论文部分内容阅读
目的:探讨在超过10min的心肺复苏(CPR)过程中联合应用尿激酶静脉溶栓救治ST段抬高性心肌梗死(STEMI)并发心搏骤停(CA)的有效性和安全性。方法:将STEMI并发CA经过约10min的常规CPR仍未能实现自主循环恢复(ROSC)的45例患者,依其家属是否书面同意CPR过程中溶栓分为治疗组(18例)和对照组(27例)。治疗组在持续CPR的过程中,加用尿激酶溶栓,对照组只持续进行常规CPR。观察两组的自主循环恢复率、冠状动脉再通率、24h存活率、出院率以及血气胸、脑出血发生率。结果:治疗组的疗效显著高于对照组:自主循环恢复率:61%/15%(P<0.05);冠状动脉再通率:44%/0%(P<0.05);24h存活率:44%/7%(P<0.05);出院率:33%/4%(P<0.05)。两组均未发现血气胸及脑出血。结论:STEMI并发CA,经过约10min的常规CPR仍未恢复自主循环的,在持续CPR过程中加用尿激酶静脉溶栓是有效的、安全的。
Objective: To investigate the efficacy and safety of intravenous thrombolysis with urokinase in the treatment of ST-segment elevation myocardial infarction (STEMI) complicated with cardiac arrest (CA) during cardiopulmonary resuscitation (CPR) over 10 minutes. METHODS: Forty-five patients who failed to achieve spontaneous circulation recovery (ROSC) after STEMI complicated with CA over conventional CPR of about 10 minutes were divided into treatment group (18 cases) and control group 27 cases). The treatment group in the continuous CPR process, plus urokinase thrombolysis, the control group continued only conventional CPR. The recovery rate of autonomic circulation, the rate of coronary recanalization, the survival rate of 24h, the discharge rate and the incidence of pneumothorax and cerebral hemorrhage were observed. Results: The curative effect of the treatment group was significantly higher than that of the control group: the rate of spontaneous circulation recovery was 61% / 15% (P <0.05); the rate of coronary recanalization was 44% / 0% (P <0.05); 24h survival rate was 44 % / 7% (P <0.05). The discharge rate was 33% / 4% (P <0.05). No pneumothorax and cerebral hemorrhage were found in either group. Conclusion: STEMI complicated with CA, CPR after about 10min has not yet recovered spontaneous circulation, in the continuous CPR with intravenous urokinase thrombolytic therapy is effective and safe.