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连续41例急性穿壁性心肌梗塞病例,年龄32～82(平均64)岁。其中6例有心源性休克,伴有严重低血压和肺毛细楔状压增高。冠状动脉造影证实冠状动脉完全闭塞者39例,次全闭塞者2例。病人均于急性心肌梗塞症状出现后3小时内入院,以链激酶(SK)2,000U/min 作冠状动脉内灌注,灌注前作:①冠状动脉内注射硝酸甘油0.5mg,以排除冠状动脉痉挛;②用可弯曲的导线机械地使冠状血管再通;③冠状动脉内注射纤维蛋白溶解酶500U,以增加 SK 灌注的效果。本组30例获得再通成功,包括以下几种情况:1例在SK 灌注前先用硝酸甘油冠状动脉内注射;7例冠状
A consecutive 41 cases of acute transmural myocardial infarction, aged 32 to 82 (average 64) years old. Six cases had cardiogenic shock, accompanied by severe hypotension and increased capillary wedge pressure. Coronary angiography confirmed complete occlusion of coronary arteries in 39 cases, subtotal occlusion in 2 cases. All patients were admitted to hospital within 3 hours after the onset of acute myocardial infarction symptoms and were given intracoronary infusion of 2,000 U / min streptokinase (SK). Before perfusion, patients were given intracoronary nitroglycerin 0.5 mg to exclude coronary artery spasms. Correctly recapitulate coronary vessels with a flexible guidewire; ③ Inject 500U of fibrinolytic enzyme into the coronary arteries to increase the effect of SK perfusion. This group of 30 patients to obtain recanalization success, including the following situations: a case of SK injection prior to intracoronary nitroglycerin injection; 7 cases of coronary