Greco A
J Intraven Nurs. 1989 Jan-Feb;12(1):20-4.
Intravenous thrombolytic therapy is rapidly gaining acceptance in the care of acute myocardial infarction (AMI) patients. There are several thrombolytic agents in use; however, this article will focus on tissue type plasminogen activator (t-PA). A thorough understanding of the benefits and risks associated with thrombolytic administration will be critical in the successful utilization of this form of therapy. Recent data show that infarct size is linked to mortality. In the 1980s, therapy for acute myocardial infarction patients is directed at salvaging myocardium and limiting infarct size. Prior to this, therapy consisted mainly of supportive care that resulted only in minor effects on the patients prognosis. Intracoronary thrombus has recently been recognized as the cause in most cases of acute myocardial infarction. Thrombolytic therapy represents a method of dissolving a thrombus and reestablishing blood flow to the previously occluded coronary artery. Early reperfusion of ischemic myocardial tissue can limit the amount of damage caused by evolving myocardial infarction. Intervention with thrombolytic therapy in the early hours of acute myocardial infarctions has been associated with reduction in the infarct size, improvement in left ventricular function and reduction in mortality. Nursing plays a critical role in ensuring the successful use of thrombolytic therapy by early identification of appropriate patients and accurate administration of the thrombolytic agent.
静脉溶栓疗法在急性心肌梗死（AMI）患者的治疗中迅速得到认可。目前有几种溶栓药物在使用；然而，本文将重点关注组织型纤溶酶原激活剂（t-PA）。全面了解溶栓治疗相关的益处和风险对于成功应用这种治疗方式至关重要。最近的数据表明梗死面积与死亡率相关。在20世纪80年代，急性心肌梗死患者的治疗旨在挽救心肌并限制梗死面积。在此之前，治疗主要是支持性护理，对患者预后仅有轻微影响。最近已认识到冠状动脉内血栓是大多数急性心肌梗死病例的病因。溶栓治疗是一种溶解血栓并重新建立血流至先前闭塞冠状动脉的方法。缺血心肌组织的早期再灌注可限制进展性心肌梗死造成的损伤量。在急性心肌梗死早期进行溶栓治疗干预与梗死面积减小、左心室功能改善及死亡率降低相关。护士在确保溶栓治疗成功应用方面起着关键作用，包括早期识别合适的患者以及准确给予溶栓药物。
