《论文_急性心肌梗塞心肺复苏后溶栓治疗(定稿)》

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1、急性心肌梗塞心肺复苏后溶栓治疗【摘要】1=1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22例。治疗组13例，心肺复苏后即刻静脉予尿激酶12()〜200万U、链激酶150万U或rt-PA5()mg溶栓治疗，部分行冠状动脉造影检査。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(20.1%)。9例随访3.3±1.5(1〜6)年，3例死亡。对照组心肺复苏48小时后无一例存活。两组急救

2、存活率有显著性差异(PV0.001)。结论在没有条件实行急诊血管重建的医院，急性心肌梗塞心肺复苏后溶栓治疗能明显提高其住院存活率。【关键词】急性心肌梗塞心肺复苏溶栓治疗ThrombolytictreatmentofacutemyocardialinfarctionfollowingcardiopulmonaryresuscitationBaiShugong,LiZhizhong,LiLi(InstituteofBeijingHeart,LungandBloodVesselDisease,AnZh

3、enHospital,Beijing100029)【Abstract]ObjectiveToevaluatefeasibility,necessity,prognosisofthrombolytictreatmentfollowingcardiopulmonaryresuscitationofthepatientswithacutemyocardialinfarction.MethodsTwentytwopatientswithacutemyocardialinfarctioncomplicat

4、edwithcardiacarrestweredividedinto2groups,onereceivingintravenousthrombolytictreatmentandtheotherwascontrolgioup.Inthethrombolyticgrouptherewere13patients.Theyweretreatedwithintravenouslyurokinase1.2〜2.()millionUorstreptokinase1.5millionUorrecombinan

5、ttissue-typeplasminaogenactivator50mgrightaftercardiopulmonaryresuscitationandperformedcoronaryarteriographiesandfolloweduptoevaluateefficiencyandprognosis.9patientsactedascontrols,theyweregivengeneraltreatmentsexceptfromthrombolysisaftercardiopulmon

6、aryresuscitation.ResultsTherewereelevenrecanalizationsduetothrombolysisaftercardiopulmonaryresuscitation(86.4%)inthrombolyticgroup.In・hopsitalmortalitywas20.08%(3of13patients),ninepatientswerefollowedupfor3.3O±1.50(range1〜6)years,3casesdicd.Nopatient

7、survivedin48hoursaftercardiopulmonaryresuscitationincontrolgroup.Therewassignificantlystatisticaldifferenceinsurvivalratebetweentwogroups(P<0.001).ConclusionsThrombolytictreatmentcanimprovethesurvivalrateforpatientswithAMIfollowingcardiopulmonaryresu

8、scitationin,especiallyinthosehospitalswithoutconditionperformingemergencyrevascularization.【Keywords]AcutemyocardialinfarctionCardiopulmonaryresuscitationThrombolytictherap既往心肺复苏是急性心肌梗塞(acutemyocardialinfarction,AMI)患者溶栓治疗的禁忌症，但近年来不断有心肌梗塞心肺复苏后溶栓治疗成功的