基层医院43例急性心肌梗死静脉溶栓治疗分析

目的观察尿激酶静脉溶栓治疗急性心肌梗死（AMI）的临床疗效及安全性。方法应用尿激酶静脉溶栓治疗AMI43例,于溶栓后观察血管开通情况,出血、再灌注心律失常（RA）等并发症及病死率。结果溶栓后血管开通率69.76%。并发症：出血表现共5例（11.62%）,其中牙龈出血3例,少量柏油样便2例;再灌注心律失常（RA）：共6例（13.95%）;死亡4例（9.30%）,死亡原因为2例心律失常,1例心源性休克,1例老年患者死于急性左心衰竭。其中5例AMI老年患者4例均开通。结论尿激酶静脉溶栓治疗AMI为一种积极、安全、有效的措施,尤其适合基层医院开展,只要严格掌握适应证,老年患者溶栓治疗也是安全有效。

43 Cases of Primary Hospital Thrombolytictherapy in Acute Myocardial Infarction

Objective To observe the intravenous thrombolytic therapy in acute myocardial infarction（AMI）clinical efficacy and safety.Methods intravenous thrombolytic therapy in AMI 43 cases were observed on recanalization after thrombolytic therapy,bleeding complications,the number of death cases.Results Patency rate after thrombolysis,69.76%;complications：Hemorrhage in 5 cases（11.62%）,and gingival bleeding in 3 cases,2 cases have a small amount of tarry;reperfusion arrhythmias（RA）：6 cases（13.95%）;4 patients died（9.30%）,cause of death：2 cases of arrhythmia,1 case of cardiogenic shock,one case of elderly patients died of acute left ventricular failure.5 cases of which 4 cases of elderly patients with AMI were opened.Conclusion Intravenous thrombolytic therapy in AMI as a positive,safe,and effective measures,especially for primary hospital,as long as the strict control indication thrombolytic therapy in elderly patients is safe and effective.