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患者女,69a。中上腹疼痛七h,诊断为冠心病、急性前壁心肌梗塞,给予去纤酶溶栓治弱。去纤酶皮试阴性后,先去纤酶1~u加生理盐水20ml静注,同时去纤酶2~u加生理盐水250ml静滴。用药后9h,发现静脉注射处出血不易止,需长时间压迫,皮肤出现瘀斑。10h解黑便二次,并出现血压下降,最低为12/0千帕,病人主诉头晕。立即停止溶栓治疗,急查血PT、APTT、TT。报告PT:76秒、APTT:63.86秒、TT:900秒,明显高于正常。即予硫酸鱼精蛋白50mg加5％葡萄糖液250ml静滴,并输血,抗纤、止血敏静滴,以及雷尼替丁、洛赛克静注和阿拉明静滴(?)理。治疗后,复查PT、APTT、TT。报告PT:35.
Patient female, 69a. Mid-abdominal pain seven h, diagnosis of coronary heart disease, acute anterior myocardial infarction, given defibrase thrombolytic weak. After defibrinated skin test negative, go first fibrinase 1 ~ u plus normal saline 20ml intravenous injection, while defibrase 2 ~ u plus saline 250ml intravenous infusion. 9h after treatment, intravenous bleeding found not easy to stop, need long time oppression, the skin appears ecchymosis. 10h solution black then secondary, and blood pressure dropped, the minimum is 12/0 kPa, the patient complained of dizziness. Immediate thrombolytic therapy, acute blood test PT, APTT, TT. Report PT: 76 seconds, APTT: 63.86 seconds, TT: 900 seconds, significantly higher than normal. That is to protamine sulfate 50mg plus 5% glucose 250ml intravenous infusion, and blood transfusion, anti-fibrinolysis, intravenous infusion, and ranitidine, Losec intravenous and Alamin intravenous (?) Management. After treatment, review PT, APTT, TT. Report PT: 35.