院外静脉溶栓救治急性心肌梗死

目的:使急性心肌梗死(AMI)患者得到良好的临床治疗效果,并探讨院外AMI患者溶栓治疗的可行性、安全性.方法:连续观察发病≤6小时的120例在院外给予静脉溶栓的AMI 患者,其中发病≤3小时内溶栓者91例,发病4～6小时溶栓者29例,对比两者的冠状动脉(冠脉)再通率;同时与同期住院治疗的120例AMI患者比较.结果:再通率:≤3小时溶栓者68.13%,4～6小时溶栓者58.33%,两者比较差异显著,P<0.005.确诊为AMI距接受溶栓时间:院外组为(0.54±0.58)小时, 院内组为(2.74±1.02)小时;2组比较P<0.000 1.院外AMI诊断准确率达98.4 %,无一例死亡.结论:急性心肌梗死院外静脉溶栓能减少不必要的耽搁时间,溶栓时间越早,冠脉再通率越高;院外溶栓治疗安全、可行.

Intravenous thrombolytic therapy in the onthespot treatm ent of acute myocardial infarction

ObjectiveTo verify the safety and practicability of intravenous thrombolytic therapy in t he onthespot treatment of the patients suffering from ac ute myocardial infarction (AMI) so as to shorten the time between the onset of t he disease and the treatment,thus improving the therapeutic effects of AMI.MethodsOne hundred and twenty AMI patients receiving onthespot intravenous thrombolytic therapy were included in the study (group A).Ninetyone patients received the treatment within 3 hours after AMI,and the oth er 29 patients received the treatment between 46 hours after AMI.On e hundred and twenty AMI patients received the treatment in hospital were includ ed in the study as control.ResultsThe rates of reopening of coronary blood vessel were 68.13％ and 58.33％ res pectively in patients who received thrombolytic therapy within 3 hours and 46 hours after AMI,and the difference was very significant (P<0.0 05).The time for the patients to receive intravenous thrombolytic therapy was (0.54±0.58) hours in group A and (2.74±1.02) hours in control.Th e difference was also very significant (P<0.000 1).The accurate rate of diagnosis for AMI was 98.4％,and no patients died in group A.ConclusionsOnthespot intravenous thrombolytic therapy can shorten t he time interval between the onset of AMI and the treatment,significantly increa se the reopening rate of coronary artery.Thus it is safe and practical.