尿激酶静脉溶栓治疗急性心肌梗死的临床疗效分析

目的：探讨尿激酶静脉溶栓治疗急性心肌梗死的临床疗效。方法：对本院心内科在2012年11月-2013年2月期间收治的36例急性心肌梗死患者给予尿激酶静脉溶栓治疗。对发病时间、治疗后的冠脉再通率和不良反应进行评价分析。观察分析尿激酶静脉溶栓治疗急性心肌梗死的临床疗效及治疗的最佳时间窗和注意事项。结果：36例急性心肌梗死患者有24例冠脉再通，再通率为66.7%。冠脉再通率与发病时间成反比，发病时间越短，再通率越高，2 h以内再通率最高，为77.3%。溶栓治疗后胸痛症状有效改善的有31例，总有效率为86.1%，心电图有效改善的有25例，总有效率为69.4%。经溶栓治疗后出现上消化道出血的有1例，出现齿龈出血的有3例，出现皮下出血的有1例，经相应对症处理后不良反应均在短期内消失。结论：尿激酶静脉溶栓治疗急性心肌梗死能溶解血栓，恢复血流再灌注，改善心功能及减少急性心律失常的发生。溶栓治疗尽量要在冠脉闭塞后3h内进行，尿激酶在严格掌握适应证和严格检测治疗过程凝血指标的前提下进行静脉溶栓治疗安全系数较高，不良反应发生率少。

Analysis of Clinical Efficacy of Urokinase Thrombolytic Therapy in Acute Myocardial Infarction

Objective：To explore the clinical effect of thrombolytic urokinase in the treatment of acute myocardial infarction. Method：Thirty-six cases of acute myocardial infarction were given intravenous thrombolytic therapy of coronary artery disease in the hospital from November 2012 to February 2013 in department of cardiology. The treatment time,the recanalization rate and adverse reaction were analyzed after treatment. The clinical curative effect,the best time window and the care matters of urokinase thrombolytic therapy in acute myocardial infarction were analyzed after treatment. Result：Thirty-six acute myocardial infarction had 24 hat veins again,lead to 66.7%. Hat vein again rate and outbreak time became inverse ratio,and be taken bad,hat vein again rate was more higher when the time more shorter. Hat vein again rate was 77.3%in 2 h which was tallest. After dissolving to bolt to cure chest pain symptom effectively improved was 31 cases,always efficient was 86.1%,electrocardiogram effectively improved was 25 cases,always efficient was 69.4%. After dissolving and bolting a treatment appear a digest way and bleed of there was 1 case,appear having of gum issue of blood were 3 case,appear skin bottom issue of blood there was 1 cases,through correspond to the disease handle behind badly respond to all disappear in the short run. Conclusion：The thrombolytic urokinase in the treatment of acute myocardial infarction can dissolve thrombus.It can restore blood reperfusion,improve cardiac function and reduce the occurrence rate of acute cardiac arrhythmias.The treatment of thrombolysis as far as possible within 3 h after coronary occlusion Intravenous thrombolysis therapy safety coefficient is higher and adverse reactions is less when strict at indication of this disease and coagulation indicator.