急性心肌梗死患者心肺复苏后溶栓治疗的研究

目的探讨急性心肌梗死(AMI)患者心肺复苏(CPR)后静脉溶栓的可行性及预后。方法AMI并发呼吸心跳骤停患者42例。治疗组25例，心肺复苏后即刻静脉给予尿激酶150～200万U，30min内静脉注射；对照组17例，在心肺复苏后予除静脉溶栓外的积极抢救治疗。观察其自主循环和呼吸恢复率，24h存活率及出院存活率，自主循环和呼吸恢复时间及出血发生率。结果治疗组的自主循环恢复率、自主呼吸恢复率，24h存活率和出院存活率明显高于对照组，自主循环恢复时间、自主呼吸恢复时间明显短于对照组。结论AMI患者心肺复苏后进行溶栓治疗，能明显提高患者的自主循环、自主呼吸恢复率、24h存活率、出院存活率，缩短自主循环、自主呼吸恢复时间，且不增加继发出血发生率。

Thrombolytic treatment of acute myocardial infarction following cardiopulmonary resuscitation

Objective To evaluate the feasibility and prognosis of thrombolysis administered to resuscitated patients due to acute myocardial infarction(AMI).Methods 42 AMI cases with cardiac arrest were divided into two groups: treatment group( n=25) received intravenous urokinase 150-200 U after cardiopulmonary resuscitation(CPR) and the control group( n=17) were given general treatment except thrombolysis after CPR.The rate of spontaneous circulation and respiration restoration,the survival rate in 24 hours and the out-hospital survival rate,the average time of spontaneous circulation,and respiration restoration,and the incidence of bleeding were monitored in each group.Results The rates of spontaneous circulation and respiration restoration,the survival rate in 24 hours,the out-hospital survival rate in the treatment group were significantly higher than that in control group,and the average time of spontaneous circulation and respiration restoration in the treatment group were significantly shorter than that in control group at the same time.Conclusion Thrombolysis for AMI after CPR significantly increase the spontaneous circulation and respiration restoration and the survival rate in 24 hours and the out-hospital survival rate,and may shorten the average time of the average time of spontaneous circulation and respiration restoration,but the incidence of secondary bleeding is not significantly different from that of nonthrombolytic patients.