溶栓治疗急性ST段抬高型心肌梗死疗效和安全性分析.docVIP

溶栓治疗急性ST段抬高型心肌梗死疗效和安全性分析 　　DOI：10.16662/j.cnki.1674-0742.2017.25.131 　　[摘要] 目的 探析在基?右皆喝芩ㄖ瘟萍毙?ST段抬高型心肌梗死的疗效与安全性。方法 回顾性分析该院2010年4月―2014年5月收治的75例采用静脉溶栓治疗的急性ST段抬高型心肌梗死患者。结果 75例患者中溶栓成功67例、出血2例、病死4例；静脉溶栓时发病≤3 h的患者与发病3 h的患者的溶栓成功率、不良反应率、病死率对比差异无统计学意义（P0.05）；静脉溶栓时0.05），但在病死率上对比差异有统计学意义（P0.05）。结论 在基层医院中，如果FMC-D的时间无法达到指南要求≤90 min或因客观原因无法行急诊PCI，静脉溶栓治疗仍是急性ST段抬高性心肌梗死早期再灌注治疗的最佳选择。溶栓治疗疗效肯定、安全可行。对老年患者静脉溶栓仍可获益，且安全性好。 　　[关键词] 急性ST段抬高型心肌梗死；重组组织型纤溶酶原激活剂（rt-PA）；静脉溶栓 　　[中图分类号] R542 [文献标识码] A [文章编号] 1674-0742（2017）09（a）-0131-03 　　Analysis of Efficacy and Safety of Thrombolytic Therapy in Patients with Acute ST-segment Elevation Myocardial Infarction 　　WU Yi-ming 　　Department of Cardiology， Yixing People’s Hospital， Yixing， Jiangsu Province， 214200 China 　　[Abstract] Objective This paper tries to investigate the efficacy and safety of thrombolytic therapy for acute ST segment elevation myocardial infarction in the primary hospital. Methods A retrospective analysis of 75 patients with acute ST segment elevation myocardial infarction treated by intravenous thrombolysis in this hospital from April 2010 to May 2014 was performed. Results Among the 75 patients， 67 cases were successfully treated by thrombolytic therapy， 2 cases of hemorrhage， 4 cases of death. There were no statistically significant differnces in the success rate of thrombolysis， the rate of adverse reactions， and the fatality rate between the two groups of patients who had illness within three hours and those more than three hours during the intravenous thrombolysis （P0.05）； there were no significant differences in the success rate of thrombolysis and the rate of adverse reactions between the patients whose age was less than 70 years old and those whose age was more than or equal to 70 years old during intravenous thrombolysis （P0.05）， but the difference in mortality rate was statistically significant （P0.05）. Conclusion In the primary hospital， if the FMC-D time cannot reach the requirements for less than or equal to