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目的探讨静脉溶栓治疗急性心肌梗死的疗效。方法回顾分析45例患者的临床资料。结果本组45例患者中,再通31例,未通14例。再通31例胸痛迅速缓解,其余14例胸痛缓解不理想,酌情给予对症处理,胸痛渐缓解。酶峰值7～14h31例,其余酶值在15～30h内。31例再通病例中再灌注心律失常20例,包括频发房早4例,室早14例,短阵室速1例,一过性高度房室传导阻滞1例,未见出血并发症;死亡1例,于48h以内,死因为Ⅲ度房室传导阻滞合并心源性休克。结论静脉溶栓是目前治疗急性心肌梗死的重要有效的手段,患者开始溶栓时间越早,溶栓的治疗效果越佳,死亡率越低,再通率越高,患者的预后越好。
Objective To investigate the curative effect of intravenous thrombolysis on acute myocardial infarction. Methods The clinical data of 45 patients were retrospectively analyzed. Results Of the 45 patients in this group, 31 cases were reopened and 14 cases failed. Thirty-one cases of rapid chest pain relief, the remaining 14 cases of chest pain relief is not ideal, as appropriate symptomatic treatment, chest pain gradually ease. Enzymatic peak 7 ~ 14h31 cases, the rest of the enzyme in 15 ~ 30h. There were 20 reperfusion arrhythmias in 31 recanalization cases, including 4 cases of frequent ascending room, 14 cases of early ascending chamber, 1 case of transient ventricular tachycardia, 1 case of transient atrioventricular block, and no bleeding complications ; 1 died, within 48h, died of Ⅲ degree atrioventricular block with cardiogenic shock. Conclusion Intravenous thrombolysis is an important and effective method for the treatment of acute myocardial infarction. The earlier the thrombolysis time, the better the therapeutic effect of thrombolysis, the lower the mortality and the higher the recanalization rate, the better the prognosis of the patients.