摘要
目的 探讨急性心肌梗塞心肺复苏后溶栓治疗的可行性、必要性及预后。方法 急性心肌梗塞并发心脏骤停的患者 2 2例。治疗组 13例 ,心肺复苏后即刻静脉予尿激酶 12 0～ 2 0 0万U、链激酶 150万 U或 rt- PA50 mg溶栓治疗 ,部分行冠状动脉造影检查。对照组 9例 ,在心肺复苏后予除溶栓外的积极抢救治疗。结果 治疗组 13例中 11例复苏后溶栓再通 ,占 84 .6。住院死亡 3例 ( 2 0 .1% )。 9例随访 3.3± 1.5( 1～ 6)年 ,3例死亡。对照组心肺复苏 4 8小时后无一例存活。两组急救存活率有显著性差异 ( P<0 .0 0 1)。结论 在没有条件实行急诊血管重建的医院 。
Objective To evaluate feasibility,necessity,prognosis of thrombolytic treatment following cardiopulmonary resuscitation of the patients with acute myocardial infarction.Methods Twentytwo patients with acute myocardial infarction complicated with cardiac arrest were divided into 2 groups,one receiving intravenous thrombolytic treatment and the other was control group.In the thrombolytic group there were 13 patients.They were treated with intravenously urokinase 1.2～2.0 million U or streptokinase 1.5 million U or recombinant tissue type plasminaogen activator 50mg right after cardiopulmonary resuscitation and performed coronary arteriographies and followed up to evaluate efficiency and prognosis.9 patients acted as controls,they were given general treatments except from thrombolysis after cardiopulmonary resuscitation.Results There were eleven recanalizations due to thrombolysis after cardiopulmonary resuscitation (86.4%) in thrombolytic group.In hopsital mortality was 20.08% (3 of 13 patients),nine patients were followed up for 3.30±1.50 (range 1～6) years,3 cases died.No patient survived in 48 hours after cardiopulmonary resuscitation in control group.There was significantly statistical difference in survival rate between two groups ( P <0 001).Conclusions Thrombolytic treatment can improve the survival rate for patients with AMI following cardiopulmonary resuscitationin,especially in those hospitals without condition performing emergency revascularization.
出处
《北京医学》
CAS
北大核心
2000年第6期357-359,共3页
Beijing Medical Journal
关键词
急性心肌梗塞
心肺复苏
溶栓治疗
药物疗法
Acute myocardial infarction Cardiopulmonary resuscitation Thrombolytic theX
