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目的探讨重组组织型纤溶酶原激活剂(rt-PA)溶栓治疗急性心肌梗死的疗效及静脉溶栓的护理要点。方法入选54例急性心肌梗死患者,常规应用阿司匹林和肝素等药物,静脉注射重组组织型纤溶酶原激活剂(rt-PA)100mg,同时予积极护理干预。观察患者溶栓后的冠状动脉开通率(根据临床判定),出血等并发症和发病30d左室射血分数。结果冠状动脉开通率为81.5%(44例);30d左室射血分数为(51.6±7.8)%;54例患者中20例出现穿刺处皮下淤血,2例肉眼血尿,29例心律失常,9例低血压。结论重组组织型纤溶酶原激活剂(rt-PA)溶栓治疗急性心肌梗死具有较好疗效,同时结合有效的心理护理,溶栓前、中、后的观察及护理和正确合理的生活护理可防止患者溶栓后出血,心肌再灌注性心律失常等并发症。
Objective To investigate the curative effect of thrombolytic therapy of recombinant tissue plasminogen activator (rt-PA) on acute myocardial infarction and the nursing points of intravenous thrombolysis. Methods Fifty-four patients with acute myocardial infarction were enrolled in the study. Aspirin and heparin were given routinely. Intravenous injection of 100 mg recombinant tissue plasminogen activator (rt-PA) was given as active nursing intervention. Patients underwent thrombolytic coronary artery opening rate (based on clinical judgment), complications such as bleeding and incidence of left ventricular ejection fraction 30d. Results The opening rate of coronary artery was 81.5% (44 cases). The ejection fraction of left ventricular ejection fraction was (51.6 ± 7.8)% at 30 days. Subcutaneous congestion was observed in 20 of 54 cases, gross hematuria in 2 cases, 29 cases of arrhythmia, 9 Cases of hypotension. Conclusions Recombinant tissue plasminogen activator (rt-PA) has a good curative effect in thrombolytic therapy of acute myocardial infarction. Combined with effective psychological care, observation before and after thrombolytic therapy, and correct and reasonable nursing care To prevent bleeding after thrombolysis in patients, myocardial reperfusion arrhythmias and other complications.