Borst R H, Wolf H
Anaesthesist. 1976 Aug;25(8):398-401.
As a result of the case described the administration of streptokinase in a high initial dosage of about 750,000-1,000,000 U within a few minutes appears to be effective in serious lethal pulmonary embolism. In spite of hypoxic cardiac arrest a 35-year-old female patient was reanimated successfully 20 minutes after the occurrence of pulmonary embolism on the 10th day after caesarian section. The development indicated that the high dosage of streptokinase led to lysis of the embolus and thus to perfusion of the lungs. In spite of complications haemothorax 4,000 ml, uterine haemorrhage the fibrinolytic and later the anticoagulante therapy was continued until lysis of the embolus was assumed as judged by the condition of the patient. To prevent a renewed cardiac arrest a temporary pacemaker was applied. The patient survived without evidence of a cerebral lesion. This paper wants to advocate the administration of streptokinase in "exorbitant" dosage in hopeless cases of serious pulmonary embolism of which a high percentage die. It is essential that the injection be made within a few minutes and must not be extended over the normally recommended period of time.
鉴于上述病例，在数分钟内给予约750,000 - 1,000,000单位的高初始剂量链激酶，对严重致死性肺栓塞似乎有效。尽管发生了缺氧性心脏骤停，但一名35岁的女性患者在剖宫产术后第10天发生肺栓塞20分钟后成功复苏。病情发展表明，高剂量链激酶导致栓子溶解，从而使肺部实现灌注。尽管出现了并发症——4000毫升血胸、子宫出血，但根据患者病情判断，在假定栓子溶解之前，继续进行了纤溶治疗及后续抗凝治疗。为防止再次发生心脏骤停，应用了临时起搏器。患者存活，未出现脑损伤迹象。本文主张在严重肺栓塞的绝望病例中给予“超大”剂量链激酶，此类病例死亡率很高。必须在数分钟内注射，且不得超过正常推荐的时间范围。
