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文献中,溶栓疗法引起出血性并发症已有广泛报道,但和血栓溶解有关的血性心包填塞仅有4例。本例由组织型纤维蛋白原激活剂(t-PA)引起心包填塞则是第一次报道。患者女,54岁。因典型心绞痛8小时,心电图V_1-V_6ST段抬高1.5～3mm。即给利多卡因、硝酸甘油及t-PA100mg。疼痛完全消除。3小时后再度胸痛、低血压。紧急心导管发现冠状动脉左前降支有一血凝块。左心室造影提示心前壁尖部、中隔严重运动失调。低血压是心脏填塞所致。作心包穿刺抽出
In the literature, hemorrhagic complications caused by thrombolytic therapy have been widely reported, but there are only 4 cases of hemorrhagic tamponade associated with thrombolysis. This case of tissue-type fibrinogen activator (t-PA) caused by pericardial stuffing is the first report. Female patient, 54 years old. Due to typical angina 8 hours, electrocardiogram V_1-V_6ST segment elevation 1.5 ~ 3mm. Give lidocaine, nitroglycerin and t-PA100mg. Complete elimination of pain. 3 hours later chest pain, low blood pressure. Emergency cardiac catheterization found that the left anterior descending coronary artery with a blood clot. Left ventricular angiography prompted the tip of the anterior wall, septal serious motor disorders. Hypotension is caused by heart packing. Pericardial puncture out