心脏性猝死45例临床分析

目的：探讨心脏性猝（sudden cardiac death，SCD）的临床特点及其心肺复苏的治疗措施。方法：分析45例SCD患者的基础疾病、诱发SCD前的心电图表现以及心肺复苏的治疗措施、复苏存活率。结果：45例SCD的患者均有器质性心脏病，69％为冠心病引起。SCD前心电图表现，心室颤动31例，室性心动过速3例，心室停搏4例，完全性房室传导阻滞3例，无脉性电活动3例。发生SCD的直接诱因与高热、饱餐、情绪激动、用力排便、呼吸性酸中毒、低钾血症、低钠血症有关。经心肺复苏45例SCD中17例恢复自主循环，6例存活出院，存活率为13.33％。并且电击次数少、电击能量小、电击除颤早及复苏时肾上脉素用量少者复苏存活率高。结论：SCD患者均有器质性心脏病史，69％为冠心病，尽早施行电击除颤，尽量减小电击能量、电击次数，尽量减少肾上腺素用量是恢复自主循环及提高存活率的关键。

A Clinical Analysis of 45 Cases of Sudden Cardiac Death

Objective:To explore the characteristics of sudden cardiac death(SCD)and its cardio-pulmonary resuscitation.Methods:An ahalysis was made of basal diseases,ECG findings,and cardio-pulmonary resuscitation in 45 patients with SCD.Results:The results showed that all these patients had organic diseases,60% of which were caused by coronary heart disease.ECG findings before SCD showed ventricular fibrillation in 31,supreventricular tachycardia in 3,ventricular standstill in 4,complete atrioventricular block in 3,acrotic electric activity in 3.Direct causes were associated with high tempenature,heavy meals,emotion,forced defecation,respiratory acidosis,hypoklemia,and hypoatremia.Of 45 patients who resuscitated,17 regained autonomous circulation,6 survived and left hospital with a survival rate 13.33%,and those who recieved less sideration,smaller sideration enangy,less ardrenalin had a higher survival rate.Conclusion:SCD patients have a case history of organic heart disease,early sideration,less sideration energy,fewer sideration times and less dose of ardrenalin are very important for recovery of autonomous circulation and higher survival rate.