Brooks-Brunn J A
Department of Medical Research, Methodist Hospital of Indiana, Indianapolis 46202.
Heart Lung. 1988 Nov;17(6 Pt 2):756-61.
A review of six thrombolytic trials utilizing the endpoint of mortality shows that thrombolytic therapy and time to treatment are essential elements in reducing the mortality associated with acute MI. As a critical care nurse, one must incorporate this knowledge when putting this therapy into clinical practice. Clinical trials have demonstrated that thrombolytic therapy can indeed reduce mortality, but one must critically examine study data. It is difficult to compare the results of different studies with varying inclusion-exclusion criteria, sample size, study designs, and interventions. At present, it appears that t-PA plus heparin and aspirin therapy produces the lowest mortality at 14 days, 30 days, and 3 months after MI. In addition, the time-critical nature of thrombolytic therapy must be ingrained in the critical care nurse's assessment process. To reduce mortality in the patient with acute MI, assessment and initiation of therapy must be prompt.
一项对六项以死亡率为终点的溶栓试验的综述表明，溶栓治疗及治疗时间是降低急性心肌梗死相关死亡率的关键因素。作为一名重症护理护士，在将这种治疗方法应用于临床实践时必须融入这一知识。临床试验已证明溶栓治疗确实能降低死亡率，但必须严格审查研究数据。由于不同研究的纳入排除标准、样本量、研究设计和干预措施各不相同，很难比较其结果。目前，似乎在心肌梗死后14天、30天和3个月时，组织型纤溶酶原激活剂（t-PA）加肝素和阿司匹林治疗的死亡率最低。此外，溶栓治疗的时间紧迫性必须深深印刻在重症护理护士的评估过程中。为降低急性心肌梗死患者的死亡率，评估和启动治疗必须迅速。
