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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。
Objective To observe the clinical efficacy and safety of intravenous thrombolytic therapy of urokinase for acute myocardial infarction (AMI). Methods Thirty-four cases of AMI were treated with intravenous thrombolytic therapy of urokinase. The complications such as blood vessel opening, bleeding, reperfusion arrhythmia (RA) and mortality were observed after thrombolysis. Results The rate of blood vessel opening after thrombolysis was 69.76%. Complications: A total of 5 cases (11.62%) had bleeding manifestations, including 3 cases of bleeding gums and 2 cases of asparagus. Reperfusion arrhythmia (RA): 6 cases (13.95%), 4 cases (9.30% The cause of death was 2 arrhythmias, 1 cardiogenic shock, and 1 elderly patient who died of acute left heart failure. Among them, 5 cases of AMI elderly patients were opened in 4 cases. Conclusions Urokinase intravenous thrombolysis is an active, safe and effective measure for AMI. It is especially suitable for primary hospitals. As long as indications are strictly controlled, thrombolytic therapy in elderly patients is also safe and effective.