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经皮冠状动脉腔内溶栓术是近来国内外治疗急性心肌梗塞(AMI)的一种新技术,我院1989年开展1例,现报告如下: 患者,男,64岁。因持续性胸骨后疼痛3.5小时急诊入院。急查心电图示:急性下壁心肌梗塞。立即给予硝酸甘油5mg静滴,尿激酶10万u静注,心绞痛不能缓解,紧急做冠状动脉数字减影造影,见左冠正常,右冠状动脉近端完全闭塞。发病后6小时进行溶栓治疗。经右冠状动脉导管内缓慢注入上海生物制药厂产尿激酶60万u。以每分钟1万u的速度注入。1小时后患者感疼痛减轻,ECG示:抬高的ST段有所下降,并出现短时间Ⅱ°Ⅱ型房室传导阻滞,此时重复右冠造影,见阻塞段再通,远端显影,但仍有残存狭窄50～75％,继续注入10
Percutaneous transluminal coronary thrombolysis is a new technique for the treatment of acute myocardial infarction (AMI) at home and abroad recently. One case was carried out in our hospital in 1989 and the report is as follows: The patient, male, 64 years old. 3.5 hours due to persistent chest pain emergency admission. Emergency ECG: Acute inferior myocardial infarction. Immediately given nitroglycerin 5mg intravenous infusion of urokinase 100000 u, angina pectoris can not be alleviated, emergency digital subtraction coronary angiography, see the normal left coronary artery, proximal coronary artery complete occlusion. Six hours after onset of thrombolytic therapy. The right coronary catheter was slowly injected into the Shanghai Biological Pharmaceutical Factory urokinase 600,000 u. To 10000 per minute rate of injection. 1 hour after the patient’s pain relief, ECG showed: elevation of the ST segment decreased, and a short time Ⅱ ° Ⅱ atrioventricular block, then repeat the right coronary angiography, see the blocking section recanalization, the distal development , But there are still remaining 50 to 75% of the narrow, continue to inject 10