心脏猝死的预告信号

心脏猝死(SCD)之前常有心脏病症状,但德国研究者的研究结果显示,许多病人猝死之前很久已有预告,显然病人已有心脏病或心脏危险因子,这些症状常被误解或未曾意识到。研究者发现,猝死常并非出现于健康或很低危人群,他们所研究     

谨防"心脏猝死"

全世界每年有数百万人死于心脏病。心脏病通常有两种死亡形式。一种是人们熟知的心肌梗塞，常常是伴随着越来越严重的冠状动脉硬化、淤塞、心绞痛和呼吸困难等症状出现的。另一种就是所谓的“心脏猝死”。也叫心源性猝死。病人突然出现症状，６个小时内迅速死亡，有的在几分钟甚至几秒钟之内心跳停止，猝然死去。心脏猝死是突然发生的，很多死者平素健康，在死神来临之前，他们根本不相信自己会突然离开人世。据统计，美国每年出现的心脏猝死者达１万以上，其中青壮年２０％～４０％。约７５％的死者生前没有心脏病史。使研究者感到大为困惑…     

当心运动中的猝死

日前，我们医院出诊抢救在晨跑、登山中猝死的青年学生、中年人各一名，医生回天乏术。据报载，曾荣获四次美国马拉松赛冠军、28岁的谢伊在马拉松赛途中意外倒地，经抢救无效，骤然离世。     

关键词：心脏猝死急救

编辑同志：著名相声演员侯耀文在家中突发心脏病，引起心源性猝死，让我想到一个问题：如果当时有人在场，应该采取哪些急救措施呢？[第一段]     

不得不防的冬季心脏猝死

美国一项跟踪随访长达26年的研究告诉我们,75％的猝死是由于心脏原因而引起的,被称为心脏性猝死.心脏性猝死是指由心脏原因引起的,在症状开始1小时内发生的任何自然死亡.在我国,估计每年心脏性猝死的总人数也高达54.4万人,其中80％的心脏性猝死是由恶性室性心律失常所引起的.因此,恶性室性心律失常的早期发现、及时而有效的治...     

心脏猝死成为中青年男性的大敌

时至隆冬。正是心脑血管病高发季节。最近，运动猝死的报道又不断见诸媒体，其中不乏事业如日中天的企业家、优秀运动员、前途似锦的莘莘学子。尤其是北京市某所高校一名大学生在球场猝死和前一阵一名业余马拉松选手在北京国际马拉松比赛中的猝死，更直接引起了社会各界对运动性猝死的关注，也使人们产生了困惑和担忧。为什么一下子有那么多人发生猝死？什么是运动性猝死呢？     

心脏疾病猝死流行病学调研分析

目的 分析心血管疾病住院患者以及猝死患者的年龄段分布特征,为识别高危人群、降低心血管疾病死亡率提供参考依据.方法 收集整理2021年1月河北省重点医院心内科住院患者资料与全国抗疫一线殉职人员资料,对其流行病学特征进行分析.结果 (1)河北省11个地区128家医院心内科住院患者年龄段主要分布在＞60岁,占比62.3％,与...     

明星之患——心脏猝死

说起猝死，也许很多人不了解这个名词。用通俗点的话讲，就是一个看起来活蹦乱跳的人、或者无病无痛的人、或者是小病小痛的人，在超乎人们预料和接受能力的情况下，突然撒手西去。从医学上来说，猝死有严格的定义，大致上是指平时身体“健康”或病情基本稳定的患者，发生非预料中的突然死亡，一般说来，发病至死亡的时间在1小时内。     

Role of epidemiologic information system in sudden death prevention among Croatia's haemodialysis patients

The main aim of Croatia's epidemiological information system is to enable the monitoring of infectious diseases as well as to enable necessary interventions. Its 24-hour epidemiologic alert mechanism made it possible for initial reports of sudden death clusters in haemodialysis units to reach epidemiologists on the night of 12 October 2001. The alert about the sudden deaths among haemodialysis patients in two hospitals has prompted us to do an epidemiological inquiry during that night and early the next morning. It looked at suspicions of a possible link between Baxter Plivadial P-15 lot 2001F075 dialyser and these deaths. As the suspicion was based on a small amount of data, it needed confirmation from a countrywide inquiry involving the other 40 haemodialysis units. A phone inquiry showed that 23 haemodialysis deaths occurred on 8–13 October 2001. It suggested that also dialyser of a different type and lot (P-18 2001B17R) should be incriminated. During the inquiry (October 13), all haemodialysis units were informed of the suspicions regarding incriminated dialysers, and of the necessity of temporary withdrawal of these from use. The withdrawal on 13 October of incriminated dialysers stopped the deaths among haemodialysis patients. No more such sudden deaths have been recorded since that could be linked either to the described period or to this clinical picture.     

Pre-participation screening for the prevention of sudden cardiac death in athletes

Pre-partecipation screening is the systematic practice of medically evaluating large populations of athletes before participation in sport activities for the purpose of identifying abnormalities that could cause disease progression or sudden death. In order to prevent sudden cardiac death (SCD), cardiovascular screening should include a strategy for excluding high-risk subjects from athletic and vigorous exercise. There are two major screening programmes in the world. In the United States competitive athletes are screened by means of family and personal history and physical examination. In Italy there is a mandatory screening for competitive athletes, which includes a resting electrocardiogram (ECG) for the detection of cardiac abnormalities. The most important issue to be addressed is whether a screened subject is really guaranteed that she/he is not suffering from any cardiac disease or at risk for SCD. Conceivably, the introduction of echocardiogram during the pre-participation screening, could be reasonable, despite the discrete sensitivity of ECG, in raising clinical suspicions of severe cardiac alterations predisposing to SCD. It is clear that the cost-benefit ratio per saved lives of the ECG screening is a benchmark of the Public Health policy. On the contrary, the additional introduction of echocardiography in a large population screening programme seems to be too much expansive for the Public Health and for this reason not easily practicable, even if useful and not invasive. Even if we strongly believe that a saved life is more important than any cost-efficacy evaluation, the issue of the economical impact of this approach should be further assessed.     

老年患者猝死临床分析

目的分析老年患者猝死的原因及危险因素,为降低老年科住院患者猝死发生率提供依据。方法对2010年1月～2011年10月老年科住院期间发生猝死病例的临床资料进行回顾性分析。结果猝死原因有心源性猝死、脑血管意外、急性呼吸衰竭:心源性猝死16例,占51.61%,为主要原因。猝死高危年龄:80岁以上;人院1月内均为猝死高危期。有诱因者占51.61%,有先兆症状者占54.84%。结论老年科猝死病例多患有心脏疾病且伴有其他疾病,对于此类患者应严密观察及治疗。     

Infant temperament characteristics related to sudden infant death syndrome and its risk factors

Three major components have been repeatedly implicated for the origin(s) of sudden infant death syndrome (SIDS): system, minor sickness and surroundings. All these factors also frame infant temperament, and therefore it seems logical to suppose that the babies who either succumb to or are at risk of SIDS may present with certain behavioural features. The infants who have died of SIDS moved less when lying awake in the crib, during feeding and during nail cutting; less often turned their head away and looked for their mother when held by a new person; were more frequently reported to show an extreme response (either almost never protested or almost always objected) when approached by someone other than main caregiver; and exhibited extreme behavioural patterns when the infant's vocalising on waking up was studied. The infants who died of SIDS had lower activity scores. An unfavourable microenvironment can increase the risk of SIDS, and the babies facing less developmental stimulation had a more negative mood and were less distractible; less organised infants presented with a more negative mood, less distractible behaviour, lower rhythmicity, lower persistence and lower adaptability. The infants born to smoking mothers who are at risk of SIDS had more intensive reactions. The low-birth-weight infants who are at high risk of SIDS were more withdrawing and less adaptable. Infant-parent(s) bed sharing may increase the risk of SIDS, and solitary sleeping infants had a more positive mood and were more persistent. Use of a pacifier may be protective against SIDS, and pacifier users presented with higher rhythmicity. Prone sleep is known to increase the risk of SIDS, and the lowest persistence was a feature of those babies who were usually put to sleep supine and found prone. Infants who snored and/or had noisy breathing in sleep were characterised by more negative mood. Infants with signs of repetitive regurgitation were less distractible.     

新生儿猝死综合征5例分析

目的 :探讨新生儿猝死综合征发生的原因。方法 :回顾分析 1990年 1月～ 2 0 0 0年 12月我院发生的 5例新生儿猝死综合征的分娩情况、新生儿情况及新生儿死亡时的临床表现。结果 :5例新生儿猝死综合征中男婴占多数 ,死亡时间为清晨 4～6时 ,多发生在睡眠中 ,发病突然 ,一发现异常即无呼吸 ,抢救不易成功。结论 :新生儿猝死综合征的病因目前尚不清楚 ,可能与新生儿呼吸暂停、胃肠返流及呼吸中枢不成熟有关。目前对新生儿猝死无有效的预防措施 ,应强调对新生儿生命体征的监护 ,预防呼吸暂停和胃肠返流的发生     

A temporal-spatial cluster of sudden infant death syndrome in Navarre,Spain

An apparent temporal-spatial cluster of Sudden Infant Death Syndrome (SIDS) was noted in the Autonomous Community of Navarre, Spain, when four unrelated children aged between 1 and 6 months died unexpectedly within a 7-day interval in January, 1990. The population under one year of age in Navarre was approximately 4,800. The scan test of temporal clustering showed that the sudden infant deaths occurred closer to one another in time significantly more often than would be expected by chance. All four infants lived in a neighbourhood of the capital of Navarre, which accounts for approximately half the region's population. The clustered cases coincided with an outbreak of influenza type A detected by the epidemiological surveillance system and seen by the increase in 1990 over the same period in the previous year in the number of paediatric emergency-ward admissions during the epidemic days. The results confirm the presence of a temporal-spatial cluster of SIDS and favour an environmental etiology where exposure to influenza A viruses is implicated.     

严重胸腔积液猝死尸检的病理学研究

目的 探讨胸腔积液死亡遗体的病理学研究.方法 对2004～2010年间9～65岁之间胸腔积液猝死尸体进行了系统病理解剖、组织学检查、细胞学检查及临床分析,用光学显微镜和免疫组织化学染色进行研究.结果 胸腔积液猝死6例患者遗体病理学研究形态改变:(1)6例胸腔积液量均在400ml以上,仅右侧胸腔积液1例(1/6),仅左侧胸腔积液1例(1/6),双侧胸腔积液4例(4/6),细胞学检查无恶性肿瘤细胞、化验结果均为漏出液;(2)确诊为风湿性心脏病者3例(3/6); (3)确诊慢性肺源性心脏病者2例(2/6); (4)食管下端周围静脉丛血栓机化栓塞伴间质性肺炎者1例(1/6).结论 6例胸腔积液患者均有心血管系统疾病,而就诊时临床症状隐蔽,与病情不吻合,早期诊断困难.为提高对本病的认识,对可疑患者选用全面检查手段,能有效地减少误诊及延误治疗,降低患者死亡率.     

新生儿猝死的表现及其死因与预防措施探讨

目的:探讨新生儿猝死(SDN)的表现、死因和预防措施。方法:对比分析本院1例和文献报告的36例SDN资料。结果:SDN发生于医院的占86.48％,足月儿占72.97％,男婴占78.38％,顺产占43.224％。发病前表现为正常状态的占43.24％,吃奶减少的占32.43％,体温35.5℃~36.0℃和反应低下各占18.92％。发病时表现为呼吸心跳骤停型占40.54％,青紫型占35.14％,休克型占24.32％。经过尸检的30例死因为肺部感染占33.33％,颅内出血和脑水肿各占13.34％,先心病和死因不明各占10.00％,胃食管返流性窒息占6.67％。结论:SDN发生于医院内、足月顺产和状态正常的男婴,以呼吸心跳骤停为主,90％的死因是爆发型感染、脑部病变、心脏疾患和胃食管返流性窒息等。使用包括19个项目的剑桥婴儿评估方案(cambridge baby check)是较好的预防措施。     

云南不明原因猝死病区人群社会支持对心理健康的影响

目的 了解云南不明原因猝死病区人群的社会支持现况,分析社会支持对心理健康的影响.方法 采用社会支持评定量表、焦虑和抑郁自评量表进行横断面入户调查,用Epi Data 3.1软件建立数据库,用SPSS 11.0统计软件进行统计分析.结果 病区组和对照组相比,在社会支持方面,两组的总得分、主观支持和客观支持得分差异均有统计学意义(均有P＜0.05);在心理健康方面,两组在焦虑和抑郁得分差异均有统计学意义(均有P＜0.05),进一步进行了焦虑程度和抑郁程度比较,虽两组中无重度抑郁患者,但焦虑程度和抑郁程度上的差异均有统计学意义(均有P＜0.05).结论 病区人群因社会支持低于一般人群,导致心理健康状况较差,希望相关部门提供足够的社会支持,以改善病区人群心理健康状况.     

5例食管和贲门癌术后近期内猝死的原因探讨

目的总结近期食管癌和贲门癌开胸术后10-21d内突然死亡病例的死因,为进一步完善手术术式和围手术期处理提供支持。方法2008年12月至2009年8月共80例食管癌和贲门癌患者行开胸手术,5例病例术后近期死亡,因现实中很难进行尸解。排除术后10d因各种原因和并发吻合口瘘等显著原因所造成的死亡病例。回顾术前诊断及查体情况、手术术式、术后治疗、进食情况,从解剖、生理、病理方面分析探讨。结果意外死亡可能和大出血、胸腔器官改变引起迷走神经反射过度、睡眠中误吸有关。结论外科大夫应重视这段时间的随访,出院前制定详细的治疗计划和注意事项,以降低猝死发生率。