12年住院心血管病人死亡时间及死因分析

Analysis on death time and causes of cardiovascular hospitalization patients

在我国，心血管病死亡率已占全国人口死因首位，而且心血管疾病在慢性病中发病率占首位。如何降低心血管病人死亡率是当今的重要课题。近年来研究发现，心率、血压基本节律的发生与维持是非常复杂的过程，受到外部环境和内稳态等多种因素的影响，生物节律性生命现象的基本特征之一。人体各种生命现象都表现出不同周期的节律性变化，一些生理指标如心率、心律、神经传导功能等的节律变化周期也多接近一昼夜网。因此，进行此研究项目旨在调查心血管病人死亡时间及原因是否有一定的规律性，从而指导临床工作，加强风险管理，提高心血管病人的抢救成功率。

Objective By analyzing the death time and causes of 269 hospitalization patients with cardiovascular disease, intending to find out some clinical rules to improve the prevention and cure of this disease. Method Studying the death cases data in our department from Jan 1993 to Dec 2001, and analyzing the death time and cause of 269 pa- tients in recent 12 years. Result The number of male was 2.1 times of female. Among all these cases, the first class of disease cause was CHD, and other causes were hypertension, rheumatic heart disease, cardiomyopathy, and aortic dissection. The main death cause was ventricular fibrillation, and others were cardiac arrest, ventricular tachyarrhythm, pump failure, cardiogenic shock, respiratory failure, breath arrest, multiorgan dysfunction, and so on. The usual death time was during 8am-12am, others were 4am-8am, 4pm-8pm, 0am-4am, 12pm-4pm and 8pm-0am. Conclusion The time from 8am to 12pm was the most usual death time for patients with cardiovas cular patients. The ventricular arrhythmia is the main cause of death. So it is very necessary for nurse to strengthen visiting, to observe the cardiac rhythm variety carefully and to prepare to give rescue during this period. At the same time, nurse should give patients and their family the health education, to care the patients intensively during this time period.