急性心肌梗死心肺复苏后急诊溶栓治疗3例报道并文献复习  

Thrombolytic Therapy on Acute Myocardial Infarction after Cardiopulmonary Resuscitation:Three Cases Report and Literature Review

作　　者：张从艳 郑志远[2] 修明文[1] 何淼[1] 饶世俊 赵雅静 ZHANG Cong yan;ZHENG Zhi yuan;XIU Ming wen;HE Miao;RAO Shi jun;ZHAO Ya jing(Central Hospital of China Petroleum and Natural Gas Group Corporation 065000,China)

机构地区：[1]中国石油天然气集团公司中心医院急诊科,廊坊065000 [2]廊坊市人民医院心内2科

出　　处：《中国急救复苏与灾害医学杂志》2019年第1期15-18,共4页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：廊坊市科学技术研究与发展计划自筹经费项目(2017013059).

摘　　要：目的通过报道3例急性心肌梗死合并心脏骤停心肺复苏后给予重组人组织型纤溶酶原激酶衍生物(瑞通立)静脉溶栓治疗的救治过程,结合文献复习探讨急性心肌梗死合并心脏骤停心肺复苏后急诊静脉溶栓治疗的可行性及有效性。方法回顾分析3例急性心肌梗死合并心脏骤停心肺复苏后静脉溶栓救治过程,并复习相关文献,探讨急性心肌梗死合并心脏骤停心肺复苏后无法急诊PCI治疗患者的急诊静脉溶栓治疗的可行性及有效性。结果3例患者预后均较好,后均进行了冠脉造影检查证实溶栓成功,追踪至今预后良好。结论急性心肌梗死合并心脏骤停高质量心肺复苏后再灌注治疗是患者生存的必备条件,急诊PCI为首选治疗,但各种原因无法完成急诊PCI治疗时急诊静脉溶栓治疗是有根据和可行的,静脉溶栓治疗相对安全且疗效显著。Objecfive Investigate the feasibility and effectiveness of intravenous thrombolysis treatment for the acute myocardial infarction complicating cardiae arrest after eardiopulmonary resuscitation (CPR)according to the report of 3 cases and the literature review.Methods Analyze the intravenous thrombolysis treatment process of 3 cases of acute myocardial infarction complicating cardiac arrest after cardiopulmonary resuscitation (CPR)retrospectively,and review the relevant literature,to explore the feasibility and effectiveness of thrombolytic therapy on acute myocardial infarction after eardiopulmonary resuscitation.Results All three patients had better prognosis,and were confirmed the suceess of thrombolysis by coronary angiography,and have good prognosis up to now.Conclusion Repeffusion therapy is the essential condition of survival for patients of acute myocardial infarction complicating cardiac arrest after high-quality cardiopulmonary resuscitation (CPR),emergency pereutaneous coronary intervention (PCI)is the first choice,but if patients can not complete emergency PCI for a variety of reasons,emergency intravenous thrombolysis therapy is reliable,feasible,relative safe and effective.

关 键 词：心脏骤停 急性心肌梗死 心肺复苏 静脉溶栓 

分 类 号：R459.7[医药卫生—急诊医学]