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急诊死亡原因临床研究

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资料包括: 论文(3页3028字) 
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【摘要】 目的 探讨医院急诊救治的最佳模式,以提高急危重病人的抢救成功率。方法 回顾性分析2001~2004年1月急诊死亡完整病历86份,其中男57例,女29例,平均年龄42.8岁。结果 院前死亡21例,占24.4%。经抢救无效24h内死亡65例,占75.6%。主要病因:严重创伤25例,急性中毒22例,心血管病19例,脑血管病15例,多器官功能衰竭3例,其他疾病2例。结论 (1)急诊死亡者男性多于女性;(2)青少年死亡病因以急性中毒、创伤为主,猝死次之;(3)中老年人死亡病因以心脑血管病多见;(4)早期监测血清心肌酶的变化,对于一氧化碳中毒预后的判断有重要意义;(5)加强对青少年健康和安全意识教育,加强对全体公民一般性急救知识和技能的普及,建立公民急救卡系统和急救网络体系,是提高急诊病人的抢救成功率、降低死亡率的关键措施。
  
【关键词】 急诊处理,死亡原因,治疗
 
 Clinical analysis of death reasons of cases in emergency department
  
【Abstract】 Objective To explore an optimal protocol of emergenct care in hospital to increase a successful resuscitation rate of acute and severe-illed cases.Methods 86 cases of the emergency department who died during emergency care were analyzed retrospectively from January 2001 to January 2004 with 57 men and 29 women,averagely aged 42.8 years.Results 21 cases of death before hospitalization occupied 24.4% of all cases,and 65 patients died in 24 hours in spite of the rescuing treatments accounting for 75.6%.The cause of death mainly included severe trauma in 25 patients,acute poisoning in 22 patients,cardiovascular diseases in 19 patients,cerebrovascular diseases in 15 patients,multiple system organ failure in 3 patients and other diseases in 2 patients.Conclusion (1)For young persons the dorminating cause of death is acute poisoning and trauma followed by sudden death.(2)The middle-aged persons and old aged persons are mainly died from cardiovascular and cerebrovascular diseases.(3)Men are more than women in all cases of death.(4)Early measuring blood serum myocardial enzymes is much valuable in judging prognosis of acute carbon monoxide poisoning.(5)To carry on the education of the healthy and safe consciousness for the youth,to popularize the common knowledge and technical ability of the emergency treatment for all citizens and to set up a first-aidcard system and network system of hospital are the keys to increase the rescue level for the patients of the emergency and to decrease the mortality of the diseases.
 
【Key words】 emergency treatment;cause of death;therapy
目录:
  1 资料与方法

  2 结果

  3 讨论


参考文献:
  1 Sirbaugh PE,Pepe PE,Shook JE,et al.A prospective,population-based study of the demographics,epidemiology,and outcome of out-of hospital pediatric cardiopulmonary arrest.Ann Emerg Med,1999,33(2):8.
  2 吴广球,张耀芬.5216例交通事故的院前急救.中华创伤杂志,1997,5:311-313.
  3 赵冬,吴兆苏,姚丽,等.北京地区急性冠心病事件病死率的变化趋势—MONICA方案的研究结果.中华心血管病杂志,1994,5:353-355.
  4 淑英,赵敏,王玉芝,等.616例急性中毒患者流行病学调查.中华急诊医学杂志,2004,13(6):400.
  5 扬道元,李枝,刘彩风,等.急性一氧化碳中毒病人早期血清心肌酶变化的观察.人民军医,2004,12:690.
  6 林兆奋,军炳文,扬兴易,等.气管内应用地塞米松对急性肺损伤及急性呼吸窘迫综合征的防治作用.中华急诊医学杂志,2004,13(5):306.
  7 翟国春,费国忠,钟后德.上海市民急救意识调查报告.急诊医学,1997,6:372.


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