小剂量尿激酶联合低分子肝素钙在心肺复苏中的疗效和安全性研究  

Study of curative effect and safety of low dose of urokinase combined with low molecular heparin calcium

作　　者：谢宜[1] 李贵才[2] 郭剑虹[1] 陈汉波[3] 郑树鑫[1] 黄斌[2] 郑瑞琪[1] 

机构地区：[1]广东省潮州市中心医院急诊科,521000 [2]广东省潮州市中心医院儿内科,521000 [3]广东省潮州市中心医院神经内科,521000

出　　处：《中国医师进修杂志》2011年第34期4-7,共4页Chinese Journal of Postgraduates of Medicine

基　　金：广东省科技厅科技计划（20108031500001）

摘　　要：目的探讨小剂量尿激酶（uK）联合低分子肝素钙在心肺复苏中的疗效和安全性。方法将64例心脏骤停患者按随机数字表法分为治疗组和对照组，每组32例，两组均按《2005国际心肺复苏与心血管急救指南》进行心肺复苏，治疗组在心肺复苏早期使用UK20万U，30min内静脉泵人，低分子肝素钙4100U皮下注射。观察两组自主循环恢复（ROSC）、存活〉24h及存活30d情况，观察两组是否有出血或因出血致死情况。结果对照组ROSC率为34．4％（11／32），治疗组为62．5％（20／32），两组ROSC率比较差异有统计学意义（P〈0．05）；对照组存活〉24h率为15．6％（5／32），治疗组为40．6％（13／32），两组存活〉24h率比较差异有统计学意义（P〈0．05）；对照组存活30d率为6．2％（2／32），治疗组为25．0％（8／32），两组存活30d率比较差异有统计学意义（P〈0．01）。对照组未出现皮下出血或其他脏器出血情况，治疗组有1例在低分子肝素钙注射部位出现皮下局限性淤血。治疗组治疗前后纤维蛋白原比较差异有统计学意义（P〈0．01），而凝血酶原时间、血小板计数比较差异无统计学意义（P〉0．05）。结论心肺复苏中使用小剂量UK和低分子肝素钙治疗安全、有效。Objective To study the curative effect and safety of low dose of urokinase （UK） combined with low molecular heparin calcium. Methods Sixty-four cases of sudden cardiac arrest patients were divided into treatment group and control group by random digits table with 32 cases each. Two groups were given cardiopulmonary resuscitation according to the 2005 international guide for cardiopulmonary resuscitation and emergency cardiovascular care. Early in the recovery, the patients in treatment group were pumped in vein with low dose of UK （200 000 U） and injected subcutaneous with low molecular heparin calcium （4100 U ） in 30 minutes. The rate of return of spontaneous circulation （ROSC）, survival rate longer than 24 hours and 30 days in two groups and patients dying of bleeding or bleeding conditions in treatment group were observed. Results There were 11 cases （34.4%） of ROSC in control group, and compared with 20 cases （62.5%） in treatment group, there was significant difference （P 〈0.05）. There were 5 eases （ 15.6% ） of survival longer than 24 hours in control group, and compared with 13 cases （40.6%） in treatment group, there was significant difference （P 〈 0.05 ）. There were 2 cases （6.2%） of survival 30 days in control group,and compared with 8 cases （25.0%） in treatment group, there was significant difference （P〈 0.01 ）. Nobody had subcutaneous bleeding or other organ hemorrhage in control group. But there was 1 patient who had subcutaneous limited ecchymosis in the injection site in treatment group. The difference of fibrinogen before and after treatment in treatment group was statistically significant （P 〈 0.01 ）, but there was no significant difference in prothrombin time and platelet count before and after treatment in treatment group （P 〉 0.05）. Conehmions It is safe and effective in cardiopulmonary resuscitation with low dose of UK combined with low molecular heparin calcium.

关 键 词：心肺复苏术 尿纤溶酶原激活物 治疗结果 低分子肝素钙 安全性 

分 类 号：R45[医药卫生—治疗学]