目的:研究在急性肺栓塞(AcutePulmonaryElnbolism,ApE)心肺复 苏(Cardipulmonaryresuseitation,CPR)中进行溶栓治疗的可行性 方法:回顾分析2005年9月至2010年9月因心脏骤停行心肺复苏 治疗的23例急性肺栓塞患者,其中12例给予了溶栓治疗,n例未行溶 栓治疗比较两组患者在心肺复苏后自主循环恢复及存活情况 结果:溶栓治疗组自主循环恢复8例,存活5例,最终死亡7例; 非溶栓治疗组自主循环恢复2例,存活1例,最终死亡10例溶栓治 疗组自主循环恢复及存活率均明显高于未溶栓组两组间自主循环恢复 及存活率比较均具有显著性差异(P<0.05) 结论:对发生心脏骤停的急性肺栓塞患者心肺复苏同时行溶栓治疗 可明显提高此类患者自主循环恢复及存活率,具有较好的疗效 硕士研究生韩钦凤心血管内科学 指导教师杜波教授 关键词肺栓塞;心肺复苏;溶栓;自主循环;存活率TheFeasibilityStudyoftheThrombolysisTheraPyinCPRofthe AcutePulmonaryEmbolism Abstract objeetive:TOstudythefeasibilityofthethrombolysistheraPyin cardioPulmonaryresuscitationoftheacutePulmonaryembolism. Methods:Analyzingthe23caseswithsuddendeatheausedbyacute Pulmonaryembolismfrom2005.9to2010.9retrosPeetively,ofwhieh,12 casesweretreatedwiththroxllbolysis,11caseswerenottreatedwith thronlbolysisduringeardioPulmonaryresuscitationParedthereturnof sPontaneouseirculationandthesurvivorshiPbetweenthetwogrouPs. Results:Therewere8caseswiththereturnofsPontaneouseireulation and5caseswithsurvivorshiP,7easeswithdeathinthegrouPwith thrombolysis.2caseswiththereturnofsPontaneouseirculationand1eases withsurvivorshiP,10easeswithdeathinthegrouPwithoutthronlbolysis.The retu扭ofsPontaneouscirculationandthesurviVOrshiPrateinthegrouPwith throlnbolysisweresignificantlyhigherthanthoseinthegrouPwithout thronlbolysis.ThereweresignificantdifferencebetweenthetwogrouPs (P<0.05). Conelusions:ThetroxnbolytietherapyduringtheCPRofaeute PulmonaryembolismeouldraisethereturnofsPontaneouseirculationand thesurvivorshiPandhaveagoodelinicaleffect.Postgraduatestudent:HanQinfeng (InternalmedieinedePartmentofcardiovaseular) DirectedbyProf.DuBo Keywords:Pulmonaryembolism;eardi sPontaneouseireulation;survivorshiP oPulmonaryresuseitation;thronibolysis目录 引言#1 第一章资料与方法#/.-.-..-00./2 1.11陆床资料2 1.2诊断方法3 1.3溶栓方法3 1.3.1溶栓药品3 1.3.2应用设备#,3 1.3.3一般处理一5 1.3.4溶栓药物应用方法5 1.3.5疗效判断指标5 1.3.6统计学方法5 第二章结果#6 2.1两组肺动脉栓塞的诊断方法6 2.2溶栓治疗和非溶栓治疗组心肺复苏后自主循环恢复及存活率比较7 2.3心肺复苏期间行溶栓治疗的并发症,#8 第三章讨论#9 结论#16