. ;

Corresponding?author：

王健, Email: 42523748@qq.com

Keywords：

心搏驟停; 腦復蘇; 溶栓治療

DOI：

10.7507/1002-0179.20150184

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

心搏驟停是臨床上常見的急癥，病死率很高。任何原因導致的心搏驟停或其他急性事件引起的嚴重心肺損害發生后，由于腦組織失去系統循環及腦氧輸送，將迅速導致不可逆性的缺氧-缺血性腦損傷，這也正是復蘇后期患者死亡的主要原因。心肺復蘇后，盡管存在足夠的系統循環容量，但腦組織常發生微循環再灌注衰竭，使組織缺血延長，進而導致并加重繼發性腦損傷，影響復蘇治療的遠期預后。因此，心肺復蘇成功的標志不僅僅是自主循環的恢復，其最終目的是保護并恢復完整的腦功能。溶栓治療無論是對冠狀動脈血栓形成或肺栓子的直接作用，還是對微循環再灌注的作用，均可能改善神經學后果，但由于懼怕嚴重出血并發癥，溶栓治療腦復蘇長期被視為禁忌。現對心搏驟停后是否行溶栓治療以及溶栓時機的選擇等研究內容作一綜述。

Citation： 唐艷, 王健. 心搏驟停后的溶栓治療. West China Medical Journal, 2015, 30(4): 631-634. doi: 10.7507/1002-0179.20150184 Copy

1.	Howard RS, Holmes PA, Koutroumanidis MA. Hypoxic-ischaemic brain injury[J]. Pract Neurol, 2011, 11(1):4-18.
2.	Maca J, Kula R, Jahoda J, et al. Thrombolysis and cardiac arrest[J]. Bratisl Lek Listy, 2010, 111(11):619-624.
3.	FischerM, Hossmann KA. Volume expansion during cardiopulmonary resuscitation reduces cerebral no-reflow[J]. Resuscitation, 1996, 32(3):227-240.
4.	B?ttiger BW, Schmitz B, Wiessner C, et al. Neuronal stress response and neuronal cell damage after cardiocirculatory arrest in rats[J]. J Cereb Blood Flow Metab, 1998, 18(10):1077-1087.
5.	Bottiger BW, Motsch J, Braun V, et al. Marked activation of complement and leukocytes and an increase in the concentrations of soluble endothelial adhesion molecules during cardiopulmonary resuscitation and early reperfusion after cardiac arrest in humans[J]. Crit Care Med, 2002, 30(11):2473-2480.
6.	Harper A, Coates L. Role of thrombolysis in resuscitation[J]. Lancet, 2001, 358(9290):1371.
7.	B?ttiger BW, Martin E. Thrombolytic therapy during cardiopulmonary resuscitation and the role of coagulation activation after cardiac arrest[J]. Curr Opin Crit Care, 2001, 7(3):176-183.
8.	Wetsch WA, Spoehr F, Teschendorf P, et al. Thrombolysis during cardio-pulmonary resuscitation[J]. Deutsche Medizinische Wochenschrift, 2010, 135(40):1983-1988.
9.	Logan JK, Pantle H, Huiras P, et al. Evidence-based diagnosis and thrombolytic treatment of cardiac arrest or periarrest due to suspected pulmonary embolism[J]. Am J Emerg Med, 2014, 32(7):789-796.
10.	Tranberg T, Vagner NJ, Christensen A, et al. Acute pulmonary embolism and cardiac arrest treated with thrombolysis and an automatic chest compression device[J]. Ugeskr Laeger, 2013, 175(36):2043-2044.
11.	Gupta R, Jindal A, Cranston-D'amato H. Benefits of thrombolytics in prolonged cardiac arrest and hypothermia over its bleeding risk[J]. Int J Crit Illn Inj Sci, 2014, 4(1):88-90.
12.	Sp?hr F, B?ttiger BW. Thrombolytic therapy during or after cardiopulmonary resuscitation. Efficacy and safety of a new therapeutic approach[J]. Minerva Anestesiol, 2003, 69(5):357-364.
13.	Ruiz-Bailen M, De Hoyos EA, Serrano-Corcoles MA, et al. Efficacy of thrombolysis in patients with acute myocardial infarction requiring cardiopulmonary resuscitation[J]. Intensive Care Med, 2001, 27(6):1050-1057.
14.	Voipio V, Kuisma M, Alaspaa A, et al. Thrombolytic treatment of acute myocardial infarction after out-of-hospital cardiac arrest[J]. Resuscitation, 2001, 49(3):251-258.
15.	Schreiber W, Gabriel D, Sterz F, et al. Thrombolytic therapy after cardiac arrest and its effect on neurological outcome[J]. Resuscitation, 2002, 52(1):63-69.
16.	Kurkciyan I, Meron G, Sterz F, et al. Major bleeding complications after cardiopulmonary resuscitation:impact of thrombolytic treatment[J]. J Intern Med, 2003, 253(2):128-135.
17.	Lederer W, Lichtenberger C, Pechlaner C, et al. Recombinant tissue plasminogen activator during cardiopulmonary resuscitation in 108 patients with out-of-hospital cardiac arrest[J]. Resuscitation, 2001, 50(1):71-76.
18.	Lederer W, Lichtenberger C, Pechlaner C, et al. Long-term survival and neurological outcome of patients who received recombinant tissue plasminogen activator during out-of-hospital cardiac arrest[J]. Resuscitation, 2004, 61(2):123-129.
19.	Li X, Fu QL, Jing XL, et al. A meta-analysis of cardiopulmonary resuscitation with and without the administration of thrombolytic agents[J]. Resuscitation, 2006, 70(1):31-36.
20.	Renard A, Verret C, Jost D, et al. Impact of fibrinolysis on immediate prognosis of patients with out-of-hospital cardiac arrest[J]. J Thromb Thrombolysis, 2011, 32(4):405-409.
21.	Perrott J, Henneberry RJ, Zed PJ. Thrombolytics for cardiac arrest:case report and systematic review of controlled trials[J]. Ann Pharmacother, 2010, 44(12):2007-2013.
22.	B?ttiger BW, Bode C, Kern S, et al. Efficacy and safety of thrombolytic therapy after initially unsuccessful cardiopulmonary resuscitation:a perspective clinical trial[J]. Lancet, 2001, 357(9268):1583-1585.
23.	Abu-Laban RB, Christenson JM, Innes GD, et al. Tissue plasminogen activator in cardiac arrest with pulseless electrical activity[J]. N Engl J Med, 2002, 346(20):1522-1528.
24.	Fatovich DM, Dobb GJ, Clugston RA. A pilot randomised trial of thrombolysis in cardiac arrest (The TICA trial)[J]. Resuscitation, 2004, 61(3):309-313.
25.	Bozeman WP, Kleiner DM, Ferguson KL. Empiric tenecteplase is associated with increased return of spontaneous circulation and short term survival in cardiac arrest patients unresponsive to standard interventions[J]. Resuscitation, 2006, 69(3):399-406.
26.	B?ttiger BW, Arntz HR, Chamberlain DA, et al. Thrombolysis during resuscitation for out-of-hospital cardiac arrest[J]. N Engl J Med, 2008, 359(25):2651-2662.
27.	Sp?hr F, B?ttiger BW. Safety of thrombolysis during cardiopulmonary resuscitation[J]. Drug Saf, 2003, 26(6):367-379.

1. Howard RS, Holmes PA, Koutroumanidis MA. Hypoxic-ischaemic brain injury[J]. Pract Neurol, 2011, 11(1):4-18.
2. Maca J, Kula R, Jahoda J, et al. Thrombolysis and cardiac arrest[J]. Bratisl Lek Listy, 2010, 111(11):619-624.
3. FischerM, Hossmann KA. Volume expansion during cardiopulmonary resuscitation reduces cerebral no-reflow[J]. Resuscitation, 1996, 32(3):227-240.
4. B?ttiger BW, Schmitz B, Wiessner C, et al. Neuronal stress response and neuronal cell damage after cardiocirculatory arrest in rats[J]. J Cereb Blood Flow Metab, 1998, 18(10):1077-1087.
5. Bottiger BW, Motsch J, Braun V, et al. Marked activation of complement and leukocytes and an increase in the concentrations of soluble endothelial adhesion molecules during cardiopulmonary resuscitation and early reperfusion after cardiac arrest in humans[J]. Crit Care Med, 2002, 30(11):2473-2480.
6. Harper A, Coates L. Role of thrombolysis in resuscitation[J]. Lancet, 2001, 358(9290):1371.
7. B?ttiger BW, Martin E. Thrombolytic therapy during cardiopulmonary resuscitation and the role of coagulation activation after cardiac arrest[J]. Curr Opin Crit Care, 2001, 7(3):176-183.
8. Wetsch WA, Spoehr F, Teschendorf P, et al. Thrombolysis during cardio-pulmonary resuscitation[J]. Deutsche Medizinische Wochenschrift, 2010, 135(40):1983-1988.
9. Logan JK, Pantle H, Huiras P, et al. Evidence-based diagnosis and thrombolytic treatment of cardiac arrest or periarrest due to suspected pulmonary embolism[J]. Am J Emerg Med, 2014, 32(7):789-796.
10. Tranberg T, Vagner NJ, Christensen A, et al. Acute pulmonary embolism and cardiac arrest treated with thrombolysis and an automatic chest compression device[J]. Ugeskr Laeger, 2013, 175(36):2043-2044.
11. Gupta R, Jindal A, Cranston-D'amato H. Benefits of thrombolytics in prolonged cardiac arrest and hypothermia over its bleeding risk[J]. Int J Crit Illn Inj Sci, 2014, 4(1):88-90.
12. Sp?hr F, B?ttiger BW. Thrombolytic therapy during or after cardiopulmonary resuscitation. Efficacy and safety of a new therapeutic approach[J]. Minerva Anestesiol, 2003, 69(5):357-364.
13. Ruiz-Bailen M, De Hoyos EA, Serrano-Corcoles MA, et al. Efficacy of thrombolysis in patients with acute myocardial infarction requiring cardiopulmonary resuscitation[J]. Intensive Care Med, 2001, 27(6):1050-1057.
14. Voipio V, Kuisma M, Alaspaa A, et al. Thrombolytic treatment of acute myocardial infarction after out-of-hospital cardiac arrest[J]. Resuscitation, 2001, 49(3):251-258.
15. Schreiber W, Gabriel D, Sterz F, et al. Thrombolytic therapy after cardiac arrest and its effect on neurological outcome[J]. Resuscitation, 2002, 52(1):63-69.
16. Kurkciyan I, Meron G, Sterz F, et al. Major bleeding complications after cardiopulmonary resuscitation:impact of thrombolytic treatment[J]. J Intern Med, 2003, 253(2):128-135.
17. Lederer W, Lichtenberger C, Pechlaner C, et al. Recombinant tissue plasminogen activator during cardiopulmonary resuscitation in 108 patients with out-of-hospital cardiac arrest[J]. Resuscitation, 2001, 50(1):71-76.
18. Lederer W, Lichtenberger C, Pechlaner C, et al. Long-term survival and neurological outcome of patients who received recombinant tissue plasminogen activator during out-of-hospital cardiac arrest[J]. Resuscitation, 2004, 61(2):123-129.
19. Li X, Fu QL, Jing XL, et al. A meta-analysis of cardiopulmonary resuscitation with and without the administration of thrombolytic agents[J]. Resuscitation, 2006, 70(1):31-36.
20. Renard A, Verret C, Jost D, et al. Impact of fibrinolysis on immediate prognosis of patients with out-of-hospital cardiac arrest[J]. J Thromb Thrombolysis, 2011, 32(4):405-409.
21. Perrott J, Henneberry RJ, Zed PJ. Thrombolytics for cardiac arrest:case report and systematic review of controlled trials[J]. Ann Pharmacother, 2010, 44(12):2007-2013.
22. B?ttiger BW, Bode C, Kern S, et al. Efficacy and safety of thrombolytic therapy after initially unsuccessful cardiopulmonary resuscitation:a perspective clinical trial[J]. Lancet, 2001, 357(9268):1583-1585.
23. Abu-Laban RB, Christenson JM, Innes GD, et al. Tissue plasminogen activator in cardiac arrest with pulseless electrical activity[J]. N Engl J Med, 2002, 346(20):1522-1528.
24. Fatovich DM, Dobb GJ, Clugston RA. A pilot randomised trial of thrombolysis in cardiac arrest (The TICA trial)[J]. Resuscitation, 2004, 61(3):309-313.
25. Bozeman WP, Kleiner DM, Ferguson KL. Empiric tenecteplase is associated with increased return of spontaneous circulation and short term survival in cardiac arrest patients unresponsive to standard interventions[J]. Resuscitation, 2006, 69(3):399-406.
26. B?ttiger BW, Arntz HR, Chamberlain DA, et al. Thrombolysis during resuscitation for out-of-hospital cardiac arrest[J]. N Engl J Med, 2008, 359(25):2651-2662.
27. Sp?hr F, B?ttiger BW. Safety of thrombolysis during cardiopulmonary resuscitation[J]. Drug Saf, 2003, 26(6):367-379.

Previous Article
誤診為視神經炎的Leber遺傳性視神經病變一例
Next Article
Chaihu Drop-pill in Treatment of Common Cold: A Multi-center and Randomized Controlled Trial

West China Medical Journal

心搏驟停后的溶栓治療

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content