急诊抢救205例猝死分析及预防探讨

目的：分析我院急诊科收治猝死病例的临床特点、发生特点和规律。方法：选择1999年6月～2008年12月我院急诊抢救的猝死患者205例,按年龄、性别、时间分布特征、转归及临床特点等进行回顾性临床分析。结果：（1）年龄段分布,年龄〈18岁21例（10.24%）,18～39岁34例（16.58%）,40～59岁68例（33.17%）,60～79岁60例（29.27%）,≥80岁22例（10.7%）;（2）按季度统计,一季度58例（28.29%）,二季度41例（20.00%）,三季度45例（21.95%）,四季度61例（29.76%）。以一、四季度发生猝死病例数最多;（3）猝死患者在入院死亡病例中所占比例有逐年增高的趋势;（4）猝死患者中男129例,女76例,男：女=1.70：1。青壮年所占比例较大（18～59岁102例,占49.76%）;（5）未成年人猝死者多发生在新生儿和婴幼儿期15例（71.43%）,尤以1月～1岁最常见;（6）未成年人猝死患者存在的基础疾患以呼吸系统疾病为多,共10例（47.62%）。成年猝死患者中存在心血管疾病69例（37.50%）占第一位,而其中冠心病28例（40.58%）占主导地位,高血压13例（18.83%）,是一个重要的危险因素,此外慢性肺原性心脏病发生猝死者8例在本组病例中占很高的比例（11.59%）。结论：必须对青壮年男性以及存在冠心病、高血压等高危因素人群加强健康教育,同时重视婴幼儿的猝死问题。医院要加强急诊科队伍的建设和医务人员综合抢救能力的培训,从而提高猝死病例的抢救成功率。

Emergency anaIysis of 205 cases of sudden death and prevention

Objective：To analyze the hospital emergency department in our hospital the clinical features of sudden death,the occurrence of the characteristics and laws.Methods：205 cases of sudden death were choiced in June 1999-December 2008 in our hospital＇s emergency rescue,by age,gender,time distribution,clinical characteristics and prognosis were retrospectively clinical analysis.Results：（1） 205 cases of sudden death in patients with age distribution,age 18 years of 21 cases,accounting for 10.24%;18 ～ 39-year-old 34 cases,accounting for 16.58%;40 ～ 59-year-old 68 cases,accounting for 33.17%;60 ～ 79-year-old 60 cases,accounting for 29.27%;≥ 80-year-old in 22 cases,accounting for 10.73%.（2） quarterly statistics,58 cases of the first quarter,accounting for 28.29%,41 cases of the second quarter,accounting for 20.00%,45 cases of the third quarter,accounting for 21.95%,61 cases of the fourth quarter,accounting for 29.76%.With a sudden death occurred in the fourth quarter number.（3） the sudden death of patients admitted to the proportion of deaths have increased year-on-year trend.（4） the sudden death of 129 cases of male patients,76 cases of female,male：female=1.70：1.Larger proportion of young adults （18～59 years old 102 cases,accounting for 49.76%）.（5） minors more sudden death occurred in the newborn and infant period （15 cases,accounting for 71.43%）,particularly in January-year-old the most common.（6） minors based on the existence of sudden death in patients with respiratory diseases for the disease to more than （10 cases,accounting for 47.62%）.The existence of adult sudden death in patients with cardiovascular disease in 69 cases （37.50%） rank first,of which 28 cases of coronary heart disease （40.58%） dominated,high blood pressure in 13 cases （18.83%）,is an important risk factor,in addition to chronic pulmonary heart disease occurred in eight cases of sudden death cases in this group accounted for a high proportion （11.59%）.Conclusions：Our results must be the existence of young and middle-aged men,as well as coronary heart disease,high blood pressure risk factors,such as strengthening the health education group,at the same time attention to the issue of the sudden death of infants and young children.Hospital emergency department personnel to strengthen the construction of a comprehensive rescue and medical personnel training capacity,thereby enhancing the survival rate of sudden death.