院外急救途中死亡63例分析

目的了解院外途中死亡患者的情况和影响因素。方法2004年7月至2006年5月63例院外急救途中死亡患者,33例男性和30例女性,平均年龄71.3岁(12~92岁)的情况及死亡的影响因素。结果71.4%的患者年龄在60岁以上,81.0%患有各种慢性疾病,包括高血压伴心脏病、肺部疾病伴心脏病、肝病、糖尿病、心律失常和肿瘤。92%有神志障碍,74%有低血压,42.9%有心律失常,73.2%有瞳孔反射迟钝,79.4%呼吸困难,89%有血氧饱和度异常。现场抢救时间18例少于5min,41例为5~30min,4例超过30min。77.8%于救护车到达并救治后15min内死亡。影响院外死亡的因素包括年龄、基础疾病、疾病的严重程度、以及抢救措施是否足够。结论年龄,疾病严重程度,基础疾病,以及抢救措施均影响院前外救死亡的发生。

On-the-way death of patients undergoing pre-hospital first aid: analysis of 63 cases

Objective To understand the conditions and causes of on-the-way death of patients undergoing first aid. MethodsThe clinical data of 63 patients who died during on-the-filed first aid from July 2004 to May 2006, 33 males and 30 females, aged 71.3 (12~92), were analyzed. Results71.4% of the 63 patients were aged >60. 81.0% of them were with different chronic diseases, including hypertension with cardiac disease, lung disease with cardiac disease, liver disease, diabetes mellitus, arrhythmia, and tumor. 92% of the 63 patients had disorders of mind, 74% had hypotension, 73.2% had retardation of pupillary reflex, 79.4% had respiratory abnormality, 42.9% had arrhythmia, and 89% had abnormality of blood oxygen saturation. The on-the-spot rescue time of 18 cases was less than 5 min, 5~15 min in 32 cases, 15~30 min in 9 cases, and >30 min in 4 cases. The time since the arrival of ambulance to the death of patient were less than 5 min in 20 cases, 5~30 min in 38 cases, and more than 30 min in 5 cases. 77.8% of the patients died within 15 min after the arriving of the ambulance. The factors influencing the death of the patients included age, existence of underlying diseases, severity of diseases, and insufficiency of rescue measurements. ConclusionAge, severity of disease, underlying disease, and rescue measurements all influence the outcome of on-the-spot first aid.