静脉溶栓治疗高龄急性心肌梗死患者的临床探讨

目的　探讨静脉溶栓疗法对高龄急性心肌梗死患者的疗效及安全性。 方法　将 82例高龄急性心肌梗死患者随机分为溶栓组和常规治疗组。溶栓组 40例 ,采用尿激酶静脉溶栓加皮下注射低分子肝素钙。常规治疗组 42例 ,除不用尿激酶及低分子肝素钙外 ,其余治疗均与溶栓组相同。 结果　 血管再通率溶栓组为6 5 %(2 6 / 40 ) ,常规治疗组为 14.3%(6 / 42 ) ,两组血管再通率比较差异具有显著性 (P <0 .0 5 )。溶栓组未见严重出血等并发症。住院 4周内病死率为 5 %。而常规治疗组病死率为 2 3.8%(10 / 42 ) ,两组比较具有显著差异性(P <0 .0 5 )。 结论　 尿激酶静脉溶栓治疗高龄急性心肌梗死可以提高冠脉再通率 ,降低死亡率和改善预后 ,是可行性治疗措施。

Clinical Exploration of Treatment of Senile Acute Myocardial Infarction by Venous Thrombolysis

Objective explore the effect and safety of venous thrombolysis in treating senile acute myocardial infarction.Methods 82 patients are randomly divided into regular treatment group and thrombolysis group.For thrombolysis group 40 cases take urokinase venous thrombolysis and hypodermic injected low molecular calcium hepatin.For regular treatment group 42 cases,except urokinase and low molecular caluium hepatin,the rest is same as that of thrombolysis group.Results the blood vessel redrainage rate of thrombolysis group is 65%(26/40).that of regular group is 14.3%(6/42) there's obvious difference between the two groups (P<0.05).no severe hemorrhage happened in thrombolysis group,the mortality of 4 weeks hospitalization is 5% while the mortality of regular group is 23.8%(10/42) there's obvious difference (P<0.05)?Conclusion urokinase venous thrombolysis can increase the redrainage rate of coronary artery,decrease mortality and improve prognosis.