急性心肌梗死静脉溶栓治疗分析

目的：对急性心肌梗死静脉溶栓治疗的临床疗效与安全性进行分析。方法选取本院于2011年5月～2013年9月收治急性心肌梗死患者72例,随机分为对照组与观察组各36例,对照组给予常规治疗,观察组在常规治疗基础上给予链激酶静脉溶栓治疗,对两组患者冠脉临床疗效与并发症发生情况进行观察。结果观察组冠脉再通率显著高于对照组,3d后胸痛症状发生率显著低于对照组,心律失常、血尿、心源性休克等并发症发生率均显著高于对照组（P〈0.05）。结论静脉溶栓方法在急性心肌梗死治疗中具有显著疗效,可有效改善患者临床症状,促进冠脉再通,值得在临床中推广。     

静脉溶栓治疗急性心肌梗死护理

急性心肌梗死属内科急症。如果治疗护理不当，会严重地威胁患者生命。溶栓治疗是近几年来治疗急性心梗的主要进展之一。通过溶解冠脉内血栓，使闭塞的血管再通，恢复对缺血心肌的再灌注，缩小梗死面积。改善预后。     

静脉溶栓治疗急性心肌梗死临床分析

目的 通过急性心肌梗死运用溶栓治疗,分析观察治疗效果.方法 选取我院2011年6月至12月收治急性心肌梗死患者68例,随机分为治疗组和对照组,各34例患者,均没有出现静脉溶栓禁忌证,治疗组选择静脉溶栓治疗,对照组选择常规方法治疗.结果 经过治疗,治疗组成功再通22例,再通率64.71%;对照组成功再通5例,再通率14.71%,两组患者静脉溶栓后,治疗组血清CK-MB峰值和出现时间分为为(366±58)U/L和(16.12±2.71)h,随用药ST段回降18(52.94%)例;对照组血清CK-MB峰值和出现时间分为为(378±30)U/L和(21.42±2.31)h,随用药ST段回降3(8.82%)例.5周后观察疗效,治疗组好转出院33(97.06%)例,死亡1(2.94%)例,死亡率2.94%;对照组好转出院26(76.49%)例,死亡8(23.53%)例,死亡率23.53%,治疗组出现静脉穿刺部位淤斑3例,不排除由于按压不当导致,2例牙龈出血,减量或是停药后2周后均消失,未出现严重消化道或是脑出血倾向.结论 静脉溶栓治疗急性心肌梗死只要时掌握窗口期积极治疗,具有再通率高,症状恢复快、死亡率低、不良反应少、预后良好等优点,值得临床进一步推广.     

静脉溶栓治疗急性心肌梗死临床分析

目的探讨静脉溶栓治疗急性心肌梗死的疗效。方法回顾分析45例患者的临床资料。结果本组45例患者中,再通31例,未通14例。再通31例胸痛迅速缓解,其余14例胸痛缓解不理想,酌情给予对症处理,胸痛渐缓解。酶峰值7～14h31例,其余酶值在15～30h内。31例再通病例中再灌注心律失常20例,包括频发房早4例,室早14例,短阵室速1例,一过性高度房室传导阻滞1例,未见出血并发症;死亡1例,于48h以内,死因为Ⅲ度房室传导阻滞合并心源性休克。结论静脉溶栓是目前治疗急性心肌梗死的重要有效的手段,患者开始溶栓时间越早,溶栓的治疗效果越佳,死亡率越低,再通率越高,患者的预后越好。     

静脉溶栓治疗急性心肌梗死临床分析

目的观察尿激酶(UK)静脉溶栓治疗急性心肌梗死(AMI)的临床效果及安全性。方法应用尿激酶进行静脉溶栓治疗AMI患者58例。结果 58例AMI患者经尿激酶静脉溶栓治疗后,再通占69.0%(40/58),未通占31.0%(18/58)。其中,发病6h内溶栓再通率83.9%(26/31);6～12h溶栓再通率56.5%(13/23);12～24h内溶栓再通率25.0%(1/4)。死亡5例(8.6%,5/58),其中2例为心源性休克,2例死于心力衰竭,1例发生室颤抢救无效死亡。并发症发生率8.6%(5/58),其中血尿(+～++)3例,皮肤黏膜出血和轻微牙龈出血各1例,无过敏反应及脑出血、大量咯血及消化道出血等严重不良反应发生。结论尿激酶静脉溶栓治疗AMI可明显改善幸存者心功能,降低病死率。     

静脉溶栓治疗老年急性心肌梗死疗效分析

目的探讨老年急性心肌梗死接受静脉溶栓治疗的疗效。方法60例急性心肌梗死患者分为静脉溶栓组（A组）和非静脉溶栓组（B组）,分别对两组的临床疗效进行比较。结果静脉溶栓组再通率为22例,占73．3％,非静脉溶栓组再通率为12例,占40％,静脉溶栓组30d死亡2例（6．7％）,非静脉溶栓30d死亡8例（26．7％）,（P〈0．05）具有临床统计学意义,并发症静脉溶栓组均低于非静脉溶栓组（P〈0．05）。结论老年急性心肌梗死及早行静脉溶栓治疗疗效显著,值得推广。     

急性心肌梗死患者的静脉溶栓治疗分析

目的探讨急性心肌梗死患者的静脉溶栓治疗效果。方法分析我院2006年2月至2009年10月42例急性心肌梗死患者的临床资料。结果溶栓治疗组冠脉再通、心功能改善、严重心律失常及死亡发生率分别为76.00%、90.50%、11.20%、4.95%;常规治疗组冠脉再通、心功能改善、严重心律失常及死亡发生率分别为11.20%、62.00%、32.50%、28.5%。两组比较,差异有显著性（P〈0.05）。结论急性心肌梗死（AMI）患者在常规治疗的基础上,尽早充分持久地疏通梗死相关血管,可缩小梗死面积,保护心功能,降低病死率。     

静脉溶栓治疗急性心肌梗死的体会

目的分析静脉溶栓治疗急性心肌梗死的（AMI）临床治疗效果。方法分析新郑市第二人民医院35例AMI患者的临床治疗情况,以及常规治疗的主要方式、溶栓成功的指标。结果 2h内溶栓成功11例,2～6h溶栓成功13例,6～12h溶栓成功7例,〉12h溶栓成功4例。冠状动脉再通共29例。结论静脉溶栓治疗AMI是一种操作简单、安全经济的治疗方法,但患者在AMI发病1h内进行溶栓治疗的效果最佳。     

静脉溶栓治疗急性心肌梗死的临床分析

目的探讨静脉溶栓治疗急性心肌梗死的临床疗效。方法回顾分析80例患者的临床资料。结果溶栓治疗组冠脉再通、心功能改善、严重心律失常及死亡发生率分别为76.12%、89.05%、12.89%、3.85%;常规治疗组冠脉再通、心功能改善、严重心律失常及死亡发生率分别为8.91%、57.62%、34.47%、21.01%。两组比较,差异有统计学意义,P<0.05。结论 AMI患者在休息、吸氧、抗血小板、扩血管药以及肝素抗凝等治疗的基础上,尽早开通梗死相关血管,可缩小梗死面积,保护心功能,降低病死率。     

48例急性心肌梗死静脉溶栓治疗临床分析

目的分析探讨急性心肌梗死静脉溶栓治疗的临床疗效。方法选择急性心肌梗死患者96例,随机分为观察组和对照组各48例。对照组采用急性心肌梗死常规治疗,观察组采用尿激酶溶栓治疗。观察两组患者再通情况和治疗后并发症、病死率。结果观察组在6h内和6～12h内以及总的再通率均高于对照组,差异有统计学意义(P<0.05);对照组的病死率、并发症均高于观察组,差异有统计学意义(P<0.05)。结论尿激酶溶栓治疗急性心肌梗死可以显著改善患者的预后,提高血管的再通率。     

Thrombolytic therapy in acute myocardial infarction

Early reperfusion of thrombotically occluded coronary arteries by thrombolytic therapy has become a routine option in initial therapy of acute myocardial infarction. Many efforts have been made to improve the biological properties of thrombolytic agents in terms of fibrin specificity, plasma half-life and resistance to natural plasma inhibitors, to improve adjuvant therapy and to shorten the 'pain to reperfusion' time. Numerous randomised, multicentre trials have analysed the benefit of the various thrombolytic agents and regimens, which has enabled the creation of a 'current standard of therapy'. This review presents an update on available thrombolytic agents, their biochemical and pharmacological properties and results from clinical trials.     

Thrombolytic therapy in acute myocardial infarction

Thrombolytic therapy represents the major advancement for the treatment of acute myocardial infarction (MI) that has been achieved in recent years. Based on the recognition of acute totally occlusive intracoronary thrombosis as the primary cause of ST-elevation MI, thrombolytics were evaluated alone or in combination with antithrombotics for the treatment of acute MI. Streptokinase, APSAC and t-PA were the first "standard" regimens evaluated. The "accelerated" t-PA infusion was introduced as the "gold standard" thrombolytic regimen with the GUSTO trial, and was administered in combination with aspirin and intravenous heparin. Many newer thrombolytics have been developed with the expectation to further decrease acute MI mortality, to decrease bleeding complications or to facilitate drug administration. The introduction of platelet glycoprotein IIb/IIIa inhibitors in clinical pharmacology has added a novel drug category for potential use for primary thrombolysis or in combination with thrombolytics. Conceptualizing thrombolytic and anti-thrombotic combination regimens will optimize treatment of acute MI in the future.     

急性心肌梗死院前溶栓与院内溶栓的临床分析

目的 探讨院前溶栓治疗急性心肌梗死的临床效果.方法 回顾分析本院收治的AMI患者46例,其中20例于我院急诊科进行院前溶栓治疗,26例进行院内溶栓,并将两者对比分析.结果 就诊至溶栓治疗时间,院前溶栓组为(15.11±10.25)min,院内溶仑组为(45.51±15.29)min.血管再通率院前组为70%,院内组为6...     

尿激酶溶栓治疗急性心肌梗死疗效观察

目的判断尿激酶静脉溶栓治疗急性心肌梗死(AMI)的疗效。方法回顾分析我科1997年2月-2005年2月应用尿激酶(150万u,30 min内静滴)治疗69例AMI患者的临床症状、心电图、心肌酶谱的变化及不良反应,根据冠脉再通间接指征判断冠脉再通率。结果冠脉再通率达到73.9%,69例患者溶栓后早期(24h内)T波倒置49例,其中冠脉再通43例,早期T波未倒置20例中冠脉再通8例。结论AMI患者早期使用尿激酶静脉溶栓安全可靠,疗效满意,溶栓后早期T波倒置对判定冠脉再通有重要价值。     

介入与溶栓治疗急性心肌梗死的疗效研究

目的：对急性心肌梗死(AMI)行冠状动脉内成型加支架置入术的疗效与静脉内溶栓治疗进行对比评价。方法：对51例行急诊介入治疗的AMI患者，与同期146例行静脉内溶栓治疗的AMI患者进行对比研究。结果：急诊介入组梗死相关血管再通98.2％，其中TIMI--3级血流为96．5％。术中、术后无死亡病例。其中8例因3例支血管病变而行冠状动脉旁路移植术，术后随访3个月复发胸痛3例。静脉内溶栓组再通率67．1％，在院死亡13例。出院后随访3个月死亡5例，反复性胸痛及再梗死128例。结论：急诊介入是抢救心肌梗死，降低死亡率改善预后的最佳方法。     

Thrombolytic therapy for acute myocardial infarction. A review .

In the past 10 years, thrombolytics have become standard therapy for acute myocardial infarction. Although the ability of streptokinase to lyse clot was first recognised in the 1930s, thrombolytic therapy was not used to treat acute myocardial infarction until the early 1980s, when the importance of thrombosis in the pathogenesis of acute infarction was fully recognised. In addition to streptokinase and urokinase, recombinant human tissue plasminogen activator (tPA) and anistreplase were developed and widely used in the 1980s. Saruplase (prourokinase) and BM-06022 (recombinant plasminogen activator) have also undergone human clinical studies. All of these agents are effective at achieving clot lysis and coronary patency. Large, randomised clinical trials have demonstrated that thrombolytic therapy reduces mortality in patients with ST elevation treated within the first 6 to 12 hours of acute infarction, with an approximately 0.5% risk of intracranial haemorrhage. Recent data have more clearly identified which patients benefit from thrombolytic therapy. Efforts have been made to improve the speed of reperfusion, decrease reocclusion, simplify administration and reduce adverse effects. The characteristics of fibrin specificity and more rapid clot lysis with tissue plasminogen activator have not yet been translated into overall clinical benefit compared with the less expensive streptokinase. The lack of close association of improved early patency and improved global left ventricular function with improved survival challenges the very paradigm which led to the use of thrombolytic therapy for acute myocardial infarction. The need for development of additional methods for evaluation of new thrombolytic agents is evident.     

急性心肌梗死急诊溶栓的临床观察

目的探讨急性心肌梗死(AMI)急诊溶栓的疗效和安全性。方法60例AMI患者被随机分为急诊溶栓组(A组)和入院后溶栓组(B组),各30例。A组患者诊断为AMI后,在急诊科立即给予尿激酶(UK)静脉点滴,B组患者按常规办完入院手续后再按上述方法溶栓治疗。结果从发病到开始溶栓的时间: A组(145±33)min,B组(253±116)min(P<0．05)。梗死相关血管开通率:A组86．7％,B组63．3％(P< 0．05)。A、B两组的并发症发生率相似。结论急诊溶栓可缩短AMI患者溶栓开始的时间,增加冠状动脉的再通率,安全可行。     

急性ST段抬高型心肌梗死溶栓治疗的疗效与安全性

对于急性ST段抬高型心肌梗死患者,早期的再灌注治疗能有效开通梗死相关血管,减少心肌损伤,促进心功能的恢复。本文就近年来急性ST段抬高型心肌梗死溶栓治疗的发展进行综述,分析心肌梗死溶栓治疗的优势和需要解决的问题。     

老年人急性心肌梗塞84例临床分析

本文分析了84例老年急性心肌梗塞的临床资料。结果表明,老年急性心肌埂塞女性患者相对增多;临床症状不典型、短,异位痛等非特异性症状较为常见;并发症多,且两种或两种以上的并发症并存的机率高,病死率高是其又一特点。死因中仍以心律失常为首位,泵衰竭为第二位。