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目的探讨静脉溶栓治疗急性心肌梗死的临床疗效。方法回顾性分析52例患者的临床资料。结果 81例再通,其中男59例,女22例;发生加速性室性自主心律42例,未经特殊处理,10min后自行缓解;6例发生Ⅰ度房室传导阻滞,治疗后1d～2d消失;7例出现鼻黏膜出血,经局部治疗好转;4例出现心室颤动,经除颤转复窦性心率;89例心肌梗死患者死亡3例,死因均系广泛前壁心肌梗死并发心源性休克,8例溶栓失败。结论静脉溶栓是安全的,只要严格把握适应证,其严重并发症发生率极低;另外,静脉溶栓后1周,均建议患者转院冠脉造影,进一步行PCI术,以解除冠脉狭窄,有效防止再梗发生率,提高生活质量。
Objective To investigate the clinical efficacy of intravenous thrombolysis in the treatment of acute myocardial infarction. Methods The clinical data of 52 patients were retrospectively analyzed. The results of 81 cases recanalization, including 59 males and 22 females; 42 cases of accelerated ventricular spontaneous rhythm, without special treatment, 10min after remission; Ⅰ degree atrioventricular block in 6 cases, 1d ~ 2d disappeared; nasal mucosal hemorrhage in 7 cases, local treatment improved; 4 cases of ventricular fibrillation, defibrillation to reverse sinus rhythm; 89 cases of myocardial infarction died in 3 cases, the cause of death were extensive anterior myocardial infarction complicated by cardiac Sexual shock, eight cases of thrombolysis failed. Conclusion Intravenous thrombolysis is safe. As long as indications are strictly controlled, the incidence of serious complications is extremely low. In addition, patients undergoing coronary artery bypass grafting underwent coronary angiography one week after intravenous thrombolysis. PCI was further performed to relieve coronary stenosis , Effectively prevent the incidence of re-stem and improve the quality of life.