急诊心肌梗死尿激酶静脉溶栓的临床效果观察

Emergency Myocardial Infarction Observed Clinical Effects of Intravenous Thrombolysis with Urokinase

目的探讨尿激酶静脉溶栓治疗急性心肌梗死(AMI)的临床疗效。方法回顾性分析我院2009年至2010年度的80例急诊尿激酶静脉溶栓治疗的AMI病例。并且将这80例患者进行分组,分组依据是从发病到溶栓的时间,以6h为界限,然后对两组病例的临床治疗效果进行对比分析。结果本组冠状动脉再通率75.00%;轻度出血发生率12.50%,病死率17.50%,主要的死因有两方面一是心脏泵出现了衰竭和和心脏出现了严重的心律失常情况。时间<6h一组其冠状动脉再通率、轻度出血发生率和病死率分别为:85.01%、11.00%、8.02%;时间为6h和12h组的冠状动脉再通率、发生轻度出血的概率和病死率分别是54.00%、14.98%、31.00%;对比分析两组的冠状动脉再通率和病死率发现结构具有显著统计学差异(P值分别<0.101和<0.105)。对比分析轻度出血发生率发现结果没有显著统计学差异。结论通过临床治疗效果的观察可以得出急诊尿激酶静脉溶栓治疗急性心肌梗死方法是可行的,它能够使AMI的救治疗效显著提高,该方法值得推广。

Objective Study on urokinase thrombolytic therapy in acute myocardial infarction（AMI） clinical effects.Methods Retrospective analysis of 2009-2010 hospital emergency intravenous thrombolytic therapy with urokinase AMI 80 cases.And to group these 80 patients,based on the time from onset to thrombolysis to 6h for the limit,then the clinical efficacy of two groups of patients were analyzed.Results This group of crown arteries pass rate 75.00% again;the mild hemorrhage formation rate 12.50%,the case fatality rate 17.50%,the main cause of death had two aspects one is the heart pump had the failure and had the serious arrythmia situation with the heart.Time 6h group whose coronary recanalization rate,the incidence of mild bleeding and mortality were： 85.01%,11.00%,8.02%;time of 6h and 12h group of coronary recanalization rate,the probability of mild bleeding and the mortality rate is 54.00%,14.98%,31.00%;comparative analysis of two groups of coronary recanalization and mortality found that the structure has a statistically significant difference（P values were 0.101 and 0.105）.Comparative analysis of the incidence of mild bleeding results found no significant statistical difference.Conclusion Emergency through clinical observation on the therapeutic effect of intravenous urokinase in thrombolytic therapy in acute myocardial infarction method is feasible,it can make the effect significantly improved the treatment of AMI,the method worth promoting.