急性心肌梗死静脉溶栓治疗160例临床剖析.docVIP

急性心肌梗死静脉溶栓治疗160例临床剖析 　　[摘要] 目的:探讨静脉溶栓治疗急性心肌梗死(AMI)的临床效果。方法:应用尿激酶进行静脉溶栓治疗早期AMI患者160例。结果:本组108例再通,再通率为67.5%。其中6 h内AMI患者再通94例,再通率为87.0%(94/108)。本组死亡4例,死亡率为2.5%。结论:对于AMI患者,只要具有溶栓指征而无禁忌证,应尽可能早地应用尿激酶进行静脉溶栓,再通率高,副作用小,值得推广应用。 　　[关键词] 急性心肌梗死;静脉溶栓;尿激酶;再通;并发症 　　[中图分类号] R542.2+2[文献标识码]A [文章编号]1673-7210(2009)08(b)-021-02 　　 　　Clinical analysis of 160 cases of acute myocardial infarction treated with intravenous thrombolytic therapy 　　PAN Yongli, WU Zongjin 　　(1.Department of Internal Medicine, the Hospital in the East Coast of Gaozhou City, Guangdong Province, Gaozhou 525232, China; 2.Chinese Medicine Hospital of Gaozhou City, Guangdong Province, Gaozhou 525200, China) 　　[Abstract] Objective: To explore the clinical effect of intravenous thrombolytic therapy on acute myocardial infarction (ACI). Methods: Intravenous urokinase thrombolysis was applied to treat 160 cases of patients with early AMI. Results: There were 108 cases of recanalization in this group, the recanalization rate was 67.5%. Among these cases, 94 cases of patients with AMI developed recanalization within 6 h, the recanalization rate was 87.0% (94/108). 4 cases died in this group, the mortality rate was 2.5%. Conclusion: For patients with AMI as long as with thrombolytic therapy and without contraindications indications, the application of intravenous urokinase thrombolysis should be developed as soon as possible, the recanalization rate is high, the side effects is tiny, and it is worth popularizing. 　　[Key words] Acute myocardial infarction; Intravenous thrombolysis; Urokinase; Recanalization; Complications 　　 　　急性心肌梗死(AMI)是一种较常见的心血管急症,表现为持久的胸骨后剧烈疼痛、血清心肌坏死标志物增高及心电图进行性改变,须紧急救治。随着人们生活水平的提高,AMI的发病率明显增加,严重威胁着人们的生命和健康,对AMI患者采取早期积极静脉溶栓治疗,可明显改善AMI的近期疗效及预后,提高抢救成功率,减少病死率。我科2002年5月～2007年11月选择早期AMI患者160例,用国产尿激酶进行静脉溶栓治疗,取得满意疗效,现报道如下: 　　1 资料与方法 　　1.1 一般资料 　　我科2002年5月～2007年11月收治160例AMI患者,其中,男性103例,女性57例;年31～78岁,平均59.3岁。本组所有患者均符合中华心血管学会颁布的AMI诊断标准[1-2]。心肌梗死(心梗)部位:前壁心梗52例,下壁心梗67例,下壁+后壁心梗32例,后壁+前壁心梗9例。发病时间:均为早期AM