摘要
目的:观察心肺复苏(CPR)后急性心肌梗死(AMI)患者静脉溶栓的疗效及存在的问题。方法:对35例CPR后AMI患者(CPR组)尿激酶静脉溶栓治疗情况进行回顾性分析,并与同期42例无CPRAMI患者(对照组)静脉溶栓情况进行对比分析。结果:CPR组发病至心脏停搏时间平均为(84.0±33.6)分钟,CPR时间(7.7±3.0)分钟,平均溶栓时间为(93.6±48.8)分钟〔与对照组(163.1±69.2)分钟比较,P<0.001〕;冠脉再通率为74.3%(与对照组66.7%比较,P>0.05),CPR组无一例发生胸内出血,但有8例(22.9%)发生上消化道出血,其中1例严重出血(与对照组上消化道出血7.1%比较,P<0.05)。结论:对CRP成功后无创AMI患者迅速进行静脉溶栓治疗不仅安全有效,而且可适当扩大溶栓治疗的“时间窗”;CPR后需注意预防机体应激性反应,尤其是上消化道出血的发生。
Objective :To
observe the effect of thrombolytic therapy on patients with acute myocardial infarction (AMI)
after cardiopulmonary resuscitation (CPR). Methods :A retrospective investigation was made in
two groups:patients after CPR were assigned in CPR group (n=35),and patients without CPR
were in the control group (n=42). Results :Patients in CPR group received thrombolytic therapy
much earlier than those in control group (936488)min vs.(1631692)min,P<0001,and coronary
reperfusion rate in CPR group was higher compared with controls (743%
vs.667%,P>005).However,the incidence of bleeding complications in upper gastrointestinal tract
in CPR was significantly higher than in the control group (229% vs .71%,P<005). Conclusions
:Thrombolytic therapy for non invasive patients with AMI after CPR is both feasible and safe,the
time window of thrombolytic therapy may be extended properly.It is very important to prevent
and treat bleeding complications induced by stress response on gastrointestinal tract afte
出处
《中国危重病急救医学》
CAS
CSCD
1999年第7期416-418,共3页
Chinese Critical Care Medicine
关键词
心肺复苏术
溶栓疗法
尿激酶
心肌梗塞
治疗
acute myocardial infarction
cardiopulmonary resuscitation
intravenous thrombolytic
therapy
urokinase