二种溶栓剂应用致死亡的病例分析

目的分析2005～2009年期间本院应用重组组织型纤溶酶原激活剂（rt-PA）和尿激酶（UK）静脉溶栓治疗患者的院内死亡发生情况。方法对应用rt-PA或UK溶栓治疗的ST段抬高的急性心肌梗死患者（n=57）和肺血栓栓塞症患者（n=60）的溶栓剂应用情况、死亡原因等进行回顾分析研究。结果117例接受溶栓治疗的患者院内死亡10例（8.5%）,原因为心源性休克（6例）、心脏破裂（3例）和心室颤动（1例）。10例死亡患者中,无1例因出血并发症死亡;7例为ST段抬高的急性心肌梗死患者,肺血栓栓塞症患者因心源性休克死亡3例。应用rt-PA溶栓治疗的98例（84%）患者院内死亡7例,19例患者接受UK溶栓治疗,死亡3例。结论接受溶栓治疗患者的院内死因主要与基础疾病相关,科学规范的应用溶栓治疗是安全的。

Analysis of the In-Hospital Mortality Rate of the Patients Using Two Types Thrombolytic Agents

Objective To study the in-hospital mortality rate of recombinant human tissue-type plasrninogen activator（rt-PA） and urokinase（UK） from 2005 to 2009.Methods We retrospectively analyzed the type of thrombolytic agents and cause of death in ST elevated acute myocardial infarctiong patients（n=57） and pulmonary thromboembolism patients（n=60）.Results In the 117cases,ten patients died in hospital due to cardiac shock（n=6）、cardiac rupture（n=3） and ventricular fibrillation（n=1）.No case died of bleeding complication.Seven of ten deaths suffered acute myocardial infarction.The other 3 deathes due to cardiac shock suffered pulmonary thromboembolism.About 84%（98 cases） patients used rt-PA,of whom seven patients died.In the patients using UK（n=19）,3 cases died.Conclusion The in-hospital mortality rate of the patients using thrombolytic therapy was mainly associated with underlying diseases.The scientific and standardized thrombolytic therapy is safe.