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目的:探讨急性心肌梗死(AMI)合并心脏骤停,经心肺复苏成功后静脉溶栓治疗疗效。方法:将我院AMI并发心脏骤停62例,分为心肺复苏后立即静脉滴注重组组织型纤溶酶原激活药治疗30例(rt-PA组),即刻静脉滴注尿激酶治疗22例(尿激酶溶栓组),不使用溶栓药物治疗10例(对照组)。比较3组血管再通率、4周出院存活率及出血发生率。结果:rt-PA溶栓组再通率和出血并发症发生率与尿激酶溶栓组比较,差异显著(P<0.05);4周出院存活率二者差异不显著(P>0.05);与未溶栓组比较,再通率和4周出院存活率均差异非常显著(P<0.01),出血并发症发生率与未溶栓组比较,差异不显著(P>0.05)。结论:对AMI合并心脏骤停心肺复苏成功后,立即静脉溶栓治疗较安全,成功率高。
Objective: To investigate the efficacy of intravenous thrombolysis in patients with acute myocardial infarction (AMI) complicated with cardiac arrest after successful cardiopulmonary resuscitation. Methods: Sixty-two cases of AMI complicated with cardiac arrest in our hospital were divided into three groups (rt-PA group) treated by intravenous infusion of recombinant tissue plasminogen activator immediately after cardiopulmonary resuscitation. Immediate intravenous infusion of urokinase in 22 cases (Urokinase thrombolytic group), without treatment of thrombolytic drugs in 10 cases (control group). The rate of vascular recanalization, the survival rate of discharge in 4 weeks and the incidence of bleeding were compared. Results: The rate of recanalization and hemorrhagic complications in rt-PA thrombolysis group was significantly different from that in urokinase thrombolysis group (P <0.05). There was no significant difference in survival rate after 4 weeks of discharge (P> 0.05) No significant difference was found between the rate of recanalization and the 4-week discharge rate (P <0.01). There was no significant difference in the incidence of bleeding complications between the two groups (P> 0.05). Conclusions: Immediate success of intravenous thrombolysis after AMI with cardioversion of cardiopulmonary resuscitation is safe and successful.