急性心肌梗死心肺复苏术后溶栓疗效观察

Acute myocardial Infarction cardiopulmonary resuscitation(CPR) postoperative thrombolysis curative effects

目的:观察急性心肌梗死(AMI)心肺复苏术后溶栓治疗的有效性及安全性。方法:选择笔者所在医院急诊科2008年1月-2012年1月确诊为急性心肌梗死心脏骤停患者52例,年龄<65岁,随机分为溶栓组与非溶栓组各26例,进行临床疗效对比。结果:溶栓组自主循环恢复21例(80.8%),其中溶栓后出血5例(23.8%);死亡5例(19.2%)。非溶栓组自主循环恢复14例(53.8%),其中出血4例(28.6%);死亡12例(46.2%)。两组比较出血发生率差异无统计学意义(P>0.05),未见危及生命的出血;溶栓组的病死率显著低于未溶栓组。结论:对于心脏骤停时间小于5min、心肺复苏30min内恢复自主循环的中年男性AMI患者,静脉溶栓冠状动脉容易再通且相对安全。

Objective ：Observe the efficacy and safety of acute myocardial infarction （AMI）, thrombolytic therapy in cardiopulmonary resuscitation. Methods ： The author＇s hospital emergency department from January 2008 to January 2012 and diagnosed as acute myocardial infarction cardiac arrest in 52 cases, age 〈 65 years, were randomly divided into thrombolysis group and non thrombolysis group with 26 cases in each group, for effect comparison. Results ： The restoration of spontaneous circulation in thrombolysis group in 21 cases （80.8%）, hemorrhage after thrombolysis in 5 cases （23.8%）, 5 cases died （19.2%）. Non thrombolysis group the restoration of spontaneous circulation in 14 cases （53.8%）, bleeding in 4 cases （ 28.6% ）, 12 cases died （46.2%）. Compared with the incidence of bleeding, no increased significantly （P〉0.05）, no life-threatening hemorrhage; thrombolysis group were significantly lower than the fatality rate non thrombolysis group. Conclusion ： Cardiac arrest cardiopulmonary resuscitation time is legs than 5 min, 30 rain restoration of spontaneous circulation in middle- aged male patients with AMI, intravenous thrombolvsis recanalization of coronary artery is easy and relatively safe.